Archive for April 2019

Abby Martin is one of our leading international voices among younger American journalists and media activists.  She is the host of the investigative documentary news program The Empire Files that was aired on pan-Latin American network Telesur TV English out of Caracas Venezuela.  The Empire Files features hard hitting investigative history and insights into subjects ignored by mainstream corporate media. Earlier Abby was the host of Breaking the Set on the Russia Today network. She is a founder of the organization Media Roots that supports citizen journalism, and serves on the board of the Media Freedom Foundation which manages Project Censored, which airs on the PRN network. She also co-directed the film “99%: The Occupy Wall Street Collaboration.”  Older Empire Files episodes can be viewed at and on Youtube, and Abby's personal website as an accomplished visual artist is


Gary Null
Progressive Radio Network, April 8, 2019
The AMA did its best to undercut workmen’s compensation programs for chiropractic care, but it was fighting a losing battle on that front, because evidence mounted that for typical industrial injuries– the strains, sprains, and wrenched backs typically caused by lifting something too heavy—chiropractic is nearly twice as effective as any treatment by medical physicians, measured by the number of days it takes for workers with comparable neck or back injuries to go back on the job.
During the Chicago trial, the chiropractors relied only on those studies that had been done by medical physicians in order to obviate any argument of bias. There was a famous study done of 1,000 cases in California by C. Richard Wolf. M.D., of the California workmen’s compensation bureau. Dr. Wolf concluded that while it took 32 days for a medical physician to get the average injured worker back on the job, the chiropractors average time was 15.6 days for comparable injuries, or slightly less than one-half.
There was also a study by the Oregon Workmen’s Compensation Board, Dr Rolland A. Martin, an M.D and medical director of the board, found that chiropractors,
on average, got twice as many injured workers back on the job within a week as medical doctors
If you think about it, you’ll see why the workmen’s compensation boards have been relatively impervious to influence by the AMA. If, out of 1,000 workers, 500 of them take 30 days to get back on the job and 500 of them take 15, that adds up to a difference of over 20 years of lost time between the two groups, attributable to half of the patients having been unlucky enough to land in medical physicians’ offices rather than chiropractors.
Workmen’s compensation boards are under pressure from employers to see that employees get back to work quickly, because the cost of 20 years of workmen’s time when those workers are totally nonproductive is high. Moreover, society loses the workers’ productivity when they are laid up. Then there is the expense of the insurance provider in paying either the medical physician or the chiropractor. So, ultimately, the taxpayers’ money is wasted in paying for that extra 20 years of lost time in our sample group of 1,000 injured workers.
To millions of Americans, chiropractic adjustments are the only reasonable way of relieving chronic pain. If it were left to the American Medical Association, chiropractic would have ceased to exist many years ago. Claiming chiropractic to be a cult with no scientific validity, the AMA, in 1963, formed a special investigative unit which had as its assigned task the isolation and elimination of chiropractic. A plan for this was drawn up by an attorney named Robert Throckmorton, who worked with the AMA as its general counsel. His plan involved insurance companies, hospitals, state medical-licensing boards, public and private colleges, and lobbying efforts.
The legality of the AMA’s actions was finally challenged in 1975, when five chiropractors filed an anti-trust suit against the AMA and ten other medical organizations. The suit went to trial in federal district court in Chicago in late 1980, and the jury found the defendants not guilty. But in 1983, a federal circuit court judge ruled that the case must be retried.
The AMA was willing to go to great lengths to carry out its anti-chiropractic campaign. Nowhere is this better illustrated than in its “containment” of physicians’ studies on chiropractic that were conducted for workmen’s compensation boards.
The Oregon Workmen’s Compensation Board once scheduled a seminar for all providers of health care to industrial accident victims. These providers included osteopaths, medical physicians, company doctors and others involved in workmen’s compensation programs. A chiropractor was invited to address the group.
When the session was first proposed, the Multnomah County Medical Society and the Oregon State Medical Society, without the knowledge that a chiropractor was to be involved, planned to cosponsor the meeting in order to help build interest in it. Medical physicians who attended it, they announced, would receive continuing medical-education credit toward their license-renewal program. But when it became known that a chiropractor was going to address the session, the medical societies immediately withdrew their sponsorship, and notified prospective attendees that they would not receive education credit for attending. In fact, some of the medical panel members then backed out, and the program went forward with a much reduced attendance.
What a tragedy– that skilled physicians would refuse to listen to another licensed health-care provider explain how to treat injured industrial workers, when evidence indicated that his profession got markedly superior results in reducing human pain and agony and in reducing the costs of industrial accidents.
It is ironic that one of the AMA’s major arguments against chiropractic was that chiropractors do not do research in their field. At one time this was largely true when chiropractic was a profession struggling with limited resources, and was not able to support a cadre of researchers. The graduates of chiropractic colleges went out and practiced; they relied on clinical results rather than formal research. The AMA criticized their failure to publish.
But in academic parlance, to “publish” a paper often means to read it to one’s peers at a conference, where the work is subject to colleagues’ questions and criticism. Yet, in the case of the Oregon seminar — when medical physicians had the opportunity to examine and criticize the ideas of a chiropractor– they decided instead to boycott the session, effectively preventing the chiropractor from sharing his findings.
The individual doctors cannot be entirely blamed: They were under terrific pressure from their medical societies.
Another example of the AMA’s attempting to sabotage chiropractic education in a manner that was directly damaging to its own membership and their patients is the case of Dr. Philip R. Weinstein, a California neurologist. Dr. Weinstein had given many lectures to chiropractors on diagnosing illnesses of the spine before he learned of the extent of the AMA’s opposition to inter-professional exchanges with chiropractors. He testified at the trial that chiropractors– who often serve as portals of entry to the health-care delivery system– ought to be better able to recognize several, more exotic physical conditions. They would thus know when to refer their patients to their medical colleagues (thereby benefiting medical doctors as well as patients).
But pressure was brought to bear on Dr. Weinstein, and he canceled his lectures. His letter to a chiropractic group reads. “Please accept our sincerest apologies for this late cancellation due to circumstances beyond our control. We were unaware that delivering medical lectures to your [organization] was prohibited.” But the AMA’s efforts went far beyond canceling or undermining a few professional seminars.
Perhaps the most insidious and indefensible activities exposed at the trial were the efforts by medical groups to prevent chiropractors from expanding or improving their educational base. While the only issue in the court case was whether or not this was in violation of antitrust statues, the question for the public is much larger: whether a private organization hindered learning, study, and expression of ideas. In effect, the AMA sought to establish absolute control over the dissemination of medical and health information in the United States.
In its zeal to destroy chiropractic, the AMA had committed itself, through Robert Throckmorton’s master plan, to contain chiropractic schools: “To the extent that [the schools’] financial problems continue to multiply, and to the extent that the schools are unsuccessful in their recruiting programs, the chiropractic menace of the future will be reduced and possibly eliminated.”
The AMA maneuvered on many fronts. In order that “the [schools’] financial problems” should “continue to multiply,” the AMA tried to prevent the government from granting chiropractic students guaranteed student loans. More successfully, it also tried to put a stop to government grants for research and teaching at chiropractic colleges.
