Chiropractic/Archive 15

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Practice Styles, Schools of Thought Revisions

I think hyperbole made a good edit in moving the practice style up the wiki as the article has better flow and better educates the reader in the differing viewpoints of DCs.

I do think, however, that the entire definitional things of straight vs. objective straight vs. mixer vs. reform is too bloated, however. There really is no 'reform' group, it's just an evolution/subgroup of mixer and need not be mentioned.

Overall, I'd like to see the article as a whole pruned and tightened up. There have been recent meta-analyses which offers a better, more reliable and credible summary of the scientific inquiries, both pro and con of manipulation and chiropractic care. I hope our regular editors and admins will embark with me in reducing the bloat here, providing more up to date references/evidences and to be fair to both sides of the story.

EBDCM

01:05, 3 February 2008 (UTC)

Thank you. I have some problems with dematt's table, though - specifically, that I don't understand it at all. Is there anything that can be done to make it more coherent to a layperson? --Hyperbole01:08, 3 February 2008 (UTC)

The reform section should stay. All viewpoints are welcomed. The table looks out of place. QuackGuru Quack 01:11, 3 February 2008 (UTC)

I think the table looks good there (anything to break up the massive, unrelenting block of text this article has become, especially at the beginning of the "scientific inquiries into chiropractic" subhead. I just don't understand what the heck the table means. --Hyperbole01:12, 3 February 2008 (UTC)

I still have a problem with the incoherent table. QuackGuru08:00, 13 February 2008 (UTC)

The table makes no sense to the average person. Thoughts. QuackGuru04:22, 16 February 2008 (UTC)

I'll see what I can do to make it more readable. -- Dematt Dēmatt 04:49, 16 February 2008 (UTC)

I'll put it here to work on it:

| class="wikitable" style="text-align:left;margin-left:4em;"

!width="150"| Perspective Attribute

!width="350"| Potential Belief Endpoints

|-

| Scope of practice:

| align = "center"|narrow ("straight") broad ("mixer")

|-

| Diagnostic approach:

| align = "center"|intuitive analytical

|-

| Philosophic orientation:

| align = "center"|vitalistic materialistic

|-

| Scientific orientation:

| align = "center"|descriptive experimental

|-

| Process orientation:

| align = "center"|implicit explicit

|-

| Practice attitude:

| align = "center"|doctor/model-centered patient-situation-centered

|-

|Professional integration :

|align = "center"|separate and distinct integrated into mainstream

|-

| colspan="2" width="400" style="font-size:9px;text-align:left;" | Table 2. Range of Belief in Chiropractic

Source: Phillips RB, Mootz RD. Contemporary chiropractic philosophy. In Haldeman S (ed). Principles and Practice of Chiropractic, 2nd Ed. Norwalk, CT: Appleton Lange, 1992. Chart reprinted from Keating J (1995), D.D. Palmer's Forgotten Theories of Chiropractichttp://www.chiroweb.com/archives/ahcpr/uschiros.PDF

|

-- Dematt Dēmatt 04:54, 16 February 2008 (UTC)

QG, what is it that you don't understand about the table? -- Dematt Dēmatt 04:56, 16 February 2008 (UTC)

Scope of practice: narrow ("straight") broad ("mixer")

Philosophic orientation: vitalistic materialistic

These two. Is there a reason for leaving out "objective straight" and "reformer" groups. QuackGuru05:08, 16 February 2008 (UTC)

The table looked out of place where it was. Maybe it could be formatted differently to have a narrow table (less wide) and off to the right hand side. QuackGuru05:19, 16 February 2008 (UTC)

Ah, I see what you mean. Something like this:

objective straight reform

The problem is that if we did this it would be original research because we would essentially be changing the table to fit our needs rather than what the original referenced author stated. -- Dematt Dēmatt 05:19, 16 February 2008 (UTC)

However, if you add another reference or two about the other two groups it would be NPOV. QuackGuru05:23, 16 February 2008 (UTC)

I think you are right. Find me those sources, but they have to be verifiable and reliable, and let's see what we can do. -- Dematt Dēmatt 05:39, 16 February 2008 (UTC)

Or maybe we can take out the straight and mixer:

narrow broad

-- Dematt Dēmatt 05:41, 16 February 2008 (UTC)

For the other one, we could wikilink the words for those who don't know what they mean:

vitalism materialism

Does that help? -- Dematt Dēmatt 05:45, 16 February 2008 (UTC)

narrow broad This is good and NPOV.

vitalism materialism I prefer no links.

I will edit the article and show you what I think will work. QuackGuru06:27, 16 February 2008 (UTC)

I re-arranged it some, but am not sure if it will stick. Though, it is functionally acceptable, it may still be OR. This would require consensus to keep. -- Dematt Dēmatt 13:56, 16 February 2008 (UTC)

I prefer we move it to the right. It still looks out of place. Do I have permission to improve it. QuackGuru04:08, 17 February 2008 (UTC)

undent QG, as per Hughgr's recommedations, bring a proposed edit here on the talk page that incorporates objective straights in the straight section and integrate reform under the mixer heading. That way that should solve the problem since we can verify the 2 main styles whilst acknowledging the recent off-shoots (subsets) in each. Agreed? EBDCM02:21, 18 February 2008 (UTC)

Thanks for your comment. I'm not sure how to write it. If you have any ideas, please edit the article. Be BOLD. QuackGuru05:02, 18 February 2008 (UTC)

Too long!

The Wikipedia manual of style recommends that articles be no longer than between 6,000 to 10,000 words, or 30 to 50K. This article, right now, is 10,395 words and 73K. It's too long; no reader is going to want to read the whole thing.

Almost one third of this article consists of the "Scientific inquiries into chiropractic care" section - which, itself, is just one study after another after another and badly needs cleanup. I propose that we start a new article called Scientific inquiries into chiropractic care, move the section over there, and leave behind a link to that article along with a brief synopsis (not that writing such a thing will be easy). Support/oppose? --Hyperbole01:18, 3 February 2008 (UTC)

I support, so long as the rest of the article remains balanced. I would like to introduce the evidence-based clinical practice guidelines which deals with the NMS and non NMS aspects of chiropractic care (7 of the 8 deal with NMS).

I'd also like to see more pictures removed (i.e. DD, BJ, Lillard, etc.)

EBDCM

01:27, 3 February 2008 (UTC)

I'm okay with the science article. How about taking out Lillard and the subluxation picture? -- Dematt Dēmatt 03:36, 3 February 2008 (UTC)

Elimination of reform chiro

Hyper,

I began to revise the practice styles section but cannot get the table that dematt made to be centered and not interfere with the next headline (subluxation history). A little help in making it esthetically pleasing?

EBDCM

01:48, 3 February 2008 (UTC)

Hi EBDCM, I think I fixed the table, check it out. -- Dematt Dēmatt 03:34, 3 February 2008 (UTC)

The wrong section was shortened and eliminated the significant minority reformers. QuackGuru Quack 01:51, 3 February 2008 (UTC)

Quack,

The scientific and skeptic section will be truncated, however the practice styles was grossly bloated, at least for the main article. What is the difference between reformers and mixers? Reformers are simply an offshoot of mixers but I'd be more than happy to add a blurb saying as much and giving a brief description of the reform movement under the mixer heading since they come from them.

EBDCM

02:02, 3 February 2008 (UTC)

Please add this back in and you can work on it.

Reform chiropractors are a minority group who advocate the use of palpation and manipulation to identify and treat osteoarthritis, painful joints, and other musculoskeletal problems. They do not subscribe to the Palmer philosophy of Innate Intelligence and vertebral subluxations, do not believe that spinal joint dysfunction causes organic or systemic disease, and tend not to use alternative medicine methods. They prefer to align themselves more with medical and osteopathic physicians in their views of disease causes, processes and responses to manipulative therapy. Reformers tend to share the viewpoints found in the National Association for Chiropractic Medicine.

cite news

|last=

|first=

|title=The Skeptical Inquirer magazine blasts chiropractic as unscientific 'societal problem'

|url=http://www.worldchiropracticalliance.org/tcj/1988/jan/jan1988f.htm

|date=January 1988

|work=

|publisher=The Chiropractic Journal

|accessdate=2007-06-07

|quote=

cite news

|last=

|first=

|title=Berkeley newsletter says: 'Be wary of chiropractors'

|url=http://www.worldchiropracticalliance.org/tcj/1992/oct/oct1992c.htm

|date=October 1992

|work=

|publisher=The Chiropractic Journal

|accessdate=2007-06-07

|quote=

Thanks, QuackGuru Quack 02:07, 3 February 2008 (UTC)

We simply don't have enough references at all to break chiropractors down into these four categories. I have no personal knowledge on whether those categories exist, but the article looks like blatant OR. For example, the reference above, about the existence of "Reform chiropractors," includes a single sentence: "He notes that the National Association of Chiropractic Medicine (NACM) was formed as an attempt to organize reform-minded chiropractors." That is absolutely not enough to establish that "reform chiropractics" is an established movement outside the minds of Wikipedia editors. --Hyperbole02:14, 3 February 2008 (UTC)

Hyperbole, I think you are mostly correct. We have always had trouble verifying a lot of that section. Feel free to rework that section and if anyone has trouble then they should bring the appropriate sources. -- Dematt Dēmatt 03:33, 3 February 2008 (UTC)

According to Dematt we "should bring the appropriate sources." http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=nextoldid=188760445 Agreed. QuackGuru Quack 07:49, 3 February 2008 (UTC)

Quack Guru, why the hard interest in separating reform from mixer? The NACM, which is proprietary, has less than 1000 members, much like the WCA. Small organizations like these need not be mentioned in the main article as we are trying to make it more succint.

EBDCM

01:37, 4 February 2008 (UTC)

All important viewpoints are needed in this article for NPOV. I would like the section expanded a bit. I perferred the previous version. Reform chiros are real and it is slow but growing group. I like reformers. QuackGuru Quack 08:32, 4 February 2008 (UTC)

"There are 2 main practice styles and schools of thought." This sentence seems misleading to me. There may be two main but there is a total of four, I think. QuackGuru Quack 09:19, 4 February 2008 (UTC)

QG,

The article was too long, as hyperbole (and many others) suggested and there were several sections with undue weight, including practice styles/philosophies. I think it would be reasonable if you wanted to start a fork (is this the right term for another page which can be linked from the main page?) that expands on the 2 MAIN practice styles of thought. Consider:

(1) the so-called objective viewpoint is apparently an off-shoot of traditional straight and

(2) the so-called reform viewpoint is an off-shoot of mixer.

Also, I notice that you keep plugging the NACM. I think we should drop mention of it since it is very small and proprietary, much like the WCA which gets not mention. Furthermore, "reform" minded DCs need not be a member of the NACM and indeed the majority of reform DCs are not members of the NACM.

Lastly, it has been shown here in archives that the NACM organization may have ties to Stephen Barrett, MD which would clearly be in violation of NPOV.

Looking forward to your reply.

EBDCM

15:00, 4 February 2008 (UTC)

It is irrelevant whether NACM org has ties to SB. It has been demonstrated by the archives that there are some pro-mainstream chiros who want to eliminate minority POV which is clearly in violation of one of our core policies, NPOV. There still is 4 main types of chiros whether they are off-shoots or not. I think the section could be a little more clear about the different practicing schools of thought. The article is still too long. The section http://en.wikipedia.org/wiki/ChiropracticScientific_inquiries_into_chiropractic_care Scientific inquiries into chiropractic care has consensus to start a new article and shorten it into a summary here. QuackGuru Quack 19:11, 4 February 2008 (UTC)

I respectfully disagree. Seeing that SB has a vehement bias against the chiropractic profession, the NACM would simply be a mouthpiece/puppet for his individual views. The NACM, simiilar to the NCHF is purported to be a "consumer advocate" oganization which does not fill the role of a state/provincial/national association nor a regulatory college. With less than 1000 members out an estimated 80k North American DCs, this further reinforces my point that it is a trivial organization. If you want to talk about reform under the mixer heading I think we could compromise on that, but the NACM plug, IMO, is neither necessary nor warranted. Thoughts anyone?

I agree that the Scientific section needs to be tightened up as well and I'm in the midst of acquiring evidence-based practice guidelines for the chiropractic clinical care since they have essentially done all the lit reviews and recommendations for us. I'd like to see different subsections under the scientific heading separating NMS disorders from non NMS disorders which will add clarity for the layperson reading the article. Chiropractic care for NMS disorders isn't really that controversial, especially compared to non-NMS management.

EBDCM

00:46, 5 February 2008 (UTC)

This is your opinion about SB and NACM which you are entitled to have. Reformers are the minority and the minority view is always important. Info about the minority organization maintains NPOV. It is the belief of the reformers that they tend to share the views of NACM. The size of NACM is irrelevant. I think adding more info about the other types of chiro practices would be a better idea rather then limiting the reformer bit. I think that section is very vague. QuackGuru Quack 01:11, 5 February 2008 (UTC)

Objective Straight chiropractorshttp://www.f-a-c-e.com/positionpaper1.htm Position Paper One - What is Objective Straight Chiropractic? are a minority group and a recent off-shoot of the traditional straights. This group is differentiated from traditional straights mainly by the claims made. While traditional straights claimed that chiropractic adjustments are a plausible treatment for a wide range of diseases, objective straights only focus on the correction of chiropractic vertebral subluxations. Like traditional straights, objective straights typically do not diagnose patient complaints. Their guiding principles are summed up as: "We do not want to diagnose and treat diseases, even diseases of the spine." and "We do not want chiropractic to be practiced as an alternative to medicine."http://www.f-a-c-e.com/v3n3.htm F.A.C.E. three guiding principles They also don't refer to other professionals, but do encourage their patients "to see a medical physician if they indicate that they want to be treated for the symptoms they are experiencing or if they would like a medical diagnosis to determine the cause of their symptoms."http://www.f-a-c-e.com/positionpaper5.htm Position Paper Five - Referral Most objective straights limit treatment to spinal adjustments. Objective straights tend to share the viewpoints found in the Foundation for the Advancement of Chiropractic Education (F.A.C.E.).

Here is more info missing from the article. x EBDCM, please consider adding some of this info back into the article. There are 4 different schools of thought. Agreed? QuackGuru Quack 06:09, 5 February 2008 (UTC)

I believe that there are only just two schools of thought. However within each school there are moderates and extremists. With regards to the NACM, last I heard their numbers were in the low hundreds and falling fast. I am not convinced that they are still in existence as I haven't seen them do or say anything in a couple of years now. -- Levine211206:23, 5 February 2008 (UTC)

The last you heard is speculation and it is irrelevant how small the organization is. I believe that are four schools of thought and the article should represent and explain each one. QuackGuru Quack 07:36, 5 February 2008 (UTC)

"The last I heard" is actually based on a verifiable source from several years ago. If you have something newer which negates the decreasing membership of NACM or something recent the organization has done, then please provide a source. If you don't then = "I believe that are four schools of thought" - what is this belief of yours, if not speculation? Per UNDUE, it is relevant how small the organization is: "Articles that compare views should not give minority views as much or as detailed a description as more popular views, and "'may not include tiny-minority views at all"'." -- Levine211207:54, 5 February 2008 (UTC)

It is irrelevant the size of the org. The org is being used to show the beliefs of the reformers. There are four types of chiros. I read the refs. QuackGuru Quack 08:00, 5 February 2008 (UTC)

There are two main types and a couple of fringe extremists in each group. Again, please provide evidence that NACM has grown at all or is not defunct or is anything more than a couple of guys with a chip on their shoulder. -- Levine211208:11, 5 February 2008 (UTC)

That is your opinion a couple of fringe extremists exist. That would make at least four types. You have not provided evidence of a defunct org. If they are defunt then the word defunct can be added to the article. That is your speculation of "a couple of guys with a chip on their shoulder." Thank you. QuackGuru Quack 08:18, 5 February 2008 (UTC)

It is common knowledge that there is 4 groups. Agreed? QuackGuru04:24, 16 February 2008 (UTC)

QuackGuru, I cannot find an external source that states that there are four groups, except those that have copied from our article to their sites. However, I would be okay with adding something back in about objective straights if we can find some reliable references and include reform as long as we don't capitalize the "r", because, while we are finding lots of stuff about 'reform', I cannot find anything that says "Reform" (can you?). But, I don't think we should say there are 4, because there might be 5 or 8 or 3, we just don't know enough to put a number on it. -- Dematt Dēmatt 05:34, 16 February 2008 (UTC)

I have done enough research to say there are four groups. Trust me, okay. Read the references in the article. I will add more references to resolve this issue too. And, I will add the objective straights to the proper section. Agreed? QuackGuru05:54, 16 February 2008 (UTC)

For the record, since this conversation is still going, reform chiropractors tend to be mixers, but mixers are not necessarily reform chiropractors. Unfortunately, since the reform movement is small, I do not have a source to back this up. It is interesting to see EBDCM claim that mixers and reform chiropractors are the same, because in my experience, evidence based doctors of chiropractic medicine (EBDCMs) are mixers and reform chiropractors, but should have experienced mixers that are not reform. DigitalC23:56, 20 February 2008 (UTC)

Well put, but I recognize that reform is different from mixer, but that mixer organizations, such as the ACA are adopting more 'reform' positions. —Preceding ) 00:27, 21 February 2008 (UTC)

I checked two reliable sources on this subject.

The first talks only about traditional straight, mixers, and objective-straight (which it calls "purpose-straight" (PSC) and mentions also the alias "super-straight"). After characterizing purpose-straight, it has the following to say about the politics:

The PSC approach to chiropractic came into conflict with several constituencies. The nondiagnostic orientation of this perspective stands in contrast to most statutes governing the practice of chiropractic. Some degree of compromise by the chief institutional proponent of PSC, Sherman College of Straight Chiropractic (SCSC), was apparently reached with the CCE circa 1995, when the SCSC was first recognized by the accreditation agency. The CCE's educational standards require training in diagnosis and referral when appropriate to other health care providers. Accordingly, there would seem to be some disconnect between this institution's ideology and its actual instructional practices. It should be noted that several of SCSC's presidents (e.g., Thomas Gelardi, DC, David Koch, DC) have been articulate contributors to philosophical dialogue within the profession (e.g., reference 64).

Here's the citation for the above quote: cite book |author= Keating JC Jr |chapter= Philosophy in chiropractic |pages=77–98 |title= Principles and Practice of Chiropractic |edition= 3rd ed. |editor= Haldeman S, Dagenais S, Budgell B "et al." (eds.) |publisher=McGraw-Hill |date=2005 |isbn=0-07-137534-1

The second is a more-recent source (2008 versus 2005). It talks only about straights and mixers. Here's the citation: cite journal |journal= J Pain Symptom Manage |date=2008 |title= Chiropractic: a critical evaluation |author= Ernst E |doi=10.1016/j.jpainsymman.2007.07.004 |pmid=18280103

I looked in Google Scholar for any paper mentioning "straight", "mixer", "reform", and "chiropractic". In the summaries I found, there was no mention of "reform chiropractic" or "reform chiropractors" or anything like that. It seems clear that this reform group is marginal and is currently overemphasized in Chiropractic. The PSC/objective straight group seems to be somewhat overemphasized as well: it seems to be a group that is no longer bifurcated from straight. Perhaps discussion of PSC aka objective straights should be moved to the "History" section. Eubulides00:30, 21 February 2008 (UTC)

Scientific inquiries into chiropractic care

http://en.wikipedia.org/wiki/ChiropracticScientific_inquiries_into_chiropractic_care Scientific inquiries into chiropractic care I will go ahead and shorten this long section. QuackGuru Quack 20:32, 5 February 2008 (UTC)

QuackGuru has begun a new article with the information he has excised: Scientific inquiries into chiropractic care. My fear is that it may be regarded as a POVFORK. -- Levine211201:09, 6 February 2008 (UTC)

this section below needs to be shortened

The Manga Report

The Manga Report was an outcomes-study funded by the Ontario Ministry of Health and conducted by three health economists led by Professor Pran Manga. The Report supported the scientific validity, safety, efficacy, and cost-effectiveness of chiropractic for low-back pain, and found that chiropractic care had higher patient satisfaction levels than conventional alternatives. The report states that "The literature clearly and consistently shows that the major savings from chiropractic management come from fewer and lower costs of auxiliary services, fewer hospitalizations, and a highly significant reduction in chronic problems, as well as in levels and duration of disability."Manga P, Angus D. (1998) Enhanced Chiropractic Coverage Under OHIP as a Means of Reducing Health Care Costs, Attaining Better Health Outcomes and Achieving Equitable Access to Health Services. Retrieved 08 29 2006, from http://www.chiropractic.on.ca/main.html OCA

Workers' Compensation studies

In 1998, a study of 10,652 Florida workers' compensation cases was conducted by Steve Wolk. He concluded that "a claimant with a back-related injury, when initially treated by a chiropractor versus a medical doctor, is less likely to become temporarily disabled, or if disabled, remains disabled for a shorter period of time; and claimants treated by medical doctors were hospitalized at a much higher rate than claimants treated by chiropractors."Wolk S. (1988) An analysis of Florida workers' compensation medical claims for back-related injuries. "J Amer Chir Ass" 27:50-59 Similarly, a 1991 study of Oregon Workers' Compensation Claims examined 201 randomly selected workers' compensation cases that involved disabling low-back injuries: when individuals with similar injuries were compared, those who visited DCs generally missed fewer days of work than those who visited MDs.Nyiendo J. (1991) Disability low back Oregon workers' compensation claims. Part II: Time loss. "J Manip Physiol Ther" 14:231-239

A 1989 study analyzed data on Iowa state records from individuals who filed claims for back or neck injuries. The study compared benefits and the cost of care from MDs, DCs and DOs, focusing on individuals who had missed days of work and who had received compensation for their injuries. Individuals who visited DCs missed on average 2.3 fewer days than those who visited MDs, and 3.8 fewer days than those who saw DOs, and accordingly, less money was dispersed as employment compensation on average for individuals who visited DCs.Johnson M. (1989) A comparison of chiropractic, medical and osteopathic care for work-related sprains/strains. "J Manip Physiol Ther" 12:335-344

In 1989, a survey by Cherkin "et al." concluded that patients receiving care from health maintenance organizations in the state of Washington were three times as likely to report satisfaction with care from DCs as they were with care from other physicians. The patients were also more likely to believe that their chiropractor was concerned about them.Cherkin CD, MacCornack FA, Berg AO (1988) http://www.pubmedcentral.gov/articlerender.fcgi?artid=1026519 Managing low back pain. A comparison of the beliefs and behaviours of family physicians and chiropractors."West J Med" 149:475–480

American Medical Association (AMA)

In 1997, the following statement was adopted as policy of the AMA after a report on a number of alternative therapies.http://www.ama-assn.org/ama/pub/category/13638.html AMA (CSAPH) Report 12 of the Council on Scientific Affairs (A-97) Full Text

Specifically about chiropractic it said,

"Manipulation has been shown to have a reasonably good degree of efficacy in ameliorating back pain, headache, and similar musculoskeletal complaints."

In 1992, the AMA issued this statement:

"It is ethical for a physician to associate professionally with chiropractors provided that the physician believes that such association is in the best interests of his or her patient. A physician may refer a patient for diagnostic or therapeutic services to a chiropractor permitted by law to furnish such services whenever the physician believes that this may benefit his or her patient. Physicians may also ethically teach in recognized schools of chiropractic. (V, VI)"http://www.ama-assn.org/ama/pub/category/8332.html AMA (Professionalism) E-3.041 Chiropractic

British Medical Association

The British Medical Association notes that "There is also no problem with GPs doctors referring patients to practitioners in osteopathy and chiropractic who are registered with the relevant statutory regulatory bodies, as a similar means of redress is available to the patient."British Medical Association, http://www.bma.org.uk/ap.nsf/Content/refcomtherap0406?OpenDocumentHighlight=2,Chiropractic Referrals to complementary therapists

In Addition to this, a placebo-controlled study published in March of 2007, showed that Chiropractic adjustments actually lower high blood pressure..."Web MD, http://www.webmd.com/hypertension-high-blood-pressure/news/20070316/chiropractic-cuts-blood-pressure

Any suggestions, QuackGuru Quack 01:47, 6 February 2008 (UTC)

Why does it need to be shortened? Perhaps it can be included in the new article you started. But why does it need to be shortened? -- Levine211202:13, 6 February 2008 (UTC)

It is duplication. It can be shortened in this article or the new article. QuackGuru Quack 02:21, 6 February 2008 (UTC)

I am still not convinced that we need that other article; that all the material should be restored here. However, if there is consensus to have two articles, then certainly attempt to summarize all of the material you transfered and then point readers to the new article. -- Levine211202:26, 6 February 2008 (UTC)

I think there is consensus to have two articles and it would be appropriate to summarize all the text here. QuackGuru Quack 02:32, 6 February 2008 (UTC)

What are you basing "consensus" on? Was there discussion about thus? -- Levine211206:45, 6 February 2008 (UTC)

http://en.wikipedia.org/wiki/Talk:ChiropracticToo_long.21 It was consensus. QuackGuru Quack 07:19, 6 February 2008 (UTC)

Thanks. I didn't see that before. -- Levine211207:22, 7 February 2008 (UTC)

There are four practice styles and schools of thought

There are 4 main practice styles and schools of thought. "Objective Straights" have a place in this article. Agreed. QuackGuru Quack 02:39, 6 February 2008 (UTC)

Disagree. There is nothing "main" about the so-called "Reform" group. Tiny minority.-- Levine211203:04, 6 February 2008 (UTC)

http://www.psychologytoday.com/mind-body/chiropractic_overview.htmlhttp://www.healthprofs.com/cam/content/chiropractic_choose.html Read the refs in the article. QuackGuru Quack 03:13, 6 February 2008 (UTC)

Those are pretty minor sources and only one supports your position that there are 4 groups (the other suggests that there are 3). -- Levine211206:46, 6 February 2008 (UTC)

Which reference supports the fact of 4 groups according to you? QuackGuru Quack 06:50, 6 February 2008 (UTC)

http://skeptoid.com/episodes/4042 http://www.drensley.com/chiropractic.php http://www.chiropractordallas.net/tips.html Here is more refs to support the fact that there is 4 and not 2. QuackGuru Quack 07:06, 6 February 2008 (UTC)

Disagree as well. There are 2 main schools of thought, straight and their offshoots and mixer and their offshoots. You need to consider, QG that as far as I understand, the USA is the only country with so called objective and reform groups. We're trying to give the article a more global and balanced look. Is there ANY scientific literature that supports your assertion of 4 views?

EBDCM

14:59, 6 February 2008 (UTC)

Unless I missed it, I want to bring to the attentions of all that there are chiropractor that actually work with doctors and do their work under the ideas of said doctor they are working with. I don't know what this kind of chiropractor is called but recently I had contact with one, he also did prescriptions if needed and had help from Dematt on what was being done and what to expect as I was hesitant. Maybe you all should bring Dematt to this conversation for his input. He is very fair and stays within the boundries of NPOV. This is just a suggest of course. --Crohnie "'Crohnie"'"'Gal"' 15:35, 6 February 2008 (UTC)

I think that's a reasonable suggestion, Crohnie. I too am currently working alongside medical doctors and handle all the neuromusculoskeletal complaints and co-manage chronic pain patients with them as well. I consider myself to a more modern chiropractor and have been educated under the evidence-based curriculum. I practice like a mixer I suppose (soft tissue work, exercise-rehab, ergonomomics, etc..) but would be called a 'reformer' under QGs rules since I use general manipulation and do not subscribe to subluxation theory as the straights do. However, I use medical acupuncture and have a holistic approach (natural therapies, and realize the inter-dependent complexities of psychosocial issues, physical issues, environmental issues, etc so I don't fit into the model proposed by QG. I'm definitely for integration of chiropractic into mainstream health care and want to work collaboratively with MDs, RNs, PTs, etc. It'll be interesting to hear QGs take.

EBDCM

17:12, 6 February 2008 (UTC)

Please provide references. I have provided the references that explains that there are 4. QuackGuru Quack 20:17, 6 February 2008 (UTC)

There are 2 main styles and then subsets of each. Perhaps reform could be included, but without the plug to the NACM. Like Hyperbole mentioned earlier, the previous section seemed very much like OR and it was long and confusing. We are trying to clean up and shorten the article and you keep inserting various quotes from various practitioners. I would like to see all quotes removed including the Wilk et. al vs AMA quote by the judge. The reader just needs to know there was an anti-trust lawsuit and that Wilk successfully argued his case.

Why are you dodging my question, BTW?

EBDCM

01:07, 7 February 2008 (UTC)

http://www.ltsc.ucsb.edu/health/info_sheets/Chiropractics.pdf

EBDCM

01:07, 7 February 2008 (UTC)

Precisely put, EBDCM. Thanks! -- Levine211201:14, 8 February 2008 (UTC)

I have no support to add 4 to this article. Consensus has changed. Wikipedia is about consensus and NOT truth! QuackGuru Quack 22:18, 8 February 2008 (UTC)

The references you provided seem to suggest that ("Traditional") Straight is the oldest form of chiropractic; that Mixer is the largest group in the United States; and that Reform is a small but important minority. But "Objective Straight", based on those references, seems to be a small and unimportant minority that may well represent a FRINGE viewpoint. Right now, the article mentions straights, mixers, and reform - three styles. Based on the references I've read, I tend to think this is the best approach. --Hyperbole22:34, 8 February 2008 (UTC)

I don't see any consensus for the reformers bit. QuackGuru Quack 22:38, 8 February 2008 (UTC)

Well, every one of your references mentioned them, and they are currently mentioned in the article. EBDCM, who originally asserted that there were two groups (straight and their offshoots, and mixer and their offshoots) has since concluded that reform should be mentioned as long as we are careful not to assign UNDUE weight to it. --Hyperbole22:43, 8 February 2008 (UTC)

However EBDCM and Levine2112 believe there are only two main practices. Therefore, no consensus. QuackGuru Quack 22:57, 8 February 2008 (UTC)

As a compromise, I would accept the mention "3" if the minority Reform group was played down because now it seems to violate WEIGHT. Certainly, we should drop the mention of NACM, which if it is truly still in existence as all, has a membership base comprising about one-tenth of one percent (0.1%) of all chiropractor worldwide. To minor to mention and perhaps too un-notable to have its own article. -- Levine211223:09, 8 February 2008 (UTC)

EBDCM considers "reform" an offshoot of "mixer," but acknowledges that it may be an important enough group to mention as long as we observe WEIGHT. Levine2112 has a similar stance. Keep in mind that "consensus" does not mean "unanimity." I'm having a very hard time determining exactly where consensus falls on this issue. For example, I haven't heard anyone at all argue that "objective straight" is an important group that needs to be specifically distinguished in the article from other straights. --Hyperbole23:14, 8 February 2008 (UTC)

An off-shoot is not a main group, I think. It has weight problems. QuackGuru Quack 23:17, 8 February 2008 (UTC)

The word "offshoot" refers to something's origin, not its prominence. --Hyperbole23:21, 8 February 2008 (UTC)

Here's the thing - and not that this is citable, but it is a real-world example - EBDCM ("E"vidence "B"ased "D"octor of "C"hiropractic "M"edicine) seems to have all of the attributes of what some may call a "Reformer". However, EBDCM doesn't consider himself a reformer but rather a "Mixer" who doesn't subscribe to subluxation theory. Right? BTW, I don't know that deleting "Reform" outright is the way to go either; but rather as it stood before, I think we were giving it too much prominence. The question remains: Is "Reform" it's own distinct group or is it a subgroup of "Mixer"? Also, are there "Straights" who don't subscribe to subluxation theory? -- Levine211223:33, 8 February 2008 (UTC)

There is nothing main about a tiny minority. QuackGuru Quack 01:37, 9 February 2008 (UTC)

Good point. So either we reword "main" or leave it out as QuackGuru suggests. (Or find a source which verifies "Reform" as a main group.) -- Levine211202:00, 9 February 2008 (UTC)

Leave it out. No consensus. QuackGuru Quack 02:03, 9 February 2008 (UTC)

This is very strange - Quack Guru posted five references specifically to prove that reform chiros are a notable viewpoint - and now he's aggressively removing all mention of them from the article. WEIGHT isn't a binary "yes it goes in" vs "no it doesn't" policy. What the policy suggests is that we shouldn't go on and on about them in an attempt to make their viewpoint seem mainstream. It certainly doesn't suggest in any way that we should eliminate them from the article entirely. And I have no idea what is meant by "no consensus," when I see no real opposition on the talk page to mentioning the group. --Hyperbole02:06, 9 February 2008 (UTC)

This is very easy to understand. I have read the archives and past discussions. I have read the references. I do not see anything notable about a tiny minority and I do not see any broad consensus. QuackGuru Quack 02:22, 9 February 2008 (UTC)

No QuackGuru. You are involved in a POINT violation that is destructive and assumes bad faith of the many editors who have worked hard to achieve a stable article. You are betraying them. You seem to be choosing the either/or demonstrative and tantrum position when you don't get your way, and are thereby sacrificing easily documentable facts for compromise with the long-standing attempts to whitewash the article of all mentions of controversy. Pretty unwikipedian, disruptive, and contributing to a shortchanging of the complexity and depth of this whole subject. There is no legitimate reason for shortening the article. A small overshooting of a guideline on size (not a policy) is no justification for destroying the hard work of many editors. -- Fyslee / 06:21, 9 February 2008 (UTC)

Levine2112

You're right; I would practice what would be called "reform" but because I use medical acupuncture I technically couldn't be a "reform" practitioner because I'm using an "alt-med".

I agree that reform should be recognized, however we're going to have to be very specific about a distinction from the mixer group. The first thing that comes to mind is that mixers aren't EBM practitioners because they still use some very dubious methods (AK, ionic foot baths) and can make some exagerrated claims without supporting evidence.

I'll take a stab at doing a rewrite, but I'm going to have to find some decent references, because many of the ones given by QG seem to be OR and is not of scholarly quality of any kind.

Quack, why the sudden backtrack? Did someone give you orders for a retraction? It does seem odd with your sudden inexplicable need delete reformers. Also, as an aside, your link to "criticism of chiropractic care" under the "scientific inquiries" section was not in good taste. —Preceding ) 02:17, 10 February 2008 (UTC)

There are "four" Practice styles and schools of thought which is supported by the references. This should be included in the article. QuackGuru21:29, 12 February 2008 (UTC)

What references?--Hughgr22:26, 12 February 2008 (UTC)

Read the refs in the Practice styles and schools of thought section. Material about all four groups would imrpove that section. Agreed? QuackGuru22:38, 12 February 2008 (UTC)

Objective Straight chiropractors is also part of the four groups and can be noted in the appropriate area. Per LEAD, mentioning the four groups in the lead qualifies. This is a notable issue and we have a section about the different type of chiros. QuackGuru07:44, 13 February 2008 (UTC)

Irony

It seems the passionate debates here at the talk page have by and large help make the Chiropractic wiki one of the best referenced. Out of sheer curiosity I went to the Medicine wiki to compare and found only 5 citations. We're at 53 and counting. Who says we're not EBM? ;)

EBDCM

05:35, 7 February 2008 (UTC)

Bias towards Chiropractic Methods

Is it just me or is there few, if any balanced opinions on this page about the alternatives to chiropractic treatment, including physiotherapy and medication. This pages has few negatives towards chiropractic treatment, a qualified doctor of Medicine should write the negatives to chiropractic treatment considering it is a pseudo-science. —Preceding 02:52, 8 February 2008 (UTC)

You'll have to be more specific. On Wikipedia, it's usually the case that saying "This is too biased in X direction; I want more bias in Y direction" gets us nowhere. Are you proposing any specific changes? --Hyperbole02:56, 8 February 2008 (UTC)

I'm not the person who made the above comment; I just now came to the article because I was editing Vaccine controversy and discovered to my surprise that there is a strong antivaccinationist element among chiropractic. In reviewing this article I see several examples of bias:

The lead mentions the theory of vertebral subluxation without mentioning that the theory lacks scientific validity and is largely responsible for chiropractic's often-dodgy reputation.

The philosophy section has a long, approving title. It should just be "Philosophy of chiropractic".

Agreed. I changed it to chiropractic care, however, which is the proper terminology. EBDCM17:32, 12 February 2008 (UTC)

That contradicts the Wikipedia manual of style, which says section headings should "Avoid restating or directly referring to the topic". For example, Tourette syndrome has a section called "Causes", not "Causes of Tourette syndrome". None of the section headers in Tourette syndrome say "Tourette syndrome"; it's redundant, and the manual of style says section headers should be short. I'll change it back. I have some other suggestions to help shorten the longwinded section headers in Chiropractic:

"Chiropractic manipulative treatment techniques" → "Manipulative techniques"

"Most frequently used manipulation techniques (US)". Remove this section header, merging the contents into the previous section.

"Chiropractic history and the subluxation construct" → "History"

"Medicine vs. chiropractic" → "Medical opposition"

"BJ Palmer re-develops chiropractic". Remove this section header, merging the contents into the previous section so that the history is told chronologically.

"The movement toward science" → "Movement toward science"

"Scientific inquiries into chiropractic care" → "Scientific inquiries"

"Safety issues" → "Safety"

Eubulides

20:46, 12 February 2008 (UTC)

Good idea.

The philosophy section contains phrases like "According to Robert Mootz D.C. and Reed Phillips D.C., Ph.D." that are intended to make the text sound more credible. Peacock phrases like that are out of place in Wikipedia. Just make the claim and put the sources in a citation.

The introduction to the philosophy section disapprovingly calls mainstream medicine "reductionist" in contrast to chiropractic's "holistic".

This is factual. CAM therapies, in general, are holistic in nature whereas conventional medicine is reductionist. The reader can draw their own conclusions, as it stands its simply contrasting 2 different philosophies of care. EBDCM17:32, 12 February 2008 (UTC)

When the philosophy section talks about chiropractic's opinion of conventional medicine, that should be clearly labeled as opinion, not fact. It is not a "fact" that conventional medicine is reductionist. Many practitioners of conventional medicine use holistic techniques. Eubulides20:58, 12 February 2008 (UTC)

Are you kidding, Eubulides? Reductionistic thinking has been occuring in medicine for the last 200 years. It is by far the most dominant way of thinking of mainstream medicine. Take a look: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1459480. The % of conventional medical practitioners using a holistic approach is minimal at best, and those who do take that approach are usually scorned by their peers. The biopsychosocial model was created in response to the limits of the biomedical model used by mainstream medicine.

The source you cite completely undermines your argument. Ahn "et al." 2006 (PMID|1459480) write "While the implementation of clinical medicine is systems-oriented, the science of clinical medicine is fundamentally reductionist." In other words, as I wrote, it is not a "fact" that conventional medicine is reductionist. Conventional medicine has many reductionist elements, sure, but so does chiropractic. It is completely misleading to divide the world into "reductionist" conventional medicine and "holistic" chiropractic. Such a division may well be a tenet of conventional chiropractic thinking, but it should be clearly labeled as opinion in Chiropractic, which is not the case now. Eubulides09:59, 13 February 2008 (UTC)

The philosophy section lists several bullets like "emphasizes understanding the cause of illness in an effort to eradicate, rather than palliate, associated symptoms" that apply equally well to mainstream medicine, implying that mainstream practitioners do not emphasize cause.

The section incorrectly implies that chiropractic emphasizes prevention more than mainstream medicine does. (This one I attempted to fix somewhat with http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=190585829oldid=190570570 this change, but the coverage is still unbalanced.)

The section incorrectly implies that mainstream medicine does not emphasize the importance of healthy lifestyles.

Implies? I think not, no previous skeptic has complained of that before. Does it suggest that conv med does not take into account lifestyle factors? Don't forget, conv. medicine uses a biomedical approach in contrast to the biopsychosocial approach used by DCs. EBDCM17:32, 12 February 2008 (UTC)

The current wording clearly places chiropractic in opposition to conventional medicine. It says, for example, that conventional medicine is not "holistic" and that holistic approaches are noninvasive. But many techniques in conventional medicine are noninvasive too. This is just one example of the problem; there are many more. Eubulides20:58, 12 February 2008 (UTC)

Chiropractic philosophy IS at the other end of the spectrum of coventional medicine. Conventional medicine has long been opposed to philosophy of chiropractic and other holistic practices. See the medicine vs. chiropractic section for more history. Your continued insistence that mainstream med is holistic is absurd. Show me a paper that supports your claim otherwise we should move onto another subject. The "problem" is that you don't seem to understand the chiropractic perspective and seem to trying to dilute or neuter long established chiropractic principles.

This is completely backwards. The current wording, which paints chiropractic as the good-guy "holistic" and conventional medicine as the bad-guy "reductionistic", is not supported by reliable sources. The cited sources talk about what chiropractic philosophy asserts, not about what mainstream medicine is actually like. The problem is that ChiropracticPhilosophy too often presents this philosophy as fact, without clearly separating opinion from fact. Clearly chiropractors are the best sources for the definition of their own philosophy; but they are not the most unbiased and reliable sources for how mainstream medicine works. And yet the current "Philosophy" section is written as if they were. This is the problem that needs to get fixed. Eubulides09:59, 13 February 2008 (UTC)

And this is just the first section. And I haven't listed all its biased bullets. At this point I got tired of reading it. I don't expect this article to be some anti-chiropractic screed, but the lead and the first section (which is all I read) are clearly biased in favor of chiropractic. Eubulides09:54, 11 February 2008 (UTC)

I disagree that it is clearly biased in favour. Rather, it is simply contrasting chiropractic vs. conventional med approaches. Is it not factual? Are you debating any of the facts listed in the philosophy section? EBDCM17:32, 12 February 2008 (UTC)

I am not debating. I am listing a few problems with the current philosophy section. It has many problems; this is just a partial list. Eubulides20:58, 12 February 2008 (UTC)

No, YOU think it has many problems. Until YOU came along all the regulars here including many experienced editors, pro and con did not see "many" problems philosophy section as you do. As always, please bring the appropriate references to support your position that medicine is holistic, or has a sizeable enough faction that is worth mentioning. Cheers. EBDCM00:10, 13 February 2008 (UTC)

Sometimes a fresh eye can easily see problems that people who have read the text over and over again simply miss. Again, the burden of proof is to support the text that is in the article. It needs reliable sources. It is not necessary for me to provide sources to support my position. If the current text is not supported by reliable sources, it needs to be changed. Eubulides09:59, 13 February 2008 (UTC)

No comments so far, so I took one minor step in addressing the above issues by http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=190926402oldid=190900601 renaming "The philosophy of chiropractic care: a complementary and holistic approach to health care" to "Philosophy". This conforms better to the manual of style, which says section headings should be short and should not repeat the subject. Eubulides16:47, 12 February 2008 (UTC)

I will consider some of the suggestions made in this thread, including shortening the names of sections. Please review my edit. QuackGuru08:26, 13 February 2008 (UTC)

Thanks; I noticed that you missed the "Safety issues" → "Safety" renaming so I http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=191108858oldid=191105174 did that. Eubulides10:08, 13 February 2008 (UTC)

I actually did not miss the "Safety issues." I decided to leave it as is. QuackGuru10:11, 13 February 2008 (UTC)

Ah, thanks, I see. Well, "Safety" is shorter and the word "issues" doesn't add any information, so let's try it the shorter way. The Wikipedia manual of style prefers brevity, after all. Eubulides10:20, 13 February 2008 (UTC)

I see that those edits also removed the POV tag. But the abovementioned issues about POV in ChiropracticPhilosophy and in the lead remain and continue to be discussed here; it's more than just vaccination. So I http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=191112958oldid=191112146 restored the tag for now. Eubulides10:39, 13 February 2008 (UTC)

Talk seems to have died down so I'm now looking at Chiropractic Philosophy in more detail so that I can propose something concrete. My first cut was to improve the quality of its citations. In reviewing these citations I have some comments

The citation to Black 1990 is pretty obscure. The book is out of print and is not easily available. A more-available citation is needed.

*I discovered that the quotation that cites Black 1990 is actually taken from Mootz Phillips 1997. So there's no need for that old citation at all. I http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=191526604oldid=191507176 replaced it with Mootz Phillips. Eubulides23:22, 14 February 2008 (UTC)

The citation to Keating 1998 is unnecessary. It appears to be supporting the claim that Janse used to be president of the NCC. That sort of detail is out of place here. "Philosophy" should not even mention Janse's name other than in a citation.

*In looking into this I discovered something much worse: there's a huge quote by Janse that is uncited. This is a definite no-no: all quotations must be cited. Talk:Chiropractic/Archive 12Added quote says the quote is "by Joseph Janse of National Chiropractic College in 1976 titled 'The Wholistic Concept of Health Care Management', found in V. Strangs book called Principles and Practice of Chiropractic p.26" but that is not nearly an adequate citation; I'm not sure where to look for it and it sounds hard-to-find and dated. I looked for another, more up-to-date and more easily-obtainable reliable source on chiropractic and prevention and found this one, which I propose to use instead: cite journal |journal= Chiropr Osteopat |date=2006 |volume=14 |pages=23 |title= The Council on Chiropractic Education's new wellness standard: a call to action for the chiropractic profession |author= Evans MW Jr, Rupert R |doi=10.1186/1746-1340-14-23 |pmid=17038180 |url=http://chiroandosteo.com/content/14/1/23

The last paragraph of "Philosophy" has nothing to do with philosophy; it's about popularity. It should be in a different section.

Eubulides

22:00, 14 February 2008 (UTC)

I agree that the last paragraph should be moved. We could perhaps create a "usage and trends" section or something more appropriate. EBDCM23:14, 14 February 2008 (UTC)

"In looking into this I discovered something much worse: there's a huge quote by Janse that is uncited. This is a definite no-no: all quotations must be cited. Talk:Chiropractic/Archive 12Added quote says the quote is "by Joseph Janse of National Chiropractic College in 1976 titled 'The Wholistic Concept of Health Care Management', found in V. Strangs book called Principles and Practice of Chiropractic p.26" but that is not nearly an adequate citation; I'm not sure where to look for it"

User:Eubulides The quote is descriptive for chiro prevention. The ref you provided http://chiroandosteo.com/content/14/1/23 doesn't describe this, it is about the teaching of prevention. See http://www.amazon.com/Essential-Principles-Chiropractic-Virgil-Strang/dp/9996768295, this is the book and the quote is on pg.26. What else do you think is needed?--Hughgr00:16, 15 February 2008 (UTC)

What is needed first is that the article must cite all quotes; see CITE When quoting someone. I just now http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=191599676oldid=191599408 did that. But in the long run this quote should go: it is "very" dated ("roentgenograms"?). More important, Wikipedia should be an encyclopedia that is written in its own terms; it should not depend on long quotes from other sources to make basic points. Featured articles like Immune system or Tourette syndrome don't have long quotes like that, and Chiropractic should strive for that level of quality. Eubulides07:16, 15 February 2008 (UTC)

In looking for better references for chiropractic philosophy, preferably ones that are reliable, recent, online, and easily available, I found:

cite journal |journal= J Manipulative Physiol Ther |date=1988 |volume=11 |issue=4 |pages=325–8 |title= Which philosophy of chiropractic? |author= Keating JC Jr, Sawyer CE |pmid=3049894

cite book |author= Keating JC Jr |chapter= Philosophy in chiropractic |pages=77–98 |title= Principles and Practice of Chiropractic |edition= 3rd ed. |editor= Haldeman S, Dagenais S, Budgell B "et al." (eds.) |publisher=McGraw-Hill |date=2005 |isbn=0-07-137534-1

cite book |author= Gay RE, Nelson CF |chapter= Chiropractic philosophy |chapterurl=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=altrehab.section.336

|editor= Wainapel SF, Fast A (eds.) |title= Alternative Medicine and Rehabilitation: a Guide for Practitioners |date=2003 |isbn=1-888799-66-8 |location= New York |publisher= Demos Medical Publishing

I'm sure there are others. Eubulides09:38, 15 February 2008 (UTC)

Review of philosophy section

In reviewing the cited sources, the above-mentioned other sources, and the current text, I have some comments that I hope will be helpful in improving ChiropracticPhilosophy.

The current text consists of 1 large chunk emphasizing holism (taken from Mootz Phillips 1997), 1 chunk emphasizing prevention taken from Janse (unknown date), 1 chunk about vaccination (contributed recently), and finally an out-of-place chunk about popularity. But if you look at Mootz Phillips 1997, it gives several other key components of chiropractic philosophy, including:

*vitalism (e.g., innate intelligence) vs materialism (e.g., restoration of structural integrity)

*comparison to osteopathy naturopathy

*dogma vs scientific method

Gay Nelson 2003 (cited above) give just three central principles of chiropractic philosophy. These seem pretty basic and it is surprising that they are not covered in ChiropracticPhilosophy:

*"There is a fundamental and important relationship between the spine and health, which is mediated through the nervous system."

*"Mechanical and functional disorders of the spine can degrade health."

*"Correction of subluxations may bring about a restoration of health."

If only it was that simple. Gary Nelson is giving the straight version of chiropractic and this would certainly be a good source for straight philosophy.

Actually, this source was written by Ralph Gay and Craig Nelson, both chiropractors at the Mayo Clinic. I agree it is not that simple, but this seems a fair summary of straight chiropractic. Eubulides07:24, 17 February 2008 (UTC)

Keating 2005 (cited above) lists several other important points about chiropractic, which deserve at least a mention:

*There is a wide diversity of beliefs.

*Homeostasis

*Holism (this topic is the only one currently covered by ChiropracticPhilosophy)

*Conservatism (rejection of risky, invasive techniques)

*Strategic role of the nervous system (e.g., subluxation)

*Desire for professional autonomy

*Chiropractic philosophy evolved partly out of a need for legal and political defenses for the profession in its early ears. Initially, it rejected the inferential reasoning of scientific method in favor of deduction from first principles.

*Classical philosophy is a process of probing and skeptical inquiry, and matches well to the epistemology of science favored by many modern chiropractors.

*Chiropractors have employed many epistemologies, including empiricism (e.g., private research), rationalism, spiritual inspiration, and the scientific method. They have also employed logical fallacies, which are chaff that need to be separated from the wheat.

Most of these have been in the article at one point or another and slowly axed due to the length of the article. Some was preserved in the Chiropractic History article, but yes, we have lost some of the "reasoning" that goes along with the philosophy. Fe free to incorporate as much as you can.

Thanks, I will do my best. Eubulides07:24, 17 February 2008 (UTC)

Neither Mootz Phillips nor Keating nor Gay Nelson talk about prevention, and yet ChiropracticPhilosophy has a long section on prevention. It appears that the material on prevention is out of place, as not being a core part of chiropractic philosophy; like the material on popularity, it belongs in a different section.

Holism is clearly an important part of chiropractic philosophy, but it is not the whole thing, and does not deserve to have over half of the section as it does now. It needs to be pruned back.

As near as I can make out, the WFC citation talks about the identity of chiropractic, not its philosophy; it is there to support just a single word in this section, "biopsychosocial". This is stitching-together sources and is too close to OR for comfort; it should go.

As mentioned above, the Ahn "et al." 2006 (PMID|16681415) does not support the article's claim that conventional medicine is reductionistic. The text should be rewritten to reflect what Ahn "et al." actually say..

Eubulides

06:37, 16 February 2008 (UTC)

Prevention has always been stressed as part of chiropractic education and training. This has been consistent since it's inception and every style of chiropractor would agree on this. http://www.ncbi.nlm.nih.gov/pubmed/17038180?ordinalpos=11itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum. It belongs here. The biopsychosocial model is being taught at all the institutions nowadays. It is akin to holism in that it looks at the whole person, the biological, psychological and social aspects of health and disease. This is philosophical and belongs here. Conventional medicine has been reductionistic for over 200 years. What is the primary is the highest standard of 'evidence'? Double Blind RCTs. RCTs are reductionistic. Reductionism isn't necessarily a bad thing; in fact most of EBM is founded on it. But, it has it's limits. If conventional medicine doesn't primarily use a reductionistic model, Eubulides, what do you propose it uses instead? EBDCM07:12, 16 February 2008 (UTC)

Yes to EBDCM. Prevention may be the only thing all chiropractors have in common. It is the reason to treat - to prevent further deterioration - whether to prevent degenerative disc disease for reformers (Phase IV degeneration for straights) and forestall future effects of that breakdown - whether arthritis/medication dependency and resulting side effects (for reformers) or any type-O diseases (for the straights). If chiropractic philosophy were just to treat pain, they would already be mainstreamed. To me, all those sources are talking about prevention.-- Dematt Dēmatt 14:36, 16 February 2008 (UTC)

I realize that is your and EBCDM's opinion, but reliable sources disagree with you. For example, the http://www.wfc.org/website/wfc/Website.nsf/WebPage/IdentityConsultation?OpenDocumentppos=2spos=5rsn=y WFC Unanimous Agreement on Identity of the Profession does not mention prevention. This article has to follow what reliable sources say. Eubulides07:24, 17 February 2008 (UTC)

Chiropractic Philosophy is about philosophy, not education and training. If prevention is stressed as part of education and and training, then that is an argument for covering prevention in the article, but that does not mean prevention belongs in the "Philosophy" section. Does chiropractic philosophy stress prevention more than it stresses subluxation? or conservativism? etc.? The above sources say no, and I don't know of any source that says yes. It's a question of balance. ChiropracticPhilosophy should not devote so much space to a lengthy and obsolescent quote about prevention, while devoting zero space to these other more-central topics.

If biopsychosocial is an important part of modern chiropractic philosophy, then it should be explained, with a reliable source to the effect that it is an important part of the philosophy; it does not suffice to merely mention the word (with a citation to a source that does not discuss chiropractic philosophy).

