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If you want to read this entire series Please click here for part #1 Please click here for part #2 Please click here for part #3 Please click here for part #4
For the past few posts we have covered some popular myths about chiropractic. Some myths are spread by others and some are spread by many chiropractors themselves. This post is likely the last on in this series and is dedicated to a myth that our whole culture promotes. The myth that Chiropractic is a form of alternative medicine. There are two versions of this article, the short one first for those of you who don’t like to read and the long one that follows for those who want to know the reasons why this common perception about chiropractic is a myth AND why it is important to debunk it.
This myth is false!
1) Medicine is focused on controlling diseases and symptoms.
2) Chiropractic is true health care because it does not treat diseases or symptoms (no, not even back pain!) rather is only focused on increasing a person’s ability to function and adapt.
3) The definition of “alternative medicine” does not include chiropractic because chiropractic is actually part of this country’s tradition AND it is integrated into the current dominant health care system.
Don’t get it? (My wife doesn’t either.) That’s why having a short version is dumb. Now, on to the…
This is the long version so strap yourself in and don’t get surprised if we get into some semantics with this one. Words are powerful in their ability to deliver a message. We must get specific with them to deliver a message clearly. The message that chiropractic fits under the umbrella of ‘alternative medicine’ is totally false. Too many are under the impression that anything outside of the American Medical Association’s promoted list of services and products that an MD offers is ‘alternative medicine.’ One false impression leads to another.
Unfortunately the history of chiropractic is rife with turmoil as well as those who think chiropractic makes an excellent alternative medicine, much to the founders dismay. This is why, today, about half of the chiropractic schools do not teach much about real chiropractic. So it is only natural that this myth is so widely promoted and marketed by both the Chiropractic profession and the Medical profession inside our country’s healthcare system today. It really does not help in the debunking of this myth that the founder of chiropractic and his son were both very outspoken in their distain with the medical profession and its practices of their day. Many seemingly anti-medicine quotes are spouted by people that are authored by these two men. However when we look at their writings in context we find a different message. A pro-Chiropractic message is different from an alternative or anti-medicine message.
Here come the semantics! First we are going to start off with some working definitions so we can all be clear about what the message behind the words actually is, versus how some people choose to interpret it. Actual definitions can be very broad, words can have multiple meanings and meanings can be described with multiple words. This is where working definitions come in handy. A working definition is a refined definition chosen for a particular occasion or circumstance because the full definition is not practical in its ability to correctly differentiate between thoughts or ideas described by the words used. In this particular case, the definition of medicine is a perfect example. According to the MedlinePlus branch of the Marriam-Webster dictionary, one of the definitions of medicine is; 2 a: the science and art dealing with the maintenance of health and the prevention, alleviation, or cure of disease. However, if we actually apply this definition then technically every farmer on the planet is practicing medicine without a license because food is important to maintain health and prevent diseases such as scurvy. Since the prevention of some diseases like obesity or degenerative disc and joint disease requires correct movement of the body, all personal trainers are also practicing medicine without a license. This broad definition does not work in the real world even if the American Medical Association (AMA) really really really wants to have a monopoly on health care. So taking into consideration what the AMA actually promotes in this country and filtering out those who do not fit into that box, we finally come up with a working definition of medicine.
Medicine: The treatment of diseases and symptoms by any means necessary including but not limited to drugs and surgery and whose practitioners (in the USA) require a license from a Board of Medical Examiners.
The reason we must exclude the term ‘health’ from the working definition of medicine is because the definition of health itself renders it outside the practice of medicine. Health: The condition of an organism or one of its parts in which it performs its vital functions normally or properly. Although some medical treatments do result in the restoration of health this is not the goal or common practice. For example, if we have a disease or symptom and we go to a medical doctor the doctor will attempt to control that disease or symptom usually by chemically stimulating or inhibiting another function of the body to compensate for the symptom. Most MD’s, except an extreme minority who are practicing on the fringe of medicine, will not attempt to help the body restore normal function on its own. Even when we go for a physical or routine check up, an average MD is not looking for normal function or to enhance it. They are trained to look for abnormal function, and they are very good at finding it with the amazing technology we have today. Thus the AMA has set out to describe “normal” function as a means of ruling in/out abnormal function. Unfortunately this effort has resulted in the misconception that the average function in a population equates to normal function in any one individual. Most people do not spend enough time with their MD to be able to identify their unique normal function. If there was a medical art that attempted to restore normal function, (not metrics or “levels”,) then this art has been lost by today’s dominant medical practice in America.
