Chiropractors are not doctors, but rather a type of licensed health care professional. Their treatments are usually safe, but they may not be right for everyone. A 2003 survey of professionals found that most chiropractors (whether “heterosexual” or “mixed”) continue to hold views on innate intelligence and on the cause and cure of diseases (not just back pain) that match those of the Palmers.
A critical evaluation stated that chiropractic is rooted in mystical concepts.
This led to an internal conflict within the chiropractic profession, which continues today. Chiropractors, including Palmer, were jailed for practicing medicine without a license.Palmer considered establishing chiropractic as a religion to solve this problem. For most of its existence, chiropractic has had problems with conventional medicine, based on anti-scientific and pseudoscientific ideas, such as vertebral subluxation. In the 1950s, the number of chiropractors grew in Iowa, and chiropractors were seeking equality with other health professions through legislation. In response, the Iowa State Medical Society created a chiropractic committee to control chiropractic and pushed for the creation of the “Iowa Plan” to contain and eliminate the chiropractic profession.
The plan convinced AMA leaders and they hired the legislative counsel of the Iowa State Medical Society, who structured the operation. The AMA adopted the Iowa Plan for implementation across the country to eradicate chiropractic. The formation of the AMA Chiropractic Committee, which was later renamed the Quackery Committee (CoQ), led to open and covert campaigns against chiropractic. Both national chiropractic associations were fully aware of many but not all of the organized medicine plans to restrict chiropractic.
In the 1960s, organized medicine redoubled its efforts to contain and eliminate the chiropractic profession. The intensified campaign began in Iowa and was adopted by the AMA as a national campaign. Although the AMA committee meetings were not public, the war on chiropractic was widely distributed in lay publications, medical sources, and even chiropractic journals. Over time, details about the events would be revealed in more detail during the lawsuits between Wilk and the AMA.
The leaders of the American Medical Association (AMA) were increasingly concerned about the decline in the number of AMA members. It was also reported that some doctors worked openly with chiropractors, despite the AMA code that prohibited this activity. With increasing pressure from chiropractic associations to expand the scope of practice or achieve parity with doctors, the leaders of the medical associations reacted to these activities as threats in the medical territory and took aggressive measures against chiropractors.1 These historic events surrounding this demand are important for today's chiropractors, because they help explain the increase in scientific growth2 to 21 and the improvement in access to chiropractic care for those who patients once the barriers implemented by the AMA were removed, 22—35 These events clarify previous chiropractic difficulties and how past experiences may be influencing current events. The obstacles and challenges that chiropractic overcame can help explain current culture and help identify issues that the chiropractic profession may need to address in the future.
The 1957 report of the ISMS Chiropractic Committee showed that members of the ISMS had questions about chiropractic not only at the local level but also at the national level, even in its parent organization, the AMA. The report of the Chiropractic Committee said: “Almost all states have obtained information about the cult's reach, its background and growth, and about the effectiveness of efforts made to combat its rise in other parts of the country, and voluminous material has been obtained from the AMA Medical Services Council.”In addition, members were able to individually obtain a large amount of literature, particularly from several of the chiropractic schools across the country, 47 Since the AMA is attempting to determine the scope of healer practices in the chiropractic profession by contacting the medical profession, the NCA will attempt to determine the extent of charlatan practices in the medical profession by contacting the chiropractic profession, 62 The NCA counterattack included 38 much longer survey questions about the profession chiropractic who attacked medicine and asked chiropractors to send the full survey to the NCA Research Department. The author concluded: “We regret the need to wage a battle for statistics with the AMA, but they have left us with no other alternative of self-protection. The AMA's CoQ was based primarily on work that began in Iowa in the 1950s.
IMS officials were committed to impeding the progress of chiropractic. They asked their general counsel, Robert Throckmorton, to develop a plan to address “the problem of chiropractic.” On the day, AMA leaders announced that Throckmorton would be their new legal counsel. He immediately recommended that the AMA form a special group to address the problem of chiropractic, thus founding the CoQ. The committee proposed that the AMA adopt the Iowa Plan.
The AMA hired Doyl Taylor, former executive secretary of the ISMS and a founding member of the ISMS Chiropractic Committee, to implement the AMA plan. In 1963, the Iowa plan was completely covered up. The president of the IMS Chiropractic Committee met with Throckmorton to discuss future action plans, which included traveling to medical societies in the county to offer programs on how to control chiropractic. The IMS continued to state that it would collaborate closely with the AMA [71].
