The Chiro Wars have recently been rebranded from “straights vs. mixers” to the ultra-condescending “vitalists vs. evidence-based.”
Young chiropractors, with increasing levels of student loans and historically low job prospects, have taken to social media calling for a “professional divorce” between the two camps.
Citing the eventual downfall of chiropractic if we don’t integrate into medicine, the “evidence-based” kids view any lack of progress as the fault of the subluxation-based (subbies) who cling to antiquated theories and treatments, use unethical marketing practices, irradiate their patients without reason. The subbies claim to treat disease with magic adjustments, and are staunch anti-vaxxers.
On the other hand, so-called “vitalists” have generally been in practice longer and continue to practice according to their training, within a narrower scope. Most prefer a cash-based, family practice, that focuses on optimal performance of the spine and nervous system, as well as prevention. They use limited therapies, keep a low overhead, and use the chiropractic adjustment as their primary form of care.
The newly minted subbies will often disparage the “mixers” as wannabe physiotherapists, but typically maintain an inclusive “room for everyone” ethos. Unfortunately, this group is also more likely to adopt an anti-establishment, martyr complex. They tend to prefer volume over quality and typically push an anti-medicine stance.
Sound familiar? Its a story as old as chiropractic itself.
Let me be clear: This is a gross generalization of the conflict and I recognize that most of the in-fighting can be attributed to a small, but vocal minority of GIANT ASSHOLES who use social media to amplify their voices. Do they represent all chiropractors? Not even close.
Historically, there were very few outlets for these village idiots on both sides to express their opinions. Maybe an AGM or occasional 60 minutes news piece. Now there are many. You, and a few hundred others, are currently reading one of these media outlets (minus the village idiots, of course).
The loudest in the profession have also recruited allies from outside the profession to bolster their claims. Conspiracy theorists, skeptics, and natural health blogs have rallied behind both sides while we continue to air our professional dirty laundry in public, like a bunch of amateurs.
So here is my contribution, from the middle of the road where most chiropractors reside.
A Declaration of Chiropractic Independence.
A healthy spine is important for life. Everyone with a spine needs a chiropractor.
Chiropractic restores proper motion, function, and afferent/efferent signaling of the CNS.
I take care of kids for the same reason I take care of adults. Chiropractic care for children is safe and ethical.
I believe subluxations = dysfunctional spinal segments = central segmental motor control problems = fixated vertebrae = spinal lesions, etc.
I do not get hung up on terminology and adapt my language according to who I am talking to. I don’t care which term you use but give credit where credit is due - Subluxations are where we started.
An adjustment and a manipulation are NOT the same thing, and I use both. A chiropractic adjustment is more precise. A manipulation is sometimes needed too.
I do not claim to treat disease, or illness. However, some people experience results with non-musculoskeletal conditions. These results are not explained away by placebo effect or coincidence.
I treat people with cancer, with ADHD, with ear infections, with HIV, with heart disease, with GI dysfunction, etc. Not necessarily for those conditions, but because they also need chiropractic care.
I am compassionate about a patient’s pain however, it is not my main focus. Spinal function and human performance are my primary concerns.
Posture is cool, 100% spinal movement is better.
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 as professionals.
I read and support chiropractic research with my financial donations. I also read the research I don’t agree with philosophically.
I believe 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 simply 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, and I don’t use payment plans to enforce compliance.
I think physios and massage therapists are better at physio and massage than chiros. I refer patients to them often.
I am a patient-centered, traditional chiropractor. This means: I primarily use chiropractic adjustments to restore function and neurological control of the spine.
There’s nothing wrong with PT, modalities. etc. If you are well-trained and have the time, please help your patients. Treat those with insurance coverage for PT the same as those without.
I believe that a specific chiropractic adjustment, after a thorough examination and assessment, is the best and most effective service we can provide.
I believe subluxation-based care is mostly synonymous with evidence-based care and I make no claims above the current evidence. We still have more research to do.
I believe x-rays are valuable in chiropractic practice beyond pathology and can be an important assessment tool when used appropriately.
Plain film x-ray, Insight, Myovision, etc are great but they 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.
I make reasonable recommendations for care based on my technique, experience, and primarily the 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.
If you think you can “fix” someone in a couple of visits, you are doing it wrong. Focus on function as an outcome, not symptoms.
I don’t base my treatment plan and recommendations on the amount of your insurance coverage.
Orthotics for everyone with insurance coverage is bullshit.
Prevention is superior to treatment.
I’m not anti-medicine, but I think people should take fewer medications and be pro-active towards their health.
I’m not a mixer.
I’m not a straight.
I am a modern, independent thinking chiropractor.
Did I miss anything?
Let me know your thoughts in the comments section below.
Who wrote this Declaration article please?
Thanks, Jeff