Crisis

EDUCATION

The Crisis in Chiropractic Education and Practice: A Review of
History and Opportunities for Reform
Matthew McCoy DC, MPH1
__________________________________________________________________________________________
ABSTRACT
Objective: To review the tumultuous history of chiropractic
educational accreditation and related scope of practice issues and
provide suggestions for a dialogue as the profession deals with
its current obstacles in these areas.
Methods: A review of the historical literature and current events
was undertaken in the areas of chiropractic education,
accreditation, legal issues and scope of practice.
Discussion: The chiropractic profession has been fractured since
its inception on issues related to education, accreditation and

scope of practice. The current crisis seems perched to forever
change the nature of the profession no matter the outcome.
Conclusion: In the current crisis, the chiropractic profession is
presented with the opportunity to come to grips with its internal
differences and come to a resolution that benefits all parties
including patients, practitioners and students. Whether the
profession will accept the challenge remains to be seen.
Key Words: Chiropractic, education, accreditation, Council on
Chiropractic Education, United States Department of Education,
vertebral subluxation, primary care

____________________________________________________________________________________________________________
Introduction
The chiropractic profession finds itself once again at a
crossroads. In the swirl of a perfect storm brewing within and
outside of the profession chiropractic is searching for ways to
stop declining enrollment in its schools, increase shrinking
market share, and stop an ever increasing decline in
chiropractor¶s incomes.
Despite chiropractic¶s historical embrace of paradigmatic
enquiry, the profession seems to be retreating to Einstein¶s old
saw about doing the same thing and expecting different
results. The answer thus far to address declining enrollment is
for field doctors to simply refer more of their patients to
chiropractic colleges.1
The solutions for decreased market share and shrinking
incomes include a media campaign consisting of athletes,
cheerleaders and other third party endorsements regarding
how chiropractic helped them with their back pain.2 Other

1. Vice President ² Foundation for Vertebral Subluxation

Crisis in Chiropractic Education

efforts are geared toward getting chiropractors included in the
Medical Home Model as first responders for musculoskeletal
disorders.3
Those efforts however, seem relatively innocuous when
compared to the organized efforts within the profession to
dramatically alter the very nature of chiropractic by claiming
to be primary care providers, gaining prescription drug
privileges and systematically marginalizing the management
of vertebral subluxation. The arguments for doing so are
cloaked primarily in a veil of concern for patient needs but the
real motivation exists just below the surface and consists of a
vigorously held belief that the expansion of our scope will
open up a revenue stream and pull the profession back from
the brink.4,5
Just within the past two years the profession¶s only
educational accrediting agency has stripped the notion of
³without drugs and surgery´ from its accreditation criteria
known as the Standards. It also removed any significant focus
on vertebral subluxation from those same Standards.6

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1

This paper attempts to provide a brief overview of the
emergence of a Cartel within the chiropractic profession that
has systematically worked over a period of decades to redefine what chiropractors are and what chiropractors do. Their
efforts have in large part created a façade for third party
payors that chiropractors are trained to provide the full
spectrum of primary care. Focusing on the current crisis in
chiropractic education and accreditation, the paper will offer
an overview of the possible scenarios and related outcomes
that present themselves to the profession.
The Chiropractic Cartel
Laying the Groundwork
In the Fall of 2002 the Journal of Chiropractic Medicine
(JCM) published an issue devoted to the topics of prescriptive
drug rights, primary care and the formal tiering of the
chiropractic profession.7
That issue of JCM went largely unnoticed by those factions
within the profession that adhere to a more conservative,
traditional role for chiropractic based on the clinical
management of vertebral subluxation. It wasn¶t until more
recently that leaders within this faction started to take notice
of the articles and controversies contained within that issue of
the journal.
This is important in that this journal issue laid out in clear
terms the agenda of what has become known as the
Chiropractic Cartel which was first described by Dr.
Lawrence J. DeNardis - a Committee Member of the United
States Department of Education¶s Office of Postsecondary
Education and the National Advisory Committee on
Institutional Quality and Integrity (NACIQI). He made the
following comments during the Hearing for consideration of
Renewal of Recognition of the Council on Chiropractic
Education in 2006:
Madam Chair, we've heard charges and
countercharges from I trust a wide, fairly wide
spectrum of the chiropractic profession. At least that's
the way it seems to me. Battles over turf, battles over
philosophy, maybe battles over personal ambition,
but divisions of every kind. And some of this, maybe
most of it, is a consequence of, at least as I see it, a
monopoly control of a profession which has led to the
establishment of a virtual cartel, not unusual. There
are several other professions that we deal with that
have a virtual cartel control of the profession.
We can't change that, but we can consider measures
that will try to send a message to the prevailing
control group that they should try to be more
inclusive rather than less inclusive and I suggest that
we try to figure out what is within our range of
alternatives to do that. Because I believe if we simply
hear it, discuss it, anguish over it, and then give them
five years of recognition, that we haven't been the
impetus for any corrective action for the profession
and I worry about the profession.8
The Chiropractic Cartel is believed to be made up of the
2

J. Philosophy, Principles & Practice of Chiropractic ± March 5, 2012

following organizations:9
x
x
x
x
x
x
x

The Council on Chiropractic Education
The National Board of Chiropractic Examiners
The Federation of Chiropractic Licensing Boards
The American Chiropractic Association
The Congress of Chiropractic State Associations
Chiropractic Colleges
Various For Profit Business Entities

It is important to remember that these groups also function
together in a multitude of ways and that there is a great deal of
overlap between them and other groups and organizations that
might not necessarily be considered willing participants in the
Cartel itself. For example, a large umbrella group currently
operating within chiropractic calling itself the Chiropractic
Summit is run largely by Cartel interests and holds similar
goals such as those related to primary care, physician status,
and third party reimbursement.10 While prescriptive drug
rights is not a specific goal stated by the Summit, the concept
of physician status brings with it those practices that would
confer such broad scope status including prescription drugs.
The Cartel Agenda ± Accreditation History
The CCE was created in 1971 when the American
Chiropractic Association (ACA) separated the ACA Council
on Accreditation from the ACA itself and incorporated the
Council on Chiropractic Education.11 The CCE quickly
requested recognition from the United States Office of
Education (USOE) but was denied because the USOE was not
willing to recognize two chiropractic agencies. At this time
there were two accrediting agencies ± the CCE and the
Association of Chiropractic Colleges (This is not the same
ACC we have today). Neither could claim to represent the
entire profession nationally and at the time this was a
stipulation for any professional accrediting body to gain
recognition by the USOE.11
There were efforts to force the two agencies to merge
including those by the Federation of Chiropractic Licensing
Boards (FCLB) which issued a resolution to the effect.11
However, there were also state by state efforts at solidifying
the CCE as the sole accrediting agency. For example, in June
1972, the Florida State Board of Chiropractic Examiners
revised its regulations so as to accept applications for licensure
only from graduates of schools accredited by the CCE. This
action was repeated in several other states.11
According to Kent:12
Major changes in chiropractic education were
initiated in the early to mid-1970s. At this time,
chiropractic colleges were accredited by either the
American Chiropractic Association (ACA) or the
International Chiropractors Association (ICA). In an
effort to "upgrade the image" of the profession, both
the ACA and the ICA decided to pursue federal
recognition for their respective accrediting bodies.
The ACA had the Council on Chiropractic Education
(CCE) and the ICA schools were represented by the
Association of Chiropractic Colleges (ACC). (Note:
That ACC is not related to the current ACC.)
Crisis in Chiropractic Education

Heated debate characterized the efforts of the two
bodies to approach the federal government with one
agency. An agreement was reached to defer the
submission of formal applications for Department of
Health, Education and Welfare (DHEW) recognition
by both groups. It was hoped that the two
associations would be able to resolve their
differences and approach the federal government
with one agency. Despite this agreement, the CCE
submitted an application and obtained approval,
while the ACC waited as promised.

