24 years ago : American Medical Association (AMA) GUILTY of conspiring to conduct an illegal boycott of Chiropractors

Image: Ambro / FreeDigitalPhotos.net *

“Most people never learned of this landmark Supreme Court case because most newspapers didn’t cover it.”

“It was considered by many legal experts and health practitioners one of the most important cases involving health care in American history . Yet, it was almost totally ignored by the news media.“(1)

During the proceedings, it was shown that the AMA attempted to (2):

  • Undermine Chiropractic schools
  • Undercut insurance programs for Chiropractic patients
  • Conceal evidence of the effectiveness of Chiropractic care
  • Subvert government inquiries into the effectiveness of Chiropractic
  • Promote other activities that would control the monopoly that the AMA had on health care

By Dr Sylvain Boisvert, Chiropractor
CanadaNewsLibre.com

In 1987, United States Supreme Court Judge Susan Getzendanner issued her opinion that the AMA had violated Section 1 of the Sherman Act, and that it had engaged in an unlawful conspiracy in restraint of trade “to contain and eliminate the chiropractic profession.” (Wilk v. American Medical Ass’n, 671 F. Supp. 1465, N.D. Ill. 1987). She further opined that the “AMA had entered into a long history of illegal behavior”. And, she then issued a permanent injunction against the AMA under Section 16 of the Clayton Act to prevent such future behavior.

Wilk v. American Medical Association, 895 F.2d 352, was a federal antitrust suit brought against the American Medical Association (AMA) and 10 co-defendants by chiropractor Chester A. Wilk, DC, and four co-plaintiffs. (3)

History:

The case began in 1976, when Chester Wilk, an Illinois chiropractor, and four other doctors of chiropractic, filled a restraint-of-trade lawsuit against the AMA. They charged that the AMA’s discrimination against chiropractors hurt their practices. But the real problem started many years before.

According to the evidence produced during the trial, the medical community had for decades tried to establish a monopoly by stamping out alternative practitioners. As chiropractic began to grow in popularity, the need to stop such a fierce competitor became even more urgent.

Throughout the Wilk case, as it came to be known, the chiropractors’ evidence – including official AMA memos – showed that the giant organization was waging a systematic campaign to destroy the credibility of any alternative health care field. Because chiropractic was the most threatening to them, it was the prime target.

Distorted information and outright lies were spread about chiropractic, which the AMA labeled an “unscientific cult.” Its member doctors were forbidden to refer patients to chiropractors or accept referrals from them. Doctors of chiropractic were barred from working in hospitals, or even ordering diagnostic tests from medical facilities.

The evidence also clearly indicated that these steps were NOT taken to protect the public. They were taken in order to eliminate the competition.

At long last, thanks to this case, chiropractic was vindicated. The lies and propaganda put out by the AMA were finally going to be exposed – or were they?

At the end of the trial, the judge ordered the AMA to stop its illegal activities against chiropractic, and even made it publish the entire court injunction in its Journal of the American Medical Association. But, despite efforts by chiropractic organizations around the country, there was little media coverage of the case.

A couple of paragraphs appeared in a few newspapers, and a quick statement was included on one or two television shows, but for the most part, information on the landmark case was buried. What if the case had involved a conspiracy by Pepsi to illegally destroy Coca Cola? What if Burger King had sued McDonalds for telling lies in order to eliminate the competition? The media would have had daily coverage of every accusation. But, the story of a handful of chiropractors going against the powerful medical organization – a true “David and Goliath” battle – was virtually ignored.

One reason was that, despite the evidence brought forward during the trial, many people – including news reporters – still believed the old tales about chiropractors. Health news editors were usually M.D.’s, who had been thoroughly indoctrinated in anti-chiropractic bias. The stories never made it past their desks.

Another reason for the news blackout was fear of economic pressure from the pharmaceutical industry, which is closely aligned to the medical profession. Chiropractic is a drug-free health care approach and obviously isn’t in favor with the multi-billion dollar pharmaceutical complex.

Although information on this important Supreme Court case should have been yelled from the rooftops, it was only whispered. Yet the sound of a whisper can carry, and hopefully the internet may bring this important message to the whole world by giving it a second breath.

Summary of Judge’s Opinion and Order (3)

On August 27, 1987, Judge Susan Getzendanner, United States District Judge for the Northern District of Illinois Eastern Division, found the American Medical Association, The American College of Surgeons, and The American College of Radiology, guilty of having conspired to destroy the profession of chiropractic in the United States.

In a 101-page opinion, Judge Getzendanner ruled that the American Medical Association and its co-conspirators had violated the Sherman Antitrust Laws of the United States. Judge Getzendanner ruled that they had done this by organizing a national boycott of doctors of chiropractic by medical physicians and hospitals using an ethics ban on interprofessional cooperation.

Evidence at the trial showed that the defendants took active steps, often covert, to undermine chiropractic educational institutions, conceal evidence of the usefulness of chiropractic care, undercut insurance programs for patients of chiropractors, subvert government inquiries into the efficacy of chiropractic, engage in a massive disinformation campaign to discredit and destabilize the chiropractic profession and engage in numerous other activities to maintain a medical physician monopoly over health care in this country.