This brings us to the next working definition we need to address before debunking this myth. We need a working definition of the medical system we have in the United States of America today to see what the alternative forms of this system might be. Now, the more we hesitate to define something in a clear way the less we can rely on the scientific method. Science revolves around observation and we must clearly define what we are observing to collect accurate data and make hypotheses. Dr. James F. Winterstein, DC, president of National University of Health Sciences, once said in an interview; “Chiropractic is what chiropractors do.” This is a terrible attitude to take toward studying something, especially the effect of medical or health based practice. What is the purpose of a license to participate in a particular profession if the practitioner can simply do what they want and say their license covers it? Should your Electrician fix your plumbing? Should your Veterinarian charge you for approving the foundation on your office building?
With this in mind let us look at what our current medical system is and does to clearly define it. I don’t think that most people reading this will argue with the fact that the United States has the worlds best medical technology and emergency rooms. The treatment of communicable diseases and emergencies in this country is rivaled by very few. People travel from all over the world to receive treatment from American medical specialists. However when you look at the health of the American population it is ranked far below other industrialized nations. In the United States today, we have one of the world’s best disease and crisis care systems but we have a pitiful health care system. It is important to make this distinction because disease care does not equal health care. Both are important but different. The working definition of today’s medical system revolves around the treatment of diseases and symptoms. Both symptoms and diseases are caused by abnormal function. But does today’s dominant medical system really seek to normalize those functions or just to normalize the results of the body’s inability to regulate the functioning parts?
If you go to an MD and they find your cholesterol levels are higher than average you will likely be prescribed a statin drug. A statin drug does not restore the body’s ability to “normalize” the production or use of cholesterol, but rather it chemically alters the body’s ability to make cholesterol. This renders one of the the vital functions dependent on the drug. Or you might go in for a check up and report that you have been feeling depressed. The MD might give you an SSRI drug. An SSRI anti-depresant does not address the body’s ability to regulate the neurotransmitters involved in positive emotions but rather it chemically alters the body’s ability to reabsorb serotonin. If a drug was to actually restore health then it would only be taken for a short amount of time until the body would be able to function better, or at least the same as it did before the disease or symptom began. Same is true of most surgeries. Does the removal of a tumor do anything to address the body’s malfunctioning immune system that allowed to over growth of cells to begin with? When the most common approach utilized to treat a person are drugs and surgery then our current medical system is disease care by working definition.
Now there are many different types of medical professionals who practice the art of disease and symptom care; MD’s, DO’s, DPT’s, ND’s, Dietitians, Dentists, and technically even witchdoctors. So it is easy to get convoluted in our definition and interpretation of medicine. We bring in additions to the word medicine like; traditional, alternative, modern, mind-body, evidence-based, integrative, sports, or natural. I find it funny that most people in this country call natural treatments, herbs, and life style changes “alternative medicine” while the most recently developed drugs and surgery they call just ‘medicine’. The natural treatments are the original and drugs/surgery should be the alternative. But I digress… Anyway, most of us can agree that although there are different types of medicine they all have the common focus and goal of treating diseases (illness) and/or symptoms.
This brings us to the place where we need a good differentiation of modern (American) verses traditional verses alternative medicine, if that is even possible. According to the World Health Organization:
Traditional Medicine: the sum total of the knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness.
