Dept. of Education to Council on Chiropractic Education: “Straighten Up!”

When most people think about the U.S. Department of Education, they picture student loans, Pell Grants, and a mountain of paperwork. They don’t usually imagine federal officials essentially telling a specialized accrediting agency, “Get your act together or lose your status.” Yet that’s exactly what happened when the Department of Education reviewed the Council on Chiropractic Education (CCE) the organization that decides whether U.S. chiropractic schools are “good enough” to qualify their students for federal financial aid.

Science-Based Medicine took a close look at this showdown and translated the bureaucratic drama into plain language: the Department wasn’t thrilled with how CCE was overseeing chiropractic schools, and it delivered something very close to a formal “straighten up” order. The case is a great example of how accreditation, politics, professional infighting, and science (or the lack of it) collide.

In this article, we’ll unpack what happened, why the CCE ended up in hot water, what it means for chiropractic education, and why Science-Based Medicine argues that accreditation must be tightly linked to scientific standards not just professional tradition or popularity.

Who (and What) Is the Council on Chiropractic Education?

The Council on Chiropractic Education is a private, non-profit accrediting agency founded in the early 1970s specifically to oversee chiropractic education programs. It accredits Doctor of Chiropractic (DC) programs and some chiropractic residency programs in the United States and certain other jurisdictions. Recognition by the U.S. Department of Education and the Council for Higher Education Accreditation (CHEA) gives CCE a powerful gatekeeping role: if your chiropractic school isn’t accredited by CCE, its students are typically not eligible for federal student aid, and many states won’t accept its degree for licensure.

In plain terms, CCE is the “quality stamp” that makes a chiropractic college financially viable. Without that stamp, schools lose access to federally backed loans and risk being shut out of licensure pipelines. That’s why the Department of Education’s recognition of CCE matters so much it doesn’t just affect a few bureaucrats in Washington; it affects every chiropractic student, every chiropractic college, and ultimately, patients who see chiropractors in the clinic.

How Federal Recognition of Accreditors Works

The Department of Education doesn’t accredit colleges directly. Instead, it recognizes accrediting agencies like CCE that do the day-to-day review of schools. To maintain recognition, an accrediting agency has to follow federal law (notably 20 U.S.C. § 1099b) and detailed regulations in the Code of Federal Regulations. These rules require agencies to:

• Apply their standards consistently and evenhandedly.
• Have transparent and fair procedures for evaluation and appeals.
• Investigate and resolve student complaints.
• Review the reliability of how institutions assign credit hours.
• Manage conflicts of interest so that decisions aren’t captured by insiders.

Periodically, the Department reviews whether an accrediting agency is still meeting these criteria. A staff analysis is prepared and then taken to the National Advisory Committee on Institutional Quality and Integrity (NACIQI), a federal advisory body that holds public meetings, hears testimony, and makes recommendations. Based on this process, the Secretary of Education decides whether to continue, limit, or withdraw recognition.

For most agencies, this is a fairly routine process. For the CCE, it turned into a public, somewhat messy reckoning.

Why the Department Told CCE to “Straighten Up”

When CCE came up for its periodic review, Department of Education staff didn’t just find a few minor paperwork problems. They concluded that CCE was out of compliance with dozens of federal recognition criteria. Their analysis flagged problems in areas you’d expect any serious accreditor to take very seriously: conflict-of-interest policies, documentation and record keeping, how student complaints were handled, and the thoroughness of on-site reviews of chiropractic programs.

One glaring gap involved credit hours. The Department requires accreditors to evaluate whether institutions’ credit hour assignments are reliable and consistent with widely accepted norms in higher education. That’s not just red tape; credit hours are tied directly to tuition, financial aid, and how much instruction students actually receive. Failing to evaluate credit hours means you don’t really know what kind of educational value students are getting in exchange for federal loan dollars.

The Department’s staff report painted a picture of an accrediting body that, at least in certain key areas, wasn’t doing the kind of rigorous, transparent evaluation that taxpayers and students should expect. NACIQI agreed and voted unanimously to accept the staff’s findings and push CCE to fix its deficiencies within a year.

The Subluxation Showdown Inside Chiropractic

While the Department’s formal concerns were about process and compliance, the review became a lightning rod for a more philosophical battle within chiropractic itself a fight over subluxation and what chiropractic students should actually be taught.

In traditional chiropractic, “vertebral subluxation” is a central idea: a supposed misalignment of the spine that disrupts nervous system function and, in theory, causes a wide range of health problems. The problem? This broad, quasi-mystical version of subluxation hasn’t been shown to exist in a scientifically meaningful way. It’s an article of professional faith, not a well-supported medical concept.

