Confessions of a Former Chiropractor: Navigating the World of Alternative Medicine
In the 1980s, I found myself drawn to chiropractic care for a stiff neck, despite my initial skepticism. Little did I know that this decision would lead me down a path of discovery and disillusionment within the world of alternative medicine.
As a trained program evaluator, I was intrigued by the hands-on approach of chiropractic, a profession that seemed to offer a humane alternative to the overreliance on pharmaceuticals and procedures in conventional medicine. I envisioned a future of self-employment, ethical work, and improved health, a stark contrast to the pseudoscientific theater of my previous profession.
However, as I delved deeper into the chiropractic world, I encountered a parallel universe where metaphysical concepts like subtle vital forces and spinal "subluxations" persisted, even in modern curricula. The 1990s brought a brief flirtation with legitimacy, fueled by philanthropic enthusiasm from abroad, but this was short-lived.
My discomfort grew as I witnessed the failure of chiropractic diagnostics to pass a basic test of face validity. I encountered applied kinesiology, a method that claimed to diagnose disease by testing muscle strength, with an accuracy of about half the time. This raised questions about the scientific rigor and validity of chiropractic practices.
The economics of chiropractic education further concerned me. The profession prioritized practice management over clinical outcomes, with a focus on selling care plans, frequency, and fear. The mantra of "Always Be Closing" permeated the industry, emphasizing profit over patient well-being.
Chiropractic leaders, or "paycheck chiropractors," held authority despite their detachment from the day-to-day practice. They advised clinicians on treatment and expectations, despite their lack of firsthand experience. This arrangement fostered a culture of blame and personal deficiency among practicing chiropractors, hindering collective accountability.
As graduates faced the harsh reality of limited job opportunities, a lack of meaningful referral networks within medicine, and accumulating studies failing to support chiropractic's clinical utility, they began to question the profession's foundations. The apparent effectiveness of chiropractic care dissolved into non-specific factors like expectation, attention, and natural history.
The profession's structure, with its two-tiered and one-directional system, rarely led to improvement. Leaders stuck to early-20th-century dogma, steering chiropractic away from medicine by avoiding diagnosis and disease. This resistance to change and tolerance of honest uncertainty created a culture of betrayal, where leaving the profession felt like a necessary step towards hygiene.
In the end, I realized that my time as a chiropractor had come to an end. Many of my former classmates shared this conclusion, privately admitting that much of what they had been taught was baloney. The profession's focus on belief systems over evidence and its inability to correct assumptions left a lasting impact on the chiropractic landscape.
