In this paper we pay homage to Dr Alan H. Adams, who was born on November 3, 1945, and passed away on December 26, 2020. An early adopter of problem-based learning and evidence-based medicine, he contributed substantially to improving chiropractic education, research, and developing an evidence-based practice mindset for chiropractic practice. People who knew Al best recall that he was a fluent instigator of collaborative relationships, and he inspired and advanced many people in their academic and scientific careers. His curiosity, expertise, and mentorship were appreciated by many people and developed numerous interprofessional collaborations.
"The power of our mentors is not necessarily in the models of good teaching they gave us, models that may turn out to have little to do with who we are as teachers. Their power is in their capacity to awaken a truth within us, a truth we can reclaim years later by recalling their impact on our lives. If we discovered a teacher's heart in ourselves by meeting a great teacher, recalling that meeting may help us take heart in teaching once more."1
In this paper we share our remembrances of Dr Alan H. Adams (Fig. 1). Al had a substantial positive influence on each of us individually, on the chiropractic profession, and on research in the field of spine care. We pause to reflect on Al's accomplishments and how much light and hope he brought to others. He saw what chiropractic could become and then worked to make that happen. We offer our recollections that tell of the spirit, ethos, and enduring impact of Al as a person, educator, and researcher.
When Dr Adams entered chiropractic college in the late 1960s, chiropractic was not yet recognized as a licensed health profession in all jurisdictions of the United States and was still emerging as a profession.2 To understand why his work with building interprofessional collaborations and a chiropractic ethos for research was extraordinary, his achievements should be recalled within the context of the sociological and political environment during his time. Therefore, we must first briefly review the turbulent social and historical context of chiropractic. The challenges that chiropractic faced were many and most of the causes originated over a century before.
Since the American Medical Association (AMA) began in 1847, it worked to establish its dominance in the US health care marketplace. The first AMA Code of Medical Ethics included the “consultation clause” that prohibited AMA members from consulting with any practitioner who came from a school that was not considered to be regular (orthodox) medicine. To protect the interest of its members, the AMA suppressed attempts by other medical professions to gain legal recognition and licensure to practice across America.3,4
When chiropractic began in 1895, organized medicine was establishing its monopoly in health care.3 To survive, chiropractic established itself as a separate and distinct healing profession.5,6 Chiropractic organizations devoted their limited resources to legal defense and to establish licensure state by state. These actions were essential because without licensure, chiropractors were prosecuted for practicing “medicine.” Many chiropractors served time in jail instead of paying their fines, as they declared that they were practicing chiropractic and they did not want the money to be used to prosecute more chiropractors.4
In the following decades, the AMA distributed propaganda that would sway the medical profession and the public to believe that chiropractors were ineffective or harmful, even though no scientific evidence supported such statements.4 Through its influence, the AMA continued to prevent medical physicians from working with chiropractors and forbade hospitals from allowing chiropractors on staff, which made interprofessional relationships nearly impossible.3,4,6,7
Chiropractic continued to grow across America and the AMA intensified its efforts. In the late 1950s, a lawyer for the Iowa State Medical Society presented a plan to control chiropractic, which was adopted by the AMA. From that plan, the AMA established a clandestine committee “to contain and eliminate the chiropractic profession.”3,4,6–11 The committee's plan continued to forbid medical doctors from working with chiropractors, but also worked to oppose: chiropractic inroads in third party and federal health insurance, inclusion of chiropractors on hospital medical staffs, and federal recognition of an educational accreditation agency for chiropractic colleges.7 These efforts influenced decisions made by legislators, health care providers, and policy makers, which resulted in a negative impact on chiropracors' ability to practice and collaborate with other health professions.7
American chiropractors continued to persevere and in 1974, the Council on Chiropractic Education achieved federal recognition as the accrediting body for chiropractic training programs. Also in that year, licensure was finally gained in all 50 states.5,6 In 1976, several chiropractors sued the AMA for violation of US antitrust laws. It was not until 1980 that the AMA revised its policy and allowed medical doctors to collaborate with chiropractors.10 The protracted lawsuit lasted through 1990, when the chiropractors finally won.12 Thus, it was not until the early 1990s that there was any hope that interprofessional relationships could be established between organized medicine and chiropractic.
Nearly a century of barriers had been built that thwarted interprofessional research collaborations and prevented chiropractic and medical practitioners from working together. However, there were those who recognized that much could be gained for patients and the health professions if interprofessional relationships could be established.
