Abandon the Terms Subluxation & Adjustment Says Dean of Chiropractic Medicine at Keiser University
The Dean of the College of Chiropractic Medicine at Keiser University in Palm Beach Florida had a paper published by the Association of Chiropractic Colleges in their Journal of Chiropractic Education in which he repeatedly disparages chiropractors who manage vertebral subluxation.
The paper titled: Designing a 21st century chiropractic educational program: A time for reflection, a time for action by Michael R. Wiles, DC is a hit piece on the fundamental tenets of subluxation management disguised as a scholarly paper on curricular design and implementation.
In his paper, Wiles couches his disparaging and false statements about subluxation with so called "medical educational innovations and design principles from the experience of those involved in starting
new health care programs".
Wiles suggests that Keiser's chiropractic medicine program is the epitome of a "curriculum focused on evidence based health care practices" and that Keiser also used "best evidence in the design of the new curriculum."
Regardless of his grandiose claims the "innovative and evidence based curricular elements" the Keiser chiropractic medical program incorporated and brags about as cutting edge are simply features of chiropractic education that most, if not all, chiropractic programs have been using for many years. These include starting clinical education in early quarters, using case based scenarios and integrating the basic and clinical sciences. That's it - that's Wiles claim to innovation at Keiser. Do what everyone else is already doing and say they aren't doing it.
These features are not new to chiropractic education but since Keiser's program is new - Wiles may not be aware of that. The actual purpose of his Commentary is revealed once the reader dissects out the parts of the paper that simply reviews the characteristics of most of chiropractic educational programs.
Once that is peeled away all one is left with are anti-subluxation rants typical of subluxation deniers. And despite Wiles' claims that Keiser is evidence based, his contentions regarding the management of vertebral subluxation make it clear he doesn't know the first thing about the evidence base supporting such care.
What Wiles, Keiser and the rest of the Deniers advocate for is the manipulation of stuck spinal and extremity joints for the alleviation of pain syndromes and despite their claims of evidence the literature supporting such an approach is very weak. For example, the methods used to determine where and when to manipulate stuck joints have not been shown to be objective, valid or reliable.
But that does not stop Subluxation Deniers like Wiles.
Wiles quotes fellow subluxation denier and chiropractic drug pusher Richard Brown DC the Secretary General of the World Federation of Chiropractic in an attempt to buttress his argument that unsticking stuck joints is evidence based but managing vertebral subluxation is not.
Brown, he writes:
"Wrote about the global challenges facing the chiropractic profession. In his former role as a key participant in the development of the chiropractic profession in Great Britain and his current role as secretary-general of the World Federation of Chiropractic, his words are to be considered carefully. He, too, emphasizes evidence-based education and practice, in the context of the profession’s evolution from esotericism. He bluntly calls for the profession to 'jettison . . . historical baggage and commit . . . to modern, evidence-based, research driven healthcare.'"
Readers may recall that Brown is a well known subluxation denier himself and critic of the management of vertebral subluxation referring to those who practice in such a fashion as practicing a psuedo-religion and a cult. Brown has called for those who practice this way to be "eradicated".
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What Wiles is really interested in is dismantling the ability to practice in a vitalistic, salutogenic manner in regards to vertebral subluxation by removing the related unique terminology such as subluxation and adjustment.
Wiles uses a medical review of the Flexner Report to call for the "importance and need for standardization of language to develop a shared vision of the road ahead.’’
Simon Senzon MA, DC, a Fellow at the Foundation for Vertebral Subluxation and a Ph.D Candidate at Southern Cross University has referred to this practice as "lexicon cleansing" and describes this in the larger context of the control of research journals and domination of chiropractic institutions to redirect the chiropractic profession toward the medical paradigm.
Wiles laments: "the continued chiropractic inclination to use outdated and anatomically incorrect language to describe the nature of the manipulable lesion ('subluxation') and the method of treatment ('adjustment').
Wiles goes on to assert that the use of the terms subluxation and adjustment have "plagued the profession since its founding" and he claims (without any evidence) that the terms create confusion in the minds of non-chiropractic health care providers.
He goes on to call the nerve compression (bone out of place) model of subluxation: "simplistic", "outdated" and "offensive" and claims he feels sad for any chiropractor who believes in such a model because they are either "naieve" or "poorly educated".
Wiles makes these statements despite the fact that the nerve root compression model is one of the most well entrenched and evidenced models of subluxation in the chiropractic and medical literature.
He offers no references to support his contentions.
He eventually gets to the point of his diatribe by stating the terminology we use should be:
" . . . consistent with the language used in the other medical profession that utilizes manipulative therapy, that is, osteopathic medicine."
And once he gets to the point he calls for the " . . . abandonment of the subluxation as an outdated, unscientific concept." Instead, Wiles suggests vertebral subluxations are akin to a ". . . pulled elbow, or subluxed radial head, in children."
Once Wiles is done removing subluxation from our terminology he moves on to the word "adjustment" and calls for it to be abandoned as well because he contends it is used to describe the movement of vertebral positions that are only "imagined" by chiropractors. The same naieve and poorly educated chiropractors that believe in nerve compression apparently.
In the place of adjustment Wiles wants us to use:
- Chiropractic manipulative treatment
- Chiropractic manipulative therapy
- Chiropractic manipulation
- Spinal manipulative treatment
- Spinal manipulative therapy
- Spinal manipulation
He then calls for chiropractic educational institutions to declare the terms subluxation and adjustment "historical and outdated" while reinforcing his terminology as "science based".
The bottom line with all of this is revealed by Wiles quoting Subluxation Denier Bruce Walker who, along with several of his colleagues that form the "usual suspects" of Deniers, runs one of the research journals engaging in the very lexicon cleansing that Wiles calls for.
Walker calls for the "marginalization of the nonsensical elements within the profession" with those nonsensical elements being things like subluxation, adjustment, vitalism, salutogenesis etc. Walker claims that silence on these issues amounts to "consent and acceptance of nonsensical ideas"
And of course no rant disparaging those who manage vertebral subluxation would be complete without dragging out the vaccination argument. Wiles connects the dots to the "well-known resistance to immunization practices by some elements of the chiropractic profession" and claims this has gotten in the way of our integration into mainstream healthcare. Wiles and Keiser it seems are fully on board with removing personal autonomy from health care decisions in their effort to bring chiropractic kicking and screaming into the evidence based era.
Thus far none of those schools and none of their Presidents have issued any statement condemning the outright lies and disparaging statements made by Wiles directed at their alumni, students, faculty and the rest of the profession that practice in that model.
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