The definition of what chiropractic ‘truly is’ has been debated probably since the day the first class of chiropractors graduated over 100 years ago and has been a topic of fevered discussion ever since. I appreciate Dr. Ghorayeb’s contribution to the discussion less because I agree, necessarily, with his definition but more because his article answered the question that has been plaguing me for the past decade – namely why are new graduates from CMCC so averse to performing spinal manipulation?
As an alumna of CMCC’s Class of ’99 the questions that were volleyed between my peers as graduation approached were more along the lines of whether we would have open or closed adjusting suites or which adjusting techniques we would offer. The fact that we would dedicate our professional lives to adjusting the spine (or performing spinal manipulative therapy) was never a question. I have noticed that it is different with new grads.
Now, the most common questions I hear revolve around whether, or not they are certified in ART (Active Release Technique) or acupuncture yet. Yet. The focus invariably seems to be on therapies such as these, exercise prescription and/or nutritional supplementation exclusively. I have come to understand that students deemed “overly” interested in learning how to perform spinal adjustments are given the pejorative name “subbies” and are looked upon with derision. While I will acknowledge that even during my time at CMCC there was some friction between those who considered themselves “principled” chiropractors and others, there was never any doubt that our common focus was to find and correct spinal misalignments for the betterment of our patient's health and well-being. The language used to express that sentiment could vary, but the sentiment was shared nonetheless. The idea that the focus of our profession is steadfastly turning away from the study and perfection of the spinal adjustment in favour of becoming an amalgam of the already established professions of physiotherapy, massage therapy, naturopathy and certified athletic trainer is harrowing.
I have enjoyed 20 years of practice in a small town in Southern Ontario and have adjusted, manipulated, or cracked (I don’t care what you call it) the spines of thousands of wonderful people of all ages (from newborns to those in their 90's) and have seen the most incredible, borderline miraculous changes in many of their states of health and well-being, both physical and mental. I am humbled and constantly grateful to be able to play a role – sometimes large, other times small – in the pageantry of life in my community and to be able to affect a change for the better by offering a service at a level of skill and professionalism that no other profession can, to the very best of my ability, daily.
Is the chiropractic adjustment some sort of much-maligned cure-all? Certainly not. Does making restricted areas of the spine move properly again (however you describe that) through the use of a high velocity, low amplitude thrust (however you choose to describe or administer that) result in changes in a patient’s actual and perceived pain and dysfunction? Undeniably, yes.
The argument that there is little research available to define and describe what we are doing can rightly be seen as a stumbling block to those who need to know (I can count myself among them). That this should be used as a reason to discount and discredit over a century of positive outcomes is, I believe, a mistake. I wonder if Dr. Ghorayeb and others like him misinterpret an absence of proof as a lack of proof? The former is the natural consequence of no one looking for answers while the latter would imply that a thorough search yielded no answers. My personal feeling is that the paucity of research-based evidence should be a call-to-action for the profession to perform the necessary studies. After all, anecdotal evidence for the use of chiropractic adjustments to alleviate unnecessary suffering of myriad types is overwhelming and CMCC, with its long history of performing world-class research, would seem to be ideally suited to take up the mantle. Unfortunately, if Dr. Ghorayeb’s perceptions of our profession and the attitudes and practices of the new graduates I’ve met are indicative of the current administration’s culture at large, it will take a paradigm shift of mammoth proportions to affect any sort of change in the direction I would consider positive.
In the meantime, I would suggest to Dr. Ghorayeb (and others) that should he wish to better understand chiropractic as it has been practiced classically, he would do well to attend a lecture from Dr. John Minardi BHK, DC or invest in his DVD lecture series on the neurology of the subluxation and chiropractic’s effect on health. Or, read research published by Dr. Heidi Haavik BSc, PhD, DC or Dr. Joyce Miller BSc, DC, FACO, FCC (UK). I would further suggest that chiropractic students take the time to shadow those of us with established practices to view firsthand the difference chiropractic spinal adjustments can make to the lives of our fellows. Trust me, it would be time well spent.
Finally, I thank Dr. Ghorayeb for his well-written and thought-provoking article. However our opinions of chiropractic may differ, I wholeheartedly agree that “chiropractors ought to focus on enhancing human adaptability and resilience, in addition to promoting self-efficacy, while recognizing the role that biological, psychological, and social factors play in influencing the patient experience and the potential indications for administering specific treatments.” To me, that will always be achieved first and foremost by the correct application of the spinal adjustment and I agree with Drs. Pooley and Thomson who wrote a year ago that “growth [of our profession] will only come from championing our uniqueness, not sharing in the mediocrity”. My fervent wish is that this sentiment continues to be shared and nurtured by our profession for centuries to come.
Yours with the greatest respect,
Dr. Samantha R. Colautti
Hons. BSc., DC
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