SUBLUXATION: End of Days or Wake Up Call?
Monday, July 12, 2010 at 12:28PM 
Dr. Joe Betz, B.S., D.C
ICA Board Member,
PCCRP Board Member
Private Practice Boise, ID
Idaho Chiropractic Association Board Member
CBP Instructor
INTRODUCTION
It’s the year 2020 and you have received a letter from the state licensing board. You open the letter wondering what they want…another request for proof of CEs? Or maybe notification of additional regulations they recently passed to regulate your practice rights? But this isn’t it at all. You are being informed that you are practicing contrary to what has been described as the “ethical” practice of Chiropractic. You have never done anything you can think of as unethical, so why have you received this determination? You read on and find that you are being investigated for unethical practice because you 1) have brochures in your office educating patients about the relationship between the spine and health and others that claim you can help patients for non-musculoskeletal conditions, 2) took X-rays of a patient to assess the biomechanical alignment (subluxation) of a patients spine before initiating treatment, 3) adjusted a patients spine for any reason beyond low back pain, neck pain and headaches, and last but not least, 4) using the term subluxation on your website while not mocking it as an antiquated historical concept.
DISCUSSION
You probably are thinking that the above sounds impossible, irrational, paranoid… right? WRONG. To point out exactly how this scenario can happen, you can begin by looking at what is transpiring in Europe. The Education Committee of the General Chiropractic Council (GCC), the UK-wide statutory body with regulatory powers, recently gave the following advice to the GCC: 1
1. “The chiropractic vertebral subluxation complex is taught only as an historical concept”; and
2. “There is no clinical research base to support the belief that it is the cause of disease or health concerns.”1
The GCC has “AGREED to accept that advice and the Education Committee’s recommendation that the GCC should issue guidance on this matter.” 2 In their “Guidance” letter on the matter, the GCC states, “The chiropractic vertebral subluxation complex is an historical concept but it remains a theoretical model. It is not supported by any clinical research evidence that would allow claims to be made that it is the cause of disease or health concerns.”2
This could arguably represent the end of the subluxation in Europe due to the recent actions of their licensing regulatory body, the GCC. Certainly the British Chiropractic Association (BCA) would stand up for Chiropractic in Europe… right? Unfortunately, in response to the GCC determination, the BCA stated, “The BCA reminds members of their obligations under the GCC Code of Practice and Standard of Proficiency. In ensuring compliance, they should refrain from making any reference to Vertebral Subluxation Complex in media to which their patients or the general public may have access.”3
The European Colleges are being advised not to teach subluxation, except as an outdated belief system that was held in the past and still held by the unscientific “fringe” of the profession. European Chiropractors are being told they should not teach the public about the benefits of Chiropractic beyond pain. Of course there are rational Chiropractors in Europe fighting this. It is my understanding that the MAJORITY of colleges and associations in Europe oppose these changes. Despite this majority opposition, this real “fringe’ element of the profession is making the decisions and calling the shots, ignoring the opinions of all others… sound familiar?
But this is in Europe and does not affect us here in the States… right? Well, you need to look no further than the CCGPP guidelines4 (REF) as another example of how one fringe element of the profession is working to redefine Chiropractic. CCGPP was commissioned and supported by COCSA (Congress of Chiropractic State Associations). They have taught the state boards through the National Board of Chiropractic Examiners (NBCE) that the guidelines can be used to go after over-utilizers.5
The CCGPP has also received support from Cleveland Chiropractic College and financial pledges companies such as Core Products ($10,000 donation). A systematic review which was published in the Journal of Manipulative and Physiological Therapeutics (JMPT)6 and soon thereafter referenced (adopted) by CCGPP7 states, “evidence from epidemiological studies does not support an association between sagittal spinal curves and health including spinal pain”.6 The CCGPP also adopted the Quebec “Red Flag Only Guidelines”8 that dictates that Chiropractors should not X-ray patients for subluxation assessment. In fact you should only take X-rays under certain parameters of pain conditions as described in “medical” guidelines.
