Politics Ahead of Patients: The Battle between Medical and Chiropractic Professional Associations over the Inclusion of Chiropractic in the American Medicare System

Young, Kenneth J.

doi:10.3138/cbmh.330-022019

Cited by 6 publications

(6 citation statements)

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“…This lexicon reinforces the separation of chiropractic from other health care professions [8,9]. Promoting chiropractic as alternative rather than complementary or mainstream may be detrimental to patients by deterring or delaying referrals both to and from other health care professionals [10][11][12][13][14]. Barker, Reid, and Lowe [15] listed three different reasons common language was important when communicating information about back pain: 1) patients seeking information from health care professionals may encounter difficulty interpreting health care literature, 2) misunderstandings may arise among health professionals, and 3) a lack of standard definitions can make comparison of research studies challenging.…”

Section: Introductionmentioning

confidence: 79%

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Words matter: the prevalence of chiropractic-specific terminology on Australian chiropractors’ websites

Young

2020

Chiropr Man Therap

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Background: Chiropractors use words and phrases in unique ways to express traditional, chiropractic-specific theories. This lexicon represents concepts that reinforce the separation of chiropractic from other health care professions. It may impact referrals both to and from chiropractors, lead to public confusion about health care issues, and reduce cross-disciplinary research. Therefore, it is important to understand how prevalent chiropracticspecific terms are in publicly available media. Methods: Five chiropractic terms were selected: subluxation, adjustment, vital (−ism/−istic), wellness, and Innate (Intelligence). States and territories in Australia were proportionately sampled according to population of chiropractors using a Google search for chiropractors' private practice websites. The top results were recorded. Websites were word-searched on every publicly available page for the five terms. Context was checked to count only terms that were used to support a chiropractic-specific concepts. The number of occurrences of each term was recorded, tallied nationally and by state/territory. Descriptive statistics were applied to determine prevalence. Results: Three hundred sixty-nine websites were sampled, based on an estimate of 5500 chiropractors practising in Australia. Nationally, 85% of chiropractors used one or more terms. The term adjust (−ing/−ment) occurred most frequently, being found on 283 websites (77%) with a total of 2249 occurrences. Wellness was found on 199 websites (54%) with 872 occurrences; subluxation was found on 104 websites (28%), 489 occurrences; vital (−ism/ −istic) on 71 websites (19%) with 158 occurrences; and Innate was least used, being found on 39 websites (11%) with 137 occurrences. Conclusion: A majority of the Australian chiropractors sampled used one or more chiropractic-specific terms on their websites. Future research should explore the effects of chiropractic language on the public, policy-makers, and other health care professionals.

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Section: Introductionmentioning

confidence: 79%

“…This representation of anti-science separates chiropractic from mainstream health care, yet many within chiropractic would like to be viewed as mainstream and scientific [76,77]. Codification of subluxation theory in American Medicare law has undoubtedly contributed to its perception by some as mainstream [13].…”

Section: Discussionmentioning

confidence: 99%

Words matter: the prevalence of chiropractic-specific terminology on Australian chiropractors’ websites

Young

2020

Chiropr Man Therap

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“…In 1972, chiropractic gained entry to the American Medicare system, based on a subluxation model. However, it was despite this model, not because of it, that chiropractors succeeded [205]. The public relations campaign taken up by the professional associations championed freedom, a powerful idea in American politics, and also resulted in at least a million letters being sent to politicians by chiropractors and their patients, [206] although one source said 3 million [207] and another 12 million [208].…”

Section: Effect Of Vitalism On Integrationmentioning

confidence: 99%

Vitalism in contemporary chiropractic: a help or a hinderance?

Simpson

Young

2020

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Background: Chiropractic emerged in 1895 and was promoted as a viable health care substitute in direct competition with the medical profession. This was an era when there was a belief that one cause and one cure for all disease would be discovered. The chiropractic version was a theory that most diseases were caused by subluxated (slightly displaced) vertebrae interfering with "nerve vibrations" (a supernatural, vital force) and could be cured by adjusting (repositioning) vertebrae, thereby removing the interference with the body's inherent capacity to heal. DD Palmer, the originator of chiropractic, established chiropractic based on vitalistic principles. Anecdotally, the authors have observed that many chiropractors who overtly claim to be "vitalists" cannot define the term. Therefore, we sought the origins of vitalism and to examine its effects on chiropractic today. Discussion: Vitalism arose out of human curiosity around the biggest questions: Where do we come from? What is life? For some, life was derived from an unknown and unknowable vital force. For others, a vital force was a placeholder, a piece of knowledge not yet grasped but attainable. Developments in science have demonstrated there is no longer a need to invoke vitalistic entities as either explanations or hypotheses for biological phenomena. Nevertheless, vitalism remains within chiropractic. In this examination of vitalism within chiropractic we explore the history of vitalism, vitalism within chiropractic and whether a vitalistic ideology is compatible with the legal and ethical requirements for registered health care professionals such as chiropractors. Conclusion: Vitalism has had many meanings throughout the centuries of recorded history. Though only vaguely defined by chiropractors, vitalism, as a representation of supernatural force and therefore an untestable hypothesis, sits at the heart of the divisions within chiropractic and acts as an impediment to chiropractic legitimacy, cultural authority and integration into mainstream health care.

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“…Interrogation of chiropractic history suggests a lapse of emphasis on patient-centeredness, a deficiency in social justice and public health behavior, and instead, prevalent engagement in market justice behavior [3,4]. Young, a chiropractic academic who has explored political influences on the chiropractic profession in the American health care system, contends that as chiropractic has fought for legitimacy, recognition, and market share, it has at times focused more on the interests of the profession than on public interests [4]. Young asserts that chiropractors' "perspectives may be altered by indoctrination in a belief system, or misinformation, so that a [chiropractor] could be confused about the reality of patient needs."…”

Section: Introductionmentioning

confidence: 99%

“…Young asserts that chiropractors' "perspectives may be altered by indoctrination in a belief system, or misinformation, so that a [chiropractor] could be confused about the reality of patient needs." [4] The aim of this paper is to explore the role of the chiropractor as an agent of neoliberal ideology which compromises patient care and is in direct conflict with the public's trust built on professionalism. We also offer strategies to aid in shifting the chiropractic practice from a market justice model toward a social justice model.…”

Section: Introductionmentioning

confidence: 99%

The Manchurian candidate: chiropractors as propagators of neoliberalism in health care

2020

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The rise of neoliberalism has influenced the health care sector, including the chiropractic profession. The neoliberal infiltration of market justice behavior is in direct conflict with the fiduciary agreement to serve the public good before self-interests and has compromised the chiropractor, who now may act as an agent of neoliberalism in health care. The purpose of this paper is to present an overview of the impact of neoliberalism on the chiropractic profession and provide recommendations for a professional philosophical shift from a market justice model to a communal and social justice model.

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Politics Ahead of Patients: The Battle between Medical and Chiropractic Professional Associations over the Inclusion of Chiropractic in the American Medicare System

Abstract: For more information about UCLan's research in this area go to http://www.uclan.ac.uk/researchgroups/ and search for .

Cited by 6 publications

References 15 publications

Words matter: the prevalence of chiropractic-specific terminology on Australian chiropractors’ websites

Words matter: the prevalence of chiropractic-specific terminology on Australian chiropractors’ websites

Vitalism in contemporary chiropractic: a help or a hinderance?

The Manchurian candidate: chiropractors as propagators of neoliberalism in health care

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