Charles Neault lifts a patient's left leg and bends it. "Does that cause pain?"
"Yeah," grunts Gerald Addis, 36, who is flat on his back, grimacing with discomfort, at Canoga Park Hospital.
Neault nods knowingly. "Positive for leg pain," he tells an assistant taking notes.
This may look like a standard physical examination, but there's nothing routine about it.
The balding man, whose nickname is Dr. Chuckles because of his sense of humor, is no medical doctor. He is a chiropractor leading an invasion of spinal biomechanics, as they sometimes call themselves, into the sacred domain of the physician.
The 72-bed hospital says it is the first in the state to welcome chiropractors, who have long been ostracized by the medical profession. Now, Neault and 29 other chiropractors can, with the approval of a staff physician, put patients in the hospital and treat them there. The hospital has even installed a special chiropractic flex table in a converted hospital room.
"A lot of people are surprised that we would do this," said Barbara Meyers, administrator at Canoga Park. Some hospital staffs might oppose opening their doors to people the American Medical Assn. had branded as quacks, but members of the board of directors at Canoga Park "have a lot of courage," she said.
If it is courage, it seems to be spreading. Pacific Hospital of Long Beach is about to offer the same privileges to chiropractors. And the California Chiropractic Assn. predicted that a federal court ruling that the AMA had participated in an illegal 20-year boycott of chiropractors will help break down the barriers at other hospitals.
There are 7,000 licensed chiropractors in California, and their association says its surveys show that one in seven people in the state visited a chiropractor within the last two years.
Chiropractors trace their antecedents to Hippocrates, the ancient Greek physician, who they say wrote books on the subject. But experts say modern chiropractic dates back about 100 years to a grocer and "magnetic healer" named D. D. Palmer, who proposed spinal manipulation as a cure for various ailments.
The AMA has for decades denounced the practice as "quackery and cultism," and in 1967 declared it unethical for physicians to be professionally associated with chiropractors.
Ruling in Illinois
Four chiropractors later filed suit. On Aug. 27, 1987, U.S. District Judge Susan Getzendanner ruled that the AMA's anti-chiropractic campaign amounted to a conspiracy and boycott, and violated antitrust law.
"Keeping chiropractors out of hospitals was one of the goals of the boycott," Getzendanner said in her ruling, handed down in Illinois.
Chiropractors say the ruling vindicates them. The AMA flatly refuses to comment on chiropractors "or any other alternative form of medicine."
The ruling aside, money is one reason for bringing the chiropractors in from the cold, hospital officials say. A tour of Canoga Park Hospital showed many rooms empty and one wing closed.
And hospital officials say empty beds do not pay the salaries of nurses, therapists, doctors and administrators. Tighter Medicare rules on what treatments will be covered by the government have made it difficult for many hospitals to keep patients in those beds, officials say.
Dr. Russell Shields, chairman of the board of directors at Canoga Park, said giving hospital privileges to chiropractors helped rescue an ailing Michigan hospital recently. He said he hopes that chiropractors can bring in enough patients to improve profits at Canoga Park, which has had "marginal profitability."
More Than Expected
"As the board chairman, my primary interest is to see that the bottom line stays black," Shields said. No figures were available on the number of patients brought in by the chiropractors since the program began in September, but Shields said the number has exceeded expectations.
"It's rather interesting what the desire for money will do to people," Dr. Richard Johnson, chairman of the editorial board of California Physician magazine, said when told about chiropractors in hospitals.
"This is capitalism," Shields said. "Every hospital in town has felt the economic crunch."
But he denied that money is a primary reason for starting the programs at the Canoga Park and Long Beach hospitals. In his view, chiropractors are professionals who have long been discriminated against. "For once, they're being respected," he said.
Since state law forbids putting chiropractors on staff, the chiropractors brought into Canoga Park Hospital are known as "allied health professionals." They are not yet equal partners with the medical staff. Neault's patients must be admitted to the hospital by a supervising physician, and the chiropractor cannot order medication for his patients or issue instructions to the nurses.