Although patients valued chiropractors as beneficial health care providers and gave them high satisfaction rates,13–17 it would require substantial effort to overcome the decades of propaganda and the stifling of research and education. The chiropractic profession needed people with vision who could navigate uncharted territories to establish interdisciplinary relationships while continuing to build research and education from within. One of these way-finders was Dr Alan Adams.
Within this challenging milieu, Dr Adams worked with others and built bridges. He had perseverance and the ability to see beyond the barriers to find a path that would create positive relationships where there were none previously. He not only developed collaborative opportunities, but he also invited others to join him on his quest to create a more scientific and distinguished profession of chiropractic. Below is a brief bio-sketch of his work and our remembrances of what he meant to us.
Alan Howard Adams
Alan Adams started on his path to become a doctor of chiropractic in 1968 and graduated from the National College of Chiropractic in 1973 (Fig. 2). He ran a private chiropractic practice from 1973 to 1979. Simultaneously he was the president of Ellwart Clinical Laboratories, a state-licensed and Medicare-approved private clinical laboratory. He then moved to Canada and from 1979 to 1984 and was Chief Academic Officer and Dean of the Canadian Memorial Chiropractic College (CMCC). From 1985 to 2002, he was on the faculty and became the Vice President for Professional Affairs at the Los Angeles College of Chiropractic (LACC), later to become the Southern California University of Health Sciences. He then moved to Florida and from 2002 to 2005 he was the Academic Administrator, Office of the Provost at the Florida State University (FSU), Tallahassee where he worked diligently to establish the first chiropractic training program in a major public university. In the final years of his career, Dr Adams was a professor and Vice-President of Academic Affairs and Program Development at the Texas Chiropractic College (TCC).
He authored papers in peer-reviewed journals, a textbook, and several book chapters (see the accompanying supplemental file online at journalchiroed.com). His research interests included clinical and health services research, systematic reviews, and educational research. Dr Adams opened doors for the chiropractic profession to collaborate with other professions in both scientific and educational research. His considerable knowledge, affable nature, and determined spirit were noticed by leaders inside of other health professions who invited him to participate in an ever-more inclusive interprofessional environment. He served as a co-investigator on several federal grants and research review committees for the Health Resources and Services Administration (HRSA) and the National Institutes of Health (NIH). From 2008 to 2009, he served on the Advisory Committee on Interdisciplinary Community Based Linkages for the Bureau of Health Professions, HRSA, US Department of Health and Human Services (see the accompanying supplemental file online at journalchiroed.com). Whenever Al transitioned a barrier, he brought collaborating institutions and individuals with him, both inside and outside of the chiropractic profession.
He received multiple recognitions across many domains over the years. As examples, he was honored with the following awards: Chiropractor of the Year in Michigan (1979), Appreciation Award by the Canadian Chiropractic Association (1982), Chiropractic Scientific Researcher of the Year Award, International Chiropractors Association (1987), Certificate of Appreciation from the Consortium for Chiropractic Research (1993), Certificate of Merit from the American Association of Bioanalysts (2000), and Academic of the Year by the American Chiropractic Association (2001).
Dr Alan Adams was a champion of improving chiropractic education and academic scholarship and participated whenever he was asked. He assisted during the formative years of the Journal of Chiropractic Education, when Grace Jacobs was the founding Editor in Chief. He began serving on the editorial board of the JCE in 1990 and continued serving through 2020.18
However, his value goes beyond his published works, honors, and career. The interpersonal relationships that he developed with others are what are most treasured. Al shaped the careers of many chiropractic and medical scholars, several of whom would become some of the most influential people in spine research, chiropractic research, and chiropractic education. The following are personal stories and recollections that share a small portion of his value and what Al Adams has meant to us and the profession.
Beautiful Human Being
Al Adams was my research partner throughout the years I worked on spinal manipulation and chiropractic projects at RAND. He was an outstanding colleague. He was hard-working, fair, supportive, and critical when need be. The chiropractic work at RAND could not have been done, or done as well, without his participation.
Al and I worked in the foxhole together. We were shoulder to shoulder for many years working on projects and to Al's immense credit, he came at everything with an open mind. And, he was willing to be skeptical and willing to say things like he saw it. I want to make sure that Al gets the credit he deserves, that folks understand how vital he was to the work we did at RAND.13,17,19–22 Although he probably could not have done that RAND work without me, I know I definitely could not have done it without him.
In addition, he was a beautiful human being. I greatly treasure our time together and will miss him.
