Motivation or Mirage ­ The New Face of Chiropractic
By W. John Cox, D.C.

Recently, a Chiropractic collegeıs first trimester class reported that only 4 of the 46 
students enrolled had ever been to a chiropractor or experienced a chiropractic adjustment.  
Forty two of the students chose to become a chiropractor upon the advice they received 
from career counselors, guidance counselors or information they read on the growth of the 
"alternative care industry" whereby chiropractic was considered a good profession.

I remember sitting in the orientation class at Palmer College of Chiropractic in 1979.  A 
faculty member asked, "How many of you have never been to a chiropractor?"  Only a 
couple of hands went up in a class of 200 students.  Several of us commented on our 
amazement and disbelief that anyone would venture into this profession without some 
kind of personal experience involving a chiropractic adjustment.  Several of my 
classmates, like myself, had a relative who was a chiropractor and at some level we 
understood the reality and benefits of a lifetime of chiropractic care.  Others related their 
personal testimony of what chiropractic care had done for them and how it had changed 
their lives.  A few had enrolled having made the decision to change careers in their 30ıs 
and 40ıs after their personal chiropractor impressed them with his or her care and related 
how rewarding chiropractic can be both personally and financially.

In the early years of chiropractic, our profession was seldom a career choice driven by 
career or guidance counselors.  I would guess that this is only a phenomenon in more 
recent years.  In the past, the motivation to become a chiropractor was most often 
personal; a chiropractic experience that in some way sparked an interest or understanding 
that Chiropractic was better or bigger than any other career choice.

Certainly there has always been an attraction to chiropractic from a financial standpoint.  
Dr. Gonstead often said, "Never worry about the money (because he knew it would come 
and be plentiful), the money will take care of itself if you concentrate on helping the 
patient and never refuse to care for a patient based on their inability to pay."  Yes, the 
financial rewards gained by establishing a successful chiropractic office are substantial and 
it would be foolish to say anyone, including Dr. Gonstead, who made a career of 
chiropractic has not enjoyed the financial benefits of it.  However, if you consider that 
todayıs student enters the profession based on statistics that claim chiropractic is a good 
business opportunity, the motivation factor for success in chiropractic also has to change.  
Gone is the motivation to enter the chiropractic profession with the predominant desire 
to learn and develop the skills to duplicate a chiropractic miracle.  Todayıs student is 
aspiring to and is given a whole new business model for chiropractic success that defines 
success in terms of financial goals rather than clinical goals.

I do not want to sound archaic as I am only in my 23rd year of practice, but when I 
graduated, we believed and understood that the way to build a successful practice was to 
get positive results with a patient and get the results fast. We were led to believe that 
while we were in chiropractic school, we needed to seriously devote long hours to the 
development and refining of our skills in motion palpation and adjusting.  Everyone told 
us that the "art" of chiropractic takes years to develop and the sooner we began practicing 
and developing these skills the better off we would be after graduation.  We believed that 
when we opened our practice after graduation, the vast majority of our success hinged on 
our ability to find and correct subluxations and achieve positive results.  And amazing as 
it may seem, many of us have built very successful practices and made a wonderful life 
based solely on this primitive concept.  Actually, up until the mid-seventies, virtually all 
of our profession grew and expanded based upon the simplicity of this concept:  "Thereıs 
too little or too much of functionŠAlways suspect a neuritis firstŠFind the 
subluxationŠAccept it where you find itŠAdjust itŠand then, Leave it aloneŠand all 
else follows."  Yes, the foundation of our profession seems so simplistic, yet once 
undertaken; it is so very demanding and so very, very powerful!

It was the "Truth of the Principle" that drove the early practitioner.  I include some of the 
younger generations in more recent years in that group, but unfortunately, an ever 
dwindling number of graduates enter practice today driven by "The Principle" of 
chiropractic.  But is it any wonder, our profession has taken great strides to move young 
chiropractors away from the original premise of chiropractic and move all of us closer to 
the medical model of care and education.  And all for one reason; we wanted to be 
accepted.  Today our chiropractic leaders want to be judged by standards established by 
the medical bureaucracy rather than sticking to the principles and truths brought forth by 
our founders.  They must return to the realization that when the original chiropractic 
principles are understood and applied, they are far superior to the medical model when it 
comes to health, wellness or the understanding of "dis-ease."  