These are the type of positions that typify the movement within the Chiropractic profession in North America to change the Chiropractic adjustment from a method that has been shown over the past 115 years to have positive effects for over 300 conditions,9 to a therapeutic procedure that may improve some types of pain, but only if successful in a few initial visits.
This can either serve as a wake-up call or you can continue to sit idly by practicing in your little apathetic bubble and let them finish what they have started. Make no mistake about it; we are at the eleventh hour. But, it is not too late for this to be stopped.
First, if you are a member of your state association (if you are not, join today) request that they immediately vote to decommission the CCGPP through COCSA. If you are a member of the ACA ask them why they have NEVER spoken out against it. If they don’t provide satisfactory answers, then perhaps you should consider becoming a member and connecting with the ICA, an association that is actively fighting against the CCGPP (Chiropractor as a glorified musculoskeletal therapist) movement and the concept of “Tiering” of the profession. You should contact the Presidents and CEO’s of the colleges and companies that financially support CCGPP and ask why they support restrictive positions such as 1) spine alignment has no impact on a patient’s health or pain, and 2) X-rays should not be taken by a Chiropractor for assessment of a patient’s spine unless they have certain parameters of pain.
SUMMARY
It is about time the vast majority of the profession speaks up and becomes vocal about what is going on. The extremes within our profession are working tirelessly to advance their agenda and bring into disrepute the practice styles of everyone else, see New Mexico’s efforts to “Tier” the profession as another example.
If every mainstream Chiropractor, such as yourself does not wake up and fight against this, it is my opinion that the 2020 licensing board scenario I opened with WILL become a reality in North America. In my estimation, there are between 50-100 individuals that are actively leading and organizing these movements, making these restrictive visions become a reality. Although their plans extend back decades, their work is now becoming a reality. It is obvious that there are tens of thousands of us practicing Chiropractors who sit in the middle who don’t agree with the direction these extremists are steering the profession.
We can make a difference, but not by complaining and whining on internet message boards or through email messages with pleas for “donations” to organizations you have never heard of before. There are organized associations, such as the ICA, that that have the infrastructure and knowledge to fight these actions, but need more funding to be able to effectively work to combat the activities of the motivated minorities. Stand up today and be heard!
Call the ICA now (800-423-4690). Become a member and join the fight. Our profession has been run by these radical academicians, researchers and policy makers long enough! This can be the end of days…or a wake-up call, it’s up to you!
References
1. Bulletin: Issue 32. General Chiropractic Council. Meeting of Council: 12 May 2010. http://tinyurl.com/2ebt46z
2. Guidance on claims made for the chiropractic vertebral subluxation complex. General Chiropractic Council. London, England. May 2010. http://tinyurl.com/322medc
3. BCA Statement on Vertebral Subluxation Complex. May 2010.
4. Council on Chiropractic Guidelines and Practice Parameters (CCGPP). http://www.ccgpp.org/
5. Best Practices Documents and Licensing Boards - A Quick Update. By Dr. David Taylor. http://tinyurl.com/2blzwlb
6. Christensen T, Hartvigsen J. Spinal curves and health: A systematic critical review of the epidemiological literature dealing with associations between sagittal spinal curves and health. J Manipulative Physiol Ther 2008;31:690-714.
7. CCGPP Diagnostic Imaging Report. 2009. http://www.ccgpp.org/diagnostic_imaging.pdf
8. Bussières AE, Peterson C, Taylor JA. Diagnostic imaging practice guidelines for musculoskeletal complaints in adults--an evidence-based approach. Part 1. Lower extremity disorders. J Manipulative Physiol Ther. 2007 Nov-Dec;30(9):684-717.
9. International Chiropractors Association. Best Practices and Practice Guidelines. 2009. www.icabestpractices.org
