Frederick Robert Carrick, D.C., Ph.D., is the Distinguished Post Graduate Professor of Clinical Neurology at Logan University and is Parker College of Chiropractic’s Professor Emeritus of Neurology. He serves as the President of the American Chiropractic Association’s Council on Neurology and is the President of the American Board of Chiropractic Specialties of the American Chiropractic Association. Professor Carrick is a 1979 graduate of the Canadian Memorial Chiropractic College and received a Doctor of Philosophy degree specialty in Brain Based Learning from Walden University’s Faculty of Education. He is the recipient of a multitude of professional, governmental and societal awards and the subject of the Emmy Award Winning Public Broadcasting Service series, Waking up the Brain. Dr. Carrick was recently honored with a Life Time Achievement Award in Contemporary Scientific Paradigms from Life University. He holds board certification in a variety of disciplines central to the neurosciences and has enjoyed an international reputation as a clinician and educator for twenty-eight years.
In an interview with The American Chiropractor (TAC), Dr. Carrick expresses some of the innovations that he has pioneered through his work.
TAC: Dr. Carrick, please tell our readers about some of the services and research that the Carrick Institute has been doing?
Carrick: The F. R. Carrick Institute for Clinical Ergonomics, Rehabilitation, and Applied Neuroscience (C.E.R.A.N.) of Leeds Metropolitan University consists of a faculty of world class scientists and clinical researchers in Biomedical Engineering and Rehabilitation, Experimental Psychology and Adult and Developmental Neuropsychology, Ergonomics and Human Factors, Cognitive Neuroscience, Linguistics, Developmental Neuroscience and research in Physical Therapy and Occupational Therapy. The participants have produced numerous patents and developments as well as translational research in fundamental biomedical technologies, including applications of high temperature superconductivity, imaging science, brain pacemakers, apnea monitoring, laparoscopy, pain management systems, neural nets, treatments for decubitus ulcer, drug delivery systems, non-invasive anesthesia, acoustic body parts identification, acoustic correlation transform, miniaturized MRI, and neurochemical modulation by weak magnetic fields. The Institute is affiliated with Winthrop-University Hospital in Mineola, New York. A doctoral program in Rehabilitation Sciences and in Clinical Rehabilitation Neuropsychology is offered by the F. R. Carrick Institute through the Faculty of Health of Leeds Metropolitan University.
The Carrick Institute for Graduate Studies conducts Graduate School Programs in Neurology in five languages and maintains thirty extension facilities throughout the world. Our program qualifies individuals for a professional Master of Neuroscience degree as well as fulfilling the requirements for the Board Certification Examination in Neurology by the American Chiropractic Neurology Board (ACNB). The ACNB was the first certification agency in chiropractic to achieve full accreditation through the National Commission for Certification Agencies (NCCA) of the National Organization for Competency Assurance (NOCA).
Our research investigations have resulted in many publications in the indexed scientific literature by our faculty and learners. We also have participated in numerous international congresses specific to neurology and rehabilitation. This year, I have been a co-author on two major publications involving Posturographic Changes and Motor Learning.1,2
We are publishing in the mainstream medical journals due to the impact factor of our investigations that represent our approach to brain function without drugs or surgery. Our acceptance and participation in major scientific congresses with platform presentations of our research have assisted us in our responsibility of sharing and service to others.
TAC: We understand that the Carrick Institute is also involved in humanitarian efforts. Could you tell us a bit more about them?
Carrick: Yes, the F. R. Carrick Clinics at the Meru District Hospital have been established to assist in serving the health care needs of the citizenry of Meru, Kenya. These people live in extreme poverty and suffer from devastating illnesses and diseases. Medicines are expensive and scarce in this area and the applications of neurological applications by chiropractors can assist in the diagnosis and treatment of many disorders without drugs or surgery. Chiropractic neurologists volunteer their time and pay their own expenses to work in our clinics. Their talents and dedication enable us to help people who truly are in need.
As well as our volunteer staffing, the Carrick Institute has coordinated the shipment of $500,000 worth of medicines and supplies to be distributed at our clinics this year. Microscopes, mosquito nets and other supplies are shipped directly to the F. R. Carrick Clinics at the Meru District Hospital. Our chiropractic neurologists work in concert with other health care providers. While the treatment of disorders of humankind without drugs or surgery is an option in developed countries, it is often a necessity in areas of the world where medicines are not available. Our interdisciplinary approach to health care and the dedication to service, above self, of our learners have allowed us to learn more about diseases not typically seen in our country and promotes the development of applications in a patient based paradigm of care.
TAC: How is the use of concepts in Functional Neurology different from what your average chiropractor is doing on a day in day out basis?
