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Without question, the adjustment and manipulation or manipulative procedures of the spine and its adjacent articulations represent the basic form of chiropractic patient care. (1) Spinal manipulation is used by millions of patients each year to relieve symptoms caused by biomechanical dysfunction of the spine. (2)
Since its beginning, the chiropractic profession's position in society has been contradictory. (3) Internally, chiropractic medicine has a dramatic legacy of strife and factionalism, (3) which influenced the formation of the National Association of Chiropractic Medicine. Externally, the profession has defended itself from vigorous opposition from political medicine, as well as from the scientific community. (3)
Opponents of NACM take issue with its stand advocating a scope of practice that adheres to a scientific basis from using manipulative and physiotherapeutic procedures to treat only musculoskeletal disorders. These critics usually place NACM at odds with mainstream chiropractic health care, which advocates spinal manipulation or spinal adjustments to "restore and maintain health."
ORIGIN AND DEVELOPMENT OF NACM
Since chiropractic's inception and continuance of a vitalistic phenomenon based on a so-called philosophy, much of the chiropractic profession's philosophers have criticized the scientific understanding of the human body. (4) Because of this, mainstream chiropractic remains, in the opinion of medical commentators and chiropractic medicine, an unscientific healing cult. (5)
Contemporary chiropractic holds that much illness is caused, directly and indirectly, by derangements in homeostasis that result from subtle vertebral malalignments called "subluxations." (5) While it is easy to understand the genesis of chiropractic, it is more difficult to comprehend the nonsense of trying to transfer and apply earliest principles to today's nomeclature. (6)
The formation of an organized body dedicated to reform of the profession was instituted by Ronald Slaughter, DC, along with the father and son contributions of Charles DuVall, Sr., DC, and Charles DuVall, Jr., DC. (7) Initially, NACM was formed out of concern for the apparent nonscientific direction the profession was headed. However, it was the request to review a paper that brought the three together.
In the early 1980's, the National Council Against Health Fraud was writing a position paper on chiropractic. William Jarvis, PhD, head of the NCAHF, contacted these three to review the work. The initial work contained accurate information but offered no remedy to the criticism given. No attempt was made to show the value of scientifically directed chiropractic.
In response, NCAHF invited these doctors to complete writing the position paper. These chiropractors believed this was a major accomplishment for chiropractic reform. The final paper, once approved by the NCAHF Board of Directors, made recommendations on what constituted appropriately applied chiropractic manipulation.
The chiropractors hoped that the recommendations would inspire the rest of the profession to ultimately reform and make a change to an applied science. However, the opposite occurred.
Organized chiropractic vehemently attacked NCAHF and the authors and maintained the status quo. This event resulted in the formation of the National Association for Chiropractic Medicine in 1984. With the assistance of both DuValls, Mark Davis, DC, and Anita (Denison) Gilbert, DC, Slaughter chartered the NACM as a nonprofit corporation in the state of Texas.
THE ORTHOPRACTIC MOVEMENT AND THE CONTROVERSY GENERATED
The orthopractic movement created a controversy within the ranks of the profession. Historically, the chiropractic profession has been at odds with organized medicine. This antagonism has been evident since chiropractic's inception in 1895. This antagonism reached its height in the 1980s when four chiropractors brought an antitrust suit against the American Medical Association (AMA).
When the AMA was found guilty of an illegal boycott of chiropractic in the 1986 Sherman antitrust lawsuit, chiropractors presented this decision as proof of the court's endorsement of chiropractic. It was not. The transcripts stated:
All of the parties to the case, including the plaintiff chiropractors and the AMA, agreed that chiropractic treatment of diseases such as diabetes, high blood pressure, cancer, heart disease, and infectious disease is not proper, and that the historic theory of chiropractic that there is a single cause and cure of disease was wrong and that there was evidence that chiropractic theory of subluxations was unscientific, and evidence that some chiropractors engaged in unscientific practices. (8)
In 1994, several chiropractors broke away from the chiropractic profession and developed a profession of scientific-based chiropractors. At the time, health care reform, demand for practice guidelines, decreased reimbursement, low professional morale, and lack of unity were prominent. If chiropractic was not going to reform and embrace scientific medicine, then the only option was to break away and start a new profession.
While the orthopractic movement did not come to fruition, it indicated that the chiropractic profession will not tolerate a manipulative competitor. Orthopractic in Canada is still active. However, since NACM withdrew support for the US movement in 1995, the orthopractic movement in the United States appears to be shelved. It would be incorrect and outdated to consider NACM to be associated with orthopractic.
PURPOSE OF THE NACM
Formal association with other chiropractic professionals enhances the creation of a professional identity, fostering a relationship that nurtures distinct attributes for its members. (10) Chiropractic medicine does not take the term "medicine" in any exclusionary sense, though it frequently seems to have the …