Chiropractic as spine care: a model for the profession.
BACKGROUND
More than 100 years after its inception the chiropractic profession has failed to define itself in a way that is understandable, credible and scientifically coherent. This failure has prevented the profession from establishing its cultural authority over any specific domain of health care.


OBJECTIVE
To present a model for the chiropractic profession to establish cultural authority and increase market share of the public seeking chiropractic care.


CONCLUSIONS
The continued failure by the chiropractic profession to remedy this state of affairs will pose a distinct threat to the future viability of the profession. Three specific characteristics of the profession are identified as impediments to the creation of a credible definition of chiropractic: Departures from accepted standards of professional ethics; reliance upon obsolete principles of chiropractic philosophy; and the promotion of chiropractors as primary care providers. A chiropractic professional identity should be based on spinal care as the defining clinical purpose of chiropractic, chiropractic as an integrated part of the healthcare mainstream, the rigorous implementation of accepted standards of professional ethics, chiropractors as portal-of-entry providers, the acceptance and promotion of evidence-based health care, and a conservative clinical approach.


CONCLUSIONS
This paper presents the spine care model as a means of developing chiropractic cultural authority and relevancy. The model is based on principles that would help integrate chiropractic care into the mainstream delivery system while still retaining self-identity for the profession.
Nelson
Craig F
CF
American Specialty Health, 777 Front St, San Diego, CA 92101, USA. craign@ashn.com
Lawrence
Dana J
DJ
Triano
John J
JJ
Bronfort
Gert
G
Perle
Stephen M
SM
Metz
R Douglas
RD
Hegetschweiler
Kurt
K
LaBrot
Thomas
T