Through its speaker office, the IMS sent representatives to several county medical societies to educate local doctors on “legislative and other matters of public interest related to the practice of chiropractic”. The JIMS announced a conference on quackery offered by the Iowa Interprofessional Association using its fact sheet “In the Public Interest” within the JIMS. The first point of the program was a speech by Oliver Field, director of the AMA Research Department, on the AMA campaign against medical quackery. The ISM Chiropractic Committee and current president of the AMA Medical Quackery Committee delivered the paper entitled “A Look at Chiropractic”.
During one of the first CoQ meetings, a debate took place to determine whether AMA representatives or committee members they should meet with chiropractors to discuss issues. Throckmorton had experience working with osteopaths and podiatrists and commented that meetings with representatives of those professions were useful. I had also witnessed what could happen if meetings were not held, for example, with optometrists who were suing the AMA because “there were no lines of communication”. That chiropractic is an unscientific cult is an established fact.
Chiropractic is not scientific because, despite all the years of its questionable existence, it has not provided a shred of scientific proof for the hypothesis on which chiropractic is based: that human disease is caused by spinal subluxation and is cured by spinal adjustment. 78 The AMA sent consistent messages to the public that it represented organized medicine and that the AMA opposed chiropractic since the beginning of the 20th century. AMA newspapers and publications made clear the dislike of organized chiropractic medicine with the publication of several revelations and news articles. The AMA's influence was far-reaching. With the participation of state and local medical associations, coordinated propaganda was developed and distributed.
By distributing the AMA message through other entities, it would appear that different organizations expressed the same point of view (fig. In 1961, the AMA House of Delegates passed a resolution declaring that it was unethical for a doctor to associate with a sectarian. However, they could not apply this ethical standard to chiropractors, since the AMA had not yet explicitly stated in its statements that chiropractors were sectarian. Therefore, to prevent doctors from working with chiropractors, it was necessary for the AMA to clearly state that chiropractors were sectarian. To achieve this, they linked the necessary drafting to the AMA Principles of Medical Ethics.
Principle 3 states that a doctor cannot associate with another doctor who does not provide science-based health care. Therefore, anyone considered unscientific by the AMA would be considered an outcast. In December 1966, the AMA passed a resolution stating: “Thanks to this resolution and its combination with the additional statements, the AMA confirmed its position that it was not considered ethical for a doctor to receive a patient from a chiropractor or to send a patient to a chiropractor” (fig. This measure publicly stated that any doctor who interacted with a chiropractor would be violating the ethical code and would therefore run the risk of being sanctioned.
The AMA had openly declared war on chiropractic. In April 1966, The Los Angeles Times published an article with the headline: “Chiropractors Will Be the Target of the AMA Campaign.” The American Medical Association. He is making chiropractors his primary target in a national campaign against medical quackery, the association's chief researcher said Saturday. In the past, the AMA has been somewhat reserved in its pronouncements about chiropractors, but researcher Doyl Taylor attacked them as “sectarians who deny the very premises of scientific medicine.” Chiropractors, in general, have little scientific medical education, he said, and the country's chiropractic schools are mostly comprised of people who don't have degrees from accredited institutions.
Taylor said at a conference on public health education that the AMA committee on quackery considers the chiropractic problem to be the biggest problem faced in an education campaign aimed at healers. He said that the AMA will review the licensing requirements in the 47 states that authorize the office. They will also request legislation that requires stricter educational standards for chiropractors 86. Since this isn't the first time Ms. Landers has used her column to make disparaging comments about chiropractic, we have good reason to believe that political medicine is using Miss Landers to spread defamatory information against the profession.
The vigour and frequency with which the AMA uses the media has increased since the inclusion of chiropractic in Medicare last year. Obviously, the AMA considers that the expansion of Medicare benefits is a threat to its monopolistic position in the American healthcare landscape 94. The AMA also influenced the United States Senate. In an AMA statement to the United States Senate, Robert Throckmorton stated: “From 1965 to 1970, chiropractors lobbied to be included in Medicare coverage. However, AMA leaders opposed these attempts.
Chiropractors continue to strive to expand the scope of their activities and their most recent strategy is to seek approval for the treatment of patients under the Medicare program. The medical profession must vigorously oppose this and all future attempts, as emphasized by Dr. Sabatier, president of the AMA Quackery Committee, in his letter to the editor of the BULLETIN dated August 96. After the release of the HEW report, the ACA and the ICA responded with an information document that denounced the participation of the AMA. The opinions contained in the white paper on chiropractic refuted each of the arguments in the HEW report.
