November 2003

WCA disputes WFC's role in determining chiropractic's 'identity'

In a press release dated Sept. 26, 2003, The World Federation of Chiropractic (WFC) announced that it would conduct an "International Consultation on Chiropractic Identity." The release stated that a 35‑member "Task Force" will "consider past surveys and research relevant to identity" before meeting in California in Feb. 2004. At that time, the WFC says, the panel will "approve surveys and other steps to be used in the consultation."

According to Dr. Peter Dixon, president of the European Chiropractors' Union, the consultation is "about 'who we are' not 'what we do.' This is not about scope of practice, whether we correct subluxations or treat conditions, whether chiropractors should provide certain specific services. It is about reaching agreement on a trademark identity for chiropractic in the eyes of the public and health care system."

Some critics, however, say "who we are" cannot be divorced from "what we do."

"The chiropractic identity is completely meshed with the chiropractic purpose and its role in the health and wellness arena," stated Terry A. Rondberg, D.C., president of the World Chiropractic Alliance (WCA). "It is impossible to establish an identity for chiropractic without addressing its purpose."

The WCA Board of Directors also had more general objections to the WFC's plan. Although invited to have a representative on the Task Force, the WCA declined. In response to the WFC's invitation, which included a request for a $5,000 donation to fund the effort, the WCA sent the letter reprinted here.

"We felt it was important for the entire profession to understand why we were refusing to take part in this exercise," Dr. Rondberg explained. "We are very much in favor of working with other organizations in the U.S. and around the world, but our history with the WFC makes it impossible for us to agree to participate in any endeavor with them, and from providing any funds to finance their activities."

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To: World Chiropractic Federation

Re: WFC Consultation on Identity

The World Chiropractic Alliance Board of Directors has reviewed your invitation to participate in the WFC "Consultation on Identity" and its request for funding. With all due respect, we must decline the invitation and refuse the request.

There are numerous reasons for this decision, which we feel are important to explain.

First and foremost, the WCA does not recognize the WFC's authority to conduct such a "consultation" on behalf of the chiropractic profession. The so‑called 'mandate' was from the WFC's own members, with no input from non‑member organizations, and therefore does not represent the full spectrum of chiropractic ideas and opinions.

The WFC and its leaders have frequently attempted to portray the organization as having legitimate authority within or over the chiropractic profession. This is not true. Neither the profession nor any government has ever conferred authority on the WFC to take any action or make any decisions for chiropractic anywhere in the world.

In his highly controversial book, "The Chiropractic Profession," Mr. David Chapman‑Smith stated that chiropractic educational standards "are monitored by the various CCEs and the World Federation of Chiropractic." Yet, the WFC has absolutely no legitimate role in developing or setting the standards of any chiropractic educational agency nor is it empowered to "monitor" any educational process.

In a letter dated January 1, 2000, to the ICA representative to the WFC, Mr. Chapman‑Smith admitted that: "The WFC has no mandate, expertise, or interest in any of the technical areas of chiropractic education, whether curriculum, faculty, accreditation of programmes or otherwise."

Yet, it continues to claim authority in this area. In its policy statement on the "Use of the title Chiropractor," the WFC states that chiropractors must be "graduates of chiropractic educational programmes that are formally accredited by a chiropractic accreditation agency or an alternative government‑recognized accreditation process in the country in question, or that are recognized and approved on an interim basis within the terms of the World Federation of Chiropractic's Tokyo Charter by the national association of chiropractors in the country in question." (emphasis added) This position paper was revised in 2003 to extend the range of the policy to cover the term "chiropractic" as well.

The WFC has no right or authority to approve any accreditation process or education program and the WFC's attempt to wrest control over these areas is blatantly unethical and without legal or moral basis.

Further, the WFC has tried to claim authority by citing its status as an NGO (Non‑Governmental Organization) with a United Nations agency, or its work with the World Health Organization. Yet, recognition as NGO does not confer any authority or indicate global "approval" of the policies of the NGO. The WCA also holds NGO status with the Department of Public Information, affiliated with the United Nations, and plays a prominent role in the work of the NGO Health Committee. According to WHO officials, no exclusive or special relations exist between WHO and WFC. The WCA also enjoys a working relationship with WHO.

The WFC has also tried to seize control over continuing education around the world. Its "Tokyo Charter" specifically pointed to the goal of establishing "one minimum international standard in chiropractic education" and stated that educational programs could be conducted only with "prior consultation with and approval by the national association or other chiropractic organization recognized by the World Federation of Chiropractic as representing chiropractors in that country..."

