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OK. I have read it and you have been judged 
Of course, I wonder what makes you think I had not read it previously, never mind considered what it says.
In any case, here's my judgment, since you asked:
Chiropractors own The Chiropractic Adjustment and all the Subluxations that these so-called "Adjustments" supposedly correct. The Chiropractic Subluxation and "Thuh" Adjustment are what uniquely define "chiropractic" and that is what not only gives chiropractors their ownership of all these Subluxation/Adjustment pairs, but insists on it in any discussions of who should be doing what to whom and why --scope of practice, if you will.
Generic manipulative therapy -- a modality --is not owned by any profession in particular, but can be used by PTs, DOs, MDs and DCs. In other words, spinal manipulative therapy isn't "chiropractic" any more than Mennell, Maitland, and Fisk are chiropractors.
Even your statement about chiropractors making spinal manipulation its main form of treatment is debatable for the reasons stated above. Had you said, chiropractors use "Thuh" Adjustment to manage the Chiropractic Subluxations they diagnose, there would be no possibility of argument -- by definition.
Is that a rhetorical question or are you asking me to comment now? I can't answer for Drs Botnick and Mirtz about any of this but don't mind talking a bit about each of the the questions you posted. Let's take a look.
Currently, "chiropractic" is a free-for-all of chirodigms asserting all manner of Chiropractic Subluxation/Adjustment combos. Of course, that doesn't mean that every single licensed practitioner relies on one or more of these arbitrary diagnostic/treatment algorithms. But, according to chiropractors' own statistics published in the NBCE "Job Analysis of Chiropractic," there are enough ideas "out there," that in any given chiropractic line-up, you can't ever tell "which witch is which." Even those who might be considered "more medical" (notably, a concept unique to the chiropractic profession), they, too, get hopelessly lost in the fracas, becoming still another kind of chiropractor doing still another --"more medical"-- kind of "chiropractic." In this way, then, "chiropractic" must be considered an Alternative Medicine (tm) --similar to homeopathy and TCM. It's called "chiropractic," in case you hadn't noticed.
Now, consider the other side of this chiropractic coin -- "chiropractic" as a specific treatment for any given medical diagnosis such as glaucoma, hypertension, bicipital tendinitis, muscular dystrophy, or a boil, for example. While this is a more straightforward question to ask -- can "chiropractic" effectively manage hypercholesterolemia, let's say, compared to a statin --again there's no good answer, and for a similar reason. Which "chiropractic" are you referencing when you say "chiropractic?"
Of course, I wonder what makes you think I had not read it previously, never mind considered what it says. In any case, here's my judgment, since you asked:
Chiropractors own The Chiropractic Adjustment and all the Subluxations that these so-called "Adjustments" supposedly correct. The Chiropractic Subluxation and "Thuh" Adjustment are what uniquely define "chiropractic" and that is what not only gives chiropractors their ownership of all these Subluxation/Adjustment pairs, but insists on it in any discussions of who should be doing what to whom and why --scope of practice, if you will.
Generic manipulative therapy -- a modality --is not owned by any profession in particular, but can be used by PTs, DOs, MDs and DCs. In other words, spinal manipulative therapy isn't "chiropractic" any more than Mennell, Maitland, and Fisk are chiropractors.
Even your statement about chiropractors making spinal manipulation its main form of treatment is debatable for the reasons stated above. Had you said, chiropractors use "Thuh" Adjustment to manage the Chiropractic Subluxations they diagnose, there would be no possibility of argument -- by definition.
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Is that a rhetorical question or are you asking me to comment now? I can't answer for Drs Botnick and Mirtz about any of this but don't mind talking a bit about each of the the questions you posted. Let's take a look.
1. Is chiropractic really an alternative to medicine?The question needs to be more clearly stated before it can be answered. Did you (or the AHCPR, if you like) want to know if "chiropractic" is an Alternative Medicine™ -- OR --is "chiropractic" an alternative treatment for any given medical diagnosis? These are two separate balls of chiropractic wax.
Currently, "chiropractic" is a free-for-all of chirodigms asserting all manner of Chiropractic Subluxation/Adjustment combos. Of course, that doesn't mean that every single licensed practitioner relies on one or more of these arbitrary diagnostic/treatment algorithms. But, according to chiropractors' own statistics published in the NBCE "Job Analysis of Chiropractic," there are enough ideas "out there," that in any given chiropractic line-up, you can't ever tell "which witch is which." Even those who might be considered "more medical" (notably, a concept unique to the chiropractic profession), they, too, get hopelessly lost in the fracas, becoming still another kind of chiropractor doing still another --"more medical"-- kind of "chiropractic." In this way, then, "chiropractic" must be considered an Alternative Medicine (tm) --similar to homeopathy and TCM. It's called "chiropractic," in case you hadn't noticed.
