Simpson Chiropractic & Manual Therapies 2012, 20:1

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CHIROPRACTIC & MANUAL THERAPIES

COMMENTARY

Open Access

The Five Eras of Chiropractic & the future of

chiropractic as seen through the eyes of a
participant observer
J Keith Simpson

Abstract
Chiropractic has endured a turbulent history, marked by tremendous advances in areas such as education and
licensing while marred by interprofessional conflict and a poor public image. The prolonged interprofessional
conflict was instrumental in shaping the culture of chiropractic. These obstacles have long-since been removed
although there are lingering effects from them.
This article examines the chiropractic professions history by dividing it into five Eras and suggests that there are
three options available for the future of the profession. One: maintaining the status quo. Two: uniting under an
evidence based scientific approach as partners in the health care delivery system that has buried the one-cause,
one-cure sacred cow. The steps required to achieve this outcome are outlined. Three: openly dividing the
profession into evidence based practitioners and subluxation based practitioners. Adopting this option would allow
each branch of the profession to move forward in the health care delivery system unhindered by the other.
It is unclear which option the profession will choose and whether the profession is mature enough to follow
option two remains to be seen. What is evident is that the time to act is now.
Background
This article is based on the second FG Roberts Memorial Lecture, delivered by the author at the Annual Conference of the Chiropractic & Osteopathic College of
Australasia, Melbourne, Australia 2011.
In the initial FG Roberts Memorial Lecture and the
subsequent paper, Dr Reggars recounted some of the
many accomplishments that the chiropractic profession
has achieved over the past 30 years and how the changes
have impacted on chiropractic and the chiropractic
profession [1].
This paper reviews the origins of chiropractic from the
unregulated 19th century health care system in the United
States of America and its frequently turbulent journey into
the 21st century. It is the authors contention that the culture of chiropractic as it stands is for a large part the result
of external forces and that unless and until the profession
recognizes how these forces have influenced its development, progression of chiropractic into the 21st century
health care system will not occur. Whilst some within the
Correspondence: k.simpson@murdoch.edu.au
School of Chiropractic & Sports Science Murdoch University, Perth, Australia

profession may consider this to be a good thing, it will be

argued that the survival of the profession hinges upon its
acceptance of science and seizing upon the tremendous
opportunity ahead.
The author came into chiropractic with an exercise
physiology background and graduated from Canadian
Memorial Chiropractic College in 1982 with no understanding of The Big Idea [2]. Following 24 years in private practice, a PhD in sociology and 7 more years in
chiropractic academia, the author still wonders what all
the fuss is about, but certainly recognizes the difficulties
that The Big Idea has presented [3].

Discussion
For the purpose of debate, the history of the profession
will be divided into five distinct and at times overlapping eras:
1.
2.
3.
4.
5.

The
The
The
The
The

Era
Era
Era
Era
Era

of
of
of
of
of

Free trade in Medicine: 1860 ~ 1900

Prosecution: 1900 ~ 1950
Persecution: 1920 ~ 2000
Legitimation: 1960 - present
Opportunity: 2000 - present

2012 Simpson; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.

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The Era of Free Trade in Medicine (1860 - 1900)

Chiropractic emerged out of what is recognized as The

Era of Free Trade in Medicine (1860-1900). This was a
time when all and sundry could ply their trade because
there was no legislation governing health care in the
United States of America [4,5].
Three predominant groups of healers were represented in the first half of the 19th century:
1. Orthodox medicine (physicians), whose principal
treatment methods included bloodletting, blistering,
purgatives (massive doses of compounds of mercury,
antimony and other mineral poisons) and tonics
(arsenical compounds);
2. Thomsonian/eclectics, whose principal treatment
methods were botanical remedies, steam baths and
rest; and
3. Homeopaths, whose principal treatment methods
were homeopathic remedies, fresh air, sunshine, bed
rest, proper diet, and personal hygiene [6].
Health care provision was not limited to members of
these three groups however. This was also the time of
the isms:

Spiritualism
Vitalism
Mesmerism
Mysticism

Add to the mix Christian Scientists, magnetic healers

and manual therapists (osteopaths, chiropractors, bone
setters) and we begin to appreciate the health care landscape of the time. It is noteworthy that, during this
deregulated period, the United States became one of the
healthiest nations in the world, boasting the worlds lowest infant mortality rate [7]. This came about largely as a
result of the work of a non-medical practitioner, Lemuel
Shattuck. Shattucks 1850 Report to the Sanitary Commission of Massachusetts has been hailed as one of the
most significant documents in the history of public
health and ultimately led to widespread adoption of public health and sanitation measures that were responsible
for saving thousands of lives [8,9]. From within this prescientific era [10], chiropractic emerged in 1895 as an
empirical health science interested in the spine and its
possible relationship to disease states [11,12]. It is important to remember that chiropractic was not the only
group interested in the notion of spinal irritation (aka:
rachialgia) and that this was a very controversial subject
[13,14].
The Era of Free Trade in Medicine gave way to the
Golden Age of Medicine and The Golden Age of Scientific Advancement (1890 - 1950). Because chiropractic

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was heavily influenced by both of these Golden Ages,

they will be considered briefly.
The Golden Age of Scientific Advancement largely
drove the Golden Age of Medicine.
These ages brought with them what were considered
miraculous medical breakthroughs, including vaccination
and antibiotics. There were dramatic declines in the mortality rate for infectious diseases as well as increases in
expected lifespan. No disease seemed incapable of being
defeated by science. The medical profession enjoyed the
benefits of these advancements with rapid progression to
the top of the professional hierarchy and a concomitant
increase in cultural authority [15,16].
This was also the era of medical education reform,
which saw a science-based curriculum introduced concomitant with university affiliation as directed by the Flexner
Report [17]. The American Medical Associations Medical
Education Committee promoted the Flexner Report to the
168 institutions providing medical education. Schools
that agreed to adopt the Flexner recommendations
received generous funding via the Rockefeller Foundation
while schools that did not assent, simply ceased operation
due to lack of funding. The result was that, by 1930, only
76 of the 168 medical schools remained [15]. In this manner, virtually all healing arts other than allopathic medicine were effectively eliminated, and the number of new
medical graduates entering the profession was dramatically
reduced from over 5440 per year to 3536 [15].
In part because of the rejection of science by a significant element within the chiropractic profession [18],
and in part because the Flexner Report dismissed the
chiropractors as unconscionable quacks who should be
dealt with by the public prosecutor and the grand jury
[17], the chiropractic profession bypassed the era of
educational reform.
With Flexners simple phrase, the chiropractic profession found itself mired in The Era of Prosecution, which
was closely overlapped by The Era of Persecution.
The Era of Prosecution: 1900 ~ 1950

Practically from its very origins in 1895, the chiropractic

profession was in conflict with allopathic medicine [19].
The relationship between political medicine and chiropractic was described by Scotton as a holy war between
the forces of good and evil[20] and Carter [21] referred to
the libel and slander campaign of dirty tricks when
describing political medicines dealings with the chiropractic profession.
The Era of Prosecution began in 1902, less than a decade after Daniel David Palmer (DD) discovered chiropractic. DD was charged with practising medicine
without a licence in 1902 and 1903, however the charges
were either dismissed, or the prosecution simply did not
proceed [22]. In 1906, DD was the first chiropractor

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jailed following his conviction for practising medicine

without a licence. He was fined $350.00 plus court costs,
and incarcerated until the fine was paid. After serving 23
days, DD paid the fine and was released [23].
In the first thirty years of the chiropractic professions
existence, there were more than 15,000 prosecutions,
about 20 percent of which resulted in incarceration [24].
In fact, Go to jail for chiropractic was the advice given to
members of the Federated Chiropractors of California, and
the Alameda County (California) Chiropractors Association deemed it mandatory for its members to go to jail
rather than pay a fine if convicted for practising medicine
without a license [12]. On one occasion there was a mass
arrest of 100 chiropractors in New York City [25]. In 1921
alone, 450 of the 600 California chiropractors chose jail
over a fine following convictions for practising medicine
without a licence [26] and such prosecutions continued
well past mid-century [27].
With DDs conviction, his son, BJ Palmer, determined
that a means of defending the profession was required
and the Universal Chiropractors Association (UCA) was
founded, primarily as a protective association for all chiropractors. Shortly after its formation, the UCA officially
condemned the mixer policies of the American Chiropractic Association, a rival association that had been
formed by Langworthy in 1922 [28]. The condemnation
was significant because, in a strictly pragmatic legal
move, the UCAs legal counsel used Langworthys textbook, Modernized Chiropractic, and the paradigm
espoused therein, as the basis for successfully defending
chiropractors charged with practising medicine without a
licence [28].
The UCAs first case was the defence of Shegataro
Morikubo, a graduate of the Palmer School and Infirmary
of Chiropractic, who was charged in 1907 with the unlicensed practice of medicine, surgery and osteopathy.
Upon learning of Morikubos indictment, BJ Palmer travelled to Lacross, Wisconsin where the case was to be
heard, and hired State Senator Tom Morris, LL.B., senior
partner in the law firm of Morris and Hartwell, for the
defence of Morikubo. The first step in the defence was to
suggest to the prosecution that, because Morikubo had
neither used any surgical procedure nor prescribed or
used any drugs, the trial should be limited to the unlicensed practice of osteopathy. The prosecutor agreed
and the trial proceeded on the sole charge of unlicensed
practice of osteopathy. In presenting the defence arguments, Morris used Modernized Chiropractic, which
stated that chiropractic had a separate and distinct philosophy and practice that was unlike any other method of
treatment. He reinforced this argument by calling several
witnesses, including practitioners trained in both osteopathy and chiropractic. Following a 30-minute deliberation, Morikubo was unanimously acquitted [29].