Paul G. Shekelle, MD, PhD
Professor, UCLA School of Medicine
Staff physician, VA Medical Center in West Los Angeles
Former Director of the Southern California Evidence-Based Practice Center, RAND Corporation
Los Angeles, CA
Teacher and Colleague
My first interactions with Al were primarily as his “teacher” and then later as a colleague. What I remember most was that Al was a model for all of us for what we now call growth mindset. He demonstrated grit and servant leadership. He was an avid and life-long learner, open to new ideas and to growing as a person and as a professional. He had a passion for chiropractic education and chiropractic medicine as a profession. He also had great perseverance in meeting his goals.
Thus, he exhibited both a growth mindset and grit. He was also a person who was a model in relation to character—a servant leader, focused on the greater good. He was humble and always kind to others.
Julie G. Nyquist, PhD
Professor, Department of Medical Education
Director, Master of Academic Medicine Program
Chair, Innovations in Medical Education Conference, 2015–2021
Keck School of Medicine of USC
Los Angeles, CA
Dr Alan Adams deserves to be remembered for his significant impact on the evolution of chiropractic education and research at key points in our profession's history. By the time I received my DC degree in 1982, I had become quite concerned about the general lack of good scientific data underpinning chiropractic theory and practice, and I had managed to nab a job as an instructor at Palmer West.
I really wanted to do something to improve chiropractic science. My mentor and boss at the time, Barney Coyle, allowed me to attend some educational conferences and before too long I met Al Adams. I recall our first meeting. After I had made one of my first bumbling research presentations, he stopped me in the hall, introduced himself, and proceeded to tell me how important it was to engage in research and that he was so glad that I was doing it. His gregarious and engaging personality was so positive, which I appreciated. Up to that point I was undecided about going into practice or staying with the academic job, but at that point my mind was made up. I have pursued chiropractic academics and research for almost 40 years now.
As it turned out, Al Adams was a copious font of knowledge (and opinions!) about education and research. He could simply not stop talking for hours at a time about these subjects to anyone who would listen. He was a voracious reader of the literature and he was always sharing papers and books to his large group of colleagues.
He was so passionate and encouraging that I believe he can be credited for impacting an entire cohort of young DCs to go into academics and research. Part of Al's toolkit was his ability to network. He was never so happy as when he was introducing people that he knew to each other. As a professional “matchmaker” Al Adams will never be surpassed. He seemed to know everybody in every important place doing every important thing in chiropractic education and research and beyond.
Al had no fear of approaching institutions and august experts. Whereas, what he did would have been very intimidating for me back then. For example, I believe Al was largely responsible for initiating the relationship with RAND that resulted in the early published meta-analyses that described more evidence for spinal manipulation than other conservative interventions for back pain. That work with RAND in the late 1980s and early 1990s was instrumental in jump-starting a great amount of additional research that we now take for granted.
Al was a key player in so many efforts to raise the quality of chiropractic education, research, and practice over the past 4 decades. Just a few that come to mind include the California Chiropractic Association supported Conferences on Research and Education (CORE), which led to the Consortium for Chiropractic Research, an organization that would eventually include almost every chiropractic college in North America. He was centrally involved in the Mercy Guidelines,23 the establishment of chiropractic in the Veteran's Health Administration and Department of Defense, the attempt to start a chiropractic program at FSU, and the growing movement to embrace the concepts of evidence-based medicine in practice and teaching. He was a huge proponent of the Association of Chiropractic Colleges Education Conferences and the Research Agenda Conferences and made many contributions to the advancement of those meetings over the years.24–27
I will miss Al Adams' curious, passionate, and energetic personality. I will miss those long and involved discussions that he loved. He was a true supporter of the concept that our profession needed to pursue what he called “cultural authority.” I believe that chiropractic has made significant gains in this regard over the past few decades, and I do believe that without Alan Adams constant engagement, those gains would not be what they are now.
William Meeker, DC, MPH
President, Palmer College of Chiropractic West
San Jose, CA
Alan Adams was well known for being very exact. He could take several minutes to answer a yes or no question because he wanted to include all of the potential possibilities. This made him the best choice to work on projects that required very specific outcomes. One example of this was the development of the Mercy Guidelines.23 Al was a member of the steering committee and was instrumental at keeping the process on the straight and narrow. The guidelines were developed based on the best available evidence combined with clinical experience. Al was the captain of the Clinical Laboratory committee, which comprised 6 additional committee members from both the academic and clinical practice sectors.
The committee was given the task of identifying and reviewing all of the applicable studies and synthesizing the data into a foundation upon which the guidelines were developed. This proved to be no small task. The culmination of their efforts required an all-night meeting of the committee at the guidelines conference during which the final draft of the Clinical Laboratory guideless were completed for presentation to the full body the next morning.
