Future of Chiropractic Curriculum

Have you ever wondered where the chiropractic curriculum developed from? It is quite an amazing story of intrigue, bootstrapping, and warfare. I won’t fill you with too many of the details today (as I am working on a two-hour online course on the history of the CCE…),1 but I would like to share a bit of my vision of what is possible with you.

The first real attempt at an integrated curriculum was pioneered at Palmer College of Chiropractic in the 1920s. The chiropractic greenbooks integrated the philosophy of innate intelligence and the central importance of the vertebral subluxation in human health and dis-ease throughout every course from chemistry to symptomatology, physiology to anatomy. I recently summarized the quotes about innate intelligence from many of these texts written by B.J .Palmer’s staff. The quotes show extraordinary evidence that the philosophy of chiropractic was on its way to becoming the first systems science of human health, rooted in a deep philosophy that explained human physiology as part of an intricate pattern of intelligence expressing through matter itself. 2

Alas, this approach was short lived due to historical circumstance, economics, philosophical and political disputes, and eventually political agendas, which would soon take over the accreditation process in all American chiropractic colleges. B.J. Palmer was voted out of his leadership role of the Universal Chiropractors’ Association (UCA) in 1926. He then started the Chiropractic Health Bureau, which became the International Chiropractors Association (ICA). According to one of chiropractic’s most revered historians, the break within the “straight” chiropractic movement in the 1920s, “had an impact that was significant enough to change the whole course of the chiropractic education and politics for the rest of the century.”3 The remainder of Palmer’s UCA joined with the newly formed ACA (1922), to become the NCA in 1935, which became the modern-day ACA in 1963. The direction of chiropractic education took a decidedly “medical” turn because of these events.

Chiropractic suffered the fate of most of the pioneering approaches to biology in the first half of the twentieth century. Chiropractic’s systems orientation was often overshadowed by a more molecular/medical approach. The brilliant ideas of emergence, holism, organismic biology, and systems theory, which all emerged around the same time as the Palmer greenbooks, were to take a backseat to the developments in molecular biology inspired by Watson and Crick’s discovery of DNA in 1952. The mechanistic approach to biological systems would gain dominance for the rest of the century.4

Chiropractic curriculum reform was undertaken by John Nugent starting in the 1930s, a Palmer graduate from the 1920s. As the NCA Director of Education, Nugent took on the task of reforming the chiropractic schools by modeling Flexner’s approach to reorganizing America’s medical schools. Not only did Nugent encourage many schools to close and merge, go from profit to nonprofit, from no pre-reqs to pre-reqs, from 18 month programs to 36 month programs, but he also led the charge on a standardized curriculum (based on the molecular/medical school curricula) and wrote the first manuals of accreditation.  In 1943, the first handbook of the NCA’s accrediting agency, Nugent wrote, “The chiropractor is a physician -a particular kind of physician, and as such is engaged in the treatment and prevention of disease…” Chiropractors from the philosophical side of the profession were outraged at being referred to as physicians. The new standardized curriculum was modeled after the medical schools. The only significant change was that drug and surgery courses were replaced by chiropractic courses. Nugent was hated by both sides of the profession. In fact, B.J. Palmer referred to Nugent as the anti-Christ. Nugent was also viewed as one of the great reformers of chiropractic education. The CCE of today can be attributed to Nugent’s efforts. 5

Calls for curriculum reform are louder than ever in chiropractic (especially with the recent controversy over the CCE’s lack of accountability to the profession, which resulted in CCE’s being required to comply with 43 violations within a year). Calls for curriculum reform span the profession, from the extreme medical fringe of the profession suggesting we fire all philosophy faculty,6 to a more balanced look at innovative approaches to pedagogy and contemporary content,7 to more visionary approaches.8,9,10  It is time we totally revamp our medical chiropractic education.

What if we start fresh and envision a chiropractic curriculum for the twenty-first century, one that keeps the important elements of the old system of education and develops something totally new? What could that look like?

Well, for starters, all students should have a clear and honest exploration of the history and philosophy of this amazing profession. These courses should be standardized and free from politics and disrespect. All future chiropractors should understand the story that is theirs, the good, the bad, the ugly, as well as the leading edge and at least some of what was left behind.