My proposal for conventional medicine is to rely on what reliable sources like Ahn "et al." 2006 say. Ahn "et al." doesn't say that conventional medicine is reductionistic, or even that it primarily uses a reductionistic model; it says "While the implementation of clinical medicine is systems-oriented, the science of clinical medicine is fundamentally reductionist." Chiropractic also has reductionist elements. Treatment in practice is far more complicated than the cartoon image (bad reductionist conventional medicine vs. good holistic chiropractic) that is currently in Chiropractic Philosophy. Here's a more accurate description of the situation: "The philosophical concepts of vitalism and reductionism have long been used as a means to segregate the chiropractic profession. Such divisions are artificial and irrelevant to practice. These concepts are not mutually exclusive. Rather, they form a nested understanding of health care delivery where vitalism/holism remains the objective and reductionism supplies the details for improving the effectiveness and quality of health care delivery." Here is the source for this quote: cite book |author= Triano J |chapter= The theoretical basis for spinal manipulation |pages=361–83 |title= Principles and Practice of Chiropractic |edition= 3rd ed. |editor= Haldeman S, Dagenais S, Budgell B "et al." (eds.) |publisher=McGraw-Hill |date=2005 |isbn=0-07-137534-1 Eubulides08:02, 16 February 2008 (UTC)

"Does chiropractic philosophy stress prevention more than it stresses subluxation? or conservativism? etc.?" This depends on the school of thought. Most don't teach "subluxation" at all (depending on your definition of subluxation), but also why EBDCM felt it necessary to add the table and we did. Conservativism would be up there with prevention, is that not in the bulleted list? Are you asking to take out the Janse statement? I think that does a good job explaining the prevention aspect. Or are you asking to expand "conservative" outlook? I'm okay with that.

Conservativism is on the bulleted list and I think should be discussed as a core part of chiropractic philosophy, so yes, I think its coverage should be expanded (to a sentence or two; I'm not talking about a lot of length here). I think the Janse statement should go: it's extremely dated, is long-winded, and is quoted 2nd-hand; we should be able to find something more up-to-date and apropos—and if we can't, that's a sign that the article's emphasis on prevention is overstated. Eubulides07:28, 17 February 2008 (UTC)

I'm still not sure why reductionist thinking whether in the context of systems-oriented or on the molecular level is so bad. It is just used to compare and contrast the holism aspect. It is the other extreme. Yes, some MDs view healthcare from a holistic perspective and that was in the last sentence that states that the approach that all healthcare professionals take depends on where they fall in that spectrum.

-- Dematt Dēmatt 14:50, 16 February 2008 (UTC)

What you write is true in theory, but ChiropracticPhilosophy's tone is clearly one of holistic good, reductionistic bad. This needs to be fixed. Eubulides07:24, 17 February 2008 (UTC)

It occurs to me that the name of this section was "Chiropractic approach to healthcare" until about one month ago. That is likely why there is now confusion here. The approach to healthcare is holistic, etc. Since I think this section does a good job of explaining the "natural" approach that chiropracic takes, maybe a separate section is in order for the Phylosophy of chiropractic. I would suspect that it would have to be large to include the different schools of thought, and might better engulf the "schools of thought" section. I'm not sure, I'm open on that? —Preceding ) 16:19, 16 February 2008 (UTC)

It was called Philosophy: a complementary and holistic approach to health care. We can perhaps reinsert something regarding the approach since it does nicely tie in with the philosophy bit but can leave out the holistic word if there are concerns about undue weight. EBDCM19:07, 16 February 2008 (UTC)

Holism is clearly a key part of chiropractic philosophy. But it is not the whole thing. Let's put it this way: currently ChiropracticPhilosophy talks only about holism and prevention. But that's way too vague: it also describes the philosophy of homeopathy, for example. The section needs to be rewritten to say what the chiropractic philosophy is, and what distinguishes it from its alternatives (not all of which are conventional medicine). Eubulides07:24, 17 February 2008 (UTC)

Disagree on 2 fronts. First, the tone is not holistic good, reductionism bad. They're simply contrasted against each other as they are the extremes at of the philosophical spectrum. There are elements of each in chiropractic and medicine, but by and large, chiropractic is more holistic and medicine is more reductionistic. Surely you can't disagree with this. As far as overlaps in philosophy with other CAM professions, it is true since they al share a common POV which is holism and natural methods. Whereas homeopathy uses homeopathic tinctures, chiropractic uses manual therapy to help regulate the nervous system function. The section does NOT need to be rewritten as you suggest and I don't see many other editors here who feel that it deserves the kind of makeover and attention you seek. I find it perplexing how you seem to insinuate that you would seem to know more about ins and outs the philosophy than the very capable and well respected editors here, like Dematt. As is, the current revision succinctly captures the major points of chiropractic philosophy while contrasting it against medicines. EBDCM07:47, 17 February 2008 (UTC)

I agree that medical/scientific "research" tends to be more reductionistic. But I disagree that medical "clinical practice" is largely reductionistic: it is not (as Ahn "et al." say). Since chiropractic has traditionally deemphasized research, it is quite a stretch to compare it to medical/scientific research; it is more realistic to compare it to medical clinical practice. And when you do so, you find that the "holistic / reductionistic" story is a poor match to what's actually happening. And this is not simply my opinion, it's taken straight from "Principles and Practice of Chiropractic", which says "Such divisions are artificial and irrelevant to practice."

The tone of ChiropracticPhilosophy is established with phrases like "the progressive minds in chiropractic", chiropractors "pioneered the all-important principle", "the doctor, the therapist, and the clinician have failed to realize exactly what is meant by disease processes", calling mainstream medicine "traditional" in contrast to chiropractic's "progressive", and using this to contrast the (good) "holistic and biopsychosocial" with the (bad) "reductionist and biomedical" philosophies. Phrases like these reek with POV.

Other editors have responded favorably to points I made, suggesting, for example, that I feel "free to incorporate as much as you can".

The question is not how much I or any other editor knows about chiropractic; it is what reliable sources say. I can't emphasize this enough. Verifiability is one of Wikipedia's core policies. It doesn't matter how many papers I personally have published in this area, or whether I have a DC or an MD or a PhD or am merely an intelligent 12-year-old: what matters are the reliable sources. And I have provided reliable sources in support of my points.

I completely disagree that ChiropracticPhilosophy succinctly captures the major points of chiropractic philosophy: it omits the wide diversity of beliefs, it omits homeostasis, it omits conservatism, it omits the strategic role of the nervous system, etc., etc. It emphasizes prevention far out of proportion to all the reliable sources mentioned so far in this thread. And it is so vague that it could just as well be describing the philosophy of osteopathy or that of naturopathy. It greatly needs to be improved, not only on tone grounds, but also on completeness and undue-weight grounds.

Eubulides

09:44, 17 February 2008 (UTC)

undentI tend to agree with x Eubulides here. The section needs to be written without puff. Parts which are not supported by sources need to be removed. The fact that an estimated 90% of chiros believe in subluxation needs to be in. Mccready09:54, 17 February 2008 (UTC)

I don't think we are far off from each other here. I think we are all saying the same thing. I agree that we could use other words along with prevention to describe what the chiropractic philosophy is about. The word maintenance comes to mind, it's all about prevention. Google searches of chiropractic and prevention http://www.google.com/search?q=chiropractic+preventionsourceid=navclient-ffie=UTF-8rls=DVFA,DVFA:1970--2,DVFA:en are rife with the word prevention so the sources are probably there to support it's use. Most of this section was written from chiropractic sources discussing chiropractic philosophy and is taken verbatim in most cases supports what is written here. Having said that, I don't mind seeing it improved. In order to avoid edit wars, I moved the section to the talk page here where we can work on it.Talk:ChiropracticPhilosophy. -- Dematt Dēmatt 14:47, 17 February 2008 (UTC)

An association between chiropractic and prevention (which is what a Google search can indicate) is not the same thing as chiropractic "philosophy" emphasizing prevention. All health philosophies that I know of are big on prevention; what's so special about chiropractic? Most of the discussion about prevention is taken directly from an ancient and 2nd-hand quote from Janse; if we can't do better than that, it's an indication that the emphasis on prevention is overblown. Eubulides21:47, 17 February 2008 (UTC)

A few points of clarification to Eubulides. Many of the the points you raise (centrality of the nervous system, homeostasis, conservatism are addressed in the text box. They may not use the exact words verbatim but their meaning is clear. That being said, I don't mind adding a bit more explanation outside the text box re: those points if readers are still unsure. Like I mentioned before, many of the CAM disciplines have a common philosophical origin and thus there will be some overlap, including with osteopathy and naturopathy. Still, the text box does suggestion differences (importance of NS, using structure to influence function, addressing problems in their functional state before structural or pathological changes occur, etc. Regarding tone, I never felt that it was suggesting that chiropractic was progressive and medicine was not. I work with MDs in practice daily and highly respect the field. Yet you seem to suggest that contrasting the two here makes medicine look bad. I disagree. The crux of prevention from a chiropractic perspective is to address issues when they are in their functional state. If we need more references, you feel to support this assertion then I'd be more than happy to get some additional ones. Either way, as Dematt has suggested one thing that either straight or reform DCs can agree on is the importance of prevention. EBDCM16:58, 17 February 2008 (UTC)

The text box is taken verbatim from Mootz Phillips. It focuses on holism, and attempts to shoehorn chiropractic into the holistic compartment. It is not bad as a first cut, but the focus on this section should be on chiropractic philosophy, not merely on holism (which is just one aspect of the philosophy).

ChiropracticPhilosophy should not rely so heavily on one source, no matter how reliable. One way to improve it would be to take the bullets of the text box and explain them, using other cited sources. After all, it is less than optimal to just take a text box from some external source and reprint it unchanged; Wikipedia is not supposed to consist of big chunks borrowed from other works.

Several specific instances of obviously-POV wording in ChiropracticPhilosophy have been cited, and nobody has challenged any of these instances.

Straight and reform DCs agree on many things besides prevention: see http://www.wfc.org/website/wfc/Website.nsf/WebPage/IdentityConsultation?OpenDocumentppos=2spos=5rsn=y the WFC identity consultation, which lists several key recommendations on the identity of chiropractic. Note that prevention did not make the cut. Why does ChiropracticPhilosophy emphasize prevention far more than its reliable sources do?

Eubulides

21:47, 17 February 2008 (UTC)

Eubulides, the philosophy section really does hit on all the major points of chiropractic philosophy that is shared by ALL chiropractors, regardless of their style of practice (straight, mixer, reform). Regarding prevention, chiropractic takes a wellness model towards this approach which is well known by most both inside and outside the profession. Your continued hints to remove prevention as part of the philosophy section does not jive historical and clinical facets of chiropractic practice. Prevention does form an important part of clinical practice. I still fail to see how your point re: obvious POV wording. The text box by Phillips and Moore is a concise and good summary of the major points in belief structure of ALL DCs. It should not be discarded because it comes from one source. It is an amalgamation of many POV and various sources already. Also, you are really projecting too much emphasis on holism. If you want to remove the title from the text box, feel free to do so. Unlike your assertion it does not shoehorn chiropractic into holism. The section is about chiropractic philosophy and not merely holism. You seem fixated on that subject. Anyways, the additions I have made to the philosophy section has touched on all your previous recommendations but I'm perplexed why you still feel this section is grossly deficient. You seem to have a rigid interpretation of what sources can make the cut here and there are many editors here who have just as much experience as you don't seem to be raising any red flags. I'm also going to propose a rewrite for your vaccination bit as it seems somewhat out of context and has choice language that could easily be construed as inappropriate. EBDCM00:03, 18 February 2008 (UTC)

(outdenting) This latest comment does not address the points I made.

Again, the question is not whether prevention forms "an important part of clinical practice"; nobody is disputing that. The question is whether prevention is a core part of chiropractic "philosophy". I've provided reliable sources to support the contention that prevention is not a core part of the philosophy, and the only dissent seen so far has been unsupported assertions.

If calling chiropractors "progressive" and mainstream medicine "traditional" is not POV, then how about if we swap the adjectives around and call chiropractors "traditional" and mainstream medicine "progressive"? Would that be OK? And similarly for the other POV terminology I mentioned. (Of course I am not being serious here; the point is that this sort of language is clearly POV.)

I disagree that the text box is shared by "all" DCs. Even Mootz Phillips do not make that claim. It's just one list; there are others. Chiropractic is not that monolithic.

The title of the text box is taken from Mootz Phillips, and indicates that source's desire to talk about chiropractic philosophy from a holistic point of view. That's fine, but there are other viewpoints, and Wikipedia should not limit itself to a single viewpoint on chiropractic philosophy.

Again, my goal is to use the highest-quality sources, as per MEDRS. We editors should strive for the best, not merely for the good-enough.

Eubulides

03:29, 18 February 2008 (UTC)

I'm sure I can go into every single chiropractic school, look in their philosophy curriculum and find mention of prevention. This common knowledge amongst ALL chiropractors. Clearly that has not been well conveyed to the public (you're the perfect example) but nonetheless, we don't need an RCT to confirm this. Your reliable source is the WFC document, which is not even a primary or secondary scientific source. Eubulides, your continued insistence that prevention is not part of chiropractic philosophy is simply wrong. All DCs and DC schools (straight, mixer, reform) agree on this principle.

I am not asking for RCTs. I am asking for reliable sources. I have cited two reliable sources, not one. One is the WFC document. The other is "Principles and Practice of Chiropractic", 3rd ed. You have supplied zero sources in support of the view that prevention is a core aspect of chiropractic philosophy. Again, I am not disputing that prevention is taught in chiropractic schools; I am disputing whether prevention is a core part of chiropractic philosophy. Do you have any reliable sources, at the level of the WFC document or the cited textbook, to counter the two sources I have mentioned? Eubulides06:51, 18 February 2008 (UTC)

This is getting tiresome, Eubulides. Prevention is a core part of chiropractic philosopy. Deal with it. Dematt has already agreed too and he is well respected here for his ability for NPOV. I learned it in my philosophy class at school. Here are sources you asked for. EBDCM02:25, 19 February 2008 (UTC)

http://www.nsirtech.com/PDF%20files/Content%20Analysis.pdf

http://drgbrennan.com/philosophy.html

http://books.google.com/books?id=xRGhUSdwCgQCpg=PA406lpg=PA406dq=chiropractic+philosophy+preventionsource=webots=lEvjdzOC85sig=GqwOFxqaZu1w0_HDg77SNlhQGGI

http://books.google.com/books?hl=enid=zsY8dwHl54YCdq=coulter+chiropracticprintsec=frontcoversource=webots=oNFxyfc4eMsig=ksiH41b7fXlvGHya4x3qtKH9VOs

The first source you mention (McAulay Naylor 2000) lists 14 major topics of chiropractic philosophy. None of them are prevention. The only mention of prevention is under the topic of "Natural Health and Healing Arts", in which one subtopic is "holistic wellness as a factor in health promotion and disease prevention". Listing of prevention as a sub-subtopic hardly constitutes support for ChiropracticPhilosophy's current weighting, which gives prevention about 1/3 of the space.

The second source is from the 2nd edition (1992) of "Principles and Practice of Chiropractic"; it briefly mentions prevention as being "chiropractic's purpose". I could not find this material in the 3rd edition (2005). This hardly constitutes a strong source for prevention being a core part of chiropractic philosophy.

The third source (Leach 2004) lists prevention in its list to "exemplify the large areas of knowledge that are almost untouched in chiropractic college curricula at this time", suggesting, again, that prevention is not a core part of chiropractic philosophy.

The fourth source (Coulter 1999) lists prevention on page 58 in its summary of Kelner "et al." 1980. This was a field study, not a review of chiropractic philosophy. Coulter mentions prevention on pages 68 and 69 but this material is inaccessible via Google Books.

In short, these sources do not at all indicate that prevention is a core part of chiropractic philosophy. On the contrary, the first and third sources clearly suggest that prevention is peripheral, and the other two sources are weak. Eubulides07:31, 19 February 2008 (UTC)

Also, even if we're just head-counting editors, there are two editors who think prevention is core (you and Dematt), and two three who don't (DigitalC, CynRN, and I). This hardly constitutes overwhelming editorial support for the claim that prevention is core. Eubulides08:02, 19 February 2008 (UTC)

Janse's quote is for illustrative purposes of philosophical differences amongst chiropractic and medicine. This gap has not yet been bridged. Stop focusing on those 2 words and focus on the bigger picture within the quote: treatment of asymptomatic individuals when functional disturbances are found as a prodrome to symptoms. In other words, treatment and correction to prevent dysfunction and disease. This forms in part, maintenance care, which is part of the chiropractic wellness model.

Someone calls mainstream medicine "traditional" and chiropractic "progressive" and I'm supposed to not notice it? Someone says that mainstream medical practitioners "have failed to realize exactly what is meant by disease processes" and I'm supposed to not notice it? Someone says that chiropractors "pioneered the all-important principle" and I'm supposed to not notice it? Sorry, but these words are blatantly POV. I don't see how anybody can seriously argue otherwise. It doesn't matter what the big picture is: if the big picture is described with blatant POV words, that is contrary to NPOV, and must get fixed.

You are over-reacting and quoting things out of context. The Janse statement, used in the whole context to illustrate the point, is NPOV despite a few POV words in there. You're also misrepresent the POV words and taking them out of context. The progressive minds refered to individuals at the time when this model of chiropractic prevention was being pioneered.

Nevertheless, again, you are being too literal. The fact I added his credentials was not peacocking. I was trying to clarify for the readers his background for more context. I did not realize you could not add those and if you feel that strongly about we can revert it. This statement is no worse than your write up of chiropractic and vaccination on the vaccine controversy page. EBDCM02:25, 19 February 2008 (UTC)

I disagree entirely. Janse is clearly supporting the chiropractic viewpoint and attacking mainstream medicine. He says nothing but good about chiropractors, and nothing but bad about mainstream medicine. It's hard to take seriously any claim that his quote is NPOV "despite a few POV words in there". It's not just his POV words: it's the entire thrust of his argument that chiropractors have it right and mainstream medicine has it wrong. Eubulides07:39, 19 February 2008 (UTC)

Eubulides

06:51, 18 February 2008 (UTC)

The table is hardly monolithic but rather an integration of the common themes that form part of chiropractic philosophy and clinical practice. It was chosen in part because Phillips is a PhD and has more credibility on the subject some another author.

The table is monolithic in the sense that it is taken verbatim from Mootz Phillips, who are writing from a particular point of view (holism) that they explicitly acknowledge in their text. This problem is not as serious as the blatant POV of Janse, but it is a problem, and it needs to get fixed as well. Holism is an important part of chiropractic philosophy, but it is not everything. Eubulides06:51, 18 February 2008 (UTC)

There's nothing wrong it being taken verbatim so long as it accurately covers the subject being discussed. It has been referenced accordingly. You could argue everything about chiropractic care is under the holistic umbrella. The table touches a myriad of topics ranging from the centrality of the nervous system, patient-centered approach, multifactorial nature of influences (structural, psychological, chemical) and its relationship with the nervous system, early intervention (prevention) treating conditions in its functional stage before pathological/structural changes occur. Then Janses quote goes on to illustrate this point. If you would like to add things that are not in the chart, then by all means do so. But the chart should stay as it addresses many more things than just holism (whole is greater than the sum of its parts). EBDCM02:25, 19 February 2008 (UTC)

If the chart can be improved, it should be: it is not cast in stone. One could certainly argue that everything in chiropractic is holistic; but that is not the only viewpoint. It is not even the viewpoint of the source that the table is taken from. Eubulides07:41, 19 February 2008 (UTC)

Anyways, we share a same goal in using the highest-quality sources, however we differ on how strictly we interpret the guidelines. I hardly feel than the philosophy section, as it is currently stands is in violation of MEDRS and is much improved because of your efforts. But, I can tell you right now, your continued insistence to remove 'prevention' from chiropractic philosophy will not fly, especially now that it has been defined and contrasted with conventional medicine's approaches. I would surmize that the majority of the editors would feel the same as well and would concur that one way or another, prevention is part of chiropractic philosophy. EBDCM06:17, 18 February 2008 (UTC)

This is backwards. It is precisely the contrast with mainstream medicine that I am objecting to most strongly. That part of ChiropracticPhilosophy is written entirely from the chiropractic viewpoint; it constitutes blatant NPOV when it attacks mainstream medicine. It's not just the biased wording that is used: it is also the biased thought. For example, the claim "Unless pathology is demonstrable under the microscope, as in the laboratory or by roentgenograms, to them allopaths it does not exist." is not supported by reliable mainstream sources. This POV must get fixed. Eubulides06:51, 18 February 2008 (UTC)

Of course the chiropractic philosophy has a chiropractic viewpoint. It's written by chiropractors! This would be no different than me complaining about 'medical philosophy' because it was POV and written by MDs. You also fail to appreciate the historical opposition of medicine towards chiropractic and vice-versa. And, lastly, the message that Janse is saying is still true: DCs always have treated mechanical dysfunctions in the functional state regardless of symptomotology. Mainstream medicine still, by and large, has not accepted this premise. In fact, in many circles it's regarded as quackery. Janse's statement illustrates this important concept in prevention but also explains the basis of the wellness model used by DCs.

As a 'reform' chiropractor who currently works with MDs and RNs, I have nothing but positive experiences in working with them. My mom was an RN for 30 yrs in the OR. I by no means bash medicine; I've been integrated in it. Nevertheless, the way the Janse quote is set-up and used is NPOV and is for illustrative purposes only. EBDCM02:25, 19 February 2008 (UTC)

I vote for removing the Janse quote, as it is clearly not NPOV. Second, this addition adds even more to the over-balance on prevention: "In addition to early intervention, chiropractors also commonly use nutrition, exercise and lifestyle counseling as part of their holistic outlook towards prevention and suggests that the level of primary care, health promotion and prevention activities of chiropractors surpasses that of other physicians" Again, "chiropractors surpass...other physicians". This is from a survey of chiropractors about what they feel is important. Do you not think that physicians would think preventative measures, like exercise and nutrition, were important, as well? CynRNCynRN07:33, 19 February 2008 (UTC)

The Janse quote is not set-up and used in an NPOV way. It bashes the fundamentals of medicine with no countervailing argument. It is introduced with text that approves of its mischaracterization of medical philosophy. Eubulides07:45, 19 February 2008 (UTC)

Wrong. DigitalC is not in favour of wellness and prevention being tied exclusively to manipulation; rather he sees it as one facet of the visit, along with appropriate exercise, nutirtional and healthy lifestyle consultation. I then added and referenced this. DCs tend to focus more clinically on exercise prescription (specifics), nutritional counseling (specifics) and healthy lifestyle factors. Thus a greater % of DCs emphasize this in clinical practice compared to physicians, and that what the article states. If you can find another, better piece of research that contradicts this or refutes it, great and we can add it, but this is factual. It's too bad you feel that way Eubulides, but this quote is really at the heart of chiropractic philosophy vs. medical philosophy. The set up is NPOV and is used to distinguish and differentiate chiropractic prevention models and clinical rational to treat. —Preceding ) 08:34, 19 February 2008 (UTC)

DigitalC criticized the statement "The chiropractic approach to health care stresses the importance of prevention and primarily utilizes conservative therapies and a wellness model to achieve this goal", writing "Again, I am not sure if I agree with this statement. Would exericse and diet be considered a wellness model? What are the efforts of Chiropractors aimed at prevention? Public awareness campaigns on lifting and backpacks?" This very much sounds like skepticism of the attitude that prevention is the core of chiropractic philosophy." I don't see any reliable source supporting the claim that a greater percentage of DCs emphasize prevention in clinical practice than physicians do; certainly the cited source (Rupert 2000) does not support that claim. It merely surveys chiropractors; it does not compare them to physicians. Nor does this source support the claim that prevention is an important part of chiropractic "philosophy"; on the contrary, it contrasts agreement about prevention from disagreements about philosophy. Again, the weight of reliable sources presented so far on the talk pages is "against" the contention that prevention is core to chiropractic philosophy. Eubulides20:22, 19 February 2008 (UTC)

It is common knowledge, Eubulides, that prevention is part of chiropractic philosophy. Nothing you say will change that fact. I have Coulter's book. Prevention is part of chiropractic's holistic approach. You misrepresent DigitalC's view. He was suggesting that manipulation alone, does not accurately reflect the various methods commonly employed by DCs, he was not questioning whether or not prevention was a part of chiropractic philosophy, like you suggest.

Again, I am not arguing that prevention is not part of chiropractic philosophy. I am arguing that it is not sufficiently important to emphasize at length, over all the other parts of chiropractic philosophy. I don't speak for DigitalC, but I accurately quoted him as questioning the efforts of chiropractors aimed at prevention. Again, it's not a question of the existence of prevention; it's a question of its "emphasis". This is an undue weight issue. Eubulides23:34, 19 February 2008 (UTC)

I am just unsure as to what we are referring to as prevention wellness. Nutritional counselling, exercise prescription, public awarenss campaigns focused on lifting techniques are all part of what I would consider to be chiropractic prevention and wellness. Preventative manipulation, is not a part of chiropractic philosophy from the reform POV, because there is no evidence to suggest efficacy. DigitalC00:00, 20 February 2008 (UTC)

From Rupert 2000: "...health promotion and prevention activities of chiropractors surpasses that of other physicians". This is a verbatim quote. You are disputing Rupert's findings. I merely provided the reference to support the claim being made. If you can provide evidence to the contrary, then like I told CynRN, please feel free to do so. We want accuracy for this article. Nevertheless, considering the context of the article and how you keep suggesting prevention is not "'part"' of chiropractic philosophy, this disagrees with your POV. Lastly, read up on this Durant C, Verhoef MJ, Conway PJ, Sauve RS. Chiropractic treatment of patients younger than 18 years of age: Frequency, patterns and chiropractors’ beliefs. Paediatr Child Health 2001;6:433-8 and get back to me. Thanks! EBDCM22:19, 19 February 2008 (UTC)

The "verbatim quote" is taken from the abstract. But if you read the body of the paper, you'll see that it does not address the health promotion and prevention activities of other physicians. The study did not survey other physicians. The paper does not cite other results pertaining to other physicians, and it does not compare the beliefs of chiropractors to that of other physicians anywhere than that one phrase in the abstract. The study itself therefore contains zero findings to support the claim that chiropractors are more concerned with prevention than mainstream physicians, and that claim should be removed from Chiropractic. I attempted to follow the reference you gave to Durant "et al." 2001 but came up dry: according to the http://www.blackwell-synergy.com/toc/jpc/37/5 table of contents for the "Journal of Paediatrics and Child Health", no such paper was published. Evidently I'm looking at the wrong place. Can you supply a more-precise citation, such as a PMID or a DOI? Thanks. Eubulides23:59, 19 February 2008 (UTC)

The Rupert 2000 abstract suggests that chiropractors are superior to other physicians in primary care, in promoting health, and in prevention. This claim is not at all supported by the study itself, so I http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=192683106oldid=192670902 removed it. The article needs a reliable source for any such extraordinary claim. Eubulides00:05, 20 February 2008 (UTC)

In the Rupert study, maintenance care was recommended to 79% of patients. Rupert concedes that there is "absence of scientific support" for this. The chiropractors in the survey thinks MC is of value to "all age groups and a variety conditions from stress to musculoskeletal and visceral conditions". But addressing the philosophy part of this, the survey seems to link recommendation of maintenance care to "maintaining income"...23% more per year. Is it their philosophy of prevention or desire to increase patient visits? The phrase "surpasses that of other physicians" is very POV and not supported by the survey.CynRNCynRN23:30, 19 February 2008 (UTC)

Absence of evidence does not equal absence of efficacy. If maintenance care is delivered along with exercise recommendations, health promotion, lifestyle counseling, its IMHO, justified. I personally don't support the visceral statement, but anectodal evidence suggests that it may be helpful There is evidence to suggest maintenance SMT is preventive in chronic LBP(http://www.ncbi.nlm.nih.gov/pubmed/15510094ordinalpos=12itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum). What would suggest the correct interpretation of Ruperts finding are? EBDCM00:57, 20 February 2008 (UTC)

First, Rupert 2000 is a primary source, and as MEDRS suggests, should be taken with a grain of salt compared to the reliable secondary sources already mentioned. Second, Rupert's study assumed maintenance care: the questionnaire's title was "Maintenance Care Questionnare", and its instructions started "Please provide your level of agreement with the following statements about maintenance care (MC) and return this questionnaire as soon as possible." Its results, therefore, are not intended to be about all chiropractic philosophy; they are only with respect to maintenance care, a subset of chiropractic. Once we restrict ourselves to maintenance care, we are already assuming interest in prevention, no? So the study's results do not provide strong evidence that prevention is core to chiropractic philosophy in general. With chiropractic, as with health in general, there is always plenty of evidence to suggest "something". That is why one needs to consult reliable secondary sources to separate the wheat from the chaff. With respect to chiropractic philosophy, Rupert 2000 is clearly part of the chaff. Eubulides06:34, 20 February 2008 (UTC)

The edit war

Okay, here's my take on this. First, no, we don't cite papers in the lead - but the sentence "based on the premise that a spinal joint dysfunction can interfere with the nervous system" - should include a mention of, and link to, subluxation. Second, I actually agree with Mccready that defining "the contemporary view" based on a single link is POV and probably inaccurate; there seem to be competing "contemporary views." Finally, I don't have a problem with mentioning that Chiropractors are called "doctors" and receive a degree with "doctor" in the name; anyone interested in that point can follow the link to Doctor of Chiropractic and learn that the degree has substantially different requirements from an M.D. or Ph.D. My one concern on this point is that I'm not sure how worldwide it is: are Chiropractors called "doctors" in, say, Japan? What's the accreditation process there? Does chiropractic even exist in Asia? These articles are extremely limited to a U.S. and European perspective. --Hyperbole03:08, 8 February 2008 (UTC)

Levine challenges me to use the talk page. That's rich. Fyslee, he and others. u need show 1. that contempory view is accepted 2. that all chiros in all jurisdictions are doctors (they would be prosecuted in Australia for daring to try) 3. why 2006 survey should not be in lead, given that it 1. refers to the central belief of chiro and 2. gives info on how many chiros in a major chiro belief area actually believe this BS. Over to you Levine et al. And try to keep it nice and on topic. 1 2 3 like. Mccready03:28, 8 February 2008 (UTC)

Yes, the talk page is a very useful tool to acheive consensus on anything - far better than edit-warring. Just a few things: first, the 2006 survey should not be in the lead because surveys should never be in leads. That doesn't mean that subluxation shouldn't be mentioned in the lead. Second, if you can find a reliable source for the academic and professional status of Australian chiropractors, that would be helpful. --Hyperbole03:59, 8 February 2008 (UTC)

Just a comment about calling chiropractors "doctor". That's true in the USA and presumeably Canada, but probably not anywhere else, with few exceptions. The previous wording that qualified the mention was more accurate. -- Fyslee / 04:13, 8 February 2008 (UTC)

There's some information on this at Chiropractic schools. It seems that the Australian degree is "Master of Clinical Chiropractic" - but Chiropractors still generally call themselves "doctors." The title "Doctor of Chiropractic" exists at least in the U.S., Canada, and Sweden. In the UK, chiropractors officially have a Bachelor's and sometimes a Master's - never a doctorate. I think we certainly need to internationalize that passage. --Hyperbole04:26, 8 February 2008 (UTC)

Hyperbole,

I can provide additional references that further supports the contemporary view. Currently it's implied that "reformers" still adjust subluxations. They don't. In fact it could easily be argued that they are diversifying as more complete manual therapists including new soft tissue methods which again, is structure and function but not in the context of suluxations. I don't think you can appreciate the difference and it's rather important because it's a different philosophy altogether. I prefer the previous version but will work towards a compromise.

Regarding the doctorate, I think it's quite simple. I have 2 university degrees; kinesiology and chiropractic which 8 years of professional schooling in neuromusculoskeletal medicine, including one year of clinical internship. In fact, it's readily known that DCs far outperform MDs in diagnosis, treatment and prevention of musculoskeletal disorders. I am a specialist in conservative NMS care. So I definitely won't apologize for being called 'doctor'. Nonetheless, I'm never ambiguous; I am a chiropractic doctor, not a medical one. I know my role in the health care system and will help patients improve their function and lives.

If the UK and Australia don't require some kind of pre-medicine/chiropractic university training (2-4 years BSc.) then I agree they should not be called doctor. 7-8 years of university should be the minimum to be able to use the 'Dr' title, and in North America, DCs along with optometrists, dentists and GPs have that 8 years. 2 Bachelor minimum. It will be interesting to see if the European or Australiasian model begin to require some kind of undergraduate work in the health sciences before applying for your chiropractic degree.

EBDCM

05:34, 8 February 2008 (UTC)

1. Somehow or other in the lead you will have to explain that an estimated 90% of chiros believe in subluxation hoodoo voodoo. There is absolutely no rule in wikipedia that says a well sourced survey cannot convey this information. If there is then put up or shut up. 2. There is a logical fallacy in trying to define "contempory view" since we all know that chiros fight cat and dog among themselves to claim whatever legitimacy they can. So I say we abandon any attempt to define a "contemporary view". 3. The words "health profession" are redundant. Simple as that. Nice that discussion is finally taking place. Mccready05:52, 8 February 2008 (UTC)

Mccready, unless you understand the scientific method, you would realize that the survey you keep trying to post was only refering to 90% of DCs surveyed. In fact, the surveyed represents less than 10% of the profession. You should maybe read the survey first...

Your frequent ad hominems notwithstading, your refusal to edit in good faith and positively contribute to this article is noted. The contemporary view is indeed legitimate, modern, and in fact was the model that every school in Canada, some of the US and most in Europe graduate under as of 2008. A growing number schools in the US teach this model as well. Subluxation-based chiropractic has had its due and evidence-based chiropractic needs to be acknowledge as a real and growing entity.

Health profession is NOT redundant, it accurately describes the medico-legal status of DCs. Just because YOU think it's not a profession does not make it so. Mccready you're going to have to accept that there is such a thing as scientific chiropractic. Being an ostridge and sticking your head in the sand won't make this reality go away so I suggest you work amicably with us to improve the article rather than trying to sandbag the whole profession based on your historically negative views.EBDCM15:11, 8 February 2008 (UTC)

You don't need to survey an entire population to generalize. Stop assuming bad faith - it appears that Mccready is willing to leave your version of the article up and discuss it on this talk page. PouponOnToast15:14, 8 February 2008 (UTC)

EBDCM what part of the word estimate do you not understand? Do you seriously believe only 9% of chiros believe in vertebral subluxation. You are violating civility to accuse me of editing in bad faith. So now you have a new article title. Scientific Chiro. Good luck. You have reverted other editors on your version of contemporary. You have refused to address my arguments above. I await your answers. Mccready15:20, 8 February 2008 (UTC)

Please would the two of you comment only on the edits and not the editor (Mccready EBDCM). I am trying to help out with Civil. Thank you to both of you. --Crohnie "'Crohnie"'"'Gal"' 18:15, 8 February 2008 (UTC)

Mccready, if anyone here has a history of disruptive and bad faith editing and who has a history of being banned, its you. Have I not already answered your questions?

Fyslee, the problem with the wording is that it implies the contemporary view takes "more general view on SUBLUXATIONS. This is not the case. There is no general view on SUBLUXATIONS because there are NO SUBLUXATIONS in the contemporary view. The contemporary view is evidence-based. How can it be evidence-based and be talking about VSC the same time? You see the problem there, do you not? While we can surely mention VSC, we also need to acknowledge the outside the US, especially in the university curriculums, the contemporary model is being taught. I've already provided references showing CMCC and UQTR adhere to this model, and I will fetch all them until it proves my point. I'm prepared to have 10+ references from various sources to support my position.

Anyways, the contemporary model is about structure and function of the WHOLE BODY (MSK) with emphasis on the spine. This takes into account various soft tissue elements as well. There are no subluxations in soft tissues, right? A biomechanical model as opposed to the subluxation model.

So, I dispute the current wording that Hyperbole made. Can you suggest an alternative? I will go and find more references that indeed does support and make reference to the contemporary view, it's surely stronger than the evidence that quack guru is bringing to the table regarding the "reform" chiropractors and yet his edit is staying (for now). It would be nice to hear from Levine, Dematt, hughgr or other more experienced editors regarding this debate. EBDCM16:30, 8 February 2008 (UTC)

EBDCM, this seems like something easily fixed: just put a prepositional phrase after "general view." If you think the wording implies "general view of subluxations" (which, incidentally, I don't), then just change it to "general view of..." whatever you think is better. You'll get a lot further making constructive edits than you will with reverting. I'll have another look and see if I can tighten up that wording. --Hyperbole18:57, 8 February 2008 (UTC)

Quaint. 3 editors now disagree with him and he insists on being uncivil. E will you please check what sanctions there are for UNCIVIL behaviour. And no, you have not answered my questions. Mccready16:51, 8 February 2008 (UTC)

Which three editors? Are you making this up on the fly? I could easily spout that I have 4+ editors who agree with me and say "I win". However, I will take the high road and try to clarify my case here at the talk forum. Besides yourself, it seems that others here are more objective and do not have a recurrent history of being banned or blocked for obtuse behaviour. EBDCM18:42, 8 February 2008 (UTC)

Instead of squabbling, let's collaborate and find a version we are all satisfied with.

Here's the current version:

""Today, chiropractors differ on how much emphasis should be placed on subluxation, with some entirely rejecting the concept and instead focusing on the relationship between structure and function and the impact of structure on neurological mechanisms.234""

That version looks pretty good to me. It implies that some still believe in VS in varying degrees, and that some reject it. That's true and we're not involved in speculations about exactly how many. If there is any fault with it (and it could certainly be argued), it seems to imply something by lack of contrast. A more balanced version would read:

""Today, chiropractors differ on how much emphasis should be placed on the vertebral subluxation, with some entirely rejecting the concept and instead focusing on the relationship between structure and function and the impact of structure on neurological mechanisms.234, and others continuing to preserve the concept.literally myriad references to JVSR, ICA, WCA, etc.""

Since the majority of chiropractors have been educated to believe in VS (in the USA - where the vast majority of chiropractors exist - and even in Canada and Europe), we can't assume that just because the younger generation is progressive and more science-based, that the existing majority has suddenly changed their position. That majority is mixed in their positions. Just think of the enormous number of chiros that have been and still are educated by the largest school, Life U. in Marietta, and other straight schools. Likewise, the lack of mention of VS in some official publications from Canada is no proof regarding a repudiation of VS, but is actually OR, even if backed up by millions of references that fail to mention VS. Just a few references that mention it blow that theory away. It's falsifiable OR. Best not to even go there. The very existence of criticism from chiropractic sources indicates that there is still a problem, especially with the older generation and some organizations (which influence Canadian and chiros in other countries. OTOH, it would be interesting to provide some notable repudiations, which do exist. Judging their effect is a much harder matter.

Even if there were a well-defined "contemporary" view, that is not the only view, and we present all views here. Tell the whole story, past, present, and very carefully even the http://www.altfutures.com/pubs/Future%20of%20Chiropractic%20Revisted%20v1.pdf future. We need to avoid deletions and wordings that simplify things so much that this reality is obscured. It's all a mixed bag, and the article needs to reflect that. Controversy and criticism are still very real, and progress is also very real, and that progress creates even more controversy as it threatens many forces within the profession. When the ICA and WCA cease to exist, maybe things will settle down. They have far greater influence than their numbers would indicate. When the profession as a whole ceases to defensively circle its wagons and starts criticizing them more than it has criticized the NACM and other critics, progress will happen at a much faster pace, and criticism will run out of fuel. Oh what a day that will be! -- Fyslee / 07:08, 9 February 2008 (UTC)

Ahh, but where would the fun be in that? ;-) I do think that there is more controversy here than there is in the real world, but it does keep the torches lit. Here's the thing concerning subluxation, http://en.wikipedia.org/wiki/User_talk:Wanderer57/Archive_3Is_Subluxation_Theory_a_Straw_Man I agree this whole subluxation argument is really more or less a diversion, detracting from the real controversy. The controversy (from within and from outside) is about remaining a separate profession that practices autonomously from medicine vs joining 'mainstream' medicine. To join them or not to join them, that has always been the question. :-) If there is anything that is changing the attitudes of chiropractors today, it is socialized medicine (notice the different philosophies in various countries depending on the different healthcare systems) and evidence based practice, both of which could care less what you call it. Even medicine in Canada is different, because of these two features. Now, surely there is a historical feature of the word subluxation in the development and 'preservation' of chiropractic as a separate profession throughout the early 20th century, but things started to change in the mid 20th. The bottom line is that, regardless of what *chiropractors say* they are treating, 90% of *patients say* they are going for musculoskeletal complaints - so that is what *chiropractors are* treating. How much weight do we need to put on a concept that was born out of an economic/political survival mechanism. Everyone knows that the subluxation of the 19th century that was used to treat cancer, mental illness, diabetes, polio are not what is meant by the term vertebral subluxation complex that is used by chiropractors of today.

The doctor dilemna: The degree structures in Europe are far different than in this country. There is really no way to compare them as far as I can see. IOWs, even MDs here are not called doctor in all countries over there. Some countries reserve the word Mr. for MD and doctor for Phds. If we want to research all the different names, we could put them in a separate section, but I don't think we need it here, maybe in the Doctor of Chiropractic or Chiropractic schools articles. Probably don't need to mention it in the lead either, though a mention of it in the education with a link is probably appropriate.

BTW, I like Fyslee's suggested sentence above, too.

---- Dematt Dēmatt 06:22, 10 February 2008 (UTC)

Your opinions are interesting perhaps but can we please stick to the facts. The survey I want in the lead is factual. It is an improvement on Fyslee's vauger formulation because the survey gives figures. Let the reader draw their own conclusions. Why shouldn't we put the survey in the lead? Mccready07:43, 10 February 2008 (UTC)

Mccready your edit has been rejected by every editor here. I think it's time you gave it a rest.

EBDCM

17:48, 10 February 2008 (UTC)

A survey does not belong in a lead section.--Hughgr20:12, 10 February 2008 (UTC)

It can be added to the body of the article. Just find the appropriate section. QuackGuru19:22, 16 February 2008 (UTC)

The survey has methodological flaws which I noted previously. Surely there has to be a better reference than that one, why don't you go to PubMed and try to find us a good secondary source which would be the ultimate one to get. —Preceding ) 19:30, 16 February 2008 (UTC)

Is that your opinion or do you have evidence of "methodological flaws." Can you tweak the sentence or we can leave it in the article for now and replace it if a better reference is available in the future. QuackGuru19:42, 16 February 2008 (UTC)

redundancy in lead

"health care profession" is redundant. Glossary_of_alternative_medicine defines altmed as

"A group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine." Alternatively defined in the Cambridge Advanced Learner's Dictionary as: a wide range of treatments for medical conditions that people use instead of or with western medicine: Alternative medicine includes treatments such as acupuncture, homeopathy and hypnotherapy.'

So can someone please justify why we need to add the three redundant words? And before EAlphabetSoup accuses me of bad faith again, try to keep it nice, and rational. Mccready16:20, 8 February 2008 (UTC)

I can't find the phrase "health care profession" in the article, or even in its recent history. By the way, please start new sections above, not below, the references section. --Hyperbole19:07, 8 February 2008 (UTC)

In response to mccready, why are you so intent on taking it out? Do you dispute that the chiropractic profession is health care position? Why do you insist on changing the definition of chiropractic as endorsed by the World Federation of Chiropractic which oversees the profession globally?

Also, I want to point out that you seem to be trying to "back door" the chiropractic wiki into alternative medicine which, on wikipedia at least, has negative connotations, especially compared to CAM (which is neutral) and complementary (which is favourable). I can also provide over 100+ references from scientific peer-reviewed journals where chiropractic care has been referred to a CAM health profession and not alt. med which you suggest. Until the alt-med wiki on here is more balanced and accurately reflects the modern and global state of events any attempt to pigeon hole the profession into that categorization really is not reflective of the reality.

EBDCM

19:25, 8 February 2008 (UTC)

Hypebole, the phrase in the lead now reads "health profession". To EBDCM please reread the first line of this thread. You will then now why I want it removed. Your other back door allegations do no merit dealing with. Please stick to the issue. Two words. In or out? Mccready07:30, 10 February 2008 (UTC)

Mccready,

Your personal opinion is irrelevant, and chiropractic is a health care ) 17:52, 10 February 2008 (UTC)

EBDCM, please reread your last paragraph. I find it very rudel Please lets all try to get along and stop attacking the editors and comment on the edits. Thanks, --Crohnie "'Crohnie"'"'Gal"' 14:41, 11 February 2008 (UTC) PS: I'm not taking sides at all, I am just trying for civility which is lacking in many articles.

Hi Crohnie

I'm just giving mccready pointed criticism based on his current and past history towards disrupting previously stable pages. If you look carefully at his log, you can see it's been over 2 years of such antics. Mr. Mccready feels its ok to steamroll his edits in there an alienates many editors with his condecending tone and has been accused of gaming the system which I would agree with. If I seem curt with him it is because I have little tolerance for individuals who claim to be scientifical minded and search for the 'truth' yet recoil in horror when the 'truth' does not agree with their personal views. Cognitive dissonance would be a good word to describe what Mr. Mccready is likely going to encounter as scientific research continues to validate traditional therapies such as manipulation and acupuncture.EBDCM17:14, 11 February 2008 (UTC)

Citizendium

Is Citizendium a RS? per http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=190445341oldid=190415854--Hughgr20:09, 10 February 2008 (UTC)

Yes. QuackGuru Quack 20:12, 10 February 2008 (UTC)

Thanks for the answer from the person who is inserting the ref... How about some thoughts from other contributors. I'm wondering if CZ is used as a ref for any other articles in wikipedia other than ones about itself. --Hughgr20:24, 10 February 2008 (UTC)

Here are some comments by other contributors.http://en.wikipedia.org/w/index.php?title=Talk%3AChiropracticdiff=188492752oldid=188489819http://en.wikipedia.org/w/index.php?title=User_talk:QuackGurudiff=nextoldid=189661763http://en.wikipedia.org/w/index.php?title=User_talk%3ADemattdiff=190342327oldid=190340884http://en.wikipedia.org/w/index.php?title=User_talk:Jim_Butlerdiff=nextoldid=189679215 QuackGuru Quack 20:50, 10 February 2008 (UTC)

Definitely, no. This appears to be more OR by quack guru. The so called objective group appears to be in tiny numbers in the US and I do not know of it's existence anywhere else in the world. Given QGs own conflicts with practice styles and his questionable referencing standards, I think we should revert to Hyperboles edit which had much more consensus than QGs.EBDCM21:30, 10 February 2008 (UTC)

I've posed this question on the RS/Noticeboard. http://en.wikipedia.org/wiki/Wikipedia:Reliable_sources/Noticeboardanother_wiki.3F--Hughgr23:25, 10 February 2008 (UTC)

There are four groups. Traditional straights, objective straights, mixers, and reformers. The two main groups are the traditional straights and mixers. The two minority groups are objective straights and reformers. Please read the references. This is obvious. Agreed? QuackGuru Quack 03:28, 11 February 2008 (UTC)

No, quack guru. The references you provide are nowhere near the quality the merits the inclusion. Furthermore, like previous editors have asserted, its seems like its OR and the one "source" (hint, hint its SB and AB) keeps on popping up. Your continuous pushing of this strange. First you want all 4. Then you want reformers deleted (which would make 2) now you want all 4 again. Prove to us that OS exists and has traction outside a small group of individuals in the US. Reform, on the other hand, does and is mentioned in peer reviewed articles (no quack guru, journal of vertebral subluxation research JVSR is not a reputable publication, so don't even go there).

This article will be one of the best on wikipedia because the standard of edits must include solid, scientific papers or high quality sources. Your edits thus far do not match that standard and I agree with other editors in noting that they have become disruptive. EBDCM04:34, 11 February 2008 (UTC)

I provided the references. I do not understand your comments. The reference states four groups. Yes? I am following where the references takes me. QuackGuru Quack 04:38, 11 February 2008 (UTC)

I have been contacted off wiki by a user who appears to be concerned by this issue. My view, and it is shared by many experienced editors, is that citizendium is not a source which should be used on wikipedia, particularly not in terms of reliability. It is not peer reviewed. Mccready06:29, 11 February 2008 (UTC)

Peer-review is not a requirement for sources here. As long as they are V RS, they can be used. Citizendium is a far better source than many of those we commonly use. -- Fyslee / 05:09, 12 February 2008 (UTC)

Citizendium has a form of peer review by credentialed topic experts. Experts have reviewed the article. This is one of the few approved articles. QuackGuru05:16, 12 February 2008 (UTC)

Please see http://en.wikipedia.org/wiki/Wikipedia:Reliable_sources/Noticeboardanother_wiki.3F. Mccready05:24, 12 February 2008 (UTC)

Please review V. This confirms we can use it as a source. Thanks. QuackGuru05:34, 12 February 2008 (UTC)

Reviewing Wikipedia:Verifiability would suggest the opposite is true and confirms that Citizendium should not be used as a source anywhere on Wikipedia. For all intents and purposes it is the same thing as using Wikipedia to source itself. Even with Citizendiums "confirmed identities", it's still an online self-published source (i.e. open wiki) and should never be used as a reference anywhere on Wikipedia. If some "expert" is publishing there, I have to imagine they have published their ideas elsewhere. Take the time to contact them and find other more acceptable source material.--Tafew13:40, 12 February 2008 (UTC)

In accordance with Wikipedia:Verifiability, this reference is reliable. See: "Self-published material may, in some circumstances, be acceptable when produced by an established expert on the topic..." Please discuss based on policy. QuackGuru20:40, 12 February 2008 (UTC)

Yes it does say that; and as I think is fairly clear by the discussion at Wikipedia:Reliable sources/Noticeboard that multiple editors have some rather serious reservations about Citzendium's ability to credibly assert the individuals writing there are actually "experts", a problem that plagues Wikipedia as well. Cherrypicking Wikipedia:Verifiability still doesn't make Citizendium reliable. You should find a better source.--Tafew20:47, 13 February 2008 (UTC)

Reliability and validity are not the same quack guru. I reverted your edit on practice styles because there was no consensus for 4 groups. Most editors here favoured 2 and then added a 3rd after persuasion. We have also discussed at length whether or not citizidium articles should be included. Ironically, it appears that there was a massive cut and paste and text dump from the citizidium site onto the practice styles. Considering that you had accused me of this issue one day ago, I thought I would politely remind you of the same. Also, there was no discussion about tossing in your styles of thought in the lead which had already been improved by Hyperboles edit. EBDCM13:39, 13 February 2008 (UTC)

Specifically citing Wikipedia:Verifiability does make Citizendium reliable when I explained how the reference conforms to Wikipedia:Verifiability policy despite the reservations. QuackGuru04:30, 16 February 2008 (UTC)

I have explained my reasons for including the reference. I am requesting permission. Do we have consensus to add the CZ reference? QuackGuru06:52, 19 February 2008 (UTC)

No, Citizendium is not yet a RS according to Wikipedia.http://en.wikipedia.org/wiki/Wikipedia:RSNanother_wiki.3F--Hughgr08:06, 19 February 2008 (UTC)

According to specific Wikipedia:Verifiability policy it is reliable. QuackGuru05:23, 20 February 2008 (UTC)

minor edit?

Is this a minor edit?http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=nextoldid=190445341 QuackGuru Quack 20:14, 10 February 2008 (UTC)

The writing was not an improvement and it was not a minor edit. QuackGuru Quack 04:02, 11 February 2008 (UTC)

Hello QuackGuru. No particular criticism of your recent edits, but I think a little more information may be required for the average reader, if it exists. Specifically, on the reasons -why- the minority-straight group does not want to give treatments as if they are medical professionals. I for one, don't quite see their reasoning and I'd like to know. Delvin Kelvin04:58, 11 February 2008 (UTC)

Read the references such as this one. http://www.ncahf.org/pp/chirop.htmlreformers The minority groups are more scientifically inclined. QuackGuru Quack 05:06, 11 February 2008 (UTC)

health profession in the lead

I suggest we delete these two words. They are redundant. What altmed is not a health profession? Mccready07:40, 11 February 2008 (UTC)

They are NOT redundant, Mccready. Is Reiki a health profession? What about Yoga? Do they have licensure examinations and a regulatory board? Simply, no they do not. Although chiropractic is a CAM health profession, not all CAM therapies ARE health professions in either the medical or legal sense. Just for you, I'm going to go through my Jurisprudence notes and show you the legal differences involved. Nevertheless, this is yet another example of your systematic attempt to destabilize the article. EBDCM17:09, 11 February 2008 (UTC)

I suggest we leave those two words in. They are descriptive and accurate.--Hughgr18:39, 11 February 2008 (UTC)

Reads also it bad like very though English. Jim62sch 0149;Jim62sch0149; 22:31, 11 February 2008 (UTC)

Leave them in. It's pretty poor English without them. -- Fyslee / 05:10, 12 February 2008 (UTC)

undent Please explain what is poor English about "Chiropractic is a complementary and alternative medicine whose purpose is etc". Indeed the current version is arguably poorer English. ie "Chiropractic is a complementary and alternative medicine health profession whose purpose is etc" Mccready05:15, 12 February 2008 (UTC)

I am a health professional (hence "Doctor").TheDoctorIsIn06:34, 12 February 2008 (UTC)

Chiropractic and vaccination

http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=190585829oldid=190570570 This change was reverted with the comment "removed anti-vacc POV for example the CCA favours vaccines. We need to discuss this on Talk first." OK, here's a proposed improvement to that change which mentions the CCA.

There are exceptions to the stress on prevention. For example, traditional chiropractic opposes vaccination on the grounds that all diseases are traceable to causes in the spine, and therefore cannot be affected by vaccines; D. D. Palmer likened vaccines to "filthy animal poisons". Although there is now overwhelming evidence that vaccination is an effective public health procedure, it remains controversial within chiropractic. The American Chiropractic Association and the International Chiropractic Association continue to support exemptions to compulsory vaccination laws. The Canadian Chiropractic Association supports vaccination, but even in Canada, surveys have found that over a quarter of chiropractors oppose vaccination and advise patients against vaccinating themselves or their children.cite journal |journal= J Manipulative Physiol Ther |date=2005 |volume=28 |issue=5 |pages=367–73 |title= Chiropractic antivaccination arguments |author= Busse JW, Morgan L, Campbell JB |doi=10.1016/j.jmpt.2005.04.011 |pmid=15965414

Eubulides

18:19, 11 February 2008 (UTC)

The fact that individual practitioners hold certain views on vaccination does not trump the fact that national associations are in favour of it. If anything, these individual DCs are putting themselves on the line and can be charged with professional misconduct.

