Dear Don,

Thank you for asking me to comment on the Koren Specific Technique (KST) seminar scheduled for June 2/3, 2007 in Berlin. Apparently this has aroused old issues between the German Chiropractic Association (GCA) and the Heilpraktikers(Health Practitioner) profession (HP). I hope my work may lead to conciliation between both parties.I have offered to present KST to the GCA and would welcome their members.

You wrote to me concerned that I was teaching chiropractic to “unqualified” individuals in an “un-recognized school” which could harm both the profession and individual patients.

Such concerns must be addressed. I appreciate your desire to get at the facts and write a balanced, fair and accurate story on this issue. Below are the facts as I know them.

First I must emphasize that my overriding goal is to help people. When I am asked to speak/teach two questions must be answered in the affirmative: First, will this benefit patients/consumers and secondly, would there be no harm? If those conditions are met I will speak to anyone and any group that are in a position to help improve the welfare of the general public. I am open to receiving information that says this is not a case that fits my criteria but have yet to see any.

KST is low-force, gentle and easy on the patient and the practitioner. It requires no “cracking,” twisting, rolling or pulling; is highly specific (hence little force is needed) and therefore is considered safe to administer. .

  • Let us address the concerns you have indicated an interest in. It seems unnecessary for me to comment that I would never do something to harm chiropractic. Anyone who has followed my career knows that I do not avoid fights on behalf of chiropractic and the rights of chiropractic patients and practitioners. Let us begin.
  • Characterizing the Heilpraktiker profession as “lay practitioners” is not accurate.
  • The 30,000 Heilpraktikers or Health practitioners (HP) who practice in Germany are a legally recognized licensed profession. As part of their license they practice manipulation. In America they are perhaps more closely related to Osteopaths and Doctors of Naturopathy.
  • Most HPs undergo a rigorous and extensive medical training at private schools (approximately 3000 hours) and pass oral and written examinations through a governmental Public Health Office to receive licensure as a “Health Practitioner” (Heilpraktiker or HP). This examination is intensely rigorous and has a high failure rate.Iunderstand that many DCs trained in Americafail this exam.
  • Many HPs attendChiropractic seminars in the U.S. without any problem.
  • Under German health regulationschiropractic is considered a subset of HP. Mr. Schwarz of the Berlin school states: “This is the reason, why in Germany there will be no separate chiropractic license. All statements to the contrary from the GCA are wishful thinking.” In fact the members of GCA who practice chiropractic legally appear to do so under an HP license. German law permits only MDs and HPs to practice chiropractic legally.
  • This school accepts only licensed HPs for their studies.
  • There are about 80 million people in Germany with 60 DCs and 30,000 HPs, including various MDs who perform manipulations “Chirotherapists.”
  • The Heilpraktikersassociation says it is desirous of working with The GCA (German Chiropractic Association) but feels it was rebuffed. “We had initiated contact with the GCA a number of years ago. Our president and I met with 5 GCA representatives at the CologneAirport. We talked more then 3 hours. They had no interest in co-operation,” says Mr. Schwarz. I do not know the details but this sounds like it might be an opportunity for Chiropractic in Germany to make its points.

These facts make me comfortable in presenting my seminar in Germany particularly so in view of the WHO guidelines on basic training and safety in chiropractic.

See the report at

Of the 27 autonomous states in Europe 23 (including Germany) do not recognize Chiropractic as a separate profession. The WHO report refers to this situation. As a sovereign nation Germany regulates and licenses the healthcare practitioners in order to ensure the public/consumer safety for its own citizens. Every nation has its own unique standards and laws and the WHO respects these differences.

In countries where no regulatory legislation currently exists, there may be no educational, professional or legal framework governing the practice of chiropractic. The minimum educational requirements needed to encourage practitioners to register and to protect patients are outlined in this document. The recognition and implementation of these minimum requirements will depend on individual country situations.

My KST seminar in Berlinfits into the WHO guidelines as one part of a program organized under category 2.2 of the WHO guidelines (below).

Section 2 of the guidelines reads:

2. Acceptable levels of education and retraining

Summarizing various training programmes in different countries, these guidelines address two levels and four different settings for chiropractic education, each preparing health care practitioners to practise in the health care system as a chiropractor. These options are available to countries to meet their individual needs.

2.1 Category I ‐full chiropractic education

• for students with no prior health care education or experience

• as the supplementary education required for medical doctors or other appropriate health care professionals to acquire a recognized qualification as a chiropractor

2.2 Category II ‐limited chiropractic education

• A limited training programme for medical personnel and other appropriate health care professionals in countries or regions introducing chiropractic where no current legislation governing the practice exists; it does not lead to full qualification.

Such training should be conducted as a temporary measure to establish a provision of chiropractic and/or as the first stage in the development of a full chiropractic programme. Such a course is established as a minimum registerable requirement and courses of this type should be replaced by appropriate full‐time programmes as soon as it is practical to do so. Guidelines on basic training and safety in chiropractic 8

• The training required to attain a minimally acceptable level of competency for students who represent existing providers of chiropractic in countries or regions without regulations but intending to introduce legislation governing the practice of chiropractic.

This provision does not lead to a full qualification, but to a minimal registerable standard. Courses of this type are a temporary measure, and should be replaced by appropriate full‐time programmes as soon as it is practical to do so.

