June '95 June '95
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Each quarter, Chiropractic OnLine Today will present the Table of Contents and current Abstracts from Aspen Publications' Topics in Clinical Chiropractic.
The following list comprises TICC's Editorial advisory board:
Robert D. Mootz, DC, DABCO, FICC
Linda J. Bowers, DC, DABCO, DABCI, DACBN, DACAN
Daniel T. Hansen, DC, DABCO, FICC
Kevin A. McCarthy, DC, DABCO
Howard Vernon, DC, FCCS
Dorrie M. Talmage, DC, DABCO
Alan H. Adams, DC
Bernard A. Coyle, PhD
Phillip S. Ebrall, BAppSC (Chiropractic)
Gary Greenstein, DC
Warren I. Hammer, DC, MS, DABCO
Karl C. Kranz, DC
Marion McGregor, Bsc, DC, FCCS (c)
Donna M. Mannello, DC
Paul J. Osterbauer, DC, MPH
Lindsay J. Rowe, MAppSc, MD, DACBR (USA), FCCR (CAN), FACCR (AUST), FICC
Olga Rutherford, BA, Msc, PhD
Tilden H. Sokoloff, DPM, MS, DC
Thomas A. Souza, DC, CCSP
Richard D. Stonebrink, BS, DC, ND, FACO, FICC
Topics in Clinical Chiropractic welcomes original scholarly manuscripts for peer review and consideration for publication. Articles relevant to topics being addressed in upcoming issues (as outlined below) will be considered. Prospective authors should submit manuscripts directly to the issue editor for a given topic or to Robert D. Mootz, DC, Associate Medical Director for Chiropractic State of Washington Department of Labor and Industries, PO Box 44321, Olympia, WA 98504-4321. Please note deadlines for receipt or completed manuscripts for each issue below. Authors are responsible for obtaining reprint permissions and paying any fees or charges for non-original charts, figures, artwork, or appendixes. For a more detailed packet of information for authors, contact Aspen Publishers, Inc., 200 Orchard Ridge Drive, Suite 200, Gaithersburg, MD 20878.
Volume 3(1): Technology Assessment. With increasing emphasis on cost effectiveness in health care, more scrutiny is being placed on new and questionable technologies. Original manuscripts dealing with the nature of literature on individual and/or groups of clinical technologies, and original studies of devices and procedures will be considered. Deadline: August 1, 1995. Issue Editor: Daniel T. Hansen, DC 1115 Black Lake Blvd. SW, Suite A, Olympia, WA 98502.
Volume 3(2): Care of the Geriatric Patient. Care and management strategies for the elderly will be the focus of this issue. Unique concerns for this population of patients should be addressed in quality manuscripts. Key diagnostic and chiropractic care issues are desirable topics for consideration. Deadline: October 1, 1995. Issue Editor: Kevin A. McCarthy, DC, Dean of Clinics, Palmer College of Chiropractic-West, 90 E. Tasman Drive, San Jose, CA 95134.
Volume 3(3): Care of the Lumbar Spine. This issue offers a review of state-of-the-art chiropractic management of lumbar spine disorders. Manuscripts are sought dealing with assessment and conservative management strategies for the lumbar spine. Anyone interested in preparing an article for submission should contact the issue editor as early as possible. Deadline: January 15, 1996. Issue Editor: Howard Vernon, DC, Director of the Center for the Study of Spinal Health, 1396 Eglington Ave. West, Toronto, Ontario M6C 2E4, Canada.
TOC
Back to basics: A review of the evolution of chiropractic concepts of subluxation
The evolving role of chiropractic within mainstream health care
Chiropractic health care: The second century begins
Chiropractic education: Fearless youth, yet new horizons and distant scenes
Centennial sentiments: Prophetic predictions or prognostic propaganda?
The politics of policy and research
Appendix
The concept of intervertebral subluxation has been one of the fundamental components of chiropractic theory since the founding of the profession. A history of the evolution of subluxation concepts is provided from DD Palmer's original anatomic and vitalistic model through BJ Palmer's model of blocked mental impulses and concluding with contemporary comprehensive theories of vertebral subluxation complex involving kinesiopathology, neuropathology, myologic and connective tissue involvement and vascular and inflammatory processes from their anatomic, physiologic and biochemical perspectives. A recommendation for the future is made encouraging a dynamic, comprehensive approach to the ongoing development and refinement by the chiropractic community of subluxation concepts. Key words: chiropractic, joint dysfunction, subluxation, vertebral subluxation complex.
