The importance of the Forum was emphasized by Christopher Kent, D.C., president of the CCP. "Practice guidelines cannot be developed in a vacuum by a self appointed mutual admiration society," he stated. "They must involve input from the profession, from the individuals who will be affected by it."

One of the biggest criticisms of the Mercy Center Guidelines was that the developers failed to obtain adequate input from the profession at large prior to drafting the document. Only after the Mercy Guidelines were published and distributed to licensing board members, insurance companies and government officials did field doctors -- and their attorneys -- have a chance to supply their perspective. This weakness has long been considered one of the "fatal flaws" of the document and a primary cause for its widespread rejection throughout the profession.

The CCP board expressed hope that the example it set by soliciting input from the profession will be followed by others who develop practice guidelines. "We have noted with some concern that many of the individuals who have been appointed by the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) for its panel are the same people who served on the Mercy Conference," Dr. Kent said. "We hope they do not repeat the same mistakes and, instead, seek an open communication with the field."

The desire on the part of the field to have such communication was evident at the CCP Open Forum. "We were gratified to see such a wide diversity of thought represented," Kent stated. The Forum was attended by numerous D.C.s, as well as technique developers, chiropractic educators -- including two former presidents of chiropractic colleges -- medical practitioners, students, attorneys, and consumers.

"Although there were significant differences in chiropractic methodology represented at the program," Kent added, "all participants left with an awareness of the unity of purpose we share in developing better strategies for locating and correcting vertebral subluxation."

Some detractors of the CCP scoffed at the idea of soliciting input from the field, claiming that guidelines must be the product of academicians and researchers, such as made up the bulk of the Mercy Conference panel.

In response to such criticism, Kent admitted that the CCP is dedicated to developing consumer-oriented guidelines meant to be used in real-life practices. "We are not interested in merely defining a research ideal," he argued. "We're talking about what's practical and most importantly what will benefit the consumer."

The Open Forum was the third of a three-part information-gathering process which began shortly after the CCP's formation in June 1995. The first event brought together 28 of the profession's most prominent technique experts to explore issues they consider vital to the progress of the profession. The second meeting, held one week later, gave the CCP board an opportunity to hear from the profession's leading practice management consultants on practical issues affecting field doctors in real-life situations.

Armed with the information and data obtained during these three meetings, as well as a comprehensive review of literature relating to chiropractic and vertebral subluxation, the CCP board will begin the arduous process of developing the first draft for a guidelines document.

Although greeted with enthusiasm by much of the profession, which voiced its support for a subluxation-based guidelines effort, the CCP has encountered the inevitable opposition, particularly from those who see it as a threat to the medically oriented Mercy Conference Guidelines or its successor, the CCGPP.

One of the first volleys was fired by Dr. Donald Harrison, publisher of The American Journal of Clinical Chiropractic. Harrison accused CCP board member Dr. Jay Holder of fraudulently claiming to have credentials which he didn't have. Harrison's article was based on an "investigation" funded by Arlan Fuhr, D.C., a technique developer who refused to attend the CCP technique symposium. Subsequent investigation by The Chiropractic Journal showed that Holder was able to document all his credentials.

"While the attack on Dr. Holder was obviously unsubstantiated and quite possibly motivated by political and economic factors," Kent stated, "there is no denying that the ethical standards of the people responsible for developing our guidelines must be carefully scrutinized."

That scrutiny has led some observers to question the inclusion of Dr. John Triano on the CCGPP board. According to public record, Triano surrendered his Colorado license for two years after admitting to unprofessional conduct in that state.

Although Dr. Kent would not comment directly on Triano's blemished record, he stated, "I would like to think that the same people who are so concerned about where Dr. Holder received his knighthood will look into matter of admitted unprofessional conduct with equal vigor."

Kent emphasized, however, that such side issues will not distract the CCP from its original goal, which is to develop evidence based guidelines, conduct research and perform other functions that will enhance the practice of chiropractic for the benefit of the consumer.