Any reference for the 25% figure or is that one out of plain air? I'm aware of the Busse study, I work with Jason. I think I can find a compromise though, which would be to insert the various vaccination positions amongst the various styles of practice. As a so called evidence-based "reform" chiropractor, I recognize the importance of vaccinations and public health. Nevertheless, the straight/traditional faction who still adhere to DD/BJ are still opposed (I think, this would need to be confirmed). What do you think? EBDCM19:14, 11 February 2008 (UTC)

EBDCM

18:55, 11 February 2008 (UTC)

We have one national association (Canada) in favor of vaccination, one (the U.S.) exempting people from vaccinations, and the international organization agreeing with the U.S.; this hardly seems to be a solid official front in favor of vaccination. The "over a quarter" figure comes from the "29%" and the "27.2%" in the following quote from Busse "et al." 2005, the cited source:

The official policy statement of the Canadian Chiropractic Association is supportive of vaccination, stating, "The CCA accepts vaccination as a cost-effective and clinically efficient public health preventive procedure for certain viral and microbial diseases, as demonstrated by the scientific community" (Policy Manual; Motion 2139/93). One might presume, therefore, that the Canadian chiropractic profession maintains a similar perspective on vaccination. Nevertheless, a recent survey of 621 students (75.2% response rate) attending the Canadian Memorial Chiropractic College (CMCC), the only English-language chiropractic college in Canada, found that approximately 29% of students graduated in the year 2000 with antivaccination attitudes, 40% being supportive of vaccination, with 31% unsure. Further, a 2002 survey of Alberta (Canada) chiropractors, many of whom will have graduated from CMCC, found that 27.2% advised patients against vaccinating themselves or their children.

As for positioning, it's fine with me if this is discussed in other sections. Still, it seems to me there should be at least some brief mention of the dissonance between (on the one hand) the lengthy contention in ChiropracticThe philosophy of chiropractic care: a complementary and holistic approach to health care that chiropractic is strong on prevention, and (on the other hand) the relatively high level of chiropractic opposition to one of the most effective disease-prevention methods known. Eubulides19:40, 11 February 2008 (UTC)

While I personally would agree with you, it could be argued that the chiropractic profession is big of NATURAL disease prevention such as proper diet and exercise, lifestyle modifications (not smoking) etc. Furthermore, regardless of schools of thoughts DCs stress the importance of prevention which is why the so called "maintenance/wellness" visits are suggested which is to screen for spinal dysfunction, trigger points, muscular imbalances, etc and nip something in the bud before it has time to manifest itself as a full blow pain episode/syndrome. —Preceding ) 19:57, 11 February 2008 (UTC)

I would also note that a follow up study perfomed in 2006 by my classmate found that the % of students being weary of vaccinations sharply dropped. I will try to get a hold of the exact figures and see if it has been published yet. Thanks for the stats. EBDCM20:01, 11 February 2008 (UTC)

Then perhaps the "Philosophy" section should be modified to say not that chiropractic is in favor of prevention per se, but that it is in favor of chiropractic prevention methods and not necessarily of mainstream medical prevention methods, using the vaccination controversy as an example. The source I cited was a review article, which according to 16461176) which found that about 15–20% of chiropractors were pro-vaccination, 15-40% were anti, and 35-70% were mixed (the wide range depends on whether interviews or surveys were used). However, Page "et al." doesn't add much to the review article's summary (it merely confirms the fact that there is a strong anti-vaccination theme in chiropractic, even today), so I'm not sure it's worth adding to Chiropractic. Eubulides20:32, 11 February 2008 (UTC)

I think that in the philosophy section we could clarify prevention and add 'holistic' or 'natural' prefix in there to help differentiate from standard medical preventative approaches (i.e. vaccination). Great job with the studies, like I said earlier on this page, I'm all about bringing the best and highest quality evidence to the table.

One of the biggest problems with the chiropractic profession as a whole is the disparity between schools of thought, teaching institutions and variances in professional orientations amongst various countries. Was the Page et al. study just American based or where DCs from other countries sampled as well? EBDCM22:11, 11 February 2008 (UTC)

The Page "et al." study was Canadian based; Calgary to be precise. But as I wrote, it doesn't alter the review's conclusions enough to be worth citing separately. What's the next step here? There is a concrete wording proposal on the table, namely the quoted text at the start of this section. It may not be perfect, but I haven't seen any specific suggestions for making it better. It should go in if it improves the existing text. Rewording the philosophy section is a bigger task; the section as a whole needs a lot of work, as noted in Bias towards Chiropractic Methods above. One step at a time, no? Eubulides05:25, 12 February 2008 (UTC)

Rewording the philosophy section? Excuse me, why would you rewrite what a chiropractic researcher (DC,PhD) espouses as the philosophy of chiropractic? What more accurate source could there be? A medical one? The chiropractic profession determines its philosophy not wikipedians. If you want to include a vaccination bit, by all means lets do it where it belongs (under the straights) and not tar the far majority of sane and rational DCs who realize that vaccinations are not within our scope.

As I said, the issues in the philosophy section are a much bigger matter. I'd rather not have that distract from this smaller issue; one thing at a time. Eubulides06:39, 12 February 2008 (UTC)

I will help you rewrite the quote, but your going to have to start by leaving classic DD Palmer quotes out of the equation. It's 2008 and not 1895. Regarding the bias, if it passes Mccready's litmus test then it must be fine (he is a hard-core chiropractic skeptic). Also it is only your opinion that any section 'needs a whole lot of work'. Feel free to debate facts on the Talk page, but as always, weight will be an issue.

Do you have a specific suggestion for improvement? The proposed quote makes it clear that traditional chiropractic is strongly opposed to vaccination, as this helps to explain the current ambivalence about vaccination among chiropractors. If this can be done more clearly and succinctly than by quoting DD Palmer that would be great (though it'd be hard to improve on his vigor :-). I don't understand the comment about bias; as far as I know, nobody has yet complained about bias in the proposed change. Again, the proposed change doesn't have to be perfect; it needs only to be a worthwhile improvement over the current article. Eubulides06:39, 12 February 2008 (UTC)

While we're on vaccination, I might as well create a section of Chiropractic in Integrative Health Care. You know, DCs working with MDs, RNs, PTs and other mainstream medical providers inhospitals and other public health spaces. Let's just say that before starting that section I'll see how you pursue the vaccination issue and if it is done professionally or will be another attempt to sand bag the whole profession because a group of renegade straights.

EBDCM

05:58, 12 February 2008 (UTC)

I like the idea of adding a section about integrative health care. I suggest Mootz 2007 (PMID|17224347) Barrett 2003 (PMID|12816630), and Meeker Haldeman 2002 (PMID|11827498) as starting points. As mentioned above, Page "et al." 2006 report that only about 15–20% of surveyed chiropractors were pro-vaccination (the rest were anti, or mixed); this is evidence that the vaccination issue is not due entirely to a group of renegade straights. Eubulides06:39, 12 February 2008 (UTC)

Good input here, keep working on it. The Mootz and Reed mention in the first paragraph was a way to illustrate that the explanation for what chiropractic 'is' was coming from chiropractors, not us. Otherwise, I think we would have a NPOV issue as you state. The bulleted points are verbatim from the source below the list. These were certainly not the way I would have stated them, but it is important to explain it in "their" words. I think overall the section is accurate and neutral because it does not leave the reader with any impression as to whether the philosophy is right or wrong, which is what we as wikipedians are asked to do.

I don't think anyone considers 'reductiionism' as a negative thing, in fact it is responsible for the science of DNA and all we know about modern chemistry, pharmacology and will likely explain how the chemistry of the brain creates life itself. So, no, I don't think reductionism should be considered a bad word. I also don't see that holism is a bad word. It should be pretty NPOV to use these words to compare and contrast as we try to explain to readers how the chiropractor thinks.

I think vaccination has many facets. It is one thing to talk about Polio vaccine, but it is another to talk about a chicken pox vaccine or the 'flu shot'. I don't think it is too outlandish to expect that chiropractors as well as some mainstream practitioners might be skeptical of using vaccines for conditions that are not life threatening... IOWs, these are complicated issues, maybe the best thing to do is to link to the Vaccine controversy article?

I probably missed some things, but we have plenty of time. -- Dematt Dēmatt 01:02, 13 February 2008 (UTC)

I disagree that the current wording clearly distinguishes chiropractors' opinion of conventional medicine from the mainstream view. It presents that opinion as fact. This is my main concern about the section. I also disagree about "reductionism": the term can be used pejoratively, and is used that way in the section. Wikilinking to Vaccine controversy is a good idea; I http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=191112146oldid=191111085 did that. Eubulides10:35, 13 February 2008 (UTC)

Holistic is almost always used in a POV fashion to imply that other modalities are not holistic. It's a weasel word which should be avoided. Similarly with reductionism. In the context here it is pejorative. If more neutral language can be found, or better for brevity of the article, the words can be deleted or linked away, great. Mccready02:55, 13 February 2008 (UTC)

With all due respect, Mccready, holism is not a weasel word. Nor is reductionism perjorative. They're simply opposite endpoints of a philosophical spectrum. I have already provided evidence to Eu which confirms that reductionistic models of thought dominate mainstream medicine. That's not a bad thing, but it has its limits. With respect to holism, it is the dominant model in CAM professions. Holism too has its limits. I think that Dematts rationalization seems to be sensible. EBDCM03:00, 13 February 2008 (UTC)

See above for why the reference you cited actually says that the implementation of conventional medicine is system-oriented, not reductionistic. It's certainly fine to present and use the terms "reductionistic" and "holistic" as chiropractors do; it's not OK to do so in such a way as to give the impression that mainstream opinion agrees with this use of terminology. Eubulides10:35, 13 February 2008 (UTC)

I see someone else added the proposed text. In the meantime x Dēmatt made some good suggestions about it in Talk:Vaccine controversy Chiropractic and the vaccine controversy so I http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=191110252oldid=191108858 made them too. Eubulides10:18, 13 February 2008 (UTC)

After the change went in, it was edited by several sources. The http://en.wikipedia.org/w/index.php?title=Chiropracticoldid=191244322 current version has some problems, though:

The linking text connecting it with the previous previous section has been removed, causing a jarring transition and making it appear out of place. The previous paragraph talks about prevention being a big part of chiropractic philosophy; the link to the current paragraph is partly that in some cases chiropractic is ambivalent about prevention.

The text is far too weak on how effective vaccines are. It says "some have been demonstrated to be effective". But one cited source (Campbell "et al." 2000) talks about the "overwhelming scientific evidence that vaccination is a highly effective method of controlling infectious". The other (Busse "et al." 2005) says "most public health authorities would agree that vaccination constitutes one of the most cost-effective infectious disease control measures of the last century". Like it or not, that is the mainstream opinion, and it should not be watered down here.

The current text has removed all evidence that it is chiropractors themselves, not merely their official organizations, who are ambivalent about vaccination. The resulting text reads too much like Pravda in the Soviet days, which reported only on what the official party line was. It's more important to know what chiropractors are actually saying and doing than what the official policy statements are.

The statement "According to the philosophy of chiropractic, disease prevention should occur from strengthening the host from within." is not supported by either of the cited sources. Either a reliable source must be found or the statement needs to be revised or eliminated.

The text quotes the CCA at length about how vaccination is cost effective and clinically efficient. This doesn't add anything to the text and (again) sounds too much like Pravda in the bad old days. It suffices to say that the CCA is pro-vaccination.

Here's a proposed rewrite to fix the above problems:

Not all forms of prevention are stressed by the chiropractic profession. Notably, although vaccination is one of the most cost-effective form of prevention against infectious disease, most chiropractic writings on vaccination focus almost exclusively on its negative aspects. Controversy on this issue exists among national associations; for example, the American Chiropractic Association supports exemptions to compulsory vaccination laws on the grounds that vaccines have risk, whereas the Canadian Chiropractic Association supports vaccination.cite journal |journal=Pediatrics |date=2000 |volume=105 |issue=4 |pages=e43 |title= Chiropractors and vaccination: a historical perspective |author= Campbell JB, Busse JW, Injeyan HS |pmid=10742364 |url=http://pediatrics.aappublications.org/cgi/content/full/105/4/e43 Individual chiropractors also disagree: for example, surveys in Canada in 2000 and 2002 found that about 40% of chiropractors supported vaccination, and that over a quarter opposed it and advised patients against vaccinating themselves or their children.cite journal |journal= J Manipulative Physiol Ther |date=2005 |volume=28 |issue=5 |pages=367–73 |title= Chiropractic antivaccination arguments |author= Busse JW, Morgan L, Campbell JB |doi=10.1016/j.jmpt.2005.04.011 |pmid=15965414

Eubulides

22:16, 13 February 2008 (UTC)

I don't believe that the "preventative" paradox is all that this is making it out to be. Chiropractors tend to believe in non-invasive preventative measures. Vaccination is certainly invasive. Further, I think that the "vaccination" issue is dealt with far too much in this article per UNDUE. -- Levine211222:30, 13 February 2008 (UTC)

ChiropracticPhilosophy talks extensively about prevention without mentioning the restriction that only prevention approved by chiropractic philosophy is allowed. If there are crucial restrictions on the form of prevention, that should be mentioned in the text; otherwise, it gives the misleading impression that chiropractic is always big on prevention, with the implication that conventional medicine is not and that chiropractic in this respect is superior to conventional medicine. As far as UNDUE goes, I agree that both the current and proposed text are too long, but shorter versions have been rejected by others. I would also be happy with a shorter version, which I'll suggest below. Eubulides23:23, 13 February 2008 (UTC)

The text is NOT far too weak on how effective vaccines are. It says "some have been demonstrated to be effective" - the reason being that others have NOT been demonstrated to be effective. You only need to look at the flu shot data to see what those "vaccinations" are effective for (hint: bank accounts). Arion 3x322:44, 13 February 2008 (UTC)

Fair enough: not all vaccines are effective; certainly there have been many experimental vaccines that did not pan out. However, the vaccines on the recommended childhood schedules are effective. The shorter version proposed below sidesteps the issue about which are effective and which are not, by merely stating that vaccines as a whole are cost-effective. Eubulides23:23, 13 February 2008 (UTC)

""Notably, although vaccination is one of the most cost-effective form of prevention against infectious disease"" is editorializing and out of place in an article on chiropractic. Arion 3x322:47, 13 February 2008 (UTC)

That comes from the cited source (Busse "et al." 2005), which says "Although most public health authorities would agree that vaccination constitutes one of the most cost-effective infectious disease control measures of the last century, few, if any, would argue that there are no problems associated with their use." It is important to briefly establish (because the chiropractically-inclined reader may not know it) that the prevention method that chiropractors are ambivalent about is extremely effective. Suggestions for improving my paraphrase are welcome. Eubulides23:23, 13 February 2008 (UTC)

Anyway, here's a shorter version, if brevity is preferred:

However, although vaccination is one of the most cost-effective form of prevention against infectious disease, it remains controversial in chiropractic. Most chiropractic writings on vaccination focus on its negative aspects. Although the Canadian Chiropractic Association supports vaccination, the American Chiropractic Association supports exemptions to compulsory vaccination laws.cite journal |journal=Pediatrics |date=2000 |volume=105 |issue=4 |pages=e43 |title= Chiropractors and vaccination: a historical perspective |author= Campbell JB, Busse JW, Injeyan HS |pmid=10742364 |url=http://pediatrics.aappublications.org/cgi/content/full/105/4/e43 Surveys in Canada in 2000 and 2002 found that about 40% of chiropractors supported vaccination, and that over a quarter opposed it and advised patients against vaccinating themselves or their children.cite journal |journal= J Manipulative Physiol Ther |date=2005 |volume=28 |issue=5 |pages=367–73 |title= Chiropractic antivaccination arguments |author= Busse JW, Morgan L, Campbell JB |doi=10.1016/j.jmpt.2005.04.011 |pmid=15965414

Eubulides

23:23, 13 February 2008 (UTC)

Getting better. I wonder with this, would we still need the vaccine philosophical distinctions in the descriptions of the three schools of chiropractic (straight, mixer, reform)? -- Levine211223:30, 13 February 2008 (UTC)

I don't think ChiropracticPractice styles and schools of thought needs to mention vaccination if it's discussed all in one spot. That would help shorten things. Eubulides23:47, 13 February 2008 (UTC)

Eubulides, the vaccination issue here is becoming undue weight in my opinion. There's no need to quote stats as they can easily be spun (a majority of cdn dcs favour vaccination efforts (40 vs 25%). I even went so far as to include the various viewpoints of the different factions re: the vaccination topic in the styles of practice section. I still strongly disagree with your reverts on the vaccine controversy section and hope we can better collaborate here. EBDCM23:38, 13 February 2008 (UTC)

As x Levine2112 notes, removing the vaccination discussion from ChiropracticPractice styles and schools of thought should lessen UNDUE concerns. Certainly "some" discussion of vaccination is apropos: it is a common source of controversy among chiropractors and between the chiropractic and mainstream communities. It's better to cite reliable sources, with actual statistics, rather than parcel out vaguer and unsourced claims among several paragraphs. The proposed text does not spin the statistics: it gives them as-is. These statistics are representative of all the surveys we've found on the subject. Eubulides23:47, 13 February 2008 (UTC)

I tried to remove the vaccination from the ChiropracticPractice styles and schools of thought but I was reverted. QuackGuru20:21, 16 February 2008 (UTC)

Chiropractic and vaccination part 2

I read through all these discussions and tried to incorporate all the issues while keeping it as NPOV as possible. Mostly I rearranged things and tweaked some. See what you think:

There are differences of opinion within the chiropractic profession regarding interventions for the prevention of some types of disease. The holistic philosophy of chiropractic suggests that disease prevention should occur by strengthening the host from within, yet there is strong evidence to support the use of vaccinations in the prevention of certain diseases. This has caused significant disparity among chiropractors as they struggle to find their niche in the healthcare arena. This disparity is exhibited even in statements within national associations, for example the American Chiropractic Association and the International Chiropractic Association support exemptions to compulsory vaccination laws on the grounds that, since vaccines have risk, patients should be allowed the freedom to choose. In contrast, the Canadian Chiropractic Association supports vaccination as a cost-effective and clinically efficient public health preventative procedure for certain viral and microbial diseases.http://www.ccachiro.org/Client/cca/cca.nsf/web/Vaccination%20and%20Immunization?OpenDocument cite journal |journal=Pediatrics |date=2000 |volume=105 |issue=4 |pages=e43 |title= Chiropractors and vaccination: a historical perspective |author= Campbell JB, Busse JW, Injeyan HS |pmid=10742364 |url=http://pediatrics.aappublications.org/cgi/content/full/105/4/e43cite journal |journal= J Manipulative Physiol Ther |date=2005 |volume=28 |issue=5 |pages=367–73 |title= Chiropractic antivaccination arguments |author= Busse JW, Morgan L, Campbell JB |doi=10.1016/j.jmpt.2005.04.011 |pmid=15965414

-- Dematt Dēmatt 01:50, 14 February 2008 (UTC)

This looks really good and tells the whole story. With this, I would be in favor off excising the vaccination info from the Practice Styles section as it is a tad redundant and gives too much undue weight to this singular issue. -- Levine211201:57, 14 February 2008 (UTC)

There are several problems with this rewrite, which I see was installed at the same time it was proposed.

It makes two claims that are not supported by the cited sources. These include:

*"The holistic philosophy of chiropractic suggests that disease prevention should occur by strengthening the host from within" None of the cited sources talk about "strengthening the host from within". None of them draw any connection between the holistic philosophy of chiropractic and disease prevention.

*"This has caused significant disparity among chiropractors as they struggle to find their niche in the healthcare arena." None of the sources talk about "struggle to find their niche in the healthcare arena".

The rewrite does not talk about what chiropractors actually "do" in this area. Do they tell their patients not to immunize? This is missing an important part of the story.

The rewrite spends too much time talking about detailed official wording by chiropractic associations, which can easily be summarized without losing any significant information. Again, this resembles too much the Pravda of yore, which would breathlessly report the latest plan of the Tractor Factory managers without bothering to report how many tractors were actually produced. There is no need to say that the CCA "supports vaccination as a cost-effective and clinically efficient public health preventative procedure for certain viral and microbial diseases" (this sounds like the fine print at the bottom of a tube of toothpaste!) when the article can simply say that the CCA supports vaccination.

The rewrite spends too much effort attempting to justify chiropractors' positions. It should just focus on the statistics and what people's positions are. It is not Wikipedia's place to guess what chiropractors' motivations are.

The rewrite is significantly longer than either version that I proposed. Not counting citations, I proposed versions totaling about 110 and 80 words, respectively; the rewrite has 140 words. It is inconsistent to criticize a 110-word version for undue weight, and then go ahead and say a heavier-weight 140-word version "looks really good".

The rewrite could use some serious wordsmithing. For example, its "There are differences of opinion within the chiropractic profession regarding interventions for the prevention of some types of disease" can be rephrased much more succintly as "Some disease prevention methods are controversial within chiropractic" without losing information.

Let's take a look at the representative sentences taken from the abstract of the first reliable source we have on the topic. (This is the milder of the two sources: the other source uses much stronger wording.)

"Although there is overwhelming evidence to show that vaccination is a highly effective method of controlling infectious diseases, a vocal element of the chiropractic profession maintains a strongly antivaccination bias.… Although more progressive, evidence-based chiropractors have embraced the concept of vaccination, the rejection of it by conservative chiropractors continues to have a negative influence on both public acceptance of vaccination and acceptance of the chiropractic profession by orthodox medicine." (Campbell "et al." 2000, PMID|10742364).

The rewrite does not reflect these sources well. Instead, it reflect editors' desires to place chiropractic in a different light than what these reliable sources say. That's not how Wikipedia is supposed to work. Wikipedia is supposed to reflect what reliable sources say on a topic, not what we "wish" the reliable sources had said.

To help fix these problems I attempted to merge the good ideas of the above drafts, and came up with the following, which I http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=191370068oldid=191359780 put into the article. Further comments are welcome of course.

Some disease prevention methods are controversial within chiropractic. Although vaccination is one of the most cost-effective forms of prevention against infectious disease, traditional chiropractic philosophy is that diseases are traceable to causes in the spine and that vaccines therefore have no benefits to outweigh their risks, and most chiropractic writings on vaccination focus on its negative aspects.cite journal |journal= J Manipulative Physiol Ther |date=2005 |volume=28 |issue=5 |pages=367–73 |title= Chiropractic antivaccination arguments |author= Busse JW, Morgan L, Campbell JB |doi=10.1016/j.jmpt.2005.04.011 |pmid=15965414 |url=http://jmptonline.org/article/S0161-4754(05)00111-9/fulltext?articleId=S0899-3467%2807%2960081-0 The Canadian Chiropractic Association supports vaccination, but the American Chiropractic Association and International Chiropractic Association cite vaccine risk and support exemptions to compulsory vaccination laws.cite journal |journal=Pediatrics |date=2000 |volume=105 |issue=4 |pages=e43 |title= Chiropractors and vaccination: a historical perspective |author= Campbell JB, Busse JW, Injeyan HS |pmid=10742364 |url=http://pediatrics.aappublications.org/cgi/content/full/105/4/e43 Surveys in Canada in 2000 and 2002 found that about 40% of chiropractors supported vaccination, and that over a quarter opposed it and advised patients against vaccinating themselves or their children.cite journal |journal= J Manipulative Physiol Ther |date=2005 |volume=28 |issue=5 |pages=367–73 |title= Chiropractic antivaccination arguments |author= Busse JW, Morgan L, Campbell JB |doi=10.1016/j.jmpt.2005.04.011 |pmid=15965414

Eubulides

07:04, 14 February 2008 (UTC)

I reverted your edit because I did not feel it was a significant improvement over Dematts and there was no agreement that your edit was superior, which IMO, I feel is not. Dematts seems to accurately capture the various POVs and intracies involved with this complicated subject. Also, the entire premise that diseases can be traced back to the spine is dubious and the arguments against mandatory vaccination are much more sophisticated now and I see no mention of them. EBDCM16:54, 14 February 2008 (UTC)

There was no agreement that either edit was superior. The only support for Dematt's version was expressed by Levine2112, but Levine2112 also liked the shorter version that I proposed. The only criticism of the shorter version was yours, on the grounds of undue weight: and yet Dematt's version is considerably longer and gives more weight to the topic, so this criticism is inconsistent. Nobody has yet addressed any of the several specific points made above, in criticism of Dematt's version. The edit I installed attempted to merge the good ideas of Dematt's edit. For now, I http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=191451373oldid=191436200 applied the shorter edit instead, as that better addresses your complaint of undue weight. Let's try to come up with a better consensus, as Dematt's version has serious problems that require discussion. Eubulides17:16, 14 February 2008 (UTC)

Looking better, sorry Eubulides, I hope you realize that that was my first rewrite, I don't have a problem with added content if it helps properly explain the concept. However, in the spirit of collaboration, I am having the same trouble verifying the two first sentences that you placed as well, even though I think they are mostly correct, though we might have to take out the words "most":

.However, although vaccination is one of the most cost-effective form of prevention against infectious diseaseFact|date=April 2008 , it remains controversial in chiropractic. Most chiropractic writings on vaccination focus on its negative aspects.Fact|date=April 2008

I can't verify the sources because they are apparently subscriptions. Do you have anything else?

-- Dematt Dēmatt 14:06, 15 February 2008 (UTC)

I can quote the source to you. Page 371 of Busse "et al." 2005 (PMID|15965414) says (p. 367), "Although most public health authorities would agree that vaccination constitutes one of the most cost-effective infectious disease control measures of the last century, few, if any, would argue that there are no problems associated with their use." In its conclusion it says (p. 371), "In the face of now overwhelming evidence to show that vaccination is an effective public health procedure, Palmer's modern followers have turned to whatever sources they can to support chiropractic's archaic anti-immunization position." As for the point about negative writings, the same source says (p. 368) "It is certainly the case that most chiropractic writings on vaccination focus almost exclusively on the negatve aspects, either ignoring the huge amount of evidence supporting the benefits of vaccination or summarily dismissing this as 'bad science' or government/industrial propaganda." Hope this helps. I removed the "fact" tags. Eubulides17:27, 15 February 2008 (UTC)

That did help, thanks. I made a couple of tweaks to help attribute and allow the appropriate people get the credit/blame depending on your POV. http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=191682637oldid=191679272. I'm okay with this formulation. -- Dematt Dēmatt 17:50, 15 February 2008 (UTC)

Actually, now that I think about it, I see that that source includes Lon Morgan. Eubulides, does he mention that there are 'reform minded' chiropractors or 'Reform' chiropractors that "agree" with vaccination? That would help us to differentiate the two groups of thought according to their vaccination stance. The ICA is really more Palmer oriented and aligned with Straights, while the CCA would be more reform minded, I'm sure. The ACA is actually a mixer organization and the impression I have come away with is that 'reform' minded DCs are driving the ACA. Again, this is more of an attribution issue, making sure the right groups are associated with which stance (if there is one). -- Dematt Dēmatt 18:00, 15 February 2008 (UTC)

The words "straight", "mixer", and "reform" do not appear in Busse "et al." 2005 (PMID|15965414). It focuses mostly on the arguments used in writings by chiropractors about vaccination; it does not focus on which groups do which writings. Campbell "et al." 2000 (PMID|10742364), the other cited source, does briefly mention straight and mixer (but not reform). Eubulides19:54, 15 February 2008 (UTC)

Chiropractic and vaccination part 3

http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=192489625oldid=192485514 This change, which was made without discussion, broke the references in ChiropracticVaccination, inserted some wording not supported by the citations, and replaced some statistics with a misleading summary of what the sources say. For example, as Campbell "et al." 2000 makes clear, in 1998 the ACA removed pro-vaccination wording from its official position. They haven't changed since. So it's misleading to simply claim "a gradual shift towards a softer stance on vaccination"; as the changes in official position since 1995 have been in the opposite direction. I http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=192688920oldid=192683106 fixed the problems I found. In the future it would be helpful to discuss controversial changes like this on the talk page. Eubulides00:41, 20 February 2008 (UTC)

Wrong again, Eubulides. I fixed it for you including putting the 'sections of chiropractors' which are obviously the straights. Anyways, considering that ALL of chiropractic was at one point ANTI-vaccination and is now NEUTRAL (ACA) and even PRO (CCA). My statement was correct and accurately reflects the trends over the past 115 years. EBDCM01:00, 20 February 2008 (UTC)

The statement was not supported by the cited source. I disagree that the ACA and the ICA are neutral; they favor exemptions to vaccination, which is mildly anti-. I also disagree that the statement "a gradual shift towards a softer stance on vaccination" accurately describes the ACA and ICA's gradual shift towards a harder stance in the past 15 years. The article could fix the problem by summarizing the entire trajectory, that is, describing all the major transitions since DD Palmer. I could draft something along those lines, but earlier attempts at adding detail to this area have been shot down on UNDUE grounds. Eubulides06:41, 20 February 2008 (UTC)

According to Rupert, 2000 "...and suggests that the level of primary care, health promotion and prevention "'activities"' of chiropractors surpasses that of other physicians."

Eubulides' claim: "Remove claim that chiropractors provide a higher level of primary care, health promotion and prevention.

What's missing? "'Activities."' The claim is not that DCs are superior in any way than other PCPs and provide a higher level of care, but rather are more engaged in health promotion and prevention activities. This can range from stuff that DigitalC said about exercise, nutrition and lifestyle counseling, but goes further into preventative campaigns as well. Such as the Canadian Chiropractic Association's Best Foot Forward Program (http://www.ccachiro.org/Client/cca/cca.nsf/web/Public%20Outreach?OpenDocument) which is a public education campaign about seniors and falls and how DCs can help with this debilitating condition. There's more public outreaches on the page, Eubulides, if you missed them. This is a chiropractic attitude which is reflected by chiropractic philosophy. This is notable and verifiable. In summary, the statement provided was factual as written and your removal of it was neither necessary nor waranted. EBDCM01:21, 20 February 2008 (UTC)

I omitted the word "activities" only in the interest of brevity. The presence or absence of the word "activities" does not change the argument in any material way. Yes, chiropractic has outreach activities, but so do other health professionals; no real evidence has been presented that chiropractic provides a higher level of primary care, health promotion, and prevention activities than other health-care professions do. The cited source (Rupert 2000) provides zero evidence to support this claim; it's only a survey of chiropractors' attitudes towards maintenance care. Eubulides06:45, 20 February 2008 (UTC)

That claim that chiropractors provide a higher level of primary care, prevention, etc, was POV and not accurate, IMHO. The study did not contrast MDs with DCs. I could find hundreds if not thousands of references on health promotion/prevention activities of physicians and other mainstream health professionals. Even HMOs are all for prevention, since it saves money! My mom's GP recommends dietary changes and exercise. She has referred her to a chiropractor and a PT for her shoulder pain.CynRNCynRN04:20, 20 February 2008 (UTC)

Accurate lead

I propose we add

A 2003 paper showed that 90% of North American chiropractors surveyed believed vertebral subluxation played a significant role in all or most diseases.McDonald W (2003) "How Chiropractors Think and Practice: The Survey of North American Chiropractors." Institute for Social Research, Ohio Northern University

Two editors, both chiros, have rejected this in the discussion section devoted to it above. A third has yet to respond despite being notified on this talkpage of the issue. I ask for reasons. My reasons are 1. it is factual 2. it conveys more information than the proposal favoured by Fyslee and others. 3. the information is vital to convey to the reader the current state of chiro (despite the wishes or beliefs of chiro editors here). Yes it's unusual to have a survey in the lead but there is no policy against it. It may look awkward so I am happy to take out the words 2003 survey and just leave it footnoted. And for the record, this is about the umpteenth time there has not been sensible discussion on this and I'm sick of the stupid slurs cast on me by editors who should know better. Please keep your answers concise, nice, and well sourced - your personal judgements, as you know, are less relevant. Mccready00:32, 12 February 2008 (UTC)

Please consider LEADContent_of_the_lead. This survey has no place in this lead because it is way too specific of an issue rather than being something which provides context for the rest of the article, define the topic, provide an accessible overview, or reflect the relative emphasis given to this issue in the rest of the article. "'Also, please add new comments ABOVE the "Notes References" section only."' Thanks. -- Levine211200:39, 12 February 2008 (UTC)

I have considered it. I don't see a problem. Please help me out. When I click on the plus icon to add a new topic to talk the system puts it at the bottom of the page. Mccready00:47, 12 February 2008 (UTC)

("I am attempting to address your "edit" / "+" issue on your talk page.") As for the LEAD, I have addressed each aspect of the content policy and why therefore the survey just doesn't fit. Might I suggest that you edit the body of an article to get information in which you think is missing and then if that information is emphasized enough (per UNDUE) it may indeed find a place in summary in the lead. -- Levine211200:57, 12 February 2008 (UTC)

Surveys don't belong in leads, Mccready. How many times and people will have to revert your edits on this topic before you stop? I don't know if there's an official wikipedia policy on this, but it's getting ridiculous. You're trying to sandbag a profession using a straw man fallacy. Not only that, your survey is of poor quality and cannot be generalizable because it did not randomly sample DCs and found a cluster group instead. Not only that, that very survey is refuted by another survey which suggests only 36% of DCs attribute VSC and disease. All I know is that since you've come back online the edits you've proposed have been highly controversial and you haven't stopped for a minute besides your block. If I may ask, why do you have such a hate-on for chiropractors? —Preceding ) 01:30, 12 February 2008 (UTC)

Levine and E neither of you have provided sources for your opinions. It would help if you did so. E please don't make false accusations. It is UNCIVIL. "just doesn't fit" is not sufficient reason. You have also failed to show how LEAD backs up your arguments, instead you give me advice. I thank you for your advice but it fails to address my concerns. Please address the issue and be nice. Mccready01:40, 12 February 2008 (UTC)

One more time. From LEADContent_of_the_lead we know that the lead should:

Establish context

Define the topic

Provide an accessible overview

Relative emphasis ("the relative emphasis given to material in the lead should reflect its relative importance to the subject according to reliable sources".)

The survey you provide does not fit into any of these categories squarely and thus doesn't belong in the lead. As for the quality of the survey itself, EBDCM makes some powerful arguments why the survey isn't all that telling and thus perhaps it doesn't have a place anywhere in this article. I don't know about that. Right now, all I can tell you is that it doesn't belong in the lead per LEADContent_of_the_lead. -- Levine211201:48, 12 February 2008 (UTC)

mccready

You have the opinion that it should be in the lead. I can count of no less than 8 reverts by various editors on that same topic yet you persist. The majority do not agree with your position. It's that simple. There have been several arguments made, most valid, why your survey does not belong in the lead, yet you ignore it and post the same survey every single day. My advice to you would be please cease on pushing your edits through.

What exactly are your concerns? I'm concerned that the article is already very long and kind of dated and there's been many good scientific studies published which demonstrates the value of contemporary (scientific) chiropractic. I'm concerned that your obsession with VSC is blinding you from the fact that 93% of DCs (practice habits, Survey of Cdn chiropractors Dec 2007) treating neuromusculoskeletal disorders. Why the fuss over 7%? Why does VSC have to be given MORE undue weight? Why are the straights (who are the minority, BTW) get all the attention whilst reformers/mixers have very little weight in contrast despite the fact they combine for 80% of the profession in the US? If you want to be productive why don't you list your 5 top beefs with the profession and let's deal with it on talk. All I know is that you have not budged one single bit since coming back to wiki from your hardcore stances. Like I mentioned in your talk page, you're no different that subluxation dogma in that your positions are fixed and rigid and do not modernize.

I'm not much different than you in that I stand for science and truth. I can be pursuaded with good scientific evidence, but it seems to be the contrary for you, especially given my point regarding medical acupuncture. In fact, I can easily draw many parallels between contemporary acupuncture and contemporary chiropractic but I'll leave that for another message.EBDCM01:55, 12 February 2008 (UTC)

Thankyou for your comments but they were not all germane. Levine, subluxation is essential to chiro. The extent to which chiros believe it is thus an essential part of the context and provides overview. In terms of relative emphasis you could not ask for more. Thus it should be part of the lead and your argument does not stand. Levine you also appear confused. You say E presents powerful arguments then you say you don't know about it. In fact they may be powerful arguments but they are at present unsourced opinion of E.

E you need to provide sources to back up your opinion. You ask me again to state my concerns. Please re-read the beginning of this thread. It is not UNDUE weight if an estimated 90% of chiros believe it. Where are your sources showing the survey is flawed? Where are your sources showing the 36% figure. Pls also provide a link to the 93% figure. Again you try to avoid the issue by asking me to list my beefs. Can you please stay on topic? We are talking about facts in the lead which establish context, define the topic, add to the overview and are appropriate for relative emphasis. Just what LEAD requires. Your abuse of me seems to extend to thinking I belong in one of the chiro camps you don't like. Wrong. Will you please stop abusing me. May I remind you of UNCIVIL and may I remind you to sign your contributions. Mccready02:59, 12 February 2008 (UTC)

mccready

A pointed critique is not being uncivil. You can keep fishing for a sympathetic response or moderator, but I have, by and large, have been civil. If you say or do something stupid, I can't be held responsible for that.

Regarding the fact that DCs overwhelmingly treat NMS conditions you can refer to the following references

Hawk C, Long CR, Boulanger KT. Prevalence of nonmusculoskeletal complaints in chiropractic practice: report from a practice-based research program. J Manipulative Physiol Ther. 2001;24:157–169. doi: 10.1067/mmt.2001.113776. PubMed

Hartvigsen J, Bolding-Jensen O, Hviid H, Grunnet-Nilsson N. Danish chiropractic patients then and now: a comparison between 1962 and 1999. J Manipulative Physiol Ther. 2003;26:65–69. doi: 10.1067/mmt.2003.14. PubMed

Coulter ID, Hurwitz EL, Adams AH, Genovese BJ, Hays R, Shekelle PG. Patients using chiropractors in North America: who are they, and why are they in chiropractic care? Spine. 2002;27:291–296. doi: 10.1097/00007632-200202010-00018. PubMed

Regarding the flawed survey, I read it and critiqued it. I've taken 2 research methods courses in university. I attended an EBM chiropractic institution. I know research methods well, my friend.

Lastly, subluxation is not essential to chiro, because if it was there would be no such thing as any mixer or reform programs that do not teach subluxation theory. The only thing essential to chiro is manipulation. We are defined by being the expert provider of spinal manipulation. Subluxation, as used in the Palmer context, is practiced by less than 20% of the profession. You can go to Steven Novella Skeptics guide and listen to the conversation between himself and David Seaman, DC for more information. The 36% study was the 1997 done by Biggs.

Simply, it seems that you lack a depth and breath of the whole chiropractic story and you continuously use VSC as a straw man fallacy. Your refusal to acknowledge scientific chiropractic is also intellectually dishonest, considering you claim to be a man of science. EBDCM03:43, 12 February 2008 (UTC)

Will you please use the indent colons. I have done so for you. It makes the discussion easier to follow. Your DOI quotes appear to be inaccurate. Could you please amend with prefix and suffix, or better provide links. I might note that NMS is not the issue. Your view on subluxation is contradicted by the survey and despite being asked, how many times, you have yet to provide a single verifiable source which proves the claims you make about the survey. Your personal critique is irrelevant. Your continuing abuse of me is UNCIVIL. For the umpteenth time, please desist. Can we now see the evidence instead of your abuse and personal opinion? Mccready04:05, 12 February 2008 (UTC)

I am not being uncivil despite your repeated protests. I'm simply debating the merits of your argument. So, we can review the facts:

1) The majority of editors have rejected your edit

2) You refuse to compromise on any edits

3) You have been blocked and/or warned many times previously for disruptive edits and I would consider this to be no different

4) You are currently being accused by others on being disruptive on the acupuncture page and fail to acknowledge medical acupuncture as a legitimate therapeutic modality taught by evidence-based medical schools. Yet you somehow still claim to be 'scientific'

5)You delete any edit which makes any reference to contemporary, scientific chiropractic and deny it's existence

6)You deny that it is a health profession

7)You overlook that DCs treat between 85-95% neuromusculoskeletal

So, let's put this one to rest. For the record, as an editor, its completely FAIR GAME to ask about where your POV stems. You're beyond a skeptic Mccready, your view on this is dogmatic and I sincerely doubt your ability to collaborate with us in good faith. Goodnight. EBDCM05:22, 12 February 2008 (UTC)

E please desist from personal abuse. You've been asked many times. Please format your contribution properly. You may wish to do so on this one http://en.wikipedia.org/w/index.php?title=Talk:Chiropracticcurid=197022diff=190839687oldid=190838889. You have yet to provide the evidence I asked for. Mccready05:30, 12 February 2008 (UTC)

I'm going to weigh in here and give both of you a spanking because you both deserve it.

Mccready, your continual refusal to listen to objections and continual returns to the same edit, getting it reverted by numerous editors, is - regardless of the rightness or wrongness of your edit - classic disruption. Stop it. Use the talk page and use tactful and convincing arguments to win other editors over to your position. That's the only way to get them to protect your edits. Otherwise your edits will be gone the moment you turn your back and all your efforts will have been wasted. If you don't have the respect of editors on all sides of the issue (and you don't!), then you are wasting your time. Try a totally different approach - less relentless bulldog, and more soothing warm tea with honey in it....;-)

Mccready, the LEAD must reflect (only) significant article content. First get your edit included in the body of the article and accepted and protected by other editors. When you have succeeded in that, then it "might" (but not necessarily) be eligible for "short" mention in the LEAD. The whole survey doesn't belong in the LEAD.

EBDCM, your comments in this and many other places are often uncivil, abrupt, condescending, uncollaborative, and smack of ownership issues. Please be more careful. You have no more rights here than any high school kid who knows nothing about chiropractic, and your COI as a chiropractor should lead you to be very careful lest you be accused of protectionism. Be very careful about deleting opposing POV.

EBDCM, subluxation is very essential to chiropractic. It is the legal foundation for chiropractic practice in the USA. No subluxation diagnosis, no reimbursement from Medicare. In fact it has often been the only thing that can legally be treated and the only thing that can be reimbursed. In the USA, the profession is so legally tied to the subluxation that it can't (even if it wanted to, which it doesn't) disentangle itself from it. The ICA is the expert on this subject and has a listing of the laws in each state, most of which require a subluxation diagnosis, IIRC.

Levine2112, no spanking! (I can be nice once in awhile...;-)

-- Fyslee / 05:47, 12 February 2008 (UTC)

Fyslee. The survey was in the article for yonks as you should know. Thanks for the sermon but that doesn't change the fact that you consistently refuse to answer a simple question. Why not have accurate figures instead of your vague statement about the number of chiros believing in vert sub. Please try to be brief. Mccready05:59, 12 February 2008 (UTC)

I don't speak Aussie. What's "yonks"? -- Fyslee / 06:22, 12 February 2008 (UTC)

Means "ages" "a long time". Looking forward to you answering the question about vagueness versus precision. Mccready06:25, 12 February 2008 (UTC)

Where can I find it? -- Fyslee / 06:34, 12 February 2008 (UTC)

Fyslee, what specific "other places" are you alluding to that I am condecending, abrupt, etc? I am only debating with Mccready. I would say that I'm a straight shooter, but I do collaborate, do promote science based manual, conservative and holistic therapies. My only POV is a scientific one. There's a major difference between science and junk science and I'll call a spade a spade. If I am being curt with Mccready it is frankly because his history dictates that he is a repeat offender for disruption and being blocked and IMO has been very disrespectful to far, far more people. Despite the fact that you and I share differing POV on this subject we move along because we are committed to the genuine scientific investigation and their outcomes. And, yes, for many 'cam' therapies, they really are healing arts such as manipulation, acupuncture that deserve their place in conventional medicine. Scientific progress in these arenas should be encouraged and not suppressed or ridiculed with straw man fallacies and un-informed bias'. Simply put, I do not think Mr. Mccready is editing in good faith at this moment and would surmize that many other editors from various CAM pages would agree.EBDCM06:37, 12 February 2008 (UTC)

Actually we often are on the same page as regards the need for reform in chiropractic, but on different pages as to what should be included here. The article should tell the whole story, and you seem to want the latest version of the story, but that would leave out the history and the disagreements. I know that's simplistic and therefore not entirely accurate. Sorry about that. As to the "other places", well, quite a few of your dealings with QG and Mccready would fit. While I often agree with your sentiments, you are engaging in calling a spade a spade, and that can get you banned. The climate here has changed quite a bit in the last couple years. When I started here we could talk like adults and disagree using pretty direct speech. Not anymore. Civility trumps scientific fact any time nowadays. Civil pushers of nonsense get protected by some admins, while our most staunch and well reasoned defenders of science and fact get blocked and banned if they are abrupt or even slightly incivil. That's why the warning. I want you to stick around and it would be sad if you got axed by some uninvolved admin who saw you use some word or accusation, no matter how true. For example, your statement above is proof of a policy violation on your part: "I do not think Mr. Mccready is editing in good faith." You might think that, but don't ever say it, for god's sake! You are not AGF, and that can get you blocked. In fact it's not even true. Mccready really does believe what he writes. He's not playing around. You've got to be better and more civil than your adversary. That's my concern, and I wouldn't warn you if I didn't care. If I wished you to get blocked, I'd be silent. -- Fyslee / 07:16, 12 February 2008 (UTC)

Thanks, Fyslee. I appreciate your approach. I agree the article should tell the whole story including the modern tale which is my perspective. As a relative noobie to the wikipedia project, I was not aware that it had went PC. The fact that civility trumps scientific fact is disturbing. I hope that really isn't the case. What does AGF stand for? Does that mean I cannot express myself as liberally, say, as an admin? I truly don't know and would appreciate clarification. Regarding my discussions with Mr. Mccready, am I not free to point out a logically inconsistency say, for example, his self-declared adherence to science and truth and then the fact that he provides a reference from quackwatch? What are the boundaries for disruptive edits? If you agree that some of his recent edits here are disruptive as he has been accused of in the acupuncture page why is nothing being done about it, especially given the fact that he is a repeat offender? If I better understood disciplinary mechanisms that would help as well, but right now I just see so many inconsistencies that I'm rather confused as to what really is acceptable wiki behaviour in both language to fellow editors and editing standards as well. EBDCM18:26, 12 February 2008 (UTC)

The survey bit belongs in the article. I will add it. Thanks, QuackGuru08:23, 13 February 2008 (UTC)

See AGF. Basically it means you should assume that other people are working to improve the encylopaedia. It doesn't matter whether you are an admin or a newbie. Everyone, me, you, Fyslee, QuackGuru, Mccready everyone all must assume good faith. And when it comes to personal opinions, generally they are not welcome on wikipedia. We don't care what you think of Mr Mccready, or chiropractic. Nor do we care what Quackguru or Mccready thinks of you or chiropractic. All we care about is improving this article, based on reliable sources. If you want to discuss chiropractic or other people you have come to the wrong place since we are an an encylopaedia not a discussion forum. If you have a problem with another editors behaviour then there are various avenues to deal with this. First you should discuss these problems with the editors, either in the talk page of an article where the problem exists or in that person's talk page. However you should only discuss the problem, not your opinion of that person or anything else that is not relevant. A person's personal opinions and who he or she is not generally relevant to such a discussion per NPA. In other words, it doesn't matter who the person you are having a problem is, nor what they believe Nil Einne10:15, 13 February 2008 (UTC)

copyright violation

A pure cut and paste.

Out of over one million patient years (the length of time the total number of patients had been under care), 818 hospitalized vertebrobasilar artery stroke patients were identified. In the patients below the age of 45, those experiencing a stroke were three times more likely to have visited either their chiropractor or their PCP than the control patients. Those over 45 showed no increased association between experiencing a stroke and having seen their chiropractor than those experiencing a stroke and having seen their PCP.

The authors concluded:

Vertebrobasilar artery stroke is a rare event in the population.

There is an association between vertebrobasilar artery stroke and chiropractic visits in those under 45 years of age.

There is also an association between vertebrobasilar artery stroke and use of primary care physician visits in all age groups.

We found no evidence of excess risk of VBA stroke associated chiropractic care.

The increased risks of vertebrobasilar artery stroke associated with chiropractic and physician visits is likely explained by patients with vertebrobasilar dissection-related neck pain and headache consulting both chiropractors and primary care physicians before their VBA stroke. http://en.wikipedia.org/wiki/Chiropractic_note-29 Click on the link and go to the website.

See http://www.fcer.org/html/News/bonejointdecade.htm here. Is there more violations in that section? QuackGuru01:54, 12 February 2008 (UTC)

QG

I will add the appropriate quotations, though it does not change the conclusions of the study. BTW, you were also guilty of the same offense with your regurgitation of the 4 practice styles of thought but conveniently overlooked it.

I was not guilty of a copyright violation. http://en.wikipedia.org/w/index.php?title=Talk:Chiropracticcurid=197022diff=190776148oldid=190775634 I would appreciate if you do not delete my comments. Please fix that too. Thanks. QuackGuru02:03, 12 February 2008 (UTC)

It is also undue weight to dump all that text and quotes. Please shorten it to something worth reading. QuackGuru02:06, 12 February 2008 (UTC)

Read policy: COPYVIO. Please fix it. Thanks. QuackGuru02:10, 12 February 2008 (UTC)

Is there more copyright violations cut and pasted from this http://www.nptf.ualberta.ca/ website. Hmmm. QuackGuru02:23, 12 February 2008 (UTC)

If you looked closely, GQ, you would see that I deleted my own comments that were supposed to be directed to mccready in another section. Also, if you can produce a more comprehensive study on neck manipulation and VBA stroke than feel free to include it. Otherwise the current version is clear, concise, factual and relevant. Sorry that it does not jive with your personal belief system. EBDCM02:32, 12 February 2008 (UTC)

You http://en.wikipedia.org/w/index.php?title=Talk:Chiropracticcurid=197022diff=190776148oldid=190775634 deleted my comment and have not addressed the policy violation. It looks like a text dump from a http://www.fcer.org/html/News/bonejointdecade.htm website. QuackGuru03:13, 12 February 2008 (UTC)

It does look like your short comment was inadvertently deleted. If you haven't done so yet, you can restore it yourself. -- Fyslee / 06:36, 12 February 2008 (UTC)

x EBDCM, please discuss the COPYVIO and WEIGHT issues at hand.http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=prevoldid=189655666 Thanks, QuackGuru20:43, 12 February 2008 (UTC)

GQ,

Your accusations aside, everything I put in the safety article was fully referenced and attributed to the correct authors. Just because the neck manipulation study goes against your view and the those who you promote (Quackwatch, Stephen Barrett) does not make it invalid. Furthermore, because of the depth, breath, duration and significance of the study and the controversy surrounding neck manipulation and stroke it is not undue weight. You can see for yourself in the previous talk pages about the controversy of neck manipulation and VBA stroke. The jury is in, and the evidence as presented by the WHO Task Force suggested that chiropractors do not raise the risk of stroke. In addition, I can easily look at your edits, in particular about the styles of practice and I can show you an exact cut and paste as well. However, because you referenced the article, I did not. If I did make a mistake, I do apologize as I certainly am not trying to break any rules here at wikipedia, though I am still learning the system. For the record, you have not addressed claims that you are presenting original research with you styles of practice edits. I can also prove that there is something untoward your particular focus on that section of the wiki, but will hold off on that for now.EBDCM23:54, 12 February 2008 (UTC)

My concerns remain. Please remove the massive COPYVIOhttp://en.wikipedia.org/w/index.php?title=Chiropracticdiff=prevoldid=189655666 Thanks, QuackGuru23:58, 12 February 2008 (UTC)

I have already addressed your COPYVIO concerns in detail in my aforementioned post. I simply quoted the findings of the authors and then correctly cited the evidence. EBDCM00:37, 13 February 2008 (UTC)

It is a text dump and COPYVIO. QuackGuru00:44, 13 February 2008 (UTC)

Nope. Hey, I think I found out why you wanted so badly to constantly revert the practice styles section. You know, the 4 main styles of thought:

« Reply 6 on Feb 2, 2008, 8:24pm »

What is the big deal between 'straight' and 'mixer'? Which one is a narrow focus? I am confused because have seen different interpretations of both.

It is confusing, "'that's why I wrote the wikipedia section that addresses exactly the beliefs of the different types of chiropractors. Read the "Practice Styles and Schools of Thought Section" (click)."'

So, proof that your edit and revert that it was original research which is a direct violation of wikipedia policy. It is gives editors insight whether or not you are a credible source, you know, being the founder of the chirotalk website. This also perfectly explains why you want to keep inserting quackwatch and stephen barrett articles in POV. And wanting to reference citizendium. You've been uncovered, QG. You have some explaining to do. EBDCM01:19, 13 February 2008 (UTC)

My edit was not original research. QuackGuru07:25, 13 February 2008 (UTC)

Safety issues (copyright &amp; weight problems)

The current Safety issues section has severe POV and weight problems. Copyright infringement is another matter. QuackGuru07:25, 13 February 2008 (UTC)

http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=prevoldid=191132649 More copyright violations. QuackGuru18:31, 13 February 2008 (UTC)

revert of x-ray info

Hughr reverted http://en.wikipedia.org/w/index.php?title=Chiropracticcurid=7738diff=190842944oldid=190819511

From 2008 radiologists in the United States can no longer order x-rays for Medicare patients referred to them by chiropractors in a non-hospital setting.http://www.acr.org/HomePageCategories/News/ACRNewsCenter/CMSScrapsChiropractorException.aspx

His edit summary was

(Undid revision 190819511 by Mccready (talk)What does this have to do with ED, LISC,REG? + non notable?)

