Chiropractic Antitrust Suit: Index
In 1976, a series of lawsuits was begun against the AMA, other professional organizations, and several individual critics, charging that they had conspired to destroy chiropractic and to illegally deprive chiropractors of access to laboratory, x-ray, and hospital facilities. Most of the defendant groups agreed in out-of-court settlements that their physician members were free to decide for themselves how to deal with chiropractors. The American Medical Association (AMA), the American College of Radiology (ACOR), the American Academy of Orthopedic Surgery (AAOS), seven other groups, and four individual defendants chose to defend in court. In January 1981, after an 8-week trial, the jury ruled unanimously in their favor. However, the case was reversed on appeal and the parties agreed to retry it in front of a …
Continue Reading >Chiropractic Antitrust Suit: ACR Liability
Memorandum Opinion and Order: Liability of Remaining Defendants 6. American College of Radiology (ACR) (a) Participation in AMA Conspiracy In the mid-1970s, ACR included 12,000 of the 14,000 radiologists in the country. ARC conditions membership on adherence to the AMA’s Principles (which are printed in the ACR’s bylaws) and the Principles of Ethical Radiological Practice. The Principles of Ethical Radiological Practice have contained Principle 3 (identical to the original AMA Principle 3) since the early 1940s. Under the bylaws, the Board of Chancellors may discipline any member of the College for violation of its principles. Any member who for reasons of moral turpitude or unethical practices ceases to be a member of the AMA or of any country, state, or provincial medical society shall have …
Continue Reading >Chiropractic Antitrust Suit: Summary of Injunction
The American Medical Association and its 275,000 members, when working in concert with the AMA, were permanently enjoined today by United States District Court Judge Susan Getzendanner from “restricting, regulating or impeding or aiding and abetting others from restricting, regulating, or impeding the freedom of any AMA members or any institution or hospital to make an individual decision as to whether or not that AMA member, institution, or hospital shall professionally associate with chiropractors, chiropractic students, or chiropractic institutions.” The Order of P*rmanent Injunction issued by the Court requires the AMA to send copies of the Order of Injunction to each of its 275,000 members, to modify the official AMA Judicial Council Opinions and Reports to reflect the AMA’s representations to the Court that it …
Continue Reading >Chiropractic Antitrust Suit: Rejection of Per Se Violation
Memorandum Opinion and Order: Liability of the AMA and Dr. Sammons 4. Rejection of Per Se Violation The Seventh Circuit has already held that Principle 3 escapes per se treatment because it involves a medical ethic which nonfrivolously addresses the importance of scientific method, a subject well within the natural ambit of a medical association. The plaintiffs argue that the Supreme Court’s decision in F.T.C. v. Indiana Federation of Dentists, 106 S. Ct. 2009 (1986), decided after Wilk compels application of the per se analysis. I disagree. First, Indiana Dentists itself was decided under a rule of reason analysis. Although the Supreme Court rejected the dentists’ rationale that the withholding of x-rays in that case was justifiable as being in the best interests of patients, …
Continue Reading >Chiropractic Antitrust Suit: Permanent Injunction
IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS EASTERN DIVISION CHESTER A. WILK, et al., Plaintiffs, v. AMERICAN MEDICAL ASSOCIATION, et al., Defendants. No. 76 C 3777 The court conducted a lengthy trial of this case in May and June of 1987 and on August 27, 1987, issued a 101-page opinion finding that the American Medical Association (“AMA”) and its members participated in a conspiracy against chiropractors in violation of the nation’s antitrust laws. Thereafter on opinion dated September 25, 1987 was substituted for the August 27, 1987 opinion. The question now before the court is the form of injunctive relief that the court wi I I order. As port of the injunctive relief to be ordered by the court against …
Continue Reading >Chiropractic Antitrust Suit: Patient Care Defense
Memorandum Opinion and Order: Liability of the AMA and Dr. Sammons 5. Patient Care Defense I now consider whether the AMA has established the Wilk patient care defense. The first element is whether the AMA and its members genuinely entertained a concern for scientific method in the care of patients. I have some question about the genuineness of the AMA’s concern for scientific method based on the fact that when the AMA adopted changes in its chiropractic policy between 1977 and 1980, it apparently did so without deciding whether chiropractic was scientific. That shows disregard for scientific method in patient care. Nevertheless, I conclude that the AMA has established this element. At the time it was attacking chiropractic as unscientific, it was attacking other unscientific …
Continue Reading >Chiropractic Antitrust Suit: New Zealand Report
Memorandum Opinion and Order: III. New Zealand Report During trial, I reserved ruling on an important evidentiary ruling, the admissibility of a report summarizing the findings of a task force appointed by the New Zealand government to study chiropractic in that notion, “Chiropractic in New Zealand: Report of the Commission of Inquiry” (“the New Zealand Report”). The New Zealand Report was heavily relied upon by the plaintiffs to show that chiropractic was a valid health care profession. The defendants opposed introduction of the report, and the parties have now briefed the issue. The Report was published in 1979 after nearly two years of investigation including 78 days of public hearings, 15 days of closed sessions, and visits to medical and chiropractic establishments both in New …
Continue Reading >Chiropractic Antitrust Suit: Liability of the American College of Surgeons
Memorandum Opinion and Order: Liability of Remaining Defendants 5. American College of Surgeons (ACS) In June of 1966, the then Director of ACS responded to an unsolicited inquiry from the Michigan State Medical Society regarding the ACS position on relationships between medical physicians and chiropractors. The Director called the AMA to find that the answer was that there should be no relationships and he then responded to the Michigan State Medical Society. He stated that “the College has never taken an official position. . . . We have followed the lead of the AMA, which is not always entirely clear.” However, the Director also stated the AMA’s position. At this time ACS hod not adopted or endorsed the AMA’s Principles. Nor had ACS endorsed the …
Continue Reading >Chiropractic Antitrust Suit: Memorandum
Memorandum Opinion and Order: Liability of Remaining Defendants 1. General Legal Principles Applicable to Co-Conspirators After the first trial, defendants JCAH, ACP, ACS and AAOS appealed the denial of their motions for directed verdict. The Court of Appeals affirmed the denial of those motions. The Court concluded that the evidence was sufficient to permit, but not require the finder of fact to conclude that each defendant knew that concerted action in a scheme was contemplated and invited and that each acquiesced and participated in that scheme. “Such a finding would hove provided sufficient footing for liability in this civil antitrust action. See Theater Enterprises, Inc. v. Paramount Film Distributing Corp , 346 U.S. 537, 540 (1954); Interstate Circuit, Inc. v. United States, 306 U.S. 208, …
Continue Reading >Chiropractic Antitrust Suit: First Trial & Wilk Decision
Memorandum Opinion and Order: I. First Trial and Wilk Decision This antitrust case is on remand for a new trial from the Court of Appeals, Wilk v. AMA, 719 F. 2d 207 (7th Cir. 1983) On May 4, 1987 the case was reassigned to me under Local Rule 2.30e for the purpose of conducting the trial. The trial was conducted during May and June of 1987 and the matter is now before the court for the entry of findings of fact and conclusions of law under Rule 52 of the Fed.R.Civ.P. The record in the case consists of 3,624 pages of transcript, approximately 1,265 exhibits, and excerpts from 73 depositions. The plaintiffs, Chester A. Wilk, James W. Bryden, Patricia A. Arthur, and Michael D. Pedigo, …
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