The Wilk vs. AMA (American Medical Association) Lawsuit
Another inquiry that further validated chiropractic came about through an antitrust suit filed by four members of the chiropractic profession against the American Medical Association (AMA). and a number of other medical organizations in the United States (Wilk et al v. AMA et al, No.90-542, October 1990).
In 1987, following 11 years of legal action, a federal appellate court judge ruled that the AMA had engaged in a “lengthy, systematic, successful and unlawful boycott” designed to restrict cooperation between MDs and chiropractors in order to eliminate the profession of chiropractic as a competitor in the United States health care system. During the preceedings it was shown that the AMA attempted to :
- Undermine Chiropractic schools
- Undercut insurance programs for Chiropractic patients
- Conceal evidence of the effectiveness of Chiropractic care
- Subvert government inquires into the effectiveness of Chiropractic
- Promote other activities that would control the monopoly that the AMA had on health care
- (This was upheld by the 7th United States Circuit Court of Appeals.)
The AMA offered a patient care defense; however, data from Workmen’s Compensation Bureau studies served to validate chiropractic care. Specifically, studies comparing chiropractic care to care by a medical physician were presented which showed that chiropractors were “twice as effective as medical physicians, for comparable injuries, in returning injured workers to work at every level of injury severity.”
The settlement of the suit included an injunctive order in which the AMA was instructed to cease its efforts to restrict the professional association of chiropractors and AMA members. The AMA was also ordered to notify its 275,000 members of the court’s injunction. In addition, the American Hospital Association (AHA) sent out 440,000 separate notices to inform hospitals across the United States that the AHA has no objection to allowing chiropractic care in hospitals.
Since the court findings and conclusions were released, a growing number of medical doctors, hospitals, and health care organizations in the United States have begun including the services of chiropractors.
Numerous research studies and various government inquiries have resulted in increasingly widespread recognition of chiropractic, and generally support the efficacy of chiropractic treatment. Excerpts from some of these studies have been highlighted below.
The Agency for Health Care Policy and Research
On December 8, 1994, The Agency for Health Care Policy and Research (AHCPR) of the U.S. Department of Health and Human Services, released an extensive study of diagnostic and treatment methods for acute low back pain. This condition is the most common health complaint experienced by working Americans today, and a condition which costs the economy at least $50 billion a year in lost wages and productivity.
The AHCPR panel — a 23-member committee of medical doctors, nurses,chiropractic doctors, experts in spine research, physical therapists, a psychologist, an occupational therapist and a consumer representative — concluded, among other things, that:
spinal manipulation is a recommended treatment for acute low back problems in adults;
conservative treatment such as manipulation should be pursued — in most cases — before surgical interventions are considered;
prescription drugs such as oral steroids, antidepressant medications and colchicine are not recommended for acute low back problems.
Canadian Studies on Chiropractic – The Manga Report
A major report on the effectiveness of chiropractic treatment was published in 1993. Tile report, entitled The Effectiveness and Cost-Effectiveness of Chiropractic Management of Low-Back Pain, was funded by the Ministry of Health in Ontario to assess the most appropriate use of health care resources.
The Ministry was particularly interested in reducing the incidence of work-related injuries and in improving the rehabilitation of disabled and injured workers. The report stated that in the past year, “twelve to thirty percent of people in modern industrialized societies reported low back pain.’
In light of these concerns, a massive literature review on the effectiveness and cost effectiveness of chiropractic treatment was undertaken by an independent panel of researchers associated with the University of Ottawa. Their findings, outlined below, overwhelmingly support the efficacy and cost-effectiveness of chiropractic for the treatment of low-back pain:
Scientifically valid clinical studies support the fact that chiropractic spinal manipulation is “more effective than alternative treatments for LBP (low-back pain). Many medical therapies are of questionable validity or are clearly inadequate.
“There would be a highly significant cost savings if more management of LBP was transferred from physicians to chiropractors. Evidence from Canada and oth