Al did not waiver in his determination to complete the assignment continuing into the morning to present each chapter guideline for discussion and debate. Al Adams' contributions to the advancement of the chiropractic profession are numerous. He will be missed in many ways.
Donald M. Petersen, Jr.
President, MPA Media—Publisher of Dynamic Chiropractic, Acupuncture Today, To Your Health & GoChiroTV
Huntington Beach, CA
Mentor and Friend
The year was 1986. I had started my chiropractic journey at LACC in the fall of 1985. I had questions. Questions about evidence, about research, about what my fellow students and I were being taught in class.
I cannot remember who suggested I meet with Dr Adams. Simply put, I would not be where I am today if it were not for the support and mentorship of and inspiring discussions with Dr Adams. He took me under his wing, introducing me to evidence-based practice (EBP), to public health and epidemiology, to research studies and the potential for a career in academia. He encouraged me to pursue graduate studies at University of California, Los Angeles (UCLA) and corralled me for the original RAND appropriateness project. As they say, the rest is history.
Dr Adams and I talked for hours on end about chiropractic history, recent studies, and the importance of evidence, of seeking the truth about the effects and mechanisms of chiropractic and spinal manipulation. We talked about articles and books, old and just-published, introducing each other to new or noteworthy books in health, medicine, and the history of science and public health. Mostly a 1-way street, however, as Dr Adams' library must be one of the most well-stocked in the country. He always seemed to have a book or journal in hand when I would visit his office. He would always have an open door and was so generous with his time. We talked about his idea of him opening a bookstore-café in his retirement, well before this became commonplace.
Dr Adams was a dear mentor, friend, and colleague. He helped me navigate the sometimes treacherous waters of academia. He even served as a mediator in the successful resolution of a conflict I had with my advisor. And before that he resolved a conflict that I had with my clinic professor so I could attend class at UCLA during my LACC internship. At LACC and at conferences and other venues, Dr Adams would introduce me to legendary researchers who have remained colleagues and friends today, including Drs Scott Haldeman and Ian Coulter.
Needless to say, Dr Adams was instrumental in opening my eyes to the possibilities, of furthering my education, of contributing to science, of working to help develop and build the nascent evidence base for chiropractic and spinal manipulative therapy.13,17,20–22,28–31
Dr Adams may have moved up to the big bookstore-café in the sky, but his legacy is alive and well and will remain so in the years and decades to come.
Eric L. Hurwitz, DC, PhD
Graduate Chair, Epidemiology PhD Program
University of Hawai‘i at Mānoa
Office of Public Health Studies
Dedication to Life-Long Learning
I first met Dr Al Adams in 1989 during my first year of chiropractic school. He gave a guest lecture in our philosophy class about the importance of research in clinical practice. He strolled throughout the classroom emphatically speaking and enthusiastically shaking his hands. He convinced us that chiropractic practice and chiropractic research were intertwined. He quoted scientific papers, handed out newly published articles, recommended books, and excited us with his stories about what was happening in important chiropractic research programs. Al was the original chiropractic EBP evangelist.
We became friends after I was hired as a faculty member at the LACC. One of my assignments was to develop and lead a course on critical appraisal of chiropractic procedures. Al found out that I was assigned to the course and invited me to his office “for a few minutes” so he could share some of his resources with me. At the time, I did not know that Al was the person who had originally designed the course and insisted that it was included in the curriculum. When I left Al's office that day, he had equipped me with everything that I needed to run the class: the class rubric, a list of guest speakers, research articles, and suggestions for engaging the students. In that meeting, Al demonstrated his incredibly generous nature and exemplified EBPs in both clinical practice and education. He inspired me to strive to integrate evidence, common sense, experience, and the end user's needs.
Al seemed to know everyone in health professions education. He introduced me to luminaries who I never would have mustered up the courage to meet otherwise. I recall the times when he introduced me to leaders of evidence-based medicine and medical education, including Geoffrey Norman, Ilene Harris, and William McGahie. His ability to inspire others and connect people have had lasting impressions on me. He inspired me to assist with fortifying and building education research capacity for the chiropractic profession through research, including in my role as a journal editor.32–36
Al had a passion to increase educational research capacity in chiropractic. With this in mind he worked with medical educators at the University of Southern California to create a master's program in health professions education that could elevate health professions educators' teaching and leadership skills. Al's dream was that chiropractic faculty members would complete the master's degree, bring their skills back to their respective chiropractic colleges, and ultimately increase educational research capacity. Al invited Claire and me to go to dinner with him and Maurice Hitchcock from the University of Southern California while they laid out their plan. All the while they asked for our input and opinions. We were there at the beginning and witnessed its creation. Within a year that master's program was offered at the University of Southern California, Al was on the faculty, Maurice was the program director, and Claire and I were in the first class of students. Al became my thesis advisor and was the ultimate mentor (Fig. 3).
