Every few years some entrepreneurial DCs surface to teach automechanics, housewives, MDs (i.e., any interested party who pays the seminar fees) how to be "chiropractors" in a few easy lessons. The students are conferred a certificate, usually in English, suitable for framing and hanging on a wall to "verify" that they are indeed a "chiropractor." A few equipment manufacturers may even follow up by selling tables and other equipment to the bogus chiropractors.
It is the height of understatement to say that these actions are seen by the chiropractic profession as unethical, an insult to doctors of chiropractic, and a great hinderance for those DCs working to get chiropractic licensing laws passed in their countries.
These irresponsible teaching practices are widespread, having cropped up in Spain, Mexico, Italy and parts of Asia. It is now happening in Germany. In a letter, Ernst Hubschmann, DC, president of the Verband Graduierter Chiropraktoren Deutschlands e.V. (German Chiropractors' Association) makes this plea to the profession worldwide:
We, the members of the German Chiropractors Association, are very concerned about the current practice of chiropractic instruction presented to non-chiropractors in Germany by chiropractors from the United States. We believe this is unethical and unprofessional conduct by our fellow chiropractors.
In Germany, there are two possibilities to practice any kind of healing -- either as a medical doctor or as a natural health practitioner (lay practitioner). A natural health practitioner is one who may heal by magnetic healing, homeopathy, acupuncture, herbology, psychotherapy, etc. German law does not require a degree from an accredited institution for one to become a natural health practitioner. Chiropractic is quite popular in Germany, but is considered a 'technique' instead of a profession. As such, chiropractic is practiced by about 50 percent of medical doctors and 70 percent of natural health practitioners with little more training than in weekend or other short-term courses. Many of these non-chiropractor groups are hiring chiropractors from the United States to present weekend or short-duration seminars and courses on chiropractic techniques. One European firm even advertises: "You can go to an American chiropractic school for $100,000 or you can go to our weekend courses for 10,000 Deutsch Marks (about $7,000) and get the same first-class training." We view this trend and approach to chiropractic as very dangerous - for the patient and for the chiropractic profession.
The German Chiropractors' Association consists of 25 doctors of chiropractic with degrees from accredited chiropractic colleges in the United States, Canada and the United Kingdom. We are struggling to establish an identity for chiropractic as a profession. It does not help when physiotherapists, massage therapists, even housewives and automechanics, as well as established medical doctors and natural health practitioners who take these courses claim they give the same quality chiropractic care to their patients as doctors of chiropractic.
A sampling of advertisements sent to natural health practitioners for chiropractic seminars is attached.
The German Chiropractors' Association asks that your association take a stand against this blatant disregard of professional ethics, sanction your members to preclude this practice and publish a warning to discourage all chiropractors from selling their profession "for thirty pieces of silver."
Ernst Hubschmann, DC
Some of the advertising (all in German) sells different techniques, including Cox and Activator. They brag about teaching the "original" method. In contacting Arlan Fuhr, DC, the developer of the Activator technique, we learned that he was unaware of his work was being used this way in Germany. He commented:
"I do not condone the teaching of Activator Methods Chiropractic Technique (AMCT) to individuals in foreign countries who are not licensed chiropractors. Activator Methods, Inc., does not hold seminars in other countries for this purpose, nor do we allow any of our certified instructors to teach such seminars. In fact, AMCT material is copyrighted and anyone who teaches such material or who uses the name "Activator" without the written permission of Activator Methods, Inc., will be prosecuted. We have had to do this in the past and will do so again if such activity take place. Not only is the teaching of non-chiropractors injurious to the good name of Activator Methods, but it is contrary to the interests of the chiropractic profession."Dr. Hubschmann included promotional literature with his letter as evidence of the types of seminars being taught in Germany. A DC from Massachusetts, Dr. Michael Abgrab, was featured as an instructor at one of the programs. When contacted, Dr. Abgrab stated that it was his understanding that he was only teaching manipulation to "chiropractors, osteopaths and neuro-therapists." Dr. Abgrab said it was his understanding that there were not lay people in attendance. Dr. Abgrab assured us that there was no hands on adjusting taught, but did admit that it was his intention to sell adjusting tables in Germany in the near future.