But then again the modern chiropractic university has become a business.  A business 
motivated by funding rather than adhering to the teaching of chiropractic.  The current 
belief held by the health science business administration is that if they present the illusion 
of medical acceptance and the curriculum of a medical education, this will more effectively 
seduce the prospective chiropractic student to enroll in their university.  I doubt that 
enrollment would be very high in todayıs market if the career counselors told prospective 
chiropractic students that they had a good chance of going to prison following graduation.  
What if a career counselor said, "Yes, Chiropractic is the correct model for health care.  
Yes, chiropractic has the ability to change the world.  Yes, chiropractic is based on 
scientifically researched facts.  Yes, chiropractic is a universal truth!  And yes, you 
should bring this truth to the masses.  So why donıt we get you signed up for our 
chiropractic college?  Oh, I should probably mention that because chiropractic is not 
condoned by the medical community and their law makers, you may go to prison for 
trying to bring forth this truth to your patients after you graduate.  Shall we sign you 
up?"  Todayıs health universities have sold out the principles of chiropractic and the 
heroic efforts of our forefathers for the sake of conformity and acceptance. 

The passion for our profession, which was based on clinical experience and results, has 
been replaced by instructors who have never practiced, failed in practice or who were 
forced into teaching by the Council on Chiropractic Education because they have a PhD 
degree, often with zero knowledge or understanding of chiropractic or its application 
clinically.  Meanwhile the modern instructor and student anxiously await the impending 
news from chiropractic researchers who define the scope of practice based on "evidence 
based" research.  Nauseating!  

This is not to say that the need for research is not important for the continued credibility 
and scientifically-proven clinical benefits of our profession, but the spread of chiropractic 
around the world over the last 110 years had nothing to do with evidence-based research.  
Chiropractic has survived and has been built upon results and patient referrals.  The only 
evidence we need as chiropractors is the evidence that a patient has a subluxation.  
Chiropractic is a truth, and someday research will explain in the scientific and academic 
circles what millions of patients have known all along.  Patient results are simply the 
manifestation of the truth that encompasses the Philosophy, Science and Art of 
Chiropractic.

Chiropractic is not just a technique or another form of therapy; it is an understanding of 
"how things work."  BJ said, "Chiropractic is an interpretation of natural law, if you work 
with that natural law that law will work with you."  DD said, "Chiropractic is a 
philosophy, science and art of things natural; a system of adjusting the segments of the 
spinal column by hand only, for the correction of the cause of dis-ease."  Today, less than 
50% of the chiropractic colleges teach any chiropractic philosophy.  The understanding of 
the "why" of what we do was the primary reason students entered chiropractic school in 
the past.  Unless you understand the "why", chiropractic becomes just another treatment 
in the world of therapies for a patientıs problems.  Today, chiropractic is being taught as 
a "treatment", just another tool used by the alternative health care provider.  

Chiropractic is the only form of alternative care that is not a therapy.  Therapies are 
provided by medicine, osteopathy, acupuncture, massage and homeopathy, but never by 
chiropractic.  We do not approach a patient with the intent of administering or applying a 
remedy for a named disease, in fact, we do not "treat" any diseases.  DD Palmer explained 
this back in 1910, "The Chiropractor traces disease directly to its cause, which is an 
interference to the normal transmission of current between the brain and the tissues and 
organs diseased.  The cause of disease is an interference to the normal transmission of 
current.  Remember we do not treat the effect of disease, but we adjust the cause.  Why 
not say, we do not treat disease or its symptoms; we adjust causes."

