Wilk v. AMA 25 Years Later: Why It Still Isn’t Over
SOURCE: ACA News ~ March 2012
By Lori A. Burkhart
The future of the chiropractic profession changed on Aug. 27, 1987, when federal court judge Susan Getzendanner found the American Medical Association (AMA) guilty of conspiring to destroy chiropractic. [1]
Early History
The nefarious plot was hatched in 1962 when the Iowa Plan was adopted by the Iowa Medical Society with the goal of eradicating chiropractic in that state. The Iowa Plan is summed up in the plaintiffs’ 132-page aid to the court, submitted June 25, 1987, in the Wilk case.
The Iowa Plan’s section “What Medicine Should Do About The Chiropractic Menace” includes a Part G titled “Undertake a positive program of ‘containment’” in which an often quoted phrase in chiropractic literature can be found: “If this program is successfully pursued, it is entirely likely that chiropractic as a profession will ‘wither on the vine’ and the chiropractic menace will die a natural but somewhat undramatic death. This policy of ‘containment’ might well be pursued along the following lines:
- Encourage ethical complaints against doctors of chiropractic;
- Oppose chiropractic inroads in health insurance;
- Oppose chiropractic inroads in workmen’s compensation;
- Oppose chiropractic inroads into labor unions;
- Oppose chiropractic inroads into hospitals; and
- Contain chiropractic schools.
The Iowa Plan states that such actions taken by the medical profession should be persistent and behind-the-scenes whenever possible. The medical community should never give professional recognition to doctors of chiropractic (DCs), and thus a successful program of containment will result in the decline of chiropractic.
In Wilk v. AMA, Judge Getzendanner explains that the AMA hired as its general counsel Robert B. Throckmorton, the author of the Iowa Plan, and that “as early as September 1963, the AMA’s objective was the complete elimination of the chiropractic profession.” Two months later, the AMA formed the Committee on Quackery under its Department of Investigation (DOI), and by 1964 its goal was to do away with chiropractic throughout the United States.
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Judge Getzendanner noted that during the 1960s and 1970s, H. Doyl Taylor, the AMA DOI chairman, and the Committee on Quackery worked aggressively to achieve its goals by:
- Conducting nationwide conferences on chiropractic;
- Distributing publications critical of chiropractic;
- Assisting others in preparation of anti-chiropractic literature;
- Warning that professional association between medical physicians and chiropractors was unethical; and
- Discouraging colleges, universities and faculty from cooperating with chiropractic schools.
In 1966, the AMA adopted a resolution calling chiropractic an “unscientific cult.” That label implicitly invoked AMA’s Principle 3, making it unethical for a physician to associate with an “unscientific practitioner.” In 1967, the AMA Judicial Council issued an opinion under Principle 3 specifically making it unethical for physicians to associate with chiropractors. That included making referrals; accepting referrals; providing diagnostic, laboratory or radiology services; teaching chiropractors or practicing together in any form. The opinion was sent to 56 medical specialty boards and associations.
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I have been practicing chiropractic care for over 33 years. What I have seen on an individual basis is that there are those medical physicians that not only refer with chiropractors, but go to them as patients. Unfortunately, the battle continues for parity and acceptance within the medical community and insurance industry. We have research of the efficacy of chiropractic care, but as long as the insurance industry is moderated by the medical community chiropractors will be second class citizens.
Is anyone aware of the new PIP bill that passed in my state, Florida?
The old law stated that a patient had 10k in PIP medical benefits.
The new law states if you go to a MD, DO, ARNP, or PA you get 10k in PIP. If you go to a Chiropractor you only get 2,500.
Welcome to the state of Florida! A state that is owned by the Insurance Industry!
The past and ongoing damage to our profession is horrible. Although, it seems as though the bias that is felt among the community becomes lessened with each person we help.
Check out the video of the Dr. Phil show. http://www.youtube.com/watch?v=AVY_aRLVbJs This was seen by thousands of people and was good PR for Chiropactic. We need more positive public viewing.
