Diversity versus unity: does making things count mean making everything count?

Throughout its history chiropractic has faced two disparate and at times conflicting demands, unity and diversity. To survive and to flourish has required unity at some level, at least politically. Not that a review of chiropractic history would convince any outsider that unity has been an operational imperative. In many countries and in the US, the profession is still largely divided around two political associations with two differing images of what constitutes chiropractic. Canada of course has provided a vivid contrast where for most of its history there has been one political association and originally only one college. Even now with two Colleges, this is not because of political or philosophical differences. But even in Canada break away groups have always raised their heads to offer an alternative to the main political body. But despite the rifts, the profession has been able to present a common profession. The disagreement might be about what constitutes chiropractic but not about whether chiropractic is a distinct and separate profession. Part of the challenge for chiropractic as a profession is there have always been a strong element of diversity within the profession. It is sociologically interesting to ponder why this is the case. Why have these groups not been driven out or broken away to form a new profession as opposed to forming just different associations? Part of the answer might be that as a group that has been widely discriminated against in the wider health care system, chiropractors have been reluctant to disown, disbar members of the profession even those with which they have strong disagreements. It might also reflect the fact that unlike medicine where a dominant paradigm (biomedicine) has characterized the profession, no such paradigm has enjoyed such dominance in chiropractic. At least two major paradigms have coexisted, straights and mixers, but even here within these groupings individual chiropractors have enjoyed considerable freedom to “mix and match” therapies. I recall when our group at the University of Toronto, were first observing chiropractors in practice, we noted that