Dispute Over Chiropractic Trends Creates an Accreditation Controversy

December 14, 2011

The process by which accreditors seek federal recognition is normally pretty staid, with any disagreements cloaked in the obtuse jargon of education bureaucracy.

But a chiropractic-program accreditor's bid to renew its recognition has attracted blunt name-calling and allegations of retribution from its critics, who hope to prevent the renewal from going through. Accrediting bodies must be recognized by the U.S. Department of Education in order to approve colleges to receive federal financial aid.

The Council on Chiropractic Education, which oversees 15 programs offering the doctor of chiropractic degree in the United States, makes its case for renewal Wednesday in front of the National Advisory Committee on Institutional Quality and Integrity, an 18-member panel that makes recommendations to the education secretary on accreditation issues. The committee's meetings rarely attract any notice at all, much less controversy.

But the chiropractic-education council has come under verbal fire from a group charging that the accreditor is being controlled by a "cartel" of "testing companies, licensing boards, state and national trade organizations, and companies doing business within the profession." An online petition opposing the renewal has gotten nearly 3,400 signatures. At least 17 people have signed up to make comments on the council's recognition at the meeting.

The council's application for recognition is one of 15 being reviewed during three days of meetings by the advisory committee, which convenes twice a year­—typically without either petitions or speakers. The federal panel is also discussing a set of recommendations it will make to the education secretary about changing the accreditation process.

The petition, which claims that the council "is no longer representative of the chiropractic profession," is sponsored by a group calling itself the Movement for Chiropractic Quality and Integrity. It says the "cartel" is "asserting its influence to turn chiropractic into a subset of the medical profession." One of the chief disputes is over whether the practice of chiropractic should expand to include treatments, such as minor surgeries and prescription medicines, that go beyond the traditional manipulation of the spine.

Steve Tullius, a chiropractor in Grover Beach, Calif., who is one of the founders of the opposition group, said more institutions would like to speak out against the expanded definition of chiropractic but fear that the council will retaliate against them by threatening their accreditation. The council is the only organization to accredit the doctor of chiropractic degree.

The council also has not responded to thousands of complaints about new accreditation standards and policies that were put in place over the past year, Mr. Tullius said.

In an open letter to the profession that was released in November, the council's chairman, David J. Wickes, said "attacks" on the organization "have been coordinated by a few outspoken but ill-informed individuals" and are based on "misconceptions, misunderstandings, and factual distortions."

Keith S. Overland, president of the American Chiropractic Association, said the dispute is just part of a conflict that has existed in the chiropractic community "since Day 1." On one side are practitioners committed to the traditional practice of chiropractic, and on the other are those willing to expand the treatment options to meet their patients' needs.

Complicating the issue, he said, is that in some states, chiropractors can operate as primary-care physicians and have to be trained to diagnose and sometimes treat a wide variety of conditions. In Oregon, for example, chiropractors can perform obstetric and gynecological services.

David O'Bryon, executive director of the Association of Chiropractic Colleges, said critics trying to derail the council's recognition have improperly conflated accreditation issues with disagreements over the scope of chiropractic practice.

A similar dispute arose in 2006, the last time the council sought recognition from the advisory committee, but the panel overwhelmingly approved the council's application.