Then in September 1981 Sherman College of Straight
Chiropractic and the Straight Chiropractic Academic
Standards Association (SCASA) filed an antitrust lawsuit in
the United States District Court of the Northern District of
Georgia against the American Chiropractic Association, Inc.,
the Council on Chiropractic Education Inc., the National
Board of Chiropractic Examiners, and Dr. Sid Williams.
Sherman and SCASA claimed that the defendants violated
antitrust laws by conspiring to restrain their ability to compete
in chiropractic education and the chiropractic profession by
engaging in a boycott of the plaintiffs.17

In May 1974 the CCE¶s application for recognition by the
USOE was finally accepted putting an end to the ACC¶s hopes
for recognition. Immediately following, sensing the
imminence of CCE' s triumph, the FCLB issued a Resolution
that its state board members revise statutes and administrative
codes to require that future applicants for licensure show
evidence of having graduated from a college recognized by the
CCE.11

Sherman and SCASA alleged that the CCE had abused its
responsibilities as an autonomous accrediting agency and had
conspired with the other defendants as well as members of
state chiropractic licensing boards and the Federation of
Chiropractic Licensing Boards to exclude Sherman graduates
from the profession:17

This action by the FCLB and the response by the states to
enact such statutes and codes remains the single biggest locus
of control that the CCE has over the educational and licensing
functions of the entire chiropractic profession.
Conservative schools experienced obvious problems existing
under the thumb of the CCE. Sherman College of Straight
Chiropractic along with ADIO Institute of Chiropractic both
embarked on a series of legal actions related to the CCE who
had denied accreditation to their schools. Armstrong made a
case that the CCE had conspired with the ACA and the FCLB
to control the profession and eliminate straight chiropractic
through control of the educational system for chiropractors.13
In 1979 Sherman College challenged the U.S. Commissioner
of Education's renewal of CCE's status as a federally
recognized accrediting agency for chiropractic colleges and
lost:14
The United States District Court for the District of
Columbia rejected Sherman College's claim, holding
that the commissioner's judgment was correct, and
that his confidence in CCE as a "reliable authority as
to the quality of training" in chiropractic colleges,
which is broadly representative of the profession and
the public interest, was fully justified. The District of
Columbia Court also found that CCE was "broadly
representative of the chiropractic profession," and
that the ideology of Sherman College was "the
doctrine of a deviant splinter group."15
In 1979, Sherman College and its allies also instigated an
investigation of CCE by the antitrust division of the United
States Department of Justice to no avail:16
For more than two years, the Antitrust Division
investigated Sherman College's claims that CCE was
involved in an alleged conspiracy to restrain competition
in chiropractic education and practice, and close the
investigation in 1981. The division's exhaustive and wideranging investigation produced no evidence of illegal
action warranting further government action.15
Crisis in Chiropractic Education

The CCE argued that the plaintiffs were improperly
using antitrust laws to prevent CCE and others from
expressing the view that doctors of chiropractic
should be adequately trained in clinical diagnosis
before they are licensed to practice chiropractic. The
CCE pointed to the fact that the vast majority of the
states agreed with CCE by requiring diagnostic
training, and rejected the extreme anti-diagnostic
views. In fact they argued that these facts supported
such training in diagnosis to protect public health and
safety.15
The court agreed and after a two week trial the court rejected
Sherman¶s and SCASA's claims and ordered them to pay the
court costs. The CCE used the court¶s decision as another
purported example of Sherman and SCASA's attempts to
harass the CCE.15
The acceptance of the Straight Chiropractic Academic
Standards Association (SCASA) as an alternative to the CCE
became an imperative if the conservative faction within the
profession was to survive. SCASA pushed forward for
recognition with the United States Department of Education
(USDE) and in December 1988 SCASA was recognized by
the USDE.18
The CCE challenged SCASA¶s authority as an accrediting
body in California and this along with Sherman¶s loss of
accreditation by the Southern Association of Colleges and
Schools (SACS), and concerns raised about SCASA¶s
accrediting activities by the USDE, eventually led to its
removal of recognition by the USDE in June 1993.11,19 With
nowhere else to go, its enrollment declining and its graduates
unable to gain licensure, Sherman applied again to the CCE
and was granted accreditation in January 1995.11 ADIO, which
had changed its named to the Pennsylvania College of Straight
Chiropractic, also applied to the CCE in 1994 but was denied
and subsequently shut down.11
Life Chiropractic College (Now Life University) received
CCE accreditation for the first time in 1985 but remained
perpetually locked in a philosophical battle with the CCE over
the issue of diagnosis and management until June 10, 2002
when the CCE stripped Life of its chiropractic accreditation
J. Philosophy, Principles & Practice of Chiropractic ± March 5, 2012

3

for alleged deficiencies in these areas.20,21 In the aftermath,
Life¶s enrollment plummeted, Life¶s Founding President, Sid
E. Williams DC, resigned and Michael Schmidt DC was
named Interim President vowing to appeal the CCE¶s
decision.22,23 During the appeal, Life retained its accreditation,
but on October 20, 2002, the appeal was rejected and the
school's accreditation was rescinded.20
Shortly after, Life brought in a new President, Ben DeSpain,
and on January 2, 2003 he filed a lawsuit against the CCE
seeking declaratory and injunctive relief.24,25 The suit alleged
that the CCE had amended its bylaws in such a manner that
they conflicted with the articles of incorporation, violated
Life's common law due process rights by conducting a flawed
and biased process for reaffirmation, refused to reconsider
Life's application for re-accreditation in a timely manner and
the most significant allegation ± that the CCE adopted
Standards for Doctor of Chiropractic Programs and
Institutions that strongly favored the liberal branch of
chiropractic philosophy at the expense of the conservative
branch.25
The Life lawsuit stated in part:
Within the chiropractic community, there have long
been two primary philosophies on the scope of
chiropractic. Adherents to the conservative
philosophy believe the scope of chiropractic care
should be limited to the traditional diagnosis and
adjustment of displacements of spinal segments or
other musculoskeletal structures. According to their
view point, any form of allopathic or homeopathic
pharmaceutical prescription or other ancillary
treatment is the practice of medicine and, therefore,
outside the scope of chiropractic. This philosophy is
promoted by the international Chiropractors
Association (ICA) and the National Association of
Chiropractic Medicine (NACM). Life¶s curriculum
has traditionally been based on this conservative
philosophy. Proponents of the competing liberal
philosophy based on a medical model, believe the
doctor of chiropractic should go beyond the diagnosis
and treatment of displacements of spinal segments or
other skeletal structures and utilize ancillary
treatment methods consistent with the role of a
primary care physician (i.e., acting as a primary care
physician but without any medical school training or
residency). In this capacity, the doctor of chiropractic
makes the preliminary diagnosis for all patient
complaints and either treats the patient directly, or
refers the patient to the proper branch of medicine for
treatment. This latter philosophy is promoted by the
American Chiropractic Association (ACA).25
Note that we see a common thread in the legal arguments from
Sherman, SCASA and Life of the existence of two schools of
thought or split within the chiropractic profession. This thread
runs through the entire history of accreditation just reviewed
and in fact runs through the entire history of the chiropractic
profession itself. Perhaps one of the earliest signs of this split
was when Howard, who was an instructor at Palmer College
of Chiropractic, left to start his own school:
4

J. Philosophy, Principles & Practice of Chiropractic ± March 5, 2012

This particular ³Event´ was precipitated by Howard
when he began to dissent from the chiropractic
fundamentalists in 1906 by creating a curriculum to
³teach chiropractic as it should be taught´ (a broad
scope, science based chiropractic, that is). Dr.
Howard referred to his Howard System as the
³rational alternative´ ± an alternative to both
chiropractic¶s zealotry and to allopathy¶s injudicious
pharmacology and unnecessary surgery all of which
were abundant in the 1906-1910 era.26
Unlike the previous attempts by Sherman and SCASA that
failed to stop the CCE¶s alleged discriminatory activity, Life
was successful with Judge Moye granting Life¶s request for an
injunction.27 Moye ruled in part:
Third, as to Plaintiff's likelihood of success, the Court
finds that Plaintiff has demonstrated that it is
substantially likely to succeed on the merits for the
following reasons: Although decisions of accrediting
agencies have historically been given deference,
where, as here, accreditation decisions are made by
actors with a financial interest in the outcome, little
deference should be given. Here, there were admitted
conflicting economic financial interests in the
decisions that were made. That fact is shown by the
recruitment of Life students, after the June 2002
decision, by competitors whose representatives were
involved in the decision making on accreditation; an
attempt by a competitor whose representative was
one of the decision makers to buy life University
after its accreditation was withdrawn, at a time when
the monetary value of Life University had been
reduced by the accreditation decision; the fact that
persons with competing financial interests to those of
Life University made the accreditation decisions on
Life University; the fact that the elimination of Life
University as a chiropractic college would increase
the number of students and money available to those
competitors; that an aggressive group of leaders of
the eight liberal chiropractic schools, who had only
one-third of the chiropractic students, had undertaken
a series of corporate manipulations in order to reduce
the representation and dominance of the eight
conservative chiropractic schools (of which Life
University was one), who had approximately twothirds of all chiropractic students; that these corporate
manipulations, which may very well have violated
CCE's corporate charter, were calculated to give
dominance to the liberal minority group over the
conservative majority group; that the end result has
been the disaccreditation of the largest of all the
colleges of chiropractic and the turning loose of
hundreds, perhaps thousands, of students to be
attracted to the other schools. Actions which would
violate the antitrust laws if incorporated in an
accreditation procedure, per se, indicate a lack of due
process.27
Life University and the CCE ended up settling their disputes, a
special accreditation process was instituted for Life and as a
result Life University College of Chiropractic has
continuously held its CCE accreditation since 1985.28
Crisis in Chiropractic Education

