Op-Ed by Dr. B.J. Hardick
Thirty years ago, Dr. Sid E. Williams, chiropractic pioneer and founder of Life University, published an article, When is a Potato a Pill, as a call to action regarding nutritional advice within the chiropractic scope of practice. At the time, multiple judicial decisions had been made against chiropractic clinics for “using vitamins and foods as medicines by prescribing them like drugs.” Dr. Sid, as he was endearingly known, responded with his paper, analyzing the decision and establishing his position on the role of nutrition and supplements in chiropractic care.
The paper was not without controversy, and as the years passed, the use of nutritional advice and supplements has remained somewhat polarizing. Some chiropractors maintain strict adherence to the premise of the spinal adjustment as a service that should not be connected with others, while others have embraced nutrition, lifestyle, and supplement use as integral to their practices.
Dr. Sid’s work made its mark on chiropractic history, so by no means would I seek to supplant his statements on “potatoes as pills,” or the line between nutrition as wellness vs. nutrition as medicine. But in a new era with a new patient demographic that is hungry for information (and seeking it online, for better or worse), and with professionals eager to speak out online regarding their own lifestyle choices including vitamins and supplements, it’s reasonable to revisit this topic, as individuals and as practitioners.
Practicing Chiropractic without Practicing Medicine
“We must realize that it is one thing to counsel a patient in a good nourishment program … but quite another to attempt to treat, to mitigate or to cure a condition…” – Dr. Sid
This was the crux of the issue in the time of When is a Potato a Pill – where should the line be drawn between advising patients nutritionally and actually treating their ailments via “prescribed” nutrients or supplements? And where should the scope of chiropractic practice extend?
As much now as it was then, the struggle is not whether to provide nutritional advice at all – with our Standard (North) American Diets, dietary changes are almost a given! Especially now, with the advent of the internet and conflicting advice available streaming 24/7, being a trusted voice for sound knowledge is vital if we are to meet our clients’ growing needs of guidance and advice. (1)
In my own practice jurisdiction, Ontario, Canada, nutritional information is deemed to be in the public domain, meaning, professionals can discuss it openly — but so can non-professionals. My higher concern for the integrity and distinctiveness of our profession rests in the question: At what point is incorporating nutrition into a professional practice treating disease or even “practicing medicine?”
The real problem begins when patients seek and chiropractors provide an allopathic approach to wellness. I adhere to traditional chiropractic beliefs, and these were supported in my education, and that’s why I would say that treating diseases or attempting to cure them with substances is medicine – not chiropractic.
Yet, we see it all the time. A patient wants to know what vitamin to take to get off blood pressure medication. “Remedies” and “How to cure…” skyrocketing in prevalence as web search terms. (Having written numerous articles, managed several websites and social media accounts, I can’t tell you how often I’ve had to insist to a copy editor that remedies and cures just don’t belong in traditional chiropractic — no matter how popular those words are for SEO purposes. I’ll even admit that I’m sure they snuck through on some of my sites in the past.)
There are clients looking for the best weight loss foods or supplements. After decades of being conditioned in the diagnose-prescribe-cure philosophy of health, society wants to somehow regain natural wellbeing while retaining the conventional approach.
Dr. Sid reminds us that our calling is much different from the standard model of care. Even as we counsel patients toward improved nutrition, the use of supplements, or altered habits, the big picture is far more complex than to say “take two vitamins and call me in the morning.”
Whole-body wellness involves a consistent lifestyle of awareness, always removing the obstacles that keep the body from performing at its best. That’s not what all of our patients will want to hear, but in order to protect our profession’s place not only as a valid but separate and distinctive approach to care, we must stand strong. Giving in to the more convenient ideal that health conditions simply need a pill of some sort not only weakens the impact of our practice but does our patients a disservice, as well.
Let Your Food Be Your Medicine?
