By David B. Koch, D.C., and Rebecca Koch
A new employee of Life University, who had no previous knowledge of chiropractors or chiropractic care, recently related a disturbing story. He said that one of the first times he told someone where he worked, the person responded with the statement, “Why would you want to work there? Chiropractors kill people.”
Where does that sort of outrageously unfounded prejudice against chiropractors come from? The people who harbor it, like most prejudiced people, would likely tell you that it’s common knowledge. Just like other forms of pernicious prejudice, the facts don’t matter. Nor do the millions of patients who have benefitted from chiropractic care, some of them to the point of having their whole lives changed for the better.
the persecution’s beginning
It might surprise some to learn that the sort of prejudice encountered by our new LIFE colleague is actually an echo of an orchestrated campaign to discredit and then eliminate Chiropractic from the face of the earth. And, even though more than 700 chiropractors went to jail to save their profession, it was actually their patients who turned the tide by demanding the release of their chiropractors so that they could continue to provide them with the care that had benefited their lives and health.
D.D. Palmer, who in 1895 discovered the benefits of correcting vertebral misalignments, established and practiced his art relatively unmolested until 1906, when he was jailed for practicing “medicine” without a license. Despite the absurdity of trying a man for a practice unrecognized by medicine, D.D. was convicted and, oddly, sentenced to serve six months and/or to pay a $350 fine. D.D. vowed he would never pay the fine, but his lawyer pointed out to D.D.’s wife the futility of D.D.’s refusal to pay the fine since the judge’s somewhat odd “and/or” clause meant that D.D. would end up having to pay the fine after he’d served the six months. Basically, the lawyer said, pay now and get out of jail or stay in jail and pay the fine. While D.D. may have kept his vow and never paid the fine, his wife did pay, and D.D. was released from the obligation to serve the six months.
Interestingly, D.D.’s son B.J. Palmer, who is honored as the developer of Chiropractic because of his lifetime of thoughtful commitment to his profession, was also indicted on the charge of practicing medicine without a license, but it never came to trial. Many have speculated that Palmer’s trial and conviction may have been the result of D.D. being something of a deadbeat when it came to paying his bills, while B.J. was scrupulous about paying his debts and generating community goodwill. However, during his father’s trial, B.J. had tried mightily to keep D.D. from being convicted, during which time he put a great deal of thought into a long-term defense strategy to protect chiropractors, as well as the fledgling profession.
B.J. worked with a politically well-connected lawyer named Tom Morris, and his legal strategy was based on the premise that chiropractors should be immune from the charge of practicing medicine without a license for the simple reason that Chiropractic is not medicine. He argued that the two were separate and distinct from one another. So, when Shegatoro Morikubo, the second chiropractor to be indicted for practicing medicine without a license, was tried, B.J’s strategy proved successful. As a result, the first significant politically active chiropractic group, the Universal Chiropractic Association (UCA), was born. The significance of the UCA was its foundation on B.J.’s promise to chiropractors that, if they would practice the way D.D. did, the UCA would defend any chiropractor charged with practicing medicine without a license. This promise not only helped firmly establish Chiropractic as a separate and distinct profession, but it created (a short-lived) uniformity and consistency within the profession.
a turn for the worse
The next significant threat to Chiropractic, interestingly, also redefined the practice of medicine as it existed at the time. In 1910, the American Medical Association (AMA) wanted to standardize the professional education of its practitioners. They commissioned Abraham Flexner, an educator, to investigate the quality of the more than 170 medical programs that existed in the U.S. at that time. Flexner had ideas, based on European models of drugs and surgery, of what constituted appropriate “orthodox” medical practice. And, in what became known as the Flexner Report, the roots of institutionalized prejudice against Chiropractic (and other “non-orthodox” practices) gained purchase. In his report, Flexner vehemently castigated Chiropractic and osteopathy along with the homeopathic medical programs, calling them all quackery. Initially, however, his report didn’t have a substantial effect on the “non-orthodox” health care educational programs since the only weapon available to the AMA was to deny Council on Medical Education (CME) accreditation, and none of those so-called non-orthodox programs were accredited anyway. Eventually, the CME was successful in its insistence that no already existing health care educational program should be allowed to continue to exist without CME accreditation. Within 20 years, homeopathic medical education had ceased to exist in the U.S., and the AMA began a trend of increased negative attention toward Chiropractic and osteopathy.
