The History of Wilk Versus the AMA

Beginning in the 1960s, the medical establishment through the American Medical Association (AMA) formally began a discrimination campaign against the chiropractic profession, which led to policies restricting even patient referrals. This attempt to contain and eliminate the profession was a tumultuous time for health care. One health profession began attacking the integrity and validity of another. Medical doctors had their freedom to refer patients to Doctors of Chiropractic constrained by a discriminatory medical ethics policy of their trade association. These actions curtailed collaboration, research, insurance reimbursement policies and coverage in federal health programs.

In the mid-1976, a group of chiropractors, led by ICA member, Dr. Chester Wilk filed a lawsuit against the AMA (American Medical Association). The ICA was actively involved behind the scenes and our members participated in helping raise the funds to cover legal costs.

Perseverance Pays Off: In 1987, the US District Judge ruled: “The plaintiffs, Chester A. Wilk, James W. Bryden, Patricia B. Arthur, and Michael D. Pedigo are licensed chiropractors. In a complaint filed in 1976, plaintiffs charged the defendants with violating Sections 1 and 2 of the Sherman Act, 15 U.S.C. Sections 1 and 2. Section 1 of the Sherman Act declares illegal every contract, combination or conspiracy in restraint of trade or commerce. Section 2 prescribes penalties for every person who shall monopolize, or attempt to monopolize, or combine or conspire with any other person or persons, to monopolize any part of the trade or commerce. …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 1 of the Sherman Act…

The Court of Appeals in Wilk, which reviewed substantially the same boycott evidence, concluded:

Through such mechanisms, individual physicians were discouraged from cooperating with chiropractors in: patient treatment, because referrals were inhibited by defendants’ activities; research; and educational activities, such as sharing clinical experience and research results. Chiropractors were denied access to the hospital facilities they considered necessary to practice their professions. Medical doctors were discouraged from aiding chiropractors in interpreting electrocardiograms. Requests by individual plaintiffs to use laboratory and X-ray facilities were not granted; requests for hospital in-patient privileges were similarly denied. Referrals from medical doctors were reduced. Public demand for chiropractic services was negatively affected….

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 past conduct…

PERMANENT INJUNCTION ORDER AGAINST AMA…As part of the injunctive relief to be ordered by the court against the AMA, the AMA shall be required to send a copy of this Permanent Injunction Order to each of its current members. The members of the AMA are bound by the terms of the Permanent Injunction Order if they act in concert with the AMA to violate the terms of the order. Accordingly, it is important that the AMA members understand the order and the reasons why the order has been entered.
Antitrust Laws Under the Sherman Act, every combination or conspiracy in restraint of trade is illegal. The court has held that the conduct of the AMA and its members constituted a conspiracy in restraint of trade based on the following facts: the purpose of the boycott was to eliminate chiropractic; chiropractors are in competition with some medical physicians; the boycott had substantial anti-competitive effects; there were no pro-competitive effects of the boycott; and the plaintiffs were injured as a result of the conduct. These facts add up to a violation of the Sherman Act…

Need for Injunctive Relief Although the conspiracy ended in 1980, there are lingering effects of the illegal boycott and conspiracy which require an injunction. Some medical physicians’ individual decisions on whether or not to professionally associate with chiropractors are still affected by the boycott. The injury to chiropractors’ reputations which resulted from the boycott has not been repaired. Chiropractors suffer current economic injury as a result of the boycott. The AMA has never affirmatively acknowledged that there are and should be no collective impediments to professional association and cooperation between chiropractors and medical physicians, except as provided by law.

An injunction is necessary to assure that the AMA does not interfere with the right of a physician, hospital, or other institution to make an individual decision on the question of professional association.
Form of Injunction

1. The AMA, its officers, agents and employees, and all persons who act in active concert with any of them and who receive actual notice of this order are hereby permanently enjoined from restricting, regulating or impeding, or aiding and abetting others from restricting, regulating or impeding, the freedom of any AMA member or any institution or hospital to make an individual decision as to whether or not that AMA member, institution, or hospital shall professionally associate with chiropractors, chiropractic students, or chiropractic institutions….”

Quoted from:

Even after the federal ruling, the AMA attempted to have the case overturned. The Appeals Court affirmed the district courts decision in 1990 And three attempts by the ACA to have a judicial review by the U.S. Supreme Court were rejected.

See Below to Read Dr. Wilk’s Comments from an ICA Publication at the Time

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