“The public lacks good information, while having to endure an endless stream of misinformation created by advertising agencies…” – Dr. Sid
As much as we have achieved with modern medicine, from ancient times, our ancestors have had sophisticated systems of medicine. While not all that is ancient is necessarily good, the last century or so has seen marked shifts in the way we approach medicine as a society.
Hippocrates has long been quoted as saying something to the effect of, “Let your food be your medicine and your medicine your food,” but that doesn’t mean generations past didn’t utilize medicine. In fact, some – like French researcher Diana Cardenas – argue that the quote has been misrepresented entirely. She writes, “For Hippocrates, even if food was closely linked to health and disease, the concept of food was not confused with that of medication.” (2) There is an undeniable difference between the way one approaches a food compared with a medicine, and there always has been.
Of course, Hippocrates’ medicine would have been found in nature and, powerful though nature can be, it would not have been a lab creation. The advent of artificial substances has altered the way we view and treat illness, and consuming them requires changes in the way the body responds.
As soon as these kinds of medications were introduced, questions were raised as to how the body would ultimately respond – it knows what to do with a potato, but what does it do with a pill? If this was the case with early artificial vitamins or rudimentary drugs, what must our bodies be struggling against now?
I’ll take this moment to underscore two things: (1) This purposes of this paper is not to comment on, recommend, or not recommend any type of medication. (2) If we dare critique the chemical composition of medicines, we ought to be just as critical of vitamins and supplements — they don’t grow on trees, either.
And — the unfortunate fact is that many products labeled as food are as artificial as many medications.
If Dr. Sid questioned whether a potato was a pill due to scope of practice, we must now consider whether a potato is a pill due to genetic modification, processing and packaging, and general contamination!
Being honest with ourselves, if members of the public are beginning to swing away from medications completely, we must avoid much of the grocery store, as well. It is becoming increasingly difficult to maintain a purist view of what should be avoided or consumed. And with the advances that Western medicine has legitimately made, we must leave room for the times it is needed, even if it is as a last resort.
These hazy lines have coupled with predatory marketing so that Dr. Sid’s raised concern that patients were being bombarded with misinformation has increased exponentially over the years. Our patients need nutritional guidance as much for what to avoid as they do for what to consume. If we are not going to help them clear their bodies of chemical inhibitions in the form of fake food, we can be sure they will return – to us or to another primary care provider – with ailments to be resolved.
Removing Interference to Allow for Maximum Expression of Life
“…providing nutrient intake which allows the maximum of the homeostatic principle of self-healing to manifest.” – Dr. Sid
Chiropractic care is deemed by most to be an alternative medicine because, ultimately, the chiropractic philosophy of health is rather counter to many mainstream messages. There is an appeal to this kind of alternative, as chiropractic has been in the top five complementary and alternative medicine approaches for over a decade. (3)
Moving beyond relief of physical discomfort, the principle that a chiropractic adjustment removes interference in the neural pathways extends to interference caused by sources other than physical traumas.
Our bodies were designed to prioritize and maintain homeostasis – normalcy, health – at all costs and at all times. As I lay out in the opening of my book, Align Your Health, It is the presence of interference that distracts the body from this task and begins to bog down the body’s systems and processes, leading to illness. In fact, it is the traditional chiropractic perspective that physical, emotional, environmental and chemical stresses can all contribute to interference in the body — particularly within the nervous system — localized to the spinal subluxation.
The current nutritional state of our society could certainly be considered chemical interference. Dietary guidance would be considered removal of interference. Because removal of interference is unquestionably the chiropractor’s highest goal, it would be difficult to suggest that dietary guidance to remove interference – particularly interference to the nervous system – is not within the chiropractor’s realm of responsibility.
It’s easy to get caught up in semantics here, but if we’re going to help our generation move toward the wellness that our bodies deserve, we can’t let words trip us up.