The AMA also sought to keep chiropractic schools from gaining accredited status, thereby discouraging the better students. For a long time, chiropractic colleges were accredited only by the chiropractors themselves. There were two accrediting groups: one sponsored by the International Chiropractors’ Association (representing “straight” chiropractors. who offer only spinal manipulation), the other sponsored by the American Chiropractic Association (the “mixers,” who provide additional modalities of therapy, such as nutrition counseling).
In the sixties, the AMA argued that chiropractic education did not meet minimal standards because the two accrediting organizations were not, in turn, accredited by any nationally recognized accreditation agency, such as the North Central Group or the New York Board of Regents. But at that time the chiropractic accrediting organizations had not been government-certified.
The AMA had publicly shed crocodile tears at what it said was the poor state of chiropractic education. Now it went into high gear to see that the status quo didn’t change. In every state, it lobbied to oppose the creation of a government-approved accreditation body. Accreditation is a quantum leap forward in status for any school, and the AMA feared that the designation of a national accreditation body for chiropractic colleges would make it hard to continue to criticize those schools. And it was right.
To the credit of HEW’s Office of Education, which was made up of educators rather than medical doctors, the AMA’s pressure was resisted. The educators’ response to the AMA was to insist that their job was to see that the proposed accreditation body met formal standards– not to become mired in a petty conflict between competing health-care systems. In 1974, the HEW Office of Education sanctioned the Council on Chiropractic Education as the national accreditation body for chiropractic schools.
This had a tremendous impact on improving educational standards at the chiropractic colleges. Whereas at one time faculty-student ratios were poor, there are now 129 professors for 1,800 students, for example, at the Palmer College of Chiropractic in Davenport, Iowa.
Chiropractors across the United States cooperated in asking legislatures to pass laws that would require two years of pre-professional education before students matriculated into a chiropractic college. In other words, a total of six years of post-high school education would be required for the Doctor of Chiropractic degree. The chiropractic organizations supported that upgrading of their profession. Even though they feared that young people contemplating a chiropractic career, perhaps already intimidated by the AMA attacks, might be reluctant to submit to a six-year program. The chiropractic groups, nevertheless, took the risk of losing some less highly motivated students, because their commitment to serving the public and upgrading their profession demanded high educational standards.

The results caught the AMA and the state medical societies by surprise. As state legislatures endorsed pre-professional courses for chiropractors, educational institutions began to make arrangements to offer high-quality undergraduate chiropractic programs.
In New York State, C.W. Post College, a division of Long Island University, was asked by Indiana’s Lincoln College of Chiropractic to cooperate in establishing a pre-professional course, and indicated it would do so. The AMA decided to try to scuttle the program. A doctor on the AMA’s Committee on Quackery published a series of articles in the medical-society newsletters sent to physicians all over New York State.
With exaggerated bombast, the doctor intoned that “the lights of the Empire State have gone out,” because one New York school was contemplating teaching courses to chiropractic students. He implored medical physicians to pressure the academic officials at C.W. Post to drop their plans.
The AMA had a lot of ammunition it could bring to bear, since any school with a premed program or any other preparatory program for health professionals has to worry about maintaining its friendships with medical organizations. If a school can’t get its premed students admitted to medical schools, its program is worthless.
An example of the pressure tactics used on C.W Post appeared in the July 1972 issue of the journal of the Medical Society of the State of New York, in an article headlined: LONG ISLAND UNIVERSITY SAYS IT WILL NOT TEACH PRE-CHIROPRACTIC STUDENTS. It reported that “the proposal was protested vigorously by the Medical Society of the State of New York in a letter which the Medical Society of the State of New York Executive Vice President … sent to medical and community leaders and the Deans of the State’s medical schools. Ernest R. Jaffe, Acting Dean of Albert Einstein College of Medicine of Yeshiva University, also added his disapproval in a letter to L.I.U. Dr. Jaffe said: ‘I urge you to take all appropriate measures to terminate any relationship with the Lincoln College of Chiropractic. It can only bring discredit to your university.”
Sadly, C.W. Post capitulated to this pressure, terminating all discussions with the chiropractic college. Thus the medical societies succeeded. This conduct strikes at the very foundation on which our health-care systems—indeed, our democratic traditions–are based. And that is education.
Nor was C.W. Post College the only institution pressured by medical organizations. Morehead State University in Kentucky also decided to add a pre-chiropractic curriculum. Members of the Kentucky State Medical Society, including a doctor who was a member of the AMA Committee on Quackery, informed Morehead’s president that the university’s accreditation would be reviewed if the chiropractic program went forward. To his credit, the president stood firm. Morehead offered the program.
The same thing occurred in St. Paul, where the College of St. Thomas entered into a cooperative program with the Northwestern College of Chiropractic. The AMA and the Minnesota Medical Society, the trial evidence showed, took steps to try to terminate that relationship.
It is difficult to understand how medical physicians and their trade associations, who have received billions of dollars in public funds for their schools and their services, had the temerity to work to prevent educational improvement for other health-care professions. Their concept of “medical ethics” apparently became so twisted that it no longer had any bearing on patient welfare– only on their own economic welfare.
The New York Board of Regents also came under intense pressure from the AMA. Many years ago, the Board of Regents had approved graduates of the National College of Chiropractic in Lombard, Illinois, to practice in New York.
The New York State Medical Society, working at the behest of the AMA, tried to get the Board of Regents to revoke National’s accreditation. The board asserted that its decision would not be influenced by partisan, competitive considerations. Its responsibility was to carry out the mandate of the state legislature to impose minimum standards for anyone practicing in the health-care field in New York State. National College met its criteria in all respects.
But National was not so lucky in its relations with Illinois institutions. The school was involved in a television program sponsored by a group related to the University of Illinois College of Medicine, and the Illinois State Medical Society. When the AMA found out about it, the chairman of the board of trustees of the Illinois State Medical Society wrote to the executive dean of the University of Illinois College of Medicine on January 11, 1974, as follows:
“I call this to your attention since the article implies that the University of Illinois College of Medicine is favorably disposed towards the National College of Chiropractic.” Any time chiropractors can gain a foothold by reporting on collaboration with the Medical Center, it will give them status. It might be wise to prohibit any contact of any kind at any time by persons at the Medical Center with any chiropractor. You might wish to discuss this with … others who have been involved in this problem. I would appreciate knowing the disposition of this matter.”
The University of Illinois is a tax-supported, public institution, and chiropractors and their patients pay taxes to support it. Yet the head of the Illinois State Medical Society asked the university to blatantly discriminate against members of a state-licensed health profession.
Placing this kind of pressure on academic institutions was central to the strategy of the AMA and the other medical organizations involved. If chiropractors had access to the same university privileges that the medical profession enjoyed– including internships and residencies in university medical-school hospitals– it would totally undercut the medical profession’s arguments that chiropractors lack the education necessary to diagnose or treat human ailments.

The AMA realized in the early 1960s that chiropractors would soon turn their attention to gaining hospital privileges. At the trial, one of the defendants’ attorneys told the jury that patients go to hospitals “for medical care.” The chiropractors’ lawyer, George P. McAndrews, replied– and the difference is more than semantic– that patients don’t go to hospitals for medical care, they go to hospitals “to get well.” The hospital is not supposed to be a low-overhead business office for medical physicians.
