In my 50 years of practice, I’ve seen many a professional movement come and go.
The argument that’s currently causing a stir in chiropractic circles is the question of “vitalism” versus “mechanism.” This debate has also been referred to as the “straights” versus the “mixers,” but it is basically the same quarrel. You can be sure that as your career progresses, you will hear these ideas pop up again and again, but with new and trendier names.
Vitalists believe in the body’s innate ability to heal itself. As Life University puts it, “Our bodies work hard to express health, to maintain health, and to recover from illnesses or other conditions that threaten our health.”
Mechanism is best understood as a reference to allopathic medicine.
Mechanistic advocates see the body as a set of mechanical systems—pulmonary or gastric, for example—and mostly treat those systems as separate entities.
When you are young and at the start of your career, it is easier to be a vitalist. Your body is youthful and resilient. With chiropractic care, exercise, and good nutrition, you will probably be quite healthy for many years. But as time advances, parts of the body are likely to deteriorate and break down, often for no other reason than age.
Ask an older member of the vitalist camp if they’ve ever needed surgery to fix a joint or remove a malfunctioning organ. Most are honest and will admit that at times they have had to turn to allopathic medicine for help. It is no sin; it’s just common sense.
You can find elements of truth in both vitalism and mechanism. Yet I don’t fully align with either point of view. I consider myself an evidence-informed clinician, one who has a business and career focusing on what works and is supported by clinical evidence. I am a patient-centered doctor who offers the best treatment based on the best evidence available. When I established my company 50 years ago, there was precious little research focusing on chiropractic. I realized that if a new technique was going to survive and receive wide acceptance, it had to be validated.
Over the past 30 years, Activator has been the subject of 150 peer-re- viewed papers and 23 clinical trials supporting its safety and effectiveness.
A commonsense approach
There is a third player in this discussion of mechanism and vitalism, which is philosophy based. Several seminars on the market now tout that approach, although most are motivational programs.
Some of these seminars can be very good and are certainly a lot of fun.
Yet, when you return to the office on Monday morning and a malpractice summons is lying on your desk, it will be hard data that saves you in court.
Let’s bring some common sense to this subject. You can honor the body’s ability to participate in its own healing—I certainly do. And you can respect what mechanists do, and look for ways to work with those ideas rather than against them. As for motivation, remember that it will always be data that saves your future.
For those who make the (advisable) decision to follow and use research, there is an evidence-based toolkit from Palmer College Research Center that might help you.1
There is currently enough fighting in this profession; doctors of chiropractic should be working to better chiropractic worldwide rather than trying to divide the profession. If you are in a professional discussion regarding vitalists versus mechanists, take a long and thoughtful look at the people who are pressuring you to take a side. Then let common sense and the facts guide you to a successful future.
Arlan W. Fuhr DC, is the co- founder and CEO of Activator Methods International. A practitioner and researcher for more than 40 years, Fuhr is widely acknowledged for bringing instrument adjusting to the chiropractic profession. He can be contacted through activator.com.
1 Palmer College of Chiropractic. “Evidence- Based Tookit for Clinicians.” http://www. palmer.edu/research/clinician-research-re- source-toolkit. Updated July 2017. Accessed July 2017