"We adjust causes."  Todayıs student learns that the adjustment, the "art" of chiropractic, 
has been redefined as a manipulation.  The ACA regularly sponsors a "Conference on 
Spinal Manipulation" for our profession.  They hold that the term manipulation is 
synonymous with adjustmentŠit is NOT!  Manipulators do not stop!  The competent 
chiropractor knows where to adjust, when to adjust, how to adjust and when to leave it 
alone and STOP!  Manipulators do not stop, it is a treatment to them that will progress 
through a predetermined number of visits or until the insurance company will no longer 
pay.  The chiropractic adjustment is given for a reason and it is also NOT given for a 
reason.  It is never randomly applied or routinely repeated on patients in a predetermined 
formulated manner.  The adjustment and its frequency is case specific for each patient and 
should be conservatively administered relying on the protocol and evaluation ascertained 
through instrumentation, palpation, motion palpation and spine-o-graphs.  Do you see 
the difference?

"A Chiropractor to B.J. was a man who applied the philosophy, science and art of 
Chiropractic to an ailing body.  B.J. knew that for Chiropractic to succeed in the eyes of 
the scientific world, Chiropractors would have to confine themselves to the spine --- the 
premise --- and by using their hands as the word implied."  From Healing Hands by 
Joseph Maynard.

"Chiropractic Philosophy is the explanation of Chiropractic.  It explains "the why" of 
everything Chiropractic.  The explanation of cause and effect.  It embraces the 
Chiropractic view of all the studies concerned in its science."  R.W. Stephenson, D.C. 

For the modern day chiropractic student, most of our chiropractic institutions have 
removed the original language and philosophy from the curriculum in an attempt to move 
closer to the medical model.  Perhaps the schools have done this knowing that throughout 
history, if any society forgets or is forced by policy to forget where it came from, that 
society will eventually perish.  Chiropractic colleges have been replaced by Universities 
of Health Science and these schools have replaced chiropractic philosophy with 
chiropractic history and banned the use of terms like subluxation and innate intelligence 
from their curriculum.  This same thought process has propagated itself beyond the walls 
of the chiropractic institutions as "chiropractic physicians" graduate and infiltrate local, 
state and national chiropractic organizations.  Thanks to modern chiropractic education, 
several states have pigeon-holed and re-defined chiropractic as care for localized neck and 
low back pain.  Radiating pain in an extremity, herniated disks, compression fractures, 
visceral pain and dysfunction, mental conditions, MS, Bellıs palsy, cerebral palsy and 
most every other named condition are now beyond the scope of chiropractic care.  
Chiropractors have been redefined and even renamed, some members of our profession 
prefer the term "manual therapist" as a replacement for the title of chiropractor.  Now 
you may be thinking this is nothing more than an argument in semantics.  Yes, it is all 
about semantics!  It is about a unique philosophy and lexicon that was meant to be 
separate and distinct from all other forms of health care.  But the sad reality for todayıs 
chiropractor is that our current chiropractic leaders have forsaken what DD and our 
forefathers had hoped and envisioned for this great profession.

The latest issue of The American Chiropractor (www.amchiropractor.com) features a 
college perspective from the President of National University of Health Sciences, Dr. 
James Winterstein.  Dr. Winterstein was also the past president of CCE where he helped 
regulate the current standards of education in the chiropractic colleges.  Dr. Winterstein 
states, "I think the chiropractic profession is perilously close to an unstoppable decline, if 
some clear leadership decisions arenıt made soon.  The broad scope practitioners must 
take a stand on how our profession should be educated and should practice."  He further 
states that his leadership "will continue to provide a solid foundation in diagnosis and 
broad scope natural medicine oriented chiropractic care, which is centered on solidly 
taught articular manipulation.  We promote integration of chiropractic medicine into 
mainstream health care systems."  He goes on to state that the strength of his health 
university education is because, "we provide a broad scope primary care based education 
through which any graduate can choose to engage in a general practice or to specialize on a 
firm and thorough foundation in diagnosis and chiropractic care."

A graduate can choose to engage in a general practice?  What will they do?  Diagnose and 
refer?  I should mention that I had a run-in with Dr. Winterstein back in the late 1980ıs.  
While helping to get a Gonstead club started on his campus, I realized that he had issues 
about what he wanted to be when he grew up and these same issues are even more evident 
today.  Because of his inability to understand the vastness of chiropractic, Dr. 
Winterstein has draped the veil of illusion in front of far too many people in an effort to 
rewrite and redefine his version of chiropractic.  You cannot redefine the truth.  However, 
you can teach your belief system to an unsuspecting student population and create a 
mirage of how chiropractic is to be defined.