So he has nothing to say other than pose questions. He has removed well sourced information from the article. I propose we reinstate it. Mccready06:07, 12 February 2008 (UTC)

It was well-sourced. End of discussion. The only questions are where to place it and how to word it. Deletion is not an option for well-sourced material. It should be reinstated. -- Fyslee / 06:25, 12 February 2008 (UTC)

ec after ec OMG :) What I've been trying to squeeze in here, is that the first time I read the sentence that Mc inserted, I could not comprehend what it was even trying to say. So I looked at the ref he used and went ooohhh, and I was going to rewrite it into something comprehensible, but I noticed the section it was in didn't fit. Then, while looking for a proper place, it occured to me that this is trivia, and Wikipedia is not a source of trivia. There are a ton of chiro trivia things that could be inserted into the article but I didn't feel this particular piece of trivia warrents inclusion. But I'm always open to suggestions. ;) --Hughgr06:38, 12 February 2008 (UTC)

Okay. Then discuss it before deleting it. That's common courtesy and helps to avoid edit warring. I'm sure you might get support from some quarters. -- Fyslee / 06:40, 12 February 2008 (UTC)

As far as the new Medicare rule goes, the rule is that 'non-treating' physicians can no longer "'order"' xrays for chiropractors. Radiologists are not 'treating physicians'. MDs can still order them for the chiropractor and the patient can get reimbursed. This stems from the original medicare fee schedule that used to 'require' xrays to demonstrate a subluxation. The AMA had that thrown into the medicare law in 1972 (back before Wilk), but the new law no longer requires xrays - they now accept exam findings and patient complaints just like for MDs. Chiropractors were required to take xrays to demonstrate the subluxation, but medicare would not pay for them - so chiropractors would ask the radiologist to take them so the patient would get paid. In the 1990's, in an effort to decrease unnecessary radiation to patients (we used to have to xray every year whether they needed them or not), chiropractors lobbied Congress to have the mandatory xray law thrown out and it was. This is a remnant of that law. Anything that we would write about that would have to be qualified in such a way, but I don't think it fits in this article. I agree with Hughgr that this is trivial. -- Dematt Dēmatt 15:59, 12 February 2008 (UTC)

Here is an old website that explains the old rule to old folks http://www.therubins.com/geninfo/chiroprac.htm. Notice that medicare only pays for correction of subluxation in the US. That is probably one reason chiropractors are reluctant to give up the word as well, but that is just more trivia :-) -- Dematt Dēmatt 16:29, 12 February 2008 (UTC)

This is about regulations and it was added to the appropriate section. QuackGuru20:24, 12 February 2008 (UTC)

I think the main points here are the obvious triviality of this information and the misleading presentation of the information as explained by Dematt above. -- Levine211220:26, 12 February 2008 (UTC)

This is clearly a regulation issue. It can be rewritten if you think the wording is not clear. QuackGuru20:31, 12 February 2008 (UTC)

Again, it seems to be a minor regulation issue which is too mundane for this article. -- Levine211220:35, 12 February 2008 (UTC)

The section is short and this provides relevant information about regulation. Does anyone have any other suggestions? If not, this can be included in this article. QuackGuru21:34, 12 February 2008 (UTC)

My suggestion is to leave it out as trivial.--Hughgr22:23, 12 February 2008 (UTC)

It is regulation and not trivia. QuackGuru22:29, 12 February 2008 (UTC)

I imagine there are a lot of trivial regulatory information such as this. We must be discerning when it comes to inclusion. -- Levine211222:43, 12 February 2008 (UTC)

You can imagine but I see very little material. The section needs a bit of expanding. QuackGuru22:45, 12 February 2008 (UTC)

Perhaps the article needs contracting. Anthon0107:26, 13 February 2008 (UTC)

Edit warring and deletions of well-sourced material

Stop it! "I don't like it" in various wikilawyering guises isn't a good reason. "Unbalanced" isn't either. Bring balance by adding, not deleting. "POV" isn't either. All edits should be including well-sourced POV. We are here to build, not tear down. Get over it when others add stuff you don't like. The worst violations of NPOV involve deleting opposing POV. Examine the sources and seek to improve the added text by discussing on the talk page, not by trigger happy deletions and reversions. The edit warring needs to stop. -- Fyslee / 06:21, 12 February 2008 (UTC)

quackwatch

The ink is not dry on Fyslee's request to stop edit warring, yet Levine revertedhttp://en.wikipedia.org/w/index.php?title=Chiropracticcurid=7738diff=190857922oldid=190857764 me seconds after I posted this

In 1998, Quackwatch, which criticizes chiropractichttp://www.quackwatch.org/01QuackeryRelatedTopics/chiro.html was recognized by the "Journal of the American Medical Association" as one of nine "select sites that provide reliable health information and resources."http://jama.ama-assn.org/cgi/reprint/280/15/1380 JAMA Patient Page - Click here: How to find reliable online health information and resources, Journal of the American Medical Association 280:1380, 1998.

His edit summary included "This belongs in the Quackwatch article. That's the advantage of an electronic encyclopdia" Despite this he failed to provide a link to the information (I will assime good faith and suggest that perhaps his failure to link was an oversight on his part). I propose that he reverts his revert, stops edit warring and uses the discussion page. The two items under the AMA heading are clearly designed to promote Chiro. The item I proposed provides balance and informs the reader that the AMA respects Quackwatch which is critical of chiro. Mccready08:17, 12 February 2008 (UTC)

Why do you think the AMA stuff is there to "promote" chiropractic? Its the most recent, factual info on the AMA's stance.--Hughgr08:32, 12 February 2008 (UTC)

Thank you Hugh. I will rephrase. The two items there are supportive of chiro. My addition was more recent. You have not reverted your earlier revert yet despite Fyslee's disagreement with you. And you have yet to apologise for your erroneous 3RR report on me. Over to you and others for comment. Mccready09:00, 12 February 2008 (UTC)

The problem is that the edit you wish to add is about quackwatch.--Hughgr09:55, 12 February 2008 (UTC)

Yes but it's about AMAs views about Quackwatch which has strong views about chiro, is it not? And you need to explain why that is not legitimate. Mccready10:39, 12 February 2008 (UTC)

This article is not about Quackwatch. The AMA's POV on Quackwatch belongs on the QW article. This article is about Chiropractic. We have much more reliable sources clarifying their view on Chiropractic. Your sentence is a convoluted way of trying to justify the inclusion of QW's POV of chiropractic. Anthon0113:50, 12 February 2008 (UTC)

Mccready, don't make it sound like I agree with you on this one. Your edit belongs in the Quackwatch article, so do it there. If you had a link that actually combined direct mention of AMA agreement with Quackwatch's position on chiropractic, that would be another matter and it might be eligible for both articles. -- Fyslee / 15:20, 12 February 2008 (UTC)

Is it considered COI if continuous edits to include quackwatch and Stephen Barrett here are done by an editor who has ties to QW and SB? It seems as though quack guru is the adminstrator of an anti-chiropractic website and has claimed to have written the old 4 practice styles here on wikipedia

http://www.chirotalk.proboards3.com/index.cgi?action=displayboard=scuhsthread=1201943337page=1

This would explain why quack guru is constantly citing quackwatch and stephen barrett in his edits and vehemently wanted to restore the 4 practices of thought which was taken down by majority consensus. It also proves previous suggestions that the old practice style section was indeed original research a clear violation of wikipedia policy. Thoughts? EBDCM03:12, 13 February 2008 (UTC)

No, it is not any more of a conflict of interest than a chiropractor editing the chiropractic page. He has just as much a right to be here. More important, we also need not concern ourselves with 'who' anyone is than 'what they are saying'. It is okay to have a POV, we all do, it's only when we push our POV's on others that it is a problem. If our POV is notable enough, then there should be verifiable and reliable sources that we can cite. Again, it is considered disrespectful to 'out' someone. There are good reasons to remain anonymous for some people, so don't bother interesting yourself with such things. It can get you banned. -- Dematt Dēmatt 03:28, 13 February 2008 (UTC)

BTW(by the way), User:ABotnick did write the Practice Styles section 2 years agohttp://en.wikipedia.org/wiki/Talk:Chiropractic/Archive_10Straights_do_a_differential_diagnosis.3F. He never tried to hide his identity. -- Dematt Dēmatt 03:37, 13 February 2008 (UTC)

I have just looked through the edit history and that section, using various titles, has existed since 2004, long before Botnick arrived here. Many editors of all persuasions have created that section. It was a consensus version that should not have been touched. -- Fyslee / 06:52, 13 February 2008 (UTC)

I apologize to QG. The learning curve is steep here. Emotions run high, especially in this article! I will follow the example of Dematt and Fyslee who really can take the high road quite well. I would rather be associated with them than certain people I'm constantly debating. Consider this a lesson learned and a good slice of humble pie. Goodnight. EBDCM06:31, 13 February 2008 (UTC)

Yes EBDCM, I too had a rough start here :), live and learn. One thing I always try and do is comment on the contributions, not the contributor. It can be difficult sometimes but its a great policy to follow.--Hughgr06:40, 13 February 2008 (UTC)

--Hughgr21:14, 17 February 2008 (UTC)== Unbelievable revert war ==

I deleted:

All chiropractors share a common approach to patient care: all are based on conservative, non-invasive, non-medication approaches via manual therapy. Nonetheless, there are significant differences amongst the practice styles, claims and beliefs between various practitioners.

from which Dematt had just removed a fact tag.

I replaced with:

Chiropractors differ significantly in practice styles, claims and beliefs.

and an edit summary which said "as per Jimbo on fact tags. we could also do without the sermon on ALL nice chiros"

Levine reverted to:

All chiropractors share a common approach to patient care: all are based on conservative, non-invasive, non-medication approaches via manual therapy. Nonetheless, there are significant differences amongst the practice styles, claims and beliefs between various practitioners.

ie Levine did not address my edit summary, did not appear to notice that the issue was removal of a fact tag and did not discuss with us before reverting.

The revert should be reverted. Alternatively you need reliable sources on ALL chiros sharing ALL the characteristics mentioned. Since the section is about differences there is no need to point out commonalities which Levine claims to be doing in his revert. I will refrain from editing for the moment while the community comments on this. I am disappointed that Dematt has apparently let this go, as he has recently been praised more than once by an editor with a scientific approach to wikipedia. Hopefully it was an oversight by Dematt and I AGF.Mccready05:27, 13 February 2008 (UTC)

Chiropractors do not share a common approach. There are four types of chiros and they differ in their beliefs.

I think a requests for comment, the noticeboard, and even Jimbo's talk page may help. We need as many uninvolved Wikipedians as possible. QuackGuru05:35, 13 February 2008 (UTC)

Mccready,

The section you tried to revert is completely factual and well known. Like QG suggested, there are different schools of thought (2,3 max!) but the one thing that unites them all is the use of manual manipulation, conservative, non-medication and non-invasive treatments. You've also just randomly slapped a POV tag on the vertebral subluxation article I'm editing which was unjust. When will you cease the disruptive editinng patterns? Please, stop! Thanks in advance. EBDCM06:13, 13 February 2008 (UTC)

"All chiropractors" share a "common approach" to patient care: all are based on conservative, non-invasive, non-medication approaches via manual therapy. Nonetheless, there are "significant differences" amongst the practice styles, claims and beliefs between various practitioners.

This text in the article is contradicting itself. QuackGuru07:11, 13 February 2008 (UTC)

I will attempt to fix the problems and NPOV the article. This includes removing white space, fixing references, expanding the lead, and balancing some sections. For example, it is a notable issue that there are four groups chiros. Another problem is the Safety issues section. I will provide balance and NPOV. QuackGuru08:06, 13 February 2008 (UTC)

Just a note about my collaborative efforts here. I am not glued to any particular text as long as it is reasonable and NPOV. WP requires it to be verifiable with a reliable source "unless it is common knowledge". So basically, there are a thousand ways to say the same thing. As far as the two formations that Levine and Mccready are concerned about, my purpose was to remove the 'fact' tag because it appeared to be common knowledge. If there is a problem, I'll be glad to put the tag back on. Otherwise, I prefer Levine's formation because it flows nicely and is accurate. But they both say the same thing. I suppose try to reach consensus here.

QG, I don't understand why you think the text 'contradicts itself'. It just says they agree on a lot of things, but disagree on others. Kinda like you and I. -- Dematt Dēmatt 14:10, 13 February 2008 (UTC)

It is original research and misleading. Agreed? QuackGuru18:29, 13 February 2008 (UTC)

I disagree with QG's assessment that this is a violation of OR. Please consider the essay on common knowledge. Sometimes it is okay to say that in France they speak French, even without a source. -- Levine211218:36, 13 February 2008 (UTC)

I agree that something that is common knowledge, such as that medical doctors prescribe drugs, does not need to have citations. It certainly should not be reverted. Arion 3x320:04, 13 February 2008 (UTC)

Greetings, Dematt. Re "common knowledge": I don't find this phrase appearing anywhere in the V policy, which says ""All quotations and any material "'challenged or likely to be challenged"' should be attributed to a reliable, published source using an inline citation."" The essay common knowledge says ""Citing sources when your edit is challenged by another editor is Wikipedia policy, and any unsourced edits may be removed."" and ""Certain kinds of claims should most definitely "'not"' be left to common knowledge without citations ... Controversial claims ... Facts about which Wikipedians themselves cannot form a rough consensus."" I think we have here some facts about which Wikipedians cannot form a rough consensus. I dispute parts of the diputed statement, for example. The "common knowledge" bit only applies if nobody challenges it, I think. Sorry about that.

I guess in some sense there's a common pattern or philosophy to chiropractic. However, I dispute the statement ""All chiropractors share a common approach to patient care."" I find that it goes too far. Maybe it could be reworded. It sounds to me as if it means that all chiropractors follow certain procedures such as greeting their patient at the door, discussing things in a seated position before beginning treatment, or whatever -- which would not be true. It's just too all-encompassing. I'm sure there are significant differences among chiropractors. The key is to find a way of describing what's the same about them all without implying they're the same in other ways too.

How about changing the first sentence to ""Common themes in chiropractic are conservative, non-invasive, non-medication approaches via manual therapy."" --Coppertwig04:18, 14 February 2008 (UTC)

""Common themes"" works for me.--Hughgr06:18, 14 February 2008 (UTC)

I like "common themes", too. I do need to clarify my statement above because I realized that I was not clear. The fact tag the I removed was after the "second" sentence:

All chiropractors share a common approach to patient care: all are based on conservative, non-invasive, non-medication approaches via manual therapy. Nonetheless, there are significant differences amongst the practice styles, claims and beliefs between various practitioners.Fact|date=April 2008

When I stated 'common knowledge', I don't think anyone disagrees that there are differences amongst practice styles, etc.. It was the first sentence that Mccready then change and Levine reverted.. I then agreed that I like Levine's formulation better. I apologize for any confusion I might have caused anyone. -- Dematt Dēmatt 17:59, 14 February 2008 (UTC)

Coppertwig's edit was a good one and makes a valid point about common knowledge. It is a well known fact that a) all chiropractors use non-invasive methods (invasive methods are not within their scope of practice) do not use medications (not within their scope of practice outside Oregon) and use all use some form of manual therapy as part of their treatments. EBDCM02:36, 15 February 2008 (UTC)

Wow, thanks for http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=191356907oldid=191354344 this, EBDCM. I was expecting all revert wars and stuff here, and here my suggested edit goes in without me doing anything. Thanks for the complments. Actually, I see quite a bit of good collaboration going on here. --Coppertwig03:10, 16 February 2008 (UTC)

The lead needs to conform to Lead. It is common knowledge of the four chiro groups. The four groups can be mentioned in the lead and in the proper section. QuackGuru04:38, 16 February 2008 (UTC)

Well there you go Coppertwig, we're not all that bad, huh! QG, the sources that you gave earlier are all copies of wikipedia's chiropractic article (our article). We can't use that to reference our own work.

http://skeptoid.com/episodes/4042

http://www.drensley.com/chiropractic.php

http://www.chiropractordallas.net/tips.html

Do you have anything else? -- Dematt Dēmatt 06:29, 16 February 2008 (UTC)

I have more. I will add it to the article for your review. QuackGuru06:37, 16 February 2008 (UTC)

It is certainly a compliment to our efforts that many websites paraphrase or copy this article on this matter. It is recognized as being true and is often paraphrased. We have originally had good sources to justify this section that had nothing to do with mirrors of Wikipedia. -- Fyslee / 08:43, 16 February 2008 (UTC)

The article states: "For practical purposes, chiropractors can be subdivided into four distinct groups based on their philosphical approach, claims made about the effects of their treatments, and whether they use other treatment modalities along with the adjustment: "traditional straights," "objective straights," "mixers," and "reform.""http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=nextoldid=191813064

The inclusion criteria is now four. The Practice styles and schools of thought section can also include and explain about the four groups. Agreed? QuackGuru19:34, 16 February 2008 (UTC)

I disagree with Dematts recent edit and feel it should left at 3 or back to 2. I'd like to hear a bit more why that was included. EBDCM19:55, 16 February 2008 (UTC)

I think we should state it as two groups. 95% of whats out there talks about straights and mixers. Thats what its historically been. Recent additions to the "mix" are the Reform (NACM), whom we haven't heard from in years, and the Objective Straights, both minority groups with small memberships.--Hughgr23:39, 16 February 2008 (UTC)

Perhaps we could word it something like:

"There are historically two groups within the chiropractic profession, straights and mixers. Straights adhere to the original concept of chiropractic and have a recent offshoot called Objective straights. Mixers have combined chiropractic with other modalities such as PT and spawned the reform movement."

I'm not saying word it exactly like that, just trying to get my idea across.--Hughgr23:46, 16 February 2008 (UTC)

Interesting, I like it. I can't think of anyone that is left out. The two groups are certainly verifiable with reliable sources. -- Dematt Dēmatt 00:13, 17 February 2008 (UTC)

I think it needs some work and a reference. There are four groups and not two. Nonetheless, it could be explained in the "History" section about there was two groups and then now there are four groups and explaned how that happened in a NPOV way. QuackGuru00:43, 17 February 2008 (UTC)

A problem is that currently the "Practice styles and schools of thought" section doesn't even mention Obj. Straights. Now I realize that could be edited in but I think that were giving undue weight to the reform and Obj. Straight minority groups this way. Neither group has memberships that can be verified and that presents a problem. They can both be verified that they exist, or have existed per say, but I think were giving to much weight to them if they have their own paragraphs. The mixer/straight are the two groups that can be verified by a gazillion refs, whereas 3 or 4 groups is much harder to find refs supporting that conclusion.--Hughgr21:14, 17 February 2008 (UTC)

So fix it and be BOLD. QuackGuru23:53, 17 February 2008 (UTC)

Hughgr, the focus on actual groups and memberships is leading us off-track here. This has happened before. The section is about "practice styles" and "schools of thought", not about actual groups, although mentioning them is very helpful and even necessary. Even if all these groups, associations, clubs, whatever, had ceased to exist three thousand years ago, it wouldn't make any difference to this section. They could claim "I think like Plato," "I think like Galileo," etc., even though they have been dead an awful long time. Get the point? There are chiropractors who think and practice in these different ways, and we can describe those ways in relation to known groups and associations that do or have existed. (If this section was about existing groups, not their practice styles and thinking, it would be another matter. The NACM style and thinking is documented in their article here, but that's not the point here.) Here we are describing various styles and thinking, and the four groupings do exist to varying degrees. -- Fyslee / 06:07, 18 February 2008 (UTC)

too wordy

It was a rallying call for chiropractic scientists and scholars.

Change this to:

It was a rallying call for chiropractors.http://en.wikipedia.org/w/index.php?title=Chiropracticoldid=191105174Movement_toward_science

Per WEASEL --QuackGuru09:45, 13 February 2008 (UTC)

I believe that would be Peacock if anything, but the point to the article was that it motivated chiropractic scientists and scholars (and yes there are some:). Taking it out sounds like it motivated even the doctors in the field, but it didn't. Those doctors still held to their beliefs. It took years for the effects to show up in the field. -- Dematt Dēmatt 14:14, 13 February 2008 (UTC)

In accordance with policy the weasel/peacock words should be deleted. QuackGuru18:28, 13 February 2008 (UTC)

Please consider the source which reads: "I view DeBoer's paper as a rallying call for chiropractic scientists and scholars." The text in our article seems rather faithful to the source. Weasel/Peacock does not apply. -- Levine211218:33, 13 February 2008 (UTC)

Please understand that chiros are not generally considered to be a scientist or a scholar. Am I wrong? QuackGuru04:13, 16 February 2008 (UTC)

No more that MDs are not generally considered to be a scientist or a scholar. This is why the source makes the distinction and this is why we need to be faithful to the source and make the distinction. Resolved. -- Levine211205:37, 16 February 2008 (UTC)

I don't understand your point. MD's (as well as chiros) are not generally considered to be a scientist or a scholar. The source makes a claim which seems false. The problem wil be solved when we remove the Peacock words. QuackGuru05:46, 16 February 2008 (UTC)

Yes, but some chiropractors are scientists and scholars. And to those people "the faculty's authority to challenge the status quo, to publicly address relevant, albeit sensitive, issues related to research, training and skepticism at chiropractic colleges, and to produce 'cultural change' within the chiropractic schools so as to increase research and professional standards" was indeed a rallying call. This at least according to DeBoer. Consider it in context of the sourced info and I think you'll get it. -- Levine211208:15, 16 February 2008 (UTC)

Chiropractors are not considered scientists and scholars when they become a chiropractor. A chiropractor can become a scientist or a scholar too but this is misleading the way it is written in the article. The sentence is saying that chiros are scientists and scholars. QuackGuru17:56, 16 February 2008 (UTC)

Thats an interesting opinion but the sentence is accurate.--Hughgr18:12, 16 February 2008 (UTC)

Chiropractors do not consider themselves to be a scientist or a scholar. When a person becomes a chiropracotor that person does not automatically become a scientist or a scholar. QuackGuru18:28, 16 February 2008 (UTC)

No, it is saying that there are chiropractic scientists (DC, PhD) and scholars (educators). —Preceding ) 19:57, 16 February 2008 (UTC)

Not all chiropractors are chiropractic scientists (DC, PhD) and scholars (educators). The sentence in the article can be tweaked or just remove the Peacock words. Most chiropractors are not scientists or scholars at all. Please fix it. QuackGuru03:10, 17 February 2008 (UTC)

This sentence doesn't imply that most chiropractors are scientists or scholars. It implies that chiropractors who are scientists or scholars found it to be a rallying call. 05:10, 21 February 2008 (UTC)

Safety section

I came here because QG e-mailed me about copyright violations. Having looked at the section, I don't really have great concerns about copyright violations but is there really any reason to have such a long quotation? Probably the conclusions need to be quoted but I don't really see any reason for the results part to be quoted, surely it can be appropriately summarised and integrated into the article? BTW, I'm making no comment on undue weight or other potential concerns here which have been raised, I haven't considered those Nil Einne22:54, 13 February 2008 (UTC)

My opinion is that this article unfortunatly has so many edit wars over wording that oftentimes the only way out is by expliciting quoting the source. Look at the section directly above this for a quick example. :)--Hughgr23:01, 13 February 2008 (UTC)

Suffice it to say the main conclusion of that research is: "no evidence of excess risk of VBA stroke associated chiropractic care." As I mentioned before, it does seem like a UNDUE violation to give so much content space to a risk with only an estimate 0.0000002% chance of serious risk. In comparison, the comparatively "stable" article surgery hardly mentions any of the associated risks even though they are astronomically higher. -- Levine211201:24, 14 February 2008 (UTC)

I had been thinking in the back of my head for a long time that one of these days I would probably have a look at the chiropractic article(s). Nearly a week ago I happened to see a user talk page message that was apparently related to this page. One thing led to another, and now here I am. I think I'll just go through the article and make any minor changes that seem advisable, suggesting any major changes on the talk page first as suggested in a template above. Please feel free to revert any you don't like (explaining why of course; perhaps the beginning of a discussion) or to ask me to x self-revert pending discussion. --Coppertwig03:19, 14 February 2008 (UTC)

There is an UNDUE violation to give so much attention to one report done in February 2008. It can be appropriately summarised. QuackGuru04:10, 16 February 2008 (UTC)

According to the February 2008 source there is an "inherent risk." QuackGuru06:30, 16 February 2008 (UTC)

I hate to do this, but I agree with QG about the unbalanced inclusion of one article to the exclusion of many others. (I am not addressing any other issue here or agreeing with QG in any other way.) Newer studies don't always negate earlier ones, and in this case most certainly do not. It is quite symptomatic of problems in the editing here, that one study is chosen to the exclusion of many more that say something else. Editorial and protective bias is dominating too much here. Anyone who wishes can email me for a long list of good sources which could be used. I'm not at liberty to post the URL because it's my own website where they are located....;-) ("This comment has been updated because of it being misused by QG.") -- Fyslee / 07:45, 17 February 2008 (UTC)

http://www.ncbi.nlm.nih.gov/pubmed/17904731?ordinalpos=2itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum The safety has not been properly addressed. Thoughts. QuackGuru03:04, 17 February 2008 (UTC)

Disagree. This is a good source as to where the research and current opinion is at in regards to safety of spinal manipulation. Posting a link to an article that was released a year earlier is not helpful. 05:07, 21 February 2008 (UTC)

exclusively scientific?

It says ""Reform chiropractors are a recent evidence-based off-shoot of mixers who use exclusively scientific methods and protocols in the treatment of neuromusculoskeletal disorders."" I highly doubt this. Medical doctors don't use exclusively scientific methods. I looked through the five footnotes and while I didn't read every word, I don't think there's a statement anywhere in them (though I could have missed it) claiming that any group of chiropractors uses "exclusively scientific" methods to treat patients. Normally, scientific methods are used to carry out experiments, while methods of treating patients (by medical doctors as well as chiropractors) are based on a mix of scientific results, personal experience and beliefs of the practitioner, custom, laws, etc. The 2nd of the 5 footnotes for that section, http://www.worldchiropracticalliance.org/tcj/1992/oct/oct1992c.htm, says

""According to information released in 1985, the NACM is "an organization of scientifically‑oriented Chiropractors ..."" Based on this, I suggest rewording to ""Reform chiropractors are a recent evidence-based off-shoot of mixers who use scientifically‑oriented methods and protocols in the treatment of neuromusculoskeletal disorders."" --Coppertwig04:45, 14 February 2008 (UTC)

Hi Coppertwig, thanks for the help. We're not really sure the NACM exists today, though we are pretty sure that a reformation occurred, but I'm not sure it would be verifiable that NACM was aware of evidence based medicine in 1985. There is still controversy over the use of Reform as a group vs reform chiropractors. QuackGuru was working on that, too. Maybe another pair of eyes could help. -- Dematt Dēmatt 05:00, 14 February 2008 (UTC)

Yes, we're having a tough time with good refs for that section. The NACM and Obj Straight groups are both small. While the OS at least has a couple? colleges associated, I don't hear anything from/about the NACM, although on someones talk page (Avb?) awhile ago had a source from a couple years ago that at least mentioned them.

I'm thinking we should rewrite that section and say there are two groups straight and mixer with offshoots (OS/NACM). I think that might solve the weight probs as most things I've read about the "groups" relates to two.http://www.chiroweb.com/archives/ahcpr/uschiros.PDF --Hughgr06:19, 14 February 2008 (UTC)

I dug up these links in June 2007:

http://www.acatoday.com/content_css.cfm?CID=250

http://www.worldchiropracticalliance.org/tcj/2007/may/b.htm

http://www.chiropractic.org/index.php?p=news/advisory_committee

Avb 17:38, 14 February 2008 (UTC)

Hi Avb, those seem to discuss NACM in the past tense as well, around 2000 or 2002. My concern is that we have not heard about or from them since DuVall (who did a good job for chiropractors on that committee I understand). Anyway, this is what I posted last year and am still not satisfied that we shouldn't at least be using the 'past tense' for this group.

Googling NACM gives two different addresses for NACM; http://www.chiromed.org/ "'15427"' Baybrook Drive Houston, TX 77062 and http://www.chiromed.org/nacm.htm "'1527"' Baybrook Drive Houston, TX 77062 with a phone number of 281-280-8262. This could be a simple enough error, but we need to know if this address is real. Googling this phone number does not reveal NACM but a person who lives close to Baybrook Dr. http://www.google.com/search?q=281-280-8262hl=enrls=com.microsoft:en-USpb=rsa=Xoi=rwpct=title. This number, however, also shows up on several web sites advertising chiropractic directories for different citieshttp://www.yellowusa.com/Listings/y88659027.htm where it is called ASSN. of Chiropractic Medicine,http://east_meadow-ny.yellowusa.com/Chiropractors_DC.html East Meadow, NY,http://montclair-nj.yellowusa.com/Chiropractors_DC.html Montclair, NJ,http://vallejo-ca.yellowusa.com/Chiropractors_DC.html Vallejo, CA, and http://www.google.com/search?q=281-280-8262hl=enrls=com.microsoft:en-USstart=30sa=N 22 other sites. I could be wrong, but it appears that it is a practice building organization under the guise of an association and it is using Stephen Barrett to gain credibility. Thoughts? ---- Dematt Dēmatt 15:01, 22 June 2007 (UTC)

-- Dematt Dēmatt 18:13, 14 February 2008 (UTC)

That whole conversation can be found http://en.wikipedia.org/w/index.php?title=Talk%3AChiropracticdiff=146897931oldid=146721601 here for the brave at heart :) BTW, I did end up calling the number and it was disconnected. We should probably redouble our efforts to see where they are at now, just to be accurate. -- Dematt Dēmatt 18:24, 14 February 2008 (UTC)

It seems to be irrelevant now since all mention of them and other organizations have been removed from the section. Below is more information about them. -- Fyslee / 03:22, 22 February 2008 (UTC)

Chiropractic article from Journal of Controversial Medicine

In 2002 the "Journal of Controversial Medical Claims" published a paper submitted by the National Association for Chiropractic Medicine entitled "NACM and its argument with mainstream chiropractic health care."Mirtz TA, Long P, Dinehart A. Slaughter RL, DuVall Jr., CE, Bryson R, Kourmadas F. Campo J. http://www.accessmylibrary.com/coms2/summary_0286-25525357_ITM NACM and its argument with mainstream chiropractic health care. "Journal of Controversial Medical Claims", 2002;9(1):11-25. (Article summary)

-- Fyslee / 03:22, 22 February 2008 (UTC)

ref for Janse statement

Putting this here for now while I search the archives http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=prevoldid=85434363 -- Dematt Dēmatt 04:53, 14 February 2008 (UTC)

Here's the reference for the Janse statement. Sorry, Hughgr, looks like I dropped the ball, but then Fyslee did change the subject! http://en.wikipedia.org/wiki/Talk:Chiropractic/Archive_12Added_quote. -- Dematt Dēmatt 05:04, 14 February 2008 (UTC)

HAHA Dematt, I was thinking I was the one who added that. Has it really been that long??? (Nov.06)??? :) --Hughgr06:03, 14 February 2008 (UTC)

Yes it has!! Where is my family?? So, is this the book http://www.amazon.com/Essential-Principles-Chiropractic-Virgil-Strang/dp/9996768295? -- Dematt Dēmatt 18:57, 14 February 2008 (UTC)

Yes.--Hughgr20:23, 14 February 2008 (UTC)

Chiropractic bashing

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! style="background-color: f2dfce;" | Collapsing inaccurate advocacy rant that violates TALK -- Fyslee / 08:53, 16 February 2008 (UTC)

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I just posted this under Upper Cervical Specific Chiropractic and am reposting it here because I can't believe the amount of unsubstantiated chiropractic bashing going on here.

Subluxations are scientifically 'accepted'. There is plenty of research to document joint fixation including many studies documenting decreased joint space in fixated joints using MRI's. Subluxations may not be accepted with the AMA, but after all in 1997 the AMA was found guilty of conspiracy to destroy the chiropractic profession. So, maybe the AMA isn't the best group to be deciding on the fate of chiropractic terminology. Also, your claim of 'plenty of victims' of stroke after neck adjustments is greatly over-exaggerated. It happens so rarely that it has been difficult to put an exact number on it. Currently, at worst the accepted number of strokes is 1 in 1,000,000 neck adjustments and at best is 1 in 7,000,000 adjustments. Although I feel for those people, these numbers don't even come close to the numbers of people dying at the hands of medical doctors from unnecessary procedures and unnecessary medications. One study sites iatrogenic deaths at 795,000 a year, making it the number one cause of death in the United States, above heart disease and cancer. Prescribed anti-inflammatories alone kill 16,000 people a year. Stroke after cervical manipulation is a microscopic drop in the bucket when you look at the big picture. Chiropractic is extremely safe. If you don't believe that, ask the people who know... the malpractice insurance companies. Chiropractic malpractice insurance is at most a few thousand dollars a year. Medical malpractice insurance is so expensive that some MD's can't even afford to practice. Get your facts and priorities straight and stop bashing chiropractic with unsubstantiated 'facts' and urban myths.

Furthermore, one person mentioned that upper cervical chiropractic was more likely to cause a stroke in patients than regular chiropractic. This is absolute nonsense. The mechanism by which a stroke occurs is from a fast stretch to the vertebral artery which occurs in a rotational (called a rotary-break) cervical adjustment. It requires a fast rotation of the neck and head to cause the stroke. Upper cervical chiropractic does not use a fast rotation to the neck and head. In-fact... in every upper cervical technique that I can think of, there is absolutely no movement of the head whatsoever making it the absolute safest chiropractic technique available. In addition to this, most chiropractic schools no longer teach the rotary-break adjustment and inform their students of its danger.

Please reference Current Concepts in Chiropractic, a collection of studies that finds stroke after cervical manipulation is at most 1 in 1,000,000. Further, the studies find that most of these strokes occurred after cervical manipulation by people other than chiropractors, including hair dressers, karate instructors, physical therapists and... medical doctors!!

Finally, to say that chiropractic does nothing and to imply that it is a mass hallucination by the millions of people that have found relief from it is pure nonsense. Chiropractic is absolutely grounded in science and there is a myriad scientific peer-reviewed studies, papers and articles to prove its efficacy. It is absolutely grounded in science and in no way is a pseudo-science. If you claim there is no science behind chiropractic, you simply haven't looked and that is just ignorance on your part. Further, there are many studies that show many medicines and surgeries are no better than placebo. Why chiropractors are always on the defensive is beyond me. Chiropractors actually help people get well while MD's patients are dropping like flies... 795,000 a year. Absurd. —Preceding ) 23:39, 14 February 2008 (UTC)

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One of the main ideals here a Wikipedia is verifying information with reliable sources. If you have such sources to verify what you are saying, please provide them and the article can be written to reflect it. -- Levine211200:01, 15 February 2008 (UTC)

I believe we have (or have had) sources which indicated that vertebral misalignment had no biological effect below the the level of an actual nerve pinch or (arthritic) joint damage. If you have a source to the contrary, please include it. As for whether there is science behind chiropractic, we would need sources as to that. We "'know"' it originated in opposition to medical science of the time. mdash; Arthur Rubin | (talk) 00:05, 15 February 2008 (UTC)

Too much is placed on the 'origin' with the chiropractic debate. Osteopathy had its origin from 'the rule of the blood', medicine started off with humors and chiropractic with metaphysical meaning to spinal manipulation. Just like those other professions have evolved, so too, by and large, has the chiropractic profession except for a vocal minority of principled (subluxation-based) chiropractors. As for science within chiropractic, you're kidding, right? ;) -- EBDCM05:04, 15 February 2008 (UTC)

That's why the article strives to tell the whole story, from quackish past to hopefully better future. -- Fyslee / 07:30, 15 February 2008 (UTC)

Two words

The debate about the words "health profession" in the lead is not yet finalised. Let's try to do so now. I'll summarise where we are up to. The proposal is that the words are redundant because everyone knows chiro is a health profession. Indeed Levine and Dematt have commented above that it is common knoweldge that chiros share a common set of attitudes to their health profession. So the debate is not whether or not chiro is a health profession, as that is common knowledge. Rather, the debate is about redundancy. The next thread of the argument is about whether the proposed formulation is poor English. Perhaps we can focus then on that. Here are the two formulations.

Current formulation:

Chiropractic is a complementary and alternative medicine health profession whose purpose is

Proposed formulation:

Chiropractic is a complementary and alternative medicine whose purpose is ...

For those who wish to keep to the current formulation, please explain why you think the proposed formulation is poor English and the current formulation is good English. Try to imagine how a reader who has never seen this article would react to each set of words. And once again. Please stick to the issue and not make this a personal attack. Mccready00:32, 15 February 2008 (UTC)

With "health profession" reads fine, it is more descriptive and it is entirely accurate. Chiropractic is a health profession. I don't understand the big deal here. -- Levine211200:49, 15 February 2008 (UTC)

Levine, do you understand that your words about a "big deal" could be read as insulting and inflammatory? Please be careful how you express yourself. The issues here are redundancy and the quality of language - both vital issues for an encyclopedia. Leaving aside the content issue for a moment, perhaps it would help you to parse the sentences and say how a naive reader might respond? Mccready01:30, 15 February 2008 (UTC)

Sorry if "big deal" offended you. That was not my intent. (The power of "two words" right?) Again, my apologies.

Onward, I fail to see how "health profession" is redundant. Redundancy would imply that something which comes before it expresses the same meaning. What comes before it? "Chiropractic is a complementary and alternative medicine". Nothing there implies "health profession" other that "chiropractic" itself (by definition it is a health profession), but as this topic sentence is in effect defining what chiropractic is, explaining that it is indeed a health profession seems highly appropriate. The naive reader may think chiropractic is just a CAM methodology or therapy, but that is not true. After all, chiropractic is an entire CAM health profession. So right off the bat, the naive reader is made aware of this.

As for the quality of language - well, that's a semantic debate and truly is in the eye of the beholder. Consensus-wise, it seems most everyone else aside from you is content with the read-ablity of this long-standing phrasing. If you have another way of wording this sentence which includes the expression "health profession" (or something which makes that clear), please feel free to suggest. However, the proposal above which leaves out "health profession" or any inference to that effect seems to me to be missing a vital detail - that chiropractic is not just a CAM therapy but rather a CAM health profession. Perhaps it would be better to say that it is a "health care profession"? -- Levine211201:45, 15 February 2008 (UTC)

Thank you Levine. Now we have a third leg to the debate. You are now putting a case of special pleading for chiro. Are you suggesting that homeopathy, acupunture, naturopathy etc are not health professions? Why, among all the CAMs should chiro be singled out in a redundant fashion in the LEAD as a health profession? Is such editing given to articles on nurses, psychologists, radiologists etc? Mccready01:58, 15 February 2008 (UTC)

As far as my understanding, homeopaths, acupuncture and naturopaths are not universally known as health professions, partly because they are not regulated amongst other things. You may want to read this http://adp.lin.ca//resource/html/Vol25/V25N2A4.HTM which suggests attributes that all professions have. I'm trying to search for the Kissinger paper which specifically addresses the topic of professionalism and professions. The lead you propose however suggests that chiropractic is a simple modality and not a profession as it is correctly stated. I would agree with Levine2112 that over the past 2 weeks or so that the majority of the editors here feel that those words were indeed valid and important enough to included in the lead. EBDCM02:07, 15 February 2008 (UTC)

I have seen the article. It is dated and provides nothing to support your assertion that other CAMs are not regarded as health professions. We have now finished with two legs of the argument and presumably only this one remains. Correct me if I'm wrong. Mccready05:25, 15 February 2008 (UTC)

undentx Mccready, there are two expressions that accurately describe your continued (How many milleniums have you done this now? Well, it seems that way anyhow...) pushing of this issue, and they are "disruption" and complete "refusal to accept a consensus" that goes against you (which itself is a disruptive action). RRR_User:Levine2112_RRR Levine2112 and RRR_User:EBDCM_RRR EBDCM are quite right. I favor "health care profession". -- Fyslee / 05:58, 15 February 2008 (UTC)

I undented for you Fyslee. Please remember to do this. You were reminding another editor here about it the other day. Your language is bordering on the inflammatory - milleniums, disruption. I shouldn't need to remind you of being civil and AGF. There is obviously no consensus. We have three editors who do not like the proposal. Not liking is not sufficient reason to reject it. The redundancy leg stands, the poor English leg falls. There is only one more reason, so far, for you rejecting the idea. That reason is the special special pleading on behalf of chiro. Could you please explain Why, among all the CAMs should chiro be singled out in a redundant fashion in the LEAD as a health profession? Is such editing given to articles on nurses, psychologists, radiologists etc? Thank you for your cooperation and continued AGF. Mccready07:31, 15 February 2008 (UTC)

I see what the problem is. Medicine is like butter. You can't have ""a medicine"" any more than you can have ""a butter"". (What are the linguistic terms for those -- quantitative rather than substantive nouns or something?) You could say "chiropractic is a form of ... medicine" but if you're going to add more words, better to add "health profession", since as pointed out by Levine2112, these words add significant meaning. Or at least "profession" does. "Chiropractic is a complementary and alternative medicine profession" has the problem that it makes one want to change "medicine" to "medical", which would then change the meaning; the urge to make this change is so strong that it interferes with just reading the sentence. But if "health" is there the urge is gone. Or to put it another way, people are not accustomed to seeing the words "medicine profession" beside each other, but they are reasonably accustomed to "health profession", so it reads easily with no double-takes. An alternative might be something like ""Chiropractic is a profession in complementary and alternative medicine,"" or ""The profession of chiropractic is a form of complementary or alternative medicine"" or ""Complementary and alternative medicine includes the chiropractic profession,"" or ""Within complementary and alternative medicine, the profession of chiropractic ..."" with something else to fill out the sentence. --Coppertwig02:24, 16 February 2008 (UTC)

Thanks for the lucidity. Hopefully it clears it up for McCready. As for your alternative, I think it is a case of "six of one, half dozen of the other" whereas, all things being equal, I prefer the version currently being used because the very first word of the article is the subject of the article and I think your one suggestion which maintains this - ""Chiropractic is a profession in complementary and alternative medicine"" - is a bit awkward. Thanks again for making this issue abundantly clear. It's a major talent to be able to make simple something which has been proven to be difficult to explain. -- Levine211202:31, 16 February 2008 (UTC)

Coppertwig, thanks for the excellent explanation. I'm not a linguist and can't explain it using the right terminology, but it's just like with pornography - "I know it when I see it" - as a Supreme Court justice said (or something like that...;-) Mccready's proposition just sounds wrong and also suppresses a fundamental fact. Regardless of whether he or I are critical of some of the details about chiropractic (and we do have problems with it), it is a "profession" that is involved with "health care", so "health care profession" works just fine for me. Many, if not most, forms of CAM are techniques and methods, not professions. Chiropractic is a fullblown profession, and I've never really heard a skeptic seriously question that fact. What skeptics question is aspects of the profession, and that's another discussion that doesn't belong in this thread. -- Fyslee / 07:57, 16 February 2008 (UTC)

If it is consensus we are looking for here, I agree to keep "healthcare profession". -- Dematt Dēmatt 14:57, 16 February 2008 (UTC)

That brings up another (more minor?) point: should it be "health profession", "health care profession" or "healthcare profession"? I prefer a space between "health" and "care"; there are about double the number of Google hits for the phrase with the space than without. I prefer to include the word "care", although "health profession" has more Google hits (about five times as many) than "health care profession". "health care industry" has three times as many Google hits as "health industry". though. I just think "health care profession" sounds better. (Sorry, no linguistics here, I just have to fall back on "I know it when I see it." :-) --Coppertwig02:40, 18 February 2008 (UTC)

Good suggestion, Coppertwig. I too prefer health care (with a space) and I made your recommended change to the main article. Thanks for making a positive contribution here and by all means, please continue to help us improve the article. EBDCM02:55, 18 February 2008 (UTC)

Thanks, EBDCM, http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=192209741oldid=192193461 for putting in my suggestion. It was Dematt's idea really, though :-) --Coppertwig03:12, 18 February 2008 (UTC)

No problem. It's a good example of collaborative writing. I hope you stick and continue your contributions to this project. EBDCM03:28, 18 February 2008 (UTC)

I hope I'm not beating a dead horse here. I still think that "complementary medicine health care profession" creates a mental stumbling block. Everyone here is used to it, and knows what it means, but a first time reader will be confused by the string of words, specifically 'medicine health profession'. It just sounds awkward! I propose putting "complementary, etc" in a separate sentence: "Chiropractic (from Greek chiro- χειρο- "hand-" + praktikós πρακτικός "concerned with action") is a health care profession whose purpose is to diagnose and treat mechanical disorders of the spine and musculoskeletal system with the intention of affecting the nervous system and improving health. Chiropractic is classified as CAM (complementary or alternative medicine)." (or 'chiropractic is a commonly used CAM'), etc. Regards, CynRN 21:23, 18 February 2008 (UTC)

I agree with CynRN that we should probably remove the CAM part from the opening sentence to make it flow better. Does the community here feel that chiropractic as a CAM profession is common knowledge therefore making the 'CAM' bit redundant? We don't want to mislead readers so I'll defer to some more experienced editors as to what we should do. EBDCM22:03, 18 February 2008 (UTC)

Mainstream Integration

I have begun a mainstream integration (integrative medicine) section as this model is increasingly becoming more prevalent with DCs being incorporated onto these teams. Please feel free to comment, suggestions as always are welcome! EBDCM03:09, 15 February 2008 (UTC)

Mccready, please explain your revert of my edit. The "puff" that you describe is inflammatory and was put there for contextual reasons and to set up the ensuing discussion. Your edit has not improved my original piece which was clear, concise, relevant and factual. I'd also like to hear from other editors beside mccready. EBDCM03:47, 15 February 2008 (UTC)

Puff is not inflammatory. It is a word used in wikipedia to describe promotional material for a POV. I have checked at least four or your sources now and NONE support the claim you make in the article. I don't propose to check any more until you can assure me they support the argument you wish to make. Thanks for desisting in editing until this is sorted. Mccready03:58, 15 February 2008 (UTC)

Mccready, that section was NPOV, well-referenced and factual. The citations were correctly attributed and was directly relevant to the statements presented. You've made a total of 7 reverts saying that all my references do not support my claims. This is completely ridiculous. I have high editing standards, bring a scientific POV and am providing notable, reliable and valid sources to support my arguments. You are being misleading with your claims that none of my sources supports the claims made.

This section was first suggested by Eubulides and I agreed that we should include one and the my draft should be reinstated as it was NPOV. Thanks for your suggestions though. - EBDCM21:25, February 14, 2008

Let's take it step by step, as I am trying to do with the two words in the lead. Please suggest a first sentence for the seciton, together with supporting source or sources. We can then decide whether we agree and whether it should go in. Mccready04:34, 15 February 2008 (UTC)

With all due respect, the two words in the leads has already been sufficiently dealt with over the last 2 weeks as well as a lengthy discussion on the talk page. Regarding the integrative medicine article, is it clear, concise, relevant, factual and most importantly NPOV. I will wait to hear from our community here first before reverting tonight as a sign of good faith. EBDCM04:41, 15 February 2008 (UTC)

undentWhy wait. I'm happy to look at your proposed first sentence and sources now. You do yourslef no credit by unilaterally declaring the two word issue to have sufficiently dealt with, particularly when there are unanswered questions on it. Mccready04:55, 15 February 2008 (UTC)

I'll wait for the other editors. Meanwhile, you can sit back and digest the fact that chiropractors are beginning to also be on the faculty at medical schools. Also, upon review, your edit summaries regarding my claims are VERY misleading to say the least. I will use mild language for now, but you should apologize for inserting such blantant falsehoods. http://www.brown.edu/Divisions/Medical_School/andera/profile.php?id=1100924820 --EBDCM05:47, 15 February 2008 (UTC)

Gentlemen, please calm down and refrain from strong language and accusations, regardless of whether they are true or not. Solo editing creates this type of problem. This is a controversial article and all new content should be developed in cooperation right here on the talk page. When a consensus version is developed, then add it. Being BOLD isn't always wise.

As to the proposed new section, exceptions to the rule should not be made to appear to be the norm. We are still dealing with relatively rare exceptions. -- Fyslee / 06:11, 15 February 2008 (UTC)

Although my writing style is in accordance with BOLD I feel it is justified because it meets and exceeds wikipedia's standards for inclusion. I agree that consensus is required changes but a good case could be made that some here are stone walling which impedes the article's natural evolution. Like I told Mccready, I will not revert it tonight as I will wait for our community to chime with their 2c. Cheers. -- EBDCM06:46, 15 February 2008 (UTC)

I hope you don't really mean that. Your words come across as uncollaborative and as actually planning to engage (reverting tomorrow instead of "tonight") in disruptive editing by being BOLD instead of developing things here on the talk page. Please don't do that. I'm trying to save you alot of grief here. We all have better things to do than to engage in edit wars that can be prevented. Once you have been warned, BOLD becomes disruptive and starts edit wars. -- Fyslee / 07:34, 15 February 2008 (UTC)

&quot;Considered&quot; - by whom?

In http://en.wikipedia.org/wiki/ChiropracticManipulative_treatment_techniques this section is found the phrase:

"...and are considered to be the expert providers of spinal adjustment, manipulation and other manual treatments."ref

When one reads the http://www.wfc.org/website/wfc/Website.nsf/WebPage/IdentityConsultation?OpenDocumentppos=2spos=5rsn=y source, we find that those words are discussing the identity by which the profession wishes to be known, not any outside reality (as yet). IOW the word "are" (considered) is up to debate. An NPOV use of that quote should state that the profession "wishes to be" considered as such:

"...and wish to be considered the expert providers of spinal adjustment, manipulation and other manual treatments.ref

-- Fyslee / 05:36, 15 February 2008 (UTC)

Fyslee, are you suggesting chiropractors are not expert at spinal manipulation? Given the fact that have been utilizing manipulation for close to 115 years, have developed hundreds of manipulative techniques (yes, some dubious ones too) and perform 90% of manipulations, it's pretty obvious from a conventional wisdom perspective that they are THE expert providers of spinal manipulation/adjustments and manual treatments. EBDCM05:51, 15 February 2008 (UTC)

I am not discussing that at all. I am discussing the source and its use. Our opinions about the issue don't count here, and are a different matter than the one I'm discussing here. Sources must be used properly and not misrepresented. Read the source, including its title. -- Fyslee / 06:02, 15 February 2008 (UTC)

If the source is questionable you can feel free to delete it, as it is already common knowledge that DCs are considered to be the expert provides of SMT and manual treatments. I inadvertently proved it with my previous post! -- EBDCM06:34, 15 February 2008 (UTC) 06:33, 15 February 2008 (UTC)

I'm not sure what you mean, but you seem to fail to understand my point. I'm not discussing "who is or is not anything." I'm discussing sourcing and policy violations. Edits must be backed up by sources, and sources should not be misused. -- Fyslee / 07:39, 15 February 2008 (UTC)

Just so we're both talking about the same thing, was my reference a violation of sourcing and policy? If so, I apologize; I didn't think that it was. The phrase in question was written some time ago and had not received any concerns until yours so I was under the impression everything was kosher. Your point is noted though and I appreciate your feedback. EBDCM19:18, 15 February 2008 (UTC)

I agree with Fyslee on this one. Either his variation or how about:

"...and consider themselves the expert providers of spinal adjustment, manipulation and other manual treatments.ref

But that still sounds suspect, how about:

"...and are the sole provider of spinal adjustment, and a major provider of manipulation and other manual treatments.ref

-- Dematt Dēmatt 19:41, 15 February 2008 (UTC)

What about ...the major provider of spinal adjustment, manipulation and manual treatments.ref The stats back this up. EBDCM23:19, 15 February 2008 (UTC)

The problem is with the word "the". Expert is just a Peacock that would be okay if we had a source that used that word, but then we should probably attribute it so that the reader can see who is saying that. No-one would have a problem with chiropractors saying they were "the experts" for using spinal adjustment, because no-one else uses the term (except some osteopaths in Europe). To claim to be the expert in a field like spinal manipulation, where others also are performing it, requires some verification, I think. Also, keep in mind, it is one thing for a chiropractic association to say they are "the experts" and another thing for a medical association to say it. Now if a neutral organization like the WHO said it, that would be different. The sentence still works leaving these two words out, but if you had a source I would be willing to re-assess. -- Dematt Dēmatt 15:06, 16 February 2008 (UTC)

(outdent) It sounds as if you're coming to a consensus wording anyway, but in case something like this comes up again, note that V does not require that every statement have a source provided to back it up: ""All quotations and any material "'challenged or likely to be challenged"' should be attributed to a reliable, published source using an inline citation."" My question earlier in this thread would therefore have been: "are you challenging the statement, Fyslee?" However, as I said, it looks as if the wording is being worked out anyway. --Coppertwig02:39, 16 February 2008 (UTC)

Coppertwig, you are correct. I am challenging the statement. We should start with the WFC source and analyze what it really says, then make a statement or quote that is true to the source. What has happened is that OR has (no doubt unintentionally) replaced a correct use of the source. Dematt understands the issue. All of our opinions are basically OR. I will certainly agree (excuse my OR for a moment) that chiropractors are certainly the only ("sole") providers of "spinal adjustments", and the main providers (90%?) of manipulation/adjustment (and we can even source that one!), but we can't use that source to state more than that. Neither can we use the WFC source to justify the existing statement. It needs to be changed to something along the lines of what Dematt has proposed. Chiropractic is making a PR push to become known as "the expert providers of spinal adjustment, manipulation and other manual treatments." That is their wish. Note that the WFC statement isn't even claiming that they "are". We can't use the WFC source to say more than what it actually says. The reality of the matter is that a growing percentage of PTs and even some MDs are using manipulation, which means that the chiropractic piece of the statistical pie is growing smaller and the statement becoming less true, but chiropractic is still a great majority provider. The same applies to an even greater measure for manual therapy, which many, if not most, PTs in clinical practice use everyday. Keep in mind that Mennel, Cyriax, Greive, Maitland, McKenzie, and Kaltenborn are not chiropractors, and their writings are what have been used in medicine and Physical Therapy for years. The one thing that chiropractors can lay claim to is a total monopoly ("sole") on providing spinal adjustments to treat vertebral subluxations. No one else believes in VS, so they don't treat it. -- Fyslee / 08:26, 16 February 2008 (UTC)

I second this. -- Dematt Dēmatt 15:11, 16 February 2008 (UTC)

See also

Fyslee, I suggest we make the ordering of the see also section by prevalence in usage or association rather than your arbitrary 'alphabetical order'. Seeing AK at the top of the list is misleading readers that it should be the first link they go to after reading the article. I recommend we place manual therapy first and AK near the bottom. I also say we include medicine, as the history of chiropractic is inextricably linked to medicine (for better of for worse) and is could be considered a speciality subdivision of medicine. What does the community think? -- EBDCM06:30, 15 February 2008 (UTC)

"edit conflict" While this is irrelevant now, the history of chiropractic, with its vehement opposition to medicine and even refusal to use the word medicine in the title of a chiropractor (many straight DCs still consider it demeaning to be called DCM), makes placing it as a subcategory of "medicine" somewhat debatable. Chiropractic has traditionally operated outside and alongside, but not subserviently or in cooperation with medicine. It has been very critical of medicine and opposed the use of medicines (drugs). It's just not that simple a matter. As far as manual therapy and joint manipulation goes, it predates chiropractic and is fundamental to massage and physical therapy in varying degrees. Here too it's not that simple. But this gets us off topic for this talk page. -- Fyslee /

Fyslee, I just noticed this re-jigged comment. I have a few opinions on the subject, as always ;) I would love to be called DCM and would prefer to have the actual separation be made clear for the public and health professions. I'm not saying this to demean straight chiropractic because it's the represents the origin of the profession, but it is not it's future. I completely favour adding 1 more year, for example, and obtaining an expanded scope of practice that would include limited prescription rights. The majority of my graduating class (2006) feel the same as well.

