CPAP 1605 Week 5 - Licensure Impacts Chiro. Education...

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Unformatted text preview: Licensure Impacts Chiro. Education Licensure Impacts Chiro. Education ► 1911 – Kansas Act is passed First chiropractic licensing act Establishes chiropractic as a “privilege” (not a right) granted by the state It is “state’s responsibility to define chiropractic” ► Good aspects of the act: Practitioners get some professional recognition PSC (BJ) writes the “scope of practice” standards Chiropractic is no longer considered “unlimited practice” (as medicine is) Licensure Impacts Chiro. Education Licensure Impacts Chiro. Education ► Bad aspects of the act: Scope of practice set/changed by individual states ► OK: Trained in acupuncture, FL: Trained in OTC drugs DCs w/o medical licenses (not MD/DCs) must identify themselves as “Chiropractor” (not “Doctor”) Chiropractors considered “different” by the law (inferior?) Educational standards set by individual states Allowed more therapeutic minded practitioners to start teaching such courses as: Public Health, Communicable Diseases, etc. Licensure Impacts Chiro. Education Licensure Impacts Chiro. Education ► Minimum educational requirement included: High school diploma ►BJ could not have gotten a license under the Kansas Act One year in a chiropractic school ►On campus ­ residence programs) Specific state­required courses ► “All doctors are doctors” Any one using title “doctor” must have “the minimum education in medical diagnosis” Licensure Impacts Chiro. Education Licensure Impacts Chiro. Education ► National School of Chiropractic and Drugless Healing has problems with Kansas Act One year residency program requirement ►National has been operating as a correspondence school ►Tries to change residency requirement, but fails Medical license required to use the title “Doctor” ►National changes from using the term “Doctor” to using the term “Physician” Licensure Impacts Chiro. Education Licensure Impacts Chiro. Education ► BJ concerned with high school requirement ► Many PSC students are older “career changers” Often had little/no high school education BJ publicly disputes Wm. Langworthy (head of mixers) who wants minimum educational requirement BJ succeeds (partially) in Kansas Kansas Act amended to include “work time” as an educational equivalent Rest of the wording “stands as is” ► All state statutes arise from Kansas Act Philosophy Comes to PSC Philosophy Comes to PSC ► During this time: PSC teaching: dis­ease, x­ray and palpation analysis UCC teaching: Meric System Ratledge (DD’s last school) teaching: Palpation analysis/adjusting Texas CC teaching: Meric System National Chiropractic College teaching: Mixing Eastern Chiropractic College founded in Newark, NJ ► Moves to NY because of strong NJ medical opposition ► Will become New York Chiropractic College Philosophy Comes to PSC Philosophy Comes to PSC ► Palmer School of Chiropractic in 1911 Has over 600 students One­year course of study DC degree ► BJ is developing “nerve tracing” technique Cause vs. symptoms concept is developed BJ beginning to say he is not treating symptoms/diseases (as opposed to DD seeking the “one­cure for all diseases”) Begins to disconnect subluxation “analysis” from disease “diagnosis” Philosophy Comes to PSC Philosophy Comes to PSC ► 1911 – First PSC philosophy class introduced Primarily concerned w/ terminology (e.g. dis­ease, dx, rx) BJ wants profession to realize the dangers of using medical terminology in chiropractic but with different meanings ► BJ accused of turning chiropractic into religion At one point, BJ suggests maybe chiropractic “should become a religion, as religions “can’t be touched” DD writes about the “religious duty” of a chiropractor ► Ten per cent (10%) of student body leaves PSC when BJ introduces philosophy classes into the curriculum Licensure Impacts Chiro. Education Licensure Impacts Chiro. Education ► 1911 – Clayton­Palmer Table First mechanically “adjustable” adjusting table Utilizes metal, rather than wood, components Invented by Bert Clayton Table ideal for popular Meric System of adjusting Licensure Impacts Chiro. Education Licensure Impacts Chiro. Education ►1912 Joe Shelby Riley MS, MD, PhD, DO, DC, PhC ►Established New England College of Chiropractic ►18­month broad scope curriculum ►Massachusetts State Supreme Court rules chiropractic is the practice of medicine ►School is closed because of MSC ruling Ruling