Chiropractic Antitrust Suit: Antitrust Injury

Memorandum Opinion and Order:
Liability of the American Medical
Association (AMA) and Dr. Sammons

3. Antitrust Injury

Having determined that the effect of Principle 3 and the implementing conduct has been to unreasonably restrict competition rather than to promote it, I now consider whether the plaintiffs have shown injury of the kind the antitrust laws were designed to prevent.

The plaintiffs principally rely on the testimony of Dr. Miron Stano, their economic expert. Dr. Stano compared the income of chiropractors, podiatrists, and optometrists over the relevant period of time and concluded that the income of chiropractors was lower than that of the other, comparable limited licensed practitioners. He viewed this as consistent with the boycott theory. He also noted a jump in chiropractors’ income during the period 1978 to 1980 and he concluded that the jump was consistent with the acknowledged lessening of the boycott by the AMA during that period.

The defendants’ economic expert, Mr. Lynk, faulted the data relied upon by Dr. Stano, but he agreed that if he were to compare chiropractors’ income to comparable groups, he would also include podiatrists and optometrists, as well as other groups, but he would seek further explanations for the differences between the groups’ incomes. Mr. Lynk further criticized the “jump” analysis done by Dr. Stano due to the fact that Dr. Stano relied on income projections from the Bureau of Labor Statistics (“BLS”). Mr. Lynk argued that BLS statistics are a poor source to begin with, and that reliance on such statistics further was not justified because in 1980 BLS began to note that it obtained its income projections for chiropractors from the American Chiropractors Association, thus signaling a change in the data collection methodology used by the BLS. This revelation caused the recalling of Dr. Stano, the introduction of a new defense expert, Mr. Robert Topel, a labor economist from the University of Chicago, and a new deposition of Dr. Stano. Mr. Topel’s testimony cast further doubt on the BLS data used by Dr. Stano. However, the cross examination of Mr. Lynk demonstrated to my satisfaction that the data used by Dr. Stano were reasonable. Several of the critical numbers had some independent verification. I have also considered Mr. Topel’s criticism but find that the data collection procedures used by the BLS during the relevant time remained consistent enough to be useful in this case.

I do not rely on Dr. Stano’s evidence in isolation. I understand that the data are not the best that could be used for such studies, but the best data, suggested by Mr. Tabor, do not exist. What lends support to Dr. Stano’s results is the very strong evidence of a pervasive, nationwide, effective conspiracy which by its very nature would have affected the demand curve for chiropractic services and adversely affected income of chiropractors. Again, defendants’ economist, Mr. Lynk, agreed that such a conspiracy would shift the demand curve for chiropractic services.

The plaintiffs also established injury to reputation suffered by chiropractors. Both economic experts believed that injury to reputation would constitute an anti-competitive effect of the boycott. See Weiss v. York Hospital, 745 F.2d 786, 806-07 (3rd Cir. 1984), cert. denied 470 U.S. 1060 (1985) (policy denying staff privileges to osteopaths likely to injure their professional reputations). In addition to labeling all chiropractors as unscientific cultists and depriving chiropractors of association with medical physicians, injury to reputation was assured by the AMA’s name-calling practice. For example, in 1973, Dr. Sabatier, an AMA official, described chiropractors cis rabid dogs and killers. Such statements were made in furtherance of the conspiracy and obviously injure reputations.

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