That is precisely what the Berlin school is doing:

  • In the Chiropractic School of Berlin German and International instructors teach Chiropractic technique. It presently has a curriculum of approximately 800 hours and is moving towards the WHO Standard Guidelines on basic training and safety in Chiropractic/Limited chiropractic education – category II (A) within the year.
  • According to Mr. Schwarz of the BerlinSchool, “The BDC (the largest Association for Professional German Chiropractors) is adapting on a “voluntary basis” their school of techniques (Chiropraktik Schule Berlin), at present with a curriculum of 1805 lessons according to the rules of the WHO.
  • “The BDC is also in preparation for a fulltime school with a training covering 4000 lessons with a four year curriculum. These 4 years cover the training for Heilpraktiker and Chiropractor at the same time and will follow the guiding rules of the WHO, beginning within 2008 / 2009.
  • “The guiding rules of the WHO are distinct. If we hold on to our planned project, we will strictly fulfil these rules. Whoever wants to, can verify this later.”
  • My seminar is considered a "post gradate seminar." The studentswill either be Heilpraktikers(HPs) or American and European trained DCs who may or may not also be HPs.It must also be stressed that I am not granting chiropractic degrees nor implying in any way thatby taking my seminar they are chiropractors.

I believe and I havebeen legally advised that my presenting my KST seminar at this school fits 2.2 of the WHO guideline and I am proud to be a part of raising the standard of education to qualified people.

Annex 4 of the WHO guidelines also addresses this issue.

Annex 4: A sample limited (conversion) programme

Category II(A) Suitable for persons with a solid medical education to attain minimalregisterable requirements to practise safely and relatively effectively as chiropractors.

Annex 4 category 2a includes many of the subjects HPs are tested in. DCs who have gone to qualified chiropractic schools in the USoften fail this test. The German health regulations allow MDs and HPs with proper training to do manipulations that fit as chiropractic under our laws. I feel obliged to comply with the legal structure in the foreign countries in which I present my KST information unless I am shown that doing so would be harmful to patients. So far I have seen no information that establishes that the German legal structure harms patients. This is particularly true in the situating of the Berlin school that attendees to my seminar will have passed the HP test.

SOT, AK and KST

Koren Specific Technique can best be described as a binary bio-feedback protocol which may be applied to chiropractic, dentistry, optometry, medicine, homeopathy, nutrition and other healthcare fields. All types of practitioners may apply its safe, gentle and accurate procedures to their respective disciplines and in accordance with the laws of their lands.

This is similar to how Sacro-Occipital Technique(SOT) and Applied Kinesiology (AK) methodsare used. SOT and AK, though discovered by DCs are taught to dentists, medical doctors, psychologists and other healthcare professionals. However that does not permit them to say they are chiropractors. Although KST is a technique DCs use it is not exclusive to chiropractic nor does using it qualify a person as a chiropractor, just as if someone uses SOT or AK it does not mean they are chiropractors.

With millions of people around the world living painful, dysfunctional subluxated lives we should work with those potential allies to teach chiropractic philosophy, science and art for the greater benefit of the consumer.

I am available to teach KST to anyone who has the interest to learn KST provided it will be in the benefit of the consumer and will not harm the consumer.

I hasten to add that the BerlinSchool is the only philosophical chiropractic school in Germany teaching chiropractic techniques. They are urgently seekingU.S. teachers to learn the philosophy of chiropractic. Ihave yet to hearany reason why American Chiropractorsshould avoid helping them.European (indeed all) consumers should have access to alternative care, especially safer, gentler and more accurate healthcare no matter what the discipline.

My chiropractic oath was a pledge to help humanity by freeing them of the onus of subluxations. DD Palmer’s graduates were charged “To heal and to teach.” I am working and teaching in the spirit of DD Palmer.

As BJ Palmer has written, “conflicts clarify.” I hope this exchange will help bring the parties involved closer, to cooperate in the spirit of helping the consumer.

Sincerely,

Tedd Koren, DC

WHO publication, Legal Status of Traditional Medicine and Complementary/Alternative Medicine: a Worldwide Review(2002) we find the following:

In 1992, the Federal German Ministry of Research and Technology initiated an

extensive research programme on complementary/alternative medicine coordinated

by the University of Written/Herdecke (172). Three-fourths of allopathic physicians use complementary/alternative medicine…. In Germany, there is no legal monopoly on the practice of medicine (172). Thus, licensed non-allopathic physicians may practice medicine, and all licensed medical practitioners are allowed to use complementary/alternative medicine.

Licensed Heilpraktikers (172) may practise medicine with the exclusion of [these] specific medical acts. To qualify for a Heilpraktiker’s licence…[the applicant must] pass an examination before a health commission proving that the candidate has sufficient knowledge and ability to practise as a Heilpraktiker and that the candidate’s treatments do not negatively affect public health. The exam verifies the candidate’s basic knowledge of anatomy, physiology, hygiene, pathology, sterilization, disinfecting, diagnosis, and health regulations, particularly the epidemic law…. According to a recent poll… 88% had from one to four years of training (172).Chiropractors must obtain a Heilpraktiker licence regardless of whether or not theyhave a degree from an accredited institution.

172. Maddalena S. The legal status of complementary medicines in Europe — a comparative analysis. Bern Stämpfli, 1999.