Al reveled in connecting people to one another, good books, new research articles, nutritious food, museums, good bargains, but most importantly sharing information that would benefit another person. Al was a maven, a giver, a terrific scholar, and health professions educator. I value his passion, his kindness, our conversations, and his dedication to life-long learning, yet these are traits that he inspired in all of us. I am grateful to have been one of his chiropractic progenies.
Bart N. Green, DC, MSEd, PhD
Chiropractor, Stanford Health Care
Lecturer, National University of Health Sciences
Editor-in-Chief, Journal of Chiropractic Education
San Diego, CA
I am deeply saddened to be writing this tribute as it involves a very dear friend, mentor, educator, and impactful leader in the chiropractic profession. There are those among us who may be able to attribute to 1 individual a significant influence on their career path. For me Dr Alan Adams was that individual.
I first met Al in spring 1979 in Toronto at CMCC. Al was the incoming Dean, and I was a first-year clinical sciences resident. Drs Adrian Grice and Ron Gitelman were instrumental in bringing Al to CMCC. They saw in Al the ability to advance the program at CMCC and for that we are forever grateful.
It did not take long to realize that health professions education was of keen interest to Al. His interest influenced several of us including Dr Mike Wiles, a classmate of mine at CMCC. Within weeks of Al's arrival at CMCC, Mike and I were sent to Harvard Medical School in June 1979. We attended courses presented by the Department of Continuing Education at Harvard Medical School including Decision-making in Clinical Medicine. Among the individuals I met at that conference was Dr Don Berwick, future Administrator of the US Centers for Medicare and Medicaid Services. The fact that this was the first time this course was taught at Harvard illustrates how well Al was informed regarding key areas related to health professions education.
Al departed CMCC and went to LACC in the 1980s. He worked with Dr Coulter and others at RAND in Los Angeles. Al was among the co-authors on RAND publications that ultimately led to a national reappraisal of chiropractic in the United States. Al never stopped connecting and contributing to the understanding of chiropractic in health care. Related to his work at RAND, Al gave a presentation on chiropractic in 1995 at first conference on Complementary and Alternative Medicine at Harvard Medical School. I was fortunate to accompany Al to that conference during which we met with Dr David Eisenberg, the convener of the conference. During that meeting, we provided Dr Eisenberg with a copy of CMCC's, Chiropractic Research Archive Collection. Dr Eisenberg was teaching a course on Complementary and Alternative Medicine at Harvard and was pleased to receive the collection. This was another example of Al connecting and sharing with others a perspective on chiropractic education.
Al went from LACC to FSU to develop a chiropractic program in the late 1990s. He was instrumental in designing a program that would have included a dual degree program DC/masters upon completion. Although the FSU program did not come to realization, Al brought many contributors to chiropractic together to advance the cause of chiropractic education at the public university level in the United States.
Al moved from FSU to TCC and heavily influenced chiropractic education once again. His leadership led to enhancing education at TCC and contributed to successful re-accreditation at the program and regional levels. In addition, Al led the development of the TCC Graduate, a learning outcomes framework patterned after the Scottish Doctor, to guide curriculum planning. This was a multiyear project that is updated regularly at TCC. The TCC Graduate continues to be used as a foundational document related to the TCC curriculum.
Al was an effective faculty recruiter and developer throughout his career. He brought many leading faculty developers to CMCC, LACC, and TCC over the years. Al, Drs Stephen Foster, Rahim Karim, and I had a poster accepted to the First International Conference on Faculty Development in the Health Professions in Toronto in 2011. If it were not for Al, we may not have been motivated to submit to the conference let alone have our submission accepted.
Al's influence as a connector has had a lasting impact. Al introduced me to Drs Claire Johnson and Bart Green leading to a life-long friendship. Claire and Bart continue to contribute to this profession. There are many more instances of Al making connections across the professions that cannot be reasonably captured in this tribute. Suffice to say that his influence was far reaching.
If you knew Al, you most likely were the recipient of numerous photocopied articles that he thought you might be interested in. Al read widely and always wanted to deliver articles to those he knew might enjoy reading them. This was a life-long habit of Al's. He had an insatiable desire to print and share scientific papers. Also, Al had a personal collection of books to rival many a chiropractic college library.