Although there were concerns about the manipulation of the AMA, these were never thoroughly investigated or rectified. The AMA used information from what it called an “impartial” HEW report as evidence of its continuing actions against chiropractic 98. These measures were part of the CoQ plan (fig. The fact that CoQ prevented academics from collaborating between the two professions restricted the intellectual growth of the chiropractic profession 74). The AMA opposed chiropractic schools receiving recognition from the United States Office of Education for their accreditation and federal funding for student loans.
If the AMA kept the quality of education as low as possible, by not allowing medical teachers to teach basic subjects such as basic sciences and diagnostics, accreditation would be much more difficult for chiropractic programs to achieve. The CoQ reasoned that if chiropractic schools could be closed, there would be no production of chiropractors, which would eliminate the “chiropractic problem” (fig. However, it was later confirmed that the AMA had provided the material, office space and funding for Smith 89's work. Smith used the archives at AMA headquarters to prepare his drafts. Mr.
Youngerman (AMA lawyer) and Doyl Taylor influenced the book by collaborating with Smith in drafting the drafts and revisions 89. The AMA had a substantial influence on the Joint Commission on Hospital Accreditation. The Commission was the primary organization that accredited Medicare and Medicaid 101 hospitals. The AMA and its sister organizations controlled the Joint Accreditation Commission of Hospitals. The Joint Commission was led by a board of commissioners, including 7 commissioners appointed by the AMA, 7 by the American Hospital Association, 3 by the American College of Physicians and 3 by the American College of Surgeons, 101 Since many of the board members of the Commission were representatives of the AMA, the Commission was pressured to include the Principles of Medical Ethics as part of its standards.
The adoption of the principles by the Commission resulted in the policy that any hospital or physician associated with a hospital accredited by the Joint Commission must comply with the AMA Principles of Medical Ethics. Therefore, if a person or the hospital violated the principles, the hospital's accreditation would have run the risk of not receiving federal funding. The AMA created the environment so that, if a doctor worked with a chiropractor, he would risk his consultation and the federal funding of his hospital if he continued to do so. This put enormous pressure on doctors and hospitals to follow AMA guidelines and avoid working with chiropractors.
The Joint Commission used the 1957 version of the AMA Principles of Medical Ethics. The Joint Commission's accreditation manual warned that hospital doctors, staff and governing bodies must comply with AMA principles of medical ethics or the hospital would face a lack of accreditation 98. The manual said: “In fact, for the accreditation of a hospital, all doctors must comply with the principles of medical ethics. This duty is based on the hospital's duty, following the recommendations of its medical staff, to protect its patients from unqualified and incompetent professionals. Cult practitioners, such as chiropractors, are incompetent professionals and are not medically qualified. These AMA actions would later be recognized, during the lawsuit against Wilk against the American Medical Association, as a restriction on chiropractors' business practices.
The AMA was a powerful organization that had a wide-ranging network and infrastructure across the United States. 105 Influence over doctors' licenses, hospital privileges, referrals, and consultations made AMA control the actions of members and who they could join. If the AMA considered a particular doctor or other professional to be unworthy, doctors would abide by that determination out of fear of being ostracized. Hyde described the power and politics of the AMA in the 1950s and stated: “It is the practitioner who is expelled or denied membership who believes that the punitive tactics of organized medicine are being used to the maximum against them.” In these cases, the lack of membership amounts to a partial revocation of the license to practice medicine.
Only an accredited doctor who is guaranteed to remain on hospital staff and specialized boards, or someone who has the security of a teaching or government position, can afford to challenge the ethical standards of the AMA. Few doctors enjoy such status, and challenging the authority of the AMA means professional suicide for most. 105 Growing trust in AMA leaders may have encouraged AMA to further strengthen its control over the American healthcare system. AMA leaders were aware that some chiropractors were trying to expand their fields of practice.
The trial of England and others against the Louisiana State Board of Medical Examiners was brought by 120 chiropractors, led by Jerry England, DC, in an attempt to establish the right of chiropractors to practice in Louisiana 106. CoQ members discussed the legal case during their November 1964 meeting. They were concerned that “if chiropractors were successful in this lawsuit, the result would be to allow them to do anything a doctor or doctor can do.”. This meant that some AMA members were becoming complacent and ignoring the AMA's code of ethics, which stated that doctors should not professionally recognize or work with health professions that the AMA considered to be irregular. The AMA used this information as leverage to take more aggressive action against the chiropractic profession.