Hospitals take care of both acute and chronic cases. There are many people in hospitals that have difficulties with their neck or back. They may be in the orthopedic wards in traction. They may be in the general medical-care wards, where they are just obtaining bed rest. They may be in the presurgery wards, where, in all probability, they would benefit from a second opinion before undergoing surgery from a doctor highly skilled in musculoskeletal mechanics, such as a chiropractor.
Among the hospital patients most likely to be in need of chiropractic care are women in the maternity wards. This issue was raised at the trial during the testimony of the late Irvin Hendryson, M.D., a distinguished orthopedic surgeon who had been a professor of surgery at the University of Colorado and a member of the board of trustees of the AMA.
Dr. Hendryson had first become aware of chiropractic in the Army as a combat surgeon during World War II at Guadalcanal. A chiropractor serving as his orderly seemed to have very good results in relieving back and neck pain, at least comparable to those of the orthopedic surgeons in nonsurgical cases. Subsequent to his wartime experience, Dr. Hendryson made further observations about the value of chiropractic adjustments in other situations. He submitted a report detailing these observations to the AMA, which refused to publish it. In his testimony, Dr. Hendryson noted that women in pregnancy, particularly during the final trimester, have all sorts of mechanical problems involving the back and neck. This is the result of human evolution: Instead of the womb being suspended gracefully from the midpoint of a horizontal spine, its weight centered between the sturdy pillars of two pairs of legs– as it is in four-legged animals– the human womb is carried awkwardly during pregnancy, in front of a vertical spine. The dislocation of the spinal vertebrae caused by this off-center weight can cause tremendous pain and discomfort as the fetus’s weight increases.
His trial testimony illuminated the AMA’s attitude toward women. Literally tens of millions of women have had to suffer unrelenting back pain during their pregnancies, or risk the adverse effects of drugs on themselves or their babies, because they were not informed of the benefits of chiropractic care during pregnancy and labor. To quote Dr. Hendryson:
“It is commonly known that in the third trimester of pregnancy, unrelenting, unmitigated back pain is one of the prices that are paid for perpetuation of the race. I have learned from personal experience that general manipulations of backs in this particular condition has given these women a great deal of physical relief. And has permitted them to go on to term and deliver without having to be bedfast during the latter term of pregnancy.
“I would not for an instant Indicate that it is manipulation alone that permits these women to go on and carry on normally, for at the present time we are giving them manipulation to relieve them of their acute symptoms and also fitting them with support, which is well recognized in medical practice. However, I must say that I am impressed by the many cases who are able to go on to term, to manage their households, to lead a comparatively comfortable third trimester without having to be hospitalized or given traction, heat, support and all the rest of it.”
This information, in the normal course of events, should have been published and made available to gynecologists and obstetricians. If it relieved back pain for five minutes in every woman who has delivered a baby in the 20 years since then, that would have been a significant contribution to health care in this country.
But if asked, few obstetricians would say that they have heard that chiropractic adjustments, either during the third trimester or during labor and delivery, would be helpful. They will most likely respond by saying. “No, and I don’t believe it would help, otherwise I would have read about it in the medical journals.”
The reason they have not read it in the medical journals becomes clear from the minutes of an AMA Committee on Quackery meeting, at which it was decided to suppress Dr. Hendryson’s report: “[One committee member] stated that many orthopedic surgeons have manipulated for years, and they probably learned these procedures on their own and not from chiropractors. He commented that there would be a strong likelihood of Dr. Hendryson’s report being misconstrued if his position were made public.”
The AMA, in effect, denied women knowledge of this conservative, noninvasive, nontoxic approach to relief of back pain during pregnancy because they didn’t want other medical physicians following Dr. Hendryson’s example of learning from a chiropractor.

The Hendryson report indicated that chiropractic could be of use in the orthopedic wards, in the general wards, and certainly in the maternity wards. Yet, instead of trying to meet that need for the sake of patients, the AMA moved to prevent chiropractors from gaining access to hospital wards.
It succeeded primarily through an organization called the Joint Commission on Accreditation of Hospitals (JCAH), which is sponsored by the AMA, the American College of Surgeons, the American College of Physicians, and the American Hospital Association (all of which are defendants in the five chiropractors’ suit). It is the JCAH– a private group– which accredits, and thereby controls, hospitals in the United States.
From accreditation, many benefits flow. From lack of accreditation, many problems can arise. Any hospital that loses its accreditation faces the loss of its internship and residency programs, its nursing affiliations, and its automatic check off for direct insurance payments. Its malpractice-insurance rates would soar, and the interest on its financial bonds for building would probably increase. The JCAH also apportions work (and hence, income) among medical specialists. For instance, the JCAH can require that all hospital X rays be read by a radiologist. Even though, in many cases, a family practitioner could do it at a savings to the patient.
In the late 1960s, the AMA asked the JCAH to add a new standard as a condition for accreditation. The new standard sounded innocent enough. It simply required all members of the medical staff in an accredited hospital to adhere to the ethics of their profession. The footnote to the standard referred to the AMA’s Principles of Medical Ethics, which prohibited its members from all forms of exchange with chiropractors.
This was the barricade that the medical societies used to keep chiropractors out of hospitals.
Most medical physicians need hospital privileges. They must have access to a hospital when their patients’ conditions require it. Years ago, a sole medical practitioner could ordinarily survive without worrying about the AMA. But that changed dramatically when the JCAH made hospitals agree to enforce the AMA’s Principles of Medical Ethics on all its attending physicians.
This put a tremendous burden on the individual M.D. who might want to consult with or refer a patient to a chiropractor, even in his private practice. The fact that he didn’t associate with the chiropractor at the hospital would be immaterial. He would still be considered an unethical practitioner. The ethics committee at the hospital would then be required to call him in and say something like the following: “Because you are dealing with a chiropractor, you are unethical. Our choices are to dismiss you from the medical staff, or to run the risk of losing accreditation for the hospital.”
When doctors were faced with this threat– that association with chiropractors would mean committing professional suicide– the outcome was predictable.
When the AMA was able to get that standard instituted, chiropractors’ efforts to obtain consultative or support services were dealt a staggering blow. The JCAH aided and abetted the AMA, as the following letter, dated August 13, 1974, from the commission to a hospital administrator, shows: ‘”Any arrangement you would make with chiropractors and your hospital would be unacceptable to the Joint Commission. This would be in violation of the Principles of Medical Ethics published by the American Medical Association that is also a requirement of the Joint Commission on Accreditation of Hospitals.”
Since most legislators feel uncomfortable dealing with medical matters, the medical profession has been allowed to grab almost complete power in regulating the health-care industry. That this private power can then be turned back to thwart the will of the people is demonstrated by another letter, dated January 9, 1973, from the JCAH to a hospital in Silver City, New Mexico: “This is an answer to your letter of December 18 referring to a bill which may be passed in New Mexico that hospitals must accept chiropractors as members of the medical staff. You are absolutely correct– the unfortunate results of this most ill-advised legislation would be that the Joint Commission could withdraw and refuse accreditation of the hospital that had chiropractors on its medical staff.”
The medical trade associations were able to enhance their members’ incomes by restricting the use of publicly subscribed facilities and equipment to their members only. The radiologists and orthopedic surgeons, for example, have free access to all of the facilities of a hospital for the care of their patients. They invest nothing in the purchase of hospital equipment. The cost of X-ray equipment does not have to be added to the costs of doing business.