Al was a wonderful and thoughtful friend. We shared many great times over the years. As an example, following a World Federation of Chiropractic conference in Paris, France in 2001 Al, his wife Sharon, my wife Elly, and I traveled by train to Nice and Provence. The scenery was fabulous and the train ride remarkable, especially the high-speed portion. Afterward, we would often share the memories of that and other trips made over the years.
Al was a friend and mentor, always stimulating me to read further and pursue my interests in education (Fig. 4). I had the privilege of knowing Al for over 40 years. I shall miss him greatly.
John Mrozek, DC, MEd, EdD
Presidents Liaison: Education and External Affairs
Texas Chiropractic College
Fostered Interdisciplinary Relations
I first met Alan in 1976 when we both were invited to present papers at a conference to investigate the chiropractic management of pneumoconiosis, which was convened by Milton J. Shapp, Governor of Pennsylvania, and chaired by Dr Louis Sportelli.37 Neither Alan nor I knew very much about pneumoconiosis but we agreed that research was necessary before any claims could be made that chiropractic might have any impact on this serious disease (Fig. 5). That meeting forged a 45-year friendship based on a mutual dedication to research and an interdisciplinary evidence-based approach to the management of people whose lives are impacted by spinal disorders and to define a role for chiropractic within this framework.
Alan brought multiple strengths and his expertise to the table, but he stood out in 3 fields where our careers intersected. His earliest strength was his expertise in clinical and laboratory diagnosis. His experience in the Ellwart clinical laboratories in the mid-70s was unique within the chiropractic profession and made him the go-to person whenever the chiropractic profession needed expertise in these fields. This was especially important as, at that time, chiropractors were denied access to or training in medical laboratory diagnosis because of the AMA ethics regulations. For many years, whenever I or anyone else was trying to define a role for chiropractic in the management of spinal disorders and needed a speaker or author to discuss diagnosis, Alan was the first person we turned to. He consistently argued for a role for diagnosis within chiropractic clinical practice.
Alan's unique skill was fostering interdisciplinary relations to advance research and teaching of chiropractors. There were very few initiatives that were aimed at increasing cooperation between the medical and chiropractic professions that Alan was not involved in. Amongst these included the early attempts to integrate chiropractic programs into state and provincial universities, and integration of chiropractic services into the Veterans Administration Chiropractic Services Demonstration Project (1985–1989) and the Chiropractic Health Services Steering Committee at the RAND corporation (1990–1997). I had the privilege of working with Alan on many of these projects.
Our friendship and collaboration increased markedly when he was working at LACC and I was on faculty at the University of California at Irvine (UCI). He achieved many of his goals of interdisciplinary cooperation through his positions on the Cedars-Sinai Steering Committee on Complementary Health Care (1997), his membership on the Southern California Center for the Study of Complementary Health Care at UCI (1997–2002) and his appointment to the Board of Advisors of the Susan Samueli Center for Complimentary & Alternative Medicine at UCI College of Medicine (2000–2002). His unrelenting devotion to interdisciplinary cooperation brought us together at international meetings and conferences almost every month. He continued this drive to integrate chiropractic into mainstream health care in his later years through his membership on the Advisory Committee on Interdisciplinary, Community-Based Linkages at the Bureau of Health Professions (HRSA US Department of Health and Human Services).38
There was, however, no greater confluence in our ideas and ideals than the drive for research, practice standards, and evidence-based guidelines in the field of spine care broadly and chiropractic practice specifically. We worked closely on the Guidelines for Chiropractic Quality Assurance and Practice Parameters (The Mercy Conference, 1992) where he served on the Steering Committee.23 He took leadership roles on the Consortium for Chiropractic Research (1990–1995), the Research Advisory Committee of the Foundation for Chiropractic Education & Research (1993–1994), the American Spinal Research Foundation (1994–1997), the National Workshop to Develop the Chiropractic Research Agenda,39 Bureau of Health Profession (1996–1999), and the Council on Chiropractic Guidelines & Practice Parameters (CCGPP) where he served for almost 20 years. The success of these initiatives is due to a large extent to Alan's commitment to EBP.
The chiropractic profession owes a great deal to Alan. His dedication to teaching, research, interdisciplinary care, and evidence-based guidelines for over 40 years markedly improved the education and practice of chiropractors and the care of the people they serve throughout the world. For those of us who knew him personally and worked closely with him for years, he will be missed but never forgotten.
Scott Haldeman DC, MD, PhD
President, World spine Care
Clinical Professor, Department of Neurology, University of California, Irvine, CA
Adjunct Professor, Ontario Tech University, Toronto, Ontario, Canada
Santa Ana, CA
It is with very deep sorrow that I write this tribute to a dear friend and great chiropractor, Al Adams. In everyone's life there is probably at least 1 individual who we can say changed our lives. But few so radically as Alan changed mine.
