By Chris G. Dalrymple D.C., F.I.C.C.
In 2016 the TCA celebrated its centennial year. The Texas Chiropractic Association’s (TCA) main purpose is to protect the chiropractic profession through advocacy and through the courts. It’s a 52-week, 365-day-a-year job, although it commands the most attention during years in which the Texas Legislature meets.
For well over 110 years chiropractic has had to struggle for its very existence. It’s no secret that some in the medical profession have long sought to curtail chiropractic as an important branch of healthcare. As demonstrated below they have long sought to eliminate the profession as unwelcome competition for healthcare dollars. Thankfully, the men and women of the chiropractic profession refuse to let it be defeated by the misunderstanding majority, and in turning back the medical lobby’s assault on chiropractic in recent years, Texas legislators have given overwhelming support to preserving and protecting the rights of the profession.
The Gilded Age, a term coined by Mark Twain to describe the time from 1870s to about 1900, was the time when the science of chiropractic was founded and developed. In 1878 Harvey Lillard lost hearing in his left ear after lifting a heavy weight while stooped. He would later become the first chiropractic patient on September 18, 1895, when D. D. Palmer successfully adjusted his spine and improved hearing resulted. By the late fall of that year Palmer had developed four methods of adjusting the vertebrae of the spine. In the summer of 1896 he also trained a few individuals in the healing art of chiropractic. Included in the chiropractic students of D. D. Palmer in 1898 was Texan Andrew P. Davis, MD, DO, DC, who may have been the first practicing chiropractic doctor in Texas.
Early in 1906 a chiropractic licensing bill was written and introduced in Minnesota. The bill passed, but was vetoed by the governor. That same year, not being eligible to become licensed as a medical practitioner under the sanctions introduced by organized medicine, both D. D. and B. J. Palmer were indicted on charges of violating the Iowa Medical Practice Act. Convicted of the charge, D.D. Palmer ultimately relinquished interest in the Palmer School of Chiropractic and moved to Medford, Oklahoma where he practiced chiropractic in his spare time.
By 1907 the Texas Legislature required applicants for medical licensure to have attended a “reputable” medical school whose course of instruction should total 4,000 hours during four college years. In August of 1908 the Carver-Denny Kiropractic College in Oklahoma City became the Carver Chiropractic College – the first substantial competitor to the Palmer Chiropractic School. These two schools would be the source for most of the chiropractic doctors drifting southward into Texas from the early 1900s to the 1920s.
J. N. Stone D.C., a graduate of the Carver-Denny Kiropractic College, was on friendly terms with both B.J. Palmer and Willard Carver. In September, 1908, a San Antonio newspaper ran a short article on Harvey Lillard’s recovery through chiropractic, and Dr. J. N. Stone founded the Chiropractic College of San Antonio, presiding there until 1913. He and his wife, Ida C. Stone, practiced in San Antonio as “Kiro-Practic Spinal Masseurs" and "Nerve Specialists.”
In 1909 the Carnegie Foundation commissioned a study on the status of medical education in the United States and Canada. The report found that many of the medical schools were substandard. The Rockefeller Foundation funded grants for the implementaiton of study findings, giving rise to the strongest professional monopoly in the United States – organized medicine. Consequently, not only was organized medicine able to “clean up” and improve their own schools, they were also able to shut down their competition by closing schools of the other healing arts — which included chiropractic schools.
They now held the cards for governing all health professions. They strenuously fought every effort by chiropractors to obtain separate licensure. Consequently, chiropractic pactcice in most states came to be considered practicing medicine without a license — a crime punishable by fine or imprisonment. While most chiropractors simply paid their fines, many decided that doing so was a plea of guilt and instead chose to stand up for their belief in their profession. Go to jail for chiropractic became a popular slogan within the chiropractic community.
