June 2001

Dear Editor,

Leon Jaroff's article titled: "The Man Who Loves to Bust Quacks" in the April 30, 2001 issue of TIME contains an absurd quote from self-proclaimed "quackbuster" Stephen Barrett regarding chiropractors. Barrett contends that subluxations (what chiropractors treat) essentially do not exist.

This statement is akin to saying that dental caries do not exist, and left unanswered poses a threat to public health since a person with a subluxation may not get needed care. Readers of TIME should know that state laws, the United States Federal Government, The World Chiropractic Alliance, The Council on Chiropractic Practice, The International Chiropractor's Association, The American Chiropractor's Association, The Federation of Straight Chiropractic Organizations, and The Association of Chiropractic Colleges all define the responsibility of chiropractors as the detection and correction of vertebral subluxation and its resultant neurological interference.

The chiropractic guideline document: "Vertebral Subluxation in Chiropractic Practice," produced by the Council on Chiropractic Practice was reviewed by an independent research agency (ECRI) which is a Collaborating Center of the World Health Organization.

Based on this review it was accepted for inclusion in the National Guideline Clearinghouse of the Agency for Health Care Policy and Research of the United States Federal Government.

The existence of subluxation is in accordance with the published paradigm statement of The Association of Chiropractic Colleges, which was accepted and signed by every Chiropractic College President in North America. The ACC defines the purpose, principles and practice of chiropractic as the finding and reduction of vertebral subluxations, which will prevent and restore health by removing interference to the body's inherent recuperative powers.

This document, among other things, states that chiropractic as a profession "focuses particular attention on the subluxation."

The assessment and management of vertebral subluxation is either taught as part of the regular curriculum of chiropractic colleges in North America or as part of their post graduate programs.

All of these programs, including the general curriculum of the chiropractic colleges and the post graduate programs, are approved and Accredited by the Council on Chiropractic Education which is subject to the rules and authority of the United States Federal Government's Department of Education. These schools also hold accreditation through various local and regional accrediting bodies.

The American Medical Association, in its Guides to the Evaluation of Permanent Impairment, list the following as acceptable means to rate impairment: Impairment due to loss of muscle power and motor function, impairment due to abnormal motion of the spine, impairment due to loss of motion segment integrity, impairment due to disc problems, impairment due to pain or sensory deficit, and segmental instability. These are, in fact, components of the Vertebral Subluxation Complex.

The Guidelines for Evaluation and Management Services published by the Health Care Financing Administration of the United States Federal Government and the American Medical Association (May 1997) outline what an objective examination should consist of and these include commonly used neuromusculoskeletal exam procedures within chiropractic such as: postural analysis, palpation, assessment for subluxation, range of motion and assessment of muscle tone. All of these are used to assess and manage subluxation.

The Federal Government of the United States specifically defines what chiropractors do as the detection and correction of subluxation under Medicare and Federal worker's compensation laws. Common to all state statutes is the adjustive process being utilized to reduce subluxations and the resultant interference to nerve transmission.

No less than 38 states employ the term adjustment in licensing laws in reference to the procedures applied by chiropractors. Eighteen state statutes additionally include the concept of manipulation, 34 states contain specific references to responsibility for neurological complications of biomechanical origin (subluxation) and over half the chiropractic profession practice in these states.

In addition, 11 states specifically discuss the concept of subluxation in their statutes by using the term and for those that do not specifically use the term there is an implied understanding of the concept in their statutes.

The existence of subluxation and its acceptance is spelled out in explicit detail by published policy statements of chiropractic organizations as well as federal and state laws regulating the practice of chiropractic.

The epidemiology of subluxation has been researched since the inception of chiropractic over 100 years ago with basic science and clinical research to further elucidate the nature of it continuing to this day.

Dr. Barrett's comments regarding subluxation are irresponsible and lack any scientific justification. I trust you will inform your readers of the facts regarding this matter.

(signed) Matthew McCoy, D.C., editor, Journal of Vertebral Subluxation Research