Judge Getzendanner ruled:

I conclude that an injunction is necessary in this case. There are lingering effects of the conspiracy; the AMA has never acknowledged the lawlessness of its post conduct and in fact to this day maintains that it has always been in compliance with the antitrust laws; there has never been an affirmative statement by the AMA that it is ethical to associate with chiropractors; there has never been a public statement to AMA members of the admission made in this court about the improved nature of chiropractic despite the fact that the AMA today claims that it made changes in its policy in recognition of the change and improvement in chiropractic; there has never been public retraction of articles such as “The Right and Duty of Hospitals to Deny Chiropractor Access to Hospitals”; a medical physician has to very carefully read the current AMA Judicial Council Opinions to realize that there has been a change in the treatment of chiropractors and the court cannot assume that members of the AMA pore over these opinions*, and finally, the systematic, long-term wrongdoing and the long-term intent to destroy a licensed profession suggests that an injunction is appropriate in this case. When all of these factors are considered in the context of this “private attorney general” antitrust suit, a proper exercise of the court’s discretion permits, and in my judgment requires, an injunction. (Opinion pp. 11).

Evidence in the case demonstrated that the AMA knew of scientific studies implying that chiropractic care was twice as effective cis medical care in relieving many painful conditions of the neck and back as well as related musculoskeletal problems. The court concluded:

There also was some evidence before the Committee that chiropractic was effective – more effective than the medical profession in treating certain kinds of problems such as workmen’s back injuries. The Committee on Quackery was also aware that some medical physicians believed chiropractic to be effective and that chiropractors were better trained to deal with musculoskeletal problems than most medical physicians. (Opinion pp. 7)

The Opinion found:

The AMA and its officials, including Dr. Sammons, instituted a boycott of chiropractors in the mid-1960s by informing AMA members that chiropractors were unscientific practitioners and that it was unethical for a medical physician to associate with chiropractors. The purpose of the boycott was to contain and eliminate the chiropractic profession. This conduct constituted a conspiracy among the AMA and its members and an unreasonable restraint of trade in violation of Section I of the Sherman Act.

The AMA sought to spread the boycott to other medical societies. Other groups agreed to participate in the boycott by agreeing to induce their members to forego any form of professional, research, or educational association with chiropractors. The defendants which knowingly joined in the conspiracy were ACS, ACR, and AAOS. None of the defendants established the patient care defense. The plaintiffs are entitled to injunctive relief against the AMA, ACS, and ACR, but not against AAOS or Dr. Sammons. The court shall conduct further proceedings regarding the form of the injunction. The actions of the other defendants, JCAH and ACP, were taken independently of the AMA boycott and these defendants did not join the conspiracy. Accordingly, defendants JCAH, ACP, AAOS and Dr. Sammons are dismissed. (Opinion pp. 2)

The Committee on Quackery disbanded in December 1974 and considered its activities a success:

The AMA believed that chiropractic would have achieved greater growth if it had not been for the Committee’s activities. (opinion pp. 4)

The Court of Appeals stated that enforcement of a code of ethics was not necessary to obtain compliance with the boycott:

The anti-competitive effects of the boycott were generally conceded by the defendants’ expert, William J. Lynk of Lexecon, Inc. Some of the anticompetitive effects acknowledged by Mr. Lynk include the following: it is anti-competitive and it raises costs to interfere with the consumer’s free choice to take the product of his liking; it is anti-competitive to prevent medical physicians from referring patients to a chiropractor; it is anti-competitive to impose higher costs on chiropractors by forcing them to pay for their own x-ray equipment rather than obtaining x-rays from hospital radiology departments or radiologists in private practice; and it is anti-competitive to prevent chiropractors from improving their education in a professional setting by preventing medical physicians from teaching or lecturing to chiropractors. Mr. Lynk agreed that in an economic sense a boycott such as the one described by plaintiffs raises the costs of chiropractic services and creates inefficiencies and economic dislocations. (Opinion pp. 6)

The anti-competitive effects of the AMA boycott were established by defendant’s witnesses:

The activities of the AMA undoubtedly have injured the reputation of chiropractors generally. This kind of injury more likely than not was sustained by the four plaintiffs. In my judgment, this injury continues to the present time and likely continues to adversely affect the plaintiffs. The AMA has never made any attempt to publicly repair the damage the boycott did to chiropractors’ reputations. (Opinion pp. 10).

ORDER

Based on the findings of fact and conclusions of low set forth in this opinion, the case is dismissed against defendants JCAH, ACP, AAOS, and Dr. Sammons, and an injunction shall issue against defendants AMA, ACS, and ACR. The plaintiffs and the AMA, ACS, and ACR, are directed to confer on the form of injunction and to report to the court on the progress of those discussions. The case is set for an in-chambers conference on September 4, 1987 at 3:00 P.M.

It is so ordered.

August 27, 1987
Susan Getzendanner
United States District Judge

References:
1. http://www.familychiropractic.org/propaganda.htm
2. http://www.chirobase.org/08Legal/AT/at01.html
3. http://en.wikipedia.org/wiki/Wilk_v._American_Medical_Association

Sylvain Boisvert D.C. is a frequent contributor to DrBoisvert.com

* Image reference:
Doctor Showing Money, by Ambro / freedigitalphotos.net

CNL Editor’s Note:

Sherman Antitrust Act (extract)

From Wikipedia, the free encyclopedia

Source: http://en.wikipedia.org/wiki/Sherman_Act

The Sherman Antitrust Act (Sherman Act,[1] July 2, 1890, ch. 647, 26 Stat. 209, 15 U.S.C. §§ 17) requires the United States federal government to investigate and pursue trusts, companies, and organizations suspected of violating the Act. It was the first Federal statute to limit cartels and monopolies, and today still forms the basis for most antitrust litigation by the United States federal government.

The Sherman Act is divided into three sections. Section 1 delineates and prohibits specific means of anticompetitive conduct.

The purpose of the Act was to oppose the combination of entities that could potentially harm competition, such as monopolies or cartels:

“The purpose of the [Sherman] Act is not to protect businesses from the working of the market; it is to protect the public from the failure of the market. The law directs itself not against conduct which is competitive, even severely so, but against conduct which unfairly tends to destroy competition itself.”[5]

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