J Manipulative Physiol Ther. 1991 Jan; 14(1): 46-50.

Chiropractic in the United States and the changing health care environment: a view from outside the profession.

Caplan RL.

Department of Urban Studies and Community Health, Rutgers University, New Brunswick, NJ.

This paper is divided into three main parts. The first part describes chiropractic in the 1960s, 1970s and 1980s. While harassment by the medical profession largely characterized the 1960s, the health care environment of the 1970s was more favorable. However, during the 1980s, the spread of prospective payment schemes and the intensification of competition have largely hurt the development of chiropractic. All three possibilities: co-optation, subordination and nationalization are problematic as far as chiropractic is concerned. In light of these prospects, this paper makes four policy recommendations: research, education, alliance-building and politics (or REAP). The paper concludes with a brief discussion of each one.