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Using similar tactics, Morris oversaw the defence of

more than 3300 chiropractors, with a win rate approaching 90 percent [28]. The Morris defense strategy was as
simple as it was effective. It involved four clear concepts:
1. Chiropractic is not medicine; chiropractic has a
separate and distinct philosophy and practice.
2. Chiropractors do not diagnose, but analyze the
spine for the cause of dis-ease.
3. Chiropractors do not treat, but adjust the spine
for the cause of dis-ease.
4. The Chiropractic profession has been built upon
success in cases where medical doctors failed [28].
Morris has been acknowledged as the architect of chiropractic philosophy because of his demonstration of
how to use chiropractic theories or philosophy in the
courtroom to defend against charges of the unlicensed
practice of medicine. In recognition of this, he was
awarded the first Philosopher of Chiropractic (PhC)
degree from BJ Palmers chiropractic school in 1907 [30].
Following Morris success in the Morikubo case, BJ
Palmer embraced chiropractic philosophy with evangelical zeal, and thus the courtroom experience of Morikubo became a powerful determinant of the chiropractic
professions development [29].
It is noteworthy that the above interpretation has been
questioned. Peters and Chance contend that Morikubo
himself established the defense used by Morris [31]. It is
clear that Morikubo and Morris consulted prior to the
trial, and considering the recognition afforded Morris, it
seems likely that Morris was the originator of the defense
strategy used, and most certainly the record shows that
he used it repeatedly and with great success.
Wardwell considered the Morikubo case the third
major event in chiropractic history, again because this
was the point at which BJ Palmer began his straight philosophical journey[32]. During this journey, the chiropractic
community developed and embraced a distinct lexicon
and rationale toward health and its maintenance in order
to emphasise the difference between medicine and chiropractic [33]. Thus the philosophy of chiropractic became
an unyielding dogma [30].
The Era of Persecution: 1920 - 2000

This Era began shortly after the Era of Prosecution and

can be divided into an informal and a formal era.
Dr Morris Fishbein was labelled the Medical Mussolini and described as the most important non-chiropractor to influence the chiropractic profession because
he was responsible for beginning the informal medical
campaign against chiropractors and orchestrated the
American Medical Associations (AMA) anti-chiropractic crusade for over fifty years [34]. From his position of

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power as editor of the Journal of the American Medical

Association (JAMA) and secretary of the AMA (1924 to
1949) he determined the tone of articles appearing in
JAMA and ensured that anti-chiropractic pieces regularly appeared [34].
In spite of, or perhaps because of having achieved market dominance, the AMA launched an all-out war on
chiropractic, the most successful of contemporary alternatives [35]. This war constitutes the formal Era of Persecution. It began in 1962 with the adoption of The Iowa
Plan and the formation of the Committee on Quackery
to implement same [36]. Simply put, the Iowa Plans
overall goal was to contain and eventually eliminate the
cult of chiropractic as a health hazard in the United
States [36].
Chiropractors and chiropractic training institutions
were in abundance during this time. To put things into
perspective, by 1910 there were some 392 schools in the
USA offering chiropractic training [37] with up to 16,000
practising chiropractors in the country [19]. This is in
contrast to the 76 medical schools at the time.
The Committee on Quackery was well funded, and
operated a highly successful campaign that was centred
on three main strategies:
1. An ethics based boycott, which deemed it unethical for AMA members to have professional dealings
with chiropractors;
2. Convincing other organizations to adopt or adapt
the AMAs anti-chiropractic policy; and
3. Instituting a comprehensive political campaign to
thwart chiropractic progress on several fronts,
including but not limited to education, research and
insurance funding [36].
The chiropractic professions response to the formal
campaign was launched in 1976 when five chiropractors,
Drs Chester A Wilk, James W Bryden, Patricia B
Arthur, Michael D Pedigo, and Steven Lumsden filed an
antitrust lawsuit against the American Medical Association (AMA) and fourteen other defendants [38].
The Era of Persecution officially ended in the United
States in 1987 when the presiding Judge, Susan Getzendanner, issued a permanent injunction order against the
AMA because she correctly recognized that there would
be lingering effects of the decades long AMA boycott: the
culture of political medicine had become anti-chiropractic
and the AMA would possibly re-offend [39,40].
The Iowa Plan was not confined to the United States.
In Australia, the Australian Medical Association had
adopted the Iowa Plans ethics based boycott as well as a
very negative exclusive dogma policy on chiropractic.
The Association was very active and successful in blocking the advancement of chiropractic within Australia [3].