In 1911 it was reported by the San Antonio Light that the first chiropractic college in Texas was chartered by the state in April 1910. The 1911 Texas State Journal of Medicine reports that the Texas College was opened with about forty enrolling. "Dr. J. N. Stone, a San Antonio chiropractor and one of the oldest workers in this field, is president of the new institution." The medical journal continued: “the course of study embraces 36 subjects, and two and one half years of study without a vacation period will be required of the students before the degree of doctor of chiropractic will be conferred. This is equivalent to four years with the usual vacation.”
From the first chiropractic act introduced in 1906, to the last chiropractic act passed in Louisiana in 1974, doctors of chiropractic have struggled against the onlsaughts of organized medicine. State chiropractic licensing laws were successfully established in Arkansas, Kansas and North Dakota in 1915. The Kansas statute was the first one passed and North Dakota was second, but the Arkansas law went into effect first. North Dakota, however, had the privilege of issuing the first chiropractic license in the world in April 1915. And though chiropractors now enjoy licensure in all 50 states, not all parts of the world enjoy that status. Arrest and jailings of chiropractors for “practicing medicine without a license” continues today for chirorpactors in some countries.
D. D. Palmer died October 21, 1913. His official death certificate listed his occupation as “Chiropractic Physician.” In 1915, the process of forming a Texas State Chiropractic Association (TSCA) begin with eight charter members who were quickly joined by 19 more. The TSCA (now the TCA) was formed in 1916. The first chiropractic licensing bill in Texas was offered in 1917. It promptly passed the house, but failed to overcome resistance in the Senate.
In 1918 an influenza epidemic swept silently across the world with an estimated 400,000 deaths. Chiropractors got fantastic results with influenza patients. One Texas chiropractor serving in the Medical Reserve Corps in France set up a makeshift influenza ward in the Base Hospital No. 84 in Southwestern France. The medical officer in charge sent all influenza patients in for chiropractic adjustments for the several months the epidemic raged in that area. In Wichita Falls, another chiropractor was pressed into service by the County Health Officer and authorized to write prescriptions for the duration of the epidemic there, but he never wrote any, getting better results without medication. Nevertheless, in 1918 there were at least 54 indictments for unlicensed medical practice across the state.
The first state-wide public relations program for chiropractic in Texas came about when the TSCA decided in 1921 to ethically advertise for the profession. Chiropractic doctors were signed up to donate a small percentage of their monthly gross to an advertising fund. Even though 1921 was a deep depression year, most Texas chiropractors supported the program and enough money was raised to place regular ads in 38 newspapers across Texas.
Beginning in 1922, however, organized medicine also began an aggressive series of ads in newspapers warning the people about “quacks” being a menace to the “public health.” Newspaper articles and radio programs proposed an “Injunction Law” whereby one found guilty of practicing medicine without a license was enjoined permanently from continuing to practice with potential for stiff jail punishment. In 1923 the state Attorney General met with the medical association of Texas and promised them that he would, “run all the chiropractors in Texas into the Gulf of Mexico.” The Injunction Law was passed in 1923.
The TSCA again sought to introduce a chiropractic licensing bill in 1923. They had one favorable vote committed in the Senate and the support of Governor Pat Neff. The bill got a lot of attention in the media, but was promptly stifled in the public health committee of the Texas Legislature. The medical monopoly strengthened its hold over the public. Organized medicine’s Council on Education and Public Instruction passed a resolution calling for a publicity campaign of its own and called for voluntary contributions from each medical association member to pay for the campaign. By February 1924, about one-fourth of the membership had responded with their donations and the assault against chiropractic continued.
The Wall Street crash of 1929 brought about the beginning of the Great Depression, but during the 1930s the unrelenting attack of the medical community continued. One chiropractic doctor was so enraged that he sued the medical association in Texas for malicious prosecution. The suit was dismissed, but he after being convicted under its provisions in 1933 he carried the constitutionality of the Medical Practice Act of Texas to the U.S. Supreme Court for a test. The U.S. Supreme Court declined to act on his suit and organized medicine continued to disparage practitioners that were not of its membership. By the 1940s the requirements to become a DC were four years of nine months each. Doctors of chiropractic continued to seek professional licensure and bills were generally submitted with each session of the legislature. Finally, in 1943 the first Chiropractic Act of Texas passed.