In recent years the chiropractic profession has seen increasing acceptance into the health care mainstream. This article reviews the relationship chiropractic has had with mainstream medicine and characterizes the changes in direction that have begun to take place. Chiropractic's traditional isolation from the mainstream of health care is discussed, and the impact this isolation has had on the profession is outlined. An overview of chiropractic's social, political, clinical and scientific growth is provided. The impacts and contributions chiropractic has offered the health care system are discussed. Potential future strategies for the profession's continuing development and evolution within mainstream health care are offered. Key words: chiropractic, health care reform, interprofessional relations, managed care.
The face of health care delivery and financing is undergoing dramatic change at a rapid pace. Despite the failure of a federal health reform package, managed care and restructuring of delivery settings will have far reaching impacts on chiropractic practice in the next decade. Chiropractic providers will have to address how they will interface in primary care, capitated reimbursement settings, rehabilitation, multidisciplinary for-profit clinics, and Medicare HMOs. All doctors, including DCs will have to cope with guidelines, outcomes data, and case management. Key words: capitation, chiropractic, managed care.
The growing acceptance of the DC as a participant in health care is opening doors to governmental and private funding, inviting the political and research leaders to sit at the policy making table. This trend, while creating a clear stage, demands at the same time a new level of responsibility and accountability in the academic domain. Although education was central to chiropractic endeavor in the 1890s, it is in many ways a forgotten stepchild in the 1990s. The success of political activity seems to have placed substantive development of chiropractic schools in the background. Currently, there is a unique opportunity for the coordination of the scholarly functions of instruction, research, and service into a model academy. The characteristics of such a future model institution are illustrated, while realizing that currently existing schools have histories that have spawned barriers to growth, and the external groves of academe, although rich in many areas, have also developed some less than optimal features that must be recognized. A front-running institution, by overcoming internal obstacles in its board, administration, faculty, and student body and by recognizing and turning external constraints to growth to its advantage, may thereby obtain and take responsibility for an unaccustomed prestige and recognition for the profession. This is an opening that chiropractic cannot afford to miss. Key words: chiropractic education, clinical competency, faculty development.
A corollary can be drawn between the contemporary state of the chiropractic profession and the historical evolution and incorporation of the 19th century homeopathic profession. A number of insights and lessons regarding chiropractic's evolving cultural authority can be drawn from the history of homeopathy. Social legitimization of chiropractic is resulting from an increasing scientific literature base. Ongoing contributions in this arena can do much to promote unity and consensus as well as greater acceptance within the social mainstream. The unique chiropractic philosophy in the appropriate context is essential for maintenance of a distinct identity. Key words: chiropractic, homeopathy, sociology.
The concept of "Innate Intelligence" is a fundamental component of chiropractic philosophy as developed by DD Palmer. As originally envisioned, this concept referred to a vague metaphysical force that permeated all living things and connected the physical with the nonphysical aspects of the universe. BJ Palmer modified the concept, popularizing a more materialistic notion of Innate that effectively equated it with "mental impulses." This article offers a critical overview of the assumptions, constructs, reasoning, and evolution of various concepts of Innate Intelligence. A discussion of the physical, metaphysical, and spiritual aspects of Innate is offered from a perspective of detecting and reducing error in the development of a reasonable model. Key words: chiropractic, criteria validation, dogma, Innate Intelligence, metaphysics.
Public acceptance of chiropractic appears to be increasing due to availability of better evidence to support utilization of some of its methods. Although such information is useful in political networking and policy development, there is a risk in extrapolating more from the available evidence than is actually there. In the past, political lobbying, favors, getting "networked into the system." and, at times, litigation have been the mainstays of chiropractic efforts to influence policy. While such activities will continue to play a role in the future, "who you know" will not be enough to drive health care policy in the coming years. "What you know" is a more important consideration than ever before. This article reviews role of various constituents involved in health policy making and provides an overview of the types of research considerations that are likely to drive both health policy and public acceptance in the future. Clinical procedures (diagnostic and therapeutic) and medical devices will be held to increasingly higher standard of effectiveness and value. Extrapolations from the scientific literature need to be accurate and not exaggerated. Strategies are provided for clinicians to assess evidence, identify proper questions, and provide accurate information in a manner that is not overstated. Such approaches are likely to have the greatest impact on rational policy development in a proactive and collaborative fashion. Key words: chiropractic, policy, research.
Topics in Clinical Chiropractic is published quarterly, for $58, by Aspen Publishers.