MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

What should we make of a discipline whose disciples are unsure of what the discipline is?

Yes, I am talking of chiropractic!

Surely, the inventor of chiropractic has told them what it is. True, DD Palmer left them no end of definitions; here are just 4 to choose from:

  • Chiropractic is the science of healing without drugs.
  • Chiropractic is the art of adjusting by hand all subluxations of the three hundred articulations of the human skeletal frame, more especially the 52 articulations of the spinal column, for the purpose of freeing impinged nerves, as they emanate thru the intervertebral foramina, causing abnormal function, in excess or not, named disease.
  • Chiropractic is a name I originated to designate the science and art of adjusting vertebrae.
  • Chiropractic is a philosophical science; it has solved one of the most profound and perplexing problems of the age, namely, what is life?

Despite this plethora of definitions, chiropractors are still struggling to define their trade. This article, entitled ‘So What Is Chiropractic?’, marks the end of a recent series of papers published in a chiro-journal trying to make progress in this regard. They revealed deeply rooted disagreements within the chiropractic profession about what chiropractic is, and what it should be, as a profession [13, 19, 20], as well as disagreements and variation in relation to education of chiropractors [14, 15] and chiropractic clinical practice [11].

In the opinion of the authors’ paper, it is ironic that, while chiropractic has a strong presence in large parts of the world [3], is taking on increasingly important roles in disability prevention [6, 7, 17], in the military [5] and in interprofessional care [8] as well as growing research capacity [16], discussions about fundamental values and direction of the profession are unresolved. They believe that this unresolved issue creates confusion for stakeholders and threatens to impede professionalization and cultural authority. If chiropractors are to remain relevant in today’s evidence-based healthcare environment, they argue, there is an urgent need to agree on, and further describe, what chiropractic is, what chiropractors do and importantly to provide evidence for value of these activities to patients and societies.

So, what do we make of chiropractic in view of the fact that chiropractors seem to be unsure what it is?

I let you decide.

30 Responses to So, what is chiropractic?

  • Hhhhh we are very sure of what Chiropractic is… the fact you have trouble accepting it is a different story all together. Differences within a profession are common and acceptable. You have trouble with this notion since you would like to minimize Chiropractic to a treatment method instead of a profession… good luck with this

    • “we are very sure of what Chiropractic is”
      is this a ‘Royal we’?
      in any case, the statement is not very bright, considering the long list of recent papers by chiros discussing the very question.

    • @ Dr. G. Almog

      Begs the obvious question: What is it, then? Given that you are so sure, please explain it to me (and the rest of your “profession.”)

      • “Dr” Almog – would you kindly explain what attracted you to spend time and trouble studying “chiropractic”?

        Why did you not qualify as a MD – and then move to manipulative techniques as a post-grad if that is where your interest lay?

        • Richard,

          At one point, you said “I am supremely interested in people, but also how they can be fooled, or want to be fooled in some ways. Magicians – and surgeons sometimes – use slight of mind rather than slight of hand – it’s amazing to learn how people can utilise it.”

          If your supreme interest is how people can be fooled, why did you spend time studying medicine? Why did you not devote more time to your supreme interest, and study medicine in your free time?

          Or maybe you did – and are using your “slight of mind” skills to make people THINK you studied medicine. hmmm….

          • @ jm

            typically dumb comment from jm

            twisting the original commenter’s words while adding no useful insights of his own
            jm is a troll who seems to believe his assinine comments make him appear clever when in fact they demonstrate a complete lack of knowledge and insight and an inability to add anything of value to the conversation. an empty vessel making the most noise as usual.

            why not do us all a favour – unless you have something of actual VALUE to add (which appears very unlikely) rather than the snide little asides you commonly pepper the site with, it would be better to keep the peace. That would be far less embarrassing for you.

            Don’t bother to reply – I’m turning off replies so as not to waste any more time reading the total twaddle that comes up every time you post.

          • mark,

            Richard wrote a book about exposing the “secrets of CAM”. He also talks about how likes to fool people – and at least some of his comments on here are definitely in the “fooling people” vein. Maybe all of his comments, and maybe his whole book – who knows?

            You can’t say he didn’t warn you.

          • jm,
            Fancy you not seeing the obvious?

            Richard, with whom I have shared a very enjoyable lunch and a beer a couple of years ago, is a professional surgeon and an amateur magician. You practice magic too, but the only purpose is to delude people to think your bruising of them is some form of healthcare.

            One is an honest endeavour, while the other is a corrupt, manipulative farce foisted on the gullible.

        • @RR: Ahh, the pivotal query to which NO chiroquacker can ever answer honestly. Although if memory serves one Doctor of Coincidence did suggest in his/her reply in another blog comment that switching professions after all the time and money he’d invested (after having been duped initially?) was simply impractical.

  • IMO, chiropractors continue to want to have their cake and eat it otherwise their industry will implode.

    For example, the World Federation of Chiropractic (WFC), an association of chiropractic organisations in 85 countries, held a consultation on ‘The Identity of the Chiropractic Profession’ in 2004-2005 that gave valuable insight into the chiropractic industry’s perceptions of itself on an international scale. It resulted in the participating chiropractors’ unanimous agreement that the most appropriate public identity for the profession was “The spinal health care experts in the health care system”. Details here https://www.wfc.org/website/index.php?option=com_content&view=article&id=94&Itemid=93

    This apparent ‘free for all’ attitude hadn’t changed by 2016 when the WFC’s Secretary General, Richard Brown DC (former British Chiropractic Association president), declared:

    QUOTE
    “With chiropractic firmly into its 13th decade of existence, the profession can celebrate areas of outstanding success and identify areas where further development is needed. A unified professional identity that does not dictate scope of practice, yet clearly articulates our expertise in spinal health and well-being, should define our status as well as our future direction.”
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5127906/

    Meanwhile, the current president of the WFC, Vivian Kil DC, has told chiropractors that “We need, at least to the outside, to act as one profession…” You can read the background to that here:
    https://edzardernst.com/2019/08/the-chiropractic-workforce-a-global-review/#comment-115615

    It seems to me that most chiropractors – even those at the top – don’t have a problem with practising deception.