Concurrent with Life¶s lawsuit, Palmer College of
Chiropractic had also filed a lawsuit against the CCE for
changes it had made in its corporate status.29 Palmer alleged
that the CCE deprived Palmer of its rights of representation in
the CCE corporate organization following CCE's attempt to
dissolve itself as a Wisconsin corporation and begin
operations as an Arizona corporation. The Palmer lawsuit
claimed these actions were taken in violation of the CCE's
own bylaws and articles of incorporation. Related issues
regarding the corporate status of CCE were raised in the Life
lawsuit as well.
The Cartel Agenda ± Primary Care, Drugs & Tiering
In large part the Cartel has effectively carried out the agenda
described in the 2002 issue of JCM one line item at a time.
One of the events that caught the attention of the subluxation
centered community was the announcement in 2009 by
National University of Health Sciences (NUHS) that they had
graduated their first class of practitioners with a Master of
Science in Advanced Clinical Practice (ACP).30 While the
notion of a ³split´ and two factions (classes) existing within
the profession has been around since the early days of the
profession, National¶s ACP Degree formalized the distinction
of two classes of chiropractors and created the formal split.
In an article contained in the 2002 JCM issue, Kremer lays out
his proposal for formalizing these two classes of
chiropractors.7 One with Advanced Practice Certification who
could practice primary care including the prescription of
drugs. The other type of chiropractor was described as a
³basic´ DC who would see patients primarily related to
neuromusculoskeletal conditions but would not practice
primary care or prescribe drugs. Clearly those aligned with the
primary care, drug and tiering agenda had been working their
plan since the time Kremer wrote his prescient article.
At the same time that NUHS was training its first class of
³advanced´ chiropractors in primary care and the basics of
drug use, the state of New Mexico¶s chiropractic board was
working on developing a safe haven for those chiropractors
who had these advanced credentials and wanted a place to
practice.31 While there is a great deal of contention
surrounding the actions of the Board in New Mexico including
the halting of the implementation of certain aspects of the
law32 they did manage to develop and implement a
formulary.33 According to the Chairman of the New Mexico
Board of Chiropractic, William Doggett, there are 19 states
that have contacted him for advice on how to do what New
Mexico has done.34
Just how far do they intend to go with this?
The New Mexico Board of Chiropractic Examiners
and the Board of Pharmacy are also negotiating a list
of intravenous drugs to add to the proposal. Members
of both boards had no estimate on when the list
would be ready and did not discuss what it might
include. 'Eventually, we hope to expand into a larger
array of prescription drugs,' said Dr. Leslie Schmidt,
an Albuquerque chiropractor and chairman of the
Board of Chiropractic Examiners. 'We're going to
have needle injectables and IV drugs.'35
Crisis in Chiropractic Education

The facts are that despite all the uproar regarding what many
believe to be the inclusion of drugs into chiropractic, some
level of prescriptive authority already exists. As Kent points
out:36
Over 20 years ago, Oklahoma authorized
intramuscular and intravenous injection of
µnutritional agents.¶ What training was required?
"The first injectable nutrient course consisted of
approximately four hours of instruction, going
through a 'hands-on' portion in which the chiropractic
physician-in-attendance would take a syringe and
needle, draw up a cc of B12, and inject it into an
orange." Today, the training required is a mere 24
hours for a vastly expanded scope of practice, which
includes treatment for shock (emergency procedures);
PICC catheter lines; intramuscular and intravenous
protocols; and oral protocols. The protocols taught
include: trigger point injections; neural therapy;
intravenous protocols for adult-onset asthma (a sulfur
detox pathway problem usually secondary to a
molybdenum deficiency); adjuvant nutritional IVs for
the cancer patient; and treating persistent,
nonresponsive subluxation complex, a result of
axonal transport defect, due to heavy metal and/or
volatile organic compound poisoning of the nerve.
While this activity in New Mexico and at NUHS was taking
place the Council on Chiropractic Education (CCE) was in the
process of revising its Standards for accreditation of
chiropractic educational programs leading to the Doctor of
Chiropractic Degree.37 Ultimately, the revised Standards, even
in draft form, met with widespread resistance from the
profession specifically surrounding its removal of any
meaningful reference to the clinical management of vertebral
subluxation and its removal of descriptors for chiropractic as
being without drugs and surgery.38,39
In place of these foundational tenets of chiropractic the CCE
reinforced the notion of chiropractors practicing as primary
care physicians. Despite protestations from some within the
medically oriented faction of the profession that notions of
primary care have been included in the Standards for some
time, this latest iteration was the boldest move yet on the part
of the CCE.40
Also occurring during this same time frame was an
announcement by the CCE that they had recently reaffirmed
NUHS Doctor of Chiropractic Medicine Program (DCM).41
This action brought up questions considering that the United
States Department of Education does not recognize the CCE
for accreditation of anything other than the Doctor of
Chiropractic Degree. The response from NUHS President,
James Winterstein DC, was based on semantics in that he
maintains NUHS DCM is a Program, not a Degree and that
NUHS issues only a DC degree at this time. NUHS maintains
they can call the Program anything they want since CCE
accredits the Degree but not the program.42
Despite Winterstein¶s assertions that NUHS DCM is a
Program and not a Degree, concurrent with the above actions
NUHS approached the chiropractic state boards throughout the
United States asking whether or not the state would recognize
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a DCM degree.43 According to a nationwide Freedom of
Information Act and Open Records Request, the Foundation
for Vertebral Subluxation (FVS) has acquired documents sent
between NUHS and the states regarding whether or not the
particular state would recognize the DCM degree. According
to one document sent to Oklahoma, NUHS contends that they
have received responses from 82 percent of the boards at the
present time and have found that the majority of those
responding would not have a problem with the DCM degree.43
Winterstein and NUHS are leaving no stone unturned in the
efforts to advance a Doctor of Chiropractic Medicine Degree.
According to a State of the University Address by Winterstein
in June 2011, NUHS has embarked on a plan to offer the
Doctor of Chiropractic Medicine Degree.44 The plan involves
offering the designation following the completion of
additional training (residencies, pharmacology training etc)
after a student completes the regular program and is issued a
DC degree. NUHS plans on sidestepping the CCE on the
accreditation issues that would invariably arise by seeking
regional accreditation for the DCM degree.44
This will effectively make any issue of drugs, surgery and
subluxation in the Standards a moot point for the DCM
contingent since NUHS has cleared a path for credentialing
chiropractors to prescribe drugs through a program that is
regionally accredited and which brings with it student loan
eligibility. Other chiropractic institutions will, if they have not
already, begin looking into offering similar DCM programs as
more states change their scope and add prescriptive rights. The
only other option for them would be to let NUHS be the only
game in town and let the additional money flow there. Given
that nearly half of the profession wants at least limited
prescriptive rights there is a great deal of money at stake for
the schools.45
Suffice it to say that the above describes a chiropractic
profession that is already officially, effectively and
functionally tiered with two classifications of chiropractors.
Further, the profession can no longer be defined as drugless
and the vertebral subluxation has been marginalized to the
benefit of those not wishing to focus scant resources on
teaching doctrine related to it.
Conservative Chiropractic Responds to the Cartel
In December 2011 the United States Department of
Education¶s National Committee on Educational Quality and
Integrity (NACIQI) held a hearing to consider the renewal of
recognition of the CCE.46 Prior to that meeting there was a
massive effort from organizations that support the
conservative, traditional faction of chiropractic centered on the
vertebral subluxation to mobilize the profession and voice
their concerns to the NACIQI.39
This included the International Federation of Chiropractors
and Organizations (IFCO), The Foundation for Vertebral
Subluxation (FVS), The Movement for Chiropractic Quality
and Integrity (MCQI) and the International Chiropractors
Association (ICA). These groups, especially MCQI exploited
Facebook and other social media outlets to organize the public
and professional concerns about the direction and leadership
of the CCE and the Chiropractic Cartel. A petition was started
6

J. Philosophy, Principles & Practice of Chiropractic ± March 5, 2012

by MCQI and a massive educational and letter writing
campaign was undertaken.47 Numerous violations of Federal
recognition criteria by the CCE were documented and cited in
those letters including but not limited to those addressed by
the Foundation for Vertebral Subluxation.48 See Table 1.
On the other end of the spectrum, the American Chiropractic
Association and the Association of Chiropractic Colleges
endorsed and praised the CCE in their reports to the
NACIQI.49,50 The ACA noted a consistent improvement in the
quality of chiropractic education and that the vast majority of
state boards agree with this, as evidenced by their requirement
that their licensees must graduate from chiropractic colleges
that are CCE accredited in order to get licensed.49
As a result of these actions the NACIQI staff reported 42
violations of recognition criteria in their preliminary report.51
So significant were the sheer number of violations that the
Vice Chairman of the Committee remarked during the hearing
that the CCE had ³hit the jackpot on deficiencies´ and that the
number and nature of the problems indicated ³sloppiness´ on
the part of the CCE.52 But more importantly is what has
become known as the 43rd violation wherein NACIQI directed
the CCE to demonstrate compliance with Section 602.13 of
the Recognition Criteria dealing with the wide acceptance of
its standards, policies, procedures, and decisions; and to
address how its standards advance quality in chiropractic
education.53
The issue of the CCE being in violation of 602.13 was
expressed by the International Federation of Chiropractors and
Organizations (IFCO) in their written complaint to the USDE
prior to the NACIQI Hearing in December 2011. In their
submission, the IFCO stated that the 2012 Standards and
Policies of the CCE were crafted to change the mission of
chiropractic from that of a limited, portal of entry profession
that contributes to patient health through the correction of
vertebral subluxation to a primary care, plenary profession
similar to allopathic and homeopathic medicine. The IFCO
asserted that this approach by the CCE is in direct conflict
with state chiropractic practice acts as they define chiropractic
as a profession that is limited to a class of conditions that
affect a limited portion of anatomy.54
The IFCO further asserted that the CCE inappropriately
classifies doctors of chiropractic as primary care physicians
contrary to the licensing statues of at least 41 states and that
their removal of the requirement to train a candidate to detect
and correct vertebral subluxation is contrary to the widely
accepted standard of what chiropractic is on the federal, state
and collegiate level.54
This issue was also addressed in a written submission by the
MCQI to the NACIQI prior to the 2011 hearing:
Most notable of the violations is the failure of the
CCE to recognize and respond appropriately to the
wishes of the institutions, faculty, practitioners and
students. This is a direct violation of section 602.13
Acceptance of the agency by others. Lack of
consideration of the opinions of the profession at
large and students in particular was witnessed with
the recent adoption of the new CCE Standards. This
Crisis in Chiropractic Education