On the other hand, the chiropractor down the street, who may be taking care of a patient with the same type of back or neck problems, has to invest $5,000 to $25,000 in X-ray equipment and add that amount to his overhead. It should be obvious that the medical physicians, with less overhead, realize a substantial profit from having their costs covered by a tax-supported or publicly subscribed hospital.
Moreover, since most hospitals pride themselves on their status as community health-care centers, it seems anomalous that patients can seek health care at such facilities only if they choose health-care providers whose trade associations have gained control of the facility.
Here is a reason given by one medical physician for keeping chiropractors and their patients from using hospital facilities: “Once chiropractors can freely send their outpatients to our hospitals, they’ll soon be able to admit inpatients. Once they can get all the scientific studies they order, it will be hard to refuse them medical staff membership on the ground that their practice is unscientific.”
Note that the doctor made reference to the hospitals as though they belonged to the medical physicians. He referred to “our” hospitals. If this viewpoint is widely held, then it would seem that the time has come for state legislators to reclaim hospitals for their owners and for the patients who rely on them for health care.
It is not only state legislatures that have been bamboozled by the AMA through the JCAH. Congress, and even another powerful lobby, the veterans associations, have not been immune to the AMA’s arm-twisting.
Many veterans, victims of trauma resulting in disabling neck and back injuries, seek care from chiropractors. These veterans and their organizations have repeatedly asked Congress either to allow chiropractic care in the VA hospitals or to reimburse hospitalized veterans for outpatient chiropractic services.
Yet the medical trade associations have been able to thwart the veterans’ organizations and even Congress on the chiropractic issue. They have been able to do this by simply stonewalling congressional suggestions that the veterans’ hospitals authorize increased use of chiropractic care, and by threatening Congress with a potential disaffiliation of all medical schools from veterans’ hospitals. This unelected “government”, composed of medical physicians, can intimidate even the Congress of the United States with letters such as that sent to a congressional committee on June 12, 1979, which states: “The fact that the Federal Government now pays for chiropractic services in a variety of programs including Medicare does not persuade this Association [of American Medical Colleges] that the practice should be extended to the programs of the VA. Previous decisions to include chiropractic services among those that are paid for by the Federal Government were improper; to now make them available to beneficiaries of the VA would simply compound the original mistake.
“Once this Pandora’s Box is opened, there would seem no logical basis for refusing to include chiropractic ‘physicians’ on the medical staffs of the VA or the house staffs. Should this happen the medical schools of the nation might well reconsider the propriety of continuing the mutually beneficial affiliations of the last three decades.”
As of today, state and federal governments do take seriously the accreditation body like the JCAH.

The decision by the Illinois State Medical Society not to back the AMA’s position on chiropractic was heartening evidence that the future will bring increasing cooperation and communication between M.D.s and chiropractors, and that chiropractors will eventually be welcome in hospitals. Of course, the transition will demand goodwill on both sides.
The medical organizations have spent decades indoctrinating their members to believe that chiropractors should not be allowed to participate in the delivery of health care– particularly when that health care is delivered in an institutional setting. Efforts will have to be made by all parties to break through this legacy of suspicion. Trust requires communication. Good communication requires understanding. There will be a period when medical physicians and chiropractors size each other up and learn the particular terminology used by the other profession. But in the long run, medical physicians who are concerned for their patients’ well-being will be pleased to refer cases they can’t treat to chiropractors competent to do so. And vice versa, of course.
The commission was very specific in analyzing the limitations that stemmed from the isolation imposed on chiropractors by the medical organizations: “In the public interest and in the interest of patients, there must be no impediment to full professional cooperation between chiropractors and medical practitioners.
“Chiropractors should, in the public interest, be accepted as partners in the general health care system. No other health professional is as well qualified by his general training to carry out a diagnosis for spinal mechanical dysfunction or to perform spinal manual therapy.”
The AMA’s actions in the health-care field are a classic illustration of a powerful special-interest group imposing self-serving rules on supposedly public institutions.
When such groups go so far in their arrogance as to severely cripple an important health-care profession, such as Wikipedia and Skeptics like Jimmy Wales, as to malign, denigrate and libel an entire healing profession, even suppressing valid scientific studies, they then, we believe, seriously damage the public interest, and we must respond. It is our hope that when 77,000 chiropractors and their 35 million patients boycott Wikipedia and demand Congressional investigations and request the Investigative General of the IRS to inquire into what we believe will prove that Wikipedia, its co-founder and its Skeptic editors will uncover extreme bias in a modern day form of slander, character assassination and alienation of all alternative and natural healthcare providers. As George Santayana wrote, “Those who do not learn history are doomed to repeat it. Today we can look at Stephen Barrett as Throckmorton and Jimmy Wales as a modern day Doyl Taylor, and Wikipedia as the transformed AMA. The witch hunts continue.
To the multitude of parents with vaccine-injured children and the millions more diagnosed with ADD and ADHD and taking psychiatric medications, this is an important lesson. These power individuals and organizations are permanent. Wikipedia promotes the long-term hegemonic cause of pharmaceutical dominance. They trust the word of Barrett and the AMA. We need to abrogate our allegiance to them and remain suspicious of their motivations, because they are not us.


Gary Null
Progressive Radio Network, April 8, 2019
The Chiropractic profession is the second leading healthcare field in modern medicine. As of 2018, there are over 77,000 practicing chiropractors, approximately a 75 percent increase since 2012. One reason for its continual growth and popularity is because, quite simply, it works. There are sufficient studies in the scientific literature to validate this non-invasive therapy now treating over 35 million patients.
But it was not always this successful. In fact, until a surreptitious source, working within the American Medical Association (AMA) headquarters in Chicago, smuggled hundreds of documents to confirm that the AMA’s secretive Department of Inquiry had been orchestrating a strategy and operations to destroy the profession for over 25 years. If these documents had not been provided to journalist Joseph Lisa and me, there is a high probability that Chiropractic would have disappeared long ago.
Why is this important today?
There continues to be three forces, loosely working together, that continue an offensive to marginalize and ultimately discredit Chiropractic. First, there is the online encyclopedia Wikipedia that misrepresents and denigrates Chiropractic medicine. In effect, Wikipedia acts as if it were still the 1960s when Chiropractic was almost abolished as an “unscientific cult.”
Second, there is Stephen Barrett, founder of the National Council on Health Fraud and Quackwatch, who carried out a four-decade long campaign to discredit the practice and harass chiropractors. Barrett has continued his animosity towards Chiropractic even after a lawsuit brought against the AMA found the organization guilty of violating the Sherman Antitrust Act and restraint of trade. However, never has Barrett himself been critically evaluated for his association with pro-pharmaceutical groups, nor in what we believe his irresponsible and unfounded writings and statements, by either the scientific medical community or the mainstream media.
Finally, there is the AMA itself. Although the organization is restricted by law from attacking Chiropractic medicine, it is still the umbrella organization for many American physicians who oppose Chiropractic therapies and all other non-toxic natural healing modalities, including alternative and complementary medicine.