Students are taught to believe that to be successful in practice it is necessary to integrate a 
variety of approaches to patients.  The primary focus of specifically finding and fixing a 
subluxation using hands only may not be enough.  Do not get me wrong or think that I 
believe that the adjustment is the only answer to a patientıs health concerns.  A 
chiropractor must know when to share a patientıs case and recommend further studies or 
care alternatives beyond the adjustment.  However, to focus on the patient from the point 
of a chiropractor, checking for a subluxation and nerve interference and then have the 
ability to specifically, masterfully and precisely correct only that subluxation with hands 
onlyŠthat my friend, takes a lifetime of dedication.  That is what makes being a 
chiropractor so hard.

But remember, todayıs chiropractic students are confused as to exactly what chiropractic 
is or what it is supposed to represent in their scope of practice following graduation.  So 
as a chiropractic institution deals with confused students, the decision has been made to 
simplify understanding and the practice of chiropractic.  Todayıs chiropractic education 
provides a variety of alternative care applications and teaches that most patients need far 
more than just an adjustment.  In order to make the adjustment easier, oops, I mean the 
manipulation easier; a mechanical device is available that will make the adjustment.  
Simply pull the trigger or push the button.  So with a variety of treatments to offer 
patients, the educational emphasis taught to the patient, which is based on the medical 
model of health and the availability of a machine to produce the manipulation, there is 
only one thing left to help make a successful chiropractor; that is, a scripted dialogue the 
graduate can read and memorize to help communicate/convince patients that the advice 
and treatment plans recommended are legitimate and critically necessary.  Enter the 
practice management organizations.

A young man, who became very successful using the Gonstead System in his office, 
wrote me a letter a few years ago.  He wanted to let me know why he decided to change 
his office procedures, moving to the "open adjusting room" concept and joining a practice 
management organization.  He felt that his life in chiropractic had become such a grind, 
dealing with patients everyday while trying to focus on providing rapid clinical results.  A 
patient would enter his office with a complaint and he felt that it was his duty to help 
alleviate that complaint and improve the patientıs condition.  But it created a constant 
stress in his life.  After joining a practice management organization, his new approach 
took him away from focusing on the patientıs chief complaint and changed his focus to 
rehabilitating their spine.  Correction of the spinal curves, packaged with scripted dialogue 
that convinced the patient to commit to at least a year of chiropractic care, prepaid of 
course, all helped to remove the challenge of feeling the necessity to produce immediate 
clinical results.  He went on to say that if results did happen in short order for the 
patient, it was a bonus for the patient.  However, his job as a chiropractor was to restore 
the proper curves to every patientıs spine as best as he could and to the limits the spinal 
column would allow.  But he felt that the best part of the management program was that 
he was taught what to say to every patient and when to say it.  Once the patient 
committed both verbally and financially to a yearıs worth of care, he felt less pressure 
being a chiropractor.  He no longer talks about symptomatic results with his patients or 
his peers.  Instead he now talks about what wonderful pre- and post- spinal changes he 
has witnessed on some of the x-rays of his patients.

I have read this management firmıs scripted dialogues. I have heard their leader speak and 
yes, he is dynamic and seems to be a very principled chiropractor.  He speaks of 
chiropractic philosophy but it is intermingled with slick ways to make the patient 
understand and agree to the dangers of a subluxation and why that patient should jump at 
the chance to sign up for a yearıs worth of care.  Lessons are given on how to give a 
report of findings that will physically make the patient sick and make them so anxious 
they cannot wait to sign up and begin the process of removing those "major" 
subluxations.  Of course, the report of findings should be given in a very small room 
which makes the patient feel very uncomfortable, while the D.C. explains the dangers of 
the silent killer known as the subluxation.  The doctor must drop his head, look down at 
the floor, take a long pause and then deliver the bad news,  "Mrs. Jones, weıve found 
three major subluxations in your spine, two of which are life threatening."  (Long pause 
and hope that the patient begins to sweat or panic and reach for their checkbook.)  

