I believe that a manipulation, an adjustment, that causes an audible release, is therapeutic only if the joint is dysfunctional when it receives the manipulation. So to practice prevention, we have to be able to identify a manipulable lesion, or a dysfunctional joint, and do a manipulation that actually improves the dysfunction. Then, it will prevent the body from having to adapt to that dysfunction in ways that could eventually lead to inflammation, degenerative changes, etc. But to just take every patient, lie them on the table, do two lumbar rolls, a thoracic crack, and two cervical cracks, will not, I believe, result in a preventive experience…

We need to be treating patients in the early stages of losing their health. We’re not disease managers like medicine; they’re excellent at doing that. We’re involved in prevention and health promotion, at least we should be.

So you would generally subscribe to the adage, “Chiropractic first, drugs second, surgery last”?

Absolutely. It’s one of the few slogans I illustrate in my practice.

You are now teaching at the Los Angeles campus of Cleveland Chiropractic College. What does your work there involve?

I’m very fortunate. I’m teaching the Tri III class in learning manipulation skills, along with the technique courses in Tri IV, Tri V and a Tri VI review class. So what I’m able to do is teach students methods of thrusting – recoil, body drop and impulse. We’ve put together about 180 different manipulations of the spine and extremities, and we’ve put out a workbook describing how to perform each of them. The goal is that the students attain a level of “conscious competency” by the time they enter clinic in Tri VII. So instead of learning something in one course and then losing that knowledge for lack of review, each class builds on the previous classes and includes review of what was learned in the previous classes. We’re seeing a high level of skill development. It’s very exciting.

That sounds very satisfying. Looking forward, in an ideal future, how do you see chiropractic developing over the coming generation?

I think there’s going to have to be a standardization of care. I see our technique programs melding, so that there will be no such thing as the “guru system.” The focus will be generic manipulation, by which I mean that the student will know how to do upper cervical recoil, the student will know how to do the placement of the blocks for SOT [sacro-occipital technique], the student will know a wide variety of manual manipulation methods, but it won’t be called Upper Cervical Specific, it won’t be called SOT, and it won’t be called Gonstead. And the techniques that say, for example, that one finger is positive while another is negative, or the techniques that “talk to the feet,” will be dropped.

We will have a rational integration of techniques that are taught with the foundation of biomechanics, the foundation of muscle assessment, recruitment order, feed-forward mechanisms and more. So we will have generically trained, evidence-based chiropractors that the rest of the world can talk to, and we will be able to talk to the rest of the world. People will learn to respect our field.

Is there anything else you’d like to add?

What I’d like to say in closing is that I look to the day that students read extensively, including going outside the box a little bit, and really start to comprehend the philosophy of a drugless therapy. And that they understand that we are going to help society to be much healthier starting with our work with younger patients, from childhood onward. We can adapt a healing philosophy that helps society and get away from a philosophy where we come first and the patient comes second.

Chiropractic must be evidence-based, not faith based. There’s a transition that has to occur at the student level, so instead of students trying to pick a technique to become a disciple of, they instead will develop individual knowledge in the fields of biomechanics, inflammation, Selye’s stress model, adjusting skills and more. We will have, if our students will adopt this kind of philosophy, a very strong profession. Because we graduate something like seven or eight percent of the profession every year, we can change the profession in ten years.

Daniel Redwood, DC, the interviewer, is an Associate Professor at Cleveland Chiropractic College – Kansas City and Editor-in-Chief of Health Insights Today (www.healthinsightstoday.com) and The Daily HIT (www.dailyhitblog.com).