Condemning Wikipedia, Barrett and the AMA for promulgating misinformation and false propaganda in and of itself doesn’t tell the whole story because the devil is in the details. We will take you step-by-step through this story why this happened three decades ago. It remains relevant because a culture of medical dominance, favoring only one discipline of medicine that is hailed as sacrosanct – the pharmaceutical paradigm – which has expanded to demonize those who question the safety and efficacy of vaccines, GMOs and factory farming, the health risks of junk food, the over-prescribing of medications, and the psychiatric pathologizing of normal behaviors. Unfortunately this trend is rampant and gaining steam.
For generations now, organized medicine has been at odds with Chiropractic. The American Medical Association—the largest and most powerful organization of doctors anywhere in the world—has denounced the profession of chiropractic as quackery and cultism, and in 1965 took the position that it was a violation of medical ethics for medical physicians to have any professional association with chiropractors whatsoever. Chiropractors maintain that by manually manipulating the spinal column, they can relieve pressure on a nerve, thus allowing the resumption of a normal flow of energy to an afflicted organ.
The AMA’s prohibition carried with it strong sanctions against any doctor who violated it, including loss of hospital privileges. By AMA decree, no matter what value a doctor may personally have believed Chiropractic could have it was still outlawed. Doctors who referred patients to chiropractors were risking their medical practices. In 1976, after years of efforts by chiropractors and professional associations to achieve a satisfactory relationship with organized medicine without resort to the courts. Dr. Chester A. Wilk of Chicago and four other chiropractors brought suit against the American Medical Association as well as ten other medical organizations, and four individuals.
The five plaintiffs charged that the AMA and the other defendants had violated the Sherman Antitrust Act, personally damaging each of the five, not to mention all other chiropractors and the public. They accused the AMA of attempting- and here I quote from an AMA Board of Trustees document presented at the trial- “to first contain, and then eliminate the profession of chiropractic in the United States.” The chiropractors asked the court to rule that the AMA’s institution and implementation of this policy hindered chiropractors’ efforts to compete in the marketplace and to earn a livelihood, and constituted an illegal conspiracy to establish a monopoly and unreasonably restrain trade. By presenting secret Internal AMA documents, the trial exposed to public view aspects of the inner workings of one of the most powerful lobby groups America.
The chiropractors’ evidence, which included testimony by medical school professors and other highly respected physicians, strongly supported their accusations. The evidence suggested that the AMA had, for over 25 years, systematically attempted to undermine, isolate, and eliminate Chiropractic. The trial revealed that the AMA had carried out a lengthy and vindictive campaign: sometimes public and more often covert, to persuade the medical community, the press, and the lay public that chiropractic had no scientific or clinical validity.
The AMA succeeded in preventing chiropractors from gaining the same hospital privileges that other doctors enjoy. This has given many people the impression that chiropractors operate somehow illicitly or sub rosa. In fact, chiropractic is a state-licensed health-care profession, chiropractic colleges are government accredited, and chiropractic patients are reimbursed by Medicare, Medicaid, and workmen’s compensation insurance. As you will see, this would not be the case if the AMA had had its way.
The chiropractors’ charges were quite specific. The courts eventually ruled that they are valid and the American Medical Association stood publicly condemned- not only of violating specific antitrust statutes, but, in order to eliminate a source of economic competition, of manipulating the delivery of our healthcare system in such a way as to deny patients the ability to freely choose their medical treatment.
During depositions and discovery over 1 million documents that showed a systematic campaign against Chiropractic. The lead plaintiffs’ attorney George P McAndrews of Chicago summarized the decision that “finally, at least in Illinois, the country’s largest and second largest health-care provider groups have decided to shake hands and work in harmony. That’s not to say there won’t be any rocky times during the period of rapprochement. But at least the professional organizations will now allow each physician to decide for him or herself what’s in the interest of their patients.”
After four years of taking depositions, the case was first tried in December 1980 and January 1981, in Chicago.
A key issue in the case was the substance of the Judge’s instructions to the jury. One of the most important charges made by the chiropractors was that the AMA had deceived Congress and the public by secretly and illegally prejudicing a congressionally mandated “objective study” on Medicare reimbursement for Chiropractic. The AMA argued in court that, like any other group of citizens, it had a right to petition Congress, and that any such actions on its part would not fall under the purview of the Sherman Antitrust Act.
The judge hearing the case, U S. District Court Judge Nicolas Bua, sided with the interpretation urged by the AMA, and instructed the Jury that, even if it believed the AMA wanted to prevent Chiropractic inclusion in Medicare, it must ignore all evidence presented by the plaintiffs that the AMA had acted illegally in its attempts to bias the study.
Following Judge Bua’s instructions, on January 30, 1980, the jury found the defendants not guilty of violating the Sherman Antitrust Act. (The case did not deal with violations of any other laws). Maintaining their objections to Judge Bua’s interpretation, the five plaintiffs appealed to the U.S. Court of Appeals for the Seventh Circuit.
On September 19, 1983, this court ruled that the instructions given to the Jury had been inadequate, and sent the case back to the lower courts for retrial. In doing so, it commented that the evidence presented at the trial, if believed by the jury, was sufficient to support a finding that there had been a conspiracy among all of the defendants in violation of antitrust law. So the purpose of a new trial would be merely to evaluate the credibility of the five chiropractors’ evidence.
When the case returned to district court the parties were informed that it might take a year or two before the case would come to trial again. The trial judge suggested the contestants use that time to explore out-of-court settlements.
Due to likely negative outcomes, two smaller groups decided to settle with the chiropractors, American Osteopathic Association and the physician members of the American Academy of Physical Medicine and Rehabilitation.
Those that held out were the American Medical Association, the American Academy of Orthopedic Surgeons, the American Hospital Association, and the Joint Commission on Accreditation of Hospitals, the American College of Radiologists, the American College of Surgeons and the American College of Physicians. However weighing in favor of the chiropractors was ironically the Illinois State Medical Society, which was no longer willing to defend the AMA’s policy concerning Chiropractic.

In 1963, the AMA announced the formation of its Committee on Quackery. It quickly became apparent that chiropractors were the committee’s main target. As a series of closed meetings it sponsored around the country issued a flood of press releases condemning Chiropractic. There was little the chiropractors could do about this other than try to defend the integrity of their profession to the public. After all, the AMA had a constitutional right to express its opinion, right or wrong, subject, of course, to libel and slander laws.
Then, in 1972, a book called In The Public Interest was published, bearing the byline of William Trevor. The book contained what purported to be internal AMA memoranda. One of the memoranda talked about a program to “contain and eliminate chiropractic.” The authenticity of the document was not confirmed by the AMA.
Two years later, in 1974, an anonymous source humorously nicknaming him or herself “Sore Throat”- possibly the same person who compiled the documents included in the book-supplied packages of AMA documents on many subjects to the U.S. Senate, the House of Representatives, and the U.S. Postal Service. The documents included internal AMA memoranda on the AMA’s attitude toward chiropractors. These are the same doctors Joseph Lisa and I received.
One of the documents in particular led chiropractors to begin discussing among themselves the possibility of bringing antitrust litigation against the AMA. That was the alleged AMA Board of Trustees document. It states explicitly that the primary purpose of the Committee on Quackery was to first contain and then eliminate the profession of chiropractic in the United States.