Alternative Medicine/Complementary Medicine (CAM): The terms “complementary medicine” or “alternative medicine” are used inter-changeably with traditional medicine in some countries. They refer to a broad set of health care practices that are not part of that country’s own tradition and are not integrated into the dominant health care system.
So we can eliminate our current medical system (in the U.S.A.) from being under the term ‘Traditional Medicine’ because it is not the sum total of indigenous knowledge, skill, or practices and it does not concern itself with the maintenance of health. How much does your health insurance pay for preventative maintenance or treatments that actually increase your body’s ability to self regulate? No, our current “health care” system is a disease and symptom based system that is not interested in health or keeping people from developing diseases. This is simply because the practice of medicine, by working definition, is wholly focused on the results/symptoms of dysfunctions and the practitioners of medicine would be out of a job if diseases were prevented.
Now, we might be able to argue that our current medical system is actually CAM because it is not part of our country’s tradition except for the past 50 years. But on the other hand, we can also eliminate our current medical system from being under the term CAM because it is the dominant “health” care system but does not include practices that are not integrated into the AMA guide lines. Many will believe that the AMA guidelines and common practices are the hight of scientific knowledge, this is unfortunately false.
Phew! After all of that, we have a working definition of Medicine: The treatment of diseases and symptoms by any means necessary. And we also have a working definition of Alternative Medicine (look up two paragraphs above this.) So now we can move on to finding out why Chiropractic cannot and does not fit into the definition of medicine, alternative or otherwise.
Chiropractic and the chiropractic art:
Since the beginning of the profession and art, chiropractic has been very narrow and exclusive about what it is and what it does. Although the scope of legal practice has been expanded to incorporate some medical philosophies and practices, this was not the original intent of chiropractic directed by the founder (Dr. D.D. Palmer) or his son, the developer (Dr. B.J. Palmer). Hundreds of early chiropractors went to jail to set the legal president that Chiropractic was a separate and distinct profession with a distinct focus and practice.
The mixing of chiropractic and medical practice and/or philosophy was intensely demonized by both D.D. and B.J. They used terms like “Mixer or Medi-practor” to distinguish between those that practiced real chiropractic and those who practiced medicine with a Chiropractic degree.
“MEDI-practic or MEDI-practor. MEDI, first two syllables of MEDI-cine and, A MEDI-practor, falsely represents MEDI-cine AND chiropractic, is an impostor to both, using subterfuging deceptions to both professions. A MEDI-practor is a mongrel, belonging to neither species or professions.” — B.J. Palmer D.C.
“Chiropractic is founded upon different principles than those of medicine.” — D.D. Palmer D.C.
Although the practice that most states define as chiropractic is technically mixed with medicine, thus allowing the medical system to incorporate it, this is a compromise of the truth. To tease apart this compromise we need to have a working definition of real chiropractic that transcends the circular logic fallacy that “chiropractic is what chiropractors do.” Let us look at the original definition and remove what does not apply to the terms of a working definition. One of the first and best textbooks on chiropractic written by Dr. R. W. Stephenson D.C., Ph.C. states:
“Chiropractic is a philosophy, science and art of things natural; a system of adjusting the segments of the spinal column by hand only, for the correction of the cause of dis-ease.”
The term ‘dis-ease’ is used to refer to a state in which it is not easy to function. And by ‘hand only’ refers to the choice to only use the application of specific force to give the tissues of the body a chance to restore ease of function. Since the spine is literally the core of who we are, the most effective place to add that force is there. Not only does it have an intimate relationship with the governing system (brain and nerves) but it also has an intimate relationship with the muscles and connective tissue that allows us to move through life. Those two systems, musculoskeletal and nervous systems, control and mechanically effect every other system of our bodies. Small dysfunctions can have systemic effects because our body works as a whole unit. The less ease of function we have the more susceptible we are to outside forces like microorganisms, poisons, pollution, stress, and negative autosuggestions.
The crux of chiropractic is the natural functions of a living body. This is where chiropractic places all of its energy and focus for the purpose of not only learning how these natural processes work but also learning how to work with them to maximize our efficient function in nature. This is why we can conclude that the working definition of chiropractic is: A system of adjusting the segments of the spinal column to support natural function through applying philosophy, science, and art.
