The last 15 years have seen a shift in the chiropractic profession away from a traditional “adjustment-centric” practice to a “therapy-based” back pain treatment. This shift has been in progress for over 100 years and has recently been rebranded from “straights vs mixers” to the ultra-condescending “vitalists vs. evidence-based” debate.
While this schism in the chiropractic profession has been brewing for a while now, it is only recently experienced the slow creep of cancel culture into the profession, and it has spread like a virus.
The chiro-wars currently look like this:
Young chiropractors, with increasing levels of student loans, and slim, historically low job prospects, have taken to social and traditional media with a renewed fervor calling for a “divorce” between the two camps. Citing the eventual downfall of chiropractic, and ultimately their lack of success as chiropractors, as being caused by the ever-present subluxation-based “subbies” who cling to antiquated theories and treatments, use unethical marketing practices, irradiate their patients without reason, claim to treat disease and illness with adjustments, and are staunch anti-vaxxers.
On the other hand, the so-called “straights” have generally been in practice longer and continue to practice according to their training. Most run cash-based, family-oriented practices that focus on optimal performance of the spine and nervous system, as well as prevention. They practice simply: Limited therapies, low overhead, and use the chiropractic adjustment as their primary form of care. They often disparage the “mixers” as wannabe physiotherapists but maintain an inclusive “room for everyone” ethos. This group is also more likely to identify as “vitalists” and adopt anti-establishment martyr complexes.
Historically, there were few outlets for these village idiots (both sides) to express their opinions. Now there are many. They have even recruited allies from outside of the profession to bolster their claims. Conspiracy theorists, skeptics, and natural health blogs have rallied behind both sides of the chiropractic profession while we air our professional dirty laundry in public.
Let me be clear: This is a gross generalization of the conflict and I recognize that most of the noise and in-fighting can be attributed to a small, but vocal minority of GIANT ASSHOLES within the profession using social media to amplify their voices. Mmkay?
So here is my contribution, from the middle of the road: A Declaration of Chiropractic Independence. I side with neither and choose to carve out a new path for chiropractic.
Here’s what I believe:
I am a patient-centered, traditional chiropractor. This means: I primarily use chiropractic adjustments to restore function and neurological control of the spine.
I believe subluxations = dysfunctional spinal segments = central segmental motor control problems = fixated vertebrae = etc. flavor of the month. I don’t care which term you use but give credit where credit is due - Subluxations are where we started. I do not get hung up on terminology and adapt my language according to who I am talking to.
An adjustment and a manipulation are NOT the same things and sometimes I use both. A chiropractic adjustment is more precise.
A healthy spine is important for life. Everyone with a spine needs a chiropractor.
I do not claim to treat pain, disease, or illness. Some people experience results with non-musculoskeletal conditions that can not be explained away by placebo or coincidence.
I treat people with cancer, ADHD, ear infections, HIV, heart disease, GI dysfunction - Not necessarily for those conditions, but because they also need chiropractic care.
Spinal function and human performance are my primary concerns. I am compassionate about a patient’s pain however, it is not my main focus.
I talk about the Nervous System to my patients. It is not a dirty word to me.
I am NOT a vitalist. I understand there is a plausible biological explanation for our results, not an abstract, mystical, or “quantum” one.
I support my chiropractic colleagues and we discuss our differences privately and as professionals.
I read and support chiropractic research with my financial donations. I also read the research I don’t agree with philosophically.
I think the discussion of vaccines is best left to the medical profession.
I take time to listen to my patients but I don’t steal their time with less-effective modalities, long appointments, or mindless chit-chat to justify my fee.
I charge a high fee for my services and I don’t make deals. Pre-pay, monthly, or per visit fees are all the same.
I think physios and massage therapists are better at physio and massage than chiros, and I refer patients to them often.
I believe that a specific chiropractic adjustment, after a specific and thorough examination and analysis, is the best and most effective service we can provide.
I believe subluxation-based care is synonymous with evidence-based care and I make no claims above the current evidence.
I believe Xrays are valuable in chiropractic practice beyond pathology and can be an important assessment tool when used appropriately.
Plain film Xray, Insight, Myovision, etc are not subluxation finders. My hands are.
If you need to adjust your patients 3x/week for 6 months, you are doing it wrong. Continuously develop your adjusting skills and get patients past corrective care to preventative care ASAP.
Focus on function as an outcome, not symptoms. If you think you can “fix” someone in a couple of visits, you are doing it wrong.
I don’t base my treatment plan and recommendations on the amount of your insurance coverage. Also, Orthotics for everyone with coverage is bullshit.
I make reasonable recommendations based on my technique, experience, and patient’s exam findings. I respect a patient’s decision to modify or stop care, but will educate and encourage them to follow the original program for the best results.
I take care of kids for the same reason I take care of adults. Chiropractic care for children is safe and ethical.
I don’t believe chiropractic is “whatever a chiro does within their scope of practice.” The practice of chiropractic is the adjustment of the spine to restore proper motion, function, and afferent/efferent signaling of the CNS.
I’m not anti-medicine, but I think people should take fewer medications and be pro-active towards their health. Prevention is superior to treatment
I’m not a quack.
I’m not a mixer.
I’m not a straight.
I am a modern chiropractor.