March 2009

Outlawing whatever we don't agree with

by Dr. Terry A. Rondberg

I admire and respect police officers. They put their lives on the line to protect us from lawbreakers, and we couldn't have a civilized society without them.

But can you imagine a society where, say, accountants decided to hit the streets and act as cops? And what if these self-proclaimed officers of the law were allowed to decide what is and isn't legal, depending on their own biases and preferences?

We'd not only have chaos, but we'd all be in danger of becoming the next victims of these renegade law enforcers.

Well, this is what's happening in our profession. Our "police" department is made up of our national regulatory boards and, in the US, of our state licensing boards. No other group, state, national or international, has the authority to make or enforce the laws controlling chiropractic.

Yet, in the past several years, we have seen the World Federation of Chiropractic (WFC) attempt to extend its control over the entire profession worldwide. They sit in judgment of what all DCs around the globe do and they decide -- unilaterally -- what is, or should be, "permitted." They like to claim they derive their authority from the member organizations in each country, but they have hand picked those member groups and allow only those that prescribe to their view of chiropractic. Not a single subluxation-centered organization has been permitted membership in the WFC, with the exception of the International Chiropractors Association, which, unfortunately, has little or no influence on the working of the group.

The latest outrage from the WFC has been its attack on Tedd Koren, DC, and practitioners in Germany who "dared" to provide instruction in the Koren Specific Technique (KST), despite the WFC's insistence that the seminars be cancelled.

Let me say right off the bat that I don't necessarily care for or recommend KST. I know from reading the explanation on Dr. Koren's website that he considers it "a healthcare protocol that any provider can use to improve their results and expand their ability to help others." In short, it's not an exclusively chiropractic technique, although in the US it's used mainly by DCs.

Frankly, I'm not particularly thrilled about this explanation, since it is specifically geared to subluxation correction and that, to me, is the unique domain of chiropractic.

Yet, I have to take into consideration that in many countries, including Germany, chiropractic does not exist as a separate and unique licensed health care profession. Instead, chiropractic care as we know it can be performed by members of a larger assembly of practitioners called Heilpraktikers -- Health Practitioners or HPs.

Thus, when Dr. Koren was invited to give a seminar in Germany about his KST methods, he accepted, knowing that it would not be a "DC-only" event but one attended by HPs as well as MDs, DOs, NDs and other health care providers.

I suppose we should be glad that in some parts of the world, medical doctors are more open to learning chiropractic concepts, but the short hairs on the back of my neck still stand on end when I think about MDs edging their way into our turf. My experience with the medical profession has taught me to be leery of its interest in our techniques. I do not believe for an instant that they want to work with chiropractors. If they learn subluxation correction and are given the right to provide that specialized care, they will try hard to push us even further onto the fringes of the health care arena.

But does that mean I get to make a "citizen's arrest" and stop Dr. Koren from teaching KST, in the US or abroad? Can I write to him and demand that he cancel all his seminars since they aren't in keeping with what I feel is best for the profession? Of course not! I don't have the authority to do that. In fact, no individual or organization -- short of the national or state government entity that has statutory control over health care professions -- has that authority.

Why, then, does the WFC continue to act as though it's the chiropractic supreme court and vigilante squad (I won't honor them with the name police department) rolled into one?

The WFC is a private organization started by an attorney in Canada -- Mr. David Chapman-Smith -- with absolutely NO official standing in the chiropractic profession. Its members are simply a carefully selected group of more medically oriented national chiropractic organizations that do not necessarily represent the entire profession in that country. Moreover, the WFC limits membership to a single organization for each nation -- making sure that subluxation-centered, wellness-oriented groups are excluded.

Given the fact that the majority of chiropractors in the US and around the world clearly support the concept of subluxation, this exclusionary policy is absurd. Yet, it is in keeping with the WFC's own definition of chiropractic, as noted on its website: "A health profession concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, and the effects of these disorders on the functions of the nervous system and general health. There is an emphasis on manual treatments including spinal adjustment and other joint and soft-tissue manipulation."

That definition -- which fails to even mention subluxation -- is itself an echo of Chapman-Smith's own vision. We shouldn't forget that he was the person who advised our profession to get rid of the whole notion of subluxation in order to make ourselves more "marketable."

But the real point isn't whether Chapman-Smith, who still holds the title "Secretary-General" of the organization, shares the profession's view of chiropractic. It's whether he and the WFC, have the power to force doctors of chiropractic to abide by its "rules" of conduct.

That would be the issue even if the WFC were passionately subluxation-centered. Would it have the authority to outlaw seminars on extremity manipulation or chiropractic treatment of disease conditions? Or prevent an American DC from presenting a class to health practitioners in Germany on using ultrasound to treat pain symptoms?

No matter what you or I might feel about such classes, as long as they are presented in compliance with all applicable legal statutes, no private chiropractic "club" has the right to made demands about them or threaten the presenters. This applies to the European Chiropractic Union (ECU) as well as the WFC since it, too, is a private group with no governmental authority.

Ironically, although it joined the WFC in its condemnation of Dr. Koren, the ECU's own list of seminars contains such topics as introduction to dry needling, sport and exercise psychology, imaging of sports related injuries and sports nutrition. Several of the instructors are non-chiropractors. The chiropractic vigilante groups don't protest these courses but attack Koren instead, whose technique is clearly subluxation-centered. Are you seeing the pattern here?

An attack article published in Dynamic Chiropractic noted several of the WFC's complaints, including the fact that the seminars are presented to non-DCs as well as American-trained chiropractors. The WFC letter -- which apparently was made available to DC even though it was not published by the WFC or made public via its website -- told Koren that "your current and proposed activities with respect to delivery of seminars in Germany and elsewhere in Europe represent serious professional misconduct. First, it is clearly against the public interest, encouraging persons without adequate chiropractic training to offer and seek to provide chiropractic services. Second, it is against the interests of the profession, undermining its reputation particularly in Germany, and its continued efforts to gain public confidence and legislative recognition throughout Europe."

The WFC even went so far as to complain that, in Koren's literature regarding the seminar, "There is the suggestion that chiropractic and osteopathy are the same thing."

What about the ECU's seminars in dry needling or psychology? Are these training sessions in the profession's best interest or do they make far more misleading suggestions about chiropractic?

The WFC also apparently gave copies of Koren's responses to Dynamic Chiropractic, which printed carefully selected excerpts. The failure of the WFC to keep its correspondence confidential and to deliberately leak such documents to one member of the chiropractic press is, in itself, an outrageous breach of professional ethics.

This is not -- repeat, NOT -- acceptable conduct for any chiropractic organization and it is just one more example of how the WFC and its allied organizations continue its campaign to forcibly steer chiropractic away from its roots and to destroy all who refuse to buy into its medicalized paradigm.

What's even more worrisome is that so many of us have become complacent lately and ignore these attempts. This attitude -- even more than the overt actions of the WFC and its allies -- poses a real threat to the survival of chiropractic as a non-medical, subluxation-centered profession.