While the history of chiroparactic and medicine has been contentious in the past, each other's criticisms have led to improvements and maturation in the respective professions and now an eventual blending in integrative medicine. CynRN has already provided a source that said 20% of UK physicians were practicing either chiropractic, naturopathic or homeopathic medicine.

With respect to PT and massage, joint manipulation and manual therapy is not their "bread and butter" and their public image doesn't portray that as well. There's simply not enough cultural authority that PTs and RMTs have an "equal" claim to manual therapy but it is literally what chiropractic care is: done by hand. EBDCM01:46, 20 February 2008 (UTC) PS: That was my last 2c!

The situation has already been solved in the proper manner since most of those links were already linked in the article. Otherwise we use alphabetical ordering to avoid POV ordering. That seems to be the only way to prevent it. There are innumerable POV reasons for changing the ordering, but alphabetical can't be discussed as it is totally arbitrary and unperturbed by POV and edit wars. -- Fyslee / 07:14, 15 February 2008 (UTC)

Do you not think that AK is being given too much weight, especially being included in the manipulative techniques section and as well as the first item on the "see also" section? I still think it goes against the spirit of the rule. I've already conceded that AK should stay in, however it being top billing, whether its alphabetical or deliberate could be better resolved. I think we're up to the task at tackling this seemingly small, yet strategically important detail. EBDCM07:19, 15 February 2008 (UTC)

Irrelevant now. -- Fyslee / 07:23, 15 February 2008 (UTC)

That works. Good edit. EBDCM07:25, 15 February 2008 (UTC)

Mainstream integration

This new section came and went so quickly that I missed it completely (and I suspect others did as well). I would like to copy it here and give us all a chance to discuss it:

With the rise of popularity of complementary and alternative therapies http://nccam.nih.gov/news/report.pdf and the reformation of health care systems internationallyhttp://www.lib.sfu.ca/researchhelp/subjectguides/ihre/healthcare_reform.htmhttp://www.nchc.org/materials/studies/reform.pdf integrative models of health care delivery are becoming increasingly prevalent. Integrative medicine is a new term that emphasizes the combination of both conventional and alternative approaches to address the biological, psychological, social and spiritual aspects of health and illness. It emphasizes respect for the human capacity for healing, the importance of the relationship between the practitioner and the patient, a collaborative approach to patient care among practitioners, and the practice of conventional, complementary, and alternative health care that is evidence-based Intehttp://www.osher.ucsf.edu/About/IntegrativeMedicine.aspx Chiropractors, in particular reform chiropractors, are beginning to become integrated in formal public health settings such as hospitalshttp://www.stmichaelshospital.com/programs/chiropractic/index.phphttp://hospitaldc.com/http://www.sciencedirect.com/science?_ob=ArticleURL_udi=B6WK1-4N3NX7Y-F_user=10_rdoc=1_fmt=_orig=search_sort=dview=c_acct=C000050221_version=1_urlVersion=0_userid=10md5=b0811d1ef0b8d30e2f2118dc1e906240, interdisciplinary health teams http://www.health.gov.on.ca/transformation/fht/guides/fht_inter_provider.pdf community health centres and universities. Chiropractors are also becoming more integrated in scientific research communitieshttp://www.fascia2007.com/presenters.php and within governmental institutionshttp://www.ccachiro.org/client/cca/cca.nsf/web/VA-Chiropractic%20Care?OpenDocumenthttp://www.chiropracticresearch.org/NEWS_US_department_of_defen.htm with promising results.

Is this something which we would like to work with to reinsert into the article? -- Levine211218:32, 15 February 2008 (UTC)

I suggest that this topic is indeed notable (as per Eubulides suggestion) and is it was cited correctly unlike Mccreadys suggestions. I dispute the 'puff' comment and hope that other editors will take an objective look and agree that it was clear and concise, veriable, notable and relevant to add. EBDCM19:15, 15 February 2008 (UTC)

I think it has potential. I am not comfortable with the word Mainstream, because nobody knows what that means, though everyone has a definition. Does mainstream mean the chiropractor still practices 'subluxation', homeopathy, applied kinesiology, or whateve else, etc., or does mainstream chiropractic 'only' practice neuromusculoskeletal in an intergrative atmosphere. We still have some 'splainin' to do. Otherwise, the subject is certainly germane. -- Dematt Dēmatt 19:52, 15 February 2008 (UTC)

I've started looking through the refs and can see how the first two relate to the proposed text. The next section is a verbatim statement that needs to be attributed. I temporarily palced it as University of California - you get the idea, so we would have to place as such:

With the rise of popularity of complementary and alternative therapies http://nccam.nih.gov/news/report.pdf and the reformation of health care systems internationallyhttp://www.lib.sfu.ca/researchhelp/subjectguides/ihre/healthcare_reform.htmhttp://www.nchc.org/materials/studies/reform.pdf integrative models of health care delivery are becoming increasingly prevalent.Fact|date=April 2008 The University of California defines Integrative medicine as "... a new term that emphasizes the combination of both conventional and alternative approaches to address the biological, psychological, social and spiritual aspects of health and illness. It emphasizes respect for the human capacity for healing, the importance of the relationship between the practitioner and the patient, a collaborative approach to patient care among practitioners, and the practice of conventional, complementary, and alternative health care that is evidence-based." Intehttp://www.osher.ucsf.edu/About/IntegrativeMedicine.aspx Chiropractors, in particular reform chiropractors, are beginning to become integrated in formal public health settings such as hospitalshttp://www.stmichaelshospital.com/programs/chiropractic/index.phphttp://hospitaldc.com/http://www.sciencedirect.com/science?_ob=ArticleURL_udi=B6WK1-4N3NX7Y-F_user=10_rdoc=1_fmt=_orig=search_sort=dview=c_acct=C000050221_version=1_urlVersion=0_userid=10md5=b0811d1ef0b8d30e2f2118dc1e906240, interdisciplinary health teams http://www.health.gov.on.ca/transformation/fht/guides/fht_inter_provider.pdf community health centres and universities. Chiropractors are also becoming more integrated in scientific research communitieshttp://www.fascia2007.com/presenters.php and within governmental institutionshttp://www.ccachiro.org/client/cca/cca.nsf/web/VA-Chiropractic%20Care?OpenDocumenthttp://www.chiropracticresearch.org/NEWS_US_department_of_defen.htm with promising results.

-- Dematt Dēmatt 20:15, 15 February 2008 (UTC)

Sorry, but this needs a lot of work. For one thing, the formatting is botched; some of the text ended up in the references. More important, the quality of the citations is low. As per 17224347) Barrett 2003 (PMID|12816630), and Meeker Haldeman 2002 (PMID|11827498) as reasonable starting points; they're all in peer-reviewed journals and Meeker Haldeman, although it's the most dated, has had real influence on later work. The idea is that to "first" find reliable sources, and "then" do our best to summarize them; it is not good to start out with a point of view and then look for sources to match our preconceived notions. I just now did a search for something more recent using Google Scholar and Pubmed, and came up with Lawrence Meeker 2007 (PMID|17241465); this one is freely available and I highly recommend reading it and following as many of its references as you can. Eubulides20:15, 15 February 2008 (UTC).

Thanks for the constructive critique, Eubulides. It looks like your refs are pretty much agreeing as well. So basically, it looks like EBDCM can go ahead with this section. -- Dematt Dēmatt 20:24, 15 February 2008 (UTC)

Quality of citations is low? I'm a little confused as to what is an acceptable citation here at Wikipedia. A close look at quack gurus edits and citations demonstrates tons of layman internet sites and that seems to pass the mustard. Yet my citation from one of Canada's most innovative medical teaching hospitals that confirms my point of hospital based DCs does not? Bizarre. Regardless, this can easily be found by searching for Kopansky-Giles AU in PubMed who authored a few papers regarding the demonstration project and subsequent permanent inclusion of DCs on staff at St-MIkes Hospital. Also, doing a pubmed search on "chiropractic integration" yields 42 papers, the most recent from 2008. For the record I did "first" find reliable sources and then summarized them to support my edit. To suggest that I started off with a POV and did the opposite does not suggest AGF. Also, your cheerleading comment is taken as inflammatory and the "becoming" and "promising" generally summarizes the trends that are occuring and can be verified. I would also comment that your edit on vaccine controversy with respect to chiropractic could be taken in the exact same light, a POV with references to support it. I could also call it "puff" as mccready suggests as well. EBDCM20:37, 15 February 2008 (UTC)

Here's a start: http://www.ncbi.nlm.nih.gov/pubmed/17996546?ordinalpos=1itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum, http://www.ncbi.nlm.nih.gov/pubmed/17416269?ordinalpos=1itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlusDrugs1. Back to work I go! EBDCM20:47, 15 February 2008 (UTC)

Sorry, I was a bit harsh. I should have written that the citation quality "can be improved" rather than that it is "low". The citations in the above-proposed text are primary studies, and thus represent the particular viewpoint of one research group. When you glue them together to tell a story, you are using your judgment as to which primary studies are important and which are not, and it's almost unavoidable that your opinions will leak into the text. It's much better to use reliable reviews instead: that doesn't escape opinion entirely, but it does mean the article relies on the judgment of reliable published experts in the field (who themselves are being more-carefully reviewed) rather than just the opinion of Wikipedia editors. By and large, the sources that I cited (for example, Lawrence Meeker 2007, PMID|17241465) meet this high standard; the sources that you're mentioning, including Kopansky-Giles "et al." 2007 (PMID|17996546) and Garner "et al." 2007 (PMID|17416269), do not. It's important in controversial areas like this to use the highest-quality sources, not just "good-enough" sources. Please see MEDRSSome definitions and basics for more on the subject of reliable sources in this context. As for words like "promising" and so forth, they really are out of place in articles like this, and should be avoided when possible. Look at a high-quality featured articles like Tourette syndrome or Autism; you won't find any uses of the word "promising" in these articles, nor will you find the word "new" used in a quasi-advertising sense of "new and improved". Chiropractic should aim for this level of quality. Eubulides21:21, 15 February 2008 (UTC)

The claim that the term "integrative medicine" is "new" is misleading. A quick Google Scholar search turned up its use in several sources that I would consider old, including the following: cite journal |journal= Psychosom Med |date=1970 |volume=32 |issue=4 |pages=427–39 |title= Strategy in psychosomatic research |author= Mason JW |pmid=5514180 |url=http://www.psychosomaticmedicine.org/cgi/reprint/32/4/427.pdf |format=PDF So at least that use of the POVish word "new" should go. Eubulides22:03, 15 February 2008 (UTC)

Eubulides, if the absolute standard here for citations were double-blind RCT level 1a evidence many medical pages would not have many references. Although I do understand your POV, the citations included here are more the reliable and valid. Also, you seem to have a bias towards including quantitative research only and ignore the value of qualitative research which is just as valuable. Not everything can be reduced and crunched. With respect to your comparison to tourettes and autism, those are completely different as they are sigular medical conditions that lend themselves well to conventional studies whereas describing a paradigm shift towards integrated medicine and the role of chiropractors within it does not. Furthermore, the integration of chiropractors in these settings were first done on a demonstration project basis (hospital, community health centres, DoD, DVA) and were either expanded are made permanent by the success of the project. If the results weren't promising the projects would have been terminated.

I did not suggest any absolute standard, nor did I suggest double-blind RCT. I merely suggested that we use the most-reliable sources, and use the usual Wikipedia guidelines (MEDRS) as to what constitute the most-reliable sources. Surely you're not disputing the Wikipedia guidelines?

No, I don't dispute guidelines, but that's what they are, guidelines and not standards. There's a difference, guidelines are merely suggestions. While I agree that it's better to stick to these, in certain cases we have the flexibility to deviate from them if required. That is my point. We cannot be too rigid here for inclusion criteria. While we might not always be able to find secondary sources, surely articles from peer-reviewed scientific journals is a good start.

But here we do have reliable secondary sources. In that case, they should be preferred to the primary sources, no? Do you dispute this part of the MEDRS guideline? Eubulides06:54, 18 February 2008 (UTC)

Again, single studies, no matter how promising, are not as good as reliable reviews by experts in the field.

I disagree with you that (for example) autism is one of the "single medical conditions that lend themselves well to conventional studies"; if you read Autism you'll see that it's not a simple condition, that many researchers don't think it's a even a single condition, that conventional studies have not done well in finding its cause, and that many are looking at it from a systems point of view rather than a reductionist viewpoint.

Nothing in the above comments ignore the value of qualitative research. I am merely saying that we should not go looking for primary studies (there are zillions of 'em, they contradict each other, and how will we choose among them?) when we have reliable secondary sources ready to hand: that is true regardless of whether we're summarizing qualities or quantities.

Eubulides

05:18, 16 February 2008 (UTC)

We're in agreement here, but sometimes in the absence of good secondary sources, primary ones will have to suffice. Also, the sources I listed that are not from scientific journals are from reputable sources (i.e. government websites) which confirms the claims being made (i.e. demonstration projects or integration of chiropractic services at governmental agencies (DoD, DVA) EBDCM03:36, 18 February 2008 (UTC)

But here we don't have an absence of good secondary sources. For starters, I've already mentioned Mootz 2007 (PMID|17224347), Barrett 2003 (PMID|12816630), Meeker Haldeman 2002 (PMID|11827498), and Lawrence Meeker 2007 (PMID|17241465). Sources like these should be preferred. Refereed-journal primary sources are not as good as these, but are certainly adequate to support claims that single studies have been made (this must be stated carefully, and should be done only for areas that are too new to be summarized in secondary sources). Announcements on government web sites of demonstration projects are reasonable to back claims that demonstration projects are under way, but by and large they do not suffice to support claims that the projects are successful, or that they are growing in popularity, etc. Reliable secondary sources are "much" better for this sort of thing. The government supports all sorts of projects that we might "wish" would succeed or become popular, but many of these projects fail. Eubulides07:01, 18 February 2008 (UTC)

Dematt, on second thought mainstream was a bad choice of words. Integrative medicine might be better. Regarding what 'types' of chiropractors are being incorporated on these teams, I would argue that it is the evidence-based wing. For example on the link provided below, DCs are obligated to refer all all non-MSK cases as part of their role on the family health teams. This policy was developed by the Ministry of Health and Long Term Care of Ontario (see page 25/32) So, naturally, dubious practices like AK would not be tolerated or supported. Anyways, onwards to the section of the article, is there a universally agreed upon definition of integrative medicine that would trump the one currently provided?

http://www.health.gov.on.ca/transformation/fht/guides/fht_inter_team.pdf

EBDCM

23:16, 15 February 2008 (UTC)

Different types of statements may require different types of reliable sources. If it's a truly medical thing, such as, does this type of surgery benefit this type of illness, you might need those review studies and whatnot. But if what you're trying to establish is more of a social trend, such as are there chiropractors working in hospitals, then double-blind studies are not required. An article on a medical topic might contain some statements that are from another field -- math, history, or whatever -- and will need the right type of source for those particular statements. --Coppertwig03:00, 16 February 2008 (UTC)

When we have reliable secondary reviews on the topic at hand, we should prefer them to random bits of information culled from primary studies on other topics. Anybody can prove almost anything if they're allowed to stitch together bits taken from random studies. It's the job of expert reviewers to come up with a reliable view of the field. We should not be second-guessing the experts. Eubulides05:18, 16 February 2008 (UTC)

Coppertwig has raised some valid points, Eubulides. Not every citation made needs to be a secondary source. It depends on the context of the statement being made. Social trends do not require these sources for inclusion criteria. Notwithstanding, the sources I provide are all from either peer reviewed scientific journals of from reputable sources. On a separate note, I don't mind of the word 'new' is not included in the text and wonder if you could help us find a consensus version of integrative medicine. —Preceding ) 05:59, 16 February 2008 (UTC)

I did not say every citation needs to be from a secondary source. I said that secondary sources should be preferred when they are available, as is the case here. Do you agree? Let's first try to get consensus about what makes for good sources; consensus on sources will make it easier to achieve consensus on what the sources say. Eubulides06:44, 16 February 2008 (UTC)

outdent Yes, we can find references that prove exceptional instances of where chiropractors are working in ER hospital settings, integrative medicine clinics alongside MDs and PTs, etc., but be careful not to give the impression that this is a common phenomena. It is the exception, and not the rule. By and large it is quite exceptional (which is why we notice it!) and also controversial. Also, the first three sentences in the paragraph deal largely with another subject than chiropractic, all to justify ending up with a single sentence sourced to several references to such exceptional instances. It's basically SYNTH and wishful thinking. -- Fyslee / 08:38, 16 February 2008 (UTC)

It may be time to go there. As painful as it may be for all of us, perhaps we should try. We seem to have a pretty good mix of POVs. How about lets agree to start with secondary sources such as Eubulides suggests, then see where it leads us. If it becomes necessary to cite primary sources, then we can agree to attribute them to the source in the article text. Everyone also needs to agree to be civil and hopefully we'll all come out of this alive :-) Avoid edit warring - this article is on the homeo watch ;-) -- Dematt Dēmatt 13:37, 16 February 2008 (UTC)

I will insert the original paragraph minus a few choice words that eubulides was objecting to. Fyslee raises a good point that readers should not be confused that integrated medicine (with DCs in it) is not the norm; but that the trend shows that it is INCREASING and becoming more prevalent. Some context is required to allow the readers to know what integrated medicine is and why that model is playing a role in the reformation of various health care systems. So, I'll find a shorter more concise version of integrative medicine. I think a good mix of secondary sources and reliable ones from reliable, notable sites that confirms the presence of the programs is a fair way to approach this. With respect to reference formatting, Eubulides seems to be quite capable of helping us out in that regard as he has done an excellent job already here in cleaning that up. EBDCM19:15, 16 February 2008 (UTC)

I hope you're kidding when you write "I will insert...." above. You should be learning by now that controversial edits should be developed on talk pages, not in article space. Doing it in the article automatically causes reverts and potential edit wars, IOW such inclusions create disruption, and that's not allowed. Please place your proposed new version here and we'll work on it together. The finished version will then be a consensus version and will be protected by those involved in its creation.

I agree with Dematt about seeing where the references lead us. If it can be done, then let's go for it. -- Fyslee / 08:26, 17 February 2008 (UTC)

Proposed amendment. Integrative Model of Care or Integrative medicine or another fitting title.

With the rise of popularity of complementary and alternative therapies 33 and the reformation of health care systems internationally3435 integrative models of health care delivery are becoming increasingly prevalent.citation needed National Center for Complementary and Alternative Medicine defines integrative medicine as combination of mainstream medical therapies and CAM therapies for which there is some high-quality scientific evidence of safety and effectiveness."36 Consequently, some chiropractors, in particular refom chiropractors, are beginning to become integrated in formal public health settings such as hospitals373839, interdisciplinary health teams 40 and within governmental institutions4142 to provide their expertise in the management of neuromusculoskeletal disorders.

I have removed some words that Eubulides objected to, shortened the definition of integrative medicine and used the def of the NCCAM rather than a single university and clarified what conditions are primarily being addressed by DCs in integrated settings. Any other suggestions? EBDCM01:45, 18 February 2008 (UTC)

This is an improvement in wording, but it is difficult to evaluate since its references are messed up. Can you please fix that by (for example) replacing the "33" with the actual … that the citation needs? As things stand, I can't tell which sources are being cited. The "citation needed" is worrisome, of course. Eubulides03:34, 18 February 2008 (UTC)

I know we have secondary sources are in agreement we should use them. Dematt covered this before as well. Sure government projects fail; and I'm not insinuating that these demo with DCs will succeed. The fact that these programs were expanded suggests something positive may have been happening. Patient satisfaction results bear this out as well. So, I'll find that citation and we can get rolling? EBDCM01:36, 19 February 2008 (UTC)

It's not just a question of finding one citation. The current draft has zero citations; it has merely uninformative references like "40". I don't know whether the draft is citing secondary sources or primary ones, for example. Without that information, I cannot verify that the claims are well-sourced. Can you please fix this so that I can do a proper review? Eubulides07:48, 19 February 2008 (UTC)

Archive this?

Fyslee, any chance we can archive some of this? I know we have a lot of conversations going on at the same time so be careful, but it would be nice to get rid of the stuff in t middle. I'm getting lost. :-) -- Dematt Dēmatt 15:13, 16 February 2008 (UTC)

Done. -- Fyslee / 08:20, 17 February 2008 (UTC)

Some Things Out of Place?

British Medical Association

The British Medical Association notes that "There is also no problem with GPs doctors referring patients to practitioners in osteopathy and chiropractic who are registered with the relevant statutory regulatory bodies, as a similar means of redress is available to the patient."51

"'In Addition to this, a placebo-controlled study published in March of 2007, showed that Chiropractic adjustments actually lower high blood pressure..."52"'

I think the article is looking a lot better than a few weeks ago. Kudos to you all! When I reread, however, I can't help noticing that the study re. blood pressure seems out of place. What does this study have to do with the BMA? Can it be moved to the end of Scientific Inquiries? By the way, this is a small pilot study, which is intriguing, but there are probably more impressive studies to use. Again, the studies should be put somewhere else, maybe in a new section under Scientific Inquiries...CynRN 18:25, 16 February 2008 (UTC)

I noticed that too, CynRN. I think the next section that will be tackled will be the science section as there are some good meta-analyses out there now that will help synthesize the information. IMO there should be a NMS care section and non-NMS section to show the variety of conditions that DCs treat and the supporting evidence for those conditions. We can start off by looking at the evidence-based clinical practice guidelines as this saves us a lot of time since a good lit review has been done. But, I agree that the manipulation and blood pressure study should be moved out of that section and I'll go do that now. EBDCM19:21, 16 February 2008 (UTC)

http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=191909017oldid=191851536_note-Duke I noticed an error in formatting. QuackGuru20:30, 16 February 2008 (UTC)

I have made the mention of the hypertension study more accurate. It's interesting to note that this small pilot study hasn't been replicated yet and doesn't seem to have been commented on anywhere else but on chiropractic websites. If anyone has more information about this, please provide it here. -- Fyslee / 09:02, 17 February 2008 (UTC)

I think your change was fine. It is important as it does give some evidence to the straight stance in a proper light. Most evidence for type-O problems at this point in the form of anecdote or "small" pilot studies. Until they come up with something better, which may or may not happen, this is appropriate, I think. -- Dematt Dēmatt 14:00, 17 February 2008 (UTC)

Fyslee, the study was definitely commented on by the mainstream media. However, I agree with you that it is interesting that it has not been replicated yet. The methodology of the actual study was quite poor too, IMHO. DigitalC06:16, 19 February 2008 (UTC)

Subluxation in the lead

I propose we say in the lead "an estimated 90% of chiros believe in subluxation" and we footnote with McDonald W (2003) "How Chiropractors Think and Practice: The Survey of North American Chiropractors." Institute for Social Research, Ohio Northern University. Mccready04:55, 17 February 2008 (UTC)

I disagree and if past history is any indicator, so does the majority of the community here. This issue has already been raised at Talk and has been talked about already extensively. It seems to me Mccready that you're using the survey in question as a straw man fallacy trying to discredit chiropractors. An estimated 20% of DCs, all of them straight chiropractors, retain the metaphysical language and tradiional Palmer view of subluxation. The majority use the term in a biomechanical context (structure) and the impact of this on neurological mechanisms function. Mixers view the impact on the NMS system with visceral sequalae, reformers primarily stick to NMS and don't use the term VSC. So, in short, subluxation means different things to the different styles of chiropractors and unless you want to get to explain it in detail (because the edit you propose is also out of context) in doesn't belong in the lead. Thanks for suggesting this first on talk rather than reverting it though. EBDCM06:24, 17 February 2008 (UTC)

I agree exactly with EBDCM concerning subluxation meaning different things to different people, thus it needs to be discussed before making such a broad statement in the lead. However, nothing wrong with including a section that has that as it's lead-in and makes a NPOV attempt to explain this. -- Dematt Dēmatt 13:45, 17 February 2008 (UTC)

Thanks Dematt and EBDCM. Would you like to present some sourced words here for us to consider? Mccready02:06, 18 February 2008 (UTC)

Reworking Philosophy section

Okay, EBDCM, I think Eubulides, Fyslee and Mccready have legitimate reasons to completely revise the Philosophy section, but rather than run the risk of edit warring, let's rewrite it here. Use this section just like the article page and let's feel free to edit it until we get it right. Be patient with each other and realize that it may sway from one POV to another on occasion until we find out where the references take us. Above all, be civil. This should be fun. Eubulides, why don't you go first and give us an idea of what you think it should look like. -- Dematt Dēmatt 13:40, 17 February 2008 (UTC)

Hmm, I see EBDCM went ahead and edited ChiropracticPhilosophy instead. Is that the suggested procedure? I'll hold off for a while until I understand what's being suggested. ChiropracticPhilosophy's citations got munged in the process, so I http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=192145856oldid=192136992 fixed that, but otherwise I edited neither it nor the section below. Eubulides21:51, 17 February 2008 (UTC)

I made some minor changes so it should not be contentious with the majority of editors here. I addressed many of your concerns too (unique philosophical approach, removing POV words, emphasizing conservative methods, adding homeostasis, removing occupational outlook blurb which was in the wrong section, clarifying the chiropractic model of prevention which is wellness based, added contextual info re: the Janse quote which highlights a core difference in approaches to care and added Janses credentials so we know more about his academic qualifications and removed the word holism a few times which appeared redundant. Thanks for those suggestions, they have improved the content and flow of the section. EBDCM02:15, 18 February 2008 (UTC)

Many of those changes were improvements but some were not. I disagree that one should put the author's degrees into the text; that is a peacockism and is out of place here. But I will try to focus on the replacement rather than worry too much about Janse's pedigree. Eubulides07:13, 18 February 2008 (UTC)

I have bitten the bullet and have taken Dematt's suggestion, with a first cut proposed below, in Philosophy. Eubulides07:30, 20 February 2008 (UTC)

While I was doing that, EBCDM and Levine2112 edited ChiropracticPhilosophy directly. Here is what EBCDM had to say about it (he omitted a signature): Eubulides08:59, 20 February 2008 (UTC)

After several days of discussion, initiated by Levine2112, this is the reworded version one which has been entirely verifiable from both primary and secondary scholarly and notable sources. It contains consensus research done by long time, resident chiropractic editors and published chiropractic textbooks. Accusations of SYNTH aside, chiropractic has been mentioned in all the articles cited.

The reworked version can be found http://en.wikipedia.org/w/index.php?title=Chiropracticoldid=192758244Holistic_and_naturopathic_approach here, and EBCDM made a copy of it in the following section: Eubulides08:59, 20 February 2008 (UTC)

Holistic and naturopathic approach

The philosophy of chiropractic involves a contextual, naturopathic approach to health care which suggests that lowered "host resistance" faciliates the disease process. Thus, treatments and care should be directed towards strengthening the host from "within" by increasing the hosts "adaptive potential" and regulating homeostasis. Chiropractic care primarily uses manipulation and other conservative and natural therapies rather than medications and surgery.http://books.google.com/books?id=6Z8_0TOepwICpg=PA13lpg=PA13dq=chiropractors+drugs+surgerysource=webots=0ZiCOCItb6sig=ixv0S4nmaJsUjbNw7UE1bY5-OTs available online The philosophy of chiropractic also emphasizes a holistic and biopsychosocial approach to health care.cite web |title= WFC consultation on the identity of the chiropractic profession |author= World Federation of Chiropractic |date=2005 |url=http://www.wfc.org/website/wfc/Website.nsf/WebPage/IdentityConsultation?OpenDocumentppos=2spos=5rsn=y |accessdate=2008-02-14 Chiropractic's unique claim to improve health by improving nervous system function by the manual correction of joint and soft tissue dysfunctions of the neuromusculoskeletal system differentiates it from mainstream medicine and other complementary and alternative medicine (CAM) disciplines.

Chiropractic philosophy also stresses the importance of prevention and primarily utilizes conservative therapies and a wellness model to achieve this goal.http://www.ncbi.nlm.nih.gov/pubmed/10658871?dopt=Abstract One aspect of chiropractic's approach towards prevention is "maintenance care" which attempts to correct structural imbalances of the neuromusculoskeletal system while in its primary, or functional state.http://www.ccachiro.org/client/cca/cca.nsf/web/Chapter%2014%20-%20Preventative-Maintenance%20Care?OpenDocument The objective is to prevent further deleterious deterioration and sequalae culminating in objective pathological changes. This aspect of chiropractic prevention has been a source of confusion and controversy in the medical community. Joseph Janse, DC, ND, attempted to describe this difference in chiropractic and medical philosophy regarding prevention and patient care:

"Unless pathology is demonstrable under the microscope, as in the laboratory or by roentgenograms, to them allopaths it does not exist. For years the progressive minds in chiropractic have pointed out this deficiency. With emphasis they chiropractors have maintained the fact that prevention is so much more effective than attempts at a cure. They pioneered the all-important principle that effective eradication of disease is accomplished only when it is in its functional (beginning) phase rather than its organic (terminal) stage. It has been their contention that in general the doctor, the therapist and the clinician have failed to realize exactly what is meant by disease processes, and have been satisfied to consider damaged organs as disease, and to think in terms of sick organs and not in terms of sick people. In other words, we have failed to contrast disease with health, and to trace the gradual deteriorization along the downward path, believing almost that mild departures from the physiological normal were of little consequence, until they were replaced by pathological changes…"cite book |author= Strang VV |title= Essential Principles of Chiropractic |location= Davenport, IA |publisher= Palmer College of Chiropractic |oclc=12102972 |date=1984 |pages= p. 26

In addition to manipulation, chiropractors also commonly use nutrition, exercise, public education, health promotion and lifestyle counseling as part of their holistic outlook towards preventive health care.http://www.sciencedirect.com/science?_ob=ArticleURL_udi=B6WK1-4DK6G4T-1_user=10_rdoc=1_fmt=_orig=search_sort=dview=c_acct=C000050221_version=1_urlVersion=0_userid=10md5=7fb28491da1f46038e6da6cfe6389209

In summary, the major premises regarding the philosophy of chiropractic include:

quotation|"'Chiropractic perspectives to patient care"'cite book |chapterurl=http://chiroweb.com/archives/ahcpr/chapter2.htm |chapter= Chiropractic belief systems |author= Mootz RD, Phillips RB |date=1997 |title= Chiropractic in the United States: Training, Practice, and Research |pages=9–16 |editor= Cherkin DC, Mootz RD (eds.) |accessdate=2008-02-14 |version= AHCPR Pub No. 98-N002 |location= Rockville, MD |publisher= Agency for Health Care Policy and Research |oclc=39856366

noninvasive, emphasizes patient's inherent recuperative abilities

recognizes dynamics between lifestyle, environment, and health

emphasizes understanding the cause of illness in an effort to eradicate, rather than palliate, associated symptoms

recognizes the centrality of the nervous system and its intimate relationship with both the structural and regulatory capacities of the body

appreciates the multifactorial nature of influences (structural, chemical, and psychological) on the nervous system

balances the benefits against the risks of clinical interventions

recognizes as imperative the need to monitor progress and effectiveness through appropriate diagnostic procedures

prevents unnecessary barriers in the doctor-patient encounter

emphasizes a patient-centered, hands-on approach intent on influencing function through structure

strives toward early intervention, emphasizing timely diagnosis and treatment of functional, reversible conditions

Comments on &quot;Holistic and naturopathic approach&quot;

Here's a brief summary of the problems I see with this version.

It gives only one sentence to chiropractic's unique claim to improve health; the rest of the section could apply almost equally well to naturopathy, etc. This is an undue lack of weight. The section should give adequate weight to what makes chiropractic special. Complementary and alternative medicine is a better place to go into details about general properties of CAM philosophy.

The philosophy of chiropractic shares many common themes and origins as other CAM professions and this deserves to be noted.

Absolutely. But only "one" sentence about what makes chiropractic unique. The other dozens of sentences are all generic to CAM? That's not right. The section should give proper weight to the core part of chiropractic, which distinguishes it from other health-care philosophies. Eubulides17:36, 20 February 2008 (UTC)

They're are not all generic to CAM but are germane to chiropractic, so it deserves mention. What is core to ALL of chiropratic is holistic and natural approach to health care via manual therapy. If you say SMT only, that's inaccurate, if you say subluxation correction, that's inaccurate. Hence the need for general terms that reflects all DCs approaches. Unique to chiropractic is the use of manual therapies (not just manipulation) to improving health and attribute this to improved neurological functioning. Also unique is WHEN to treat, i.e. in functional state prior to the arrival of symptoms. This is what Janse is saying. EBDCM19:23, 20 February 2008 (UTC)

If that is what Janse was saying, I wouldn't be objecting so strongly to that quote. But I'm afraid that's not what he's saying. For starters, the quote mentions neither manipulation nor neurological functioning. Aside from his POV wording of "the progressive minds in chiropractic", the quote is not specific to chiropractic, and could be about many forms of CAM. Here's one way to illustrate how generic his quote is: changing "chiropractic" to "naturopathy" does not affect the validity of Janse's quote. Eubulides21:32, 20 February 2008 (UTC)

It's all implied, Eubulides. What is the 1 modality of chiropractic care? spinal manipulation. What do chiropractors try to do? early intervention and correct structural imbalances (spine, ankle, anywhere) while in their functional state. Really the quote is straight forward. Considering that naturopathy and chiropractic care have common philo tenets, it's not surprising that this is similar. Where in naturopathy though, does it say that structure needs to be corrected in its functional state? EBDCM06:49, 22 February 2008 (UTC)

I'd rather have ChiropracticPhilosophy state philosophy clearly rather than leave so many matters implied. Janse's quote does not mention structure anywhere, so I'm not sure what you meant in that question about structure. Eubulides07:38, 22 February 2008 (UTC)

It greatly emphasizes prevention, but reliable secondary sources mention prevention only briefly, or do not mention prevention at all. This is way too much weight on prevention.

It mentions prevention and early intervention and attemtpts to contrast specific chiropractic prevention in the form of manipulation of functional disorders which is unique to chiropractic as well

But the discussion of prevention does not mention manipulation. It's generic. Eubulides17:36, 20 February 2008 (UTC)

Does it really have to spelt out what the primarily modality used is in chiropractic practice? What is chiropractic generally synonymous with (don't say quacks, lol..!) EBDCM19:30, 20 February 2008 (UTC)

Yes, the core part of chiropractic philosophy, the part that distinguishes it from other forms of health care, should be spelled out in the philosophy section. Eubulides21:25, 20 February 2008 (UTC)

What is "core" chiropractic philsophy, Eubulides? Subluxation or manipulation? EBDCM00:04, 21 February 2008 (UTC)

The text box is preceded by "In summary," but it does not summarize all of chiropractic philosophy; instead, it is taken verbatim from part of Mootz Phillips 1997's summary, and this omits several concepts mentioned elsewhere in Mootz Phillips:

*vitalism (e.g., innate intelligence) vs materialism (e.g., restoration of structural integrity)

*dogma vs scientific method

Vitalistic qualities are only performed by a minority of chiropractors and it could be suggested that the article already has undue weight in this regard

Dogmatic qualities are not held by the majority of the profession

Vitalism and dogmatic qualities are held by a significant minority of the profession. They should be mentioned. Otherwise, the article is biased in favor of reformers and against mixers. I am not saying that the philosophy section should emphasize vitalism, only that it should mention it. If the article has undue weight elsewhere on vitalism, perhaps that material should be moved into the philosophy section where it belongs. Eubulides17:36, 20 February 2008 (UTC)

What is significant minority? 20%? Why the superfluous adjective, significant? Do you have a source? I agree, vitalism should be used primarily in a historical context without undue weight. 80% of the profession does not practice according to vitalistic principles. Mixers are not vitalistic as you suggest. Phillips et al. has already provided evidence of this. Mixer/reform are form the overwhelmingly majority and their views, accordingly, deserve more weight. They're also the only one's evolving chiropractic philosophy as the straights still abide by Palmers original principles.EBDCM19:30, 20 February 2008 (UTC)

Yes, 20% would be a significant minority. African-Americans are a significant minority of Americans, even though they are less than 20% of Americans. A brief mention of vitalism is all that it takes, appropriate for a significant minority . Eubulides21:23, 20 February 2008 (UTC)

Do you have a reliable source that states significant minority specifically or are you editorializing? EBDCM00:02, 21 February 2008 (UTC)

as well as these ideas mentioned in the philosophy chapter of "Principles and Practice of Chiropractic", 3rd edition:

*There is a wide diversity of beliefs.

This is common knowledge and has already been ackownledge several times in the article, more undue weight

This is the first part of the article. People who read to this section won't necessarily know that there is a wide diversity. It costs only 7 words to mention it here. If there is a real duplication, then that can be removed from later sections. I disagree that it is common knowledge; it is common knowledge to chiropractors but not to the general public. I would guess most readers of Wikipedia don't know a straight from a mixer. Eubulides17:36, 20 February 2008 (UTC)

*Homeostasis (this is mentioned in the 2nd sentence, but not in the summary)

Let's put this in the summary box

*Holism (again, mentioned above, but not in summary)

Let's put it in the box

*Conservatism (mentioned only indirectly; should be spelled out)

Several examples of conservatism are found in the text box

This is supposed to be a philosophy section. It should cover the philosophy, not simply list examples and leave the reader to infer the philosophy. Eubulides17:36, 20 February 2008 (UTC)

The reader should be able to decide for themselves, this ensures NPOV. I'd rather have the reader infer than have a you define it for them. EBDCM00:02, 21 February 2008 (UTC)

*Strategic role of the nervous system (again, this is central to chiropractic, and should be in any summary)

This is in the summary already

You're right, I missed it; thanks. Eubulides17:36, 20 February 2008 (UTC)

*Desire for professional autonomy

This has nothing to do with philosophy per se.

It is a central motivation for the existence of the philosophy in the first place. As such, it belongs in the philosophy section.

DD Palmer was already philosophizing before BJ. BJ simply used it as a legal tactic. EBDCM00:02, 21 February 2008 (UTC)

*Chiropractic philosophy evolved partly out of a need for legal and political defenses for the profession in its early ears. Initially, it rejected the inferential reasoning of scientific method in favor of deduction from first principles.

This was a legal tactic already covered in medical opposition and does not need to be mentioned in the philosophy. Undue weight for history of philo again rather than accepted modern day principle amongst all factions

Again, people who are reading this article front to back won't know about the medical opposition. Furthermore, the medical opposition does not cover this important legal tactic. It would be OK to cover it there, but it should also be briefly mentioned here, since the two topics are connected.

*Classical philosophy is a process of probing and skeptical inquiry, and matches well to the epistemology of science favored by many modern chiropractors.

??

It was in the reliable source, and was emphasized heavily. Certainly the connection to classical philosophy is relevant to a philosophy section. Eubulides17:36, 20 February 2008 (UTC)

*Chiropractors have employed many epistemologies, including empiricism (e.g., private research), rationalism, spiritual inspiration, and the scientific method. They have also employed logical fallacies, which are chaff that need to be separated from the wheat.

This is a historical account again (primarily) and would better be suited in the scientific inquiries section.

Again, it's fine to cover it there, but it should also be briefly mentioned here. Eubulides17:36, 20 February 2008 (UTC)

What profession hasn't employed logical fallacies at some point? Why the special mention, Eubulides? EBDCM00:02, 21 February 2008 (UTC)

The cited source labels the text box "Chiropractic Perspectives That Reflect a Holistic Approach to Patient Care", but it's relabeled "Chiropractic perspectives to patient care" in the article, giving the incorrect impression that these are all the chiropractic perspectives (they're not; as the cited source says, they're merely perspectives that reflect a holistic approach to patient care)

Within the "holistic approach" text box you will find all the attributes you mentioned (conservatism, non-invasiveness, supremacy of nervous system)

Not all the attributes are mentioned explicitly; conservatism is not. And this doesn't address the point, which is that text box is mislabeled. Eubulides17:36, 20 February 2008 (UTC)

The citation to Rupert 2000 is weak. The article claims that chiropractors "commonly use" nutrition etc., but that is not what Rupert 2000 was measuring (it was just a survey about chiropractors' beliefs). At any rate this part should be deleted since it is not a core part of chiropractic philosophy.

Chiropractic prevention, whether or not its early intervention are conservative appraoches (exercise, nutrition, counseling, health promo, public edu) have been already documented by verifiable and peer-reviewed sources. This is also common knowledge. We can find a better reference though

I am not arguing that chiropractic prevention is unimportant. I think it's important and should be covered. The point is that it's not a core or important part of chiropractic "philosophy". Prevention belongs in another section, on practice not philosophy. Eubulides17:36, 20 February 2008 (UTC)

Thanks for your opinion again, Eubulides, but a majority of editors disagree that it's not part of philosophy and I have already provided verifiable citations that supports this claim. EBDCM00:02, 21 February 2008 (UTC)

The quote by Janse is dated, is clearly POV, is confusing as to who it's talking about (with multiple editorial interpolations, interpolations that I find dubious) and disparages mainstream medicine; the article cites it approvingly and the other side's view is not given. Appropriate weight should be given to the mainstream view here. The Janse quote is in such bad shape that the simplest thing is to replace it with something better. But again, the point about prevention should not be emphasized so much, since reliable secondary sources on chiropractic philosophy do not emphasize prevention that much.

Reliable primary sources and textbooks, chiropractic curriculums and clinical practice habits emphasize it. EBDCM00:02, 21 February 2008 (UTC)

Janse's quote is fine and accurately describes the divide in medical and chiropractic philosophy. It has been prefaced with the 'source of controversy and confusion' which sets up the quote. The article does not 'approve' of the quote per se but rather uses it illustrate a fundamental difference between mainstream and chiropractic approaches. Also your continued insistence that only secondary sources is worth adding here is not in the spirit of wiki:meds. They are only guidelines and your interpretation of it is rather rigid and omits perfectly good, verifiable and peer-reviewed sources. Also, it's worth considering why a MEDRS is even application to an alt-med article; if there are a different set of guidelines (I don't know I'm asking) they should be considered as well. EBDCM16:17, 20 February 2008 (UTC)

Eubulides

10:18, 20 February 2008 (UTC)

Janse's quote does not accurately describe the divide. It makes claims about mainstream medicine which mainstream medicine strongly disagrees with. It claims that mainstream medicine does not "realize exactly what is meant by disease processes", and that chiropractic does. The article clearly approves the quote, and holds it up as an illustration of the right way to distinguish chiropractic from mainstream medicine. I have never said that "only" secondary sources should be used; I argue only what MEDRS argues, which is that they should be preferred when available. Is it your position that alternate medicine should have a lower standard for reliable sources than mainstream medicine does? Eubulides17:36, 20 February 2008 (UTC)

Wrong again, Eubulides. I'm suggesting that medical journals are not the most appropriate place to look for chiropractic philosophy papers and when there are numerous primary sources from chiropractic journals they should not be ignored. I will ask that you please stop using MEDRS as a crutch; they're merely guidelines and not rigid rules that you claim they are. Are you disputing this as well? EBDCM00:02, 21 February 2008 (UTC)

EUBULIDES' PROPOSAL:

Philosophy

This draft is now obsolete. See Philosophy 2 below for a more-recent draft. Eubulides07:52, 22 February 2008 (UTC)

Early chiropractic philosophy emphasized spiritual inspiration and rationalism.cite book |author= Keating JC Jr |chapter= Philosophy in chiropractic |pages=77–98 |title= Principles and Practice of Chiropractic |edition= 3rd ed. |editor= Haldeman S, Dagenais S, Budgell B "et al." (eds.) |publisher=McGraw-Hill |date=2005 |isbn=0-07-137534-1 Having a philosophy based on deduction from irrefutable doctrine helped distinguish chiropractic from medicine, providing it with legal and political defenses against claims of practicing medicine without a license, and allowing chiropractors to establish themselves as an autonomous profession. This "straight" philosophy, taught to generations of chiropractors, rejects the inferential reasoning of the scientific method, and relies on deductions from vitalistic principles rather than on the materialism of science. As chiropractic matured, many practitioners accepted the role of the scientific method, although this has not yet achieved consensus.

Although a wide diversity of beliefs exists among chiropractors, even practitioners who distance themselves from straight chiropractic share three principles:cite book |author= Gay RE, Nelson CF |chapter= Chiropractic philosophy |chapterurl=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=altrehab.section.336 |editor= Wainapel SF, Fast A (eds.) |title= Alternative Medicine and Rehabilitation: a Guide for Practitioners |date=2003 |isbn=1-888799-66-8 |location= New York |publisher= Demos Medical Publishing

The spine and health are related in an important and fundamental way, and this relationship is mediated through the nervous system.

Health can be degraded by vertebral subluxations, which are mechanical and functional disorders of the spine.

Health may be restored by correcting subluxations.

Chiropractic philosophy goes beyond simply manipulating the spine. Like naturopathy and several other forms of complementary and alternative medicine, chiropractic assumes that all aspects of a patient's health are interconnected, which leads to the following perspectives:cite book |chapterurl=http://chiroweb.com/archives/ahcpr/chapter2.htm |chapter= Chiropractic belief systems |author= Mootz RD, Phillips RB |date=1997 |title= Chiropractic in the United States: Training, Practice, and Research |pages=9–16 |editor= Cherkin DC, Mootz RD (eds.) |accessdate=2008-02-14 |version= AHCPR Pub No. 98-N002 |location= Rockville, MD |publisher= Agency for Health Care Policy and Research |oclc=39856366

"'Holism"' treats the patient as a whole, and appreciates the multifactorial nature of influences (structural, chemical, and psychological) on the nervous system, recognizing dynamics between lifestyle, environment, and health.

"'Conservativism"' carefully considers the risks of clinical interventions when balancing them against their benefits. It emphasizes noninvasive treatment to minimize risk.

"'Homeostasis"' emphasizes the body's inherent recuperative abilities. Chiropractic's early notion of innate intelligence can be thought of as a metaphor for homeostasis.

A "'patient-centered"' approach focuses on the patient rather than the disease, preventing unnecessary barriers in the doctor-patient encounter. The patient is considered to be indispensable in, and ultimately responsible for, the maintenance of health.

Comments on above draft

The above draft draws heavily on the 3rd edition of "Principles and Practice of Chiropractic" (2005). It also cites Mootz Phillips 1997, which is far less comprehensive and a bit dated, but is freely readable. Likewise, it cites Gay Nelson 2003, which is very brief but is also freely readable. I have done my best to stick to reliable secondary sources, as per MEDRS. These sources did not mention prevention as being core so I have omitted prevention. Eubulides07:30, 20 February 2008 (UTC)

This is completely wrong from the start, and quite frankly that's to be expected when a mainstream medicine proponent writes the chiropractic philosophy section. It first started when you suggested that 'reform' chiropractors correct vertebral subluxations. You've also completely ignored any other source besides from secondary sources but still primary sources that from peer-reviewed publications and reputable textbooks.

MEDRS suggests preferring reliable secondary sources to primary sources when both exist, which is the case here. Part of the problem with the existing ChiropracticPhilosophy is that it attempts to stitch together primary sources, which inevitably involves POV from the editors. We cannot escape POV entirely, but it's much better for us to rely on expert POV than to use our own. I have attempted to do that in the above draft. Eubulides08:18, 20 February 2008 (UTC)

http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=altrehab.section.336 Gay Nelson 2003 say that "Correction of subluxations may bring about a restoration of health" is a "central principle" that "defines" the chiropractic profession, and that "This is true even among those factions of chiropractic that have attempted to distance themselves from their philosophic roots." This is the source I was relying on for the point you dispute. Do you disagree with the source, or with my summary of it? If the latter, how can I improve the wording? If the former, what source would be better? Eubulides08:18, 20 February 2008 (UTC)

So much for the reliable secondary source: look at the conclusion "...a chiropractor's primary clinical purpose is to identify and correct spinal subluxations. Doing so will lead to the restoration and maintenance of health". This sounds like straight philosophy, particularly objective straight. What about mixer/reform sentiments? The secondary source has not included nor differentiate important differences amongst the main groups. Hence, the necessity to be somewhat general in the philosophy section to incorportate themes that all DCs espouse. No one is distancing from 'philosophical roots' its rather an evolution of chiropractic philosophy and this article mentions nothing of it. EBDCM16:56, 20 February 2008 (UTC)

The current section distances itself from this core part of chiropractic philosophy so much that it spends only one sentence on it (and one small bullet in a long summary). That's too much distance. The section should give proper emphasis to this core and unique part of chiropractic. Currently it gives way too much emphasis to the reform side. If you prefer my substituting "Principles and Practice of Chiropractic" as the reliable source, and rewriting the text to match that, I will do that; my only preference for the current source is that it's freely readable. Eubulides17:50, 20 February 2008 (UTC)

Where in any text has it suggested that it was "core"? Philosophy is a dynamic and evolving process; chiropactic's philosophy is no different. If anything, you're given undue weight to subluxation correction as part of philosophy and the majority of the profession (not just reform but mixers as well) have evolved past the one cause one cure routine. Furthermore, there is no mention of 'reform' anywhere in the philosophy section so I don't see how your claim that 'there is too much emphasis on reform'. Regardless, I don't think we're too far off, we can improve the text box to specifically include words such as homeostasis, conservatism and other suggestions you made and reference them accordingly. EBDCM19:11, 20 February 2008 (UTC)

Dematt made a concrete suggestion about that secondary source in Philosophy 2 below, by removing the second two bullets. This is fine with me; I hope that resolves this particular issue. Eubulides21:14, 20 February 2008 (UTC)

Furthermore the reason chiropractic had to adopt the legal tactic vitalistic philosophical distinction because mainstream medicine was prosecuting chiropractors. Give me a break, Eubulides, you completely fail to incorporate any context into the matter which is required to accurately portray the argument. It's a fallacy otherwise. EBDCM07:51, 20 February 2008 (UTC)

The current draft states that the philosophy helped early chiropractic, "providing it with legal and political defenses against claims of practicing medicine without a license". Doesn't that make it clear that mainstream medicine was prosecuting chiropractors? If not, what better wording would make it clearer? The wording I am using attempts to summarize the cited source, but obviously we also want the wording to be clear. Eubulides08:18, 20 February 2008 (UTC)

You don't get it. I'm done debating with you. Your continued insistence to ONLY require secondary sources is noted; but wikipedia policy allows for reputable primary sources as well; especially if secondary sources on the subject has not yet been published. As I have mentioned several times already; guidelines allow for flexibility with sourcing and advancing arguments. EBDCM08:24, 20 February 2008 (UTC)

I have not insisted on ONLY secondary sources; all I've said is what MEDRS says, which is that secondary sources are to be preferred when both kinds of sources are available. Relying on primary sources is far more likely to lead to bias introduced by the editors; that is why secondary sources are preferred. Chiropractic should strive for the highest-quality sources available. Eubulides08:38, 20 February 2008 (UTC)

Then why the desire to get rid of all the non-secondary sources in chiropractic philosophy? Why oppose chiropractic prevention? I've clearly it from mainstream med prevention. I personally think CynRNs suggestion is the best. Surely we could be doing worse than citing primary sources, textbooks AND secondary sources. Chiropractic research is still dwarfed by conventional med hence there simply isn't that many secondary sources available but that doesn't mean you reject primary sources. of what has long been considered common knowledge amongst chiropractors because you can't track down a secondary source. Regarding you argument that Philips et. al is dated, 1997 is hardly bad, especially considering that certain papers from 1955 are still be referenced, as they should. —Preceding ) 09:13, 20 February 2008 (UTC)

If we have reliable secondary sources saying one thing, and some primary sources disagreeing, then the secondary sources are to be preferred. The reasons for this are discussed in MEDRS: it's too easy for an editor to stitch together whatever story they like out of primary sources. Secondary sources exist to give the proper perspective by experts, and in particular to tell us what is important and what is not; we shouldn't substitute our own opinion about what is important, when that opinion is already available in reliable secondary sources. Mootz Phillips is only somewhat dated; I prefer the 3rd edition of "Principles and Practice of Chiropractic" on that front because it's dated 2005; it's much more extensive and higher-quality coverage over all. Its main disadvantage is that it is not freely readable. Eubulides09:30, 20 February 2008 (UTC)

You didn't address my question and no need to sermon me on secondary sources; I've heard you for the past week. 1) Just because the secondary sources obtained does not per se. mention prevention does not mean that it overrules common knowledge amongst chiropractors and primary sources that does cites prevention and raises separate points not covered in the secondary sources. Your synth insinuations again are noted and I consider them inflammatory and lack of good faith. If the majority of editors felt I was synthing they would be reverted. You are the only one who suggests that I am doing this whereas I am providing extremely VERIFIABLE, RELIABLE, SCIENTIFIC sources that backs up the claims made. EBDCM09:39, 20 February 2008 (UTC)

Sorry, I thought I answered your questions, but let me try to do so more clearly.

You asked "why the desire to get rid of all the non-secondary sources in chiropractic philosophy?" It's because we have higher-quality secondary sources that do not agree with the primary sources in question. MEDRS says that in such situations, one should not use primary sources to undermine the secondary sources.

You asked "Why oppose chiropractic prevention?" I don't oppose chiropractic prevention. I simply don't find significant mention of it in reliable secondary sources. There's nothing even remotely approaching the weight given it in ChiropracticPhilosophy. This is an UNDUE issue.

You don't oppose prevention but your draft mentions nothing of it despite the many sources I've provided. You are mis-interpreting the weight; Janse's quote is not simply about prevention it explains the philosophical divide between med and chiropractic

I don't oppose prevention. It belongs in some other section, that's all. Janse's quote is introduced as being relevant to prevention; if it's about something else as well, the introduction should say that and place it in its proper context. Eubulides17:50, 20 February 2008 (UTC)

I disagree with the contention that "there simply isn't that many secondary sources available" for chiropractic philosophy. Several books talk about chiropractic philosophy. I've merely taken the most recent reliable one I could find.

Exactly, you've cherry picked a source which supports your claim while ignoring the books I mentioned which suggests otherwise.

