May 2003

WFC leader again ignores the subluxation

by Dr. Terry A. Rondberg

Back in 2001, when the World Federation of Chiropractic (WFC) declared that it was joining the rest of the profession in endorsing the Association of Chiropractic Colleges (ACC) "Position Paper on Chiropractic," I was cautiously optimistic.

Optimistic, because the ACC paper sets forth a clear definition of chiropractic and emphasizes the role of vertebral subluxation correction. Cautious because the WFC and its "Secretary General" David Chapman-Smith have frequently denigrated the very concept of the subluxation, and publicly urged the profession to distance itself from the term.

In my August 2001 Publisher's column, I stated: "We will look forward to seeing them alter their policies and activities to be congruent with the letter and spirit of the ACC paper. Once they do, I'm confident we will all be able to work together harmoniously."

Unfortunately, their actions haven't been congruent with the ACC paper. In fact, when Smith ‑‑ an lawyer ‑‑ testified before the Department of Veterans Affairs Chiropractic Advisory Committee on March 25, 2003, his rhetoric made it clear that he hasn't changed his stance against subluxation correction.

The Committee was formed as a result of Public Law 107‑135, which President George W. Bush signed in January 2002. The law made chiropractic available through the Veterans Affairs health system, and authorized the formation of a committee to determine exactly what the chiropractic role should be. Although the version of the law proposed by the American Chiropractic Association included reference only to neuromusculoskeletal condition, aggressive lobbying by the World Chiropractic Alliance and the International Chiropractors Association succeeded in getting a reference to subluxation correction into the bill.

Leona Marie Fischer, D.C., a member of the WCA International Board of Governors (IBG), was selected to serve on the Veterans Affairs Chiropractic Advisory Committee, which has been hearing testimony from various health care leaders. She has been steadfast in her support of subluxation‑based chiropractic and a great help in educating other committee members about the unique character of chiropractic.

When Chapman‑Smith testified before the committee, however, you'd never have known that chiropractic had anything to do with subluxations. He repeatedly talked about "chiropractic services for the management of neuromusculoskeletal disorders," and "back pain and neck pain," and even argued that "there is a natural and appropriate partnership between medical and chiropractic services for neuromusculoskeletal disorders" ‑‑ but he never once uttered the "s" word.

As the spokesman for a group that endorsed the ACC Paradigm, it's completely hypocritical that he never referred to the subluxation in any of his arguments. After all, the ACC paper states that: "Chiropractic is concerned with the preservation and restoration of health, and focuses particular attention on the subluxation."

The ACC Position Paper was written in 1996, and signed by every chiropractic college president. Later, it won the endorsement of the WCA and other major chiropractic organizations. After facing criticism for its refusal to endorse the paper, the WFC finally "endorsed" it, although Chapman‑Smith's testimony clearly shows that this was a meaningless gesture.

What was almost as outrageous as his testimony was the fact that Chapman‑Smith also distributed copies of his book, "The Chiropractic Profession" to committee members. This book not only gives an inflated impression of the authority of the WFC (which, in reality doesn't have ANY legal authority at all, in the U.S. or anywhere in the world), but it also states that subluxations are not structural entities and cannot be detected on X‑ray!

Is that the kind of "explanation" of chiropractic we want in the hands of a government committee that may ultimately decide the fate of chiropractic in all federal programs?

In one presentation to the VA Committee, Chapman‑Smith denied the validity of the subluxation (by rigorously omitting any reference to it) in his testimony, misrepresented the WFC, and maligned the foundation of chiropractic. And he says he is pro‑chiropractic? This sounds more like something we can expect from our enemies like Stephen Barrett rather than someone paid by the profession to promote chiropractic!

Unfortunately, he didn't stop there. By presenting his book to the committee, he attacked subluxation‑based chiropractic in another way. His book is extremely biased against the Council on Chiropractic Practice (CCP) guidelines because they manage to do what he fears most -- validate the concept of the vertebral subluxation and position doctors of chiropractic as non‑medical health providers who have a unique role in the health care system.

His book actually attacks the CCP saying, "This is a small splinter group not representative of the profession. With respect to duration and frequency of care, its guidelines titled Vertebral Subluxation in Chiropractic Practice provides a basis for unlimited chiropractic treatments... provides no numbers or time frames and puts no limits on the judgement of the individual chiropractor."

I can't argue much with the final sentence, since the CCP doesn't put limits on the judgment of the individual chiropractor, does show a valid basis for unlimited chiropractic care for wellness, and doesn't dictate a cookbook approach to how many visits a patient is allowed to see a D.C. That much, he got right. But including an arrogant and unprofessional attack on the CCP as a "splinter group" should have been beneath even his dignity.

It's amazing that he actually had the nerve to state that the CCP guideline "has been rejected by all major organizations in the chiropractic profession." Has he taken a good look at the list of organizations that have rejected the Mercy Guidelines?

Can you imagine the uproar if I -- or any other chiropractic leader -- had stood in front of the committee and trashed chiropractic the way Chapman‑Smith did, then passed out a book saying the ACA or Mercy Conference Committee was a "fringe group" unworthy of any consideration?

The WCA is working hard to find the common ground in our profession so we can protect all doctors of chiropractic. That's why, when we were working on the VA bill, we never suggested taking out the reference to neuromusculoskeletal conditions.

Our goal was (and continues to be) to make sure our profession isn't limited to the diagnosis and treatment of those conditions. That area is already completely "covered" by medical doctors, who simply argue that there's no sense in hiring D.C.s to duplicate what they already do. We wanted to make sure there was an acknowledgement in the law that chiropractors also do something that no one else can do -- detect and correct vertebral subluxations.

That's the biggest difference between the World Chiropractic Alliance and the World Federation of Chiropractic and its like‑minded allies. We want to broaden the chiropractic universe to include all doctors and all patients, not just those with neuromusculoskeletal conditions like back and neck pain. David Chapman‑Smith's actions show that the WFC's "endorsement" of the ACC Paradigm was merely a way to temporarily placate the profession.

Fortunately, with people like Dr. Fischer on the VA Committee, much of the damage that could have been done by Chapman‑Smith's imprudent statements and actions have been avoided. I only hope that in the future he will resist the temptation to inflate his own ego at the expense of the profession.