Yet, the WFC is an association comprised solely of those organizations that share its ideologies. It restricts membership to only one organization per nation (with an exception for the U.S., which is permitted two organizations). Organizations that represent an opposing viewpoint are not permitted representation in the WFC and have no input into its policies. As such, the actions taken by the WFC are a reflection of only one segment of the profession, with no consideration given to other opinions or philosophies. While the formation of an association of "like minded groups" is neither unethical nor uncommon, such association cannot purport to represent the entire profession or speak for it.

For this reason, the WCA strongly opposes any effort by the WFC to portray the proceedings or findings of this 'consultation' to the global health care committee as an official position of, or document reflecting the positions or conclusions of, the chiropractic profession as a whole.

While the WFC will no doubt portray its invitation to the WCA as an attempt to be "inclusive," history has taught us that participation of a few "token" subluxation‑based doctors does not translate into equal representation or input. A few subluxation‑based doctors were permitted nominal participation in the Mercy Center Conference as well, yet their opinions and input was overwhelmed by the rest of the panel, hand‑picked for their medical orientation. Later, Mercy proponents tried to use the presence of the minority to misrepresent the conference as having included all portions of the profession. This will most likely be the case with the WFC "consultation."

Finally, members of the World Chiropractic Alliance are well aware of the WFC's previous attempts to distort the true identify of chiropractic and have voiced their strong opposition to the WFC and its leaders.

In his book, Mr. Chapman‑Smith categorically stated that subluxations are not structural entities and cannot be detected on x‑ray.

In a paper titled, "Chiropractic in the 21st Century," Mr. Chapman‑Smith recommended that chiropractic follow the path of osteopathy in changing terminology. He wrote: "Chiropractors must do something similar with chiropractic subluxation ‑ use the term internally because of its rich history, but use another externally. I would recommend joint dysfunction. They must acknowledge that adjustment is manipulation, albeit precise and skilled, and that they do nothing unique ‑ they just do an interesting blend of things better."

Equating subluxation with joint dysfunction strips away the neurological component and suggesting that manipulation and adjustment are the same thing has opened the door for non‑chiropractors to offer and be reimbursed for chiropractic services.

At the Chiropractic Town Hall meeting in February 2000, Mr. Chapman‑Smith stated that his vision of chiropractic was as "the dominant force for the provision of spinal manual therapies in the mainstream health care systems throughout the world." He added: "To me, that's a very much bigger vision than simply using your own language talking about adjusting subluxations." Later at that same event, he advised chiropractic to distance itself from the concept of subluxation in public education and advertising, stating that market research has "proven" that discussing the subluxation and its effect on health will not attract patients.

On March 25, 2003, Mr. Chapman‑Smith, testifying before the Department of Veterans Affairs Chiropractic Advisory Committee repeatedly talked about "chiropractic services for the management of neuromusculoskeletal disorders," and "back pain and neck pain." Further, he argued that "there is a natural and appropriate partnership between medical and chiropractic services for neuromusculoskeletal disorders." He completely failed to use the opportunity to educate VA officials about the unique role of chiropractic. His presentation may very well have played a part in the Committee's including a medical gatekeeper provision in its final report.

WFC has consistently ignored or attacked WCA. David Chapman‑Smith attacked our NGO status in a letter to the UN. He failed to list WCA as either a national or international professional organization in his book "The Chiropractic Profession."

The book also contains a gratuitous attack on the Council on Chiropractic Practice guidelines under the heading "Real and Unreal Guidelines." Chapman‑Smith characterizes CCP as "a small splinter group not representative of the profession," and falsely claims that the guidelines provide a basis for "unlimited chiropractic treatments." In actuality, the CCP guidelines were developed using an open process, are the only guidelines designed to be international in scope, and are the only chiropractic guidelines of their kind accepted for inclusion in National Guideline Clearinghouse.

The suggestion that subluxation‑centered chiropractors represent a "splinter group" is easily refuted by a recent study published by the Institute for Social Research at Ohio Northern University. Conclusion 17 of the study states, "For all practical purposes, there is no debate on the vertebral subluxation complex. Nearly 90% want to retain the VSC as a term. Similarly, almost 90% do not want the adjustment limited to musculoskeletal conditions. The profession ‑‑as a whole ‑‑ presents a united front regarding the subluxation and the adjustment."

Given the history of anti‑chiropractic actions and statements by the WFC and its leader, under no circumstances would the WCA Board permit payment to the WFC for any purpose.

Having repeatedly advocated a rejection of chiropractic's unique identity as a drug‑free approach centering on the detection and correction of chiropractic, it is both ironic and ludicrous for the WFC to conduct a "consultation" on chiropractic identity. The process and the results will be a farce that will divide the profession and cause public embarrassment and confusion.

For all these reasons, and more, the World Chiropractic Alliance refuses to be a participant in the WFC's meeting and calls upon the organization to abandon this ill‑conceived attempt to prove the legitimacy of its oft‑stated positions.