is particularly disconcerting as the new Standards
have essential language such as ³subluxation´, nearly
removed, as well as any reference to chiropractic
being ³drugless and non-surgical.´ The Association
of Chiropractic Colleges considers both to be
essential elements of their paradigm statement. How
can a graduate expect to succeed in clinical practice
when the detection and correction of subluxation is
not considered a meta-compentency yet considered
essential to the colleges and profession at large?
Removing the language ³without drugs or surgery´
serves to move the profession closer to the inclusion
of drugs, which has become an increasing political
and philosophical battle this past year. As doctors of
chiropractic, students, and the public receiving their
care, we wish for chiropractic to remain drugless and
non-surgical.55
So unique and unprecedented was the response by the USDE
towards the CCE that the Chronicle of Higher Education
reported:
After four hours of public comments and
deliberations, the federal panel that advises the
education secretary on accreditation issues approved
a standard motion recommending to continue a
chiropractic-program accreditor's authority if it can
clean up its act within a year.56
The CCE was given one year to address all of the violations of
the recognition criteria as well as to demonstrate to the
NACIQI that there is widespread support for its Standards,
policies and procedures and that their Standards actually
improve chiropractic education. Other than the 43rd violation
the remaining are in effect bookkeeping and administrative
types of issues and should not be too difficult to remedy.
However, the CCE may have a great deal of difficulty
demonstrating widespread support and buy-in from the
profession unless the disparate factions that make up the
subluxation centered aspect of the profession work together,
make demands and get those demands met.
Coalitions Form
Following the December 2011 NACIQI Hearing there were
immediate efforts on the part of the conservative faction of the
profession to reach out to the CCE and offer assistance in
meeting the government¶s concern regarding support of the
profession. The IFCO, FVS and MCQI formed a Coalition and
sent a formal letter to the CCE Council Chair David Wickes
offering to lend support to these efforts.57,58 The ICA made
similar extensions of the olive branch.57 However, the CCE
responded to the Coalition demanding that before consulting
with them each group needed to provide the CCE with the
numbers of members or constituents that they represent and
went so far as to ask the groups to produce membership rosters
or lists as proof.58 It is not known whether or not the CCE
made similar demands to members of the Cartel such as the
American Chiropractic Association.
In the case of the ICA the CCE invited the organization to
send one representative to participate on a Presidential Search
Crisis in Chiropractic Education

Committee being organized to find a replacement for the
previous CCE President who had resigned immediately
following the NACIQI Hearing.58,59 However, the CCE placed
conditions on the inclusion of the ICA including the
requirement that the ICA: ³Understand and support the vision
and mission of the CCE´ which could not reasonably be
expected given the openly confrontational statements the ICA
had made regarding the actions of the CCE and concerns
about its actions.
The Congress of Chiropractic State Associations (COCSA)
also contacted the CCE in a January 23, 2012 letter stating in
part issues directly related to the infamous 43rd Violation:
It is our understanding that the Council devoted
considerable time addressing the 41 concerns
identified by the USDE staff and in fact has already
voted and approved changes to by-laws and policies
that will resolve many of those outstanding issues.
The concern of the COCSA Board of Directors is in
regard to some additional admonitions with regard to
acceptance of CCE and how CCE standards advance
the quality of chiropractic education, as referenced
above.
This is of particular interest to our
membership as those added charges speak
specifically to the concerns of many in the
profession. On behalf of the Congress of Chiropractic
State Associations and our membership, we wish to
inquire of the Council on Chiropractic Education as
to what specific steps the CCE intends to take to
address the two significant issues added to the
findings of noncompliance identified by the USDE
staff at the conclusion of the December 14th hearing.
Thank you for your attention to these concerns and
requests.60
No public information is available regarding the CCE¶s
response to COCSA¶s letter at the time of this writing.
Immediately following the NACIQI Hearing in December
2011 the CCE held their regular annual meeting in January
2012.59 In a highly contentious move the CCE refused to
allow stakeholders attending the meeting to address the CCE
which was especially surprising considering that the USDE
had just told the CCE to engage their stakeholders. In an even
more shocking move the CCE elected a new Chair of the
Council, Craig Little DC, DABCO, a member of the affirmed
anti-subluxation West Hartford Group.61 Little ran unopposed
for the position of Council Chairman.
The history of chiropractic education in general, and its
accreditation wars specifically, is long and detailed. The
previous overview attempted to tie together a number of key
events that have marked this tumultuous struggle between the
various factions of the chiropractic profession. In the
remaining section of this paper an attempt is made to
summarize the various scenarios that present themselves over
the next year or so as the profession addresses the concerns of
the USDE.
The conservative faction of the profession is urged to keep
foremost in their minds the control that the Cartel has
historically exercised over the conservative faction of the
J. Philosophy, Principles & Practice of Chiropractic ± March 5, 2012

7

profession. Though battles have been fought there has never
been a time where this control has not existed. There has also
never been a time in the history of the profession when power
has been so concentrated in the liberal faction of the
profession and there is nothing to suggest that this is going to
change unless dramatic action is taken. Drugs are already a
part of the profession and tiering is already taking place. On
its current path the situation will only get worse. It is in
everyone¶s best interest to take the boldest action available in
order to end the war within chiropractic.
The Way Forward ± Opportunities for Reform
The question on everyone¶s mind is what do we do now?
There is a unique opportunity provided by the 43rd Violation
for the traditional, conservative faction of the profession to
have a say in how we move forward and there is a year to
make it happen. If the CCE shows up for the next hearing with
the NACIQI and is not able to demonstrate the widespread
acceptance of its Standards, policies and procedures then there
is a real chance that the CCE¶s recognition by the Federal
government will be in jeopardy. The current discussions are
taking place behind close doors, in organization board
meetings and through social media outlets. It appears we are
faced with a few options that are outlined below.
Scenario 1: Allow the Existing CCE Agenda to Continue
We have already discussed what has taken place to this point.
The conservatives within the profession could simply allow
the CCE and the Cartel to continue to control the profession
and its direction.

choose independent practice or hospital employment. The
vast majority of practicing chiropractors treat primarily
musculoskeletal pain using manipulation and physical therapy
in an insurance-based fee system. This would put them into
the health care system that so many want to be integrated into,
open up career options for them, and give them the
opportunity to open a private practice when/if they want.
Similar potential exists for adding an MD, DO, nursing or PA
degree.
Pros: This is perhaps the most desirable option for the
traditional, conservative faction of the chiropractic profession.
On the surface it appears to stop the tiering of the profession
and eliminates the idea and burden of drug rights and primary
care.
Cons: While emotionally satisfying, this option still leaves
existing chiropractic institutions that are already focused on
primary care intact. It also leaves programs such as the DCM
at NUHS in play and these will be outside the control and
authority of the CCE. It leaves the states free to do what they
want unless the chiropractic boards are controlled by nonmedically oriented DC¶s. For this scenario to play out would
require an extremely widespread commitment by the
conservative faction of the profession. The CCE would have
to be under the control of this faction, Standards would have
to be changed and legal and regulatory actions would have to
ensue in order to stop the medically oriented faction from
using the title DC or any of its derivations including using
chiropractic to describe a type of medicine. There is no
convincing evidence that such dedication, determination and
commitment exist within the conservative camp of the
profession to carry this out.

Pros: No effort or human or financial resources would be
needed by organized groups or individuals to effect any
change.

Scenario 3: Rearrange the Deck Chairs

Cons: Without opposition the CCE and the Cartel would more
likely than not continue to define chiropractic as the practice
of primary care. Additional changes in educational
infrastructure and delivery would be needed in order to offer
rotations and residencies. States would experience continued
changes in scope to allow for drug rights. The profession
would eventually be unrecognizable from allopathic medicine.
We would likely as well see a dramatic decline in enrollment
as potential students realized the lack of value in a chiropractic
education compared to a traditional medical or allied health
degree.

Since it does not appear the conservatives are going to simply
do nothing but will also not muster the support needed to force
the medical contingent from the profession, then there are
additional options available. The least invasive is to work with
the CCE to create some structural and personnel changes to
the CCE corporate body, Council, Site Teams and other
related aspects whereby the traditionalists would potentially
have an equal vote in the functioning of the CCE. Depending
on how strong the response is to such a proposal they might
also demand that vertebral subluxation be placed back in the
Standards in some meaningful way as to reassure the
conservatives that those schools who wish to focus on it will
not be penalized moving forward.

