Not Just Back Talk by Crick and Crack: Medicine and Chiropractic – Part 5
This is the fifth article in a series looking at the relationship between the medical and chiropractic professions. As we have discussed, the story dates back to the 1500’s and the Renaissance and eventually resulted in a lawsuit (Wilk v AMA) against the American Medical Association in 1976. Last week we looked at the well-documented plot by the AMA to boycott the chiropractic profession.
On August 27, 1987, Judge Susan Getzendanner found for the plaintiffs Chester Wilk et al, and issued a permanent injunction against the American Medical Association. It ordered the AMA to remove the barriers preventing medical doctors from referring to and receiving referrals from chiropractors, and those preventing medical doctors from teaching in chiropractic colleges, among other things. The court ruled that the purpose of the AMA’s boycott was to eliminate chiropractic and that although the conspiracy ended in 1980, there were lingering effects of the illegal boycott. One example is the Medicare program, which when established attempted to exclude chiropractic. Due to massive lobbying by chiropractic patients in 1973, chiropractic was ultimately included in the Medicare Act, albeit in an extremely limited capacity. However, even now, despite the fact that chiropractors are reimbursed by every other insurance company for a multitude of procedures, Medicare still only reimburses for manipulation of the spine. Though required by Medicare to perform a consultation and examination to determine the need for treatment, ironically this service is not reimbursed by Medicare. In addition, chiropractic x-rays performed in a hospital for Medicare patients are only reimbursed when ordered by a medical physician. This example illustrates the fact that misinformation can, 60 years later, have lingering effects.
The good news is that, because of the Wilk lawsuit and its outcome, things have changed. I graduated from chiropractic college in 1980 and began my practice in St. Johnsbury that same year. I encountered both professional welcome and outright prejudice. Our local hospital was completely agreeable to performing x-rays I ordered, while another nearby hospital refused not only to perform x-rays I requested but even to release x-rays to me, even though they were required to do so by law. An orthopedic surgeon in New Hampshire likewise refused to release x-rays, but within 10 years that same surgeon referred patients to our office for treatment. In my first 10 years of practice I received two medical referrals; at present more than a third of the new patients seen in our office each week are medical referrals, accompanied by introductory letters and office notes.
One of my best friends from high school, valedictorian of his class, went on to attend Georgetown Medical School in 1981. His first month where he attended a class in which the professor began to denigrate chiropractors. He stood up and reminded the professor that as first-year medical students they were an impressionable audience, and advocated for open-mindedness and mutual respect of other professions. 37 years later our clinic now regularly has medical students spend days in our office observing evaluations and treatments as part of their clinical medical rotations with Dr. Joyce Dobbertin. Both doctors in our office have adjunct staff privileges in 6 hospitals, regularly ordering x-rays, blood work, CAT scans, and MRIs. We refer to medical offices and medical specialists within a 75-mile radius.
The beneficiary of all this mutual cooperation between medical and chiropractic physicians is THE PATIENT. Instead of barriers preventing association between practitioners, we now have conduits, including electronic medical records, to facilitate communication between practitioners so that patients can obtain efficacious, cost-effective, and appropriate care. A shining example of this was a recent study performed by the Veterans Administration, the largest of its kind, which analyzed treatment for veterans in two groups: those treated by medical practitioners only, and those treated by a team of medical and chiropractic practitioners. Those in the second group experienced significantly better outcomes, as well as greater satisfaction with care both on the short-term and long-term. As a result, Congress recently passed a law requiring that by 2021 all VA facilities will have chiropractic services available for veterans. None of this would have happened without the Wilk lawsuit.
We hope you enjoyed this 5 part series and found it interesting and informative, and that it helped you, our readers, understand how chiropractic has come to be so widely accepted today.
Have a safe and healthy Summer!
Yours in health,
Crick and Crack
Dr. Thomas Turek grew up in New Jersey and attended Rutgers University and New York Chiropractic College. He has practiced in St. Johnsbury for over 35 years, and lives in Waterford with his wife Dorothy. Dr. Travis Howard grew up in Rantoul, Ill. He was a medic in the Air Force for eight years. He attended University of Maryland European Division, Illinois State University, and Logan College of Chiropractic. He lives with his wife and three sons in Littleton, N.H. To submit a question for the column, email email@example.com.