Nor were chiropractors the only ones questioning whether the AMA’s activities were legal. As a result of the release of the documents, a congressman asked the Federal Trade Commission (FTC) to determine whether the AMA was in contravention of the Sherman Antitrust Act, and if it was why the FTC had not taken action against the AMA. Eventually, the issue was again quietly dropped.
Encouraged by these developments, a group of chiropractors and their supporters- despite the enormous risk of tackling a powerful, wealthy institution like the AMA, which can use its vast resources to influence public opinion and pay for lengthy, expensive litigation decided to pursue the matter. They formed the National Chiropractic Antitrust Committee. Its purpose was to raise funds for any chiropractors who might want to challenge in court the AMA and the other medical organizations campaigning against chiropractic.
By 1976, five chiropractors who met the requirements and were fed up with their treatment at the hands of the AMA and those under its influence had asked to initiate litigation. The five were Dr. Chester A. Wilk of Chicago, Dr. Patricia Arthur, at that lime of Estes Park, Colorado, Dr. Steven Lumsden, then practicing in Newbury, Michigan, Dr. Michael Pedigo of San Leandro, California, and Dr. James Bryden of Sedalia, Missouri.

On October 12, 1976, the five chiropractors filed a 38-page complaint in the United States District Court for the Northern District of Illinois, located in Chicago, where most of the country’s national medical organizations are headquartered. Their charges, very briefly, included the following:
• That the AMA had attempted to contain and eliminate chiropractic.
• That it had cooperated and worked with the other defendants for the common goal of boycotting chiropractors– to totally isolate them from other members of the health-care community.
• That the AMA attempted to prejudice government studies on chiropractic.
• That, operating through private organizations, it barred chiropractors from access to public facilities such as hospitals and universities.
• That it urged and abetted insurance companies to deny chiropractic patients coverage.
The legal process of discovery– the issuance of subpoena, the tracing of the claimed conspiracy, the examination of hundreds of thousands of documents– took the next five years and involved travel to 34 states and the taking of some 160 sworn depositions. Finally, on December 8, 1980, the trial began.

The evidence presented at the trial indicated that by 1963, when the AMA started its Committee on Quackery, it was well aware that Chiropractic had become the second-largest health-care delivery system in the United States. The “mixed chiropractors” had broadened their appeal by including nutritional counseling and other modalities of treatment among the therapies they offered.
As a result the AMA did a study to find out how best to “contain and eliminate” the growth of chiropractic in America, and concluded that the most important strategy was to isolate chiropractors from other health-care providers and from public facilities such as hospitals. This would not be easy: Many medical physicians and chiropractors, particularly in rural America, freely referred and consulted back and forth.
The AMA began by instructing its state societies to remind their members that its Principles of Medical Ethics required a practice of medicine based on science, and that it was unethical to deal with any unscientific practitioner or with a “member of a cult.”
This action was not effective because, at that time, the only practitioners the Principles of Medical Ethics had been interpreted to ban were osteopaths, optometrists and podiatrists. Osteopaths are trained to put much more emphasis on the musculoskeletal system than medical physicians are. Optometrists compete with ophthalmologists. Optometrists can hardly be called “unscientific” since optometry is based on the laws of optical physics, but that didn’t stop the AMA from banning professional cooperation. And podiatrists compete with orthopedic surgeons for patients with foot problems.
The new economic threat, Chiropractic, was not mentioned by name in subsequent interpretations of the Principles of Medica1 Ethics. So, in 1966, the AMA drafted a policy statement on the subject. Its wording was designed to apply a passage of the Principles of Medical Ethics directly to chiropractors. The statement’s opening sentence reads: “It is the position of the medical profession that chiropractic is an ‘unscientific cult’ whose practitioners lack the necessary training and background to diagnose and treat human disease.” Parenthetically, it is interesting to note that the AMA felt called upon to define medical ethics not just for its own members, but, as the statement says, for the medical profession as a whole. The crucial words in the policy statement “unscientific” and “cult” made it unethical for a medical physician to voluntarily associate professionally in any capacity with a chiropractor.
This prohibition was far-reaching and included teaching, lecturing, accepting referrals from, referring patients to, consulting with, sharing a practice with, jointly treating or cooperating with a chiropractor in the care of a patient, allowing hospital privileges to a chiropractor, and having virtually any kind of professional communication. Physicians were to boycott chiropractors totally. The AMA hoped that without collective sharing of knowledge and facilities with other health professions, chiropractic would– and here again, I quote from an internal document presented at the trial– “wither and die on the vine.”

The isolation of chiropractors from other health-care professionals has profoundly limited their education and the growth of their profession. The AMA has acknowledged that chiropractic was stunted by its actions– as it intended. A chiropractor was literally not allowed to communicate with a medical physician. But such communication between medical professionals is necessary, on a day-to-day basis and as a matter of course, for the sake of patients’ welfare. For example, if a family practitioner sends a patient to a gastroenterologist or a cardiologist, he or she expects a report back on the disposition of that patient’s care– or at least to be aware of the patient’s continuing medical history. lmagine a family practitioner not receiving any report from a patient’s cardiologist on the details of, say, a heart operation! Subsequent treatment of the patient could amount to dangerous groping in the dark.
Yet chiropractors, who are sometimes their patients’ primary health-care providers, were denied this routine courtesy. If a patient goes to a chiropractor and says, “I had some back surgery 20 years ago” the chiropractor would like to be able to pick up the phone and call the surgeon and ask him to describe the back operation. “What vertebra was involved, if any? Was a cyst removed, or a disc? I intend to manipulate a certain vertebra in his back: what are your recommendations? Do you think the surgery would interfere with that procedure?”
That’s a dialogue that should be earned on for the benefit of the patient. But the chiropractor was denied the right to communicate with the medical physician. Or rather, I should say, the patient was denied the benefit of that communication.
Perhaps the most telling document made public at the trial was written even before the AMA had instituted its Committee on Quackery. Dated November 11, 1962, it was drafted by Robert Throckmorton, an attorney who was at that time General
Counsel for the Iowa Medical Society, and delivered as a paper to a group of medical executives.
Throckmorton’s proposal is an amazing document. It laid down a master plan for, quote, “what medicine should do about the chiropractic menace.” Before reviewing excerpts from the document, I will tell you that Throckmorton’s suggested machinations were, unfortunately, not dismissed by the AMA national officers at the time– as of now they all regret it. Not only did the Iowa Medical Society adopt the plan, but the AMA offered Throckmorton a job as its general counsel. All the rest of the evidence presented by the plaintiffs at the trial seemed to indicate that the AMA did, indeed, put into practice most of Throckmorton’s proposals.
The plan was in the form of an outline. Here are some of its points:
“F. Encourage chiropractic disunity.
“G. Undertake a positive program of containment if this program is· successfully pursued. It is entirely likely that chiropractic as a profession will ‘wither on the vine’ and the chiropractic menace will die a natural but somewhat undramatic death. This policy of ‘containment’ might well be pursued along the following lines: … 4. Encourage ethical complaints against chiropractors. 5. Oppose chiropractic inroads in health insurance. 6. Oppose chiropractic inroads in workmen’s compensation. 7. Oppose chiropractic inroads into labor unions. 8. Oppose chiropractic inroads into hospitals. 9. Contain chiropractic schools·. . . . Any successful policy of ‘containment’ of chiropractic must necessarily be directed at the schools. To the extent that these financial problems continue or multiply and to the extent that the schools are unsuccessful in their recruiting programs the chiropractic menace of the future will be reduced and possibly eliminated.”