Scenario 2: Occupational Retraining
What some might call an extreme option for the traditional,
conservative faction of the profession would be to force those
who want to practice primary care and have drug rights to add
the appropriate credentials. This could be done by creating fast
track programs with various medical and allied health
institutions whereby chiropractors could get those
designations that allow them to practice in the style they wish.
For example, one option would be a fast track Doctor of
Physical Therapy (DPT) program for those who want to
practice manipulation and physical therapy in a 3rd party pay
model. This would enable the chiropractor as a DPT to
8

J. Philosophy, Principles & Practice of Chiropractic ± March 5, 2012

The notion of ³without drugs and surgery´ could also be put
back into the Standards to assuage any fears within these
factions that they will be forced to teach pharmacology and
other related curricular content. Since the Cartel already has
plans underway to offer a post DC DCM degree that will not
be accredited by the CCE this should no longer be a sticking
point for the CCE.
Pros: Other than potentially allowing the CCE to continue
unabated this is the least aggressive change that could be put
forward. It essentially continues and mirrors what has
happened in any previous efforts to create unity within the
profession by demonstrating that everyone has a seat at the
Crisis in Chiropractic Education

Cons: There is no way to ensure and no reason to expect that
those schools wishing to be mission focused on managing
vertebral subluxation via a non-therapeutic model would be
able to do so. In this scenario, the DCM degree still moves
forward, the profession becomes tiered and chiropractic is
used to describe a type of medicine. Because of tiering there is
the potential for DC¶s to be perceived as something less than a
DCM. There will be ongoing internal professional fighting and
legal maneuvering over this issue. Even with a marketing and
public education campaign it is not felt this could be
overcome.

the minimum threshold for licensure. Issues related to state
boards that attempt to legislate out a conservative approach
will need to be addressed. Related to this would be necessary
efforts to educate naysayers that a subluxation centered
program is no less rigorous than one focused on primary care
as this will be a major talking point of those allied against
such a scenario. This option still leaves the DCM faction free
to pursue expanded scopes, drug rights and related matters. It
also leaves the potential for tiering to occur, if not formally,
then certainly as a practical matter since there will be two
³types´ of chiropractors licensed to practice. But the
possibility of tiering and drug rights exists equally even with
every other scenario. A great deal of intraprofessional trust
would need to be summoned beyond whatever agreements
could be codified.

Scenario 4: Curricular Freedom Model

Scenario 5: Establish an Alternative Accrediting Agency

A more expansive version of the model described above is the
Curricular Freedom Model wherein substantial structural and
personnel changes would be made within the CCE in order to
create two autonomous accreditation Councils. These Councils
would enable curricular freedom for both the primary care and
conservative factions. This would require substantial changes
in the bylaws, operating structure and the function of the CCE.
The key for this model to be successful is the ability for both
Councils to work autonomously. Separate Councils would
need to be created along with separate Site Team panels and
there would need to be some type of coordination of each of
them, perhaps through a committee.

Absent the will or the ability for the factions within the
profession to work together in order to solve the accreditation
crisis and keep everything under one roof the only remaining
alternative is the establishment of a separate accrediting
agency. While it has been tried before and failed the
circumstances at this point may be more significant and due to
social media more people are informed and able to participate
in the decision making process.

table. The ICA might garner the political heft needed to make
it happen from the existing Summit group which is already
working closely with Cartel members.

This restructuring of the CCE would then offer accreditation
of two programs leading to chiropractic degrees that would be
offered by institutions. One program would lead to the already
existing Doctor of Chiropractic and the other would lead to an
as yet unnamed degree. Governance changes will need to be
made to the overall structure of CCE to ensure a workable
level of trust from stakeholders. Once established, these
autonomous Councils would develop appropriate Standards
and competencies including those for subluxation-centered
chiropractors and programs. Institutions could offer the
program they desired. This proposal would have to include the
development of similar autonomous bodies and testing
programs within the National Board of Chiropractic
Examiners or establish an additional testing arm.

During the time of SCASA a second accrediting agency was
frowned upon by the USDE however, recent discussions with
consultants reveal this is no longer the case and the NACIQI
has actually advised the conservative faction during hearings
that absent the ability to work things out one might consider
the formation of another agency.
Pros: This represents the cleanest break from the CCE and its
Cartel. It allows complete autonomy for the conservative
faction of the profession. The new agency could also serve as
a secondary accrediting body for those schools who wish to
retain CCE accreditation but also want to demonstrate that
they additionally offer a curriculum that includes subluxation
and a non-therapeutic model of health care.

Pros: This allows for the ongoing existence of the CCE as the
sole accrediting body of the chiropractic profession but with
two autonomous Councils under one main body. It also
renders moot the issues that arise in states that mandate
graduation from a CCE accredited institution for licensure.
This scenario also does away with the need for establishing a
second accrediting body in competition with the CCE.

Cons: This is the most complicated scenario due to the
multiple aspects involved. There currently exists no
infrastructure within the conservative faction of the profession
to support the development and implementation of a new
agency. A great deal of human resources and funding would
need to be secured. A new agency would need to actually be
up and running with active accreditation activities for two
years prior to applying to the NACIQI for recognition. In
addition, language would need to be changed in those states
that mandate graduation from a CCE accredited institution.
Further, and perhaps most daunting, is that existing schools
would need to voluntarily submit themselves to review by the
new agency. It is not clear regarding what would motivate a
school for doing so if they are already accredited by the CCE
other than wanting to show they are also strong in other areas.
Thus far the schools have been aligned with the CCE, at least
in official pronouncements.

Cons: Issues related to individual state scopes would have to
be addressed on a state by state basis to be certain that any
new DC programs or changes to existing DC programs meet

While none of the described scenarios offer an ideal answer to
the obstacles facing the profession, one of them is going to
come to fruition. Given the predilection within the

This proposal does not include the concept of tiering or a
hierarchy in any way as it is detrimental to both factions. More
so, it suggests that the subluxation centered chiropractor is
inferior. Under no circumstances would this proposal move
forward under such concepts.

Crisis in Chiropractic Education

J. Philosophy, Principles & Practice of Chiropractic ± March 5, 2012

9

conservative faction of the profession for passivity in the
political realm it would seem that the scenario requiring the
least commitment of resources by the greatest number of
participants is going to win out. The conservative faction of
the profession will need to consider if it is willing to live
within the environment that will grow out of such a
compromise considering that they will live with the outcome
for perhaps a generation. The profession is likely to change
dramatically during that timeframe and any hope of the
conservative faction surviving and producing offspring is
unlikely.

such reform82 and the use of technology, online delivery and
asynchronous methods are being explored.83,84
Medical schools are even taking it a step further and
developing programs where medical students are not steeped
in the biological and basic sciences but instead are focused in
the humanities and social sciences.85 Beyond health care the
legal profession is beginning to take a serious look at its
educational system and legal education reformers share some
of the same concerns as those within the conservative faction
of the chiropractic profession.86-88 Tamanaha, a law professor,
is calling for cheaper, practice-oriented law schools and states:

A New Educational Model
Beyond the need to address the immediate issues related to the
accreditation crisis, there also exists an overall crisis within
the profession as a whole and ignoring this would only be
addressing symptoms of a bigger problem.
Enrollment in chiropractic schools is down 40% across the
board,62 the market share for chiropractic services is
decreasing not expanding,63-68 incomes for chiropractors are
shrinking,69 license attrition rates, student loan burdens and
loan defaults have become problematic70,71, competition
relative to manipulative and wellness services is rapidly
increasing72-74, and anecdotal reports suggest that those getting
into chiropractic these days are doing so as a career decision
as opposed to a life changing experience that propelled them
to serve.
The value of a chiropractic degree is being questioned as the
typical curriculum of our chiropractic programs is burdensome
in terms of its length and its cost. Our students spend 4-6 years
in school and accumulate as much as $200,000.00 in student
loan debt. Data reveals that practicing chiropractors are
unhappy with their educational experience.75 The bulk of the
time in a chiropractic program is spent learning primary care
diagnosis and management as well as teaching to the National
Boards.76-78 Comparatively less is spent on chiropractic
principles and practice.75,79 Further, the focus on diagnosis and
management of disease is inconsistent with a vitalistic, nontherapeutic or meta-therapeutic model.80
The typical chiropractic educational program is based on a
traditional brick and mortar model that requires tremendous
resources to deliver. Physical classroom space, libraries,
teaching clinics and the faculty to deliver the coursework and
supervision are needed. At least $225,000,000.00 is spent
yearly to administer these programs.81
A new delivery system is needed that combines the
exploitation of the internet and asynchronous learning. It
includes a new pedagogy based on case based methods, team
based models and clinical clerkships in the field. The old
model of pushing large classes through a lengthy, one size fits
all curriculum needs to be replaced by a model that allows
individual students to proceed through various modules at
their own pace. Similar advancements are being advocated
within medical education where residents will be able to
progress at their own pace, move quickly through the skills
that come easily to them and spend more time and remediation
in areas they find challenging.82 The freedom to tailor training
to the needs of their students and patients is a key feature of
10

