We are at a crossroads in chiropractic... a time where we may lose our identity or forge forward with chiropractic leading the new paradigm of health and well-being. As practitioners, we see the evidence of chiropractic adjustments every day in our practices. To us, it is undeniable. But in terms of substantiating ourselves with the value and recognition we deserve, we are in dire need of a Research Agenda to forge forward and gain our rightful position: leaders in the chiropractic vitalistic paradigm. Advancing Futures is our best hope at accomplishing a collaborative, organized movement in this direction.
· The body is a self-regulating, self-maintaining organism;
· The nervous system controls and coordinates all functions of the body;
· The spine and vertebrae house and protect the nervous system;
· Vertebral subluxations can occur and interfere with the function of the nervous system;
· Reducing and/or correcting vertebral subluxations allows the nervous system to function better and allows the fullest expression of life.
This research agenda seeks to validate the profession and position chiropractic as a vitalistic, scientific, evidence-informed clinical practice. The more research, the greater the chance the profession will have of gaining a higher degree of respect, understanding and acceptance in the health care marketplace, the scientific community and among the patients it serves. It is imperative to make these new research advancements available to the public, other health professions, and to legislators in order to promote and to systematically advance the field of subluxation centered chiropractic through the initiation of favorable public health policy.
1. Research focused on the description and identification of the various operational models of vertebral subluxation.
2. Research focused on the validity and reliability of measures to identify and characterize vertebral subluxation.
3. Research on the epidemiology of vertebral subluxation including its incidence, prevalence, morbidity and mortality.
4. Research on clinical strategies for preventing, arresting, reducing and correcting vertebral subluxations.
5. Research on health outcomes following management of vertebral subluxation.
1. Create and support the next generation of subluxation centered scientific researchers to carry out these projects;
2. Identify and continuously update a manifest of research projects directly relevant to the agenda;
3. Involve a large segment of subluxation centered groups, organizations, associations, vendors, practitioners and patients;
4. Develop, implement and exploit central data repositories;
5. Market the project and its results to chiropractors, students, patients, legislators, policy makers and the general public through an integrated campaign.
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As a result of the illegal boycott against chiropractic organized by the American Medical Association and its co-conspirators, the chiropractic profession suffered immeasurable damage to its infrastructure during the most crucial time of its development.
This was no coincidence as it was in fact the intention of the illegal boycott to have chiropractic “wither and die on the vine.” The internal documents and memoranda that were revealed during the Wilk v. AMA lawsuit show a clear focus on destroying the educational, organizational, cultural, and research fabric of the profession.
In terms of research, the boycott kept us from federal funding and other sources of support for decades. In fact we still feel these effects. However, over the past several decades the chiropractic profession has embarked on a research agenda. An agenda that has even received federal funding – although the amount of this funding is miniscule in comparison to the vast sums of money given to the medical pharmaceutical industrial complex to conduct research.
It is estimated that the chiropractic profession has received less than $50 million from the federal government to conduct research in its entire history. Harvard University will receive over a billion dollars just from the NIH this year alone. Making matters worse is the fact that the majority of the money received for chiropractic research was used to conduct musculoskeletal and pain based studies further cementing our role in this regard.
The chiropractic profession as a whole does not appear interested in research and some actually display disdain and contempt for it. The matter becomes much worse when the discussion shifts to subluxation based research. While there is scant support for research in the profession as a whole, support for research within the subluxation based community is nearly non-existent save for a few isolated pockets of activity. In fact, very little research has been conducted that focuses on vertebral subluxation.
This is a very serious problem – one that cannot be overstated. The dearth of subluxation based research makes it very difficult to develop policy supportive of subluxation based care. Not only has this been true in the past but it is only becoming increasingly important as the health care paradigm changes and increased accountability is brought to bear. Evidence based health care, best practices, practice guidelines and objective outcomes assessment are the order of the day and will become increasingly operational in the coming years.
As with issues of policy it is naieve to believe or suggest that the profession can somehow avoid these issues by simply contracting directly with the patient in a cash exchange. The profession still sees less than 10% of the population with some surveys showing that our market share is actually decreasing. Those consumers that do seek out chiropractic services are largely innovators and early adopters. That the percentage of people seeking chiropractic services has not changed much at all in over 40 years suggests that we are not reaching the other segments of the population.
To do so requires a cultural shift. And the only way for that cultural shift to occur is by demonstrating through research the clinical meaningfulness of vertebral subluxation and its correction and then implementing a marketing program to get this information to the public and stakeholders.
Thus far the subluxation based community has relied on a “one spine at a time” strategy in regards to changing the culture. This is fundamentally flawed, naieve and simply will not work.
We haven’t the time to wait for this approach to manifest and it has not manifested in 100 years – what makes us believe it will manifest in the next hundred?
Subluxation based chiropractors will need to aggressively support research and it must closely scrutinize the projects to ensure they involve subluxation. Not only must this support come through financial donations to support subluxation based research but subluxation based chiropractors will need to get involved personally in conducting research. Every chiropractor can complete a case study. Every chiropractor can get involved in a practice based research network. Every chiropractor can contribute to research in a multitude of ways.
If we are to amass the amount of subluxation based research that will be necessary in this effort to correct the course of the profession in 15-20 years it is imperative that every subluxation based chiropractor get involved in research on some level. It must become the cultural norm and we must lead in this respect.
What we need is an organized effort within the subluxation based community to conduct a massive amount of research in as short a time frame as possible. Then, that research must be disseminated through the media and through communities both large and small. There is absolutely no reason from a technical and talent perspective why this cannot be done. The advent of the internet and the ability to manage large databases make such efforts entirely possibly. The only missing ingredient is the will on the part of the subluxation based community to make it happen.
Will you join us on this mission?
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