Under the section listing conclusions:
“C. The mixers may achieve their goal of emerging as ‘medical men’ if organized medicine remains apathetic to this problem.
” D. Any action undertaken by the medical profession should be directed toward: … 2. Containment of the chiropractic profession. 3 The stifling of chiropractic schools.
“E. Action taken by the medical profession should be… 1. Behind the scenes whenever possible… 3. Never give professional recognition to Chiropractors.
“F. A successful program of containment will result in the decline of chiropractic.”
That’s all from trial Exhibit 172. The evidence shows that the AMA pursued goals in line with these proposals. The AMA worked with the National Association of Blue Shield Plans regarding coverage of chiropractic care, even in those states that had passed so-called “insurance equality” laws. The AMA worked with the Health Insurance Association of America– a trade association of some 400 private insurance companies–to adopt policy statements that encouraged member insurance companies to cover only those health-care practitioners whose methods were based on “scientifically established methods.”
One aspect of the case raised the questions of whether the AMA had had a hand in a supposedly objective study of Medicare, done for Congress by the Department of Health, Education and Welfare (HEW), which delayed Medicare coverage for chiropractic patients by five years, and whether the AMA had virtually written the supposedly independently-arrived-at position statement of the private Health Insurance Association of America. The AMA showed Blue Shield how to word its policies so state legislatures and consumers wouldn’t realize that chiropractic coverage was being omitted from their policies
Perhaps the most influential of the AMA’s political intrigues was the alleged end run it pulled around Congress in 1968 by covertly controlling, from start to finish, the supposedly objective HEW study on the subject of Medicare coverage
In 1965, when the nation’s basic Medicare laws were passed, they included coverage for services of physicians, osteopaths, and some other health practitioners Chiropractors were excluded, although chiropractors and their patients were avidly seeking inclusion.
In 1967, Congress asked HEW for an unbiased study of the need for including chiropractic services in Medicare. In retrospect, what happened should have been anticipated. After all, a hundred or so MDs worked for HEW in the Public Health Service. One or more of them might have been expected to leak to the AMA that Congress wanted a study that would not reflect the AMA’s known bias against chiropractic.
The AMA, its internal documents reveal, was very alarmed about this study. They believed it had the potential to set the pattern for all healthcare insurance coverage for chiropractors for the next 20 years, and they were determined that it oppose coverage. The AMA had its own agenda for the study– to turn it into a blanket denunciation of chiropractic as lacking scientific validity. The AMA’s Committee on Quackery went so far as to prepare an outline of the course the study panel should follow.
HEW had assigned the Job of assembling a panel to conduct the study to a special advisory committee, the Health Insurance Benefits Advisory Council (HISAC). The evidence indicates that the AMA immediately went to work on the members of HIBAC.
In correspondence between Doyl Taylor, the secretary to the Committee on Quackery of the AMA (who also worked in the office of general counsel of the AMA as head of the AMA’s department of investigation), and Dr Samuel Sherman, the AMA representative on the committee. Taylor wrote· “I am sure you agree that the AMA hand must not ‘show’ at this stage of the proposed chiropractic study.” Five months before the study even commenced, on March 11, 1968, Dr. Sherman answered Doyl Taylor with a letter following a HIBAC meeting:
“Dear Doyl: … There was complete acceptance of the concept of preparing the decision on the basis of lack of scientific merit.” At least one future member of the panel staff was present at that HIBAC meeting and was given the AMA materials that Dr. Sherman reported HIBAC had already committed itself to using.
When the panel was finally chosen, in August 1968, it consisted largely of men sympathetic to the AMA’s position on chiropractic. For example, the chairman of the panel was Dr. Donald Duncan from the University of Texas Medical School at Galveston, who, at the very first organizational meeting of the panel– according to the testimony of Dr. John Mennell — a member who eventually voted in favor of covering chiropractic — made a speech indicating that he was opposed to chiropractic inclusion in Medicare.
Another panel member, Dr. James J. Feller was a former president of the American Society of Internal Medicine. He testified at the trial that he had a preexisting bias against chiropractic going all the way back to his medical school days, and that no one had asked him if he had any preconceptions that might interfere with his service on the panel. Dr. Feller was asked by the AMA to keep it advised of the progress of the committee’s work. A letter to Dr. Feller from an AMA representative requesting the documents reads in part:
“Dear Jim: … As indicated in our conversation, it would be helpful if we can be kept informed as to the progress of your committee work. Any reports or proceedings received will be quickly reproduced or transcribed and returned to you.” And a blind copy was sent to Doyl Taylor of the AMA Committee on Quackery.
The AMA took no chances: They made arrangements to contact not only those members they believed to be soft, but even those who were already on their side– including the chairman, Dr. Duncan. Exhibit 228, dated August 23, 1968, is a letter from a friend of Dr. Duncan’s, a Texas physician named Dr. William L. Marr, who had been requested by the Texas Medical Association to visit with Dr. Duncan and supply him with an AMA packet of materials relating to chiropractic. Dr. Marr wrote. “I called on Dr. Donald Duncan and talked with him concerning the chiropractic situation. He is most anxious to do everything he can and is completely sold on the idea that chiropractic benefits should not come under the Medicare program.”
This letter, written seven days after the first organizational meeting of the panel on August 16, confirms Dr Mennell’s testimony that Dr Duncan had made up his mind on the benefits issue before having reviewed the evidence.
There was other evidence of elaborate plans made by the AMA to contact, coach, and supply each of the panel members with its own materials denouncing chiropractic.
At least a few panel members resented the AMA’s secret approaches. One of them, Dr. Mennell– one of the world’s leading authorities on orthopedics and joint pain-took action against the AMA’s pressure tactics. In a report to Public Health officials, he complained. “I was very disturbed in the past four weeks to receive two telephone calls indirectly from but quite clearly inspired by the American Medical Association, implicitly suggesting what the tenor of my paper should be. I can only assure the consultant group that my conclusions are arrived at through my independent research, thinking and experience, unaffected by extraneous pressure.” Certainly chiropractors should not be penalized simply because of the bitter bias of the American Medical Association, when there is substantial evidence that manipulative therapy brings relief to sufferers of mechanical pain which only manipulative therapy can relieve.”
Dr. Mennell also mentioned these contacts at one of the sessions. Seated around the table with him were the chairman, who had been approached, and the other panel members, at least some of whom had also been approached. None of the other panelists mentioned attempted contacts from the AMA.
Despite all its efforts to bias the panel, when the formal vote of the expert review panel was taken, Dr. Mennell testified at the trial, it was split four to four on the issue of chiropractic inclusion. He assumed that the vote would then be reported to HIBAC, and the panel would be left to iron out its differences. But, he testified, during the time between the formal vote and the presentation of the report to the parent group by Dr. Duncan, one of the panelists changed his mind, and Dr Duncan was able to report, as he had hoped, that the panel had decided against including chiropractic in Medicare.
