September 2005

WFC's 'identity' doesn't include subluxation

The World Federation of Chiropractic (WFC) recently finalized the public "identity" it wants to impose on the profession worldwide: one that doesn't even mention subluxation correction.

The concept agreed upon by the members of the WFC's 8th Biennial Congress was as "the spinal health care experts in the health care system." The Congress is made up of organizations permitted by the WFC to represent their countries. All nations ‑‑ other than the US ‑‑ are allowed only one organization sanctioned by the WFC. All other groups are not recognized by the group and were barred from any participation in the "identity" process. This includes almost all subluxation‑centered organizations.

This appears to be in contradiction to the wishes of the majority of the profession, as surveyed by WFC prior to the Consultation. According to the WFC, the survey showed that 65% wanted the "identity" to include recognition of "vertebral subluxation and its impact on general health." The same survey showed that 83% wanted chiropractic to be viewed as "wellness care."

Yet, the emphasis of the WFC remains on "spinal care" with a key concept being that DCs are "Expertly qualified providers of spinal adjustment, manipulation and other manual treatments; exercise instruction; and patient education."

To its credit, the final report did include a recommendation to emphasize chiropractic's "Ability to improve function in the neuromusculoskeletal system, as well as overall health, well‑being and quality of life," and the fact that it was a "specialized approach to examination, diagnosis and treatment, based on best available research and clinical evidence, and with particular emphasis on the relationship between the spine and the nervous system."

Dr. Paul Carey, a past president of both the WFC and the Canadian Chiropractic Association, commented: "Complete agreement on public identity, from all sectors of the profession worldwide, is a real milestone. But this is just the first step. There must now be wider acceptance and implementation in each country, and if that happens successfully, the chiropractic profession will at last benefit from a clear, consistent and effective identity within health care, and the Sydney vote will be truly historic."

Yet, Dr. Carey's statement that there was "complete agreement...from all sectors of the profession worldwide" was questioned by many chiropractic observers.

"To formulate an 'identity' for the chiropractic profession that doesn't even include mention of subluxation correction is inconceivable," stated Terry A. Rondberg, DC, World Chiropractic Alliance president. "It is forfeiting the one unique service we can offer the world. Take that away, and we meld into a blur of alternative providers who treat disease by spinal manipulation. PTs, MDs, naturopaths and other providers all do that. Where is our 'identity'?"

The WFC Identity Consultation also appears to be out of synch with the profession's most celebrated and widely supported consensus effort: the Association of Chiropractic Colleges (ACC) position paper on chiropractic, developed in 2001, signed by every chiropractic college president, and endorsed by nearly every major chiropractic organization including the WCA and WFC.

Although the ACC paper is just as broad in its application of chiropractic, it specifically includes a statement that: "Chiropractic is concerned with the preservation and restoration of health, and focuses particular attention on the subluxation."

"Why wasn't a similar statement included in the WFC 'identity' report?" Dr. Rondberg asked. "They managed to include references to 'collaboration with other health professionals,' and even the 'personality' that chiropractic should project. Yet, they didn't feel it important to even mention subluxation. That could not have been an oversight. It had to be a deliberate decision to distance our profession from the concept."

If it were deliberate, it would be in keeping with the publicly voiced opinion of lawyer David Chapman Smith, who serves as the WFC's "Secretary General" and chief spokesperson. During a 2000 chiropractic "town hall" meeting, Smith lectured the chiropractic audience about marketing their profession. He stated that his vision of chiropractic was "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." At that same meeting, he repeatedly stated market research had "proven" that discussing the subluxation and its effect on health will not attract patients.

Although jeered for his statements at the town hall presentation, five years later, the WFC appears to have followed Smith's advice to ignore subluxation in order to market the profession as a "spinal health" approach.

 The situation has an ironic similarity to the osteopathic profession. In 1997, the American College of Physicians' magazine, ACP Observer, noted: "While osteopathic leaders emphasize osteopaths' unique identity, many osteopaths would rather not draw attention to their uniqueness." In chiropractic, the roles are reversed. Many field doctors want to emphasize chiropractic's unique identity, while its leaders ‑‑ at least those involved in the WFC ‑‑ would rather not draw attention to, or even acknowledge, that uniqueness.