April 2002

Chiropractic’s Changing Image: One MD’s Perspective
By Joseph P. Murphy, MD

There is no way I would refer a patient of mine to a chiropractor! This was the consensus of physicians at a medical meeting in the late 1950s.

New in Casper, Wyo., I was not wearing the “white hat.” The thoughts of my colleagues mirrored mine. Those were difficult days for comradeship between our two professions. Even calling chiropractic medicine a profession set some of my medical friends on fire.

A patient of mine said his chiropractor couldn’t cure his asthma by manipulating his spine. Twenty treatments with no improvement. Small wonder, I thought. I didn’t cure it either. (Although I did control it.) Then I met a Casper chiropractor, Dr. Omer C. Chilcote. He assured me he would treat only within the confines of his training. He would send his asthma and allergy, cardiac and colon problems - all medical problems - to medical doctors. Omer gently worked over bones and muscles of the back and neck and helped me give good care to our patients. Tragedy struck Dr. Chilcote. While boating at Alcova Lake, he drowned.

In the years that followed, gradually, very gradually, other chiropractors joined my referral base. Chiropractic made progress in establishing itself as a valid science. In 1987, the U.S. Supreme Court upheld a lower court decision. The American Medical Association was guilty of anti-trust violations in its attempt to eliminate the chiropractic profession.

The Annals of Internal Medicine is the masthead journal for internists. It highlighted an article in its Feb. 5, 2002, issue, “Chiropractic: A Profession at the Crossroads of Mainstream and Alternative Medicine.” A chiropractor (Dr. William Meeker) and a man who is both a chiropractor and a medical doctor (Dr. Scott Haldeman) wrote the essay.

It details much progress since 1958. What has changed?

Chiropractic is a “new” science. Minnesota was the first state to license it in 1905. Increasingly, there are tightened educational requirements. Licensure agencies have also tightened requisites for chiropractors.

Nationwide, much change has happened in the past two decades. A recent study in North Carolina showed 65% of physicians referred patients to chiropractors. Nationwide, there are now 60,000 chiropractors. By 2010, it’s projected there will be 100,000 chiropractors.

Chiropractic clinical care is high-touch. There is evidence of a strong psychological effect of chiropractic treatment. In its ranks, traditional medicine is sensing this same change.

Higher levels of trust for chiropractors have developed. Many patients with back problems opt for manipulative treatment. Trials leave little doubt that chiropractic patients are very satisfied. Physicians might be surprised if their medical patients were honest about the chiropractor they also see.

Serious complications from spinal lumbar manipulation are exceedingly rare. Estimated: One case per 100 million manipulations! These figures surprised me. Old prejudices die hard.

Payments for chiropractic care were included in Medicare in the 1970s. Now all forms of workers’ compensation and most forms of managed care are included.

The Meeker-Haldeman article contains 164 references. Read to your delight. They do not necessarily reach a particular “conclusion.” Thus the reference in the title to the “crossroads between mainstream and alternative medicine.”

Chiropractic has effectively used political, legislative, and legal measures to hasten getting its seat at the table. It has increased its market share of satisfied patients. Is this enough to effect substantive change? Image, attitude, and structural barriers remain. In many areas, each profession (chiropractic and medicine) has questions of professional and social identity to answer. In the vernacular, we do have a way to go.

It’s a whole new ball game. Drs. Meeker and Haldeman say much of this uncertainty will come to a resolution in the next 10 years. I am optimistic of the outcome for both our professions. So also, I am optimistic for you, our patients.

Dr. Murphy is a retired Casper, Wyo., physician. He was the first governor of the American College of Physicians from Wyoming. He can be reached at murphy@trib.com.
Article originally appeared in the Casper Star Tribune on Feb. 22, 2002. Reprinted with permission from Dr. Joseph P. Murphy and the Casper Star Tribune, 170 Star Lane, Box 80, Casper, WY 82602.

Editor’s Note: Thanks goes out to Nutri-West for bringing the following newspaper article to our attention. The column originally appeared in the Casper Star Tribune, the only statewide newspaper in Wyoming.