I first met Alan when I visited CMCC as part of the Canadian chiropractic study in the late 1970s (Fig. 6). Following the completion of the study, he invited me to present some of our results at the College. Following this, he then invited me to a conference in Dearborn Michigan to present to the profession. This began my 40-year journey into chiropractic.
Following the study, I became the Assistant Vice Provost of Health Sciences at the University of Toronto, not only administering all the health sciences but also serving on the Provincial Committees for the Health Sciences. At the same time, CMCC was pursuing a university affiliation project very dear to Alan's heart. At some point Alan decided that I had the correct background to help them restructure the College so that it would run more like a university with policies that would harmonize with a university structure should they become affiliated. Secondly, he concluded that I knew my way around the very committees they would have to deal with. Although I have no idea how he managed it, but somehow he convinced CMCC they should recruit me as a Vice President to help with both of these things. The fact I knew a lot about the college having spent a year there in a participant observation study was simply a bonus for Alan.
This says a lot about Alan's character, because it not only made me his boss, but this also meant I took charge of a lot of areas that had been Alan's domain at the college. But Alan's commitment to the profession was never about personal ambition. Instead, it was about advancing the best interest for the chiropractic profession. Alan was without a doubt the best educationalist I ever met, and his whole career was about improving chiropractic education.24,40 He did that at National, CMCC, LACC, and Texas. Not only did he transform their educational programs, he influenced many, many others.
I recall 2 stories from CMCC that capture the essence of Alan. The first was when I was at CMCC researching the place in 1975–1976. You were lucky if you could find the library; if you found the library, it was probably not opened, and if it was opened, there was hardly anything in it. I remember our research team being staggered how this college could function with such a poor library. By the time Alan left CMCC, it probably had the finest library in chiropractic. He recruited an outstanding librarian, Claire Callaghan. In addition to staff she recruited, the 2 of them then set about building a state-of-the-art library. The only better library was Alan's own, which was so large that on one occasion he was told to strengthen the floors in his home to accommodate the weight of the books, there being a goodly chance the floor would have collapsed. Not only did he have the largest library I ever encountered, but he also read them all. He was without doubt the best-read individual in the profession. On numerous occasions I would introduce him to colleagues from the university and he would stagger them by quoting their own work to them.
The second exemplar illustrates 1 of his key characteristics. He was always at the cutting edge of educational innovation. When McMaster University was developing the concepts of problem-based learning (PBL) and EBP, Alan was immediately attentive and not only became a student but started sending residents from CMCC to train at McMaster. They then brought back the ideas to CMCC and began introducing PBL and EBP into the curriculum. The development of both of these concepts in the profession owes a huge debt to Alan for his innovation and commitment. This also illustrates another great characteristic—his ability to mobilize and encourage others. Alan did not create the program at CMCC by himself, but he was able to initiate it and stimulate others to engage.
When Alan left CMCC to join LACC, I personally experienced a great loss. Little did I know that Alan would once again recruit me to join him in Los Angeles. To this day I am still staggered he was able to do that, but coming to LACC and RAND and then later UCLA and the Samueli Institute was to be a defining event in my career that was not even on our radar until Alan put it there.
Many stories are told about why Alan left Canada to come back to the United States. My own and Alan's version is somewhat different. One version was that he disliked Canadian taxes. He claimed it was for another reason. Quite often and unconsciously I would call Alan by my wife's name, Adelaide. They both start with A and since I interacted with both, I would sometimes get the names confused. But he claimed he decided to leave CMCC when I started calling him “Dear.” For the record, I did not ever call my wife “Alan,” which probably explains why I am still married to her.
But Alan will live on in the profession not only through his innovations but also through all the educationalists he produced and all the students he taught. And, Alan had one other invaluable asset. His wife Sharon, who not only supported Alan through all his moves but provided him with the kind of support that allowed Alan to live for his books, his students, his colleagues, and his profession. Without Sharon, Alan would not have been able to make the contribution he did, and so our debt is as much to Sharon as it is to Alan. Last year (2020) was a terrible year for all kinds of reasons, but it was a terrible year made even worse by the loss of Alan, a dear friend, an honored colleague, and simply the most dedicated educationalist I have ever meet.
Ian D. Coulter, PhD
Senior Health Policy Researcher
Santa Monica, CA
Dr Alan Adams helped us to bridge the past, where there was little available chiropractic research and few collaborative relationships with other professions, with the future, where we are now—engaged in science, research, and expanding interprofessional relationships. He accomplished this at a time when there was little hope that such accomplishments or relationships could be built.