We should also study chiropractic within the context of the paradigms that it helped to bring forth such as systems theory, holism, complexity theory, autopoiesis, non-linear thermodynamics…all of the important biological models of the 20th century. Students should not just study the linear molecular level of biology but also the 40,000 foot view. How do the systems fit together? What are the latest ideas in theoretical biology? Are those ideas consistent with the philosophy of the body as an intelligent and self-organizing system? If so, why aren’t they being taught? (As an offshoot to these additions, we should include the latest research and theory on subtle energy systems and energy medicine!)11

Of course, central to such a curriculum would be the latest science of vertebral subluxation, the leading models of spinal and neural integrity, chiropractic adjusting, instrumentation, alongside the best techniques of the past, ones that have been honed and refined for decades and mastered by the great artists of this profession.

Most importantly we need an integral model that can tie things together; chiropractic philosophy and science, practice and theory, while also developing systems where people feel nurtured and can grow within a community. The chiropractic campus could become a place where humans develop themselves while studying this great profession and feeling included in a worldwide community. Any future curriculum should model the latest ideas of Integral Education.12

Imagine if students could have all of their courses integrated each quarter, with practical hours that were relevant? Imagine if chiropractic school prepared future chiropractors with the practical and business skills needed for their future? Imagine if social networking were integrated into the curriculum not only for each class or each school, but between all chiropractic students worldwide? (I am sure there are many practicing chiropractors that would love to act as mentors through such a system.) Imagine if chiropractic education was a model for doctoral level training that centered on assisting human beings to be their best, serve at the highest, and live a flourishing life?

There is so much more to be added and subtracted to an ideal curriculum. The future of chiropractic education is bright. We are the profession. We get to set the standard if we can share a vision and move forward together.

*(previously published in LifeWest student newspaper – March 2012)

  1. Online Chiropractic Philosophy and History CE Course
  2. Third Wave of Chiropractic Philosophy
  3. Senzon S. 2003. What is Life? JVSR.
  4. Gibbons, R. 1980. The Rise of the Chiropractic Educational Establishment. In: Who’s who in Chiropractic. P. 346
  5. Gibbons R. 1985. Chiropractic’s Abraham Flexner: the lonely journey of John J. Nugent, 1935-1963. Chiropractic History 5:44-51. *Reprinted by permission of the Association for the History of Chiropractic
  6. Murphy, D, Schneider M, Seaman D, Perle S, Nelson C. How can Chiropractic become a respected mainstream profession? Chiropractic and Osteopathy 2008, 16.10.
  7. Johnson C., Green B. 2010. 100 Years after the Flexner Report: Reflections on its influence on chiropractic education. J Chiro Ed. 24(2).
  8. Kent, C. 2010. A new direction for CCE? Dynamic Chiropractic 28(24).
  9. http://mcqi.org/vitalistic-curriculum/introduction
  10. Senzon, S. 2007. What I Wish I Learned in Chiropractic College. Today’s Chiropractic Lifestyles.
  11. Senzon, S. 2008. Chiropractic and Energy Medicine: A Shared History. J Chiro Hum 15.
  12. http://nextstepintegral.org/resources/integral-education-resources

Chiropractic Games & Distortions of Truth

Do you remember a game from your
childhood called, “telephone operator?”

You know the game; everyone sits in a circle, the first person then whispers in the ear of the person next to them. The whisper makes its way around the circle until the originator of the message receives the final word. The funny part of the game is that the message usually gets morphed as it travels often into an unrecognizable shadow of its original meaning.

When you were a child, this game was probably fun. When it gets played at the professional level, real CONSEQUENCES ensue. This is often the case in the chiropractic peer-reviewed journals.

Let me explain what I mean…

There are at least three messages that have been “whispered” in the chiropractic literature (and I write whispered because most chiropractors DON’T read the literature – unfortunately).

1. The Philosophy of Chiropractic was developed by lawyer Tom Morris.

2. The Subluxation is an untestable entity.

3. Anyone who uses philosophy or subluxation in chiropractic are “Dogmatists.”

The more you tell a message, the more it seems like TRUTH even if it is distorted. The more you pass on a DISTORTED TRUTH, the less truthful it becomes even if there was a kernel of truth in the original message. In a profession, when a distorted truth gets passed on through the literature, it gains in credibility with each new publication! It seems to be TRUER. And this influences accrediting agencies (CCE), boards (FCLB), examiners (NBCE), trade organizations, and eventually legislation.

