Chiropractor’s working in Canada are lucky. Here at home, chiropractic is legal, internally regulated and recognized by Canada’s health act (1). Organizations such as the Ontario Chiropractic Association and its sister associations in the other provinces and territories actively promote chiropractic to Canadians and within the health care system. The College of Chiropractic of Ontario regulates the profession and protects the interests of the near two million patients under chiropractic care every year (2). The Canadian Chiropractic Association has a vision to have chiropractors as an integral part of every Canadians health care team by 2023, and I have seen the efforts being made to achieve this goal (3).
This happy outlook on the profession of chiropractic is not equally reflected elsewhere in the world. The chiropractic profession is young, has fought hard battles and continues to fight for the deserved rights and privileges around the world. The British Chiropractic Association (BCA) recently undertook a libel lawsuit BCA v. Singh in an effort to protect the reputation of the chiropractic profession against the harsh conclusions made by Mr. Singh in his book Trick or Treatment (4). While the freedom of speech, opinion and expression should not be stifled, the response of the BCA allowed fair discourse on the topic, put chiropractic further into the mainstream and ultimately resulted in policy change concerning slander by the British government. That being said, chiropractic in Great Britain and Europe in general is in a healthy position, with chiropractic colleges and multiple regulatory and advocacy bodies at play.
Japan on the other hand, is a country with over 20,000 total chiropractic practitioners, yet no regulation whatsoever. Of the 20,000 practitioners only 800 meet the standards set for licensing by the World Health Organisation, which may be a moot point as no license in required to practice, however it does beg the question as to what type of practice the other 19,200 “chiropractors” are running. While chiropractic may have only officially existed since D.D. Palmer’s discovery in 1895, “bone-setters” and other similar healers have existed in cultures such as Japanese for centuries. While the benefits and harm caused by traditional methods are a mystery to many, evidence-based care is the gold standard whenever possible, and countries such as Japan could certainly benefit from adopting a regulated system. The question then is; what difficulties would a profession, and a country face trying to force 19,200 so called “chiropractors” to take licensing exams, pay regulatory bodies, and most likely require extensive education to meet WHO standards. If the 800 practitioners who meet the standards chose to associate and regulate, with support of the Japanese government, great strides could be made, however causing change on that scale is difficult to say the least. I hope one day to contribute to the struggle many countries face, advocating safe and affordable health care, but I would be lying through my teeth if I didn’t say I feel extraordinarily lucky to be entering the chiropractic profession as a Canadian working in Canada. I intend to use that privilege to provide the best possible treatment and care for my future patients because it would otherwise be spitting in the face of the progress made in this country and the progress yet to be made around the world.
- Canada Health Act – Frequently Asked Questions [Internet]. Hc-sc.gc.ca. 2016 [cited 19 November 2016]. Available from: http://www.hc-sc.gc.ca/hcs-sss/medi-assur/faq-eng.php
- College of Chiropractors of Ontario | What is CCO [Internet]. Cco.on.ca. 2016 [cited 19 November 2016]. Available from: http://cco.on.ca/english/About-CCO/What-is-CCO/
- Canadian Chiropractic Association (CCA) – Association chiropratique canadienne – Chiropractors helping Canadians live healthier lives [Internet]. Chiropractic.ca. 2016 [cited 19 November 2016]. Available from: https://www.chiropractic.ca/
- Simon Singh vs the British Chiropractic Association, a new development : News blog [Internet]. Blogs.nature.com. 2016 [cited 19 November 2016]. Available from: http://blogs.nature.com/news/2009/10/simon_singh_vs_the_british_chi.html