ACA has delivered the following response to the unfortunate editorial in the Tallahassee Democrat: March 11, 2004 Letters to the Editor Tallahassee Democrat 277 North Magnolia Drive Tallahassee, FL 32301-2695 To the Editor: Jann Bellamy's March 9 editorial, "Chiropractic School Out of Alignment with Taxpayer Interests," is in fact out of alignment with the truth. Her premise that chiropractic care is somehow at odds with science ignores not only the research supporting chiropractic, but also our nation's increasing trend toward an integrative model of health care. Neither medical doctors nor doctors of chiropractic have all the answers, and either discipline would be foolish to claim that they do. But as science moves forward, chiropractic care is achieving more and more integration into today's health care system. The prestigious Texas Back Institute, for example--the largest freestanding spine specialty clinic in the United States--once included only surgeons and other medical doctors in its program of care. But after the institute's medical doctors discovered chiropractic's success with low back pain, they hired their first doctor of chiropractic. Now, about 50 percent of the institute's patients see a chiropractor first when beginning their treatment. Just a few other notable examples of chiropractic integration include the chiropractic department at the National Naval Medical Center in Bethesda, MD, the successful Complementary and Alternative Medicine Center at the National Institutes of Health, and the availability of chiropractic services to members of Congress and the Supreme Court at the Office of the Attending Physician at the U.S. Capitol Building. And while Bellamy does not appear concerned with reporting facts about the efficacy of chiropractic care, I do feel your readers are entitled to the truth. In 1994, the Agency for Health Care Policy and Research (AHCPR), a branch of the U.S. Department of Health and Human Services, developed recommendations on the treatment of acute low-back pain based on clinical evidence and extensive searches of the existing scientific literature. AHCPR's findings concluded that spinal manipulation was "safe and effective," recommending it as an initial form of therapy for acute low-back pain. More recently, a panel of 25 multidisciplinary experts concluded that spinal manipulation resulted in almost immediate improvement for cervicogenic headaches, or those that originate in the neck, and had significantly fewer side effects and longer-lasting relief of tension-type headache than a commonly prescribed medication. Bellamy's imprudent attempt to diminish the significance of back pain and headaches is ironic, as these two afflictions were recently cited in the Journal of the American Medical Association (JAMA) as the leading reasons for lost productivity and absenteeism in the workforce--costing our country more than $61 billion each year. Doctors of chiropractic are specifically and uniquely qualified to diagnose and treat problems of the musculoskeletal system, with an education that includes more than 2,000 hours of study devoted to the human spine and nervous system. Conversely, a 2002 study published in the Journal of Bone & Joint Surgery found that 78 percent of medical doctors failed to demonstrate basic competency in musculoskeletal medicine and that medical school preparation in musculoskeletal medicine is "inadequate." Facts such as these may help to explain the aforementioned trend toward clinical integration. Bellamy's misguided depiction of the rigorous education and training involved in becoming a doctor of chiropractic demands a correction. Educational requirements for doctors of chiropractic are among the most stringent of any health care profession. The typical applicant at a chiropractic college has already acquired nearly four years of pre-medical undergraduate college education, including courses in biology, inorganic and organic chemistry, physics, psychology and related lab work. Once accepted into an accredited chiropractic college, the requirements become even more demanding--four to five academic years of professional study are the standard. And because of the hands-on nature of chiropractic and its intricate adjusting techniques, a significant portion of time is devoted to clinical training. In some areas, such as anatomy, physiology, rehabilitation, nutrition and public health, doctors of chiropractic receive even more intensive education than their MD counterparts do. In total, the chiropractic curriculum includes a minimum of 4,200 hours of classroom, laboratory and clinical experience. This extensive education prepares doctors of chiropractic to diagnose health care problems, treat the problems when they are within their scope of practice and refer patients to other health care practitioners when appropriate. As members of the various health care disciplines continue to abandon their antiquated biases--such as those espoused by Jann Bellamy--the best interests of patients everywhere will win out. Sincerely, Donald Krippendorf, DC President, ACA