For example, gluten removal might be an issue, as I’ve talked about and many, many chiropractors and holistic doctors have noted. One might say that you can remove gluten to cure a given illness. Or, you might say (more accurately, in my opinion), that gluten causes stress on the digestive system and body as a whole, and removing the stress allows the body to get to work resolving the illness.
The former description is the easy, eye-catching way to go, and we’ve probably all been guilty of it. However, I believe that taking the time to encourage our clients that their bodies are capable and that change is systemic is more productive in the long run.
The Controversial Role of the Chiropractor
“Chiropractors … must be involved with the teaching of how to eat.” – Dr. Sid
A few years after Dr. Sid’s paper was published, he was mentioned in an article by Dr. William Bertrand, who saw the dilemma in a different light. Where Dr. Sid was addressing chiropractors who were stepping outside of their roles, Dr. Bertrand was concerned about chiropractors who were coming up short.
In his article, Shrink Wrapped, Dr. Bertrand described a patient who didn’t realize that there even was an alternative to prescription medications for her blood pressure condition – dietary changes included. He calls out chiropractors who won’t broach nutrition at all, ultimately finding common ground with Dr. Sid:
“He may have been right about one thing, a chiropractor is more likely to sell his patient an unproven bottle of XYZ vitamins to control hypertension than he is to advocate simple lifestyle measures that are actually known to work — like salt restriction for hypertension.” (4)
His position is certainly worth considering, depending on where you and your circle of colleagues fall on the spectrum of care and philosophy. There’s a pendulum swing here, with one side handing out supplements like a pharmacy and the other refusing to broach any topic outside of spinal adjustment.
Somewhere in the middle, I believe, lies the ultimate and most beneficial role of the chiropractor. We should be the gatekeeper of wellness without practicing medicine. I’ve recently had a patient, who is a nurse, express to me: “I go to the medical doctor if I’m dealing with an emergency. I go to the chiropractor if I want to be well.” This patient expects me to serve as her trusted advisor who can lend a listening ear and provide reliable guidance toward a lifestyle of health, without giving in to allopathic philosophy and one-and-done remedies. She doesn’t desire to live by an allopathic philosophy. She’s a nurse, though sees the bigger chiropractic picture, and as chiropractic developer Dr. B.J. Palmer would have said, she “gets the big idea.”
The fact that I can advise her family on best health care choices doesn’t distract me from delivering the very best chiropractic care – and it doesn’t distract her from receiving it.
United in Purpose
“…chiropractors need to elevate their vision to that of a global view to the tens of billions of hurting people in need of chiropractic care and nutritional counsel…” – Dr. Sid
When it comes to the need for chiropractic care today, we have little room for controversy. It’s challenging enough to integrate with primary care providers in order to provide the highest level of care for our patients. If we divide amongst ourselves on the cusp of widespread growth and more mainstream acceptance, we’ll certainly fall. (5)
There is always room at the table for discussion, multiple perspectives, and even disagreement. Without variances, we wouldn’t be able to reach broad demographics and wide populations. But we cannot allow our differences to chip away at our ultimate goals or the foundational principles of chiropractic care.
If we say that there’s no place for nutritional guidance, we miss the physical and biochemical effects that food has on the body. We miss the boxed foods that load our systems down with chemical interference. And we certainly have no place criticizing medicine for distorting the body’s physiology with toxic substances, if we’re allowing for a constant onslaught of artificial products on our plates.
If we say nutrition is the be-all-end-all, we might make some progress – but at what expense? Pursuing nutritional excellence is excellent for health, but if it’s in the name of taking a food as a medicine – to act as a pill to cure a disease – we miss the core principles that can create a lifestyle of wellness rather than a lifetime of treatments.
As chiropractors, we have the opportunity to spend time with our patients, helping them wade through the mire of misinformation, develop a new wellness perspective, and chart a new course for their health.
Potatoes shouldn’t be pills, and pills shouldn’t be potatoes. And, principally, a chiropractor should be focused on facilitating healing — not forcing it.