won’t be overturned until 1966 ►Riley then establish Washington School of Chiropractic Loban publishes The Technique and Practice of Chiropractic Chiropractic Becomes “Legal” Chiropractic Becomes “Legal” ► 1914 – BJ/UCA resist spreading legislation of the chiropractic profession DD’s last book, The Chiropractor, published posthumously In it, DD suggests practicing his theories/methods is a “religious duty, thereby exempt from legal regulation” Chiropractic Becomes “Legal” Chiropractic Becomes “Legal” ► UCA often argues for “law of survival” (caveat emptor?) Suggests that incompetent chiropractors would weed themselves out by their inability to satisfy patients BJ says only patients can determine the fate of chiropractic – based on patients’ right to choose BJ/Morris feel legislation will lead chiropractic away from “pure, straight and unadulterated” practice By 1927, UCA will have defended 3300 similar cases on this basis ► Utilizes “separate and distinct” defense together with “patient’s right to health care choice” Chiropractic Becomes “Legal” Chiropractic Becomes “Legal” ► ► 1915 – Arkansas becomes 1st state to approve a “chiropractic board,” issues first real licenses Hugh Logan, DC graduates from Universal Chiropractic College Will go on to develop Logan Basic Technique ► Based on biomechanical principle that a healthy spine is founded on a level sacrum ► Adjust the sacrum and the rest of the spine will follow Will establish Logan College of Chiropractic ► St. Louis, MO in 1935 ► Based on Logan Basic Technique ► Philosophic supporter/technique rival of BJ/PSC Chiropractic Becomes “Legal” Chiropractic Becomes “Legal” ► 1916 – In response to increasing harassment of chiropractors in states w/out chiropractic legislation, UCA adopts a “go­to­jail” strategy A form of professional “passive resistance” Begins to create “jailed martyrs for medical freedom” ► 1917 – NFC (1910) becomes the third ACA ► Elis Microdynometer is developed to measure “bio­electrical currents” Invented by Cutler­Ellis Becomes popular in the 40’s and 50’s ► PSC student Dossa Evans begins work on the NCM (Neurocalometer) Ellis Ellis Microdynometer BJ Develops PSC and Chiropractic BJ Develops PSC and Chiropractic ► 1917 – Chiropractic Spinography published E. A. Thomson, DC, PSC faculty, writes first textbook on chiropractic roentgenology Published by PCS as a “Green Book” Contains information on: ►Soft tissue techniques ►Esophageal/stomach contrast studies ►Extremity x­rays ►X­ray physics PSC also offers “Spinograph Reading Service” to practitioners ►Precursor of BJP Research Clinic PSC Spinograph Reading PSC Spinograph Reading Service E.A. Thompson, DC Analyzing X­rays E.A. Thompson, DC Analyzing X­rays for the PSC Spinograph Reading Service BJ Develops PSC and Chiropractic BJ Develops PSC and Chiropractic ► 1920 – Enrollment at PSC is 1000 students 79 chiropractic colleges nationwide By 1927 – down to 40 schools, 2000 total students ► 1921 – 3,100 students at Palmer Will be down to 300 by 1929 ► 1922 – California Chiropractors Act Keeps at least one chiropractor in jail in each county Rumored that LA county jails had more adjusting couches than all the chiropractors in the state. Chiropractors beginning to be perceived by the public as a “bullied minority, willing to go to jail in defense of their freedom” 1922 1922 ► 1922 – Wonders of Chiropractic airs WOC – BJ Palmer’s 1st radio station First radio station west of the Mississippi ► Cleveland Chiropractic College is founded in Kansas City, MO Begins four generation Cleveland “dynasty” ►Carl Cleveland, III – Current president of CCC­ KC/LA ► Fred Rubel, DC (NCC ’13) First African­American chiropractor Starts Rubel Chiropractic College in Chicago Dr. Fred Rubel Dr. Fred Rubel First African American Chiropractor ► 1913 – Graduates from National School of Chiropractic and Drugless Cure ► 1922 – Founds Rubel College of Chiropractic in Chicago, Ill 1923 1923 ► 1923 – ACA President Frank Margetts, LLB, DO, DC, crisscrosses the country recruiting new ACA members Publishes The Lifeline, a patient newsletter Broadcasts a radio show of the same name Creates a Public Speakers Bureau Builds ACA to the largest chiropractic association at the time 1923/1924 1923/1924 ► 1923 Spinographic Society is formed at the PSC Lyceum ►Will eventually merge with NCM Society and becomes the NCM and Spinographic Society Chiropraxis, a Serious Menace ►Sept. 1923 article in Wisconsin Medical Journal ►Very critical