Integrative Schizophrenia

With increased national interest in Complementary and Alternative Medicine (CAM) the government is now evaluating and researching the various alternative forms of health care.  This attention carries with it the potential for research grants and other sources of government funding.   In the past chiropractic has been strongly identified with CAM, but in recent years chiropractic has been drifting from the fringe and moving toward a place in mainstream healthcare. 

The Chiropractic profession is now betwixt and between, not fully mainstream and not fully CAM.  Unquestionably there are chiropractors who bear a resemblance to being a medical subspecialty, but there are also chiropractors who are as alternative as any shaman.  It seems that chiropractic sways to and fro, according to which title provides the greatest benefit at the time.

Should chiropractic be lumped together with alternative medicine disciplines such as sweat lodges, Reiki, color therapy, light therapy, herbology, iridology, touch for health, aura therapy, magnetism, polarity, colonics, aroma therapy, chelation, visualization, channeling, faith healing, healing crystals, etc?   Or should chiropractors be grouped together with physiatry, occupational health, orthopedics, or pain management?  There are benefits and pitfalls to each.

As a profession, chiropractic appears to be schizophrenic: We want to be CAM when it comes to receiving financial rewards earmarked for CAM, but we want to be mainstream when it comes to benefits set aside for manual medicine.  One day we may need to make a commitment to become either CAM or mainstream. 

Alternative extremes

Some CAM practitioners are opposed to anything linked to western healing, including Hippocrates’s views of healing, and will embrace everything that is counter to medicine regardless of its merit.   When one takes this stance he could be viewed as a social activist as well as an alternative healer.  Being lumped with all sorts of alternative healing arts, especially absurd or fringe arts, will damage chiropractic’s credibility.

The peril of being a specialty of mainstream healthcare

Having a uniquely chiropractic profession gives us the latitude to think differently than other professions.  Having a non-medical, non-surgical orientation is an advantage and certainly not a drawback.

One of the dangers of integration, especially by fledgling chiropractors, is the acquisition of a strongly medical orientation.  Chiropractors with a strong medical orientation may lean so far to the mainstream that they exclude chiropractic’s emphasis on natural healing and avoidance of unnecessary medication.

Public bewilderment

When you go to a medical office, you can expect to see constants in care.  Most offices will begin care with taking vital signs, a patient interview, and an exam.  A diagnosis will be rendered and a treatment proposed.  These constants are present in virtually every medical clinic in the country and familiarity with these constants reassures patients.

Chiropractic by contrast has a variety of treatment techniques, claims, philosophies and technologies.   These range from mainstream to peculiar. These variations are confusing to the public and to other professions.   When patients share their chiropractic experiences with each other, they must question whether or not they are even talking about the same profession.  To rephrase a Forest Gump quote, “Chiropractic is like a box of chocolates, you never know what you are gonna get until you look inside.”

Striking the Balance

Most modern chiropractors maintain wellness practices with a strong emphasis on musculoskeletal (MS) care: 90-95%[i]^{,[ii],[iii],[iv]}  of chiropractic patients are treated for MS conditions.  Promoting healthy living while avoiding a dependence on unnecessary drugs is not fringe, it is what most patients prefer.  This model of chiropractic is mainstream, not CAM.  Conversely, obsessively clinging to fundamentalist doctrines regardless of burgeoning evidence is CAM.

As more and more chiropractors embrace integration, consistency of care should follow. Contemporary chiropractors are constant in their inclusion of vital signs, patient interviews, informed consent, orthopedic, neurological and regional exams, a diagnosis, and treatments that include manual treatment, exercise and patient education.   Profession-wide consistency in practicing evidence-based chiropractic may be the solution to our current state of societal puzzlement regarding chiropractic.