He was involved in research studies at the time chiropractic was still emerging.42 Under his guidance as the Director of Research at the LACC, he helped to secure the largest federal grant ever obtained for chiropractic research at that time. The study was done in collaboration with the University of California, Irvine's College of Medicine Department of Physical Medicine and Rehabilitation. Under the principal investigator John Hsieh, MS, DC, the study aimed to investigate if chiropractic manipulation was the most cost-effective treatment for mechanical low back pain and how patients select a medical or chiropractic clinician to care for their low back pain and other outcomes.43,44 As one of the clinicians who provided chiropractic care for this study, I had the opportunity to work with other health professions and to see that collaboration was possible for chiropractic.
He helped bring to chiropractic education words that we take for granted today but were originally foreign in our lexicon (eg, EBP, life-long learning). He assisted chiropractic to participate and be seen in the mainstream research world at a time when chiropractic was marginalized or forbidden.
He was ahead of his time. He helped to develop integrative conferences (eg, Conference on the Study of Complementary Health Care, UCI/LACC August 9–10, 1996) before most anyone knew what the term “integrated” really meant.45 He also had a vision to include chiropractic in state education programs (ie, FSU); however, the world was not quite ready at that time.
When talking with Dr Adams, his passion about improving the chiropractic profession was contagious. He was not able to contain his enthusiasm to share information and connections to others. He was always creating opportunities. His hands would join him as he was speaking, moving in front of him, creating a space that urged people to imagine his ideas along with him. He would plant the seeds so that others could grow and care for them. Often, he had already moved on before he could taste the fruit from the trees that he originally helped plant. But for him, there was great joy in seeing others reap the benefit of the harvest.
He helped us by living as an example of what we could be. He showed us that we could be gracious and brave. As chiropractors, we could not only attend but we could make presentations at large, international, and interdisciplinary conferences. We did not have to settle for second rate education, we could also be great and contribute to health professions education at large.
Some people brag about what they have done or who they know. Dr Adams was the opposite. He would insist that we join him and participate fully in the event, and then he would introduce us to every important person he knew that was there. He provided us with opportunities that others were not willing or able to provide. He would see what was needed before anyone else could and would prepare so that we would be ready. He created safe spaces for us so that we could walk into them and reach our potential.
Al was a supreme ambassador. He was interested in being the catalyst, not necessarily being a part of the substrate. He made introductions and created the situations. He never made it about “him.” Instead, his drive was to advance the chiropractic profession. People may remember the events and what was gained, but rarely do they remember that Al was involved. However, when you look closely, you see that he was there the whole time—watching and making sure that positive change happened. He was the essence of a true servant leader.
I will remember his kind ways and what I have called his magical “Mary Poppins” bag, in which he would pull out the exact document or book that was needed at that moment and lend it so we could read it and learn, then share it with others. I will continue to try earnestly to emulate him, knowing that Al will never be replicated or replaced.
If a life could be valued in the amount of knowledge and experiences that one has given to others, I would say that Dr Alan Adams had a tremendously rich life.
Claire D. Johnson, DC, MSEd, PhD
Professor, National University of Health Sciences
Dr Adams was a great friend, mentor, and impacted our lives so much. Many of us are doing what we are doing today or have been impacted in some way because of Al's support and encouragement. He was a wonderful role-model, especially in his way of sharing and caring about others. Throughout Dr Adams' career, he challenged the status quo and created opportunities for others to engage in ways to improve the chiropractic profession, especially through education and research.
We are but a few of the people who Dr Alan Adams touched during his lifetime. Many others have benefited from his wit and wisdom. And yet many more—those who have never met him—have benefited from his passion and his efforts to advance the chiropractic profession.
FUNDING AND CONFLICTS OF INTEREST
No funding was received for this paper. The views expressed in this article are only those of the authors and do not reflect the official policy or position of any of the employers or affiliations of the authors. BNG is the editor-in-chief of the Journal of Chiropractic Education, JGN is the Assistant Editor of the Journal of Chiropractic Education. CDJ and JM are on the editorial board of the Journal of Chiropractic Education. No other conflicts of interest were reported.
Concept development: CDJ, BNG. Design: CDJ, BNG. Supervision: CDJ. Data collection/processing: CDJ. Literature search: CDJ. Writing: CDJ, BNG, IDC, SH, ELH, JGN, WM, JM, DMP, PGS. Critical review: CDJ, BNG, IDC, SH, ELH, JGN, WM, JM, DMP, PGS.