As I come to the end of my first month in the Russian Far East, I'm humbled by the realization that I am the only chiropractor in a region with eight million people. The responsibility this poses is one of many challenges I've had to come to grips with since my arrival.

Another challenge has been communication. As I've begun to learn and struggle with the basics of the Russian language, I've become increasingly conscious of the subtleties of meaning inherent in words and concepts. These subtleties affect communication within our profession as well as its communication across language barriers such as Russian. Far Eastern Russia has a long history of manual therapy and traditional (oriental) medical concepts, but has no history of chiropractic as we know it.

Since arriving, I've spent some time at the International Centre of Oriental Medicine (which is a part of the hospital system). The center is run by medical doctors Yuri and Natalia Ponomareva. Although there are similarities in the use of terms like subluxation, innate, chiropractic, etc., there are also differences in fundamental meaning as well as intent.

Of course, because of my relationship with the doctors and researchers here, these subtleties will be expressed and over time hopefully will find their way into the Russian language, culture and health care practice. Unfortunately, I've realized the chiropractic profession has no time to waste.

As I sat with the Drs. Ponomareva and discussed these issues, I had a personal revelation as I fully realized that the majority of people in the world are without chiropractors and most of the world has not even heard of chiropractic! This is a problem that threatens our profession's future -- not yours or mine, but future generations of chiropractors and the profession itself.

This experience has strengthened my resolve that chiropractic must accelerate the pace at which it adopts and teaches a universal language of objective assessment using analysis of structure and function as a measure of outcome.

Part and parcel of this must be gathering the courage to take giant steps toward a commitment to address the concept of a chiropractic subluxation. According to a paper by Dr. Christopher Kent in the recent issue of the Journal of Vertebral Subluxation Research (JVSR), there are 296 ways to say subluxation. (1)

What do WE say?

Are we going to leave the education of "the overall picture of vertebral subluxation from its origin to its correction" (2) to other fields like oriental medicine, acupuncture, osteopathy, or medicine?

The combination of centering ourselves on vertebral subluxation and objective assessment of its effects on structure, function and health outcomes, following reduction through adjustment, gives us a crystal clear goal for which to develop research agendas.

If anyone has any doubt about the importance of these issues for our profession, I urge you to talk to manual therapists, OMDs, get copies of osteopathic college curriculums, and look at the articles and advertisements in physiotherapy, osteopathy, and Eastern medicine journals for an eye opening education.

What we do in our practices and the foundation it is based on is being used, researched and verified by a host of other disciplines on an increasing basis. This is true regarding the use of objective outcome assessments as well. Where is our commitment to chiropractic research?

Some might answer that chiropractic has very little money to spend on research and that associations must use their funds to fight legislature battles, and that schools operate on shoestring budgets. In answer to this, I remind the reader that chiropractic is a $4 billion a year industry. Relatively speaking, this can be a large or paltry amount of money depending on the compression. Nevertheless it's still $4 billion and some portion of that could be directed toward worthwhile research.

I understand the importance of spending time and money on legislative issues. However, chiropractic must make an intellectual, emotional and financial commitment to chiropractic research which maximizes both short and long term gains. If this does not happen soon, future chiropractors will look back on us with disappointment and anger because we neglected our responsibility towards them and historians will document it for posterity.

The first step in solving a problem is admitting one exists. Once we do this, we can raise our thinking above the level that exists now by increasing our communication among ourselves about these issues.

Last year's forums held by the Council on Chiropractic Practice (CCP) were an excellent start and demonstrate that this can be done and progress can come from it. Hats off to the editor and publisher of JVSR, as now we at least have another vehicle to disseminate chiropractic research and ideas.

I have heard Dr. Sid Williams say that "chiropractic is bigger than medicine, bigger than law, bigger than religion." We should remember that it is the principle chiropractic is based upon which is bigger -- and that the principle is bigger than chiropractic as well.

The principle will be taught by whatever group decides to put aside selfish motives and take on the responsibility to study and apply it for the sake of suffering humanity. The principle will survive, although chiropractic may not. And as far as innate and universal intelligence are concerned, it doesn't have to.

References

1. Kent C: "Models of Vertebral Subluxation: A Review." Journal of Vertebral Subluxation Research 1996 Vol. 1. No. 1; 11-17.

2. Boone R.W.: "The Editor's Perspective." Journal of Vertebral Subluxation Research 1996 Vol 1, No. 1.