The goal of chiropractic has more to do with increasing the function of adaptability in people and less to do with fixing a symptom or disease. By the time symptoms and diseases set in, the body has been in a state of adaptive dysfunction for so long it begins to break down. Now helping the body restore ease of function is as good to a sick person as it is a healthy person. If a sick person can adapt better to the situation they have the best chance to get well. If a healthy person can adapt better to the situation then they have the best chance at staying well. In no way shape or form does a chiropractic adjustment directly fight disease, injury or symptom. This is the difference between medicine and chiropractic. It may be argued that chiropractic is AN alternative TO medicine because a person that stays well does not need medicine. However, since medicine treats the body from the outside to alter function while chiropractic helps the body remove the blockage in function from the inside, then chiropractic cannot be considered a type of alternative medicine.
Another, and less important fact that makes the classification of chiropractic as alternative medicine incorrect, is that chiropractic is technically incorporated into the dominant health care system of this country. Most insurance companies cover some chiropractic services and even the Journal of the American Medical Association (JAMA) states that chiropractic can be a useful treatment for certain symptoms. Also, it is part of this country’s tradition because it was founded and developed in Davenport Iowa around 1895.
Here is the bottom line: the goals, outcomes, practices and sciences are too different between medicine (alternative or otherwise) and chiropractic to label them in the same category. But in practical reality, why should we care how about the label of things? Labeling things and classifying them is how the language dominant hemisphere of our brain processes information. What to do with those things and their meaning is how the language non-dominant hemisphere processes information. We need both ways of processing information to be able to arrive at the best solution to life’s problems. Medicine has its place and chiropractic has its place in the complete care of an individual living human system. One to address saving life and one to address supporting life. However, we have to properly label them to be able to correctly understand what they do and how we can use them.
False labeling chiropractic can negatively affect our decision making when we start expecting chiropractic to provide medical results in scientific studies. Most scientific investigations published about chiropractic look at a medically modeled system with the measure of symptoms as the metric of success or failure. Any study, done by chiropractors or other doctors, that claims to show changes in symptoms after a chiropractic adjustment is measuring the results of chiropractic incorrectly. There are tons of studies that show chiropractic is a good treatment for some types of pain, and many others studies that indicate chiropractic can be an effective treatment for everything from scoliosis to childhood asthma. But all of these symptoms were actually changed by the people being studied not by the chiropractor. So when studies get published saying there is no evidence for “causation,” they are right. The cause and the cure, according to the Chiropractic principles, are in the patient. The best way to research the effects of the Chiropractic art is in measuring the changes in the nervous system in terms of function not symptoms. The real goal of the Chiropractic adjustment is to help remove the resistance from the flow of self organizing information in the patient’s body so that the patient’s body can function better and do more. If the flow of information has improved then there should be better information integration functions in the cells of the body. The brain and spinal cord are the first places to find evidence of a change in information integration because they are made of the most sensitive cell of the body. They are literally the cells whose main job is to inform about changes in and around every cell of the body, or sense change and respond.
More research needs to be done in this field and that responsibility rests on the chiropractic profession. I for one don’t want to do this research because I enjoy practicing Chiropractic so much. But this is a poor excuse and I hope one day to be able to give a contribution to more appropriate research on Chiropractic. Writing this blog has given me lots of time exploring the current research and it has been as challenging as it is rewarding. It has given me an appreciation of words and the writing process that I did not know existed, especially inside of me. It is because of this great respect that I must adamantly oppose the term alternative medicine in relation to chiropractic. There is medicine, there is the type of medicine that exists outside of the United States of America’s common practice and then there is health care. Chiropractic has about as much to do with medicine as eating, sleeping, and exercise. If you consider farmers medical practitioners then you will disagree with me and in that case you are free to call chiropractic an alternative medicine.
Stay adjusted and stay healthy, my friends.