The history of chiropractic is, in some ways, not to dissimilar from a good political thriller.
It is full of colorful characters, intrigue, and back room deals. As in any good political thriller, all of this came to a head. This was in the now famous 1987 Wilk v. AMA decision.
In many ways, this decision held the fate of chiropractic in its hands. Nevertheless, there were many smaller skirmishes leading up to the big battle. Understanding the events that led up to Wilk v. AMA can provide the younger generation of DCs with a better sense of where the profession came from.
Late 19th Century to mid-20th Century
As all DCs know, D.D. Palmer performed the first ever chiropractic adjustment in 1895.1 From that point until the end of World War II, the fight for chiropractic took place on two fronts. The first was on the legal front, to get chiropractors officially licensed in all 50 states. The second was on the scientific front, to show that chiropractic was an effective therapeutic option for treating patients.
Arkansas and North Dakota were the first two states to issue chiropractic licenses in 1915, and the NCA (precursor to the ACA) founded the Chiropractic Research Foundation in 1944.1
Attempts to Contain and Eliminate Chiropractic
By the 1960s, Chiropractic Economics had been established as a publication, and the National Board of Chiropractic Examiners (NCBE) was giving its first set of board exams (1965).1
However, the American Medical Association (AMA) was not going to allow the new chiropractic kids on the block to infringe on their trade.1-2
The Iowa Plan, a policy plan created by the Iowa Medical Society, was eventually adopted by the AMA as a whole.2 Its step by step plan to contain and eliminate “the chiropractic menace” included strongly discouraging medical doctors (including radiologists) from professionally associating with chiropractors.2
Medical doctors were also strongly encouraged to:
- Lodge complaints of ethics violations against DCs for infringing on their practice
- Block insurance companies from accepting DCs
- Block DCs from infringing upon worker’s compensation cases
- Block unions from allowing DCs to care for their members
- Agitate to prevent hospitals from allowing DCs to be on staff and have admitting privileges
- Work to discredit chiropractic schools2
This was to be accomplished by providing information in the form of conferences and publications to spread the AMA’s anti-chiropractic stance.2
The situation for chiropractors had become so intolerable that in 1976, Chester Wilk, DC, and four other chiropractors filed suit against the AMA, citing illegal restriction of trade.1-3 The suit also named the American Hospital Association, the American College of Surgeons, the American College of Physicians, and the Joint Commission on Accreditation of Hospitals.3
The suit alleged that the AMA had made deliberate attempts to restrict chiropractor access to hospitals, insurance plans, and radiologists. Furthermore, the suit alleged that the AMA made attempts to suppress patient information and governmental inquiries about the effectiveness of chiropractic.2-3
More than 10 years later, following a second suit that won on appeal, an injunction was imposed against the AMA and the other defendants in the suit that ordered them to stop restricting the trade of chiropractors.2-3 The defendants were also ordered to inform all of their members of the outcome of the Wilks v. AMA decision.
Fast Forward to Now
Today’s DCs not only have access to hospitals and radiologists, but they can now bill Medicare for their services and be reimbursed for treating active-duty military or veterans.
The events of Wilk v. AMA seem to be in the distant past. However, younger DCs should take heed from that decision not to allow the gains that chiropractic has made since then to slip away.
Looking back at the decision from almost 30 years ago, we can safely say that, just as in that political thriller, the good guys won that battle in the war. It is now up the current generation of DCs to ensure that chiropractic’s place as an effective therapy is not undermined.
- Chiropractic Economics. A visual history of chiropractic. Published May 2014. Accessed September 2015.
- Burkhart LA. Wilk v. AMA. 25 years later: Why it isn’t over. American Chiropractic Today. Published March 2012. Accessed September 2015.
- Chiro.org. Chiropractic antitrust suit: Wilke et al. vs. the AMA et al. Published February 2001. Accessed September 2015.