I agree with the “two types of MD’s” statement, there are the ones that give Chiropractic the “tick of approval” and refer and then there are the MD’s that actively tell their patients to avoid chiropractors. I find it disappointing that they have that view since they believe they are trying to help their patients but they are actually keeping them in the sickness care model. I believe there should be a large focus on producing more quality research, but not more studies on low back pain. I would like to see more studies on the wellness aspects of chiropractic care. One issue is that the current methods of “accepted science” is not applicable to wellness outcomes as you are not measuring the effectiveness of treatment for a condition as much as how the overall health has improved. I mean is it really that hard to understand that the body is a holistic unit that always strives for homeostasis?
Research always helps within the medical community,but we really need a good PR firm that can make chiropractic a household name!
It probably wouldn’t hurt to have a united profession either, where chiropractors stop attacking each other and focus on getting the wellness message out to the community. There is a big storm coming with the lack of funding for Medicare and insurance policies will be out of reach for many in the future due to rising costs. Overall people need to understand that it is just as important (I would argue more important) to invest in your health throughout life as it is to save for retirement.
Unfortunately many take their health for granted abusing their bodies and then one day it starts to fail and they enter into the prescription drug roundabout. Many health issues can be avoided with a proactive approach to healthcare as opposed to a reactive crisis management.
The rhetoric of trying to improve the healthcare industry is useless because the medical model won’t be changed. The Chiropractic profession is in the unique position to cause some noise. There are over medical errors that cause over 100,000 preventable deaths every year.
http://www.aarp.org/health/doctors-hospitals/info-03-2012/protect-yourself-from-hospital-errors.html
That doesn’t even count the other injuries and deaths caused by medicine. How many patients do chiropractors see that are medical failures? In my practice I see quite a few. If reimbursements were granted to those doctors based on outcome assessments, chiropractors would literally take over a large portion of the healthcare industry.
I see your point and I fully agree. I read that when doctors went on strike less people died. Here is a link to it: http://www.marketoracle.co.uk/Article981.html the irony is that the medical community are trying to say that chiropractors are dangerous and kill people. The old saying, people in glass houses comes to mind… At the end of the day medical doctors are not bad peole they truly believe that they are doing the right thing prescribing medications and cutting out “extra bits of anatomy”. One cannot learn about health when asking people who have only studied disease.
Medicine and health care in general is big business which equates to big money. There’s more and more competiton in the physical medicine arena. Therefore the medical industry will continue to take some of the chiropractic market by way of physical therapists and in house chiropractors. At the same time they will continue to question are abilities and what we do. That’s business today play both sides.
I don’t know how the insurance reimbursement is in your areas, but in my area it is almost nonexistent. We have Chiropractors giving away there services and patients are willing to take drugs over natural care because it is paid for by their insurance company. Until we receive more parity within the insurance industry the medical profession will always be in control. Patient education is slow especially when it comes down to finances. We can’t compete with advertising budget of the pharmaceutical companies.
My family has been in chiropractic practice since 1952. Incremental change has happened but chiropractic is still seen as “controversial” by the talking heads of the medical community… If they only practiced what they preached about “Health” Care.
One of the sad things about the situation in Florida seems to be a mistaken attribution of causality.
The reason that MD/DO/PA/NP have a higher cap is not likely because of some great conspiracy… it is more likely due to evidence that some DCs were abusing the system/not providing clinically relevant documentation etc…
There were suggestions within our own profession to clean things up… but we didn’t police our own. Now, DCs in Florida have 1/4 of the cap. Nurses and assistant physicians are in a better position than we are…
Lesson: It is already way past time to clean house and police our own… if we don’t, the kind of legislatively and legally imposed restrictions of DCs we saw in Texas and Florida will continue.
Hi Nick!
I suspect that the Bell Curve applies to every profession. I regularly hear of Medicare going after MD practices for Millions of dollars in fraud, so why immediately assume, especially knowing the LONG history of abuses against our profession, that WE must be the sole cause of why the table is still tipped towards MD wallets???
It’s not only unreasonably cynical, I believe it’s not grounded in FACT. Ask yourself… how many MDs sit on Insurance Company Boards when these decisions are made, versus how many DCs???
State Boards are not doing their job IF they don’t pull licenses when their are serious charges. OTOH, if a DC fails to provide medical necessity for services, the Insurers are within their rights to NOT PAY them, BUT not to penalize the rest of an honest profession. That lacks rationality and smacks of subterfuge.