I have looked at several sources, which I've cited. I have relied most heavily on the most-recent and most-reliable source, but it is not the only source. This is not cherry-picking; it's looking for the best available sources and then writing what they say. Eubulides17:50, 20 February 2008 (UTC)

I also disagree that one can rely on "common knowledge" to overrule reliable secondary sources. If it's common knowledge that prevention is core to chiropractic philosophy, then one would expect to see prevention discussed at some length in reliable sources that talk about chiropractic philosophy. I've read pages and pages of chiropractic philosophy discussed in a recent textbook, without seeing prevention mentioned. And yet ChiropracticPhilosophy devotes two paragraphs out of four to prevention. This is an UNDUE issue.

reliable, secondary sources are not always valid depending on the context. Here your argument is not valid. Also, chiropractic journals are NOT medical journals. This is an important distinction considering that medicine has long been antagonistic toward chiropractic which is proven, BTW. I've also read pages of chiropractic philosophy in a textbook and saw prevention mentioned. 2 paragraphs are not dedicated to prevention; Janses quote is bigger than that. It has already been prefixed with 'a source of controversy and confusion in the medical community' which provides appropriate context.

Janse's quote is part and parcel of a long discussion on prevention. Even if the quote were absent, there would still be undue weight on prevention. My sources are not taken from either chiropractic journals or medical journals; they are taken from textbooks. If you have read pages of chiropractic philosophy in a textbook and seen prevention mentioned heavily, please cite it. I don't follow your statement that "reliable, secondary sources are not always valid"; please explain. Eubulides17:50, 20 February 2008 (UTC)

My criticism here is based on undue weight, not synthesis.

ChiropracticPhilosophy currently relies on sources that are lower-quality than "Principles and Practice of Chiropractic", 3rd ed. Wikipedia should strive for the highest-quality sources.

No, it relies on sources other than exclusively PPC, which meet every single inclusion criteria and thensome. I have provided textbooks which mention prevention in philosophy as well. EBDCM16:44, 20 February 2008 (UTC)

Of the four examples you cited, two actually supported the claim that prevention is peripheral to chiropractic philosophy, one is from an earlier edition of a textbook whose current edition does not contain the cited material, and the last one makes only a brief mention. None of these secondary sources are cited in the current article. Eubulides17:50, 20 February 2008 (UTC)

Eubulides

09:58, 20 February 2008 (UTC)

Outdated comments on above draft

(The comments below are out of date now; the draft has been completely rewritten since they were made.) Eubulides07:30, 20 February 2008 (UTC)

This sentence is dated, non-factual and should be deleted. Also, there is another sentence saying virtually the same thing in the next paragraph:"The philosophy of chiropractic favours a holistic and biopsychosocial model of disease in contrast to the reductionist and biomedical model used in allopathic medicine." CynRNCynRN23:32, 18 February 2008 (UTC)

When you write "This sentence is dated" which sentence are you referring to? Eubulides07:50, 19 February 2008 (UTC)

"The philosophy of chiropractic favours a holistic and biopsychosocial model of disease in contrast to the reductionist and biomedical model used in allopathic medicine" I think it is dated because,philosophically, physicians have recognized the importance of the 'biopsychosocial' model for decades. CynRNCynRN19:03, 19 February 2008 (UTC)

"Because chiropractors emphasize the importance of healthy lifestyles and do not prescribe drugs or perform surgery, chiropractic care is appealing to many health-conscious Americans. Chiropractic treatment of the back, neck, extremities, and joints has become more accepted as a result of research and changing attitudes about alternative, noninvasive health care practices."cite web |url=http://stats.bls.gov/oco/ocos071.htmoutlook |author= Bureau of Labor Statistics |title= Occupational outlook handbook |date=2007 |accessdate=2008-02-14

I have taken the initiative and began reworking the philosophy section. As per Eubulides recommendations, I've added what makes chiropratic philosophy unique, added bits about conservatism, homeostasis and clarified the chiropractic model on prevention. I also sought to provide more context for Janses quote (while adding his credentials so readers know what his academic background was) to give the quote a bit more perspective. I also contrasted, compared and clarified several chiropractic and medical approaches to health care whilst acknowledging the similarities in philosophy of chiropractic with other CAM professions and highlighting differences as well. EBDCM19:54, 17 February 2008 (UTC)

In my opinion, the Janse quote mischaracterizes allopathic medicine. Dr. Engel formulated his biopsychosocial model in 1977, which has been welcomed by 'allopaths'. The statement tends to set chiropractors up as leaders in preventative medicine in opposition to other professions. CynRN 22:37, 17 February 2008 (UTC)

I'm not sure this is accurate: ""The traditional, "allopathic" or "medical" model considers disease to be generally the result of some external influence, such as a toxin, a parasite, an allergen, or an infectious agent, and the solution to be the countering of the perceived environmental factor; for example, using an antibiotic for a bacterial infection."" I thought traditional medicine tended to consider a disease such as, for example, "Attention Deficit Disorder" to be something that someone "has", that is "diagnosed" and then "treated" with a drug, while it's the alternative-medicine types who tend to view that same condition as something caused by an external factor such as mercury, lead, vaccinations, food colouring, etc. --Coppertwig02:20, 18 February 2008 (UTC)

Hmmm, that is a good point. Generally speaking you're correct that the 1 treatment by conventional medicine is medication (primarily synthetic drugs) but I don't want it to come off as derogatory, especially since I am a chiropractor and could be accused of COI. What do you propose to clarify this further? EBDCM03:00, 18 February 2008 (UTC)

I'm sure I could find quite a few good refs re. traditional physicians following the biopsychosocial model. Consideration of the 'whole person' is central to nursing,certainly, and to the physicians that I work with.I think the Janse quote is inherently negative toward non-chiropractic doctors. A physician may take offense by such a phrase as "fail to recognize what is meant by the disease process", and by implying that he/she does not care about prevention. CynRN 07:15, 18 February 2008 (UTC)

Current changes

This http://en.wikipedia.org/w/index.php?title=Talk:Chiropracticdiff=nextoldid=192313711 diff shows the changes that were made to date. -- Dematt Dēmatt 15:19, 18 February 2008 (UTC)

I think the first two paragraphs could be merged as they are both saying the same thing in different words. -- Dematt Dēmatt 15:52, 18 February 2008 (UTC)

I have noticed that this sentence is not an up-to-date description of medicine. 'The philosophy of chiropractic favours a holistic and biopsychosocial model of disease in contrast to the reductionist and biomedical model used in allopathic medicine.'1415. For decades, physicians have been incorporating the biopsychosocial model:http://cnx.org/content/m13589/latest/

Also, what is the reference for this statement? 'Unique within the philosophy of chiropractic is the ability to regulate health by improving nervous system functioning via the correction of structural imbalances/dysfunction of the neuromusculoskeletal system.'Is it just common knowledge? Yes, I agree, if the two first paragraphs are merged the section will flow much better. It is a bit redundant and these troublesome sentences can be deleted.CynRN 21:03, 18 February 2008 (UTC)

So called 'allopathic' medicine has incorporated the biopsychosocial model into practice for at least the last several decades.IMO it's not accurate to imply that chiropractic is on the other end of the spectrum in that regard:http://cnx.org/content/m13589/latest/CynRN23:41, 18 February 2008 (UTC)

Although conventional medicine has began to embrace the biopsychosocial model to an extent, the dominant model is still the biomedical one. Nevertheless, I think we can amend the section and put in a qualifier such as 'primarily'. There are holistic MDs out there too, but they're still primarily reductionist. That's not a criticism, but a fair statement of how things are currently. Regarding the Janse statement, although there may be some POV words in there, the context in which the quote was used was NPOV. EBDCM01:28, 19 February 2008 (UTC)

As far as the Janse statement, perhaps that is another reason to keep his credentials in the article, so that readers can see that it is a chiropractic educator that made the statement and can draw their conclusions from there. If we just leave it at Joseph Janse, then for all they know, he was a science guru, which, btw, he was. I don't think DC is quite the peacock as MD or even PhD. -- Dematt Dēmatt 02:48, 19 February 2008 (UTC)

As things stand, the text cites Janse approvingly and thus seems to agree with his egregiously NPOV words. This is a key part of why the article, as it stands, is not at all neutral about chiropractic. Janse is cheerleading for chiropractic, and is cheerleading against mainstream medicine, and ChiropracticPhilosophy is cheering Janse on. Putting "DC, ND" does not help the non-expert reader; they won't know what those acronyms mean, although they will get a vague sense that Janse is an expert and so his words should count more than usual (and so this is yet more cheerleading for chiropractic). Eubulides07:59, 19 February 2008 (UTC)

"Like many complementary and alternative medicine professions, chiropractic care espouses a naturopathic approach to health which suggests that lowered "host resistance" faciliates the disease process, and therefore treatments should be directed towards strengthening the host from within via natural and conservative methods to improve homeostasis and regulate physiological mechanisms."

I am not sure that I agree with this statement. What is it that causes a lowered "host resistance"? Poor posture? Subluxations? Repetetive microtrauma? How does someone coming in after a car accident with a WAD injury fall into the framework of this naturopathic approach? I could just be misunderstanding the statement, but as is I don't think I agree. DigitalC06:07, 19 February 2008 (UTC)

"The chiropractic approach to health care stresses the importance of prevention and primarily utilizes conservative therapies and a wellness model to achieve this goal."

Again, I am not sure if I agree with this statement. Would exericse and diet be considered a wellness model? What are the efforts of Chiropractors aimed at prevention? Public awareness campaigns on lifting and backpacks?DigitalC06:12, 19 February 2008 (UTC)

I included the reference for exercise, diet, lifestyle counseling, etc. It doesn't matter what "'caused"' the decreased host resistance, the emphasis is on the "'approach"' they take to restore it. I think you're misunderstanding it a bit! x EBDCM 06:41, 19 February 2008 (UTC) I think the last bit claims too much and is poorly worded, besides.: "In addition to early intervention, chiropractors also commonly use nutrition, exercise and lifestyle counseling as part of their holistic outlook towards prevention and suggests that the level of primary care, health promotion and prevention activities of chiropractors surpasses that of other physicians" Can the last phrase be cut out and the rest of it inserted somewhere above? It was a survey of attitude, not measuring time spent in health promotion/prevention.CynRNCynRN 09:01, 19 February 2008 (UTC)

Cyn RN, I'm sure something can be worked out. Do you not feel that attitude towards health promotion and prevention is an important indicator of the chiropractic stance on prevention is notable? Eubulides continues to suggest it's not part of chiropractic philosophy despite citations and consensus opinion from chiropractors that suggests otherwise. How about we split the difference and reword it, move it up but that you consider altering your stance that the Janse quote is used to bash medicine and proclaim the glories of chiropractic. I think by now you can tell the my contributions here are NPOV (see my recent edit on contraindications in the safety section, for example) and I really wouldn't say anything that was not only verifiable, but at the very least a reputable source attached to it (peer-reviewed journal, for example). Looking forward to your reply. EBDCM15:52, 19 February 2008 (UTC)

I am not at all suggesting, nor is Eubulides(I think), that prevention is not part of chiropractic philosophy. The article, now, seems to 1,Emphasize prevention too much (above other notable tenets of chiropractic philosophy), 2,Set up chiropractic as the premier provider of prevention. I'm not imputing any motives to you one way or the other, but the POV of the Janse quote is cheerleading for chiropractic and against medicine. I think the unfortunate consequence of leaving the Janse quote in the article will be the occasional 'allopathic' med person reading the article and thinking "what nerve!" and "how dare they!". What about community prevention efforts, which are spearheaded by public health physicians and nurses? CynRNCynRN19:22, 19 February 2008 (UTC)

(outdent)Family physicians are also overwhelmingly in favor of prevention. In 1991, a survey of North Carolina GPs found that 96% "agreed that (they) should assist asymptomatic patients in reducing behavioral risk factors" http://www.cdc.gov/MMWR/preview/mmwrhtml/00017371.htm

In the UK, in 1994, "93% of GPs had, on at least one occasion, suggested a referral for an alternative treatment...over 20% of GPs were Practicing alternative medicine" This included acupuncture, chiropractic, homeopathy and naturopathy.

http://www.jrsm.org/cgi/content/abstract/87/9/523

So where is the huge dichotomy between physicians and chiropractors in regard to prevention or even 'holistic' care? What Janse says may be what chiropractors believe is so, but it's not reality, as far as who is thinking about or practicing prevention. —Preceding ) 23:05, 19 February 2008 (UTC)

Hi CynRN. Thank you for your constructive comments. I don't think that the article insinuates that physicians and other mainstream health professionals such as RNs aren't interested in prevention; rather it contrasts the way they interpret patient signs (findings), the methods they use for prevention and the prevalence of practitioners who emphasize preventation and health promotion. If you feel that the article suggests that mainstream medicine does not favour or engage in preventative efforts, by all means lets correct for we all know this is not true. Again, chiropractic is by not any "premier provider" of prevention, but they approach it overwhelmingly by an naturopathic (natural therapies) and conservative manner in contrast to the allopathic model.

Regarding Janse, the whole quote isn't only about prevention; it touches upon, early intervention, differences in philosophy in terms of what should be treated and how amongst other things. I think we're getting closer to resolving this amicably, so let's keep working towards it. Suggesting that prevention is a part of chiropractic philosophy is a meaningful and good start. EBDCM23:15, 19 February 2008 (UTC)

&quot;ability to regulate health by improving nervous system&quot;

I have problems with the "'current manner of use"' of this sentence:

"Unique within the philosophy of chiropractic is the ability to regulate health by improving nervous system functioning via the correction of structural imbalances/dysfunction of the neuromusculoskeletal system."

I know that that is a unique part of the philosophy, and is a common claim, but, lacking any scientific evidence for the correctness of the claim, isn't it a bit dubious to use a PR statement like that "'"as is""'? Several of the words and phrases are mere claims: "ability to regulate health", "improving nervous system functioning", "correction", etc.. These are all fundamental claims based on the unproven existence of vertebral subluxations and their supposed influence on the nervous system and general health of the whole body. Such claims bring forth ridicule and criticism from mainstream and skeptical sources, and even some notable leaders and others in the profession (ACA lawyer, professors, historian, school president, national association leader, and authors) have warned about the continued use of such claims because of their detrimental effects on the professions's reputation, progress, and acceptance. Notable names like McAndrews, Keating, Carter, Homola, Charlton, Grod, Perle, Sikorski, and Winterstein come to mind.

See also http://www.chiroandosteo.com/content/13/1/17 Subluxation: dogma or science?:

"'Abstract"': Subluxation syndrome is a legitimate, potentially testable, theoretical construct for which there is little experimental evidence. Acceptable as hypothesis, the widespread assertion of the clinical meaningfulness of this notion brings ridicule from the scientific and health care communities and confusion within the chiropractic profession. We believe that an evidence-orientation among chiropractors requires that we distinguish between subluxation dogma vs. subluxation as the potential focus of clinical research. We lament efforts to generate unity within the profession through consensus statements concerning subluxation dogma, and believe that cultural authority will continue to elude us so long as we assert dogma as though it were validated clinical theory.

More can be found in the Internal criticism links.

"'Note"' that I am only objecting to using the statement "as is". I believe it "should" and even "must" be used (because of its importance and well-chosen wording), but it should be used in the context of using it as an example of very classic chiropractic philosophy that is very disputed both within and without the profession, and providing sources to those criticisms. Chiropractic philosophy always has been and still is a very notable and well-known and documented stumbling block and source of much controversy, and this fact should not be obscured, but deserves its own mention using good sources. The chiropractic criticisms would be quite excellent ones to use.

It could be used in this manner:

Unique within the philosophy of chiropractic is the claimed "ability to regulate health by improving nervous system functioning via the correction of structural imbalances/dysfunction of the neuromusculoskeletal system." ("Followed by discussion and sources of criticism of the claim.")

What think ye? -- Fyslee / 06:34, 19 February 2008 (UTC)

Hmmm, interesting point, Fyslee. The answer is simple though; and as usual it lies in the science and interpretation of it. Chiropractors primarily treat people in pain. With treatment pain goes away. Pain is subjective sensation; it is the summation of all the NOCICEPTIVE input from the peripheral nervous system, which then travels segmentally and then suprasegmentally in the brain (aka the biggest and most important nerve) where the signal is then modulated by the brain. The corresponding output, of the modulated signal is the PAIN sensation. As one of my profs once said "no brain, no pain".

Hence, the nervous system is intimately involved in our treatment, and our objective is to improving neurological function. This is not unique to chiropractic however any health professional that attempts to decrease pain is regulating nervous system function. Ronald Melzack who incidentally is Canadian (yay!), is a pioneer in pain research. His neuromatrix theory of pain is simply fascinating and a must read.

Many studies now show SMT as effective or better for treatment than conventional medicine for mechanical back pain syndromes and other NMS conditions. I would argue that this is good for health. After all, chronic musculoskeletal pain syndromes are the 1 reason for a PCP visit and the 1 reason for lost time claims. It's a big deal.

So, it's really been proven that chiropractors can improve health for NMS disorders(unless you think that removing someone's pain and disability is not really improving health) and inconclusive for non NMS conditions. No, the reality is, the success of chiropractic has never been at 'finding' the structural dysfunction (aka subluxation), the success lies in the art and science of spinal manipulation. It's all a matter of perspective, Fyslee... the science makes sense, but the message is incohesive. This causes confusion, then ridicule in the mainstream medical community but so much time is wasted on debating semantics and philosophies. It's time to move on and I see that trend happening by most of the profession (take a guess who's not! ;) EBDCM06:58, 19 February 2008 (UTC)

I think you are confusing the "dogma" mentioned above (unproven "improving nervous system functioning") with various effects from treating people, not necessarily even from adjustments, but other things that are happening at the same time which are producing results. Just because people are feeling better doesn't mean that it's because their nervous system is "functioning better." It is just reporting that something is feeling better. Fine. The "nervous system is functioning better" notion is pure subluxationist gibberish and that's always the way it has been used. That's simple chiro history. Revisionism doesn't change that fact. -- Fyslee / 05:02, 20 February 2008 (UTC)

Etymology

http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=192136992oldid=192135706 This change altered the etymology from ""chiro-" χειρο- hand- + "praktikós" πρακτικός action" to ""chiros" and "praktikos" meaning 'done by hand'". But the Oxford English Dictionary gives the former etymology. Specifically, it says "f. Gr. χειρο- + πρακτικός: see CHIRO- and PRACTIC a.". CHIRO- says "Gr. χειρο- combining form of χείρ hand …". PRACTIC says "ancient Greek πρακτικός concerned with action, practical, active, effective". I don't know of any reliable source that disagrees with the OED here; for now I changed it to ""chiro-" χειρο- 'hand-' + "praktikós" πρακτικός 'concerned with action'". Eubulides22:05, 17 February 2008 (UTC)

I think they are basically saying the same thing, tho yours is a bit more detail and it doesn't seem like you see it like that in many articles on WP. That said, in my research, I'd always seen it as "done by hand", hence my revert. But its not a huge deal for me so I won't revert.--Hughgr23:20, 17 February 2008 (UTC)

Well, I know ancient Greek and therefore I can say that "done by hand" is definitely wrong. cheir = Hand is undisputed, but praktikos, -e, -on is an ADJECTIVE and not a PARTICIPLE. "Done by hand" would mean cheiri prachthen (χειρί πραχθέν) in Greek. There is a set of substantialized adjectives to techne, "Art", which are taken over in western languages for sciences and co., eg. mathematike (techne) = mathematic, meaning "(art of) learning". arithmetike (techne), arithmetic, (Art) of numbers). Of course, the words like chiropracitc with no grammatical gender suffix COULD be anything, so you would circumscribe it in English with something like "related to, concernde with". But due to parallel usage mentionend above, I plead for the change formely used by me, although current version is correct. Anything but "done by hand". 12:36, 19 February 2008 (UTC)

Anon feel free to clarify if needed; whatever makes it more accurate then go for it! EBDCM15:41, 19 February 2008 (UTC)

I also would welcome any improvement, but it's important that the etymology be sourced. The source I'm using is the OED; it's not the only source, of course. Eubulides17:50, 19 February 2008 (UTC)

source is any ancient Greek dictionary, like the 22:27, 19 February 2008 (UTC)

"'Chiropractic"' (from Greek χείρ, -ος "chir,-os" and πρακτική "praktike", sc. τέχνη "techne", meaning "(Art of) doing by hand") Can we add this back in or do we need a greek reference. This may be the literal meaning and more accurate. QuackGuru05:20, 20 February 2008 (UTC)

We need a source for that alternative etymology. I've cited the OED chapter and verse for what's in there now (from Greek "chiro-" χειρο- "hand-" + "praktikós" πρακτικός "concerned with action"). Nobody has cited any source for any other etymology. This dispute cannot be resolved by going to a Greek dictionary, since "chiropractic" was originally derived in the U.S.; it is not an ancient Greek word. We need a source that also talks about English, not just Greek. Eubulides05:25, 20 February 2008 (UTC)

Very good points. The most important thing is Reverend Weed's intent and understanding. We don't know how good his Greek was. Right now the article contains this sentence:

"Friend and Rev. Samuel Weed suggested combining the words "cheiros" and "praktikos" (meaning "done by hand") and chiropractic was born."

It would be nice to have some sources to his utterances, or at least to the earliest utterances by DD Palmer on the issue of terminology. What did they say? -- Fyslee / 06:04, 20 February 2008 (UTC)

current or past version

Chiropractors generally do not have the authority to write medical prescriptions. "http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=nextoldid=191345640 I prefer Coppertwig's version."

It is generally not within the scope of practice of chiropractors to write medical prescriptions. "This is the current version."

Which version do you prefer. QuackGuru23:34, 17 February 2008 (UTC)

Thank you, QuackGuru. I appreciate the thought, and I'm sorry to let you down, but I actually prefer the http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=191801942oldid=191801384 version by EBDCM (i.e. the current version, ""It is generally not within the scope of practice of chiropractors to write medical prescriptions."") "Scope of practice" sounds to me much more like the sort of terminology you would tend to run across in articles about chiropractic and other health professions. I just didn't think of it when I wrote the "authority" edit. --Coppertwig02:10, 18 February 2008 (UTC)

Agree that "It is generally not within the scope of practice of chiropractors to write medical prescriptions." is a good NPOV way to say this. It does not have to differentiate whether 'writing prescriptions' is by choice or not, just that it 'not within the scope." Good work. -- Dematt Dēmatt 14:34, 18 February 2008 (UTC)

Great Improvement

It has been quite awhile since I have looked at this article, and I am impressed with the changes, especially the NPOV. Good work editors! DigitalC02:38, 19 February 2008 (UTC)

Thanks DigitalC, you were part of the impetus to do so. Feel free to join us! -- Dematt Dēmatt 02:49, 19 February 2008 (UTC)

Truncate/delete manipulative techniques table?

As part of our good but ongoing cleanup here, I propose we truncate or delete rather large table on the most frequent DC manipulative techniques. It's already on the main chiropractic technique page and could be seen as redundant. Let's make a deal! ;0 EBDCM06:35, 19 February 2008 (UTC)

Personally, I would agree with removing the table. I don't think that the techniques that chiropractors use are all that notable in the first place, but with the table being present on the chiropractic technique page, I don't think it needs to be in the main article as well. 08:27, 19 February 2008 (UTC)

First of all, I don't totally agree with the "cleanup" idea which is deleting and destabilizing a good article. It needs to be done only when ABSOLUTELY necessary, and this might be one place. We could do it by eliminating the table and just making it a long sentence without the numbers. Just simplify, not delete. -- Fyslee / 04:52, 20 February 2008 (UTC)

According to the banner on the top of the page regarding the cleanup taskforce I thought it was fair game. Re: the table to you want specific stats (36% USA DCs practice AK) or generalizations (some techniques practiced by chiropractors are regarded as dubious). I propose we add something regarding the purpose of various manipulative techniques as per CCA. The readers need to know all techniques are not just manual and joint manipulations. EBDCM05:06, 20 February 2008 (UTC)

The Cleanup Taskforce was invited to check the article when it was in terrible shape. Now that it is improved and stable, our job isn't general cleanup, but tweaking, possible new content, improving sourcing, etc.. Since the section also links to the techniques article (see it's beginning edit history..;-), more details can be found there, including numbers and statistics. We could add some more detail, or leave it up to the techniques article. -- Fyslee / 05:40, 20 February 2008 (UTC)

Neutrality Dispute Resolution?

I think we have made some important headway in addressing NPOV concerns. Are we ready to take down the dispute tag? EBDCM17:38, 19 February 2008 (UTC)

Yes. QuackGuru18:45, 19 February 2008 (UTC)

No, not at all. Review of philosophy section contains an active thread disputing the neutrality of ChiropracticPhilosophy. We currently have three editors who think that the section overemphasizes prevention, and two editors who say that the Janse quote is unduly biased against mainstream medicine. In contrast, two editors have weighed in in favor of the current material. This hardly constitutes consensus that the section is free of NPOV concerns. If it helps, I would support replacing the POV tag with a POV-section tag, since currently only that section is under review. I would like to review later sections for NPOV, once this unfortunately-long process of reviewing the first section is done, but that can wait until later. Eubulides20:33, 19 February 2008 (UTC)

Eubulides is right. The philosophy section is not NPOV yet.CynRNCynRN21:14, 19 February 2008 (UTC)

Eubulides is mis-representing some editors views. DigitalC wanted to see more common conservative preventative methods such as exercise, nutrition, patient education be addressed. Which three editors think prevention is overemphasized? Prior to CynRNs arrival, you were the only one who voiced concerns about bias against mainstream med. If you look at whole philo section and the whole article you will see there is no bias against mainstream medicine. You are taking one quote severely out of context. Janse was highly respected by within the chiropractic community and the scientific community. Again, the quote is for illustrative purposes and where the majority of DCs philo in terms of prevention comes from. It's essential for the article. EBDCM21:56, 19 February 2008 (UTC)

Be careful about charges of "mis-representation" as they can be construed as failure to AGF and personal attacks. Eubulides sees it that way, and from their POV may well be correct. I certainly have reservations about that and other sections, and am especially concerned about the fast paced solo editing that EBDCM is engaging in. Articles that are virtual tinder boxes of contention and dispute like this one must not be edited BOLDLY. That's disruptive and creates edit wars. Take nearly ALL edits here, except correction of direct policy violations, spelling and ref errors, and such like. Keep in mind that this article was relatively stable and a product of wide consensus editing before EBMDCM's arrival, and as a newbie we have been patient with him, but a resumption of BOLD editing is creating needless discussion here. Please discuss here first, achieve consensus, THEN make the edits. Only important edits are worth it. -- Fyslee / 04:38, 20 February 2008 (UTC)

DigitalC clarified his position and my interpretation of it was correct. Quack guru has told me to be bold, and you suggest no. It's up for interpretation and if the community feels that I am needlessly adding 'fuel to the fire' then we can slow it down a notch. I don't believe that it's a case of needless discussion; in fact the discussion (as I see it) has made this article the best it's ever been. Skeptics, critics and supporters alike are forcing editors to come up with the best citations possible. Still, 1/2 of this page was needlessly filled with certain assertions that prevention was not part of chiropractic philosophy and you did not back Dematt up when he calmly suggested that it was. I have demonstrated that I can, have and will discuss edits in talk, but do feel what I am writing quality edits to this project and hope you do not see me as a liability here. EBDCM04:57, 20 February 2008 (UTC)

DigitalC did not say that your interpretation was correct. His clarification's only mention of chiropractic philosophy was as follows: "Preventative manipulation, is not a part of chiropractic philosophy from the reform POV, because there is no evidence to suggest efficacy." In other words, DigitalC argues that many chiropractors think that one form of prevention is not a part of chiropractic philosophy. This is "all" he wrote about chiropractic philosophy in his clarification. This hardly constitutes agreement that prevention is core to chiropractic philosophy; on the contrary, it suggests the reverse. Eubulides06:58, 20 February 2008 (UTC)

""Preventative manipulation, is not a part of chiropractic philosophy from the reform POV, because there is no evidence to suggest efficacy."" Agree with this statement when considering manipulation for a well patient, also called maintenance care. But when considred as a 'reason to treat' an acute injury, the consideration is to slow or prevent further breakdown of tissue, adapative postures, and altered biomechanics in an effort to 'prevent' future manifestations of that injury. This is the form of prevention all chiropractors have in common. Maybe we could make that more clear. -- Dematt Dēmatt 19:01, 20 February 2008 (UTC)

Agreed, all Chiropractors do have this in common. DigitalC00:51, 21 February 2008 (UTC)

As for the edits to the page itself, I have been disappointed that Dematt's suggestion in Reworking Philosophy section was ignored. Aside from Dematt and myself, nobody edited the copy of the Philosophy section in the talk page; instead, major changes were immediately installed into the article proper. It would have been better to follow Dematt's suggestion. What I think is noncontroversial others are likely to disagree with, and vice versa. Eubulides06:58, 20 February 2008 (UTC)

You can lead a horse to water... :-) -- Dematt Dēmatt 19:01, 20 February 2008 (UTC)

If you would expend more of your energy here first, we'd all save time and edit wars. They are bad news. I don't doubt that you consider your edits to be "quality edits", and by normal website standards (no need for collaboration or accomodation of opposing POV) you are doing just that. It just doesn't work that way here, no matter how good they are. They need to be approved by others and then merged carefully into the article without tipping multiple balance lines (dozens!) that exist along certain locations known only to editors who have edited here for a long time. That's not your fault, since you couldn't be expected to know that, but by starting here you will have us all with you on the same page, and will also win our confidence. By all means continue. YOU aren't a liablity, but BOLD and solo editing here is taxing and unnecessarily irritating. -- Fyslee / 05:59, 20 February 2008 (UTC)

consensus or no consensus

http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=nextoldid=192706848s

I would like to get permission for this edit. Do I have any support. QuackGuru02:07, 20 February 2008 (UTC)

I disagree with this edit but commend QuackGuru for taking it to the talk page. Chiropractic care: Research and Criticism should not replace Scientific inquiriesEBDCM02:49, 20 February 2008 (UTC)

I fixed a redirect. That was it. I am confused about the disagreement. QuackGuru04:25, 20 February 2008 (UTC)

I have already done it before seeing this discussion. Consensus isn't necessary in the presence of clear policy violations. It must point directly to the existing article. If the title gets changed, then we can change it. -- Fyslee / 04:28, 20 February 2008 (UTC)

I have restored it to the title Scientific inquiries into chiropractic care which seemingly garnered the most agreement at the recent AfD. -- Levine211207:03, 20 February 2008 (UTC)

A few minor tweaks of philosophy section

The philosophy of chiropractic involves a contextual, naturopathic approach to health care, which suggests that lowered "host resistance" facilitates the disease process.14 Thus, treatments and care should be directed towards strengthening the host from within by increasing the hosts "adaptive potential" and regulating homeostasis. Chiropractic care primarily uses manipulation and other conservative and natural therapies rather than medications and surgery. 15 The philosophy of chiropractic also emphasizes a holistic and biopsychosocial approach to health care in contrast to the reductionist and biomedical model primarily used by allopathic medicine.1617 Chiropractic's unique claim to improve health by improving nervous system function by the manual correction of joint and soft tissue dysfunctions of the neuromusculoskeletal system differentiates it from mainstream medicine and other complementary and alternative medicine (CAM) disciplines.

Chiropractic philosophy also stresses the importance of prevention and primarily utilizes conservative therapies and a wellness model to achieve this goal. 18 In addition to early intervention, chiropractors also commonly use nutrition, exercise and lifestyle counseling as part of their holistic outlook towards prevention.20One aspect of chiropractic's approach towards prevention is its attempt to correct structural imbalances while in its primary, or functional state thereby preventing further deleterious sequalae culminating in objective pathological changes. This aspect of chiropractic wellness has been a source of controversy in the medical community. Today, physicians and chiropractors, alike, consider prevention an important tenet of health care. Joseph Janse attempted to describe this difference in chiropractic and medical philosophy regarding prevention and patient care, as he perceived it in 1984:

"Unless pathology is demonstrable under the microscope, as in the laboratory or by roentgenograms, to them allopaths it does not exist. For years the progressive minds in chiropractic have pointed out this deficiency. With emphasis they chiropractors have maintained the fact that prevention is so much more effective than attempts at a cure. They pioneered the all-important principle that effective eradication of disease is accomplished only when it is in its functional (beginning) phase rather than its organic (terminal) stage. It has been their contention that in general the doctor, the therapist and the clinician have failed to realize exactly what is meant by disease processes, and have been satisfied to consider damaged organs as disease, and to think in terms of sick organs and not in terms of sick people. In other words, we have failed to contrast disease with health, and to trace the gradual deteriorization along the downward path, believing almost that mild departures from the physiological normal were of little consequence, until they were replaced by pathological changes…"19

I added a qualifier that I think is needed to explain the Janse quote. It is necessary to acknowledge that chiropractors are not the only health professionals concerned with prevention, as the quote implies. If nothing is added to diffuse the negative slant toward physicians, it may cause constant edit problems. I think the Janse quote could be left out, but if not, it needs a 'reality check'. I also put the last phrase up into the second paragraph as it relates to prevention. What do you think?CynRNCynRN03:48, 20 February 2008 (UTC)

I dispute the changes made by Fyslee regarding a synth violation. This is common knowledge and the word "primarily" was the qualifier. Please discuss. Also the revert from the vaccination needs to be discussed as well. I think my edit was factual, better worded and is a an accurate representation globally, not just in North America. I will add "chiropractic prevention" as per Eubulides recommendations on Feb 12/08. Minor tweaks CynRN, and it'll look good! EBDCM04:38, 20 February 2008 (UTC)

The "synth" violation has to do with policy and sourcing. The source had nothing to do with chiropractic, and it is a synth violation to create such a sentence without the proper sourcing (which must mention chiropractic). A simple policy violation matter. Editorial opinion, even with sources, must not be included if it is done by such synthesizing of widely disparate sources. -- Fyslee / 04:42, 20 February 2008 (UTC)

Ok, I see. So, you're saying that if I can find a paper that mentions 'chiropractic' specifically in the context of reductionism and biomedical model of mainstream med I can use it? Why can't I contrast it? I've never heard of anything like this before as long as there verifiable sources that confirms medicine predominantly uses a reductionstic and biomedical model. Also, I'd like you to address my dispute re: vaccination. EBDCM05:01, 20 February 2008 (UTC)

As long as it is a V RS, it might be usable. Contrasting it by using different sources that don't all mention chiropractic is a SYNTH violation. If we do that, anyone can create an article based on their own thoughts and POV. We should start with the sources, and if an idea is notable enough, it will be possible to find good sources that directly address the issue in the context of the subject of the article. I know that sounds complicated, and it takes awhile to get one's head around some of these policies, but that's what makes an encyclopedia different from a website. The vaccination issue is another matter. That takes more time, and is why your BOLD editing is frustrating as it creates so many small fires that each take sometimes long threads here to discuss, that it's not worth it and your edits risk getting reverted just to bring us back to the original consensus version. Only change the article if you find serious problems. Discuss those problems here, develop a replacement along with other editors, then you'll have a replacement that will be a consensus version and will be protected by other editors. Assume that the existing article is a consensus version, and that your edits are upsetting the applecart, regardless of how much better you think your version must be. Not everyone will agree, and you will have started an edit war. Bad news! -- Fyslee / 05:12, 20 February 2008 (UTC)

What about the added qualifying sentence re. Janse? Any better way to say it?CynRNCynRN05:36, 20 February 2008 (UTC)

It will be better to omit Janse's quote entirely, as you suggested. Fixing it by adding qualifications would require many qualifying sentences, so much so that the article would resemble an internal debate. Eubulides07:04, 20 February 2008 (UTC)

Eubulides, I don't see many here in favour of omitting the quote entirely. Even CynRN has been more collaborative in this respect. It is properly defined now, the difference janse is explaining is maintenance care. EBDCM07:21, 20 February 2008 (UTC)

Agreed with EBDCM. The CCA citation provides sufficient verification. -- Levine211207:27, 20 February 2008 (UTC)

It's not a question of verification. It's a question of POV. Janse's quote is riddled with POV. Certainly the current version of ChiropracticPhilosophy does not properly qualify Janse's multiple aspersions against mainstream medicine. Again, I can write surrounding text to provide proper qualification, but it's going to have to be kinda long. Instead, I propose the shorter and more-to-the-point Philosophy rewrite above. Eubulides07:39, 20 February 2008 (UTC)

Is Janse not qualified to have that POV? So long as we reference that it is Janse's POV, we are okay. The "POV" we need to be worried about is ours - the editors - but we shouldn't omit the POV of reliable sources, especially if we cite it as their opinions. -- Levine211207:43, 20 February 2008 (UTC)

One cannot escape Wikipedia's NPOV requirement simply by quoting POV sources and then saying, "Well, those are accurately quoted, aren't they?" That is what is happening here. Janse's blatant attack on mainstream medicine is being cited approvingly by the article, without any presentation of the mainstream side. As a result, Chiropractic itself is clearly POV. It would be possible to present a neutral point of view overall, even with Janse's quote, but that will require a substantial addition of the other side's point of view. Eubulides07:58, 20 February 2008 (UTC)

No one is trying to "escape" NPOV by quoting a POV source, but yes, provided that we attribute the source you can absolutely quote POV sources that meet the requirements of RS and any other inclusionary policies. This is my understanding of policy. A good question to ask yourself is: How many sources can I think of that are without any POV? -- Levine211208:07, 20 February 2008 (UTC)

Obviously one can quote POV sources! That wasn't the question. The question is whether one can simply quote sources representing one side without presenting the other side, and thus escape the usual Wikipedia rule about being neutral. I don't think that would conform to Wikipedia policy on neutrality. If you disagree, I can ask at the relevant places where Wikipedia experts hang out, and see what they say. As for your second point, I am not claiming that we can find sources "without any POV". But it should be obvious that we can find sources more neutral than Janse's obviously partisan quote; or at least we can find material to balance Janse's quote. Either should be a no-brainer. Eubulides08:32, 20 February 2008 (UTC)

The Janse quote does an excellent job of describing a specific fundamental philosophical difference between chiropractors and allopaths. This is a philosophical difference ("id est" a difference in thought). Clearly this is a POV and the attribution makes that abundantly clear. What is the other side of this? That chiropractors and allopaths don't have this fundamental philosophical difference? Have you found reliable sources which make this comparison between chiropractic and allopathic philosophy and find not a contrast but rather a likening? If so, please present it here. -- Levine211216:47, 20 February 2008 (UTC)

I think part of the problem here is that medicine has changed as well since 1984. That was shortly after WIlk, so now it was suddenly okay for medical doctors to refer to and accept referrals from chiropractors. The NIH began the multidisciplinary studies of spinal manipulation that were unheard of before that. No public research money had ever been put into studying chiropractic because of the boycott. A dialogue finally began to take place between the two groups that had never happened before. This was Janse's way of explaining what chiropractic was then. Since then, I think both professions have moved toward each other, especially since research did show some positive results with this. I also agree that our concepts of prevention are still different. I.e., I am not sure statins are a chiropractors idea of prevention for heart attacks, whereas for medicine it is a first line, I think. Just some thoughts. You can completely ignore them. The Janse statement seems to be a good example that states the chiropractic philospohy on prevention. It is verifiable with a reliable source and attributed. However, if we attributed it to 'Joseph Janse, a chiropractic educator and past president of National University of Health Sciences' at least it would give some context as to whose POV we're stating. -- Dematt Dēmatt 17:06, 20 February 2008 (UTC)

Agree. Especially with regards to complete attribution. I just don't want such attribution to be called peacock-ism when clearly stating Janse's background helps the reader understand his POV. -- Levine211217:16, 20 February 2008 (UTC)

Agree with Dematts and Levines view. Let's better attribute it and call it a day. EBDCM19:34, 20 February 2008 (UTC)

Giving Janse's affiliations does not suffice to place the quote in context for the inexpert reader. On the contrary, it makes things worse by making Janse seem more authoritative than he really is. The crucial thing here is that Janse is giving the chiropractic opinion of fundamental flaws in mainstream medicine circa 25 years ago. This opinion, as Dematt notes, is quite dated, and yet that is not clear from the quote or the cite. Furthermore, the text approvingly talks about Janse's attempt to clear up confusion; and yet what Janse is doing is disparaging the other sides and trying to make his side ("progressive" chiropractors) look good. Fixing this POV will require a real discussion in the text about these problems, to make it clear to the inexpert reader that it is POV and much of Janse's comments are not widely accepted in the mainstream medical community. Or we can fix this by substituting better text for Janse's quote. Eubulides20:36, 20 February 2008 (UTC)

Eubulides, you are being argumentative. The context in which the quote is being used in NPOV. You are the only one who wants to omit the quote. You are the only one who has not compromised their stance. Janse is not attacking mainstream medicine, he is contrasting a PHILOSOPHICAL DIFFERENCE at when care should be given, i.e. in its functional state. This forms an important part of chiropractic prevention. Deal with it. Take it from someone who works in an integrative medicine. The other sides POV has nothing to do with chiropractic philosophy. EBDCM08:11, 20 February 2008 (UTC)

The context quotes Janse approvingly, and does not counter his POV with mainstream opinion. This is not a neutral context; it is a biased one. Obviously Janse is disparaging mainstream medicine: he is depicting doctors as having "failed to realize exactly what is meant by disease processes", is labeling allopathic principles as a "deficiency", and so forth. If mainstream "POV has nothing to do with chiropractic philosophy", why does Janse spend so much contrasting the two, and use so many disparaging words about the mainstream? Eubulides08:32, 20 February 2008 (UTC)

Ummmm, for the record when Janse said doctors, chiropractic, osteopathic and naturopathic doctors were included. Janse criticized chiropractic as well which led to the the evolution of mixer into reform. The surrounding context is NPOV as is even prefixed with "This aspect of chiropractic prevention has been a source of confusion and controversy in the medical community." You are reading too much into this and are projecting your personal bias' into the picture. EBDCM09:01, 20 February 2008 (UTC)

The claim that "doctors" includes chiropractic doctors is not at all evident from the quote, which says "It has been their contention that in general the doctor, the therapist and the clinician have failed to realize exactly what is meant by disease processes…". In this quote, the "their" refers to "chiropractors" (which is an editorial interpolation). The quote earlier talks about a "deficiency" of "allopaths" (again with the editorial interpolation! but it does say "allopaths" rather than "chiropractic, osteopathic and naturopathic doctors"). The most natural reading of the quote is one that casts aspersions against "allopaths", and against "the doctor, the therapist, and the clinician"; it's only natural to take this as an attack on allopathic medicine. If it was meant to be something else, it's "extremely" poorly worded, and clearer wording should be substituted, preferably wording without all the square brackets. As things stand, the wording is clearly POV, and putting it in the article without a balancing counterview is also POV. Eubulides09:42, 20 February 2008 (UTC)

Now why didn't I think of that? We've spent the last 2 days debating this (and it led to some positive edits). Now we have to fix the vaccination statement because it does not reflect global chiropractic sentiment but rather only a North American one. I also fail to see Eubulides logic in suggesting that the trend over the last 100+ years has NOT been one from staunchly opposed to mild indifference and outright support among the evidence-based movement.

Interestingly, I came across this sentiment from physicians: http://www.aapsonline.org/testimony/mandvac.htm. Looks like it meets inclusion criteria so lets use it here and at the vaccine controversy page. EBDCM07:34, 20 February 2008 (UTC)

The Association of American Physicians and Surgeons is an ultra-right-wing political group. It is not a medical organization. It is not a reliable source on vaccination safety or efficacy. Its arguments are already covered in MMR vaccination controversy and in Mark Geier; it is not clear that its position is notable enough to be mentioned in Vaccine controversy. I don't see how it's relevant to Chiropractor. Eubulides07:50, 20 February 2008 (UTC)

It's not about truth, remember Eubulides. It's about verifiability. It's notable. So is this: http://www.chiroweb.com/archives/19/14/18.html. ;) EBDCM08:00, 20 February 2008 (UTC)

If we have to have the Janse quote, what about a sentence about how physicians also stress prevention(granted, it's a different kind of prevention...but prevention, none the less!)i.e. Put "Today, physicians and chiropractors, alike, consider prevention an important tenet of health care" before the controversial quote. On the other hand, there are still elements of Janse quote derogatory to mainstream medicine. I agree with Eubulides, it's making the article more convoluted to have to counter every point. Better to remove Janse. Vote 2. CynRNCynRN08:40, 20 February 2008 (UTC)

Re. vaccination: chiropractors are very 'vocal' on Youtube and their own websites with vociferous propaganda against vaccines. I approve the 'vocal minority' wording that was previously in the section.CynRNCynRN08:40, 20 February 2008 (UTC)

How about if we add this sentence, after the first sentence of ChiropracticVaccination: "A small but vocal group of chiropractors espouse the antivaccination sentiment of what appears to be a minority of chiropractors." and cite Campbell "et al." 2000? Eubulides08:53, 20 February 2008 (UTC)

Rather than re-inventing the wheel, why don't we go with the version we came up with on Vaccine controversy, though just the part about chiropractic. I think it was pretty NPOV and well sourced. -- Dematt Dēmatt 14:05, 20 February 2008 (UTC)

I put it in chiropracticVaccination.. feel free to revert, though maybe we should build on this one instead if we want to keep working on it. -- Dematt Dēmatt 14:09, 20 February 2008 (UTC)

Thanks, that looks good to me. Eubulides20:38, 20 February 2008 (UTC)

Anecdotal but interesting

Probably not for this article, but worth a read: http://www.kcrg.com/news/health/13718517.html. -- Levine211219:33, 20 February 2008 (UTC)

There you go. That's an anecdote that means something to somebody, huh. -- Dematt Dēmatt 04:06, 21 February 2008 (UTC)

Chiropractic and Hypertension

Here an article which discusses some rather specific, blinded research suggesting that chiropractic adjustments do lower high blood pressure. The research was published in the "Journal of Human Hypertension". http://www.webmd.com/hypertension-high-blood-pressure/news/20070316/chiropractic-cuts-blood-pressure -- Levine211219:38, 20 February 2008 (UTC)

Does anyone have an impact rating on the Journal of Human Hypertension? I have read the journal article (which was quite hard to get), and it had poor methodology. Rather than including a single trial, of dubious methodological quality, I think we should be using more secondary sources (reviews, etc.). DigitalC00:14, 21 February 2008 (UTC)

The WebMD article qualifies as a secondary source here. 2006 Thomson Scientific impact factor for the Journal of Human Hypertension: 2.960. It ranked 18/52 in peripheral vascular disease. -- Levine211200:45, 21 February 2008 (UTC)

I guess the article did get a lot of media attention, so it is notable. I just don't know if it is important enough to mention in the chiropractic article, because 1 study (of dubious quality) doesn't change what chiropractic is. 02:35, 21 February 2008 (UTC)

1) Dubious according to whom? 2) Perhaps this would be better for the Scientific investigation of chiropractic articles? -- Levine211203:30, 21 February 2008 (UTC)

Definitely on the Scientific investigation of chiropractic. I'd say it does carry more weight in the JHH. -- Dematt Dēmatt 04:02, 21 February 2008 (UTC)

Apparently it is already in Scientific investigation of chiropractic. My bad. :-) -- Levine211204:19, 21 February 2008 (UTC)

Philosophy 2

Although a wide diversity of belief exists among chiropractors, they share the principle that the spine and health are related in an important and fundamental way, and this relationship is mediated through the nervous system.cite book |author= Gay RE, Nelson CF |chapter= Chiropractic philosophy |chapterurl=http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=altrehab.section.336 |editor= Wainapel SF, Fast A (eds.) |title= Alternative Medicine and Rehabilitation: a Guide for Practitioners |date=2003 |isbn=1-888799-66-8 |location= New York |publisher= Demos Medical Publishing Chiropractors pay careful attention to the biomechanics, structure and function of the spine, its effects on the nervous and musculoskeletal systems, and the role these systems play in preventing disease and restoring health.cite web |title= History of chiropractic care |author= American Chiropractic Association |accessdate=2008-02-21 |url=http://acatoday.org/level2_css.cfm?T1ID=13T2ID=62

Chiropractic philosophy goes beyond simply manipulating the spine. Like naturopathy and several other forms of complementary and alternative medicine, chiropractic assumes that all aspects of a patient's health are interconnected, which leads to the following perspectives:cite book |chapterurl=http://chiroweb.com/archives/ahcpr/chapter2.htm |chapter= Chiropractic belief systems |author= Mootz RD, Phillips RB |date=1997 |title= Chiropractic in the United States: Training, Practice, and Research |pages=9–16 |editor= Cherkin DC, Mootz RD (eds.) |accessdate=2008-02-14 |version= AHCPR Pub No. 98-N002 |location= Rockville, MD |publisher= Agency for Health Care Policy and Research |oclc=39856366

"'Holism"' treats the patient as a whole, and appreciates the multifactorial nature of influences (structural, chemical, and psychological) on the nervous system, recognizing dynamics between lifestyle, environment, and health.

"'Conservativism"' carefully considers the risks of clinical interventions when balancing them against their benefits. It emphasizes noninvasive treatment to minimize risk, and avoids surgery and medication.

"'Homeostasis"' emphasizes the body's inherent self-healing abilities. Chiropractic's early notion of innate intelligence can be thought of as a metaphor for homeostasis.

A "'patient-centered"' approach focuses on the patient rather than the disease, preventing unnecessary barriers in the doctor-patient encounter. The patient is considered to be indispensable in, and ultimately responsible for, the maintenance of health.

Chiropractic's early philosophy was rooted in spiritual inspiration and rationalism. A philosophy based on deduction from irrefutable doctrine helped distinguish chiropractic from medicine, provided it with legal and political defenses against claims of practicing medicine without a license, and allowed chiropractors to establish themselves as an autonomous profession. This "straight" philosophy, taught to generations of chiropractors, rejected the inferential reasoning of the scientific method, and relied on deductions from vitalistic principles rather than on the materialism of science.

As chiropractic has matured, most practitioners accept the value that the scientific method has to offer.cite book |author= Keating JC Jr |chapter= Philosophy in chiropractic |pages=77–98 |title= Principles and Practice of Chiropractic |edition= 3rd ed. |editor= Haldeman S, Dagenais S, Budgell B "et al." (eds.) |publisher=McGraw-Hill |date=2005 |isbn=0-07-137534-1 Balancing the dualism between the metaphysics of their predecessors and the materialistic reductionism of science, their belief systems blend experience, conviction, critical thinking, open-mindedness, and appreciation of the natural order. They emphasize the testable principle that structure affects function, and the untestable metaphor that life is self-sustaining. Their goal is to establish and maintain an organism-environment dynamic conducive to functional well-being of the whole person.

Some comments on Philosophy 2

This version is quite dry and misses many important points covered by Mootz and Phillips in addition to the many primary sources provided, though it is an improvement over Eubulides first stab. EBDCM00:05, 22 February 2008 (UTC)

Which important points of Mootz and Phillips does it miss? Eubulides00:21, 22 February 2008 (UTC)

It definitely misses the point of the bodies ability to heal itself. DigitalC03:34, 22 February 2008 (UTC)

It says "Homeostasis emphasizes the body's inherent recuperative abilities." Doesn't that suffice? Or would you prefer changing "recuperative" to "self-healing"? Eubulides07:40, 22 February 2008 (UTC)

No further comment, so I changed "recuperative" to "self-healing" in the draft. That's a simpler word, which is good. Eubulides23:28, 22 February 2008 (UTC)

Please stop steam-rolling your edits Eubulides until we have proper time for discussion. Please restore Moot and Phillips text box and we can incorporate some of you edits and then reference them accordingly. EBDCM01:01, 23 February 2008 (UTC)

No one has objected to changing "recuperative" to "self-healing". Are there any material (as opposed to procedural) objections to the change? If not, then let's move on to some more-important topic. As far as I know, the major points from Mootz and Phillips are covered in the new draft, albeit more succinctly and (in some cases) with additional sources; there's no need to go back to the text box and start over. Eubulides01:19, 23 February 2008 (UTC)

Your edit misses several important points in the text box whose language is both more professional, concise and appealing to all segments of the professions whereas yours is not. EBDCM01:34, 23 February 2008 (UTC)

That's a bit vague. Which important points, exactly, are being missed? I just now checked each point in the text box:

"noninvasive" is mentioned. "emphasizes patient's inherent recuperative abilities" is mentioned (as "self-healing")

"recognizes dynamics between lifestyle, environment, and health" is mentioned

"emphasizes understanding the cause of illness in an effort to eradicate, rather than palliate, associated symptoms" is common to all major health-care philosophies, and is not worth mentioning as being special to either chiropractic in particular or to CAM in general

"recognizes the centrality of the nervous system and its intimate relationship with both the structural and regulatory capacities of the body" is mentioned heavily

"appreciates the multifactorial nature of influences (structural, chemical, and psychological) on the nervous system" is mentioned

"balances the benefits against the risks of clinical interventions" is mentioned under "conservativism"

"recognizes as imperative the need to monitor progress and effectiveness through appropriate diagnostic procedures", again, is common to all major health-care philosophies

"prevents unnecessary barriers in the doctor-patient encounter" is mentioned under "patient-centered"

"emphasizes a patient-centered, hands-on approach intent on influencing function through structure" is mentioned, partly under patient-centered, partly under structure-and-function

"strives toward early intervention, emphasizing timely diagnosis and treatment of functional, reversible conditions", again, is common to all major health-care philosophies

The only thing missing are the bullets that are common to all major health-care philosophies. Do these need to be repeated here? If so, I can draft something along those lines, but it should be made clear that these are not exclusive to CAM or to chiropractic. Eubulides06:40, 23 February 2008 (UTC)

My contributions above

This was Eubulides version above that I missed over the weekend ( I think). I think it does a very good job with the metaphysical aspects of straight chiropractic. I struck a couple things out that didn't seem to jive, but I think this, too could be worked into our current version in some form. There are still the issues of prevention and Janse that need settling, but I don't think we are too far from something that could be workable. -- Dematt Dēmatt 19:59, 20 February 2008 (UTC)

Thanks, those strikeouts are fine. I made http://en.wikipedia.org/w/index.php?title=Talk%3AChiropracticdiff=192883352oldid=192881551 this small change to make the result flow a bit better, since there is now 1 principle not a list of 3. Eubulides21:06, 20 February 2008 (UTC)

Looking at it, I am struck by the "spiritual inspiration". We don't really know this, it could well be that the whole 'spiritual inspiration' was necessary as a defense, as we state later. I admit, I have to read the refernce. -- Dematt Dēmatt 20:07, 20 February 2008 (UTC)

The "spiritual inspiration" comes from the half-page summary of chiropractic philosophy on page 94 of "Principles and Practice of Chiropractic", 3rd ed., which says:

Chiropractors have employed a wide range of epistemologies (ways of knowing) to defend their art and professional autonomy. This diversity has included critical and uncritical empiricism (e.g., private research), critical and uncritical rationalism (e.g., so-called deductive science), spiritual inspiration, and the scientific method.