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While there was no trial or injunction order issued within

Australia, the Australian Medical Association formally
ended its ethics based boycott and rescinded its exclusive
dogma policy on chiropractic following the intervention
of the Australian Consumer and Competition Commission [41,42].
Clearly, opposition to the growing profession of chiropractic was formidable, prolonged and widespread. The
professions survival resembles the history of early social
protest and reform movements in western history. Like
the abolitionists, early chiropractors were victims of systematic persecution and often banished from one town
to another. Similar to the feminists and suffragettes, pioneer chiropractors were often ostracised in the community [43]. While the persecution and prosecution might
have been seen as impediments to the profession, the
contrary was the case. Gibbons reminds us that phase of
real persecution and enforced poverty afforded chiropractors much of their identity and motivation [44].
Importantly, from a sociological perspective, the sustained campaign by the AMA crystalized chiropractic
culture into one with a unique lexicon and a siege
mentality.
With the end of the Eras of Prosecution and Persecution came the Era of Legitimation during which the
chiropractic profession enjoyed advancements on many
fronts [32].
The Era of Legitimation: 1960 - present

The Era of Legitimation saw inquiries into chiropractic lots of inquiries - 18 in all. The New Zealand Royal
Commission, the Webb Royal Commission in Australia,
the LaCroix Royal Commission in Canada, the Layton
Committee Report again in Australia to name a few.
The inquiries reached similar conclusions:
1) Chiropractors are well positioned to manage musculoskeletal disorders,
2) Claims by chiropractors to be able to positively
affect visceral disorders are unsupported by evidence
and constitute a major obstacle to integration of
chiropractic into the health care system, and
3) Chiropractic education needs to improve.
The Era of Legitimation saw chiropractic education
move into government funded universities; a proliferation of chiropractic research; legislation governing the
practice of chiropractic in 90 jurisdictions throughout
the world and unprecedented inter-professional cooperation [45].
There was an expectation that with registration and
university based education, and the removal of other
obstacles, the profession would unite, embrace science
and take its legitimate place within the health care

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system and that the professions cultural authority would

be enhanced.
The reality is quite different. Instead, the siege mentality of the chiropractic profession largely remains and is
compounded by memory deficit disorder, whereby it
seems that these important historical facts have been
lost, resulting in a significant portion of the chiropractic
profession steadfastly continuing to espouse the original
chiropractic doctrine [46] and make unsubstantiated
claims [47,48].
The professions public image remains in tatters with
chiropractors consistently rating towards the bottom of
ethics and honesty scales [49]. The 2006 Australian
Readers Digest most trusted professions poll placed
chiropractors in 13th place out of 35 professions [50].
While this is not a good result, in 2011 chiropractors do
not even appear amongst the 45 professions listed,
which placed real estate agents, car salesmen, politicians
and tele-marketers in the last four spots [51]. While it is
recognized that the Readers Digest poll is not the most
scientific, this result is surely not a good sign for the
chiropractic professions cultural authority.
In the 2010 FG Roberts Memorial Lecture, Dr Reggars
stated that the chiropractic profession is poised at the
crossroads of marginalization and mainstream [1].
I say that the profession is at the crossroads of being
relegated to the back blocks of health care provision
(marginalization) or being recognized as the health care
provider of choice for what bothers most of the people,
most of the time.
So what is the problem?