Additional literature provided by Dr. Hubschmann revealed that two Colorado chiropractors were also teaching courses in Germany: DCs Steven Campbell and Dr. Bernard Busch. Dr. Busch has reportedly been teaching manipulation in Germany for nearly 10 years. When contacted, Dr. Campbell declined to comment, but chose to have Dr. Busch speak for both of them. After several attempts, Dr. Busch also ultimately declined to be interviewed, faxing a letter with some comments instead:
"The situation regarding chiropractic in Germany is indeed peculiar. First, there have always been health care providers (MDs and non-MDs) who have practiced various forms of spinal manipulations long before they heard about chiropractic. Then in the 1950s, Dr. Werner Pepper, a U.S. graduate chiropractor introduced "chiropractic" to medical doctors. Even Dr. Joseph Janse had contact with German MDs. The medical doctors have since severed all contacts with chiropractors and have claimed spinal manipulation or chirotherapie to be part of medicine. They have formed their own association for 'Manuelle Therapie.' Teaching spinal manipulation to medical doctors was a mistake. The German medical doctors are good researchers, but are 'lousy' manipulators.By avoiding our interview, Dr. Busch side-stepped the questions that we were curious about:
"From the non-M.D. side, a group of the Heilpraktikers (the equivalent of our naturopaths) have formed an association for the study of chiropractic and osteopathy (ACON). This group may have a membership of one thousand. Both the above groups hold regular seminars throughout Germany on 'chiropractic and osteopathy,' often led by self-proclaimed experts.
"It is true that German practioners (sic) view chiropractic as just another therapy, as another technique that is part of their armamentarium. In my opinion, the American patient does not view chiropractic as anything much different than a technique to help low back pain.
"Now, back to the concerns of the American graduate German chiropractors. How does our teaching of spinal manipulation to the Heilpraktiker (HP) affect the chiropractic profession in Germany? A chiropractic profession does not exist in Germany. The only way a DC can practice spinal manipulation is if he/she has a license, and the only license available to him/her is the HP license. Therefore, the DC becomes an HP. Now the good doctor of chiropractic can do what the Heilpraktiker can. All of a sudden the scope of practice for a DC is open to include acupuncture, injections, ozone therapy, homeopathy etc., as well as spinal manipulation. So if it were not for the HP license, the DC could not practice spinal manipulation legally. Therefore, I find it tremendously ironic that the German DCs want to prevent the HP from becoming proficient in spinal manipulation when the DC himself has become an HP. It seems like the DC wants to bite the hand that feeds him/her. This is typical short-sighted chiropractic philosophy.
"I personally, along with my colleague Dr. Steven Campbell, am proud to have directed teaching workshops for those HPs interested in improving their manipulative skills. We have presented first class material in diagnosis, examination, x-ray interpretation, and spinal manipulation. We have always stressed safety for the patient and we have truly impacted a number of HPs to be better practioners (sic). Our teachings have been offered through a state association and are conducted at a professional school."
- Why are you (Drs. Busch and Campbell) involved in teaching lay people how to adjust? Is it the money?
- The German Chiropractors' Association believes that such seminars are damaging chiropractic in Germany, and the association's ability to help establish licensure laws. How do you respond?
- Many believe that teaching lay people to adjust in 2-3 day seminars (the length of the ACON seminars according to copies of programs included in Dr. Hubschmann's materials) endangers the public (particularly in the absence of formal courses in anatomy and physiology). Do you, Drs. Busch and Campbell, ignore the potential dangers?
- Do you feel you have betrayed the chiropractic profession in any way? And if not, why not?
The actions of these individual DCs is in strict violation of the international agreements established by the national chiropractic association members of the World Federation of Chiropractic (WFC), of which the German Chiropractors' Association is a member. John Sweaney, DC, WFC president and past-president of the Chiropractors' Association of Australia explains:
"The national chiropractic associations, which include the American Chiropractic Association, the International Chiropractors Association and the German Chiropractors' Association, have all agreed that any DC or organization who wishes to conduct a seminar in another country must first contact that country's national chiropractic association. The teaching of chiropractic manipulation to non-chiropractors is expressly against state and national statutes throughout the United States and most of the world. Chiropractors who insist on violating these statutes are not only selling out their profession, but are also subject to action by their licensing boards."In support of its members and to protect the development of chiropractic worldwide, the World Federation has a policy of filing formal complaints with the applicable state licensing boards, state associations and national associations. We fully intend to file formal complaint against the DCs who are teaching chiropractic manipulation in Germany and will be asking for the strongest disciplinary action possible. In addition, we will be working with the German Chiropractors' Association to establish legal r emedies that will make any future action a crime."
In his letter, Dr. Busch states that he is "proud" of his choice to teach chiropractic to non-DCs. One wonders what the status of chiropractic would be in Germany today if Dr. Busch had spent the last 10 years working towards the recognition of chiropractic in Germany, instead of teaching chiropractic to lay people. Unfortunately, that doesn't appear to have been what Dr. Busch was motivated to do.