J. Philosophy, Principles & Practice of Chiropractic ± March 5, 2012

One set of standards or reforms does not fit all. There
is and should be room for diversity in a variety of
aspects of how law schools structure themselves,
including tuition, curriculum, how many years the
law degree takes« 86
Why is the chiropractic profession not leading in this area
instead of being stuck in an outdated model even our supposed
arch enemy and the legal profession is throwing aside?
This new model offers a shorter matriculation time because it
is not focused on the diagnosis and management of disease but
instead is focused on the management of vertebral subluxation
in a vitalistic, non-therapeutic framework. Given the shorter
matriculation time, the exploitation of asynchronous learning,
distance learning, and the shedding of bricks and mortar, this
educational model is also less expensive and frees our
graduates from the ridiculous and unmanageable loan burden
they are now saddled with.
Kent89 briefly outlines (See Table 2) an alternative curriculum
for training a new generation of chiropractors that would
include courses in:
x
x
x
x
x
x
x
x

Philosophy
Basic Science: The New Biology
Physiological Models of Vertebral Subluxation
Clinical Models of Vertebral Subluxation
Biomechanical Assessment
Neurophysiological Assessment
Biochemical Assessment
Clinical Paradigms

Whether or not such a model or its related curriculum catches
on depends in whole on the conservative, traditional faction of
the chiropractic profession and the degree of commitment they
have to seeing the perpetuation of this type of chiropractic.
History and current events as outlined in this paper clearly
point to its eventual demise without focused intervention.
Conclusion - Beyond a Fork in the Road
One thing is for certain and that is over the next year the
Cartel will be dealing with a spectrum of the profession that it
has historically sought to marginalize and cast as a fringe
element of the profession and they are likely to continue to
cast it in this fashion. It is primarily a result of the advent of
social media coupled with the recognition of a crisis by many
within the profession that has put the Cartel back on its heels.
One, or perhaps a combination of the scenarios, described in
Crisis in Chiropractic Education

this paper are going to come to fruition and none of them
involve an easy, painless process. The Cartel structured the
current system for education, testing and licensure within
chiropractic the way it did for this very reason ± to make it
difficult if not impossible to undo. What remains to be seen is
whether or not a sleeping giant has really awakened or if the
increased involvement we are seeing is simply a product of the
advent and ease of social media and despite conservative
chiropractors¶ willingness to ³like´ a Facebook post ± this
does not necessarily translate into action. The Cartel will be
banking on this.

References
1.

Greenawalt K. Growing the Future: The Chiropractic
Education Foundation. Dynamic Chiropractic.
http://www.dynamicchiropractic.com/mpacms/dc/arti
cle.php?id=55324 Accessed 2/2/2012
2. A Week to Remember: Foundation for Chiropractic
Progress Makes History. Dynamic Chiropractic
http://www.dynamicchiropractic.com/mpacms/dc/arti
cle.php?id=55632 Accessed 2/4/2012
3. Foundation for Chiropractic Progress. The Role of
Chiropractic Care in the Patient-Centered Medical
Home
http://www.foundation4cp.com/files/cpmedicalhome.pdf Accessed 2/4/2012
4. Brimhall J. How Long will Chiropractic Remain
Separate and Distinct. Today¶s Chiropractic
Lifestyle. March 2010.
5. Winterstein J. Setting the Record Straight. Outreach.
National University of Health Sciences. VOL.
XXVII, NO. 2 May/June 2011
6. Edwards J. Exposing the CCE Charade. Dynamic
Chiropractic ± April 9, 2011, Vol. 29, Issue 08
http://www.dynamicchiropractic.com/mpacms/dc/arti
cle.php?id=55252 Accessed 2/4/2012
7. Kremer RG. Strength in diversity: Professional and
legislative opportunities in primary care by the
recognition, defining and promotion of the licensure
of chiropractic medical education, competencies and
skills. J Chiropr Med. 2002 Autumn;1(4):139-48.
8. United States Department of Education¶s Office of
Postsecondary Education and the National Advisory
Committee on Institutional Quality and Integrity. The
Council on Chiropractic Education, Commission on
Accreditation Action for Consideration: Petition for
Renewal of Recognition. Transcripts of Proceedings.
Journal of Philosophy, Principles & Practice of
Chiropractic. Volume 2011, Issue 1. Pages 17-52.
9. Harrison D. FCLB¶s New µModel Practice Act¶: A
Slippery Slope. The American Journal of Clinical
Chiropractic.
February
13,
2011.
http://www.chiropracticbiophysics.com/clinical_chiropractic/2011/2/12/fclbs
-new-model-practice-act-a-slippery-slope.html
Accessed 2/4/2012
10. The Chiropractic Summit.
http://www.chiropracticcartel.com/docs/summit_ad.p
f Accessed2/5/2012
Crisis in Chiropractic Education

11. Keating JC, Callender AK, Cleveland CS. The
Accreditation Wars in A history of chiropractic
education in North America: report to the Council on
Chiropractic Education. Davenport, IA: Association
for the History of Chiropractic, 1998.
12. Kent C. A New Direction for the CCE? Dynamic
Chiropractic. November 18, 2010, Vol. 28, Issue 24.
http://www.dynamicchiropractic.com/mpacms/dc/arti
cle.php?id=55021 Last accessed 2/20/2012
13. Armstrong KS. A Report on Chiropractic Politics and
Education. Chiropractic Foundation of America
1979. Atlanta.
14. Sherman College of Straight Chiropractic, et al.,
Plaintiffs. v. United States Commissioner of
Education, et al., Defendants, The Council on
Chiropractic Education, Inc., Defendant-Intervenor.
Final Order. July 15, 1980.
15. U.S. District Court Upholds CCE Standards, Rejects
Conspiracy
Claims.
http://www.dynamicchiropractic.com/mpacms/dc/arti
cle.php?id=53071 Last accessed 2/20/2012
16. CCE Reaffirms Neutrality of Standards. Dynamic
Chiropractic. January 31, 1992, Vol. 10, Issue 03.
http://www.dynamicchiropractic.com/mpacms/dc/arti
cle.php?id=43072 Last accessed 2/20/2012
17. Sherman College of Straight Chiropractic, Straight
Chiropractic Academic Standards Association, Inc
William Sukovitch and Michael Kudlas v. American
Chiropractic Association, Inc., The Council on
Chiropractic Education, Inc, National Board of
Chiropractic Examiners, and Sid E. Williams. United
States District Court, Northern District of Georgia,
Atlanta Division. Final Order. January 9, 1986.
18. Bennett WJ, Secretary, United States Department of
Education. Letter to Moore LG, President, Straight
Chiropractic Standards Association, August 30, 1988.
19. Decision of the Secretary of Education on the
Petition for Renewal of Recognition Submitted by the
Commission on Accreditation, Straight Chiropractic
Academic Standards Association. Lamar Alexander,
Secretary of Education. United States Department of
Education. September 4, 1992.
20. Brimhall J. Chairman of the Commission on
Accreditation Council on Chiropractic Education.
Letter to Sid E. Williams denying reaffirmation of
accreditation. June 10, 2002.
J. Philosophy, Principles & Practice of Chiropractic ± March 5, 2012

11

21.

22.

23.

24.

25.

26.
27.

28.

29.

30.

31.

32.

33.

12

http://www.chirobase.org/03Edu/revocation.html
Accessed 2/17/2012
Life Files Suit Against CCE. Dynamic Chiropractic ±
February 10, 2003, Vol. 21, Issue 04.
http://www.dynamicchiropractic.com/mpacms/dc/arti
cle.php?id=9024 Accessed 2/17/2012
Sid Williams, Wife to Receive Nearly $5 Million
From Life. Dynamic Chiropractic. March 24, 2003,
Vol. 21, Issue 07.
http://www.dynamicchiropractic.com/mpacms/dc/arti
cle.php?id=9112 Last accessed 2/21/2012
Michael Schmidt, DC, Named Interim Life President.
Dynamic Chiropractic ± August 16, 2002, Vol. 20,
Issue 17.
http://www.dynamicchiropractic.com/mpacms/dc/arti
cle.php?id=15312 Last accessed 2/21/2012
Life W elcomes Dr. Ben DeSpain as New President.
Dynamic Chiropractic. January 1, 2003, Vol. 21,
Issue 01.
http://www.dynamicchiropractic.com/mpacms/dc/arti
cle.php?id=8949 Last accessed 2/20/2012
Life University v. The Council on Chiropractic
Education. Civil Action. File No. 1:03-CV-0004CAM. January 2, 2003. Complaint for Declaratory
Relief, Injunctive Relief and Damages. United States
District Court, Northern District of Georgia, Atlanta
Division.
Howard JFA. The philosophy of chiropractic and
reminiscences of its early growth and development. J.
Chiropractic Humanities.
Life University v. The Council on Chiropractic
Education. Civil Action. File No. 1:03-CV-0004CAM. March, 2003. Order on Plaintiff¶s Motion for
Preliminary Injunction. United States District Court,
Northern District of Georgia, Atlanta Division.
McGrail v. Rousse. Civil Action No. 04VS067501J.
April 24, 2005. Order Denying Plaintiff¶s Motion in
Limine to Exclude Testimony. State Court of Fulton
County. State of Georgia.
Palmer College Files Lawsuit Against the Council on
Chiropractic Education. ICA Chiropractic News
Service.
http://www.thechiropracticchoice.com/thechiropracti
cchoice.com/CNS/cns2002_12_12.htm Last accessed
2/20/2012
National Celebrates First Graduates of Master of
Science Degree Program. Dynamic Chiropractic.
September 2, 2009.
http://www.dynamicchiropractic.com/mpacms/dc/arti
cle.php?id=54038 Last accessed 2/20/2012
The Legislature of the State of New Mexico. 48th
Legislature, 2nd Session. Laws 2008 Chapter 44.
House
Bill
275,
as
amended.
http://www.sos.state.nm.us/2008/HBill275.pdf
New Mexico Court Acts to Address Questionable
Chiropractic Board Actions. International
Chiropractors Association News.
http://members.chiropractic.org/asset/docs/ICASeeks
CourtActiontoCorrrectNewMexico.pdf
Title 16 Occupational and Professional Licensing
Chapter 4 Chiropractic Practitioners Part 15
Chiropractic Advanced Practice Certification
Registry.