As if it weren’t bad enough that the AMA had tried to control the panel from start to finish, HEW and the AMA carefully obliterated all traces of the AMA hand from Congress’s view. All along, the evidence showed MDs at HEW had been collaborating with the AMA in the cover-up. For example, the AMA asked to be represented at one of the panel’s public sessions, just as the chiropractors were. An internal AMA memorandum recording a private phone call from HEW indicates that someone at HEW told the AMA not to testify: An AMA appearance would create problems for the report on Capitol Hill.
HEW’s final document– an abstract discussion, just as the AMA had wanted, of the scientific validity of chiropractic theory– didn’t sit well with either the Chiropractors or Congress. On November 21 and 22, 1968, a group of representative chiropractors had been politely, if curtly, received by the committee, and had presented their experience of the clinical value of Chiropractic for elderly patients. A month later, they were greeted with the first evidence that their testimony had been a fool’s errand. Outraged, they submitted a point-by-point white paper to Congress rebutting the HEW report. Congress, under pressure from elderly constituents to get chiropractic covered, asked for a response from HEW.
This was just the contingency HEW had feared when it told the AMA it was better off not testifying. Over and over in its answer, HEW baldly asserted that in order to fulfill Congress’s request for an objective study, it had prevented the AMA or other medical organizations from having any input or influence on the ultimate report. As evidence of its good intentions, HEW pointed to its refusal to let the AMA appear at a public session of the panel! Of course, HEW knew very well where the blueprint for the study had come from; HEW chose to confuse Congress– and the public– by mentioning the canceled public appearance to conceal the active cooperation between HEW and the AMA on the study.
Incidentally– foreshadowing practices of the Nixon administration– records of the HEW study were subsequently lost or destroyed.
The AMA had the temerity to argue in court that its Byzantine maneuvers to make Congress believe it hadn’t been involved in framing the HEW report should be seen as an exercise of its constitutional right to petition Congress.
The impact of the HEW report to Congress, as the AMA predicted, was enormous. It made the AMA’s actions to isolate chiropractic appear respectable, because a blue-ribbon panel of experts had supposedly reached an independent conclusion that chiropractic lacked a scientific foundation. Thereafter, the AMA could say, it’s not the AMA, but the government that has reached these conclusions.
After five years of intense congressional lobbying by chiropractic organizations, Medicare coverage was established. Uncounted thousands of elderly people without the money to pay their own medical expenses were no doubt forced to do without chiropractic care, perhaps suffering needless pain as a result. And, of course, they were lost as patients to the chiropractors they might otherwise have chosen to consult.
Buoyed by their success in preventing Congress from granting Medicare coverage to chiropractors, the AMA moved, in 1969, on private-sector insurance. As mentioned earlier the Health Insurance Association of America (HIAA) is a trade association for 400 private insurance companies, and provides the kind of services for insurers that other trade associations do for their sponsoring industries- lobbying, public relations, etc. The companies that belong to HIAA are independent, but any policy it urges on its members to adopt is influential.
In 1969, the AMA’s Doyl Taylor used the same kind of maneuver with the HIAA he had with the HIBAC panel. He wrote a letter to HIAA– it was presented at the trial as evidence– suggesting the exact wording for their position statement on chiropractic. It was very risky for the HIAA to adopt his statement, and they knew it. In the field of insurance, boycotts are subject to antitrust laws.
The HIAA published a very cautious statement, not naming chiropractic as such, but broadly opposing insurance for manipulative therapies. This was word-for- word, the language Doyl Taylor had proposed. The AMA gleefully seized on the statement and published it in its newsletter, American Medical News, under a headline announcing that it was directed at chiropractors.
When the chiropractors objected to the HIAA”s allowing the AMA to interpret its policy statement as an attack on chiropractic, the HIAA replied to the chiropractors with the same bland hypocrisy that characterized HEW’s dealings with Congress. The HIAA coolly informed the chiropractic organizations that it had no control over the manner in which the AMA elected to use its statement. What it didn’t mention was that the AMA”s Doyl Taylor was the author of the statement, and the HIAA, like HEW, was allowing the AMA to pull its strings. The AMA’s strategy– which by now was beginning to work– was obviously to orchestrate a veritable puppet chorus of seemingly independent public voices, all filling the air with ringing denunciations of chiropractic thereby legitimizing the AMA’s private attempts to eliminate it.
In 1967, the AMA Committee on Quackery had commenced work on the Blue Shield Association, the parent group for all the Blue Shield plans in the country. From a Committee on Quackery internal document, we read: “Staff will continue to maintain liaison with the National Association of Blue Shield Plans in regard to chiropractic attempts to gain coverage under Blue Shield (Note: A productive meeting was held with representatives of Blue Shield on this point. They are actively considering various methods of excluding chiropractors from Blue Shield coverage.)”
Blue Shield, together with Blue Cross, is the most important insurer in the country. Its boards are dominated by medical physicians. Therefore, Blue Shield cooperated with the AMA to eliminate nationwide coverage. A Blue Shield review of 1969 says, “We have filed and may use in six states an exclusion deleting manipulative services and subluxations for the purpose of removing nerve interference. Basically, the exclusion extends to services of a chiropractor by definition.” Similarly, a New York Blue Shield representative wrote to Blue Shield national headquarters on December 10, 1971: “I regret to report that . . . New York State did amend … the insurance law . . . to include chiropractic care provided through a duly licensed chiropractor as part of the definition of medical expense indemnity … U.M.S. [another Blue Shield-allied insurance company] anticipated this problem some years ago by adding an exclusion to its contract which, repeated word for word the statutory definition of what chiropractors are licensed to do ”
Blue Shield policies, then, were very misleading. They did not carry a clear cut statement, such as “Chiropractic is excluded”. Instead, there was vague language, understandable only to a lawyer, quoting the statutory language defining chiropractic, without mentioning it by name. Patients who thought their insurance covered all their health-care expenses might go to a chiropractor and run up a bill of several hundred dollars before being informed by Blue Shield’s computer that it wasn’t covered.
This exclusion, for obvious reasons, was very damaging to chiropractors. No one who can get a service from two sources is going to go to the one that doesn’t have insurance coverage. Bear in mind that upward of 90 percent of hospital charges are covered by third-party payers, most services performed by medical physicians are covered by insurance. In this day and age, only a small portion of the public can afford to patronize a provider group not covered by insurance.
Many chiropractic patients, as mentioned earlier, are elderly people living on Social Security. They may have terrible, agonizing, unrelenting back pain. If their insurance company tells them: if you go to the chiropractor, you’ve got to pay for everything out of your pocket, but if you go to the medical physician or the orthopedic surgeon, your care will be covered by insurance, the result is obvious. Economic necessity will force them to see the orthopedic surgeon and to forego the chiropractor.
So effective was this policy that in 1973, when Blue Shield did a survey of the various states to see which states covered chiropractic care, it reported: “Resistance to chiropractic payment may be indicated by the fact that fewer plans make payment than the laws require.” This would appear to be an acknowledgment that even though state legislatures had ordered Blue Shield plans to pay for chiropractic care, the Blue Shield Association and local Blue Shield plans that were working with the AMA actually paid on fewer plans than the law required.

On this episode of The Progressive Commentary Hour, Gary plays and interview from his latest documentary Treating AIDS Naturally. In the second half of the program Gary bring back some people from the documentary for a follow up. You can watch this show and documentary here 

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