“Chiropractic’s problem is that subluxation based chiropractors are not only deluding themselves, they are indoctrinating patients into believing in a purportedly dangerous mythical entity, and that without regular adjustments, patients will not only fail to reach their full potential, they will likely suffer serious health problems…Escaping from the dogma house will require extraordinary cooperation amongst all aspects of the profession. Organizations such as the World Federation of Chiropractic and all major chiropractic associations will need to agree upon and adopt a position statement identifying the chiropractic subluxation as an historical construct that remains a hypothesis, which cannot form the basis for patient care until and unless there is a body of scientific evidence to support it…The position statement will need to be backed up by these organizations incorporating and enforcing appropriate statements into their ethical codes. Further, educational accrediting bodies will have to modify their standards to clearly state that subluxation is not a concept upon which to base patient care. From this, it follows that chiropractic teaching institutions will be required to restructure their curricula accordingly. These moves will need to be reinforced by the actions of registration boards to deal harshly with the misleading and deceptive advertising on the part of subluxation based chiropractors and the unconscionable conduct that typically occurs therewith. Specifically, registration boards must prohibit the common practice whereby potential clients present to a chiropractor for a musculoskeletal complaint, only to be convinced that they are in fact suffering from subluxation related disorders and require prolonged chiropractic care. Insurance providers will need to alter their rebate guidelines to only provide payment for evidence-based care and to strike from their registers subluxation-based chiropractors. All of this must happen and the public must be informed along the way. Last, but by no means least, it will require each and every chiropractor to be intolerant of the nonsense that is out there. The contract that the profession has with society and its patients is such that, in exchange for a significant degree of autonomy over education, licensing and credentialing, members of the profession are expected to maintain high standards of competence and moral responsibility and interest. If the profession is to gain the trust of the consuming public it must, of necessity, become truly self-policing. Only in this way will chiropractic generate the cultural authority required for recognition as a group worthy of the title ‘profession’. No longer can we cast a blind eye. By our silence we are giving consent.” J Keith Simpson, Chiropractic & Manual Therapies (January 2012) [pdf]