J. Philosophy, Principles & Practice of Chiropractic ± March 5, 2012

34.
35.

36.

37.

38.

39.

40.

41.

42.

43.

44.

45.

http://www.nmcpr.state.nm.us/nmac/parts/title16/16.
04.0015.htm
Doggett, W. Posting on Facebook Group:
Chiropractors for Prescriptive Authority. November
2011.
Increased Powers? Proposal Would Allow
Practitioners to Dispense Meds, Give Injections.
Albuquerque
Journal,
Nov.
10,
2009.
http://www.pharmacynews.eu/drug-deliverysystems/increased-powers-proposal-would-allowpractitioners-to-dispense-meds-give-injectionsalbuquerque-journal-n-m Last accessed 2/15/2012
Kent C. Drugs, Chiropractic and Boiled Frogs.
Dynamic Chiropractic. February 12, 2010, Vol. 28,
Issue 04.
http://www.dynamicchiropractic.com/mpacms/dc/arti
cle.php?id=54487 Last accessed 2/15/2012
CCE Releases Draft of Revised Accreditation
Standards for Review and Comment. Dynamic
Chiropractic.
September
15,
2009.
http://www.dynamicchiropractic.com/mpacms/dc/arti
cle.php?id=54104 Last accessed 2/20/2012
URGENT ACTION REQUIRED! CCE Attempting
to Re-Invent the Standards for Chiropractic
Institutions & Doctors. American Journal of Clinical
Chiropractic.
http://www.chiropracticbiophysics.com/clinical_chiropractic/2010/9/14/urge
nt-action-required-cce-attempting-to-re-invent-thestand.html Last accessed 2/22/2012
Chiropractors Lash Out in Massive Campaign
Against Accrediting Agency. Alleged Manipulation
of Accreditation and Control of the Profession by a
Cartel. PRLog (Press Release) - Sep 12, 2011.
http://www.prlog.org/11656638-chiropractors-lashout-in-massive-campaign-against-accreditingagency.html Last accessed 2/25/2012
Winterstein J. Letter to the Editor - Primary Care Part
of CCE Standards Since 1976. The Chronicle of
Chiropractic.
December
10,
2011.
http://chiropractic.prosepoint.net/23933
CCE Accredits Doctor of Chiropractic Medicine
Program at National. The Chronicle of Chiropractic.
February 19, 2012.
http://chiropractic.prosepoint.net/23665
Winterstein J. Letter to the Editor. CCE Accredits
NUHS Program not the Degree. The Chronicle of
Chiropractic.
December
5,
2011.
http://chiropractic.prosepoint.net/23934
CCE Accredits Doctor of Chiropractic Medicine
Program at National. The Chronicle of Chiropractic.
February 19, 2012.
http://chiropractic.prosepoint.net/23665
National to Bypass CCE on Accreditation of Doctor
of Chiropractic Medicine Degree. Foundation for
Vertebral Subluxation. November 2, 2011.
http://vertebralsubluxation.mccoypress.net/2011/11/0
2/national-steps-up-efforts-on-doctor-of-chiropracticmedicine-degree-.aspx Last accessed 2/15/2012
McDonald WP, Durkin KF, Pfefer M. How
chiropractors think and practice: The survey of North
American chiropractors. Seminars in Integrative
Medicine. Volume 2, Issue 3, September 2004, Pages
92±98.
Crisis in Chiropractic Education

46. National Advisory Committee on Institutional
Quality
and
Integrity:
Meetings:
http://www2.ed.gov/about/bdscomm/list/naciqi.html#
meetings Last accessed 2/15/2012
47. Department of Education Received 4000+
Complaints Against CCE. Foundation for Vertebral
Subluxation.
October
12,
2011.
http://vertebralsubluxation.mccoypress.net/2011/10/1
2/department-of-education-received-4000complaints-against-cce.aspx Last accessed 2/20/2012
48. Foundation for Vertebral Subluxation Submits
Complaint to USDE. The Chronicle of Chiropractic.
Sunday,
October
16,
2011.
http://chiropractic.prosepoint.net/23731
49. ACC and ACA Reaffirm Alliance With CCE.
Foundation for Vertebral Subluxation. August 10,
2011
http://vertebralsubluxation.mccoypress.net/2011/08/1
0/acc-and-aca-reaffirm-alliance-with-cce.aspx
50. ACA Endorses CCE - Cements Role in Chiropractic
Cartel. The Chronicle of Chiropractic. September 14,
2011. http://chiropractic.prosepoint.net/9697
51. National Advisory Committee on Institutional
Quality and Integrity: Meetings. Final Staff Report
December
2011.
http://www2.ed.gov/about/bdscomm/list/naciqidir/2011-fall/staff-reports-december-2011.pdf
52. Sinnott R. CCE on Shaky Ground. The Palmer
Beacon. January 2012.
http://www.palmerbeacon.com/app/pdf/1326922202_
january_2012_web_copy.pdf
53. Clum G. A Month in the Life of the CCE. The Latest
Stuff From Gerry. January 15, 2012. Volume 12,
Number 22.
http://www.drgerryclum.com/Page_7.html
54. International Federation of Chiropractors &
Organizations Submits CCE Complaint to USDE.
The Chronicle of Chiropractic. Monday, October 31,
2011. http://chiropractic.prosepoint.net/24874
55. The Movement for Chiropractic Quality and Integrity
Submits CCE Complaint to USDE. Sunday, October
30, 2011 The Chronicle of Chiropractic. Monday,
October 31, 2011.
http://chiropractic.prosepoint.net/24874
56. Kelderman E. Chiropractic Accreditor Gets Extra
Scrutiny From Federal Panel. The Chronicle of
Higher
Education.
December
15,
2011.
http://chronicle.com/article/Chiropractic-AccreditorGets/130104/
57. Coalition Forms to Address Crisis in Chiropractic
Education. The Chronicle of Chiropractic. Tuesday,
December 27, 2011.
http://chiropractic.prosepoint.net/17574
58. Conservative Groups Rebuffed After Reaching Out
to CCE. The Chronicle of Chiropractic. February 22,
2012. http://chiropractic.prosepoint.net/23923
59. CCE Holds Public Meeting. Anti-Subluxation
Activist Elected as Chairman of the board.
Foundation for Vertebral Subluxation. January 17,
2012.
http://vertebralsubluxation.mccoypress.net/2012/01

Crisis in Chiropractic Education

60. Rufolo-Dreher KC. Congress of Chiropractic State
Associations Letter to Craig Little. January 23, 2012.
http://www.cocsa.org/associations/12063/files/COCS
A%20letter%20to%20CCE-Dr%20%20Little%20123-2012.pdf
61. West Hartford Group.
http://www.westhartfordgroup.com/ Last accessed
2/22/2012
62. McCoy M. Is Chiropractic in You or Are You in
Chiropractic? Research Update. April 7, 2010
http://researchupdate.mccoypress.net/2010/04/07/ischiropractic-in-you-or-are-you-in-chiropractic.aspx
63. Davis MA, Sirovich BE, Weeks WB. Utilization and
expenditures on chiropractic care in the United States
from 1997 to 2006. Health Serv Res. 2010
Jun;45(3):748-61. Epub 2009 Dec 4.
64. Hurwitz EL, Coulter ID, Adams AH, Genovese BJ,
Shekelle PG. Use of chiropractic services from 1985
through 1991 in the United States and Canada. Am J
Public Health 1998, 88:771-776.
65. Shekelle PG, Brook RH. A community-based study
of the use of chiropractic services. Am J Public
Health 1991, 81:439-442.
66. Cote P, Cassidy JD, Carroll L. The treatment of neck
and low back pain: Who seeks care? Who goes
where? Med Care 2001, 39:956-967.
67. Sherman KJ, Cherkin DC, Connelly MT, Erro J,
Savetsky JB, Davis RB, Eisenberg DM.
Complementary and alternative medical therapies for
chronic low back pain: what treatments are patients
willing to try? BMC Complement Altern Med 2004,
19(4):9. BioMed Central.
68. Lawrence D, Meeker W: Chiropractic and CAM
Utilization: A Descriptive Review. Chiropractic &
Osteopathy 2007, 15:2.
69. Davis MA, Davis AM, Luan J, Weeks W. The
Supply and Demand of Chiropractors in the United
States from 1996 to 2005. Altern Ther Health Med.
2009;15(3):36-40
70. Foreman S, Stahl M. The attrition rate of licensed
chiropractors in California: an exploratory ecological
investigation of time-trend data. Chiropr Osteopat.
2010; 18: 24. 2010 August 12. doi: 10.1186/17461340-18-24
71. Defaulted Borrowers Health Education Assistance
Loans.
Discipline
Chiropractic.
http://www.defaulteddocs.dhhs.gov/DisciplineList.as
p?Discipline=Chiropractic&Due=48778530
Last
accessed February 24,2012
72. Boissonnault W. No You Don't, Yes We Do: The
Challenge From Chiropractors. American Physical
Therapy Association.
http://www.apta.org/StateIssues/Manipulation/NoYo
uDontYesWeDo/
73. Institute for Alternative Futures, The Future of
Chiropractic Revisited: 2005-2015. Alexandria,
Virginia, 2005. the Institute for Alternative Futures.
http://www.altfutures.com.
74. Pilsner PZ. The Wellness Revolution. 2003 John
Wiley & Sons. Hoboken, New Jersey.