Over time, some chiropractors have tried to distance themselves from this idea, focusing instead on more modest claims about musculoskeletal pain relief, spinal manipulation as a manual therapy, and integration with mainstream health care. Others often called “straights” have doubled down on subluxation as the core of chiropractic identity.

When CCE updated its accreditation standards, critics from the “straight” side accused it of downplaying or removing subluxation from the curriculum. They warned that students might not be required to learn how to detect and correct subluxations, which they viewed as an existential threat to “real” chiropractic. Meanwhile, science-based critics pointed out that however the term was moved or rephrased, requiring students to identify and treat a poorly defined, unproven entity was not compatible with modern, evidence-based education.

The Department’s staff ultimately sidestepped the subluxation question. They treated it as a professional dispute within chiropractic essentially saying, “We don’t dictate curricular content; we only enforce process and compliance with federal recognition criteria.” That might make sense from a regulatory perspective, but from a science-based viewpoint it left a huge elephant in the room: if an accrediting agency accepts pseudoscientific content as part of its standards, should it be recognized at all?

Provisional Recognition: Not Quite the Victory It Sounded Like

After reviewing the staff report and public comments (thousands of them, most critical of CCE), NACIQI recommended continuing CCE’s recognition but only on a provisional basis and only for a short time. The message was clear: fix your problems or risk losing your status.

The Department’s final decision followed that recommendation. CCE’s recognition was continued, but it was given a strict deadline to come into full compliance and submit evidence that it had corrected the deficiencies. Failure to comply could lead to loss of recognition, which would be catastrophic for chiropractic schools dependent on federal student aid.

Yet CCE’s public messaging to the profession sounded much rosier. Summaries circulated in the chiropractic world emphasized that recognition had been “renewed” technically true, but omitting the uncomfortable part about being on a short leash with a long to-do list. Science-Based Medicine pointed out this selective reporting and argued that it was misleading at best.

Beyond Paperwork: The Real-World Stakes of Accreditation

It’s tempting to view the entire episode as bureaucrats arguing over checklists, but the stakes are real and substantial:

• Students: Prospective chiropractic students often assume that accreditation equals quality and scientific legitimacy. If the accreditor itself tolerates weak or pseudoscientific standards, students can spend years and tens of thousands of dollars on a degree that doesn’t deliver the kind of evidence-based training patients expect from health professionals.
• Taxpayers: Federal student loans are public money. When they flow into programs that teach scientifically questionable or discredited concepts, we’re effectively subsidizing misinformation and low-value care.
• Patients: Chiropractors are direct-access providers. Patients may seek them out for back pain or for asthma, colic, or other conditions that lack solid evidence for chiropractic treatment. The content of chiropractic education influences what chiropractors recommend in the exam room.
• Higher Education: When a specialized accreditor is perceived as too cozy with the profession it oversees, it undermines confidence in accreditation as a whole, especially when academic journalists highlight issues like high administrator salaries, nepotism, and weak oversight in chiropractic colleges.

Science-Based Medicine’s bottom line is blunt: if an accrediting agency won’t insist on science-based education for health professionals, the Department of Education shouldn’t recognize it. No recognition means no federally backed loans; without that money, schools that rely on pseudoscience would be forced to reform or close.

Did CCE Actually Straighten Up?

After the “straighten up” moment, CCE did make changes and has continued to be recognized by both the Department of Education and CHEA. Subsequent reviews and public documents describe more detailed policies, explicit standards, and continued oversight of chiropractic programs.

From the profession’s side, CCE has emphasized outcomes-based accreditation and alignment with broader quality-assurance norms in higher education. It points to its recognition by major oversight bodies and membership in specialized accreditors’ associations as evidence that it operates like other professional accreditors.

From the science-based side, though, the fundamental critique hasn’t disappeared. You can improve your conflict-of-interest policies and complaint procedures and still allow scientifically shaky concepts like poorly defined “subluxations” with sweeping health claims to remain embedded in the core of the curriculum. Procedural reforms matter, but they don’t magically turn pseudoscience into science.

What Science-Based Medicine Wants from Accreditors

Science-Based Medicine isn’t arguing that chiropractic education must look exactly like medical school. Instead, it’s calling for a minimum standard that any health profession should meet:

• Teach anatomy, physiology, and pathology in line with current scientific understanding.
• Base clinical claims on high-quality evidence, not tradition or marketing.
• Be honest about where evidence is weak, conflicting, or absent.
• Drop supernatural or speculative concepts masquerading as “biomechanics.”
• Prepare graduates to work ethically within the broader healthcare system, not in a parallel universe built on unfalsifiable ideas.

