Mounting a United Effort in an Aggressive Health-care Market

An interview with David Chapman-Smith, secretary-general of the World Federation of Chiropractic.

David Chapman-Smith is the secretary-general of the World Federation of Chiropractic and serves as general legal counsel for the Ontario Chiropractic Association.  As chiropractic in our country enters into its second century, Chapman-Smith joins Canadian Chiropractor Magazine in a Q and A session to speak of the profession nationally and around the world today.

From the standpoint of the World Federation of Chiropractic, what are some exciting developments in global chiropractic?
First and foremost, leaders in the profession – whether in national associations, research, education, sports chiropractic or other specialties – are now working together much more co-operatively.  The World Federation of Chiropractic (WFC) had leaders from 47 countries, including strong delegations from both the American Chiropractic Association (ACA) led by Chairman Dr. Lewis Bazakos, and the International Chiropractors Association (ICA) led by President Dr. John Maltby, at our congress in Portugal in May.  The president of the Canadian Chiropractic Association (CCA), Dr. Stan Gorchynski, led the Canadian delegation.

Second, the results of this united effort: There is now firm support for the profession from the World Health Organization (WHO) whose recent Guidelines on Basic Training and Safety in Chiropractic, recommending to governments worldwide that chiropractic services should be an integral part of their health-care systems, are now available in English, Finnish, French, German, Japanese, Korean, Portuguese and Spanish. The WFC has recently accepted WHO’s invitation to organize and administer the WHO International Symposium on Manual Therapies and Chiropractic to be held in October 2008 in Bejing, China.

Because of co-operative partnerships across countries and institutions, there are many new chiropractic schools opening throughout the world – very important for the future independence and identity of the profession. Next month, a chiropractic school starts at a major university in Escorial, Spain, and next year, a school commences at the prestigious University of Zurich in Switzerland. With international net-working, there is a consistent and appropriate legal scope of chiropractic legislation in many countries. In Thailand recently, first licensing examinations, jointly administered by the Thai Ministry of Health, the WFC and the International Board of Chiropractic Examiners, were held in July.

Finally, co-operation has produced an agreed fundamental market identity for chiropractors worldwide as the experts in spinal health and now, international development of the Straighten Up program, the hugely successful three-minute daily exercise program for spinal health for children and adults that was begun as Straighten up America.

Where is the profession facing serious issues?
The profession is facing serious issues in Brazil and some other Latin American countries where there is still no chiropractic legislation. The physiotherapy profession is lobbying for laws declaring chiropractic a specialty of physiotherapy. If those laws pass, it would be very serious for the profession internationally! That’s why a WFC fundraising campaign has been successful in raising almost $100,000 to help the Brazilian Chiropractic Association in its fight for the profession.
The single most repressive country, in which chiropractors are still being prosecuted for illegal practice of medicine, is Taiwan.

I believe the profession is facing a serious issue of identity in Canada as well as in a number of other countries where it is long established – for example, Australia and New Zealand. In these countries, the profession remains camped at the crossroads between mainstream health care on one hand and complementary health care on the other. In Canada, the CCA leadership and both chiropractic schools are doing a good job of promoting a trusted mainstream identity but is the profession acting this out consistently in the community? Chiropractic will only receive the significant public funding it deserves for its education, practice and research when it is seen as a mature and mainstream discipline. The fact that such funding is readily attainable is demonstrated in countries such as Denmark and Norway.

Would you agree that Canadian chiropractors have been ex-tremely influential on the world stage?
Without question! One thinks back to pioneers in education such as Dr. Earl Homewood and Dr. Herb Vear and pioneers in research such as Dr. Adrian Rice and Ron Gitelman.  Dr. Jean Moss, recently president of the Association of Chiropractic Colleges, and currently president of the Canadian Memorial Chiropractic College (CMCC), has been very influential in educational circles internationally. The most prominent chiropractic researchers in Australia (Dr. Lynton Giles), Canada (Dr. David Cassidy, now closely followed by many others), and Europe (Dr. Alan Breen) are all CMCC graduates. The WFC grew strongly under its past president, Dr. Paul Carey of Stratford, Ontario, who has brokered many important international meetings and advances. Under him, the Canadian Chiropractic Protective Association (CCPA) has given financial support for major projects, the most recent of which is the Bone and Joint Decade Neck Pain Task Force led by Dr. Scott Haldemann and Dr. David Cassidy.

The president and vice-president of The College of Chiropractic Sports Sciences (Canada),  Dr. Gregt Uchacz  and Dr. Brian Seaman respectively, are seen as key leaders in international sports chiropractic, establishing educational and practice standards and official access to chiropractic services at the Olympic Games. 
I could go on and name many others.

Should the profession appreciate and encourage diversity within?
Yes – every profession should. I think of two DCs I know who are married to each other – one practises Network Spinal Analysis (NET) and the other has a strongly evidence-based practice with comprehensive rehabilitation services. Both are highly successful, with patients with different needs attracted to each. Chiropractic should celebrate diversity – but it shouldn’t celebrate hucksterism or practice patterns that serve the interests of the doctor and not those of the patient.

How important is it that the chiropractic profession speak with one voice?
Absolutely and totally important! 

Living in and around the chiropractic profession, we see its growth and dynamism. The profession actually remains very small and vulnerable in a very aggressive and competitive marketplace – modern health care. 
Chiropractic will not be heard of if it speaks with more than one voice.•