It is apparent that in chiropractic there are two groups of people that become "Hyper-
Philosophical" about our profession.  These groups of individuals who master quoting the 
Green Books or attempt to present the Big Idea of chiropractic always seem to be either 
practice management organizations or HIO practitioners.  However, when these people 
use philosophy to the extreme to justify the over-utilization of chiropractic care or to 
rationalize one adjustment on one segment as the only chiropractic approach (Iım not 
talking about results), look very closely to their motivation and their rationale.  The 
bottom line to any practice management organization is to see the same patient more 
often and convince them through scripted dialogue of the benefits of chiropractic care and 
the urgency with which they need to begin and remain on care.  They give the patient a 
game plan that equals 90 plus visits the first year.  Then, into the second or third month 
of care, a new x-ray is taken which is followed by a second report of findings.  At that 
point, the patient is given the continued bad news that they are not demonstrating the 
progress the doctor had hoped for in their case.  They are subsequently signed up for an 
additional yearŠpre-paid of course.  Take the performance out of chiropractic, take the 
results out of chiropractic and it is possible to make a mediocre to poor chiropractor 
financially successful.  All the management companies need to do is teach the fledgling 
chiropractor how to "sell" the big idea of chiropractic regardless of adjusting skills or the 
ability to produce any clinical results.  Hallelujah, the future is here and the profession is 
saved!

Again just semantics, just another way for the management companies to rationalize and 
justify their unethical and criminal actions.  Unsuspecting chiropractors can be seduced 
into accepting these management company protocols when belief and conviction reach a 
level of understanding congruent with the managementıs opinion of what is best for both 
the patient and the profession.  If you believe, the mirage can become reality and the 
conviction in your actions becomes legitimate and ethical.  Ah, but perhaps my thinking is 
just tainted or antiquated.  Arenıt these organizations still getting the big idea of 
chiropractic to more people and helping the masses?  Anything in life can be justified or 
rationalized.  You put the "con-job" words in the right order with the right amount of 
ethical/philosophically-based quotes, have it delivered by a dynamic speaker who can 
convince anyone that their motives are reasonable and ethicalŠand those who fear the 
unknown or dream of more will show up for the coaching.  It is a well-known fact that 
two out of three people suffer from low self-esteem and more than half of any graduating 
chiropractic class will never make it in practice.  Our profession is stock piled with 
individuals filled with fear looking for anyone to lead them by the hand and show them 
how to make it without skill or hard work.  But rest assured, everything goes full circle 
and eventually the future of chiropractic will come back to clinical results with patients 
who experience the wonders of chiropractic ethically.  Patients will ultimately realize the 
facade of the management mirage and will seek and refer their family and friends to those 
chiropractors who care for them like humans, not like cattle.

Palmer College recently adopted a new mechanical adjusting device called the Pro 
Adjuster.  The use of the Pro Adjuster is an elective course in the Palmer curriculum but 
offers another new definition of chiropractic adjusting that can now be used by students 
in the Palmer clinic.  "If you are looking for the perfect spinal analysis, the perfect 
treatment, and the perfect adjustment ­ one that is on target, precise, and easy on the 
body every time ­ one that is painless, with no popping or cracking noises, yet highly 
effective, then the Pro-Adjuster is the ideal solution for you."  This statement comes from 
the Pro-Solutions for Healthy Living magazine produced by the marketers of the Pro 
Adjuster.  This is just one more example of our profession making life easier on the new 
and impressionable chiropractic student.  Since we have taken away the old dogmatic 
philosophy and replaced it with new slick scripted dialogue to memorize and regurgitate 
to the patient, we might as well take away the art and talent required to give a chiropractic 
hands-on adjustment, right?  Over 80 years ago, Dr. R.W. Stephenson wrote about and 
recognized the frustrations associated with learning to master the skills necessary to give a 
hands-on adjustment: "Poor chiropractors are apt to substitute machinery for 
knowledge."  

