Re: Is chiropractic a CAM therapy or is it a separate profession?

To the Editor: Anytime I read a commentary that uses emotive expressions, and metaphorical analogies, the scientific hairs on the back of my neck go up. This happened when I read Dr. L. Morgan’s commentary on CAM and Chiropractic. Roman mythology, implications of insanity, calling ourselves schizophrenic, and referring to philosophy as the methamphetamine of chiropractic are comments that fume of bias so unscientific that his comments are hard to swallow. Dr. Morgan unilaterally declares subluxation as a myth even though 65% of chiropractors (WFC Survey - 2004) feel that chiropractic should be focused on the management of vertebral subluxations. It may be true there is no gold standard for determining the presence of subluxation in all its presentations, but surely this does not immediately make it a myth as Dr. Morgan so strongly declares. Only 10 pages later, Dr. Ford, in fact, briefly mentions some of the science supporting the existence of subluxation. All I hear from Dr. Morgan is dogmatic preaching and a few references based on other’s opinions including his own with not one piece of scientific literature refuting the existence of subluxation. As far as his claim of doing the same thing over and over again because of insanity, Dr. Morgan himself certainly seems to fall into that extreme camp that has tried over and over again to keep chiropractic at a very limited musculoskeletal scope since chiropractic dichotomized in the early part of this century. Extremism at both ends of the chiropractic spectrum stifles our profession and is the very thing that is preventing our total acceptance within society. While the “orthopedic only” camp battles the “subluxation only” group, there is a quiet majority middle group of chiropractors that believes there is a benefit to our profession by recognizing subluxation, and at the same time, offering management of spinal injuries. Dr. Morgan is part of the problem by trying to ramrod his biased belief system to whoever will listen. I have a real issue with the use of schizophrenia as an adjective implying chiropractic wants to be both alternative and scientific at the same time. Dr. Morgan is using the word schizophrenia when he really means multiple personality disorder. This incorrect use of schizophrenia is outdated although still common amongst laypersons. I am also deeply disturbed by Dr. Morgan’s use of the term Methamphetamine. “Crystal meth” is easily recognized as one of society’s most destructive drugs. Such a comparison, even metaphorically, becomes a purely emotional statement and further expresses the underlying bias that he has of those that disagree with his viewpoint. As far as osteopathy goes, Dr. Morgan implies that we should follow their footsteps. They appear to be making a better living than chiropractors in the US as his quotes on student loan default rates imply. I have one question for Dr. Morgan though. Where are they in Canada? I would hazard a guess that chiropractic is accredited in more countries than osteopathy. Also we, unlike osteopaths, did not prescribe any Vioxx to some of the thousands that lost their lives due to its use. Why was Vioxx allowed to be used in the first place? The answer is the dogmatic belief in “evidence based health care”. The latest survey findings of high rates of fudging and plagiarism by scientists under pressure by vested parties shows that “evidence based health care” is more often like “evidence biased health care”. Evidence is helpful, but our whole profession should not solely be based on it, or we could be handing out back pain brochures for a living instead of adjusting the objective findings that we encounter on a daily basis. In reference to the Nelson, Lawrence, Triano paper, they paint a vision of chiropractic that excludes what the majority of chiropractors want. The WFC has recently created a landmark agreement on chiropractic identity that allows the vast majority of chiropractors to function in. It allows most of the subluxation camp to carry on as well as the orthopedic camp. It’s not perfect and yes, the 2 opposite tails of the bell curve are crying foul, but let’s continue the debate within our profession with evidence based outcomes, not opinionated rantings and ravings. Chiropractic will never be a 2 party race. We need to present to the public as one unified organization.

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