Now, consider the other side of this chiropractic coin -- "chiropractic" as a specific treatment for any given medical diagnosis such as glaucoma, hypertension, bicipital tendinitis, muscular dystrophy, or a boil, for example. While this is a more straightforward question to ask -- can "chiropractic" effectively manage hypercholesterolemia, let's say, compared to a statin --again there's no good answer, and for a similar reason. Which "chiropractic" are you referencing when you say "chiropractic?"
It's a little like saying, "MEDICINE™ can lower cholesterol" without stating which particular treatment, from everything that's medical, has been demonstrated to lower it. "Chiropractic" is like having a pharmacy with only one medicine on the shelves --but with many different colors and shapes of pills, all indicated for, and presumably equally effective for the same thing. Just take two chiropractors and call me in the morning.
It's possible, I imagine, for you to comb the literature and find some specific studies that suggest spinal manipulative therapy (SMT) is sometimes helpful for some people some of the time for some named diagnosis. But then, recall that SMT isn't "chiropractic" anymore than Mennell, Fisk, and Maitland are chiropractors. An endorsement of SMT for a named condition only means that it is a treatment option --not an entire profession as chiropractors would like to believe. SMT isn't an Alternative Medicine but "chiropractic" is -- at least until it can be defined consistently from one chiropractor to another and as something more specific than: "Anything done by a chiropractor."
2. Is there a complementary role that includes collaborative care?
Do you mean a complementary role for Activator, NUCCA, Thompson, Chiropractic BioPhysics, Motion Palpation, Gonstead, SOT, Toftness, AK, and Pierce-Stillwagon practitioners, let's say, to treat ... *burp* ... "whut" 
What's Collaborative Care™, anyways, without a diagnosis and a statement of what therapy you're using, what OTHER "collaborative" therapy is being used with it, and who you're collaborating with. Yes, I can see a chiropractor collaborating with another practitioner -- an acupuncturist or a homeopath, for example-- although I think "colluding" would be a more appropriate term, if you know what I mean.
Again, if you (or the AHCPR, if you prefer) are referencing some sort of manual medicine as part of the management, let's say, of a peripheral neuropathy in a diabetic -- I wouldn't consult the Yellow Pages for a chiropractor. Would you? It's a crap shoot once you open the door to the Chiropractic Byzantium even for management of a headache. That's what we're talking about, in case you hadn't noticed. Collaborations can only occur when collaborators are on the same medical or non-medical page. This is more likely to occur with a PT, DO, or another MD. Even the few DCs who do "collaborate" often aren't really "collaborating" --in the so-called "multidisciplinary setting," let's say. Too often, the only thing the massage therapist and/or DC have in common with the MD is the secretary who coordinates the patient billing.
I wouldn't call what PTs do a "collaboration," either. An MD might refer to one, even within the same office, for a course of some sort of physical therapy. In a similar fashion, I suppose an MD might refer a patient for a trial of Chiropractic Care (tm). But, how would they do this without knowing which "chiropractic" their patient was going to get? In other words, is the patient going to get a trial of SMT or "chiropractic" if they are referred to an Activator office, let's say.
It's a jungle out there in Chiroville. Until this is resolved completely --there's hardly much more that can be said about "working" together and/or "collaborating" --except for a DC here and there, perhaps. And, what can be done about this, really, except to put padlocks on most every chiropractic school door. If you do this, however, what are you going to tell Dr. Blum and his organization of SOT adherents? What is SOTO-USA going to tell you? What are the Gonsteaders going to do with their neurocalometers and rolling X-ray markers? And what is the Upper Cervicalist, who has put all their\ chiropractic eggs into a monobonal basket, suppose to tell their patients -- that they were only kidding?
You see the problem.
I think, in a society with limited health care resources, chiropractors should take responsibility for their mess, give-up the chiropractic ghost, and gracefully bow-out of the race. If people want to see a chiropractor, homeopath, acupuncturist, colonic therapist, or psychic healer -- this should remain their business, but not mine. Enthusiasts can pay out of pocket like they would for any other form of entertainment.
If a trial of manipulative therapy in a particular patient is warranted, have it done by a trained physical therapist. The argument we hear from chiropractors that PTs don't have enough training is easily remediable -- considerably easier and more "down-hill" compared to cleaning a chiropractic house, in case you hadn't noticed. For one reason after another, chiropractors apparently don't have what it takes to heal themselves. For one thing, they can't imagine that they're ill in any way. "Sure we've got problems; every profession has problems" is as close as I've observed chiropractors ever get to house-cleaning.