Despite this negative attention, chiropractic licensure began around 1914. The persecution of chiropractors persisted, though, because they had accepted limited licensure in several states, and in some states, that licensure was granted by medical boards. The licensure and persecution issues came to a head in California, in part because the California legislature fought chiropractic licensure so hard, and in part because California is such a big state. As one of the largest states, California had one of the largest populations of chiropractors—and chiropractic patients—in the nation. So, when California started its campaign of wiping out Chiropractic by jailing chiropractors, there was a huge backlash of protest from the jailed chiropractors’ patients, eventually resulting in a public referendum in which California citizens voted for the right to receive chiropractic care.
As licensure battles began to be fought in states across the nation, persecution and jailing of chiropractors increased. However, in B.J.’s view, the net effect of the massive California persecution had been positive because it resulted in patients demanding their right to chiropractic access. So, B.J. and his lawyer, Tom Morris, began their own campaign of asking convicted chiropractors across the country to go to jail rather than pay fines for their convictions of practicing medicine without a license. Just as B.J. had hoped and believed, patients continued to defend their chiropractors and protest them being jailed. B.J. stepped up his efforts to channel this patient support and formed the Chiropractic Health Bureau to create a level of patient solidarity, which eventually resulted in more than 8,000 chiropractic patients showing up in Madison Square Garden to protest the persecution of their chiropractors.
Intersecting B.J.’s campaign of encouraging chiropractors to accept jail time was a sustained assault on Chiropractic by the Journal of the American Medical Association, which was under the leadership of president Morris Fishbein from 1924-1950. Fishbein pursued what seemed like a personal vendetta, establishing a long-standing and concerted anti-quackery campaign against Chiropractic. Eventually, the battle came to a head in the late 1970s with the National Chiropractic Antitrust Committee’s lawsuit against the American Medical Association. Sixteen years in court and several millions of dollars later, the AMA was found guilty of violating the Sherman Antitrust laws, a victory for Chiropractic that saved the profession.
Some of the chiropractic martyrs, like Herbert Reaver, the most jailed chiropractor in history, faced a different kind of persecution. Even as it was being established, some states placed chiropractic licensure under the jurisdiction of the state medical board. This was the case in Ohio in the late 1940s and early 1950s when Reaver practiced in Cincinnati. Reaver, a hero in the fights for both Chiropractic and civil rights, wasn’t jailed for practicing medicine without a license. He was jailed, multiple times, for practicing Chiropractic without a license in a state that allowed medical doctors to define the educational requirements for chiropractors. Reaver had been a successful and much loved chiropractor for more than 20 years when his home state began to require that DCs have the same education in the sciences that medical doctors receive. Reaver argued that because the two professions had been established as separate and distinct, the education for the two professions should also be separate and distinct. Moreover, Reaver refused to accept that a medical board had jurisdiction over making any decisions in the licensing of chiropractors.
It should be noted here, and in the minds of subluxation-based chiropractors everywhere, that Reaver lost this battle. It can be argued that his loss marked the same loss by the profession he loved. There was no B.J. Palmer and no Chiropractic Health Bureau to lead the fight by encouraging other chiropractors to refuse to submit to the medical definition of Chiropractic and to defend them for practicing their art in the way that had changed the lives of and restored health to generations of patients. Reaver stands as the emblem of the second wave of persecuted chiropractors who persevered in their principles. After spending six months in the Cincinnati work house, he left Ohio and continued his practice in St. Petersburg, Fla., where his battles shifted more toward civil rights for the Cuban and African-American patients he served there. Even after he returned to Ohio, he practiced Chiropractic unlicensed in the state in which he lived, until a day or two before he died at the age of 93.
As we lose the last of the greatest generation of chiropractors, what should today’s practitioners vow to pass on of the legacy granted to them by these pioneers? It may be that the crucial element never to be forgotten is the fact that the AMA’s persecution of Chiropractic was real. And, even though the AMA was found guilty of illegally restricting the chiropractic profession, it doesn’t mean the anti-quackery campaign ever stopped. It seems that the question chiropractors must ask themselves, now more than ever, is whether they are willing to discard their predecessors’ hard-won successes in the fight for a separate and distinct healing art and risk becoming a second-rate subset of a health care system that is clearly beginning to collapse under the weight of its own unsustainable, outside-in assumptions about the source of health.