I plan to discuss these “truths” in more detail in future blogs, and, I have written about them already (most of my articles are posted on this website), and I have developed a series of online courses exploring these issues (SHAMELESS PLUG). But for now, let’s just explore the latest assault on the foundations of chiropractic in the literature…

In a recent article by Keith Simpson in the journal, Chiropractic and Manual Therapies, he describes the five eras of chiropractic, yet he relies on whispered and distorted truths from the literature and he even invents some new ones.

Simpson, who decides to tell us about his credentials in the article (Doctor of Chiropractic and Doctorate of Sociology), takes on all three of the messages above and embraces them whole-heartedly. Not only does he pass on the tired and very distorted interpretation of the philosophy of chiropractic, but he makes up a new distorted truth (which is an obvious mistake, but you might think a Ph.D. and a journal editor would catch it…)

The first tired distorted truth:
“Tom Morris was the architect of the philosophy of chiropractic.”

The new distorted truth:
“Solon Langworthy started the 1922 ACA.”

By now, you might be asking…”What does this have to do with me or my practice?” Or more directly, “Why should I keep reading?”
KEEP READING…it relates directly to you and the future of chiropractic!

Remember, these whispers continue through the chiropractic generations precisely because most chiropractors are NOT paying attention to the peer-review literature!

The idea that Tom Morris was the architect of the philosophy of chiropractic is rooted in facts, first espoused in the 1950s by Cyrus Lerner in his unpublished Report. In order to win the first landmark case for chiropractic, philosophy was used as part of the defense; “Chiropractic has a separate and distinct philosophy.” Soon after, B.J. Palmer and even D.D. Palmer wrote and taught about the philosophy as central to chiropractic, one of its three pillars. They also codified philosophical terminology to distinguish the differences between chiropractic and medicine such as adjustment and analysis.

The defense was used thereafter to win 90% of 3,300 cases against chiropractors in the next twenty years. This aspect of the facts has been whispered through the literature by Rehm, Keating, Seaman and several others in the last thirty years. THIS is how it goes from partial fact to distorted truth.

None of these arguments including Simpson take into consideration the FACT that D.D. Palmer had been studying the philosophy of healing for thirty years prior to the Morkibubo case. (I explore these issues in more detail with the actual texts D.D. was studying in two of my books (ANOTHER PLUG)!) Nor do they account for the FACT that the philosophy of chiropractic has many similarities to the 20th century philosophies of biology, philosophies that led to the current trends in systems theory, complexity theory, chaos theory, and other more interesting approaches such as Non Equilibrium Thermodynamics and Subtle Energy Systems. Basically, there were many factors that led to the importance of the philosophy in chiropractic and these dismissivist approaches merely point to ONE and suggest it is EVERYTHING.

You ask, “Why is this important?” Well, by dismissing the philosophy of chiropractic as a relic of an earlier time, when there were not many licensing laws, it gets erroneously argued that we no longer need philosophy because we don’t need that “phony” defense anymore! This of course leads to licensing boards (GCC) and accrediting agencies (CCE) to diminish the need for philosophy and subluxation, which leads to changes of scope and education.

Before I get to the subluxation part, let’s address the new distorted truth

Simpson, WRONGLY asserts that Solon Langworthy (the man credited with writing the first chiropractic textbook and coining the term vertebral subluxation), started the ACA in 1922. This is a mistake and hopefully the journal will publish a retraction. In 1903, Langworthy started The American School of Chiropractic in Cedar Rapids, Iowa. The association he started in 1905 was called the American Chiropractic Association, and was probably an alumni group. It had no relationship to the ACA, which formed in 1922, which later became the NCA, which in 1963 became the ACA of today.

And so you ask, “Who cares about all this history Simon?” Let’s look at the problem and the new whispers that will start from this very scholarly article of Simpson’s. It goes something like this… Since Tom Morris used Langworthy’s textbook to establish chiropractic as separate and distinct, and Morris was the architect of the philosophy, and since Langworthy started the ACA…well…that organization and their beliefs must hold the real flame of chiropractic legitimacy… and the whispers go on.

I will just end this rant by noting that Simpson’s assumption that evidence based practice and subluxation are mutually exclusive does not have any foundation except what is whispered in his carefully chosen references. He misses the important study called How Chiropractors Think and Practice (2003), which shows 88% in North America prefer to keep the term subluxation. He also misses much of the current literature on subluxation and history.

