![]() 17 Palmer's major revision of traditional magnetism was to call it "innate intelligence" and to claim that its pathway was the human nervous system, especially the spinal cord. For 9 years before his discovery of chiropractic, Palmer was one of a small army of healers who routinely "magnetized" their patients. Palmer acknowledged a special debt to magnetic healing when he wrote, "chiropractic was not evolved from medicine or any other method, except that of magnetic." 16(p111) Derived from Anton Mesmer's (1734-1815) investigations into the supposed curative effects of animal magnetism, practitioners of magnetic healing identified the unimpeded flow of energy with health and defined illness as obstruction. This integrity has to do with the profession's belief in the importance of biomechanics the centrality of manual therapy, especially for the spine and a clinical dynamic that provides patients with explanations, meaning, and concrete experiences that promote a strong patient-physician bond, a sense of caring, and a restored sense of well-being.Īlthough the bonesetting tradition gave chiropractic its method, "magnetic healing" provided the theory. Yet, despite external conflicts and perhaps partly because of them, and despite the intraprofessional disagreements and uncertainty about its scope of practice, chiropractic has found an internal coherence that has allowed it to become an enduring presence in the United States. The mode of chiropractic intervention-by means of the hands-and its unique therapeutic niche, primarily pain disorders, seem too narrow a foundation for its claim to encompass a distinct health system with autonomous licensing, credentialing, and educational institutions. A multiplicity of competing adjustment techniques also vie with each other under the rubric of chiropractic. ![]() Various theories vie for dominance within the profession. Since its inception, chiropractors have disagreed about the definition of the therapy and its scope of practice. ![]() 7 - 9 Although the American Medical Association (AMA) no longer prohibits its members from consulting with chiropractors, especially since it was found guilty of conspiracy in this regard (see below), chiropractic's size and power have not translated into complete acceptance.Ĭontradictions and tensions exist not only between chiropractic and mainstream medicine but within chiropractic itself. Only a few small hospitals permit chiropractors to treat inpatients, and to our knowledge, university-affiliated teaching centers have not yet granted chiropractors privileges to perform manipulation on patients. 6ĭespite such impressive credentials, academic medicine regards chiropractic theory as speculative at best and its claims of clinical success, at least outside of low back pain, as unsubstantiated. 5 In addition, the profession is growing: the number of chiropractors in the United States-now at 50,000-is expected to double by 2010 (whereas the number of physicians is expected to increase by only 16%). In 1994, the Agency for Health Care Policy and Research removed much of the onus of marginality from chiropractic by declaring that spinal manipulation can alleviate low back pain. 4 Since 1972, Medicare has reimbursed patients for chiropractic treatments, and these treatments are covered as well by most major insurance companies. ![]() ![]() 1 In 1988 (the latest year with reliable statistics), between $2.4 2 and $4 billion 3 was spent on chiropractic care, and in 1990, 160 million office visits were made to chiropractors. An estimated 1 of 3 persons with lower back pain is treated by chiropractors. Facts such as the following attest to its status and success: Chiropractic is licensed in all 50 states. Shared Decision Making and CommunicationĬhiropractic, the medical profession that specializes in manual therapy and especially spinal manipulation, is the most important example of alternative medicine in the United States and alternative medicine's greatest anomaly.Įven to call chiropractic "alternative" is problematic in many ways, it is distinctly mainstream.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography. ![]()
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