Chiropractic as spine care: a model for the profession

Chiropractic as spine care: a model for the profession
Received May 20, 2005; Accepted July 6, 2005.
Published online 2005 July 6
Craig F Nelson,1 Dana J Lawrence,2 John J Triano,3 Gert Bronfort,4 Stephen M Perle,5 R Douglas Metz,1 Kurt Hegetschweiler,1 and Thomas LaBrot1
Chiropractic & Osteopathy
PubMed Central

1American Specialty Health 777 Front St. San Diego, CA 92101, USA
2Palmer Centre for Chiropractic Research, Palmer College of Chisopractic, 1000 Brady Street Davenport, IA 52803, USA
3Texas Back Institute 6020 W. Parker Road Plano, TX 75093, USA
4Northwestern Health Sciences University 2501 W. 84th St. Bloomington, MN 55431, USA
5University of Bridgeport 126 Park Avenue Bridgeport, CT 06604, USA
Corresponding author.
Craig F Nelson: craign@ashn.com; Dana J Lawrence: dana.lawrence@palmer.edu; John J Triano: jtriano@texasback.com; Gert Bronfort: gbronfort@nwhealth.edu; Stephen M Perle: perle@bridgeport.edu; R Douglas Metz: dougm@ashn.com; Kurt Hegetschweiler: kurth@ashn.com; Thomas LaBrot: thomasl@ashn.com

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract
Background
More than 100 years after its inception the chiropractic profession has failed to define itself in a way that is understandable, credible and scientifically coherent. This failure has prevented the profession from establishing its cultural authority over any specific domain of health care.

Objective
To present a model for the chiropractic profession to establish cultural authority and increase market share of the public seeking chiropractic care.

Discussion
The continued failure by the chiropractic profession to remedy this state of affairs will pose a distinct threat to the future viability of the profession. Three specific characteristics of the profession are identified as impediments to the creation of a credible definition of chiropractic: Departures from accepted standards of professional ethics; reliance upon obsolete principles of chiropractic philosophy; and the promotion of chiropractors as primary care providers. A chiropractic professional identity should be based on spinal care as the defining clinical purpose of chiropractic, chiropractic as an integrated part of the healthcare mainstream, the rigorous implementation of accepted standards of professional ethics, chiropractors as portal-of-entry providers, the acceptance and promotion of evidence-based health care, and a conservative clinical approach.

Conclusion
This paper presents the spine care model as a means of developing chiropractic cultural authority and relevancy. The model is based on principles that would help integrate chiropractic care into the mainstream delivery system while still retaining self-identity for the profession.

Keywords: Chiropractic, Evidence-Based Health Care, Health Care Professions, Professional Ethics

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