Finally, Simpson uses this tired group of distorted facts to dredge up yet another and another, that somehow philosophical chiropractors and subluxation chiropractors must ALL be following a “dogma” that believes the idea of ONE-CAUSE ONE-CURE and whatever goes with it. For the one cure issue, I refer you to the 2003 study mentioned above, for the worn out use of the term “dogma” in discussing chiropractic and its philosophers, you may just have to take my 12 hour online course, where I go into it in detail. (LAST SHAMELESS PLUG!)

With sincerity,

Dr. Simon Senzon

References

For a fascinating, albeit slanted, view of the interconnections between the CCE, FCLB, NBCE, and the ACA, please read the online pdf version of Moore and Wise’s book, A Report on Chiropractic Politics and Education (1979).

Dr. Senzon’s most recent series of articles published in the Journal of Chiropractic Humanities explicitly address the “legal ploy argument,” and its implications for modern chiropractors, especially in terms of the policies of the GCC and the CCE.

Keith Simpson’s recent article, The Five Eras of Chiropractic was published in the Journal of Chiropractic and Manual Therapies.

To learn more about Tom Morris, please go to the Earliest Philosophers section and click on the Tom Morris page.

To read Cyrus Lerner’s 1952 report on chiropractic’s origins, please click here for the pdf: Lerner Report

Simpson references an article by Keating to support his claims about Morris as “the architect of chiropractic philosophy.” Keating also uses this piece to discuss his opinion on “dogma” in chiropractic.

Seaman’s articles on the “Curse of Chiropractic” are good examples of how this “legal ploy argument” is used to attempt to discredit traditional philosophical concepts in chiropractic. Unfortunately, Seaman chose an obscure passage from Stephenson’s Chiropractic Textbook (1927) to make his point, and it seems that he misquoted Stephenson…

D.D. Palmer’s traveling library is discussed in detail in Dr. Senzon’s books.

  • The impact of Langworthy and the Morikubo case are discussed in: Secret History of Chiropractic
  • The traveling library is published in abridged version in Dr. Senzon’s book: Chiropractic Foundations

To read more about the Dismissivist approach, please read McAulay’s article from the JCH:

To learn more about the GCC’s attempt to dismiss chiropractic philosophy and define the vertebral subluxation as an historical artifact, please see

To explore the latest controversy over the CCE’s new standards please see:

To learn more about Solon Langworthy, please please read Gibbon’s paper: Solon Massey Langworthy: Keeper of the Flame (posted with permission from the Association of Chiropractic History).

How Chiropractors Think and Practice was published as a book but the findings are available online:
New Study Finds Unity in Chiropractic

Finally the ideas of Dogma in chiropractic go along with the spurious claim that subluxation cannot be tested and is somehow mutually exclusive of evidenced base practice.

Dr. Senzon addresses many of these issues in his current series in the JCH on Constructing a Philosophy of Chiropractic:

But nowhere are the issues of dogma, subluxation, worldviews, and the philosophy of chiropractic addressed in more detail than in Dr. Senzon’s new online 12 hour curriculum.

What recent students are saying about Dr. Senzon’s online courses:

  • Dr. Gregg Stern of Stern Chiropractic writes, “It was like a great book you just could not put down!  I don’t know if 2 days is a record but I finished the 12 hrs and look forward to the next 2.”
  • Dr. Jay Komarek of Boulder Sol Chiropractic writes, “”Simon, I want to take a moment to thank you. I am just about to finish your 12 hour program online. I have to say that I did it for CE. That being said, I would do it again just for the joy of it! After 34 years of mostly joyous practice I was uplifted by your program on so many levels…your message stands like a lighthouse pointing a way out. I am greatly appreciative of what you have done.”
  • Dr. Martha Nessler of Innate Expressions writes, “”Simon’s passion for the historical preservation of chiropractic is inspiring and contagious. With his focus on BJ and the journey he traveled as he developed the profession of chiropractic, you are instantly re-connected to your roots. His blend of information and photos allows you to see where chiropractic has been and to realize your role in where it is headed. Simon is brilliant, devoted, and knowledgeable. His dedication to chiropractic’s heritage is what we need to preserve this profession.
    A must do for ALL chiropractors!”
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