If everyone in the world had a subluxation at the level of C7, each and every one of those 
C7 subluxations would require a unique and different amount of lift, line-of-drive and 
depth of thrust to achieve the best possible correction.  A "feel" is required that can only 
be accomplished through the hands of a skilled chiropractor.  Using a mechanical adjusting 
device only cheapens the art of the adjustment and helps define a poor chiropractor.  To 
develop the art of giving a professional hands-on adjustment is no different than the time 
and effort required to become a professional dancer, golfer or musician.  Very few 
individuals will devote the time or make the commitment to reach the professional level of 
excellence required to publicly demonstrate and receive a fee for their art form.  That is 
why very few amateur dancers, athletes or musicians ever actually make it to the 
professional level of excellence.  Giving a hands-on adjustment is hard; if it was easy, 
everyone would be doing it. Instead, individuals opt for manipulation, mechanical devices 
or physical therapy to fill the void and lack of adjusting talent.  Dr. Gonstead said, 
"Anyone can become a physical therapist, a manipulator or a medical doctor, but it is 
hard to become a chiropractor."  

But it is the HARD that makes chiropractic great!  

These arguments are nothing new to our profession as everything goes full circle.  Just 15 
years after the birth of chiropractic, DD Palmer wrote in The Science, Art and Philosophy 
of Chiropractic, "When Chiropractic was an infant I jealously watched its development 
and growth.  But there came a time when unprincipled shysters tried to change its 
principles.  There are many claiming to practice chiropractic who know but little of it as a 
science."  Unfortunately, we may all come to realize that over the next few decades there 
will be a new breed emerging from "Health Science Universities" that present themselves 
to the general public as chiropractors.  But these new "chiropractors" will only be a 
mirage.   

Chiropractic as we know it and as defined by our founders will be gone in these new 
universities.  Graduates will continue to be given the right to use the term Œchiropracticı as 
an umbrella to practice everything but chiropractic.  Under this umbrella, they will use 
mechanical adjusting devices, traction, defined as a Œslow adjustment,ı massage, physical 
therapeutics, acupuncture, colonics, etc.  Then they will expose the new graduate to 
management companies that teach tactics of fear and persuasion as the keys to more 
patient visits and financial success and voila, the new face of chiropractic! 

Perhaps you feel these issues may not affect you or your practice and it is just a fact 
within our profession that chiropractors have always been their own worst enemy.  Even 
though this is true, there are those outside of chiropractic who have realized the benefits 
and value of manipulative therapy.  It will affect you sooner or later if you allow yourself 
or the young chiropractors of today to buy into the concept that the adjustment and 
manipulation are synonymous and the only purpose of spinal manipulation is to improve 
spinal biomechanics.  This is the mirage of reality currently being taught to the young 
chiropractor of today and this reality lowers chiropractors to the same playing field as 
osteopaths, physical therapists or anyone else who offers a manipulation.  Remember, 
there will always be chiropractors but there may not always be chiropractic.

DD Palmer recognized the necessity for distinction from manipulators in 1910.  He said, 
"instead of using the thumb and finger when making an adjustment, I use both hands 
combined.  The Paris doctors give the back bone a general overhauling, very similar to the 
Osteopaths, whereas I adjust only one vertebra, making the adjustment direct and 
specific, the difference being that one move adjusts, while the other manipulates, the 
dissimilarity indicates that one of the methods must be an improvement upon the other."  
He went on to say, "Chiropractic is specific; in saying this, I do not refer to those who 
know but little of it as a science.  Osteopathy in its practice of contraction, relaxation, 
extension, rotation and counter-extension is neither specific nor direct."