J. Philosophy, Principles & Practice of Chiropractic ± March 5, 2012

13

75. McCoy M, Kent C, Decken W, George H, Brown M,
Risser B, Ross N, Thompson J, Nay F. A Survey of
Chiropractors Attitudes and Opinions Regarding
Chiropractic College Curricular Content, Length,
Relationship
to
Practice
Success
and
Recommendations for Change. Journal of
Philosophy, Principles & Practice of Chiropractic.
Volume 2011, Issue 2. Pages 10-11.
76. Coulter I, Adams A, Coggan P, Wilkes M, Gonyea
M. A Comparative Study of Chiropractic and
Medical Education. Altern Ther Health Med. 1998
(Sep);4 (5):64±75
77. Painter F. Chiropractic Training vs. Medical Training
Course
Hour
Comparison.
http://www.chiro.org/LINKS/ABSTRACTS/Chiropra
ctic_vs_Medical_Training.shtml
Last accessed
February 24, 2012
78. Chiropractic in the United States: Training, Practice,
and Research. AHCPR Publication No. 98-N002.
December 1997.
http://chiroweb.com/archives/ahcpr/uschiros.htm
79. Decken W, Risser B, Schroeder G. An Analysis of
Chiropractic Philosophy Courses in United States
Chiropractic College Curriculums. Proceedings of the
8th Annual International Research and Philosophy
Symposium. Sherman College of Chiropractic
Spartanburg, South Carolina. October 22-23, 2011.
Annals of Vertebral Subluxation Research.
November 28, 2011. Pages 189-238.
80. Stempsey W. Disease and Diagnosis: Value
Dependent Realism (Philosophy and Medicine).
Kluwer Academic Publishers. Dordrect, Netherlands.
81. Flanagan, J. & Giordano, J. The role of the institution
in developing the next generation chiropractor,
clinician and researcher. The Journal of Manipulative
and Physiological Therapeutics. 25(3), 193-196.
82. Nasca TJ, Philibert I, Brigham T, Flynn T. The Next
GME Accreditation System ² Rationale and
Benefits. New England Journal of Medicine.
February 22, 2012.
83. Mount Sinai School of Medicine. Humanities and
Medicine
Early
Acceptance
Program
http://www.mssm.edu/education/medicaleducation/programs/humanities-and-medicine-earlyacceptance-program Accessed 2/25/12
84. Hartocollis A. Getting Into Med School Without
Hard Sciences. New York Times. July 29, 2010.
http://www.nytimes.com/2010/07/30/nyregion/30me
dschools.html?pagewanted=all Accessed 2/25/12
85. Kim S. The Future of e-Learning in Medical
Education: Current Trend and Future Opportunity. J
Educ Eval Health Prof 2006, 3:3 DOI
10.3352/jeehp.2006.3.3
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2631
188/pdf/jeehp-3-3.pdf

14

J. Philosophy, Principles & Practice of Chiropractic ± March 5, 2012

86. Cassens-Weiss D. Law Prof¶s Upcoming Book
Chronicles Oversupply of New Lawyers, Proposes
Flexible Legal Ed System. American Bar Association
Journal. Feb 22, 2012.
http://www.abajournal.com/news/article/law_profs_u
pcoming_book_chronicles_oversupply_of_new_lawy
ers_proposes_flexi/?utm_source=maestro&utm_medi
um=email&utm_campaign=weekly_email Accessed
2/20/12
87. Henderson WD, Zahorsky RM. The Law School
Bubble: How Long Will It Last if Law Grads Can¶t
Pay Bills? American Bar Association Journal. Jan 1,
2012
http://www.abajournal.com/magazine/article/the_law
_school_bubble_how_long_will_it_last_if_law_grads
_cant_pay_bills/ Accessed 2/20/12
88. Hansen M. NY Times Reporter Sounds off on Legal
Education, Accreditation and the µCrazy¶ Race for
Rankings. American Bar Association Journal. Jan 27,
2012.
http://www.abajournal.com/news/article/ny_times_re
porter_sounds_off_on_legal_education_accredition_a
nd_the_crazy/ Accessed 2/20/12
89. Kent C. A New Direction for the CCE? Dynamic
Chiropractic. November 18, 2010, Vol. 28, Issue 24.
http://www.dynamicchiropractic.com/mpacms/dc/arti
cle.php?id=55021 Last accessed 2/15/2012

Crisis in Chiropractic Education

Table 1 - Violations of Federal recognition criteria by the CCE documented and cited in a letter to
the NACIQI by the Foundation for Vertebral Subluxation.

1. §602.15(a)(6) Conflicts of interest of board members,
commissioners, and evaluation team members.
2. §602.16(a)(1)(i) and §602.16(a)(1)(ii). Curriculum. ³The
agency¶s accreditation standards effectively address the
quality of the institution or program in the following areas: (i)
Success with respect to student achievement in relation to the
institution¶s mission, which may include different standards
for different institutions or programs, as established by the
institution, including, as appropriate, consideration of course
completion, State licensing examination, and job placement
rates. (ii) Curriculum.

4. §602.21(b)(4). Review of standards. The agency must
ensure that its program of review involves all of the agency¶s
relevant constituencies in the review and affords them a
meaningful opportunity to provide input into the review.
5. §602.23(c)(1) concerning the manner in which it must
respond to complaints against itself.
6. §602.23(e) (3) The accrediting agency must provide for
the public correction of incorrect or misleading information an
accredited or preaccredited institution or program releases
about the agency's accrediting or preaccrediting actions with
respect to the institution or program.

3. §602.16(a)(1)(i) and §602.16(a)(1)(ii). Curriculum. ³The
agency¶s accreditation standards effectively address the
quality of the institution or program in the following areas: (i)
Success with respect to student achievement in relation to the
institution¶s mission, which may include different standards
for different institutions or programs, as established by the
institution, including, as appropriate, consideration of course
completion, state licensing examination, and job placement
rates. (ii) Curriculum; and §602.21(a) ³An agency must
maintain a systematic program of review that demonstrates
that its standards are adequate to evaluate the quality of the
education or training provided by the institutions and
programs it accredits and relevant to the educational or
training needs of students.´

Crisis in Chiropractic Education

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15

Table 2 ± Proposed Outline of Alternative Chiropractic Curriculum. From: Kent C. A New Direction for the CCE?
Dynamic Chiropractic. November 18, 2010, Vol. 28, Issue 24.

Philosophy
x
x
x
x
x
x
x

Metaphysics
Epistemology
Ethics
Politics
Esthetics
Logic and logical fallacies
Vitalism vs. mechanism

Basic Science: The New Biology
x
x
x
x
x
x
x
x
x
x
x

The living matrix
Tone and tensegrity
Semiconductor theory
Non-synaptic communications: Chemical and electronic coupling through gap junctions, ephaptic transmissions, field effect
interactions, glial cell messaging, neural rhythmic pulsations
Connectomes
Neuroplasticity
Holographic neural theory
Biological oscillators
Coherence
Entrainment
Learning / memory in the spinal cord

Physiological Models of Vertebral Subluxation
x
x
x
x
x
x
x

Dysafferentation
Nerve compression and stretch
Axoplasmic flow
Segmental facilitation
Dysponesis
Dyskinesia
Autonomic dystonia

Clinical Models of Vertebral Subluxation
x Segmental
x Postural
x Tonal
Biomechanical Assessment
x
x
x
x
x

X-ray spinography
CT
MRI, including weight-bearing and kinetic
Postural measurements
Dynamic ROM

Neurophysiological Assessment
x
x
x
x
x
x
16

Thermography
Surface electromyography
Algometry
Heart rate variability
Functional MRI
Evoked potentials
J. Philosophy, Principles & Practice of Chiropractic ± March 5, 2012

Crisis in Chiropractic Education

Biochemical Assessment
x
x
x
x
x

Oxidative stress
DNA repair capability
Inflammation
Metabolic syndrome
Immune indices

Clinical Paradigms
x Salutogenesis
x Eu-stress vs. Dis-stress
x Ease vs. Dis-ease

Crisis in Chiropractic Education

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17