What's Collaborative Care™, anyways, without a diagnosis and a statement of what therapy you're using, what OTHER "collaborative" therapy is being used with it, and who you're collaborating with. Yes, I can see a chiropractor collaborating with another practitioner -- an acupuncturist or a homeopath, for example-- although I think "colluding" would be a more appropriate term, if you know what I mean.Again, if you (or the AHCPR, if you prefer) are referencing some sort of manual medicine as part of the management, let's say, of a peripheral neuropathy in a diabetic -- I wouldn't consult the Yellow Pages for a chiropractor. Would you? It's a crap shoot once you open the door to the Chiropractic Byzantium even for management of a headache. That's what we're talking about, in case you hadn't noticed. Collaborations can only occur when collaborators are on the same medical or non-medical page. This is more likely to occur with a PT, DO, or another MD. Even the few DCs who do "collaborate" often aren't really "collaborating" --in the so-called "multidisciplinary setting," let's say. Too often, the only thing the massage therapist and/or DC have in common with the MD is the secretary who coordinates the patient billing.
I wouldn't call what PTs do a "collaboration," either. An MD might refer to one, even within the same office, for a course of some sort of physical therapy. In a similar fashion, I suppose an MD might refer a patient for a trial of Chiropractic Care (tm). But, how would they do this without knowing which "chiropractic" their patient was going to get? In other words, is the patient going to get a trial of SMT or "chiropractic" if they are referred to an Activator office, let's say.
It's a jungle out there in Chiroville. Until this is resolved completely --there's hardly much more that can be said about "working" together and/or "collaborating" --except for a DC here and there, perhaps. And, what can be done about this, really, except to put padlocks on most every chiropractic school door. If you do this, however, what are you going to tell Dr. Blum and his organization of SOT adherents? What is SOTO-USA going to tell you? What are the Gonsteaders going to do with their neurocalometers and rolling X-ray markers? And what is the Upper Cervicalist, who has put all their\ chiropractic eggs into a monobonal basket, suppose to tell their patients -- that they were only kidding?
You see the problem.
3. Should chiropractic remain a separate and distinct profession or seek inclusion into medicine as a subspecialty in musculoskeletal conditions?What musculoskeletal conditions and what subspecialty of medicine are we talking about -- a new "subspecialty" called "chiropractic?"
I think, in a society with limited health care resources, chiropractors should take responsibility for their mess, give-up the chiropractic ghost, and gracefully bow-out of the race. If people want to see a chiropractor, homeopath, acupuncturist, colonic therapist, or psychic healer -- this should remain their business, but not mine. Enthusiasts can pay out of pocket like they would for any other form of entertainment.
If a trial of manipulative therapy in a particular patient is warranted, have it done by a trained physical therapist. The argument we hear from chiropractors that PTs don't have enough training is easily remediable -- considerably easier and more "down-hill" compared to cleaning a chiropractic house, in case you hadn't noticed. For one reason after another, chiropractors apparently don't have what it takes to heal themselves. For one thing, they can't imagine that they're ill in any way. "Sure we've got problems; every profession has problems" is as close as I've observed chiropractors ever get to house-cleaning.
4. Should chiropractic education seek affiliation with major universities and colleges housing medical education?
If you've read this far, I think you'll understand --but maybe not agree-- why I would think this is a bad idea. For one thing, it assumes "a chiropractic" that has yet, despite all the inertia and infrastructure that's in place, to establish itself in any consistent and credible way. Have you noticed? It's that "free-for-all" thing again. So, at the very least, it would be a waste of a society's already limited resources, in my opinion.
Since its inception, chiropractic oobleck has been finding its way through every crack it can find in the health care woodwork. Some of this is just the mindless automatism of the chiropractic organism finding new and better ways to adapt and survive. Affiliating with universities, medical schools, and hospitals seems to represent such an effort. I guess the idea would be to get close to medical science and medicine as a way of legitimizing a profession with a history of anything "butt."
A chiropractor can say, "That's me standing next to a medical doctor" --the hope being that the critical association will be made. And, I suppose there's some idea that since chiropractors can't take responsibility for what takes place at most every one of their own pantheons of chiropractism, they might imagine that these chiropractic ding-dong schools will at some point fall off their chiropractic body like so much dead skin.
In short, I think this sort of chiropractic maneuvering is poorly motivated, self-serving, and
neurotically driven.
~TEO.
John Badanes, DC, PharmD
(LCCW '84, UCSF '97)
Since its inception, chiropractic oobleck has been finding its way through every crack it can find in the health care woodwork. Some of this is just the mindless automatism of the chiropractic organism finding new and better ways to adapt and survive. Affiliating with universities, medical schools, and hospitals seems to represent such an effort. I guess the idea would be to get close to medical science and medicine as a way of legitimizing a profession with a history of anything "butt."
A chiropractor can say, "That's me standing next to a medical doctor" --the hope being that the critical association will be made. And, I suppose there's some idea that since chiropractors can't take responsibility for what takes place at most every one of their own pantheons of chiropractism, they might imagine that these chiropractic ding-dong schools will at some point fall off their chiropractic body like so much dead skin.
In short, I think this sort of chiropractic maneuvering is poorly motivated, self-serving, and
neurotically driven.
~TEO.
John Badanes, DC, PharmD
(LCCW '84, UCSF '97)