  • The profession will eventually officially/legally split. Currently it’s in a bad marriage heading for a divorce. What each party does after is yet to be seen as well as who gets the kids.

    That is what chiropractic currently is.

    • I didn’t know you could, in addition to cracking backs, also foresee the future.

    • @D(octors) of C(oincidence), it’s funny how you are neither funny, insightful or prophetic yet seem desperate to be so. Much like Chiroquackery…a substance-less “profession” desperate to mean something to somebody.

        • DC wrote: “The profession will eventually officially/legally split. Currently it’s in a bad marriage heading for a divorce”. A little further on, DC linked to this paper which was published in February 2019:
          Chiropractic, one big unhappy family: better together or apart?
          https://chiromt.biomedcentral.com/articles/10.1186/s12998-018-0221-z

          IMO, DC’s confidence is surprising and seems highly over-optimistic. I think it’s important to point out here that the World Federation of Chiropractic’s [WFC] Strategic Plan 2019-2022, under its ‘Values’, states: “We respect diversity in the range of approaches that chiropractors take.”
          https://www.wfc.org/website/images/wfc/docs/Strategic_Plan_2019-2022/WFC_STRATEGIC_PLAN_2019-2022.pdf (see p.7)

          Indeed, its Secretary General, Richard Brown, is of this view:

          QUOTE
          “The WFC has unity as one of its core pillars. While it would seem very simple to cut adrift a section of the chiropractic community with whom we disagree, the reality is that this is neither possible nor desirable…The richness of the chiropractic profession lies in its diversity of approaches…Education is delivered differently. The philosophy of chiropractic care takes many forms, some aligned with other health professions, others quite distinct…The WFC values evidence-informed care and promotes research as a means of developing the chiropractic profession.”
          Ref: https://www.wfc.org/website/images/wfc/qwr/QWR_2017JUL.pdf (pp 5-6)

          Apparently in support of the above, in March 2019, the WFC partnered with the European Chiropractors Union (ECU – an autonomous organisation established by chiropractors and with no statutory powers) for an ‘EPIC’ event https://tinyurl.com/yyz7423m and in doing so would have known that the ECU’s education arm accredits the subluxation-based McTimoney and Barcelona chiropractic colleges:
          http://www.cce-europe.org/accredited-institutions.html

          There was a damning, skeptical write up of the event beforehand:
          https://complementaryandalternative.wordpress.com/2019/03/18/world-federation-of-chiropractic-biennial-congress-epic2019-evidence-based-or-not/

          …and another one after it:
          https://edzardernst.com/2019/05/chiros-at-war/

          Both write ups are well worth a read. Note in the final link that Vivian Kil DC, current president of the WFC, states that part of her vision is:

          QUOTE

          1. That we will (the chiropractic profession) set aside our differences within the profession, unite as a profession, and agree that becoming the source of nonsurgical, nonpharmacological, primary, spine care expertise and management should be a primary common goal.
          2. That for us to do the necessary work to fulfill this role and do it with the entire profession, every chiropractor will be involved and not just a small active group of leaders.

          IOW, it looks like the marriage will continue – in the form of an arranged one based on pecuniary interests – similar to what Michael C. Copland-Griffiths, former Chairman of the UK General Chiropractic Council, described some years ago:

          QUOTE
          “In spite of strong mutual suspicion and distrust, the profession united under a group formed specifically to pursue regulation and secured the Chiropractors Act (1994)…..Regulation for a new profession will literally ‘legitimise it’, establishing its members within the community, making them feel more valued. In turn, this brings greater opportunity for more clients and a healthier bank balance.”

          Ref: https://www.ebm-first.com/chiropractic/uk-chiropractic-issues/1437-statutory-regulation-the-chiropractic-experience.html

          • well, I say that those who think the profession will continue as is, or not end up splitting, are not fully aware of the deep and growing strife within the profession.

            The EB group is fed up with the “vitalisitic”, “philosophy based” “anti-vax” rants and claims.

            Perhaps it will only be a small portion who splits off, but it will happen.

          • I suspect you have little idea how fierce chiros have been fighting amongst each other; father (DD) and son (BJ) Palmer set the example and ever since they have continued.
            in any case, if you split, don’t think for a moment that ‘the mixers’ will become evidence-based. even Leboef-Yde calls them only ‘evidence-influenced’ [what’s that supposed to be? Trump is also ‘evidence-influenced’ regarding climate change!]

          • DC (ditherer of chiro),
            It is a pity the so-called EB group has no more E than the non-E group.

          • @FC
            “It is a pity the so-called EB group has no more E than the non-E group.”
            Sweeping statements. Love them.
            Time to follow the research and key researchers and not blogs.
            You should apply to join Marc Bronson’s Facebook page “Evidence Based Chiropractors” 10,300+ chiro’s discussing and disseminating research with 150+ PhD’s contributing. 200+ chiro’s a month apply to join.

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