attack on chiropractors ► 1924 Joy Loban (UCC) introduces standing lumbo­ pelvic x­rays to assess spinal bio­mechanics National Spinographic Society National Spinographic Society 1923 “The Hour Has Struck” ► 1924 – BJ introduces “his new” NCM to the chiropractic profession August: BJ unveils the Neurocalometer (NCM) in a Lyceum address called “The Hour Has Struck” ►“Reading the spinograph is not a mathematical problem because the descriptive parts are not symmetrical. Therefore the seeming problem is only an estimate.” ►“No chiropractor can practice chiropractic without an NCM. No chiropractor can render efficient, competent, or honest service without the NCM. ” Early Neurocalometer ► BJ markets it as the “next stage in the progress of scientific chiropractic practice…” ► Many chiropractors perceive it as a money­ making scheme to make BJ rich ► BJ proclaims that it is time for the profession to support him after years of him supporting the profession “The Hour Has Struck” ► It is supposed to help find the ‘hotbox’ ‘Hotbox’ was a reference to a common railroad problem. Lack of lubrication in the wheel box allowed friction to build up and develop a hot box, often resulting in fires ► PSC will lease NCMs for $300 and $5/month Expensive car: $1000, average home: $3500 PSC will retain ownership and maintain/repair units Leases eventually reach $3500 and $100/month ► This marks the beginning of BJ’s decline as the leader of the chiropractic profession 1925 1925 ► BJ forms Chiropractic Health Bureau (CHB) Purpose: Legal defense of straight chiropractors CHB merges with/becomes ICA on Sept. 4, 1925 BJ resigns from UCA, becomes president of ICA ► “Knee chest” table is developed Upper cervical emphasis drives changes in equipment Knee­chest table “ideal” for PSC’s toggle­recoil adjustment NCM and HIO continue to alienate many 1925 1925 ► BJ decides his “subluxation theory” eliminates the need for strong basic sciences curriculum “Chiropractor adjusts the subluxation, Innate heals the patient” ► Harvey Lillard dies September 7, 1925 ► Charles C. Lemly (1892­1970) graduates Runs a Chiropractic Sanitarium in Waco, TX “Most arrested chiropractor” with 66 arrests Sacro­Occipital Technique Sacro­Occipital Technique ► 1925 – Major B. DeJarnette, DO, DC begins to develop Sacro­Occipital Technique (SOT) Basis hypothesis: ►Sacrum is connected w/ cranium via dura mater ►Sacrum has a sagittal plane respiratory movement ►Synchronizing sacral/cranial motion helps to normalize cerebrospinal fluid (CSF) circulation Classifies spinal distortions into three categories ►Each category requires different “adjustment” with wedge shaped blocks ►Blocks are put under the pelvis ►Legs are checked to evaluate effectiveness Sacro­Occipital Technique Sacro­Occipital Technique ► Major B. DeJarnette, DO, DC also helps develop cranial/reflex therapy techniques Hypothesizes that each vertebra related to a specific visceral area, thus affecting all the internal organs From this, he develops Chiropractic Manipulative Reflex Technique (CMRT) a.k.a. “bloodless surgery” ► Number of chiropractic colleges peaks out at 82 nationwide 1926 1926 ► September – FCLB founded Representatives from 16 states form the International Congress of Chiropractic Examining Boards in KC Eugene Cox of NC is first president Eventually will becomes Federation of Chiropractic Licensing Boards (FCLB) ► Leads to “International Chiropractic Congress” Mostly “neutral” organization of chiropractic colleges Formed to work on common problems Becomes Association of Chiropractic Colleges (ACC) Clear View Sanitarium Clear View Sanitarium 1926 – Clear View Sanitarium is built on Eastern Ave in Davenport. It will operate for 25 years and will become the mental health branch of the Palmer Research Clinic. Mental Health and Chiropractic is written about the chiropractic experiences there. Another “Defection” Another “Defection” ► 1926 – Lincoln Chiropractic College Four of BJ’s top faculty disagree ►Steven Burich, James Firth, Harry Vedder and A.G Hendricks – the “Big Four” or the “Four Horsemen” Disagree with BJ over NCM “requirement” Resign and leave to start the Lincoln College of Chiropractic ►Located in Indianapolis, Indiana ►Pushes the four­year required curriculum ►Eventually “absorbed” by NCC in 1959 The “Big Four” of the PSC Faculty The “Big Four” of the PSC Faculty Authored several of the Green Books Broke with BJ in 1926 over NCM Left to form Lincoln College of Chiropractic