Yes, the key here being "to defend"... they used spiritual inspiration...

This summarizes a longer section on page 90, which says, for example:

There have been other ways of knowing in the profession. Old Dad Chiro suggested that he had acquired his understanding of chiropractic concepts from a physician who had practiced in Davenport, Iowa, some 50 years earlier; it has been suggested that this Jim Atkinson was deceased, and had perhaps imparted his knowledge to D. D. Palmer through seances. Spiritual inspiration was also a theme of the "Developer," B.J. Palmer who credited many of his insights to listening to the Innate Intelligence within him. Dr. Fred H. Barge continued this tradition when he suggested that his literary offerings derived from "listening to my Innate teacher"; he characterized himself as "only the scribe," and stated the positions that "belief in chiropractic philosophy gives one a "life without fear"" and there are no alternatives to "true chiropractic philosophy."

Yes, this "revelation" came right after DD was accused of stealing this concept from A. Still's osteopathy and just before the 1908 trial that successfully defended a chiropractor using the different philosophy. Is this source actually claiming that DD got it spiritually, or was DD claiming it to protect the profession. We can't know for sure and need to be careful how we use this.

The source does not say either way. Page 58 of the same source says under "Spiritual Inspiration" the following:

"This method of knowing is a special case of an appeal to authority; in this method, the authority figure is some supernatural being such as Innate Intelligence. For example, D. D. Palmer claimed that the principles of chiropractic were revealed to him by Dr. Jim Atkinson, who was apparently a deceased physician.

The current proposed wording doesn't claim that DD claimed spiritual inspiration to protect the profession; it merely says that having such a philosophy helped provide the early profession with legal and political defenses. This allows for the possibility that the original claim of spiritual inspiration was made for other reasons. Eubulides21:42, 20 February 2008 (UTC)

So basically, I think if we are careful how we use the words, we can mention it, but in such a way that does not lead the reader to either conclusion. If we can't then we just shouldn't go there. -- Dematt Dēmatt 22:19, 20 February 2008 (UTC)

There is also some discussion of it on page 80. For example:

Ralph W. Stephenson's first principle posited the existence of God as the explanation of all things, and the rest of the 33 catechism-like tenets were said to be derivable therefrom.

Armed with this "Palmer philosophy," B. J., the self-styled "Developer" of chiropractic, preached the "gospel" of chiropractic as absolute truth wherein all of life and all of the universe were explained, and without which chiropractic was no longer "pure, straight, and unadulterated."

Gotta love a good sermon ;-) This is the straight philosophy.

Eubulides

20:55, 20 February 2008 (UTC)

I like the second sentence a lot, I think it is accurate, V and RS and NPOV. I changed some of the present tense verbs to past tense, i.e. rejects - rejected, etc. to try and show the transformation from then to now more clearly. -- Dematt Dēmatt 22:28, 20 February 2008 (UTC)

Yes, thanks, past tense sounds good. Eubulides22:37, 20 February 2008 (UTC)

But see below (look for "past tense"); later changes suggested that we undo this change. Eubulides23:32, 22 February 2008 (UTC)

Could we strike this section: "and this relationship is mediated through the nervous system"? I am not sure that this fits with a reform POV. Perhaps EBDCM has comment?. Reform/EB Chiropractors tend to focus on the musculoskeletal system, not the nervous system, although some claim to focus on the neuromusculoskeletal system. I'm just not sure that about the claim that the relationship between health and the spine is MEDIATED through the nervous system. DigitalC00:20, 21 February 2008 (UTC)

I dunno, once you take that out, what's left? We can't keep taking out material until we have only a philosophy that every chiropractor agrees with. The section has to mention the spine and manipulation "somewhere"; they're what make chiropractic unique. Note that the current text does not claim that all chiropractors agree with every word of this section (on the contrary, it emphasizes the diversity of opinion). But surely the great majority of chiropractors agree with the principle as cited; that's good enough. Eubulides00:36, 21 February 2008 (UTC)

Reform DCs practice almost exclusively NMS care. That being said, what controls the muscles and joints? Where does central command come from? EBDCM00:30, 21 February 2008 (UTC)

I don't know, tell us ;-) -- Dematt Dēmatt 02:21, 21 February 2008 (UTC)

Well then it isn't notable to put in there, as EVERYONE believe that nerves control muscles and joints. The statement is that the relationship between the spine and health is mediated through the nervous system. Eublides, the statement says that even those who are removed from straight chiropractic believe that. Reform are as far removed from straight chiropractic as you can get, and as such, does it imply that reform believe that? 02:29, 21 February 2008 (UTC)

(unindent) "I dunno, once you take that out, what's left?" Hehe, hey you guys started this :D Now you know why we were so glad to finally get a stable version till you guys came along :-) But, I do have to admit, it is nice to have the input from reforms that we didn't have before. We were beginning to doubt that they existed. Also nice to have some levelheaded medical input. I do think we are doing well, and if we continue, we just might be able to get everyone's POV right. Be patient and keep thinking. -- Dematt Dēmatt 02:21, 21 February 2008 (UTC)

Okay, take a look at this; It's Eubulide's work from above with some of the things we talked about above and trying to put some context to it, stating what we know with what we don't know and preparing to differentiate to straight/mixer then maybe we can integrate EBDCM's and DigitalC's reform POVs. So I've just worked on the first paragraph for now and give everyone a chance to see if we're still on the same page. I am open to any re-writing anyone thinks is necessary, so go for it.

Chiropractic's early philosophy was rooted in spiritual inspiration and rationalism. Whether by necessity or design, a philosophy based on deduction from irrefutable doctrine helped distinguish chiropractic from medicine, provided it with legal and political defenses against claims of practicing medicine without a license, and allowed chiropractors to establish themselves as an autonomous profession. This philosophy became known as chiropractic's "straight" philosophy. It was taught to generations of chiropractors; without the inferential reasoning of the scientific method, and relying on deductions from vitalistic principles rather than on the materialism of science.cite book |author= Keating JC Jr |chapter= Philosophy in chiropractic |pages=77–98 |title= Principles and Practice of Chiropractic |edition= 3rd ed. |editor= Haldeman S, Dagenais S, Budgell B "et al." (eds.) |publisher=McGraw-Hill |date=2005 |isbn=0-07-137534-1

I also moved the references to the bottom just for readability. -- Dematt Dēmatt 03:08, 21 February 2008 (UTC)

Looks very good. 04:59, 21 February 2008 (UTC)

I really like Eubulides philosophy version, much more readable...and well referenced. The edits by Dematt are fine. Surely, the idea of "mediated through the nervous system" must be included, however. Subluxation should be mentioned, maybe with qualifiers. I don't know about trying to make sure that only applies to straights. That reduces readability again.

How about Eubulides verson becomes the framework and some points on prevention are worked into it? Maintenance care as an important tenet of prevention should be explained.

Please lose the Janse quote. Eubulides explained very well how it related to the time when physicians and chiropractors were alienated. The quote will continue to 'alienate' those of us who don't see that yawning chasm between physicians and (at least)reform chiropractors.CynRNCynRN06:57, 21 February 2008 (UTC)

I disagree, Eubulides version has several omissions and heavily emphasizes some points that are clearly not accepted by many chiropractors, and his references omit many primary sources which raises alternate arguments. Regarding readability, that should not trump concision and a factual, verifiable and well-referenced sources. The major problem with Eubulides version is that it does not have an appreciation of the many POV of various chiropractic philosophies and the language he uses to describe certain aspects would be rejected by a healthy proportion of mixer and reform DCs. Thus, generalizations, common themes, etc is necessary to adequately capture the whole scope of chiropractic philosophy. EBDCM15:51, 21 February 2008 (UTC)

I hear your plea and am taking it to heart. -- Dematt Dēmatt 15:39, 21 February 2008 (UTC)

I also agree that the section should not ascribe to chiropractors a philosophy that they do not have consensus on. Where there is important disagreement among chiropractors on philosophy, all sides should be covered. However, this is not the same as watering down the philosophy section to talk only about areas where all chiropractors agree. Eubulides20:12, 21 February 2008 (UTC)

Thanks. I merged the nice wording changes into the version at the start of Philosophy 2. I have some questions about some of the other changes:

"Whether by necessity or design" is not taken from the cited source; it's our deduction/inference. We'd need a reliable source for that.

(reply) I'm not sure we can use 'spiritual inspiration' without using this phrase. -- Dematt Dēmatt 15:39, 21 February 2008 (UTC)

Why is speculating on the motivation for spiritual inspiration a necessary prerequisite for mentioning spiritual inspiration? In general, the motivation behind spiritual inspiration is a deep, difficult, and controversial subject. Why not just be silent on a matter for which we have no reliable source? Eubulides20:09, 21 February 2008 (UTC)

"This philosophy became known as chiropractic's "straight" philosophy. It was taught to generations of chiropractors; without the inferential reasoning of the scientific method, and relying on deductions from vitalistic principles rather than on the materialism of science." The first sentence is a bit awkward (repeats "philosophy" twice), and the second isn't quite grammatical. Was it an attempt to make the point that straight philosophy wasn't called "straight" until a bit later? But I doubt whether that point is worth highlighting here. Or perhaps it was because italicizing "straight" was confusing? If so, I attempted to fix that by quoting the word instead.

(reply) Yes, this was later referred to as straight philosophy when mixers (MDs, Naturopaths, Osteopaths) began to infiltrate the profession. BJ invented it to differentiate from those that mixed chiropractic with other disciplines. He also began to refuse to teach MDs in the 1920s. -- Dematt Dēmatt 15:49, 21 February 2008 (UTC)

OK, but is it necessary to go into that much detail in the philosophy section? The origin of the term "straight chiropractic" is early enough here that, from the point of view of philosophy, it doesn't really matter that the name "straight" was first used in the 1920s. After all, chiropractic wasn't originally called "chiropractic", but we don't say "This health care method, which eventually came to be called "chiropractic",…". The http://www.f-a-c-e.com/Books.html blurb for the book "Refined by Fire: The Evolution of Straight Chiropractic" says "This book follows the development of straight chiropractic from 1895 through 1994." which indicates that at least one expert in the field is comfortable with talking about the existence of straight chiropractic philosophy from the beginning, even if the name came later. Eubulides20:27, 21 February 2008 (UTC)

When cleaning up the footnotes it removed the citation to Mootz Phillips 1997. Was that intended? For now, I left that citation in but removed the other footnotes.

(reply) This was inadvertent. We need that reference. -- Dematt Dēmatt 15:39, 21 February 2008 (UTC)

Eubulides

06:48, 21 February 2008 (UTC)

Why is there a reluctance to include the importance of finding and treating subluxations? This is still taught in some colleges, and is on their "what we believe" page. Just because a minority of reformers reject the idea, doesn't make it unimportant. IMO it's a huge part of Philosophy.CynRNCynRN09:08, 21 February 2008 (UTC)

I agree with CynRN that subluxations need to be mentioned and are a key part of the philosophy of (some) chiropractors. --Coppertwig13:11, 21 February 2008 (UTC)

My concern is that we haven't explained what a subluxation is. Not to mention that it means differnt things to different chiropractors.. like saying someone has a chemical imbalance. That really doesn't tell the reader much. Subluxation is just what chiropractors call what they treat, which depends on your philosophy. -- Dematt Dēmatt 15:39, 21 February 2008 (UTC)

How about this? ""Although a wide diversity of beliefs exists among chiropractors,52 even practitioners who distance themselves from straight chiropractic share the principle that the spine and health are related in an important and fundamental way, and that this relationship is mediated through the nervous system.55 Many chiropractors emphasize that health can be degraded by vertebral subluxations, which are mechanical and functional disorders of the spine, and that it may be restored by correcting these subluxations."" I suppose a source would be required for the subluxations bit. --Coppertwig13:18, 21 February 2008 (UTC)

see above. -- Dematt Dēmatt 15:39, 21 February 2008 (UTC)

Again, non-DCs here fail to recognize the intense debate, opposition and controversy of vertebral subluxation as part of philosophy, in part because of the many, many different interepretations of it and its philosophical and clinical significance. This is why language such as structure and function, which is increasingly being used to describe the goal/purpose of DCs, adequately captures and spans the various philosophical POVs. It also is broad enough as well so that it applies to non-spinal areas which mixers and reformers regularly treat. If you say vert sub, this its ONLY spinal; and negates that treatment is given to other areas as well for the same purpose: regulating function through structure. Eubulides has inadvertently opened a can of worms and this is what you get. EBDCM16:01, 21 February 2008 (UTC)

(outdent) OK, how about this, then? ""Although a wide diversity of beliefs exists among chiropractors,52 even practitioners who distance themselves from straight chiropractic share the principle that the spine and health are related in an important and fundamental way, and that this relationship is mediated through the nervous system.55 Many chiropractors emphasize that health can be degraded by mechanical and functional disorders of the musculo-skeletal system, and that health may be restored by correcting these disorders."" However, why not mention subluxations as something that many chiropractors talk about, and then add a few words to represent the other points of view e.g. "though not all chiropractors characterize the situation in this way" (can't think of a good wording right now) --Coppertwig03:37, 22 February 2008 (UTC)

Coppertwig is on the rignt path. I would add neuromusculoskeletal rather than MSK which better reflects the 3 systems worked on (ART to address peripheral nerve entrapments, DigitalC!)

Rather than degraded perhaps 'compromised'. For the vert sub talk, I don't oppose a mention but that's a pandora's box and IMO it's better dealt in history or the vert sub article. EBDCM04:11, 22 February 2008 (UTC)

This latest proposal from Coppertwig seems to be based on the earlier draft in Philosophy rather than the more-recent draft in Philosophy 2. I assume the intent is to apply a change to the most-recent version? In that case, the new stuff in Coppertwig's latest proposal is the sentence "Many chiropractors emphasize that health can be degraded by mechanical and functional disorders of the musculo-skeletal system, and that health may be restored by correcting these disorders." But since Philosophy was written, Philosophy 2 has added the text "Many chiropractors emphasize that health can be degraded by mechanical and functional disorders of the musculo-skeletal system, and that health may be restored by correcting these disorders." Does that capture the same notion sufficiently well? If not, how would you improve the draft in Philosophy 2? Eubulides07:51, 22 February 2008 (UTC)

"neuromusculoskeletal" sounds OK to me. I'm sorry, I haven't had time to follow the whole conversation. However, the two sentences you quote, Eubulides, look identical to me, so either more than one person coincidentally formed the same sentence, or something -- it doesn't matter.

I think there are things we can say about subluxations that are not Pandora's boxes. For example, "Some chiropractors use the term 'subluxation'". Surely that's perfectly true and non-controversial? I would just like to see the word "subluxation" in the philosphy section somehow -- unless recent chiropractic literature almost completely avoids it, but even then probably it should be mentioned as a word that was often used until recently. --Coppertwig02:13, 24 February 2008 (UTC)

There is an issue with this philosophy though

It just occurred to me though, I think we have to ask ourselves what the first two paragraphs have to do with chiropractic philosophy. Shouldn't we need to start with what the philosophy "is", not "why" it is... We need to re-arrange it some. Whatcha think? -- Dematt Dēmatt 15:18, 21 February 2008 (UTC)

I did try writing it the way you suggested first, and found that the result was drier and harder-to-follow. It's better to mention motivation early. Without motivation, the inexpert reader will miss a lot of why the philosophy is the way it is, and will more easily get lost. I'm not sure what the "two paragraphs" alludes to; in Philosophy 2 only one phrase is devoted to motivation: "distinguish chiropractic from medicine, providing provided it with legal and political defenses against claims of practicing medicine without a license, and allowing allowed chiropractors to establish themselves as an autonomous profession". 30 words is a cheap price to pay for explaining the "why" to the reader. Eubulides20:41, 21 February 2008 (UTC)

I'm not sure we are succeeding in making it more understandable by adding motivation. We might be making this more difficult than it has to be. Lets just explain the "current" philosophy similar to the way the ACA has done (see CYN's post below) and if we find we need to explain motivation, we can do it then. Although, we can continue to work on 'motivation', if nothing else, we can add it to Chiropractic history. -- Dematt Dēmatt 21:29, 21 February 2008 (UTC)

I agree and feel that the current version adequately captures that for the most part. There has been some productive dialogue here so lets keep going; but non-expert editors here on chiropractic do need to realize the complexities of the profession and philosophy is at the heart of it. I'd rather focus on what unifies ALL DCs as opposed to picking the stuff that separates them with respect to philosophy. The differences are already explained, but the most part, in the practice styles section. EBDCM23:47, 21 February 2008 (UTC)

In reading the current version of Philosophy 2 (with the motivation at the end rather than the beginning) I guess it's OK. It's a bit drier but there's still enough juice in it. Eubulides23:57, 21 February 2008 (UTC)

This is how Mootz and Phillps's article summarizes chiropractic philosophy:

G. Summary

Traditional chiropractic belief systems focused on the body's ability to self-heal, the nervous system's role in overall health, and the role body structure was thought to play in function of the nervous system. Early articulation of these concepts by chiropractors was often cloaked in terminology that conveyed spiritual connotations. In addition, vitalistic explanations of self-healing confounded many outside the profession when used by early chiropractors to deny the value of quantitative evidence on clinical effectiveness.

Contemporary chiropractic belief systems embrace a blend of experience, conviction, critical thinking, open-mindedness, and appreciation of the natural order of things. Emphasis is on the tangible, testable principle that structure affects function, and, the untestable, metaphorical recognition that life is self-sustaining and the doctor’s aim is to foster the establishment and maintenance of an organism-environment dynamic that is the most conducive to functional well-being.

Contemporary chiropractic philosophy recognizes its partnership with the greater body of philosophy and science in general. Most contemporary chiropractors and their organizations distinguish between what is known and what is believed. Chiropractic belief systems embrace the holistic paradigm of wellness while incorporating deterministic materialism for the establishment of valid chiropractic principles. Chiropractic’s philosophic foundation serves as the basis for theoretical development, not a substitution for it (Phillips, 1992).

Notice it doesn't say anything about subluxation or conventional medicine. It does talk about holism. I think the "cloaked" is similar to "whether by necessity or design.. but mostly I think this is what is meant by philosophy, rather than trying to figure out what a subluxation is. Thoughts? -- Dematt Dēmatt 16:51, 21 February 2008 (UTC)

I do know that 'subluxation' is very controversial among chiropractors. It is their 'achilles heel' according to Ronald Carter. It seems to be the dominant philosophy of disease in America, however, taught in schools and on most DC's websites. It's still taught at CMCC. The whole controversy over the word and how to define it warrants more than it is given in the lead of the article.CynRN —Preceding ) 18:18, 21 February 2008 (UTC)

Yes, the achilles heel part is notable and very important, at least as far as "the reason" for controversy among chiropractors themselves and medicine, though I am not sure if the everyday medical professional really understands why the concept of 'subluxation' developed (whether by necessity or by design ;-). That would be our job in another section or even the vertebral subluxation article. -- Dematt Dēmatt 19:35, 21 February 2008 (UTC)

This is patently false. CMCC does not teach nor endorse subluxation theory. I graduated there 2 years ago, my fiancee 1 year ago. Subluxation is given historical mention only in 1st year ethics and principles class. Subluxation is not an acceptable diagnosis in clinic. Subluxation is not an acceptable term in clinic, it was either joint fixation/restriction/hypomobility/dyskinesia. No school in Canada, for that matter (all 2 of them) teach the VSC. Only diversified technique is taught in the curriculum as well as generic myofascial release techniques. Anyways, please, please do not perpetuate this myth that CMCC or UQTR teaches or endorses subluxation theory. If you got your information from chirotalk, you're better off getting info from a non-biased site or group. EBDCM20:02, 21 February 2008 (UTC)

Yes, "it is still taught" at CMCC. However, it is talk in a historical philosophical perspective. As EBDCM mentioned, subluxation is not an acceptable diagnosis in the CMCC clinic, and it is definitely not endorsed by CMCC. Furthermore, it is not simply switching the word to "joint fixation" or restriction etc, as there needs to be a diagnosis to treat a patient, and these are simply joint findings. DigitalC22:01, 21 February 2008 (UTC)

I apologize for saying CMCC taught subluxation. I did Not get my info from Chirotalk! I was searching curricula late last night and thought I saw "subluxation". Hey, it was late! I did find Northwestern, Bridgeport, Logan ("particular attention to subluxation") and Cleveland with VSC right in the "who we are and what we believe" or in the classes. After you mentioned the said site, I did go there and see that subluxation was taught there up until 2002 or so and that Dr. Moss supported the VSC concept. As of 1997, a minority, 18%, of Canadian DCs rejected traditional Palmer style philosophy(Biggs, et al). I'm not trying to be inflammatory, I'm just here as an editorCynRnCynRN00:45, 22 February 2008 (UTC)

DigitalC is correct, he finished my thoughts; that joint dysfunction is simply a finding and not a Dx. EBDCM23:43, 21 February 2008 (UTC)

As a former student of CMCC I know that VSC has not been taught there since 1999 or the introduction of the integrated curriculum. Feel free to go to www.cmcc.ca and download our academic calendar and find me a reference to VSC in any shape or form. Reform schools does not teach VSC except in the historical context usually in ethics and principles class. Dr. Moss, to prevent from being the only one who did not sign the 1996 ACC paradigm signed on but has quietly moved on. Regarding the Biggs' study, how many DCs embraced Palmer philo, is the better question. There's a soft juicy middle that retain some Palmer (i.e. non NMS care) but based on the 2007 (internal circulation) survey 93% of DCs treat NMS primarily. So, again a mixed picture. The better question to ask is how many DCs believe in the Palmer one cause one cure? You may be surprised by the answer. EBDCM04:06, 22 February 2008 (UTC)

Then there is the ACA's version of philosophy which omits subluxation and includes prevention and even public health:Chiropractic Philosophy

"As a profession, the primary belief is in natural and conservative methods of health care. Doctors of chiropractic have a deep respect for the human body's ability to heal itself without the use of surgery or medication. These doctors devote careful attention to the biomechanics, structure and function of the spine, its effects on the musculoskeletal and neurological systems, and the role played by the proper function of these systems in the preservation and restoration of health. A Doctor of chiropractic is one who is involved in the treatment and prevention of disease, as well as the promotion of public health, and a wellness approach to patient healthcare."Short and sweet!

https://www.acatoday.org/level2_css.cfm?T1ID=13T2ID=62

CynRNCynRN18:24, 21 February 2008 (UTC)

And Simple! It includes everybody... -- Dematt Dēmatt 19:29, 21 February 2008 (UTC)

Good find, Cyn. The omission of vert sub is necessary nowadays because many more DCs (reform and many mixers) are sticking to structure and function because it more accurately describes what we do. Vert sub has so much stigma and has been used as a straw man fallacy for so long to discredit DCs that IMO, its a useless term. The CCA, which represents 85% of canadian DCs also no longer uses the term. Indivdual DCs, particularly older graduates still use vert sub; but it seems like its more in a biomechanical context than "your organ is shutting down cause of this stiff joint) context. EBDCM20:07, 21 February 2008 (UTC)

I also like that summary. The web page says it's supported by three published sources. I checked the one source I have access to (the Spinal Manipulation Policy Statement) but it's not on this topic, so for now I guess we'll have to make do with citing the web page. I http://en.wikipedia.org/w/index.php?title=Talk%3AChiropracticdiff=193121662oldid=193120834 added what it said about biomechanics, structure-and-function, relationship to musculoskeletal and nervous systems, prevention, and avoiding surgery and medication to the draft in Philosophy 2. I hope this helps to achieve consensus (especially the bit about prevention…). Eubulides21:33, 21 February 2008 (UTC)

That does help. We can probably trim some. I did http://en.wikipedia.org/w/index.php?title=Talk%3AChiropracticdiff=193124747oldid=193123285 reversed the paragraphs which seems to address some of my earlier concerns. It seems to work. -- Dematt Dēmatt 21:43, 21 February 2008 (UTC)

Very good find. Again, I guess it goes back to finding good sources first. DigitalC22:03, 21 February 2008 (UTC)

Coming together nicely I think. Good move on the last paragraph. I took out the agreed upon strikes so that we can see what it looks like so far. -- Dematt Dēmatt 22:05, 21 February 2008 (UTC)

the last two sentences

Looks much better. The last two sentences of the last paragraph need some work:

This "straight" philosophy, taught to generations of chiropractors, rejected the inferential reasoning of the scientific method,52 and relied on deductions from vitalistic principles rather than on the materialism of science.45 As chiropractic matured, many practitioners accepted the role of the scientific method.52

The words rejected and accepted underlined above add some pretty heavy emphasis. If we consider that, as the Mootz/Phillips paper noted, that the profession 'cloaked' chiropractic in spiritualism, then rejected is not the right word, maybe resisted. And then of course, now with the advent of universal healthcare, evidence based medicine, and growing acceptance of CAMs, that cloaking could be removed, it's not a matter of accepting, but more of embracing. It changes the meaning of the history, so it is important. The question is, "what do you think the sources are saying?" -- Dematt Dēmatt 22:41, 21 February 2008 (UTC)

"Rejected" is not too strong. The source consistently uses the word "rejected" to talk about the scientific method. For example, page 94 (the summary of the chiropractic philosophy chapter) of "Principles and Practice of Chiropractic" says "B. J. rejected the inferential reasoning of the scientific method in favor of deduction from 'true principles.'" Another example: p. 91 says "A. Earl Homewood (Fig. 4-12) opined that in his nearly 50 years as a chiropractor he had never seen any benefit derived from research in the profession. Others observe the shroud of science in which allopathy has wrapped itself, and in rejecting the persecution by medicine, tend to reject the scientific method as well. Still others are unaware of the epistemology inherent in the scientific method." That chapter never uses the word "resist". I think "resist" is too weak to be supported by the source. "Rejects or is unaware of the scientific method" would be supported, though it's a bit longer and harder to parse. Eubulides23:42, 21 February 2008 (UTC)

I disagree. It's not a NPOV word. Mixers did not reject the scientific method, in fact the reason why they even splintered off from straights was because all straight was in essence was vitalism. EBDCM00:00, 22 February 2008 (UTC)

The subject of the sentence is "This 'straight' philosophy", so the sentence is not talking about mixers. "Rejected" is appropriate where straight philosophy is concerned. "PPC" consistently uses "rejected" in this context; there's no reason to water it down. Eubulides00:25, 22 February 2008 (UTC)

Eubulides, please don't lecture us on 'watering it down'. Your draft is a completely watered down mess. You incessant use of PPC exclusively is a weight issue now, IMO. Do you any other sources which supports your assertions, or shall we rename the chiropractic article "Principles and Practice of Chiropratic"? EBDCM00:57, 23 February 2008 (UTC)

The current text relies heavily (but not exclusively) on "PPC" because "PPC" is a high-quality recent textbook with a chapter on philosophy. If there is some better source, by all means let's use it. In the meantime the article should use the best sources we can find, and should not materially alter what they say. Eubulides06:22, 23 February 2008 (UTC)

You are cutting out many primary sources from various peer-reviewed journals, university and governmental sites which backs any claims and rely on one textbook when there are literally over 200+ quality chiropractic textoks that uses different language that you suggest "rejected" "accepted" etc. Everything seems to be a false dichotomy with your edits. As an editor; you fail to appreciate the ebb and flow of historical and current trends and take a particular piece of literature into proper context. So, your reliance on PPC to be the "be all end all" reference is lacks the depth and breath of the chiropractic story which is better captured with the current lead. It understands the subtle complexities of chiropractic but covers the all the major tenets that every DC believes in. You realize by now, Eubulides, that not an easy task, but you opened the pandora's box. It is the art, science and philosophy of chiropractic and this article will reflect both factually, reliably with a healthy diversity of quality sources but that is truthful to the chiropractic story in an objective manner. You have made a few strong suggestions with your research, Eubulides, and I commend you for that; but it's clear that your version lacks the subtle nuances, the gray zones as opposed to the strict dichotomy you present. There is a spectrum to this, but unfortunately even your writing is tainted with reductionistic qualities. EBDCM06:47, 23 February 2008 (UTC)

Please feel free to cite one of those other 200+ quality chiropractic textbooks, or any other secondary source of similar quality to "PPC". It's better to use a more-recent source, as chiropractic has changed somewhat in the past two or three decades. The draft does not rely solely on "PPC"; it relies on other sources (though admittedly they are not as strong). Improving the quality and/or diversity of these other sources would be nice. Eubulides08:03, 23 February 2008 (UTC)

"Accepted" is not too weak. The same source says, for example, "Throughout most of its early history the chiropractic profession differed from other health care provider groups in that it did not widely accept the principles of the scientific method". Another word that it uses is "adopt", e.g., "Chiropractors may adopt or reject the scientific method as a means of furthering knowledge of health and illness." (p. 85). The chapter does not use "embrace"; I think "embrace" is too strong to be supported by the source. But "adopted" would be OK if you prefer that. Eubulides23:42, 21 February 2008 (UTC)

I disagree. Accepted is weak and not only that it makes it seem as those it wasn't voluntary or something. Evolved is my preference but adopted is OK too. EBDCM00:00, 22 February 2008 (UTC)

In rereading the current version I see that the reordering has made it more likely for readers to incorrectly think that straight chiropractic is extinct. The discussion of straight philosophy is entirely in the past tense. This was a bit of an issue before, but the reordering has made it worse, at least in my eyes. I propose changing one sentence back from the past to the present tense, resulting in: "This "straight" philosophy, taught to generations of chiropractors, rejects the inferential reasoning of the scientific method, and relies on deductions from vitalistic principles rather than on the materialism of science."

Eubulides

23:42, 21 February 2008 (UTC)

If you were to pay attention to historical trends, you would see the straight chiropractic is becoming increasingly marginalized, but within and outside the profession. In fact, I can only think of 1 school outside the USA that teaches straight chiropratic.

It may be marginalized but it is by no means extinct; a significant minority of chiropractors are straight. ChiropracticPhilosophy should not use the past tense for straight philosophy and the present tense for mixers; that's bias. Eubulides00:29, 22 February 2008 (UTC)

No further comment so I changed the tense in the draft as suggested above. Eubulides23:32, 22 February 2008 (UTC)

I disagree with this edit. I was working. Please change it back until we have agreed. Thanks. EBDCM00:58, 23 February 2008 (UTC)

I have changed it back for now. At this point, we have two editors who think it should be present tense and have given NPOV-oriented reasons, one who thinks it should be past tense but has not given a reason, and one who thought it should be in past tense in a long-ago draft but gave no reason. At this point seems only fair to ask for reasons: why should straight chiropractic philosophy be mentioned only in the past tense? Eubulides06:47, 23 February 2008 (UTC)

One other thing: my assumption is that the Philosophy 2 draft is intended to replace the current contents of ChiropracticPhilosophy. This means that the current subsection header ChiropracticHolistic and naturopathic approach would be removed, as would be the Janse quote and the text box. It's a bit weird to have that subsection header there (a section with just one subsection and no intro?). The Janse quote should not be necessary any more, as the new draft talks about prevention and holism both. Similarly, the old text box is superseded by the new bullet list and surrounding discussion. Eubulides23:50, 21 February 2008 (UTC)

Subsection header is fine. Naturpathic and holistic perfectly describe the major tenets. Janse's quote stays; it has been given appropriate context. The majority of editors agree. EBDCM00:00, 22 February 2008 (UTC)

There's no need for the subsection header; the content of the section adequately discuss naturopathy and holism. It's not the case that the majority of editors agree that the Janse quote together with its context is better than what's in Philosophy 2. The Janse quote + context has several problems (POV, dated, oddly sourced, debatable editorial interpolations, etc., etc.), and Philosophy 2 fixes these problems. Eubulides00:33, 22 February 2008 (UTC)

Sorry, EBDCM, I agree with Eubulides. Janse is so 1984. His stance may have been understandable before chiropractors were integrated more into mainstream medicine. They saw themselves on the absolute opposite side of the holism/reductionism continuum. The new philosophy draft includes prevention and is more readable and concise.CynRNCynRN00:52, 22 February 2008 (UTC)

If we wanted to concisely and accurately describe in 2 words chiropractic philosophy that applies to all stripes of DCs what would it be? Naturalism and Holism. Maybe we can add conservatism as well. The only 2 here who oppose Janse are the above editors who both work in mainstream med and do not understand its historical and philosophical importance. More editors have been in favour of retaining Janse. Considering that the Eubulides is trying to propose a complete rewrite and has somehow managed to remove any possible mention and contrast with the most dominant medical model in history I'm weary of further diluting the section which has been already severely compromised by glaring omissions by Mr. Eubulides. EBDCM03:57, 22 February 2008 (UTC)

The current draft in Philosophy 2 emphasizes holism. It does not emphasize naturalism (do you mean metaphysical naturalism or methodological naturalism?) because none of the cited sources mention naturalism. If you can supply a similarly high-quality source saying naturalism is an important part of chiropractic philosophy, then by all means let's modify the draft to mention naturalism as well. Eubulides08:23, 22 February 2008 (UTC)

I omitted a blow-by-blow comparison of chiropractic philosophy to that of mainstream medicine mostly because I felt that a more appropriate place to describe this battle is the "medical opposition" section. However, if there is consensus that ChiropracticPhilosophy should briefly contrast the two philosophies, I'm certainly willing to propose something, based on recent reliable sources such as Ahn "et al." 2006 (PMID|16681415). The Janse quote is not suitable for this purpose for reasons already described; it can be improved on. Eubulides08:23, 22 February 2008 (UTC)

There is no "battle" Eubulides. You're projecting again. It's a comparison and contrast between the chiropractic model and the medical model. It's factual, verifiable, relevant, conscise and from peer-reviewed sources. Using red herring terms such as 'battle' does not advance your argument and in the contrary, it does some disservice to your arguments. EBDCM02:44, 23 February 2008 (UTC)

As Janse describes it, it's a battle. Any discussion contrasting the "reductionism" of mainstream medicine to the "holism" of chiropractic will replay, in some form or another, battles between chiropractic and mainstream medicine. Any such discussion must take care to be NPOV, precisely because it's such a controversial topic. Janse is definitely not neutral on this topic: his quote is from the chiropractic side only. His quote is "factual" only in the sense that it's a quote from the chiropractic side. It is not by itself a reliable summary of the dispute. Eubulides07:00, 23 February 2008 (UTC)

Nah... There no battles Eubulides, they're simply the dominant belief systems of the respective professions. DCs have to embraced reductionism to improve its scientific foundations and prove the many known (to DCs) clinical effects of SMT and the chiropractic encouter (notice its not just the modality but the whole clinical experience. This very different that conventional medicine). Anyways, Janse is explaining a philosophical difference and we all know whose side he's on. But it is qualified that this is simply Janse's idea but it reflects a fundamental difference in approach regarding early intervention but from a different perspective, a chiropractic one. As a mainstream med proponent, Eubulides, you fail to understand the argument and importance of this quote. CynRN has made helpful suggestions already regarding this and I have offered to move it as a compromise in exchange for some compromises on your behalf. But you cannot deny the fact that medicine and chiropractic are forever intertwined, for better and worse, and that medicine has had a HUGE impact on the foundation, development and future of chiropractic. A contrast is definitely warranted and necessary and don't worry: it's all along a spectrum with medicine being on one end, and chiropractic on the other. Many practitioners are not extremists and incorporate various approaches, but by and large there significant majorities in each camp. It's time to let this one go, Eubulides. How many times do we have to go over this? EBDCM07:29, 23 February 2008 (UTC)

Moving Janse to the medical-vs-chiropractic section makes a lot of sense. Let's do that. We can then resume this conversation when we start reviewing that section. Eubulides08:09, 23 February 2008 (UTC)

Actually, the source that cited naturalism is the one you wanted to remove. Take a look closely, Eubulides. You're creating a mess, and that's what happens when someone tries to edit chiropractic philosohy and has no clue of chiropractic philosophy. It's like me going into the medicine article and telling MDs what their philosophy is because I found 1 source. Common knowledge trumps this Eubulides and I have already provided peer-reviewed research to support all my claims. You're of the opinion that if its not in PPC, it doesn't exist. Wrong. Naturopathic and Holism are fundamental to ALL of chiropractic. Vitalism is not. The draft wouldn't need to be modified if you have agreed to collaborate with experienced chiropractic editors here and be willing to give a little. EBDCM00:54, 23 February 2008 (UTC)

In Wikipedia, common knowledge does not trump reliable sources. Nor can primary studies, even if peer-reviewed, trump the first-quality secondary sources. If we can turn up other sources to match the quality of "PPC" that would be fine; until then we need to trust the best experts' opinions, and not second-guess them. Eubulides07:00, 23 February 2008 (UTC)

I have provided reliable sources AND common knowledge and both the primary and secondary sources I've provided which accurately describes the breadth of the chiropractic study. In contrast your incessant claim that only secondary sources are valid here amounts to a form of censorship. I've already explained to you time and again that just because a secondary source paper has not yet been written that does not mean we can't use the many primary sources which supports the claim being made. Also, you only use PPC now which is but one chirorpractic text for your ENTIRE rewrite of chiropractic philosophy, done by an editor who seems to be a strong medical proponent and has been history of misunderstand the topic at hand (see the numerous challenges to your re-write). Anyways, I am assuming good faith and have already commended you for some good work on this; but it seems like we are beating a dead horse here and will have to compromise. We will incorporate the salient points of your proposal into the current text and we can compromise and MOVE Janse to medical opposition, but we are keeping it as per the majority consensus here. We will also do a medical and chiropractic philosophy/practice styles contrast because there are many differences between chiropractic care and medical care and the reader needs to know what to expect. I hope you stick around and help us out with that one and we tie it into integrative medicine; the hybrid love child. EBDCM07:19, 23 February 2008 (UTC)

I don't recall any reliable sources being presented for chiropractic and naturalism (again, do you mean metaphysical naturalism or methodological naturalism?). Moving Janse to some other section sounds good for now. It's OK to contrast the styles, as long as it's well sourced and is done with NPOV. Eubulides08:09, 23 February 2008 (UTC)

It's irrelevant whether editors opposed to the inclusion of the Janse quote work in mainstream med. What matters is NPOV and what reliable sources say. When Janse wrote decades ago about chiropractic, he was reliable; but when he wrote about mainstream medicine, he was not; and he was certainly not reliable about mainstream medicine today. I disagree that more editors are in favor of retaining Janse over the current draft in Philosophy 2; so far only three editors have weighed in on that question, and two have opposed the current use of Janse. The current use of Janse is blatant POV and must be replaced by something that's more neutral. Eubulides08:09, 22 February 2008 (UTC)

Look throughout the history of the discussion. Myself, Dematt, DigitalC, Levine2112 and Hughgr and in favour of retaining Janse. It's not blatant POV because it has been qualified appropriately. Time to cut bait, Eubulides. EBDCM02:39, 23 February 2008 (UTC)

These editors have not all approved of Janse over and above the current draft. Nor do they all agree that there is not a POV problem. But this can all be deferred for now, if we move Janse to some other section. Eubulides08:12, 23 February 2008 (UTC)

There is still hope for compromise here.I am just trying to help the article be NPOV. The Janse quote is interesting, but pretty biased on his part against mainstream med. It would need, at the very least, a hefty qualification, pointing out that physicians are not exclusively reductionist and that his viewpoint was reflective of his time. Better to use another source that doesn't anger mainstream medical people. Would you be willing to use Eubulides' draft as a starting point and add some of your points from the current phil. verson into his?CynRNCynRN04:34, 22 February 2008 (UTC)

Actually, it may not matter according to Wikipedia rules, but according to moral and ethical rules, its shady to pretend you're being NPOV and omitting agreed upon citations and statements which support those citations. EBDCM00:54, 23 February 2008 (UTC)

Please assume good faith. There is no reason to doubt that CynRN is trying to help the article be NPOV. I'm not sure what was meant by "agreed upon citations"; certainly Janse is not agreed upon. Eubulides07:00, 23 February 2008 (UTC)

I'm here to help the chiropractic article be the best it can, so of course I'm willing to compromise. I definitely think it's possible to blend the best of Eubulides version and the current text but that will require some concessions from Eubulides who hasn't made any. Every contrast to mainstream med is gone (I think this is personally a glaring omission and had reliable primary sources to support the reductionist and biomedical model that is PRIMARILY used currently in allopathic medicine) and yet Eubulides won't budge on Janse and prevention which is fundamental to all chiropractors in some way shape or form (and you should be able to appreciate that given the diversity of DCs in terms of practice styles and philo) EBDCM05:22, 22 February 2008 (UTC)

I have made several compromises. I originally opposed mentioning prevention, but changed my mind when someone turned up a reliable source that supported a brief mention, and prevention is mentioned in the current draft. I originally thought that motivation should be presented first, but Dematt felt otherwise, and I accepted that. My draft originally mentioned subluxations, but that was removed at Dematt's suggestion. All in all I have incorporated many of the specific suggestions that have been made, and have attempted to respond constructively to specific suggestions that I didn't understand or didn't initially agree with. I am not opposed to including a contrast to mainstream medicine, so long as it's NPOV and is supported by recent reliable chiropractic and mainstream sources; however, I would prefer hearing other editors' views on that change before drafting it. Eubulides08:34, 22 February 2008 (UTC)

That's highly debatable, Eubulides. If you call compromising by refusing to acknowledge any primary sources presented that dispute yours, wanting to completely eliminate any mention of medicine in any way shape or form, want to omit Janse who is a highly respected chiropractic educator and scientist if you call you outright denial of including prevention (despite the many sources provided and 1 expert opinion), than sure I guess you're compromising. EBDCM00:47, 23 February 2008 (UTC)

There must be some confusion here. I put prevention into the draft despite my initial opposition; this was after someone came up with a reliable secondary source (not as good as "PPC", but good enough). It's MEDRS that prefers secondary sources to primary when they disagree, and there are good reasons for this guideline. It doesn't matter how respected Janse is as a chiropractor; if his quote is strongly POV against mainstream medicine it needs to be balanced by mainstream opinion. Like it or not, Wikipedia emphasizes mainstream sources, particularly when covering important claims that disagree with mainstream sources. Please see Wikipedia:Verifiability for details. Eubulides07:12, 23 February 2008 (UTC)

A couple of points. The reductionist model is NOT the one currently used by the mainstream docs I know, even in the hospital!. It used to be, for sure. Engel pioneered the biopsychosocial model decades ago, and it is the one I see in practice in my community.http://www.annfammed.org/cgi/content/full/2/6/576

Second, I think Coppertwig had a problem with the Janse quote, too, and maybe DigitalC, but we'd have to ask him. Finally, I don't have a problem with having prevention in the philosophy section.CynRNCynRN07:41, 22 February 2008 (UTC)

Your points are anecdotal in nature and not change the fact that the biomedical model is the DOMINANT model within mainstream medicine. This is well known. I know there's progressive MDs and RNs and mainstream practitioners out there but to they form the majority? No. DigitalC favours Janse, Coppertwig seems to be on the fence with a few qualifiers. EBDCM00:47, 23 February 2008 (UTC)

You keep using "common knowledge" as the basis for maintaining that the biomedical model is dominant in medicine. Does not CMCC teach biomedical practices as an integrated part of patient centered care? I really want to know, in practice, how the the 'contrasting' approaches to patient care, (holistic vs reductionist, etc) would play out in, for instance, a well child visit to a chiropractor vs a pediatrician. Would a chiropractor be able to address the breadth of concerns that a pediatrician would? I don't know, I am really curious.CynRNCynRN23:38, 23 February 2008 (UTC)

I think a compromise would be against NPOV. For example, the Janse stuff is a clear example of an NPOV issue. The past tense is another problem. I recommend a proposed draft be done based on NPOV and not degrading the quality of work. I checked the history of this article. It has been under dispute for years. I recommend we seek to get more uninvolved editors to help out here. With all do respect, can we stay focused on NPOV. I want to see a proposed draft that "is" NPOV and "not" a compromise. I must say, it seems that a compromise would in fact be POVish. QuackGuru09:19, 22 February 2008 (UTC)

I changed the past tense to the present tense, to work around that particular problem. Eubulides23:32, 22 February 2008 (UTC)

Here are more options to consider: Wikipedia:WikiProject Neutrality DR. The last resort is Wikipedia:RFARB. QuackGuru10:01, 22 February 2008 (UTC)

I really don't think that Janse is a big NPOV issue. Furthermore, progress is being made, as so I don't think we need to think about DR or RFARB. DigitalC12:39, 22 February 2008 (UTC)

That leaves CynRN and Eubulides. Janse stays. EBDCM00:47, 23 February 2008 (UTC)

Hi everybody, remember, this is everybody's work. When we are finished, this will be "our" work. The beauty of this is that it is the work of a wide variety of editors with varying POVs coming together to create something accurate. It still has to make it past a lot of other editors. Our job here is to document what we think and that is what defends our edits. Each of our contributions are important, so hang in there till the end. I haven't closed my mind to anything, yet, Janse, reductionist, holism, etc.. I don't have to, and neither should any of you. QG is right, compromise is not what we are after, we are after V and RS. It is not a compromise if someone is convinced by the sources to change their mind. Also, I think both versions have dropped reductionist. If we were to use that word now, I think I would avoid using it to compare to conventional medicine. The point is that everyone now realizes that health care cannot be reduced to the molecular or system level and cure all diseases, because there are emergent factors that we cannot escape. The only point we need to make is that chiropractic has always felt that way. It is the foundation of holism and vitalism, whether you believe it is due to spirtual or emergent reasons. That really is the only reason to use the word, though it is an important one, we just don't have to use it to compare us to medicine - we're all just healthcare professionals doing our best to get our patients well. -- Dematt Dēmatt 14:34, 22 February 2008 (UTC)

I disagree that chiropractic can be so easily distinguished between mainstream medicine that way. Chiropractic has always used some reductionist techniques, just as mainstream medicine has. Our primary reliable source tends to agree. The word "reductionist" is used in the text of "PPC" (3rd ed.) in two places to describe aspects of chiropractic, and in one place to describe mainstream medicine. Page 331 contains the main use of the word "reductionist" to describe chiropractic. It says "There is an inherent, but healthy, tension between vitalism and reductionism within the concept of health. Vitalism suggests the wonder of life and its robust complexity. It provides a metaphor for 'subluxation' and 'adjustment' and the ability to imagine new frameworks for thinking. Reductionist exploration provides answers on how life remains so robust. It provides the details that allow the doctor to intervene productively using a theoretical foundation for the doctor's discipline." This is in the chapter on chiropractic theory (not chiropractic philosophy), but it's relevant to any attempt to discuss reductionism in ChiropracticPhilosophy. Page 65 contains the only use of the word "reductionistic" to describe mainstream medicine, and it's talking about the disputes with allopathic medicine at the time of B. J. Palmer. If we use "reductionistic" in that way, it would be appropriate to mention it in the discussion of straight philosophy. However, this source does not support using "reductionistic" to disparage, or even describe, current mainstream medicine. Eubulides17:57, 22 February 2008 (UTC)

Of course you do, Eubulides. You object to anything less than your own edit. If you suggest that holism isn't PRIMARILY chiropratic and REDUCTIONISM isn't primarily medicine you're out to lunch. Why are you so scared of the contrast, Eubulides? Why can we not contrast medicine and chiropractic philosophy? Lastly, I think it's time you use another source for your arguments, PPC isn't the only chiropractic book around, you know. Anyways, you are being less than forthright by insinuating that somehow mainstream med is not primarily reductionistic. I'll get more sources to prove this point and that they primarily use the biomedical model and then we can contrast them for contextual purposes. Thanks! EBDCM00:41, 23 February 2008 (UTC)

I disagree that the implementation of clinical medicine is primarily reductionistic. My source for this is Ahn "et al." 2006 (PMID|1459480). which says that it's system-oriented, not reductionistic. I agree that the "science" of clinical medicine is primarily reductionistic; but that's because science is primarily reductionistic, not because medicine is. I would be willing to contrast chiropractic from mainstream medical philosophy in ChiropracticPhilosophy, but it would need to be a contrast taken from reliable sources on both sides of the dispute, as opposed to the current one-sided account. Eubulides07:34, 23 February 2008 (UTC)

I'm not sure people understood what I wrote above. -- Dematt Dēmatt 02:42, 23 February 2008 (UTC)

I understood it to mean that the draft should focus more on vitalism and holism, and shouldn't use "reductionistic" to criticize mainstream medicine. The current draft does this, no? Eubulides07:23, 23 February 2008 (UTC)

As for coming together, we will never establish universal consensus. There are aspects of the current draft I disagree with, as mentioned above (have you had time to think about my comment about past tense?). However, the remaining suggestions are relatively minor . It's time we installed this draft into the main article. It can use improvements no doubt, but it's far better than what's in ChiropracticPhilosophy now. Time to stop cutting bait and start fishing, no? Eubulides17:57, 22 February 2008 (UTC)

I'm not sure what part of the world your in, or your occupation, but we need to give everybody time to digest each others thoughts. -- Dematt Dēmatt 02:42, 23 February 2008 (UTC)

Regarding the term 'public health' in the last paragraph, the ref. doesn't support this. It talks about "preventative maintenance care". I don't doubt that some chiropractors volunteer in the chiropractic section of the American Assoc of Public Health, but when I try to find 'chiropractic public health' I don't find much support for the concept. See: http://findarticles.com/p/articles/mi_qa3987/is_200506/ai_n13643777 CynRNCynRN18:51, 22 February 2008 (UTC)

The last paragraph of the current draft (in Philosophy 2) doesn't metion public health. Perhaps you're talking about some other draft? Anyway, it sounds like the current draft avoids the problem you're mentioning. Eubulides23:26, 22 February 2008 (UTC)

I was referring to the current version of Phil, not your Phil 2 version and that wording has been changed since, I think. CynRNCynRN23:38, 23 February 2008 (UTC)

No further comment on the present vs past tense issue, so for now I changed the discussion of straight chiropractic philosophy to use the present tense. Eubulides23:32, 22 February 2008 (UTC)

CynRN, I always look to see if it is coming from a Verifiable and Reliable source. If it is, then I look to make sure the source was quoted accurately and then to see if it captured the tone of the author. If so, then I leave it there and continue working with it. I am really not married to anything I write, so feel free to change whatever you want. Eventually, we'll get something that we are both equally happy/upset with. -- Dematt Dēmatt 02:42, 23 February 2008 (UTC)

Please change it back to past tense. You jumped the gun here again, Eubulides. Regarding that it's far better, I disagree completely, if anything it's generally poorly written, bland, has major omissions, fails to adequately contrast this philosophy vs. medical one, relies too much on one source (PPC) omits Janse which the majority of the editors want to retain, etc. Regarding public health initiatives, our mainstream editors again fail to realize that chiropractic and CAM professions DO NOT do the same public health measures as mainstream med, partially because of the historical bias and antagonism displayed by mainstream med towards chiropractic (look at this talk page for numerous examples). EBDCM00:41, 23 February 2008 (UTC)

EBDCM, how about taking a look and adding some of your input to the Philosophy2 so we can see how it will all look together. -- Dematt Dēmatt 02:42, 23 February 2008 (UTC)

Dematt, as per your suggestion I made a preliminary first draft on a hybrid philo based on eubulides version and the current draft. Feel free to re-arrange, edit, add anything you think should be covered but I think we've addressed the majority of topics talked about here. Any other thoughts, suggestions? List them below the integrated draft. Cheers. EBDCM08:35, 23 February 2008 (UTC)

Public health and wellness

Additional info:

"The amount and content of courses in public health conducted at the 16 accredited U.S. chiropractic colleges are not standardized. The course hours are considerably lower than in medical education. Courses vary widely, depending on the interests and expertise of the individual instructor. Many courses do not mention the chiropractor's role in public health, and neglect several important prevention topics." http://findarticles.com/p/articles/mi_qa3987/is_200105/ai_n8943700

-- Fyslee / 02:28, 23 February 2008 (UTC)

This article also supports the pubic health citation, albeit in its infany. I wouldn't expect that chiropractic's role in public health would duplicate medicine's responsibility. -- Dematt Dēmatt 02:59, 23 February 2008 (UTC)

Anything more recent Fyslee, say from 2007....? Whoa, there it is! http://www.chiro.org/research/ABSTRACTS/CCE_Adopts.shtml Let's include this as well. It's verifiable. EBDCM02:39, 23 February 2008 (UTC)

Certainly more recent sources should also be included, since the history of this issue is both old and new, with changing emphasis, which means that we have both conservative and progressive POV within the profession at the same time. Most of the references in the 2007 abstract you found are from a time when "wellness" meant nearly only one thing within chiropractic - "wellness care" - IOW mainly adjustments as the subluxation-based treatment of choice of "well" patients for a lifetime, even in the absence of symptoms. This concept has nothing to do with "public health" education as practiced in the medical world, where "wellness" involves lifestyle changes as the main emphasis. Chiropractic "wellness" care is focused on getting patients to become dependent on adjustments. One of the greatest and most popular proponents of this concept in modern times was the late http://www.worldchiropracticalliance.org/tcj/2004/sep/e.htm Joseph Flesia http://www.google.com/search?sourceid=navclientie=UTF-8oe=UTF-8q=chiropractic+joseph+flesia, who described the chiropractic "wellness" paradigm very eloquently, a paradigm that has been embraced by untold numbers of chiropractors. It is briefly summarized in this statement:

"My position is that the 81% of society into wellness today are ALL prospective subluxation-based, vitalistic/innate intelligence chiropractic wellness patients. With their entire families, children and parents -- for a lifetime, of course. Renaissance Seminars has been teaching and maturing this very same message for 21 years." - Joseph Flesia, DC

Needless to say, his seminars were almost entirely focused on adjustments and subluxation-based treatment, with little if any overlapping with normal mainstream medical "public health" concerns. You can find more information http://www.chirobase.org/03Edu/flesia.html about him here.

The http://www.ccp-guidelines.org/guideline-1998.pdf CCP Guidelines on Vertebral Subluxation in Chiropractic Practice are interesting on this phenomenon.

There are other, probably younger, chiropractors who are slowly gaining dominance (but not before all the old ones are dead and relinguish power), who would likely share similar definitions of "wellness" as MDs and others in mainstream medicine, IOW without any dependence on adjustments as a form of prevention of disease. They educate their patients in "wellness" as lifestyle changes, not as dependence on adjustments.