These efforts also appeared to be an attempt to unite AMA members by designating chiropractors as their enemies. More efforts were made by hiring a legal team that would draw up a plan aimed at containing and eliminating the chiropractic profession. Despite the efforts of professional chiropractic organizations that attempt to shed a positive light on chiropractic through advertising and the popular press, the AMA giant had superior resources. AMA campaigns, whether overt or clandestine, influenced public opinion.
Reading the newspaper headlines made it clear that the AMA was directly attacking chiropractic. However, it was not clear how subversive they were It was the actions. The ghostwriting for the popular press and the great influence on the reports submitted to Congress were actions that would not be visualized until this evidence was revealed later during the Wilk v. AMA lawsuits.
Although the AMA was working in secret to implement its plan, the claims that chiropractors were unaware of the AMA's attacks on the chiropractic profession are baseless. Many of the measures taken by the AMA were made available to the public in medical publications, public statements or newspapers, and were well known to chiropractic professionals (fig. Not all doctors were opposed to chiropractors. Most doctors in the United States were probably unaware of CoQ's efforts, and some were thrilled to work with their chiropractic colleagues.
However, the AMA controlled the means by which doctors could practice. This control included obtaining licenses, accrediting hospitals, medical associations and sources of payment. Therefore, all doctors who would have been willing to collaborate outside the AMA rules ended up being forced to give in to the will of the AMA. Because the AMA strongly influenced medical education, it was able to indoctrinate medical students to perceive that all chiropractors were enemies of medical practice and harmful to the public.
In this way, the AMA created generations of doctors who, even when it was demonstrated that chiropractic could be useful for patients, refused to accept the possibility of collaborating. For decades, the AMA continued to create a large amount of propaganda against chiropractic to make the medical profession and the public believe that chiropractors were ineffective or harmful, even though there was no scientific evidence to support these claims. This created generations of people who were indoctrinated with anti-chiropractic messages. This environment influenced decisions made by the public, legislators, healthcare providers, and policymakers, all of which had a negative impact on the chiropractic profession's ability to practice and do business.
While AMA efforts against chiropractic persisted, patients continued to seek care from chiropractors in their neighborhood. As chiropractors felt increasing oppression and criticism, a few were forced to take action. Throughout the 20th century, AMA developed its power over hospitals, insurance companies, and multiple forms of health care. His strong lobbying force and his communications with the media facilitated his ability to control the public and government's view of chiropractic.
The intensified campaign to eliminate chiropractic began in Iowa and was later adopted by the AMA as a national campaign. Although the meetings of the AMA committees responsible for organizing the campaign were not public, the war against chiropractic was widely distributed in profane publications, medical sources, and even chiropractic journals. Over time, details about the events would be revealed in more detail as evidence during the Wilk trials. and AMA.
He served on the medical staff of the San Diego Naval Medical Center in interprofessional spinal injury care, sports and combat clinics, and provided chiropractic care to active-duty military personnel. The medical association and legal counsel perceived that chiropractors posed a threat to medicine and, therefore, called for concerted efforts to prevent the two chiropractic associations from joining a single group and expanding their scope of practice in the field of health care. Claire Johnson, DC, MSEd, PhD, has been licensed chiropractic for 30 years and is the editor-in-chief of 3 scientific journals, Journal of Manipulative and Physiological Therapeutics, Journal of Chiropractic Medicine and Journal of Chiropractic Humanities. Since this was included in a publication on chiropractic, chiropractors were well aware of these measures that the American Medical Association was using to attack the chiropractic.
The U.S. federal government pays for limited chiropractic services under Medicare, Medicaid and its vocational rehabilitation program, and the Internal Revenue Service allows a medical deduction for chiropractic services. In 1955, a law was proposed that would have allowed chiropractors to have rights, duties, and obligations similar to those of doctors. He has developed doctoral courses in the fields of chiropractic history and clinical education in several chiropractic programs.
At the 1955 general assembly, the “mixers” waged an unsuccessful struggle, against the opposition of “heterosexuals” and the state medical society, to liberalize the law chiropractic. Another thing that sets chiropractic care apart from the conventional practice of taking pain relievers to treat musculoskeletal pain is that with chiropractic therapy, there are no side effects like with medications. Unlike before, doctors are now asking patients who must undergo surgery as a result of musculoskeletal pain, especially in the lower back, to try chiropractic manipulation therapy first. Chiropractors often receive additional training and certification in a wide variety of specialties, such as nutrition, sports medicine and orthopedic rehabilitation.