First Stab at “Chiropractic Unity” First Stab at “Chiropractic Unity” ► 1928 ► Tom Morris, UCA counsel and BJ supporter, dies at 60 years of age This opens the way for a merger of ACA and UCA ► 1929 – NCA formed by ACA/UCA merger ACA (1500 members) and UCA (1500 members) meet in LaSalle Hotel (Chicago) in October President Charles Schilling (UCA) and President Frank Margetts (ACA) both agree to step down ► Continue to work behind the scenes to orchestrate the merger NCA considered to be the “4th ACA” BJ’s Media Empire Grows BJ’s Media Empire Grows ► 1929 – BJ: Midwest radio entrepreneur WOC broadcasts from BJ Palmer’s living room ►Ronald Reagan is sports announcer at WOC ►BJ fires Ronnie, then rehires him Palmer also purchases WHO – 1040AM ►First 50KW station in the country ►Located in Des Moines, IA ► AMA (!) inspection team visits PSC and proclaims BJ’s osteology collection to be “the best collection of spines in existence” WHO IS THIS FELLA? WHO IS THIS FELLA? WAZZUP WAZZUP DAVENPORT!! DAVENPORT!! WOC WOC WOC WOC ► The antenna is on the roof of the Administration Building at the top of Brady Hill ► The studio is in the living room of BJ’s mansion, just down the street ► BJ has a $75K pipe organ in his $25K mansion to play the music broadcast from 4 ­ 7 pm daily October, 1929 October, 1929 The Great Depression Hits ► BJ/PSC weather the Great Depression and stay afloat, even though PSC enrollment plummets BJ’s printing empire is going well PSC has steady income from NCM leases PSC cafeteria (soup kitchen) attracts locals BJ acquires WHO (With Hands Only) radio station at a “fire sale’ price BJ’s shrewd business sense serves him and PSC very well Chiropractic in the 1930s Chiropractic in the 1930s ► 1930’s Electric “Hy­lo” table is developed HIO becomes popular, exclusively taught at PSC until 1949 Side posture tables are developed, begin to be utilized in HIO toggle/recoil adjusting Carver, known as the “Constructor of Chiropractic” establishes many schools around the country, but none survive Chiropractic in the 1930s Chiropractic in the 1930s ► 1931 The Rise of Chiropractic is written ►“Palmer differs from osteopathy in that short, sharp thrusts into the specific joints to replace inflammation­producing dislocations of the anatomy, thereby avoiding friction and overheating of bodily tissues” Ernest A. Thompson, head of PSC Department of Spinography, incorporates the assessment of anomalies into classes, and PSC’s Spinograph Reading Service ►All chiropractic schools now teach post graduate programs in radiography X­Ray X­Ray ► 1932 – Warren Sausser, DC develops the single exposure full spine x­ray Full spine films become so widely used by chiropractors that, in the ’50s, the syndicated game show “To Tell The Truth” once had three contestants on stage with their full spine films in front of them, each claiming to be “Miss Perfect Posture” Of course, to tell the truth, only one was the actual “Miss Perfect Posture” Warren Sausser (on left) Warren Sausser (on left) and his Full Spine Spinograph To Tell The Truth ­ FS X­ray To Tell The Truth ­ FS X­ray Chiropractic in the 1930s Chiropractic in the 1930s ► 1934 – HIO is in its heyday at PSC The Subluxation Specific, The Adjustment Specific (Green Book Vol. 18) is written ► 21 or fewer schools operating nationwide ► Mixer (broad scope) vs. straight (narrow scope) conflict in full swing NCA vs. ICA National vs. PSC Palmer supporters vs. everyone else Chiropractic in the 1930s Chiropractic in the 1930s ► 1935 – Committee on Educational Standards Established by NCA (broad­scope agenda) John J. Nugent, DC ­ NCA “Director of Education” Begins effort to upgrade chiropractic education ►Smaller schools must merge ►All schools must teach “4 years of 9” ►Non­profit status (eliminate proprietary schools) ►Faculties strengthened ►Clinical opportunities expanded Publishes list of accredited schools JOHN JOHN NUGENT ► ► ► “The Abraham Flexner of the chiropractic profession” Worked for 35 years to upgrade chiropractic education Became “the most hated man in the profession” Chiropractic in the 1930s Chiropractic in the 1930s Midterm to here 091 ► 1935 – Logan Basic Chiropractic College Established by Hugh Logan, DC (UCC ’15) He contends that “segmental subluxations are the result of body distortions” Deficient unilateral body support caused by one or a combination of the following: ►Unilateral sacral subluxation ►Leg length discrepancy ►Unilateral L5 wedging Develops “Logan Basic” contact/adjustment B.J. Palmer B.J. Palmer Chiropractic Research Clinic ► B.J. Palmer Chiropractic Research Clinic Costs BJ $1,000,000 (in 1935 dollars) to build Dedicated at 1935 Lyceum Research Clinic includes: ►Complete medical diagnostic labs ►Complete chiropractic analytical labs Including the most modern chiropractic spinography facility, consulting rooms, adjusting rooms, resting rooms, and a complete rehabilitation facility ►An auditorium for public lectures ►BJ’s extensive osteology collection ►Chiropractic memorabilia display B.J. Palmer B.J. Palmer Chiropractic Research Clinic ► B.J. Palmer Chiropractic Research Clinic Accepts difficult cases from field chiropractors Has separate medical/chiropractic divisions ► New patients first diagnosed by MDs, (full lab values, etc.) ► Separate chiropractic analysis followed (x­ray, NCM, etc.) ► Upper cervical HIO adjustment(s), usually by BJ himself ► Complete chiropractic/medical reassessments at end of care Neither patient nor DCs told dx or “disease outcome” Patient discharged, sent back to referring chiropractor w/ complete case file and instructions for follow­up B.J. Palmer B.J. Palmer Chiropractic Research Clinic ► BJ says the research clinic’s objective is to treat “impossible” cases and prove to the medical profession that chiropractic “works” ► In a later Lyceum speech, BJ says that his research is not intended to agree or disagree with medical diagnosis, but to refute its validity, necessity to achieve chiropractic results ► He claims that, while field chiropractors don’t need to use them, he needs to obtain lab values in his research to “prove that chiropractic works” B.J. Palmer B.J. Palmer Chiropractic Research Clinic ► BJ also wanted it to be clear that he was “fighting” the medical “system,” not medical doctors ► MDs attack the clinic’s research, because BJ didn’t use any control groups (RCCT) ► BJ says that his clinic research is not proving subluxations exist, but documenting the effects correcting subluxation can have on physiology B.J. Palmer B.J. Palmer Chiropractic Research Clinic ► BJ’s Chiropractic Research Clinic produces many advances in chiropractic technology Graph Pattern Analysis work developed ►NCM combined w/ paper graph recorder to create Neurocalograph ►Pre­/post­adjustment graphs recorded, compared Neuroelectroencephalomentimpograph ►Electrical machine to track “mental impulse” from brain down spinal cord ►Precursor to modern electroencephalograph (EEG) Electro­encephalo­neuro­ment­imp­ograph Electro­encephalo­neuro­ment­imp­ograph ► Tracked micro­ voltages from brain down spinal cord through a series of surface probes ► Used in a “copper shielded room” to eliminate stray electromagnetic influences BJ Obtains the “Wet Specimen” BJ Obtains the “Wet Specimen ► Medical community continues to claim that subluxations can’t and don’t exist Neural foramina/IVFs too big in proportion to nerves Subluxations cannot “pinch nerve flow off” ► BJ responds: Previous experiments done on dry specimens Cadaver dissection research bears little relevance to living beings (philosophic argument) Rigor mortis produces significant tissue shrinkage (anatomical argument) BJ Obtains the “Wet Specimen” BJ Obtains the “Wet Specimen ► BJ goes to Dresden (Germany) to pursue a “wet specimen” of occipito­atlanto­axial area of spine Wet specimen: immediate post­mortem dissection ► Results of the “wet specimen”: Nerves did sufficiently fill foramina (or at least the fluids that bathe the nerves did) to allow impingement BJ embellished a bit, saying he had proved that C1/C2 was the only region of the spine where the neural components are sufficiently cramped to “subluxate” In fact, this was the only area actually studied Chiropractic in the 1930s Chiropractic • 1938 – Associated Chiropractic Colleges of America (ACCA) is formed – 4 - 5 colleges strong – Mainly PSC aligned “straight schools” – Formed to combat John Nugent’s Committee on Educational Standards • 1939 – Neurocalograph (NCGH) is introduced – Developed by a PSC engineering consultant – Allows much improved clinical record keeping Neurocalograph Neurocalograph • With attached NCM, NCGH produced a paper graph record of the bilateral surface heat variation in any region of the spine • Successive similar (static) graphs established subluxation “pattern” • Adjustment led to changing (dynamic) graphs, indicating ongoing adaptation ...
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