Accreditation is one of the few real levers the public has to insist on these standards. If agencies like CCE are willing to align chiropractic education with modern evidence, recognition is appropriate. If they’re not, the Department of Education’s message should be less “straighten up” and more “we’re done here.”

Practical Takeaways for Students, Patients, and Policymakers

For prospective chiropractic students

Don’t assume that accreditation automatically means a program is strongly evidence-based. Before enrolling, look at course descriptions, faculty backgrounds, and how the school talks about subluxation and the scope of chiropractic practice. Are claims grounded in clinical trials and guidelines or in vague promises about “aligning the spine to restore innate intelligence”?

For patients

If you see a chiropractor, be skeptical of broad claims that spinal adjustments can treat systemic diseases, boost immunity, or replace vaccines and conventional medical care. Chiropractors who focus on musculoskeletal pain, work collaboratively with physicians, and respect established medical science are operating closer to the science-based end of the spectrum.

For policymakers and regulators

The CCE episode is a reminder that recognition of accreditors must be more than a rubber stamp. When an accrediting agency oversees education for health professionals, its standards directly affect patient safety and public spending. Requiring genuine science-based content isn’t “meddling” in professional autonomy it’s basic consumer protection.

Reflections and Experiences Around “Straighten Up!”

While the Department of Education–CCE saga is mostly documented in official letters and meeting minutes, the issues it raises show up in everyday experiences of students, educators, and patients. Consider a few illustrative scenarios that echo themes from this controversy.

Imagine a college junior who’s fascinated by musculoskeletal anatomy and helping people with pain. She’s looking at chiropractic schools because the marketing promises a “doctorate” in just a few years and a path to being a primary care provider. The brochures emphasize holistic care, natural treatments, and independence from “big medicine.” What they don’t emphasize is how much of the curriculum rests on concepts that aren’t well-supported by modern science, or how contentious the profession’s internal debates really are. Without a critical eye and without strong, science-based accreditation standards she may not realize the gap between the image sold to applicants and the reality of the education she’ll receive.

Now picture a faculty member at a mainstream university who serves on an institutional accreditation committee. When she reads about CCE being cited for failing to adequately review credit hours or handle complaints, she’s stunned; those are Accreditation 101 issues. At her institution, those topics trigger intense internal audits and detailed reporting. Seeing a specialized health-profession accreditor fall short in these areas raises uncomfortable questions: if the process is this loose, how secure can we be about the substance of the education being delivered?

Patients encounter the downstream effects in subtle ways. A middle-aged office worker walks into a chiropractic office for low back pain. One chiropractor gives him a straightforward conversation: there’s decent evidence that spinal manipulation can help with some kinds of acute back pain, here are the risks and benefits, and if things don’t improve or red-flag symptoms appear, he should see his primary care doctor for imaging or further evaluation. Another chiropractor, trained under a more subluxation-centered model, might frame every complaint back pain, headaches, or even allergies as a sign that his spine needs lifelong “maintenance adjustments.” The difference isn’t just individual style; it’s rooted in what was taught, emphasized, and validated in school.

Policymakers feel the ripple effects too. When journalists highlight that presidents of some chiropractic colleges are earning salaries comparable to leaders of elite research universities despite much smaller budgets and weaker evidence bases, legislators start to ask what exactly taxpayers are getting in return for subsidizing those institutions through federal loans. The Department of Education’s provisional warning to CCE becomes part of a larger conversation about value, accountability, and whether accreditation is doing its job in weeding out low-quality or pseudoscientific programs.

Even within chiropractic, the “straighten up” moment has become a quiet reference point. Reform-minded chiropractors who want their profession to be fully integrated into evidence-based healthcare see the Department’s scrutiny as validation of their concerns. They argue that strong, science-focused accreditation protects the future of chiropractic by pushing schools away from untestable dogma and toward demonstrable clinical value. Their more traditional colleagues, by contrast, may view federal oversight as an existential threat to chiropractic identity, fearing that if subluxation fully disappears from the curriculum, chiropractic becomes “just spinal physical therapy with a different name.”

These experiences hypothetical but closely aligned with real-world patterns highlight why the Department of Education’s message to CCE resonated far beyond a single review cycle. “Straighten up” wasn’t only about paperwork or meeting deadlines. It was a reminder that accrediting agencies sit at the crossroads of science, education, and public trust. When those agencies oversee health professions, the responsibility is even greater: to ensure that what’s taught in the classroom and clinic lab is not just traditional or profitable, but actually consistent with the best available evidence.

Whether chiropractic education fully embraces that standard remains an open question. But the Science-Based Medicine perspective is clear: accreditation should be a tool for nudging professions toward scientific rigor, not a shield that protects outdated ideas from scrutiny.

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