So beyond the internal efforts that exist in our own profession to change the definition of 
chiropractic to the level of manual therapist, what other organizations are competing for 
the right to manipulate?  Here is the vision statement of the American Physical Therapist 
Association:  

"Physical therapy, by 2020, will be provided by physical therapists who are doctors of 
physical therapy and who may be board-certified specialists. Consumers will have direct 
access to physical therapists in all environments for patient/client management, 
prevention, and wellness services. Physical therapists will be practitioners of choice in 
clients' health networks and will hold all privileges of autonomous practice. Physical 
therapists may be assisted by physical therapist assistants who are educated and licensed 
to provide physical therapist-directed and -supervised components of interventions. 
Guided by integrity, life-long learning, and a commitment to comprehensive and accessible 
health programs for all people, physical therapists and physical therapist assistants will 
render evidence-based service throughout the continuum of care and improve quality of 
life for society. They will provide culturally sensitive care distinguished by trust, respect, 
and an appreciation for individual differences. 
While fully availing themselves of new technologies, as well as basic and clinical research, 
physical therapists will continue to provide direct care. They will maintain active 
responsibility for the growth of the physical therapy profession and the health of the 
people it serves."
Or, here is how they define what a physical therapist does:  
"The cornerstones of physical therapist treatment are therapeutic exercise and functional 
training. In addition to "hands-on" care, physical therapists also educate patients to take 
care of themselves and to perform certain exercises on their own. Depending on the 
particular needs of a patient, physical therapists may also "mobilize" or "manipulate" a 
joint (that is, perform certain types of movements at the end of your range of motion) or 
massage a muscle to promote proper movement and function. Physical therapists also use 
methods such as ultrasound (which uses high frequency waves to produce heat), hot 
packs, and ice. Although other kinds of practitioners will offer some of these treatments 
as "physical therapy," itıs important for you to know that physical therapy can only be 
provided by qualified physical therapists or by physical therapist assistants, who must 
complete a 2-year education program and who work only under the direction and 
supervision of physical therapists."
And here is a recent research article that physical therapists have conducted:   
Clinical Prediction Rule Identifies Patients with Lower Back 
Pain who will Benefit from Spinal Manipulation
ALEXANDRIA, VA, Dec. 21, 2004 -- A patient's status on a clinical prediction rule for 
low back pain indicates the likelihood of successful outcome from spinal manipulation 
treatment, according to a study recently published this month in the Annals of Internal 
Medicine. 
Physical therapist Maj John D Childs, PT, PhD, of Wilford Hall Medical Center, 
Lackland Air Force Base, Texas, and other physical therapist researchers have validated a 
clinical prediction rule that determined the likelihood that a patient with low back pain 
will benefit from spinal manipulation. Factors in the prediction rule include symptom 
duration, symptom location, fear-avoidance beliefs, lumbar mobility, and hip rotation 
range of motion. The best results were from those patients who were positive on the rule, 
defined as meeting at least 4 out of 5 criteria. 
"Attempts to identify effective interventions for individuals with low back pain have 
been largely unsuccessful, especially where spinal manipulation is concerned," Childs 
explained. "Conflicting conclusions may be attributable to the failure of researchers to 
adequately consider the importance of classification. Developing methods for matching 
patients with low back pain to treatments that are most likely to benefit them is an 
important research priority." 
The study examined 131 patients with low back pain, 18 to 60 years of age, who were 
referred to care provided by physical therapists. Patients were randomly assigned to 
receive physical therapy that included two sessions of high-velocity thrust spinal 
manipulation plus an exercise program (manipulation group) or an exercise program 
without spinal manipulation (exercise group). During the first two sessions, patients in 
the manipulation group received high-velocity thrust spinal manipulation and a range-of-
motion exercise only. Patients in the exercise group (and patients in the manipulation 
group after the first two sessions of high-velocity thrust manipulation) were treated with 
a low-stress aerobic and lumbar spine-strengthening program. Patients in both groups 
attended physical therapy twice during the first week and then once a week for the next 3 
weeks, for a total of five sessions. 
Significantly greater improvements in pain and disability were observed after 1 and 4 
weeks of treatment among patients receiving physical therapy that included spinal 
manipulation compared with patients receiving an exercise program without manipulation. 
At the 6-month follow-up, patients who did not receive spinal manipulation 
demonstrated statistically significantly greater use of medication, health care utilization, 
and lost time from work due to back pain than did patients in the manipulation group. 
Results indicated that a patient who is positive on the rule and treated with spinal 
manipulation has a 92% chance of achieving a successful outcome by the end of one week. 
"A patient's status on the rule was of little relevance in determining the outcome of 
patients treated with the exercise intervention," Childs said, supporting the notion that 
the rule is specifically predicting a response to spinal manipulation. "The results of this 
study mean that physical therapists can have increased confidence in using the rule to 
identify patients with low back pain who are good candidates for spinal manipulation."