Summary: "Public health" and "wellness" mean different things to the medical mainstream and most chiropractors, but some younger chiropractors share the mainstream medical understandings. Dematt is correct. There is likely little duplication since there is a different emphasis. MDs look at many lifestyle factors and tie different factors to different illnesses and conditions, and treat and advise accordingly in their public health and treatment efforts. Conservative chiroprators would tend to treat the spine and assume that this will prepare the body to better deal with all types of healthcare issues. Thus adjustments are the cure all. Now that's an obvious generalization, but not too far off the mark. -- Fyslee / 07:28, 23 February 2008 (UTC)

Fyslee, who is the main organization/parties behind the CCP and what credibility does it have next to the CCGPP? Insurance carries and governments clearly cannot have 2 different practice guidelines on the same topic from the same profession? Do the straight guidelines not get trumped by the better evidence and research in the CCPG? EBDCM07:36, 23 February 2008 (UTC)

It makes no difference to Wikipedia. Both exist and are part of the whole story, so both should be used. There is no such thing as "trumping", since that would introduce editorial bias as to which sources we use. We use both when they present different aspects of the whole story. -- Fyslee / 07:41, 23 February 2008 (UTC)

Chiropractors in different countries

I would like some information on chiropractors in different countries. Most of this article seems to be about America.

I havent seen any advertisment of chiro-practice in mainland Europe, but I know it exists in Ireland. However, in Irelnd, there is no regulating body, and it seems to be rife with quackery (I was doing work experiance in a physiotherapists clinic, and saw its ill effects). What is its international state? Is it recognised by the WHO or any specific countires. Also, does it have a bad status with the official governing body of any counries, states, etc. Crakker21:13, 22 February 2008 (UTC)

This is a good thought Crakker. The Chiropractic schools article seems to say that there is, it would be nice if we had someone adding some content for this, how about you! ;-) -- Dematt Dēmatt 02:27, 23 February 2008 (UTC)

Agreed. There is plenty of room for more information on this subject, no doubt from several different angles. As we are very aware, chiropractic, chiropractors, and chiropractic education can be quite different and varied, which makes this all a very interesting and fascinating subject. -- Fyslee / 00:35, 24 February 2008 (UTC)

[[Wikipedia:WikiProject Neutrality|serious NPOV issues (oh my)]]

Lead

There are serious NPOV issues with this article. The lead needs to conform to LEAD and be neutrally written.

The word confusion in the lead does not make much sense to me. I don't get it with respect to the word confusion.

There needs to be references to verify the text in the lead. For example, a reference to support the inclusion of the four distinct chiropractic groups is necessary. --QuackGuru21:55, 22 February 2008 (UTC)

There is still no explanation to the usage of the word confusion in the lead. Please discuss. QuackGuru19:53, 26 February 2008 (UTC)

Practice styles and schools of thought

The Practice styles and schools of thought secton is cluttered and difficult to read. In its recent form it is hard to follow and does not flow well. For example, mixing the "Straight" chiropractors and "Objective" chiropractors in the same paragraph is confusing. Having each group in its own paragraph would be best. Per WEIGHT, we can still incude each group. An off-shoot refers to its origin and not its prominence anyhow. A well writtened introduction to the Practice styles and schools of thought secton is lacking. It is short but can easily be expanded. I think it would be better to move the table to the right. --QuackGuru21:55, 22 February 2008 (UTC)

It actually reads quite well. Objective are offshoots of straights and share many similarities as straight and, accordingly, should be talked about in the straight section. Same logic goes for the reform and mixer groups. EBDCM —Preceding comment was added at 01:55, 23 February 2008 (UTC)

For readability purposes it should be in its own paragraph. The objective straights addition can be limited but also in its own paragraph. QuackGuru03:36, 24 February 2008 (UTC)

"Common themes in chiropractic care are conservative, non-invasive, non-medication approaches via manual therapy.19 Nonetheless, there are significant differences amongst the practice styles, claims and beliefs between various practitioners.20 Those differences are reflected in the varied viewpoints of multiple national practice associations.33 There are four practice styles and schools of thought among chiropractors.1534" This was in the article and was a nice introduction to the section and well sourced. Please explain the http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=nextoldid=193388116 deletion. Thanks. QuackGuru03:40, 24 February 2008 (UTC)

I apologize for deleting the citations; they were inadvertently taken out while I reverted your omnibus bill of an edit which spanned almost every section of the article. In the future, if you keep your edits to one section at a time, they're less likely to be mistakenly taken out. Feel free to add those citations again. Thanks. EBDCM07:56, 24 February 2008 (UTC)

"At times manual therapy is synonymous with"manual medicine". Philosophically, reform chiropractors focus on the structural and functional relationships of the neuromusculoskeletal system in both health and disease. Reform chiropractors support vaccination as a cost-effective and proven preventative health measure."

"There have been some calls to differentiate reform or 'contemporary' chiropractors from both straight and mixer chiropractors by establishing a Doctor of Chiropractic Medicine (D.C.M.) degree. It is argued this would distinguish them from previous diplomas, and would allow current DCs to upgrade their education to the DCM degree whivh would permit DCMs to utilize prescription drugs suitable to the limitations of their practices and have a unified scope of practice across all jurisdictions."

These sentences don't add much to the article. The section needs to be cleaned up. The vaccination bit should remain in the vaccination section and not this section. QuackGuru20:43, 24 February 2008 (UTC)

It's notable and verifiable re: the DCM and it was written by a skeptic of chiropractic as well. It's important to clearly differentiate the different styles of thoughts and approaches hence the structure and function which is also verifiable from a reliable source. Thanks for your input, QG! EBDCM23:58, 24 February 2008 (UTC)

According to what references it's notable and verifiable. Please explain. QuackGuru01:15, 25 February 2008 (UTC)

I added back in the citations. QuackGuru01:55, 25 February 2008 (UTC)

You http://en.wikipedia.org/w/index.php?title=Talk:Chiropracticdiff=nextoldid=193660160 apoligized for deleting the citations but you http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=nextoldid=193860469 deleted the citations again. Please discuss the deletions. QuackGuru05:33, 25 February 2008 (UTC)

History

The history section can include the survey. It does not fit in the lead but can be included somewhere else in this article such as the history section. The text of the survey is as follows: A 2003 paper showed that 90% of North American chiropractors surveyed believed vertebral subluxation played a significant role in all or most diseases. --QuackGuru21:55, 22 February 2008 (UTC)

The survey was selected by Mccready. If editors prefer, we can select another study. That's fine with me. I thought this information would improve this article. We can try using other references such as the Biggs study. We can add the Biggs study instead "http://en.wikipedia.org/w/index.php?title=Talk:Chiropracticdiff=nextoldid=193404105 that shows that 36% of DCs think vert sub causes disease." I am open to suggestions. --QuackGuru04:31, 23 February 2008 (UTC)

Safety

The safetey section is a huge POV probem. There is too much WEIGHT being given to describing The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. It seems pointy to have a lengthy description of The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. It can be shortened. The reference linking to the The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders website and the reference linking to chiropractic advocacy group's news release in the article are not RS. This can easily be fixed by replacing it with the "Spine" journal reference. The following text in the safety section seems out of place and is not referenced: "Patients should be screened and undergo a complete clinical exam including history, physical and at times additional specialized imaging and laboratory diagnostics in order to rule out any of these contraindications before undergoing a treatment regime that includes spinal manipulation. Spinal manipulation is a controlled health act and should not be performed except by licensed health professionals whose scope allows it." There are many references to include in this section that will expand and explain about the safety issues. Deleting well sourced sentences supported by references is a clear NPOV issue. In this regard, my first option would be the Wikipedia:WikiProject Neutrality. We need more uninvolved Wikipedians. Agreed? --QuackGuru21:55, 22 February 2008 (UTC)

I agree that we should use spine as the main reference. Good suggestion, GQ. Lets get those references (you do agree that there is a clinical examination and diagnosis prior to treatment and SMT, right? You do agree that the practice of SMT is limited by scope of practice and legislated acts, right? What do oyu mean by uninvolved? Uninformed? The community here is very knowlegeable and has a scientific bent to it which, IMO is a huge bonus because the quality of citations, and accordingly, the article, goes up. EBDCM08:39, 23 February 2008 (UTC)

I did not say to use the Spine ref as the main ref. It should be the only ref because it is RS and because The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders and the chiropractic advocacy group is not RS. It there a RS ref for "the practice of SMT is limited by scope of practice and legislated acts" you described above? What do I mean by uninvolved? I want more uninvolved editors to help NPOV this article. Please explain your reasons for http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=nextoldid=193388116 deleting the new Spine ref, the WHO reference, and the Edzard Ernst ref anyhow. --QuackGuru03:33, 24 February 2008 (UTC)

"http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=nextoldid=193389928 In February 2008, the World Health Organization sponsored Bone and Joint Decade 2000-2010 Task Force on Neck Pain and its Associated Disorders, the largest and most comprehensive study on neck pain to date. The task force was comprised of a group of international clinician-scientists and methodologists to undertake a best-evidence synthesis on neck pain and its associated disorder and make recommendations of clinical practice guidelines for the management of neck pain and its associated disorders. This included a consensus of the top experts in the world whose findings will be collated using best-evidence synthesis, which addresses risk and prevention, diagnosis, prognosis and treatment risks and benefits." Please explain your reason to add such a HUGE amount of text to describe The Joint Decade 2000-2010 Task Force on Neck Pain and its Associated Disorders. It "smacks" POINT. QuackGuru03:58, 24 February 2008 (UTC)

The NPOV problems with this section has continued. I will restore the facts and add more information to strengthen NPOV. QuackGuru20:59, 24 February 2008 (UTC)

The neck pain study was 6 years in length, comprised over 1 million patient years and was a landmark study which included a various array of health professionals and researchers (i.e. there was a consensus). This helps readers to know that the findings and conclusions are accepted by a wide majority of professional researchers. It also explains to readers why it's an important study whose conclusions are worth including. Thanks. EBDCM00:00, 25 February 2008 (UTC)

It is still way too much text. The length of the study does not mean we should add such a huge amount of text. QuackGuru01:11, 25 February 2008 (UTC)

Describing The Joint Decade 2000-2010 Task Force on Neck Pain and its Associated Disorders does not need to be so long. QuackGuru01:31, 25 February 2008 (UTC)

The WHO report in the 'Safety' section was http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=prevoldid=191131592 referenced but the reference was http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=nextoldid=191131592 deleted. Please explain this. QuackGuru01:17, 26 February 2008 (UTC)

I don't understand this last comment. The first URL does not point at a reference, and the second URL does not point at the deletion of a reference. Eubulides01:30, 26 February 2008 (UTC)

http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=prevoldid=191131592 In a 2005 report, the World Health Organization states that when "employed skilfully and appropriately, chiropractic care is safe and effective for the prevention and management of a number of health problems." The WHO report goes on to say, "there are however, known risks and contraindications to manual and therapeutic protocols used in chiropractic practice," and, "Contraindications to spinal manipulative therapy range from a nonindication for such an intervention, where manipulation or mobilization may do no good, but should cause no harm, to an absolute contraindication... where manipulation or mobilization could be life‐threatening." This was http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=prevoldid=191131592Safety referenced but the http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=prevoldid=191131592_note-WHO reference got http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=nextoldid=191131592 deleted. QuackGuru02:14, 26 February 2008 (UTC)

Sorry, I still can't make heads or tails of that comment. All its URLs point to the same diff listing, which contain zero diffs, so I don't see what changed. I agree with you that the section in question is overly POV. But I still don't understand this specific comment. Eubulides08:38, 26 February 2008 (UTC)

A lot of the above text (including the reference) was removed and now it reads: "According to the World Health Organization "employed skilfully and appropriately, chiropractic care is safe and effective for the prevention and management of a number of health problems."cite this quote" I will add the text + reference back. QuackGuru08:45, 26 February 2008 (UTC)

Originally the 2005 WHO report was NPOV and referenced. Currently it is POV and unreferenced. QuackGuru08:56, 26 February 2008 (UTC)

I have included more text and references to verify the facts but it was deleted without any good explanation. QuackGuru19:56, 26 February 2008 (UTC)

Vaccination

All the tweaking to this section had diluted the entire section. I will restore the missing well sourced sentences. QuackGuru20:47, 24 February 2008 (UTC)

This first sentence is a little wierd."Mandatory vaccination is controversial within the chiropractic community controversial with different schools of thought" Controversial with different schools of thought doesn't make sense. I think it means straights often oppose it and mixers may not, but it could use clearing up. Just a little history of where the opposition came from would be useful; initial opposition to the germ theory, etc.CynRNCynRN21:23, 24 February 2008 (UTC)

I liked this lead in from Eubulides:"although vaccination is one of the most cost-effective form of prevention against infectious disease, it remains controversial in chiropractic. Most chiropractic writings on vaccination focus on its negative aspects.16" This is accurate and referenced.CynRNCynRN21:30, 24 February 2008 (UTC)

As long as it differentiates between the varying opinions within the chiropractic profession it's all good by me though we really don't need to go into germ theory, IMO. EBDCM00:02, 25 February 2008 (UTC)

"Most chiropractic writings on vaccination focus on its negative aspects, despite its being one of the most cost-effective forms of disease prevention." I think this would work too. QuackGuru01:21, 25 February 2008 (UTC)

I http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=193827870oldid=193822790 brought back the wording CynRN liked at about the same time that you suggested the other wording. Either wording is fine with me. Eubulides01:29, 25 February 2008 (UTC)

Both ways work for me. QuackGuru02:12, 25 February 2008 (UTC)

Education, licensing, and regulation

I will fix the red links and format a ref. QuackGuru20:52, 24 February 2008 (UTC)

I fixed the red links and formatted a reference but it was reverted. QuackGuru05:36, 25 February 2008 (UTC)

I fixed the red links again and formatted a reference among other things. It was reverted. The edit was http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=nextoldid=194142433 partial vandalism to this section. QuackGuru19:50, 26 February 2008 (UTC)

Treatment techniques vs. Manipulative treatment techniques

I think the appropriate title for the section should be "Chiropractic treatment techniques" because there is more than just manipulative techniques. QuackGuru21:13, 24 February 2008 (UTC)

The name "Chiropractic treatment techniques" runs afoul of HEAD, which says "Avoid restating or directly referring to the topic." To fix this particular problem I http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=193837981oldid=193832516 removed the word "Chiropractic" from the section header. Currently the body of the section talks only about manipulative techniques: shouldn't that be fixed too? Eubulides02:30, 25 February 2008 (UTC)

Agreed. "Treatment techniques" works in accordance with HEAD. QuackGuru02:36, 25 February 2008 (UTC)

Are all techniques manipulative or http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=prevoldid=192743594 not all techniques are manipulative. QuackGuru05:23, 25 February 2008 (UTC)

Holistic and naturopathic approach

This header seems unecessary. I don't see any point to keeping it. QuackGuru22:23, 24 February 2008 (UTC)

I agree. The current redrafts of the philosophy section seem to omit it, so it looks like it will go at some point. Eubulides02:31, 25 February 2008 (UTC)

Disagree. Why don't you want to readers to know this? EBDCM04:52, 25 February 2008 (UTC)

Section headers are supposed to be short and to the point. It's not a question of what I want readers to know; the material in question will be in the body, and doesn't need to be in a section header. Besides, it's strange for the entire contents of a section to consist of a single subsection, with no other text; I don't recall ever seeing that in any featured article in Wikipedia. Eubulides05:21, 25 February 2008 (UTC)

Comments on the 2008-02-22 12:06:18 edit

Here are some comments on the http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=193362220oldid=193276506 2008-02-22 12:06:18 edit that QuackGuru just made.

There are a lot of changes in that one edit, and many of them are no doubt controversial. Surely it'd be better to discuss the changes one by one; that's more likely to achieve a working consensus.

http://biochemistry.louisville.edu/education/chiro06.pdf Wheeler 2006 is not published in a refereed journal. I'd prefer a higher-quality citation.

I disagree that chiropractors fall into four distinct groups. See the comment "I checked two reliable sources on this subject." in Elimination of reform chiro above. Reliable sources agree about the two main groups (straights and mixers); the existence of the other two as formal groups is in doubt, and the article should not give greater emphasis to the other groups than reliable sources do. It is OK to mention the two less-well-supported groups, but not in so much detail that they appear to be just as important as the two main groups.

The cited source does not support the claim that "All groups, except reform, treat patients using a subluxation-based system." It doesn't say that mixers use a subluxation-based system.

The claim "A 2003 paper showed that 90% of North American chiropractors surveyed believed vertebral subluxation played a significant role in all or most diseases." is supported by McDonald 2003. I don't have easy access to that source, but http://www.chiroweb.com/archives/21/12/19.html this summary doesn't mention that figure. The summary mentions a bunch of other numbers, which may well be more notable than the 90% figure; why was the 90% figure selected here? Eubulides00:18, 23 February 2008 (UTC)

I haven't had the time to wade through all the studies on the efficacy and safety of spinal manipulation so I can't comment on the material in the many edits made in that section. However, I suggest using "cite journal" with pmid= instead of "cite news" with URLs in citations to Pubmed-indexed articles. I http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=193388116oldid=193362220 made that change just for Ernst 2008, to give you a feeling for how it works. Eubulides00:18, 23 February 2008 (UTC)

Eubulides

00:18, 23 February 2008 (UTC)

It appears that quack guru has cherry picked the evidence and neglected to include meta-analyses which have already been performed on this subject and shown SMT for LBP to be both safe and effective. It also demonstrates common reductionistic thinking that still pervades conv med. http://theintegratorblog.com/site/index.php?option=com_contenttask=viewid=381Itemid=1 EBDCM02:01, 23 February 2008 (UTC)

I will make the necessary adjustments based on all the comments above. QuackGuru21:20, 24 February 2008 (UTC)

I will adhere to NPOV and edit the article. QuackGuru10:32, 26 February 2008 (UTC)

I have included a meta-analyses study in the Safety section but it was http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=nextoldid=194142433 deleted. QuackGuru20:01, 26 February 2008 (UTC)

partial vandalism and NPOV violation

http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=nextoldid=194142433 This edit was in part vandalism. For example, references were removed that cited the text. "Evidence at the trial showed that the defendants took active steps, often covert, to undermine chiropractic educational institutions, conceal evidence of the usefulness of chiropractic care, undercut insurance programs for patients of chiropractors, subvert government inquiries into the efficacy of chiropractic, engage in a massive disinformation campaign to discredit and destabilize the chiropractic profession and engage in numerous other activities to maintain a medical physician monopoly over health care in this country." I provided a http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=prevoldid=194142433_note-ChiroBase reference that verified the above text.

A 2005 World Health Organization report states that when "employed skilfully and appropriately, chiropractic care is safe and effective for the prevention and management of a number of health problems." The report continued, "there are however, known risks and contraindications to manual and therapeutic protocols used in chiropractic practice," and, "Contraindications to spinal manipulative therapy range from a nonindication for such an intervention, where manipulation or mobilization may do no good, but should cause no harm, to an absolute contraindication... where manipulation or mobilization could be life‐threatening."51 I provided a http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=prevoldid=194142433_note-WHO_guidelines reference that verified the above text.

The current text reads: "According to the World Health Organization "employed skilfully and appropriately, chiropractic care is safe and effective for the prevention and management of a number of health problems."cite this quote" This is not the entire story of the 2005 report by WHO. The reference was deleted along with the balance facts. Therefore, it is an NPOV violation.

"In February 2008, the World Health Organization sponsored Bone and Joint Decade 2000-2010 Task Force on Neck Pain and its Associated Disorders, the largest and most comprehensive study on neck pain to date. The task force was comprised of a group of international clinician-scientists and methodologists to undertake a best-evidence synthesis on neck pain and its associated disorder and make recommendations of clinical practice guidelines for the management of neck pain and its associated disorders. This included a consensus of the top experts in the world whose findings will be collated using best-evidence synthesis, which addresses risk and prevention, diagnosis, prognosis and treatment risks and benefits.77"

Here is another example of an NPOV violation. The above text is a description of The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and its Associated Disorders. It also has WEIGHT problems.

http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=prevoldid=194142433Safety In February 2008, the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and its Associated Disorders, comprising a group of experts to evaluate neck pain and its associated disorder, released a manuscript of their findings with recommendations and guidelines, including associated risks and benefits. Here is the shortened text.

http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=prevoldid=194142433Safety This edit shortened the text and is NPOV as ever.

Also a http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=prevoldid=194142433_note-Spine_journal Spinal journal reference was added to replace the unreliable reference but it got deleted. The Spinal journal is a reliable reference.

http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=prevoldid=194142433Education.2C_licensing.2C_and_regulation The same edit fixed the red links and formatted a reference in the Education, licensing, and regulation section. But the formatted reference and the proper blue links were http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=nextoldid=194142433Education.2C_licensing.2C_and_regulation reverted. It was a clear policy violation (partial vandalism) to remove a formatted reference.

http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=prevoldid=194142433_note-Edzard_Ernst "formatted reference number 79"

http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=nextoldid=194142433_note-Edzard_Ernst "deleted reference number 70 in red"

A http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=prevoldid=194142433_note-Edzard_Ernst reference was formatted but the reference was http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=nextoldid=194142433_note-Edzard_Ernst deleted.

Spinal manipulation is a regulated medical intervention and can only be performed by chiropractors and a limited number of physical medicine professionals.9091

Most patients have no adverse effects from cervical manipulation,95 though the risk of stroke is not zero.9697

Here are a couple of more examples. The above text was referenced but the references were deleted.

There are problems with the Practice style and schools of thought section.

The four different groups were in its own paragraph along with a nice introduction but the introduction got shortened and the citation got removed. The current version reads: "Common themes in chiropractic care are conservative, non-invasive, non-medication approaches via manual therapy. Nonetheless, there are significant differences amongst the practice styles, claims and beliefs between various practitioners." Notice the missing citations.

"Common themes in chiropractic care are conservative, non-invasive, non-medication approaches via manual therapy.18 Nonetheless, there are significant differences amongst the practice styles, claims and beliefs between various practitioners.19 Those differences are reflected in the varied viewpoints of multiple national practice associations.34 There are four practice styles and schools of thought among chiropractors.1535" Now here is a quality introduction to that section along with references. No good explanation has been given to remove a good introduction.

http://en.wikipedia.org/w/index.php?title=Chiropracticoldid=194142433Practice_styles_and_schools_of_thought Before and NPOV.

http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=nextoldid=194142433Practice_styles_and_schools_of_thought After and POV.

It was a POINT violation to undo a quality edit. --QuackGuru21:12, 26 February 2008 (UTC)

http://en.wikipedia.org/w/index.php?title=Talk:Chiropracticdiff=prevoldid=194131680 Eubulides agrees with me that the 'Safety' section in question is overly POV. Any suggestions to NPOV this article would be helpful. QuackGuru21:49, 26 February 2008 (UTC)

Integrated Philosophy

Contemporary chiropractic belief systems vary along a spectrum of beliefs that range from dogmatic empirical deduction from vitalistic roots to an almost equally dogmatic denial of vitalistic concepts in materialism. Between these two extremes can be found principles such as "vitalism, holism, naturalism, therapeutic conservatism, critical rationalism, and thoughts from the phenomenological and humanistic paradigms."(Phillips, PPC page 73)

Vitalism, the belief that living things contain an element that cannot be explained through matter, and materialism, the belief that all things have material explanations, have been debated since the time of Plato and Aristotle and continued into the 20th century legally and politically differentiating early chiropractic from allopathic medicine and thereby helping ensure professional autonomy. Today's individual chiropractor balances this dualism by placing some degree of emphasis on the tangible, testable principle that structure affects function, and, the untestable, metaphorical recognition that life is self-sustaining.(Mootz) The chiropractor's purpose is to foster the establishment and maintenance of an organism-environment dynamic that is the most conducive to functional well-being of the person as a whole.(ACA, Philosophy, website)

Whether vitalist, naturalist, or materialist a holistic practitioner is patient-centered, appreciates the multifactorial nature of influences (i.e. structural, chemical, and psychological) on the functioning of the body in health and disease, and recognizes the dynamics and interplay between lifestyle, environment, and health. Holism is not unique to chiropractic philosophy as it pervades throughout most complimentary and alternative methods and the allied health care professions. This is also consistent with the biopsychosocial approach emphasized by both chiropractic and medicine.

Naturopathic, therapeutic conservative and naturalist elements suggest that lowered "host resistance" of the body facilitates the disease process and natural interventions are directed towards strengthening the host in it's effort to battle disease and return to homeostasis. Chiropractic care primarily uses manipulation and other conservative and natural therapies rather than medications and surgery.http://books.google.com/books?id=6Z8_0TOepwICpg=PA13lpg=PA13dq=chiropractors+drugs+surgerysource=webots=0ZiCOCItb6sig=ixv0S4nmaJsUjbNw7UE1bY5-OTs available online

Chiropractors also commonly use nutrition, exercise, public education, health promotion and lifestyle counseling as part of their holistic outlook towards preventive health care.http://www.sciencedirect.com/science?_ob=ArticleURL_udi=B6WK1-4DK6G4T-1_user=10_rdoc=1_fmt=_orig=search_sort=dview=c_acct=C000050221_version=1_urlVersion=0_userid=10md5=7fb28491da1f46038e6da6cfe6389209 Chiropractic's unique claim to improve health by improving biomechanical and neural function by the manual correction of joint and soft tissue dysfunctions of the neuromusculoskeletal system differentiates it from mainstream medicine and other complementary and alternative medicine (CAM) disciplines, but has been a part of osteopathy and many eastern medicine interventions.(Phillips, PPC) All chiropractic paradigms emphasize the spine as their focus, but their rationales for treating vary depending on their particular belief system.

Chiropractic philosophy also stresses the importance of prevention and primarily utilizes a pro-active approach and a wellness model to achieve this goal.http://www.ncbi.nlm.nih.gov/pubmed/10658871?dopt=Abstract For some, prevention include a concept of "maintenance care" which attempts to "detect and correct" structural imbalances of the neuromusculoskeletal system while in its primary, or functional state.http://www.ccachiro.org/client/cca/cca.nsf/web/Chapter%2014%20-%20Preventative-Maintenance%20Care?OpenDocument The objective is early identification of mechanical dysfunctions to prevent subsequent deterioration resulting in permanent pathological changes. (Janse)

In summary, the major premises regarding the philosophy of chiropractic include:

"The major principles within the philosophy of chiropractic care"'cite book |chapterurl=http://chiroweb.com/archives/ahcpr/chapter2.htm |chapter= Chiropractic belief systems |author= Mootz RD, Phillips RB |date=1997 |title= Chiropractic in the United States: Training, Practice, and Research |pages=9–16 |editor= Cherkin DC, Mootz RD (eds.) |accessdate=2008-02-14 |version= AHCPR Pub No. 98-N002 |location= Rockville, MD |publisher= Agency for Health Care Policy and Research |oclc=39856366note-type-WikipediaModel_ref_notenote-type-WikipediaModel_ref_note

"Holism"

noninvasive, emphasizes patient's inherent recuperative abilities

recognizes dynamics between lifestyle, environment, and health

spine and health are related in an important and fundamental way, and this relationship is mediated through the nervous system.56

recognizes the centrality of the nervous system and its intimate relationship with both the structural and regulatory capacities of the body

appreciates the multifactorial nature of influences (structural, chemical, and psychological) on the nervous system

"Conservatism"

balances the benefits against the risks of clinical interventions

emphasizes noninvasive treatments to minimize risk with a preference to avoid surgery and medication

recognizes as imperative the need to monitor progress and effectiveness through appropriate diagnostic procedures

prevents unnecessary barriers in the doctor-patient encounter

"Manual and Biopsychosocial Approaches"

strives toward early intervention, emphasizing timely diagnosis and treatment of functional, reversible conditions

emphasizes a patient-centered model whereby the patient is considered to be indispensable in, and ultimately responsible for, the maintenance of health.53

Unique approach of improving health through influencing function through structure primarily via manual theapies

Comments on &quot;Integrated philosophy&quot;

There is a hybrid between Eubulides version and the current text. We're almost there, but lets not rehash old battles (Janse, prevention for example)... Is there anything missing from this that is a game breaker? How about the contrast in belief systems? I think that one is fair game, it's NPOV and simply states the PREFERENCES of the MAJORITY of practitioners in their respective fields. EBDCM08:20, 23 February 2008 (UTC)

I thought you were in favor of moving Janse to the medical opposition section? Eubulides09:04, 23 February 2008 (UTC)

That is up for discussion, yes. Until we arrive at some kind of compromise, let's keep it here.

This draft omits all discussion of straight chiropractic philosophy. That goes too far. Straight chiropractic philosophy is still used by a significant minority, and it is an important source for the mixers (even if they reject much of it). Eubulides09:04, 23 February 2008 (UTC)

How do you propose we include it? If straight philosophy gets a mention, what about the mixer and reform POV? EBDCM16:13, 23 February 2008 (UTC)

It's fine to mention all three, roughly in proportion to the relative importance. Number of adherents is one way to measure weight; importance to the development of chiropractic is another; both methods should contribute to weight. Either way, the section cannot ignore straight philosophy. Philosophy 2 shows one way to mention it; there are others. Eubulides02:36, 25 February 2008 (UTC)

This version is too repetitive. By my count it contains 819 words as opposed to Philosophy 2's 378 words. And yet it doesn't cover that much more. (How many times does it say "holism", for example?) Let's add whatever stuff is needed to Philosophy 2; that'll be less work than trimming from this version. Eubulides09:04, 23 February 2008 (UTC)

The a significant section is spent on explaining Janse. If we move Janse (and the qualifying statements) to medical opposition it's not much longer that your proposal but includes many more omitted points. I will do some trimming above as per your and Dematt's suggestions. EBDCM16:13, 23 February 2008 (UTC)

Well, this does need work ;-). It doesn't matter to me whether we clean up the other one or this one, theoretically, we should end up with the same thing as long as the same group of people are here. The factor that this one has that the other one doesn't is EBDCM's input, so maybe it woul dbe better to clean this one and then we should have everyone's POV covered.

Just for the record, I am having trouble following all the conversations that are occurring throughout this page. This is not anyone's problem, but my own as my time is split between various activities that don't allow long periods of time to read and respond to all the important converstaions. However, if there is something that you feel you need my response to, please feel free to drop a note on my talk page to take a look, but you probably don't need me to decide most of this stuff. If you use verifiable and reliable sources, it should be okay.

Eubulides, you seem to be looking at an searchable source of the PPC. Is it online? Can you provide me with a link? Nevermind, I found it http://books.google.com/books?id=6AxzMPihC94Cpg=PA285lpg=PA285dq=principles+and+practice+of+chiropractic+3rd+edsource=webots=F5ZJScEf26sig=cqOoAz240MS228rjPT8Q5PTTQYA in google books.

EBDCM, some of your stuff above is not clearly sourced, so as I go through it, if I delete something that you think is important, just show me where it was in your reference and I'll rethink my edit, too.

That sounds reasonable. If something needs to stay or deserves mention I'll track down an appropriate reference and we can discuss it.

QG, I have been concentrating on this philosophy section, so forgive me if I don't respond directly to your concerns, yet.

CybRN, I think we will eventually be able to rid ourselves of the Janse quote, but will need to find another way to make the same points first. Whatever it is, it will be handled NPOV. Feel free to work this out.

As I alluded to before, we can pontentially move it to the medical opposition section with the appropriate qualifiers. Cyn seems fairly level-headed on this and her input as to what may be a good qualifier for that section would be appropriate. That way Janse stays, but is out of philosophy but goes to med. opp with appropriate context around it. EBDCM16:13, 23 February 2008 (UTC)

-- Dematt Dēmatt 15:28, 23 February 2008 (UTC)

A medical opposition section could be very interesting, although the main article is pretty long as it stands. Hopefully, the chiropractic doctors here will acknowledge that conventional medicine is closer to holism than they want to believe. From Wikipedia, nurse practitioner: "The core philosophy of the field is individualized care. Nurse Practitioners focus on patients' conditions as well as the effects of illness on the lives of the patients and their families. Informing patients about their health care and encouraging them to participate in decisions are central to the care provided by NPs." I admit neurosurgeons can be pretty 'reductionist' but any decent primary care practitioner practices in a holistic way. A subheading about medical opposition will hopefully make it clear that the differences, at least in modern times,are not so extreme. —Preceding ) 05:11, 24 February 2008 (UTC)

Yes, CynRN, I don't doubt you one bit. I am personally of the opinion that, in reality, most of the problems that exist among medicine and chiropractic are manufactured as marketing tools by each profession. I really don't see why we should perpetuate the myth by adding a medical opposition section. The current section was part of the history of chiropractic, which is where it belongs. -- Dematt Dēmatt 14:11, 24 February 2008 (UTC)

Wow, that was tough. That took two days. After reading all the sources and takiing into account all the POVs here, I molded, melded, integrated, castrated and mutilated as much as I could. It has parts of everyone. A true melting pot of ideas. It still needs work. Read it through and lets take it from there. I put the new version below. -- Dematt Dēmatt 18:19, 24 February 2008 (UTC)

Another philosphy conglomeration

Contemporary chiropractic belief systems vary along a spectrum that ranges from deduction from vitalistic roots to the materialism of science. Between these two extremes can be found principles such as "vitalism, holism, naturalism, therapeutic conservatism, critical rationalism, and thoughts from the phenomenological and humanistic paradigms."cite book |author= Phillips RB |chapter= The evolution of vitalism and materialism and its impact on philosophy |pages=65–76 |title= Principles and Practice of Chiropractic |edition= 3rd ed. |editor= Haldeman S, Dagenais S, Budgell B "et al." (eds.) |publisher=McGraw-Hill |date=2005 |isbn=0-07-137534-1

Vitalism, the belief that living things contain an element that cannot be explained through matter, and materialism, the belief that all things have material explanations, have been debated since the time of Plato and Aristotle, continuing into the 20th century, legally and politically differentiating early chiropractic from allopathic medicine and thereby helping ensure professional autonomy.cite book |author= Keating JC Jr |chapter= Philosophy in chiropractic |pages=77–98 |title= Principles and Practice of Chiropractic |edition= 3rd ed. |editor= Haldeman S, Dagenais S, Budgell B "et al." (eds.) |publisher=McGraw-Hill |date=2005 |isbn=0-07-137534-1 Today's individual chiropractor balances this dualism by emphasizing both the tangible, testable principle that structure affects function, and the untestable, metaphorical recognition that life is self-sustaining. The chiropractor's purpose is to foster the establishment and maintenance of an organism-environment dynamic that is the most conducive to functional well-being of the person as a whole.

Whether vitalist, naturalist, or materialist, a holistic practitioner takes a patient-centered approach, appreciates the multifactorial nature of influences (i.e. structural, chemical, and psychological) on the functioning of the body in health and disease, and recognizes the dynamics and interplay between lifestyle, environment, and health. Holism is not unique to chiropractic philosophy, as it pervades throughout most complementary and alternative methods and the allied health care professions. This is also consistent with the biopsychosocial approach emphasized by both chiropractic and medicine.

Therapeutic conservative, naturopathic and naturalist elements suggest that lowered "host resistance" of the body facilitates the disease process and natural interventions are directed towards strengthening the host in its effort to battle disease and return to homeostasis. Chiropractic care primarily uses manipulation rather than medications and surgery.cite book |editor= Mootz RD, Hansen DT |title= Chiropractic technologies |publisher= Jones Bartlett |date=1999 |isbn=0834213737 |author= Hansen DT, Mootz RD |chapter= Formal processes in health care technology assessment: a primer for the chiropractic profession |pages=3–17

Chiropractors also commonly use nutrition, exercise, patient education, health promotion and lifestyle counseling as part of their holistic outlook towards preventive health care.cite journal |journal= J Manipulative Physiol Ther |date=2000 |volume=23 |issue=1 |pages=1–9 |title= A survey of practice patterns and the health promotion and prevention attitudes of US chiropractors, maintenance care: part I |author= Rupert RL |doi=10.1016/S0161-4754(00)90107-6 |pmid=10658870 Chiropractic's unique claim to improve health by improving biomechanical and neural function by the manual correction of joint and soft tissue dysfunctions of the neuromusculoskeletal system differentiates it from mainstream medicine and other complementary and alternative medicine (CAM) disciplines, but has been a part of osteopathy and many eastern medicine interventions. All chiropractic paradigms emphasize the spine as their focus, but their rationales for treatment vary depending on their particular belief system.

Chiropractic philosophy also stresses the importance of prevention and primarily utilizes a pro-active approach and a wellness model to achieve this goal.cite journal |journal= J Manipulative Physiol Ther |date=2000 |volume=23 |issue=1 |pages=10–9 |title= Maintenance care: health promotion services administered to US chiropractic patients aged 65 and older, part II |author= Rupert RL, Manello D, Sandefur R |doi=10.1016/S0161-4754(00)90108-8 |pmid=10658871 For some, prevention includes a concept of "maintenance care" which attempts to "detect and correct" structural imbalances of the neuromusculoskeletal system while in its primary, or functional state.cite web |author= Canadian Chiropractic Association |title= Glenerin guidelines: preventive maintenance care |url=http://www.ccachiro.org/client/cca/cca.nsf/web/Chapter+14+-+Preventative-Maintenance+Care!OpenDocument |date=1996 |accessdate=2008-02-26 The objective is early identification of mechanical dysfunctions to prevent subsequent deterioration which would result in permanent pathological changes.cite book |author= Strang VV |title= Essential Principles of Chiropractic |location= Davenport, IA |publisher= Palmer College of Chiropractic |oclc=12102972 |date=1984 |pages= p. 26

In summary, the major premises regarding the philosophy of chiropractic include:cite book |chapterurl=http://chiroweb.com/archives/ahcpr/chapter2.htm |chapter= Chiropractic belief systems |author= Mootz RD, Phillips RB |date=1997 |title= Chiropractic in the United States: Training, Practice, and Research |pages=9–16 |editor= Cherkin DC, Mootz RD (eds.) |accessdate=2008-02-14 |version= AHCPR Pub No. 98-N002 |location= Rockville, MD |publisher= Agency for Health Care Policy and Research |oclc=39856366

Holism

noninvasive, emphasizes patient's inherent recuperative abilities

recognizes dynamics between lifestyle, environment, and health

spine and health are related in an important and fundamental way, and this relationship is mediated through the nervous system.56

recognizes the centrality of the nervous system and its intimate relationship with both the structural and regulatory capacities of the body

appreciates the multifactorial nature of influences (structural, chemical, and psychological) on the nervous system

Conservatism

balances the benefits against the risks of clinical interventions

emphasizes noninvasive treatments to minimize risk with a preference to avoid surgery and medication

recognizes as imperative the need to monitor progress and effectiveness through appropriate diagnostic procedures

prevents unnecessary barriers in the doctor-patient encounter

Manual and biopsychosocial approaches

strives toward early intervention, emphasizing timely diagnosis and treatment of functional, reversible conditions before loss of functionality

emphasizes a patient-centered model whereby the patient is considered to be indispensable in, and ultimately responsible for, the maintenance of health.53

Unique Approach of improving health through influencing function through structure primarily via manual thetapies

Comments on philosophy #3 conglomeration

Wow, Dematt, that was a huge job. I did not envy anyone brave enough to tackle it. It flows well, I think. The language is dense with many concepts the average person won't understand, but that may be inevitable in a philosophy treatise. One tiny quibble. The Rupert ref. doesn't support 'public education' but does mention 'patient education'. Great job!CynRNCynRN18:37, 24 February 2008 (UTC)

Thanks CynRn, Good catch on Rupert, got it ;-) I do think you are going to be good at this stuff! -- Dematt Dēmatt 22:50, 24 February 2008 (UTC)

Congrats, Dematt, it is indeed a great melting pot. I will try to add some nice prose here and there (if required) so it reads well. My English professor would be so proud. Again, excellent proposal, glad you are around to navigate us! :) EBDCM00:05, 25 February 2008 (UTC)

""Contemporary chiropractic belief systems vary along a spectrum that range from dogmatic empirical deduction from vitalistic roots to an almost equally dogmatic denial of vitalistic concepts in materialism."" Um ... Could you translate that into Simple English, please? Seriously, I find this sentence a bit much, especially this part: "dogmatic empirical deduction from vitalistic roots". Four big words in a row. Just can't handle it without re-reading the sentence multiple times. I think it would be greatly improved by simply deleting the word "empirical", which seems to me to be just about a direct contradiction of the word "dogmatic". --Coppertwig01:46, 25 February 2008 (UTC)

Your right, that must have been about midnight ;-) I took empirical out. Feel free to make any other changes, too. You might be able to work your way through the sources and make sure we've got it right. -- Dematt Dēmatt 02:13, 25 February 2008 (UTC)

Thanks. Actually, both "dogmatic empirical" and "empirical deduction" strike me as oxymora, which is why I had trouble. I think it's much more readable now.

It's still missing something, so keep an eye out. -- Dematt Dēmatt 16:12, 25 February 2008 (UTC)

Oh. You want me to actually look at the sources. Maybe if I have time.

I'm going to make some edits directly in the above draft -- hope that's OK. --Coppertwig02:34, 25 February 2008 (UTC)

OK, I found the Mootz reference. Could you give me some guidance where to find the others, e.g. "ACA, Philosophy, website"?

Of course!

https://www.acatoday.org/level2_css.cfm?T1ID=13T2ID=62 ACA citation see philosophy section

http://books.google.com/books?id=6AxzMPihC94Cpg=PA285lpg=PA285dq=principles+and+practice+of+chiropractic+3rd+edsource=webots=F5ZJScEf26sig=cqOoAz240MS228rjPT8Q5PTTQYA Haldeman S PPC - on google books This is actually a textbook that has two or three sections on philosophy and beliefs. Very thorough synopses.

-- Dematt Dēmatt 16:04, 25 February 2008 (UTC)

The word "legally" doesn't appear in Mootz, I don't think. Where does that part come from, and what does it mean for beliefs to legally separate two professions? --Coppertwig03:21, 25 February 2008 (UTC)

Comes from the http://books.google.com/books?id=6AxzMPihC94Cpg=PA285lpg=PA285dq=principles+and+practice+of+chiropractic+3rd+edsource=webots=F5ZJScEf26sig=cqOoAz240MS228rjPT8Q5PTTQYAPPA71,M1 PPC textbook above - the Phillips section on philosophy page 71. At the turn of the 20th century organized medicine prosecuted chiropractors for practicing medicine without a license. After DD went to jail, attorney Tom Morris was able to legally differentiate that chiropractors were not practicing medicine because they were not treating people, they were adjusting Innate; they were not diagnosing conditions, they were detecting subluxations. BJ then set out to develop an entire 'philosophy' to legally protect the profession. By creating a metaphysical construct such as subluxation, medicine could not claim it because it was not empirical ;-). This is why the straight philosophy saved the profession, but at the same time, holds it back from being recognized in mainstream medicine. -- Dematt Dēmatt 16:23, 25 February 2008 (UTC)

This draft fixes my main objection against ChiropracticPhilosophy, which is its lack of neutrality. Aside from its evident formatting and citation bugs, I would support replacing ChiropracticPhilosophy with it right now. It's way long and it's repetitive and it rambles, but that can be fixed later. I see Coppertwig is going to be editing it so I'll wait for a bit before looking at it more detail. Eubulides02:51, 25 February 2008 (UTC)

OK, that's probably all the edits I'll do to it for now. Once it's in the article maybe I'll have an easier time finding the references? --Coppertwig03:45, 25 February 2008 (UTC)

QuackGuru, how do you feel about this version? Can we put it in? We can contniue to work on it from there, but is this a good enough start for you? -- Dematt Dēmatt 16:57, 25 February 2008 (UTC)

Almost there but not quite. Dematt, does 'dogmatic' have to appear 2x in the first sentence? What about a ref for professional autonomy; it's well known in chiropractic circles that BJ Palmer used a vitalistic philosophy (untestable) to prevent DCs from being jailed for practicing medicine. EBDCM03:55, 26 February 2008 (UTC)

Good points both. I http://en.wikipedia.org/w/index.php?title=Talk%3AChiropracticdiff=194133345oldid=194133319 removed both "dogma"s (why cast stones?) and http://en.wikipedia.org/w/index.php?title=Talk%3AChiropracticdiff=194132965oldid=194132683 added a citation for professional autonomy, unstriking that point. Eubulides08:59, 26 February 2008 (UTC)

Okay, I read the whole thing, which we all should, but this was the conclusion from http://books.google.com/books?id=6AxzMPihC94Cpg=PA285lpg=PA285dq=principles+and+practice+of+chiropractic+3rd+edsource=webots=F5ZJScEf26sig=cqOoAz240MS228rjPT8Q5PTTQYA Haldeman S PPC - on google books starting on page 72 to 73.

"Allopathic hegemony attempted to eliminate the budding profession using legal means. Unable to withstand a frontal assault, chiropractic leadership sought a refuge under the shield of an alternative vernacular. B.J. Palmer argued that the practice of chiropractic was different from the practice of medicine and, therefore, a chiropractor could not be punished for practicing medicine without a license.

This protective shield apparently prompted a segment of the profession to extend its comfort zone by adopting not only an anti medicine position but an anti science stand. Chiropractors remained isolated from the scientific and academic community. Science, for BJ meant sustaining the Major Premise and derivative theory and technique. The Major Premise (and other lessor premises) needed no explanation, because they were derived from a higher source and could not be questioned.

Although this anti intellectual position persists in a small percentage of chiropractors in this twenty-first century, the profession never developed the broad-base consensus around Stephensn's 33 principlesBJ's Major Premise. The current spectrum of thought ranges from these traditional concepts espoused by BJ, Stephenson, and their adherents to an equally dogmatic denial of vitalistic concepts at the other end of the spectrum."

If you really think about it, it is true. The spectrum of beliefs ranges from those that dogmatically believe that chiropractic is all "vitalistic" to those that dogmatically think there is nothing "vitalistic" about it. The rest are somewhere in between. It gives a good example of how the effort to legally protect the profession led to some actually adopting these vitalistic qualities as "truth" and never doubted them again. From there, they made deductions based on the assumption that 'subluxations' interfered with 'Innate' because every time someone's pain went away, it was proof that 'it worked'. Meanwhile, scientifically minded doctors distanced themselves as far away as possible - to the other extreme - denying even the possibility that science may one day prove that there is a testable relationship between spine and health. Somewhere in between, the rest treat using philosophies that include holism, rationalism, conservatism, etc.. and everything except drugs and surgery.

Having said all that, I still agree that it can be cleaned up some more. -- Dematt Dēmatt 05:14, 26 February 2008 (UTC)

No doubt it can be improved further. But unless I'm missing something, nobody has serious objections to this proposed revision. It is clearly an improvement over what is now in ChiropracticPhilosophy. Any objections to replacing ChiropracticPhilosophy with the contents of Another philosphy conglomeration? We can continue to improve it after copying it to the article. Eubulides08:44, 26 February 2008 (UTC)

Agreed. QuackGuru10:24, 26 February 2008 (UTC)

Okay, then I'll put it in. I'm sure it will need some tweaks if we forgot something, but overall I think we have something that is pretty accurate, NPOV, and handles all POVs. Good job everybody! I think we did great! -- Dematt Dēmatt 15:18, 26 February 2008 (UTC)

Switching sentences in prescribing drugs paragraph

It says, ""It is generally not within the scope of practice of chiropractors to write medical prescriptions. Traditionally they have opposed prescription drugs but recently a majority of North American chiropractors have supported limited prescription rights.McDonald W (2003) "How Chiropractors Think and Practice: The Survey of North American Chiropractors." Institute for Social Research, Ohio Northern University A notable exception is the state of Oregon, which allows chiropractors with minor additional qualification to prescribe over-the-counter drugs.http://gov.oregon.gov/OBCE/pdfs/CE_conteducation.pdf "" The only problem here is that the sentence "A notable exception ..." comes right after a sentence which is not contrasting with it. In other words, the thing that it's an exception to is not what comes in the sentence before, or at least not in the second half of that sentence. I suggest re-arranging it like this:

""It is generally not within the scope of practice of chiropractors to write medical prescriptions. A notable exception is the state of Oregon, which allows chiropractors with minor additional qualification to prescribe over-the-counter drugs.http://gov.oregon.gov/OBCE/pdfs/CE_conteducation.pdf Traditionally, chiropractors have opposed prescription drugs, but recently a majority of North American chiropractors have supported limited prescription rights.McDonald W (2003) "How Chiropractors Think and Practice: The Survey of North American Chiropractors." Institute for Social Research, Ohio Northern University --Coppertwig02:03, 24 February 2008 (UTC)

Yep I agree ;-), change that one. -- Dematt Dēmatt 02:16, 24 February 2008 (UTC)

"'Done."' Thanks. Thank you very much. --Coppertwig17:00, 24 February 2008 (UTC)

Evidence of continued discrimination

It looks like there is continued descrimination of chiropractic and other professions that aren't normally considered part of the Allied Health Professions:

http://www.amerchiro.org/content_css.cfm?CID=1323 ACA mention of problem

http://www.patientsrightscoalition.org/statement/support/AMA_ACA_06-09.pdf ACA response

-- Fyslee / 19:09, 24 February 2008 (UTC)

Isn't that rather logical though? If one has qualms about a profession's competence one would of course discriminate against them. After all, one would discriminate against the health advice of a hobo in the street over that of a medical doctor. Jefffire19:22, 24 February 2008 (UTC)

Come on guys, flamebait is below you. Sorry, My bad. -- Dematt Dēmatt 19:32, 24 February 2008 (UTC)

To be fair, I could of worded that a (lot) better. I'm just a bit pedantic about the use of the word "discrimination" as a pejorative. Jefffire15:55, 25 February 2008 (UTC)

Agreed, and that was not the intention. It's just information I found on the ACA website and it surprised me. Whether it can or can't be used in the article is another matter, and I had no specific plans or intentions in that direction. -- Fyslee / 19:41, 24 February 2008 (UTC)

That was 2006. -- Dematt Dēmatt 20:20, 24 February 2008 (UTC)

And it is also the Allied healthcare fields like http://www.aafp.org/online/en/home/publications/news/news-now/professional-issues/20060403scope.html Nurse practitioners and Physical therapists - notice the list of http://www.ons.org/media/pdf/general/joint.pdf those opposed to SOPP on the bottom of the page. IOWs, for once we're all on the same side ;-) -- Dematt Dēmatt 20:23, 24 February 2008 (UTC)

I would suppose that would have implications for the Doctor of Physical Therapy (DPT) program. I guess they aren't happy. -- Dematt Dēmatt 20:36, 24 February 2008 (UTC)

In fact, 21 of the 24 allied professional organizations against this proposal are from nursing ! Looks like we nurses need to keep an eye on the AMA docs, too, with their nefarious plans to restrict scope.CynRNCynRN21:08, 24 February 2008 (UTC)

Hehe, and you thought chiropractors were paranoid :-) -- Dematt Dēmatt 22:51, 24 February 2008 (UTC)

I have an idea. There are 2.3 mill. RNs, 77,000 chiropractors. If you get nurses on the side of chiropractors, there would be no stopping them. I suggest one free chiropractic exam/treatment offer to any nurse. We have bad backs!CynRNCynRN23:18, 24 February 2008 (UTC)

Interesting. I work very closely with nurse practitioners since I work in a smaller rural community and we feel the same (generally speaking, of course) about the historical reluctance of MDs to allow other health practitioners to expand their scope and relieve the burden on the health care system. The OMA is opposed to allowing DCs advanced imaging (MRI, CT) and lab diagnosis (even though we are trained for it in school) even for DDx of NMS disorders, whereas the nurse practitioners had to fight tooth and nail to get basic Rx rights. If MDs in general were to acknowledge the expertise of their allied professionals their job would be better off and so would the health of Ontarians. EBDCM00:11, 25 February 2008 (UTC)

"I suggest one free chiropractic exam/treatment offer to any nurse" - You've got a deal! -- Dematt Dēmatt 01:55, 25 February 2008 (UTC)

Who is &quot;Friend&quot;?

In the History section it says ""Friend and Rev. Samuel Weed ..."". Is "Friend" the surname of another person, or a description of the relationship with Rev. Samuel Weed? Can anybody find any first name or first initial for "Friend"?

He was his 'friend', or so the legend goes. I think it can safely go. -- Dematt Dēmatt 15:47, 25 February 2008 (UTC)

I think it looks better to put periods after initials, e.g. "D.D. Palmer" rather than "DD Palmer". Is there anything in the Manual of Style about that? In Wikipedia:Proper names it doesn't say specifically, I don't think, but one of the examples it gives is "George H.W. Bush", which, however, redirects to an article which has a space between the H and the W. In either case, there are periods, though. --Coppertwig04:02, 25 February 2008 (UTC)

I don't think the Manual of Style says one way or another. Obviously the article should be internally consistent. The Palmer College of Chiropractic tends to use the style "D.D. Palmer"; is that a good enough tiebreaker? See http://www.palmer.edu/history2.aspx?id=1144 The Palmer Family. Eubulides06:55, 25 February 2008 (UTC)

P.S. I fixed Wikipedia:Proper names to spell Bush's name the same way George H. W. Bush does it. Eubulides06:57, 25 February 2008 (UTC)

Good to have some consistency. Chiros called them "DD" and "BJ" so I think that is why the periods are not there. -- Dematt Dēmatt 15:47, 25 February 2008 (UTC)

I'd tend to lean towards being consistent with other Wikipedia articles, but being consistent with how they're mentioned in the literature also has merit. --Coppertwig02:32, 26 February 2008 (UTC)

Let's keep the periods. If it is good enough for Palmer college, it's good enough for me. Unless someone comes by that knows of a better reason, I think it is best to go with consistency. -- Dematt Dēmatt 03:19, 26 February 2008 (UTC)

I believe Weed was a "friend" of Palmer, hence the mention. Since we are writing an encyclopedia, maybe the more formal D. D. Palmer would be best. When using quotes that use the very common "DD Palmer", we can still use the informal form. -- Fyslee / 07:30, 26 February 2008 (UTC)

Time to archive?

Any objections to archiving this talk page? It's getting kinda long. Eubulides17:43, 26 February 2008 (UTC)

Please do, -- Dematt Dēmatt 18:26, 26 February 2008 (UTC)

http://en.wikipedia.org/wiki/Talk:Chiropracticserious_NPOV_issues_.28oh_my.29 and the partial vandalism and NPOV violation. I am currently in a discussion with serious NPOV violations with this article. Archiving the unrelated threads is fine with me. QuackGuru20:58, 26 February 2008 (UTC)

Notes &amp; references

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