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An Ethnography of a Chiropractic Clinic:
Definitions of a Deviant Situation

© 1975
James B. Cowie, PhD
Julian B. Roebuck, PhD

While chiropractic has sought professional recognition and approval, it continues to be regarded as "deviant" by the medical profession. This book for the first time studies chiropractic in its natural setting -- the clinic. It examines the health care practice of one chiropractor, within the unconventional behavioral context of his clinic. A number of questions are addressed:

  • How does the clinic "set the stage" for the chiropractor? What symbolic meanings does it present to the patients?
  • How does the chiropractor present himself to his patients? In what way is his behavior different from an establishment doctor's ?
  • How does the chiropractor characterize his patients? Why are some "unacceptable" for treatment? How are they handled?
  • How does the chiropractor manage his "deviant" status within society?

Based on participant observation -- coauthor Cowie worked as part-time assistant in the clinic under study -- this ethnography combines the perspective of symbolic interactionism with a behavior setting approach. The study focuses on the participants' own social definitions and rationalizations of the situation within the specific ongoing operation of the clinic setting.

The authors review the general history, philosophy, and legal status of chiropractic, as perceived by the practitioner himself. They then examine the physical characteristics of the clinic, the influence of this setting on the behavioral patterns of those involved, and the actual interaction among the chiropractor, his assistant, and his patients, including the chiropractor's methods of neutralizing his "deviant" status. The passages written in the first person reflect Dr. Cowie's experiences.

This book is an important addition to studies of deviant behavior both in its unique methodological approach and its emphasis on a figure who, in spite of a "deviant" label, carries a considerable degree of social power in ways that have until now been little understood.

In 1975, Dr. Cowie was Assistant Professor of Sociology at Delta State University and Dr. Roebuck was Professor of Sociology at Mississippi State University.

Table of Contents

 Preface
 Acknowledgements

1.

Introduction to an Ethnographic Analysis of a Chiropractic Clinic
 
Labeling the Chiropractor as Deviant
Orientation of the Study
The Methodology of Symbolic Interactionism
The Behavior Setting
Study Design
Patient Typology

2.

General Chiropractic History, Philosophy, Associations, and the Law
Chiropractic Methodography: The Actor as Methodologist
Chiropractic History
Chiropractic Philosophy
Chiropractic Associations
Chiropractic and the Law
New Life for Chiropractic: Dr. Sid Williams and Dynamic Essential

3.

The Behavior Setting
Exterior Characteristics
The Waiting Room

4.

Subsetting Interaction
The Waiting Room: Situational Interaction
The Adjustment Area Subsetting
Encounter Termination: The Patient's "Burden of Proof"
Backstage Interaction

5.

A Chiropractic Patient Typology

 

 

The Deviant (Chiropractor) as Labeler
The Chiropractor as Martyr
The Problems of Patient Response
The Criteria of Patient Acceptability
The Typology

 6.

General Review, Statement of Contributions, and Suggestions for Future Research
 Appendix A. Definition of "Practice of Chiropractic" from the Chiropractic Act of Louisiana (1974)
 Appendix B. The Thirty-Three Principles of Chiropractic Philosophy

 

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