Carl Sagan tells of a fire-breathing dragon living in his garage. When we look inside and cannot see his dragon he
advises that it is invisible, and it cannot be detected with
infrared because its fire is heatless; it leaves no footprints
because it floats in the air and its body cannot be shown
because it is incorporeal. Indeed, it cannot be detected by
any known means. Sagan is the only one who knows it is
there. Sagan asks what the difference is between a dragon
that cannot be detected by any means and no dragon at
all? If there is no way to disprove his dragons existence,
what does it mean to say that his dragon exists? The
inability to invalidate his hypothesis is not at all the same
thing as proving it true. Sagan advises that untestable
claims and assertions incapable of disproof are worthless,
even though they may excite us and fill us with wonder.
To believe in Sagans dragon in the absence of evidence is
to do so on his authority alone [52].
The Association of Chiropractic Colleges defines the
purpose, principles and practice of chiropractic as the
finding and reduction of vertebral subluxations that
compromise neural integrity and may influence organ
system function and general health. [53]. An internet

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search will advise that chiropractors have known about

the dangers of subluxations for over one hundred years;
that chiropractors are the only health professionals
trained in the detection, and correction of the vertebral
subluxation [54-56].
The problem is that there is no credible evidence that
subluxations are any more real or dangerous [57,58]
than Sagans dragon. While Sagan may be deluding himself, he is unlikely to harm others because of his belief.
Chiropractics problem is that subluxation based chiropractors [59] are not only deluding themselves, they
are indoctrinating patients into believing in a purportedly dangerous mythical entity, and that without regular
adjustments, patients will not only fail to reach their full
potential, they will likely suffer serious health problems.
Some authors have suggested that this may be a threat
to public health [60-62]. And this, at a time when the
profession has just entered The Era of Chiropractic
Opportunity.
The Era of Chiropractic Opportunity: 2000 - present

Consider the following facts regarding musculoskeletal

disorders (MSD). MSD are the leading cause of pain
and disability in Australia. They are the second most
common cause for a visit to a general medical practitioner and the third leading cause of expenditure in the
Australian health care system: $3 billion per year ($8.2
million per day). Annually, MSD are responsible for
300000 hospital admissions, 15 million general medical
practitioner office visits, and 13 million prescriptions,
and MSD from motor vehicle accidents account for 25%
of all health care expenditure [63,64].
This is just the beginning - these figures are only
going to get worse. There is an aging population that
requires more care for MSD, with a shortage of health
care providers who are poorly distributed [65]. The
solution to this problem has been known by health
economists for decades: provider substitution [66]. Until
recently, governments have not had the political will to
implement this major policy reform. The health care
landscape has changed sufficiently so that provider substitution is not only being considered a possibility, it has
been implemented, examined and found to be a viable
option that results in high levels of patient satisfaction
and good clinical outcomes [67,68]. In the area of MSD,
in particular low back pain, chiropractic care has long
been shown to be an effective and cost effective alternative to conventional medical care [69,70].
Given these circumstances, it would appear that chiropractic is favorably positioned to play a strong role in
the health care delivery system, but as Dr Reggars
pointed out, this seems unlikely to happen given the
current chiropractic landscape [1].

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The Way Forward

It seems that there are three options available to the

profession:
1) Maintain the status quo.
2) Move forward as a united profession.
3) Divide the profession and let each faction fend for
itself.
These options will be explored.
Option 1) While maintaining the status quo is an
option, this course of action effectively prevents the profession from taking full advantage of the Era of
Opportunity.
Option 2) In an ideal world, the profession would move
forward in a united fashion and take its rightful place
within the health care delivery system. To do this would
require significant maturation on the part of the profession as demonstrated by taking the following steps:
1) Slay the one-cause (subluxation), one-cure
(adjustment) sacred cow. While this may have been
the original a priori Palmerian philosophy, in synchrony with similar concepts of the late-nineteenth
century [71,72], it is not acceptable as a basis for
patient care in light of todays knowledge-base [57].
Rather than bury the corpse, it should be taught as
chiropractic history, warts and all. It would be a travesty to forget the professions checkered past.
2) The profession needs to get out of the dogmahouse and cease espousing Palmerian doctrine as
gospel. While it was beyond distasteful to be labeled
an unscientific cult that follows an exclusive dogma
[3], when one considers the definitions of dogma i
and cultii, the label may have been appropriate for
part of the profession, and indeed may still be
appropriate.
Escaping from the dogma house will require extraordinary cooperation amongst all aspects of the profession.
Organizations such as the World Federation of Chiropractic and all major chiropractic associations will need
to agree upon and adopt a position statement identifying
the chiropractic subluxation as an historical construct
that remains a hypothesis, which cannot form the basis
for patient care until and unless there is a body of scientific evidence to support it. This is not dissimilar to
what has occurred in the United Kingdom [73].
The position statement will need to be backed up by
these organizations incorporating and enforcing appropriate statements into their ethical codes. Further, educational accrediting bodies will have to modify their
standards to clearly state that subluxation is not a concept upon which to base patient care. From this, it

