September 2003

The power of unity

by Dr. Terry A. Rondberg

Over the past few years, the American Chiropractic Association (ACA) has raised (and spent) about $5 million in a campaign dubbed "Save our Subluxation."  The effort was supposed to ensure chiropractic's exclusive domain over subluxation correction and prevent physical therapists and other health care providers from being reimbursed for the unique chiropractic service of subluxation correction. The message was supposed to be clear, that physical therapy and chiropractic are two different things.

At the same time, the ACA is positioning chiropractors as physical therapists.

According to an ACA press release, thanks to "the aggressive legal posture of the American Chiropractic Association (ACA) ... doctors of chiropractic will be reimbursed for providing physical therapy services under the national Blue Cross Blue Shield Association's (BCBSA) Federal Employee Program (FEP)."

The message is becoming a bit garbled at this point.

We are, supposedly, different from physical therapists, yet we fight to be reimbursed for physical therapy services ‑‑  and the ACA calls this one of the "benefits of ACA Legal Action."

What's more perplexing is why the ACA feels that being considered a physical therapist is a "promotion" for chiropractors.

That's exactly what they say in the press release: "... this inclusion brought about a welcome elevation in status for doctors of chiropractic, as they became formally recognized as 'covered providers' under both the FEP's basic and standard options."

Nowhere does the release mention the word subluxation.

In fact, the word seldom shows up in ACA material.

The "ACA ACTION BULLETIN" it sent out to spur support for its Medicare Demonstration Project doesn't use the word. Neither does their press release, "What is Causing the Asthma Epidemic? Journal of the American Chiropractic Association Looks for Answers," or the highly touted Public Service Announcement featuring Olympic skater Derek Parra.

Why would the ACA bother trying to "save" the subluxation if they're never going to mention it? Who are they 'saving' it for?

To find out who is really saving the subluxation ‑‑ and the unique character of the chiropractic profession ‑‑ you don't need to look any further than a small but courageous band of college presidents who are working to rescue the profession from the near disaster created by the ill‑conceived diagnosis statement developed by the Association of Chiropractic Colleges.

As you can read in the front page story, the ACC statement on diagnosis literally stripped away the neurological component of the subluxation and mandated "physical, neurological, orthopedic, and other appropriate examination procedures."

No one is quite sure how the statement managed to pass by a unanimous vote. There has been a suggestion that a critical word (specifying that "diagnosis by a doctor of chiropractic MAY include...) was part of the original version of the statement, but was omitted in the final version without notifying the presidents. Apparently, the text was displayed on a screen in a darkened room and no mention was made of the revision.

There's no way to prove at this point whether the wording was changed, or if it just slipped by the group by mistake. But the statement as passed would have dramatically changed the entire definition of chiropractic.

The ACC Position Paper No. 1, which has been endorsed by nearly every major chiropractic organization in the world, is a model of the "inclusive" vision of chiropractic. It allows for doctors who focus solely on the detection and correction of vertebral subluxation, as well as those whose practice purpose includes diagnosis and treatment of neuromusculoskeletal conditions. This new statement of diagnosis would have tossed that historic document into the garbage can.

Something had to be done, and done quickly. That's when the Chiropractic Coalition stepped in. Within hours of learning about the statement (even before the ACA made its official announcement), the leaders of the Coalition's three founding organizations ‑‑ the ICA, WCA, and FSCO ‑‑ were discussing the issue and taking actions to rectify the situation.

The Coalition leaders worked together with efficiency and solidarity on a joint response and strategy to prevent the ACC statement from destroying the nature of chiropractic. It was an incredible experience for those of us who have witnessed so much intra‑professional animosity and conflict over the years.

The Coalition then contacted those college presidents who have, in the past, shown the most commitment to subluxation‑centered chiropractic or a true willingness to be inclusive in their definition of chiropractic.

At the top of the list were Drs. Jerry Hardee, Carl Cleveland, Jr., Guy Reikeman, Fabrizio Mancini and Gerry Clum. For several days, they discussed the issue and decided to ask David S. O'Bryon, ACC Executive Director, to poll the presidents for another vote. Dr. Hardee made the first strong stand by withdrawing his approval of the statement until the wording can be corrected.

At the very least, the ACC will not be able to claim "unanimous approval" of the statement and hopefully it will see the wisdom of making the needed corrections.

Regardless of the outcome, what is clear is that these college presidents took the slogan "save our subluxation" to heart and pulled our profession from the brink of catastrophe.

Most academicians have the reputation for moving at a slow, deliberate pace, for being better at theorizing than acting. But these presidents have shown that, when it comes to defending chiropractic, they can move swiftly and surely ‑‑ and in unity. They have the courage of their convictions and place their principles before their ambitions and their egos.

The next time you hear someone complain about the "in‑fighting" in chiropractic, point to the actions of the Chiropractic Coalition and these college presidents. It will provide ample proof that we can ‑‑ and do ‑‑ work together as long as we share a similar vision of chiropractic.