That research sounds familiar doesnıt it?  Were you aware that physical therapists out-
number chiropractors in the U.S. almost 2/1?  They are united as an organization and late 
last year, they graduated the first class of "Doctors" of physical therapy.  They are far 
more favored in the eyes of the medical community and as an organization they desire to 
work hand-in-hand with the American Medical Association.  So let us suppose that in the 
near future insurance companies recognize physical therapists as primary care physicians.  
The insurance companies will then evaluate the physical therapistıs means of "treatment" 
for a patient and deem that what a chiropractor does and what a physical therapist does is 
considered a "duplication of service."  Whom do you suppose the insurance companies 
will lean toward in reimbursing payment for manipulative care?  Physical therapists are 
united and have great lobbying power in the political arenas.  We have made every 
attempt in the past few decades in chiropractic to conform to the medical model in 
education and standards of care, we have changed our lexicon to sound more like physical 
therapists and others in the medical community and we have moved away from the 
original premise of why, when and how we give an adjustment.  The physical therapists 
will win this battle.  If you run an insurance practice you may very well be left out of the 
reimbursement loop.  Remember the words of Dr. Fred Barge, "A society or profession 
will perish when it forgets where it came from.  A great profession can only be sustained 
through the authentic transmission of its principles from generation to generation."  

So the health care profession known as chiropractic may very well be consumed by those 
wishing to be nothing more than manual therapists delivering a treatment.  

But, there will always be chiropractors!  

Rest assured that for as long as there is life in me or any other members of the Gonstead 
Seminar of Chiropractic, there will be a voice of reason and a voice recounting the truth 
that exists in the practice of real chiropractic.  Although our audience may dwindle in the 
future as the cycle perpetuates itself, we will hold steadfast to the principles laid down 
by our forefathers and patiently wait for the pride to rise again within the chiropractic 
profession.

We know that confusion and deception will always exist in chiropractic.  We challenge 
those of you who cherish our principles and the gift we have been given to join us in a 
united effort to expose the deception and fraud that exists in many of our colleges and 
chiropractic organizations today.  Every chiropractic student around the world should be 
exposed to the wonders of chiropractic from individuals who live the sermon and do not 
simply preach the sermon.  Chiropractors who give a hands-on adjustment and fully 
understand the "why", as DD stated, "We give the adjustment to improve the normal 
transmission of current between the brain and the tissues and organs diseased."

Chiropractic will rise again, but it will only happen when you voice your opinion with 
the same ferocity as those who wish to diminish or destroy chiropractic.  Be proud to 
stand up for chiropractic and explain to your patients and those young chiropractic 
students that we are separate and distinct, and when we give a specific adjustment to a 
subluxated vertebra, explain how we are dealing with the "Powers that move the 
universe"!  In the simple words of Dr. Gonstead, "You boys donıt understand the power 
of chiropractic!"

We do not nor will we ever all get along in this profession.  You and I do not need to have 
more friends in chiropractic; we need more colleagues!  We need colleagues who are united 
under the single definition and the principles already defined for us by DD Palmer.  We 
need dedicated colleagues who will deliver chiropractic to the public with the proper 
ethics and intent.

"The most wonderful study of mankind is man.  The grandest and greatest science is 
Chiropractic."  Passionate words from DD.  Will you be passionate enough to respond, 
write or speak out for the greatest science known to man?

BJ Palmer asked for your help over 50 years ago, it is still not too late to respond:  "What 
a glorious epoch in the worldıs history!  WHO is to bring about this utopia during the 
next 100 years?  YOU are the foundation stock.  You are to prepare the way for future 
generations to follow.  You are to blaze the way, blast the rocks, clear all rubbish of 
ignorance and prejudice, and open up the grand highway of truth."

The best time to start the revolution and make the pride rise again in our profession is 
TODAY!  If you feel you are a member of the "foundation stock", we look forward to 
your response.  

W. John Cox, Chiropractor