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follows that chiropractic teaching institutions will be

required to restructure their curricula accordingly.
These moves will need to be reinforced by the actions
of registration boards to deal harshly with misleading
and deceptive advertising on the part of subluxation
based chiropractors and the unconscionable conduct
that typically occurs therewith. Specifically, registration
boards must prohibit the common practice whereby
potential clients present to a chiropractor for a musculoskeletal complaint, only to be convinced that they are
in fact suffering from subluxation related disorders and
require prolonged chiropractic care.
Insurance providers will need to alter their rebate
guidelines to only provide payment for evidence-based
care and to strike from their registers subluxation-based
chiropractors.
All of this must happen and the public must be
informed along the way.
Last, but by no means least, it will require each and
every chiropractor to be intolerant of the nonsense that
is out there.
The contract that the profession has with society and
its patients is such that, in exchange for a significant
degree of autonomy over education, licensing and credentialing, members of the profession are expected to
maintain high standards of competence and moral
responsibility and to subordinate financial gain to the
higher values of responsibility to clients and the public
interest [74,75].
If the profession is to gain the trust of the consuming
public it must, of necessity, become truly self-policing.
Only in this way will chiropractic generate the cultural
authority required for recognition as a group worthy of
the title Profession.
No longer can we cast a blind eye. By our silence we
are giving consent.
Chiropractic is not about hope in a jar and philosophy
is not about faith or dogma. Philosophy is about seeking
truth, questioning ones beliefs and altering those beliefs
in accordance with the best available evidence.
George W Bush once said:
I know what I believe. I will continue to articulate
what I believe and what I believe - I believe what I
believe is right [76].
While this type of thinking may be acceptable for a
United States President, faith and dogma must not be
the driving forces of our profession.
According to Alvin Toffler,
The illiterate of the 21st century will not be those
who cannot read and write, but those who cannot
learn, unlearn, and relearn [77].

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The chiropractic profession can choose to be illiterate,

but it will do so at its peril. It is realized that thinking is
hard and that those who are unaccustomed to thinking
may even find it unpleasant. On the other hand, thinkers have always found it rather fun and there are no
confirmed reports of anyone dying or being seriously
injured by thinking. Thinking may necessitate changing
our minds - which may not be a bad thing. At the very
least the profession owes it to its patients.
Option 3) If a unified profession is not achievable, the
other path is to split the profession into clear divisions:
evidence based chiropractors and subluxation based chiropractors with each division openly declaring its hand.
Evidence based chiropractors will become active contributors to mainstream health care while subluxation
based practitioners will opt out and take their chances.

Conclusion
The chiropractic profession emerged from an unregulated, unscientific era in health care. During its 116-year
history, chiropractors have endured decades of prosecution and persecution and developed a siege mentality for
survival. Following a protracted legal battle in the United States and a shorter non-courtroom stoush in Australia, the discriminatory anti-chiropractic behavior on
the part of political medicine largely ceased. Sadly, to
the detriment of the profession as a whole, some parts
of the chiropractic profession remain mired in a nineteenth century mind-set. This is particularly perplexing
considering the progress that the profession has made
and the opportunities it now has.
This paper has explored these issues and suggested a
way for the profession to proceed as a united group.
This author would not be willing to wager on a unified
future, but does know this: the future of the chiropractic
profession is well and truly in its own hands and the
time to act is now.
Endnotes
i
Dogma: An authoritative principle, belief, or statement
of ideas or opinion, especially one considered to be
absolutely true.
The American Heritage Dictionary of the English Language, 4th Edition. Houghton Mifflin Company. 2009
ii
Cult: A system for the cure of disease based on
dogma set forth by its promulgator. The Merriam-Webster Online Dictionary. http://www.merriam-webster.
com 2010
Competing interests
The authors declare that they have no competing interests.
Received: 10 December 2011 Accepted: 19 January 2012
Published: 19 January 2012

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References
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doi:10.1186/2045-709X-20-1
Cite this article as: Simpson: The Five Eras of Chiropractic & the future
of chiropractic as seen through the eyes of a participant observer.
Chiropractic & Manual Therapies 2012 20:1.

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