ICA Report to the White House Commission

Stephen Barrett, M.D.
March 12, 2001

The International Chiropractors Association (ICA), which is the second largest chiropractic organization, has submitted a 44-page report titled “Chiropractic Science and Practice in the United States” to the White House Commission Complementary and Alternative Medicine Policy.

The commission was established through an executive order issued in March 2000 by President Clinton. Its purpose was to gather information and issue recommendations about the education and training of practitioners; research into practices and products; provision of reliable information to the public; and access to “complementary and alternative” care.

The ICA’s report, dated February 14, 2001, states that it “focuses on the unique nature of chiropractic as a profession because of the need to fully understand the separate and distinct nature of chiropractic science and practice.” This “separate and distinct” nature is embodied in the following passages taken from various parts of the document:

  • The basic premise of chiropractic science is that abnormalities and misalignments of the spine, defined as subluxation(s) in chiropractic science, can and do distort and interrupt the normal function of the nervous system and may create serious negative health consequences. The correction and/or reduction of subluxation(s) through the adjustment of spinal structures can remove nervous system interference and restore the optimal function of the body.
  • Behavior such as physical and emotional stress, tension, chemical/environmental stress or repetitive motion, over-extension of spinal tissues and/or characteristics such as posture, weight, or even footwear can establish patterns of progressive subluxation that lead to the degeneration of spinal segments.
  • Subluxation(s) have been demonstrated to be present in persons of all ages, from the newborn infant to the most senior citizen.
  • Subluxation is a progressive condition and it is therefore in the patients’ essential interest to have subluxation addressed through the chiropractic adjustment at the earliest moment. Delay in receiving chiropractic care can result in increasingly severe subluxation dysfunction and require an extended period of chiropractic procedures to correct, proportionally prolonged according to duration of the period of neglect.
  • Such early detection and intervention to address emerging subluxation patterns is basic, essential patient care, and is addressed at the routine checkup and prevention visit. When the objective indicators of subluxation show the presence of a defined spinal lesion, the doctor of chiropractic is alerted to the specific anatomical and physiological basis for chiropractic intervention.
  • Periodic chiropractic examinations to determine objectively the presence of subluxation(s) are in the patient’s interest, and are called routine checkups and prevention visits. This is often referred to as maintenance or wellness care. The frequency of the need for such examinations must be determined on the basis of individual evaluation. Such periodic examinations are a vital component of quality basic health care. In the absence of subjective patient complaints of specific symptoms, the doctor of chiropractic must focus on objective measures and fully educate the patient on the status of their condition, and the measures to be taken to achieve optimal health.
  • Only the doctor of chiropractic is professionally competent to evaluate the chiropractic needs of a patient and to determine the level of service appropriate to meet those needs. Chiropractic intervention is indicated in all instances where the objective and/or subjective presence of subluxation can be demonstrated and/or in a setting of routine checkups. Patient needs must be individually determined on the basis of recognized procedures, but the issue of clinical necessity of providing adjustive care shall be based on the presence of subluxation, and/or other structural mis-articulations, which may or may not have yet manifested subjective symptoms.
  • Subluxation is a responsible and credible diagnosis for the doctor of chiropractic and this condition should be recognized and reimbursed as a primary diagnosis by all third-party payment organizations, both public and private.
  • Chiropractic perceives the correction of subluxation at the earliest possible moment as the most basic, essential responsibility of the doctor of chiropractic. The adjustment of the subluxation(s) determined to be present is held by the chiropractic profession to be the unique, fundamental intervention chiropractic has to offer.

In other words, everyone’s health is threatened by spinal problems, which (a) may not have any symptoms, (b) can only be detected by chiropractors, (c) should be searched for and corrected periodically from birth onward, (d) and should be covered by insurance policies. These above passages illustrate why most physicians, physical therapists, and insurance officials have a low opinion of the chiropractic profession.

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This article was posted on March 12, 2001.