J Manipulative Physiol Ther. 1991 Jan; 14(1): 14-21.

Legitimacy at the expense of narrowing of scope of practice: chiropractic in Canada.

Coburn D.

Department of Behavioural Science, University of Toronto, Ontario, Canada.

A number of researchers from Australia, Britain, the United States and Canada describe the twentieth century development of chiropractic in terms of increased official and public recognition "in exchange for" a narrowing of scope of practice claims. This process in Canada is briefly described and is illustrated by examining chiropractic's relationships with naturopathy, a broad scope of practice health occupation. It is shown that chiropractic in Canada first used naturopathy to try to expand its own scope of practice, but then quickly rejected any official connections with a broad scope naturopathy in a recent drive to gain state recognition for a chiropractic "purified" of its past all-inclusive claims, a drive which has been at least partially successful. Yet, this narrowing contradicts chiropractic's frequent claims to be a holistic health discipline and presents practical problems for chiropractic. While chiropractic is in the process of gaining official recognition under proposed health disciplines legislation in Ontario, it is faced with dilemmas produced by its contradictory claims to narrowing and to holism. At the same time, chiropractic, along with many other previously subordinate health occupations, seems to be in the process of replacing medical dominance with a broader, but perhaps just as authoritarian, regime of "professional dominance." Will success inevitably bring not only an implicit acknowledgement of the claims of orthodox medicine, but also a separation of chiropractors from patients, those whom chiropractors once made a unique claim to serve?