As the law was conceived and submitted by the combined TSCA and Texas Chiropractic Research Society it was not controversial. But the medical association in Texas persuaded the Senate to attach amendments designed to cripple the chiropractors in years to come. The bill passed, however, and was signed into law. But the 1943 law had a fatal defect in its constitutionality in that it did not restrict chiropractors to a portion of the human body, instead of the entirety of the body. The law was found to be unconstitutional and was overturned in 1944.
In 1947 chiropractic doctors were again seeking a licensure law and had a constitutional lawyer draft the next proposal so it would be satisfactory to both the chiropractic and legal professions. The revised bill was introduced into the 1947 Legislature, but failed to gain enough support to pass. A Texas Supreme Courte judge stepped down from the State Supreme Court after a 21 year career and was soon employed by the TSCA to write a Chiropractic Act in a constitutional manner. Ultimately an effective Chiroparctic Act was passed by the 1949 legislature. That same year the basic science law passed and added two years of college outside of chiropractic college and specified required basic science subjects. In the next session, the chiropractic profession was included by the legislature in the Workmen’s Compensation Act of 1951.
The AMA’s plan to undermine chiropractic became even more zealous. In 1963. The American Medical Association (AMA) formed the committee on Quackery, its primary mission: to contain and eliminate the profession of chiropractic. In 1976, Chester Wilk and four other chiropractors sued the AMA and others for violations of the Sherman Antitrust Act. The plaintiffs lost at the first trial in 1981, but obtained a new trial on appeal in 1983 and prevailed.
As a result of the antitrust lawsuit, in 1977 the AMA reluctantly made three major policy changes. The first would allow the referral of patients between chiropractors and medical doctors; secondly they would allow specialists within both professions to consult with each other concerning a particular patient; and the third they would allow medical doctors to engage in any teaching for which they are qualified, meaning they could be employed as teachers in chiropractic colleges.
In 2001 the TCA was actively included and consulted in legislative negotiations regarding the Texas Workers’ Compensation Commission overhaul, but in 2002, the University Interscholastic League (UIL) prohibited chiropractic doctors from performing and signing school physicals. TCA filed a lawsuit in that year against both the UIL the Texas Workers’ Compensation Commission for discriminatory regulations against the chiropractic profession regarding their use of designated doctors.
In 2003 the TCA’s MGCT study demonstrated cost effectiveness of chiropractic care within the Texas Workers’ Compensation System. A law including chiropractic doctors as those who may be protected from liability when performing voluntary school physical examinations was passed. The UIL reversed its discriminatory policy against chiropractic doctors and chiropractors were again allowed to sign school physical examination forms.
But organized medicine has been ever ready to seek to oppress those it deemed to be lesser than they. In 2006 the AMA announced an industry consortium known as the “Scope of Practice Partnership” (SOPP) that included as one of its founding members the TMA. That same year the TMA sued the Texas Board of Chiropractic Examiners (TBCE) asserting a violation of the Texas Constitution in an infringement of the “rights” of the Texas Board of Medical Examiners (TBME). TMA challenged the right of chiropractic doctors to “diagnose” stating that ONLY medical doctors have that right.
In 2014 the Texas Association of Acupuncture and Oriental Medicine (TAAOM) sued the TBCE in district court. Reiterating the arguments of the TMA from previous lawsuits. It still seems that organized medicine is of the belief that a state license is a government issued monopoly rather than a permit to practice as the government has defined.
In 2017 a record four pro-chiropractic bills were signed into law, and in both the 2017 and 2019 legislative sessions, around 600 DCs, staff, students, faculty and patients met at the Capitol to advocate for chiropractic.
The profession has struggled for nearly 125 years, its practitioners and patients are not yet convinced to give up the struggle for the profession. The battle is not over. Even now the TMA challenges the right of chiropractors to evaluate and treat neurological conditions (including subluxation). So the struggle shifts from primarily the statehouse, to both the statehouse AND the courtroom. It is a struggle as old as the profession itself.