This paper provides the authors' introduction to Looking Back: A Historical Review of the Lawsuit That Transformed the Chiropractic Profession, which is a series of papers that reviews events surrounding the federal antitrust lawsuit Wilk v American Medical Association. Information in this series describes the events before, during, and after the lawsuit and the relevant issues related to the transformation of American mainstream health care and chiropractic. These papers give insight into many of the factors that shaped the chiropractic profession that we know today.
Looking back at the path that we have traveled provides insight into our present and gives us the wisdom to navigate our future. Although it may seem paradoxical, to move ahead, we must start by looking back.
The enigma of chiropractic has fascinated people for more than a century. This profession has gathered both fans and foes, each arguing about what they perceive chiropractic to be or should be.
From its founding and early theory development to becoming an established and recognized health profession, various external and internal forces have shaped the chiropractic profession. Legislation, culture, world events, societal values, and other health professions each have left their impressions. However, one could argue that there has been no greater course-altering force than that imposed by organized medicine, primarily through the actions of the American Medical Association (AMA), which is the largest and oldest professional health care association in the United States.
To investigate chiropractic development and its presence within health care, we examined a critical event in the profession's history: the federal antitrust lawsuit Wilk v American Medical Association (AMA).1,2 We synthesized hundreds of historical documents and interviewed key participants (Figs. 1–4).
The result of our research is this series of papers,3–10 which was written for people who are curious about chiropractic. Why is chiropractic the way it is? Where does the perceived tension between medicine and chiropractic come from? Was this trial necessary for chiropractic to exist as a health profession? Looking more closely at the Wilk v AMA1,2 federal antitrust lawsuit helps to provide some of the answers.
These papers describe American mainstream health care, chiropractic, and the events leading up to the lawsuit. Included are details about a small group of chiropractors who charged the medical establishment with conspiring to monopolize health care services and restrain chiropractors from competing in delivering health care to the American public. They alleged that the AMA and its codefendants plotted to “isolate and then eliminate the chiropractic profession in the United States.”11
The recounting of events surrounding the lawsuit provides some insights of which many people are unaware. Our goal in writing this series was to offer an objective historical narrative to further illuminate the discussion surrounding these issues. We recognize that this viewpoint comes from authors who are within the chiropractic profession. Yet we hope that this story will inspire readers from all fields to be empowered to engage in healthy dialogue and to improve collaboration among the health professions to better serve the public.
When considering the facts revealed in these papers, we urge readers to consider the context before judging any person or profession. To judge past events using today's standards takes them out of context, leading to misunderstandings. Chiropractic historian Pierre Louis Gaucher-Peslherbe warned against using contemporary views to exact criticism of those before us. He stated,
A science must be constantly on its guard against this kind of attempt to manipulate its history, or it will be cheated of its heritage even if it is cheated by itself. Chiropractic will not be a properly constituted science until it can disentangle itself from its history, but neither will it last long as a science if it does not accept the truth about this history.12
The world has changed immeasurably since this lawsuit concluded. Since that time, there has been a substantial increase in collaboration among health care professions throughout the world. If we are to move beyond previous events, we must recognize the discord, learn from past mistakes, strive to find common ground, and work together to find a path to tolerance and harmony. We should do this not only for ourselves but also for the patients and the public that we serve.
As authors, we have been heartened by the support of everyone who has taken an interest in our investigations. We hope that you will find this historical series Looking Back inspirational and informative and that it will provide a better understanding of the chiropractic that we know today.
We thank the following people for their detailed reviews and feedback during development of this project: Ms Mariah Branson, Dr Alana Callender, Dr Cindy Chapman, Dr Gerry Clum, Dr Scott Haldeman, Mr Bryan Harding, Mr Patrick McNerney, Dr Louis Sportelli, Mr Glenn Ritchie, Dr Eric Russell, Dr Randy Tripp, Mr Mike Whitmer, Dr James Winterstein, Dr Wayne Wolfson, and Dr Kenneth Young.
FUNDING AND CONFLICTS OF INTEREST
This project was funded and the copyright is owned by NCMIC. The views expressed in this article are only those of the authors and do not reflect the official policy or position of NCMIC, the National University of Health Sciences, or the Association of Chiropractic Colleges. BNG is the editor in chief of the Journal of Chiropractic Education, and CDJ is on the NCMIC board and the editorial board of the Journal of Chiropractic Education. No other conflicts of interest were reported.
Claire Johnson, DC, MSEd, PhD, has been a licensed chiropractor for 30 years and is the editor in chief for 3 scientific journals: Journal of Manipulative and Physiological Therapeutics, Journal of Chiropractic Medicine, and Journal of Chiropractic Humanities. She has decades of experience publishing in the fields of clinical and historical research and is a professor at the National University of Health Sciences. The daughter of a medical physician, she grew up in the San Francisco Bay Area, where she witnessed the conflicts between medical and chiropractic providers and wondered why such tensions existed. One of her passions has been to try to unravel this mystery and find a way forward. Her work with interprofessional relationships has included coordination of a team of international spine experts who developed an evidence-informed spine care model for communities around the world. Her master's degree in health professions education and her public health doctorate contribute to her expanded worldview and greater understanding of the interconnectivity of this important historical subject, including the impact of this trial on chiropractic, patients, and the public. Claire Johnson is a professor at the National University of Health Sciences (200 East Roosevelt Road, Lombard, IL 60148; firstname.lastname@example.org).
Bart Green, DC, MSEd, PhD, provides chiropractic care in an interdisciplinary, on-site corporate health center in San Diego, California, and is a faculty member at the National University of Health Sciences. He has developed doctorate courses in the domains of chiropractic history and clinical education at several chiropractic programs. He is the editor in chief of the Journal of Chiropractic Education. He was raised in the Los Angeles area, where he observed health disparities and the need for both medical and chiropractic care to be made more available for underserved populations. He is a skilled communicator and has experience navigating the complexity of interprofessional collaborative relationships in the medical health care environment. He served on the medical staff at Naval Medical Center San Diego in interprofessional spine, sports, and combat casualty care clinics, providing chiropractic care to active-duty military members. He has taught in clinical settings training chiropractors, chiropractic students, medical students, nursing students, residents, physician assistant students, and navy corpsmen. Bart Green is a lecturer at the National University of Health Sciences (200 East Roosevelt Road, Lombard IL 60148; email@example.com).
Concept development: CDJ, BNG. Design: CDJ, BNG. Supervision: CDJ. Data collection/processing: CDJ, BNG. Analysis/interpretation: CDJ, BNG. Literature search: CDJ, BNG. Writing: CDJ, BNG. Critical review: CDJ, BNG.