Fritz Perls, a gestalt psychotherapist, used to ask patients who complained of being chronically depressed to make a detailed list of exactly how they were keeping themselves that way. His idea was that human emotions normally change continually; so if someone experiences any emotional state for very long they must be really working to maintain it by suppressing the other emotions which would have happened naturally. Of course, his patients used to complain about having to do this exercise, but it was amazingly effective. Perls felt that we are usually more responsible for our predicaments than we realize; and by taking responsibility for the way we are rather than blaming it onto someone else we take the necessary first step toward improving ourselves. The utility that this conceptual reversal generates in this and other gestalt exercises is analogous, I believe, to the leverage that newtonian physics creates: Aristotle had conceived of physical objects as static, at rest, unless forced to move. Newton conceptually reversed this idea and conceived of objects as continuing to move unless restrained.
A popular notion these days in chiropractic circles is that significant research has not happened because the necessary extraordinary forces have not been applied. Various external causes for this inadequacy are usually blamed, (e.g., the AMA, the bias of government funding agencies, etc.). There are two assumptions here: First, such opinions assume that research is a rare, exotic, and unusual human activity requiring large expenditures of energy to get started. It also assumes that this has not happened primarily because of factors external to chiropractic.
The fact is, far from being an unusual activity, research is perhaps the most normal and natural thing a human being can do. Exploring, trying to find out how things work, human beings everywhere have always done these things incessantly unless actively restrained or prevented from doing them. We do not require the application of extraordinary external forces to get us started; Curiosity is our natural state.
Applying Newtonian ideas then, if we find something standing still that should naturally be happening, we should look for what has stopped it, not for what has failed to start it. In the case of chiropractic research we must ask, what has stopped the thousands of research studies which should have happened naturally in the past 95 years? Furthermore, if we want to move forward we must be mature enough to take responsibility for the way we are. This means that we must stop blaming external forces and begin to look inward. Perls would make us ask ourselves: How have we in chiropractic managed to suppress our natural tendencies toward research so successfully for so long?
In my personal opinion, the lack of understanding of what science is, of what it can and cannot do, has been primary in causing the history of underactivity in chiropractic research. Keep in mind that for most of the past 95 years there have been few or no professionally trained scientists at chiropractic colleges, and that the colleges themselves have been isolated from universities where scientists can normally be found. This isolation from scientific activity and lack of contact with scientists meant that both the potential and the limitations of science itself were not well understood. Non-scientists (including every kind of clinical practitioner) tend to either seriously overestimate the power of scientific research, which can make it appear dangerous, or to seriously underestimate it, which can make it appear trivial. Even today, it is my strong impression that many chiropractors have either an inflated opinion of scientific research, thinking that "chiropractic" will or will not be "validated" by scientific testing, or a cavalier disregard for what is seen as an expensive and irrelevant waste of time. The truth is, of course, somewhere in between.
Historically, probably the most effective defense against the (mis)perceived risks of scientific testing has been to selectively develop axiomatic beliefs which, though they appear to have been generated empirically (clinically), are, in fact, inherently untestable, i.e., are impossible to falsify under any circumstances (the body is "innately" intelligent, wants to be symmetrical, healthy, etc.).
Another way we may have defended against doing potentially threatening scientific tests was to deny that there was really a need to do them (because we already know from clinical experience that chiropractic "works.") A historical variation of this denial defense was to claim that such tests could not be done at all: We would have liked to do them but the clinical "art" of chiropractic is just so intuitive and complex that it is impossible to quantify the experience [not true, of course: If you can experience something at all, i.e., if you can perceptually discriminate it from its background, you have already quantified it, at least in a simple way. Measuring physical events and human experiences that may have never been measured before is precisely what scientists do for a living.]
The Consortium for Chiropractic Research is dedicated to ending the scientific isolation and lack of scientific contact that is responsible for what has unfortunately become a tradition of errors about what research can or cannot do for chiropractic. By bringing working scientists and practitioners from everywhere in the world together for the purpose of discussing, designing, and performing scientific chiropractic research, we can move beyond that unfortunate tradition and finally put research in a realistic and productive perspective which neither exaggerates nor trivializes its importance.
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
On Feb. 1, 2024, two more legislators – John R. Carter (R-Texas) and Robert “Bob” Good (R-Va.) – co-sponsored the Chiropractic Medicare Coverage Modernization Act of 2023, bringing the co-sponsor total to 155, two more than the total achieved over the entire two-year congressional cycle in which identical legislation last appeared (2021-22).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