Carrick: Functional Neurology promotes an ability to understand the nervous system at a specialist level that compliments the role of the chiropractor and other health professionals specific to the nervous system of humankind. When we refer to function, we embrace not only the pathology in a system but those areas that are intact. A Functional Neurologist is trained to serve as a specialist consultant in the field of neurology. His/her examinations need to be more detailed than the general practitioner, and the treatment parameters are often different with a greater emphasis on multi-modal environmental stimulations including light, sound, temperature and rehabilitation. We find that many general practitioner chiropractors elect to train in neurology to enhance their skills and service to their community without a desire to become Board Certified.
Certainly, we attract chiropractors from very diverse backgrounds such that a neurological approach to patient care can be utilized to measure the consequence of a therapy. A functional neurological approach to patient care can allow the practitioner to know if his/her applications are in the best interest of a patient or if there is a need to do something different. By attending to a therapeutic approach addressing maximizing human neurological potential, we tend to embrace a different concept from those practitioners who have a pathology based practice.
TAC: Is this approach only taught to chiropractors?
Carrick: Our institute trains a variety of health professionals in functional neurology. Our programs are based upon neurophysiological principles that are true to all disciplines. In some locations, our participants are mostly medical doctors, whereas in others they might be mostly chiropractors and, oftentimes, a blend. Our training is not discipline specific but more specific to the diagnosis and treatment of neurological conditions without drugs or surgery. These types of treatments are being actively embraced by the global community subsequent to the needs of our public and growing concerns over the utilization of pharmaceuticals. Our methods of examination are standard in neurology and our learners are also trained to identify those conditions that are not best treated in these manners. Ours is a realistic program of education that prepares our clinicians to recommend the best mode of treatment in a paradigm that is patient based. The acceptance of our work by peer reviewed scientific committees for presentation at specialty congresses demonstrates an increased receptiveness of a functional neurological approach in health care.
TAC: Can you tell us about chiropractors and medical doctors studying together with the Carrick Institute?
Carrick: Our Institute provides instruction in a variety of areas central to the function of the human nervous system. The breadth and depth of material is central to all professions, whereas the applications that we provide are those that do not use drugs or surgery. There is a great demand from the public for the types of applications we provide.
While we do not teach medical doctors to adjust joints, we surely teach them the need for referral to a qualified chiropractor for certain conditions and vice versa. We attract learners from all disciplines because of the expertise of our faculty in sharing material which applies to all health care providers. We have very talented instructors and our programs have become very popular. For example, our program in Functional Brain Anatomy serves the needs of all disciplines and our program in this knowledge area is attended by both medical doctors and chiropractors. Our chiropractic learners’ level of knowledge is most impressive and they are on par with learners from other disciplines. In fact, it is most impressive when you observe a chiropractic neurologist on research rounds in the brain lab; they make us very proud.
TAC: What is it that motivates your activities with the Carrick Institute?
Carrick: We are motivated primarily by our service to humankind. We are an educational institution and our programs exist only due to the demands and needs of our learners to serve others. We are the largest provider of graduate school education in neurology to chiropractors and serve the clinical educational needs of a present learner enrollment of approximately 4,000 individuals. We have a responsibility to them and their patients to facilitate their learning of a difficult knowledge area. We have learned how to teach and how to inspire a mastery of a specialty through our attention to the breadth and depth of the subject material and by our direction to an application based outcome.
TAC: What are some of the obstacles you have had to overcome to arrive where you are?
Carrick: Our greatest obstacles have been our ability to serve the demand for our programs. We continue to have a greater demand than we can serve. We pride ourselves in attracting faculty who are skilled clinicians and talented educators. We only accept faculty that have the ability to teach and are considered top in their field. As a consequence, we find our programs very popular but we are limited in the number of programs we can maintain. We are able to maintain thirty programs throughout the world but, unfortunately, cannot serve the demands of all communities for our educational programs. We do not offer faculty appointments to individuals who are not best suited to clinical instruction and leadership. We have maintained a superior sharing and education but continue to face the obstacle of saying no to groups of doctors who desire our program in their area.
TAC: How are the attitudes toward this approach from other professionals you work with?
Carrick: We train our learners to be skilled professionals who speak the same language as others specific to the nervous system. Consequentially, we attract a diverse population of professionals as learners and our graduates are able to participate in a team approach to health care. Our candidates do well in multi-disciplinary scenarios. For example, at a recent symposium in Amsterdam on coma and vegetative states, our chiropractic learners sat side by side with medical neurologists and neurosurgeons who are also our learners. The level of understanding and fluency in mutual disciplines promoted a superior sharing which has benefited our global patient population. I am very proud of all of them; they work together and understand the skills and abilities of each other and, more so, they become more than colleagues, they become a global family of neuromates. So, I would suggest that the attitudes of those exposed to our programs and to our graduates is wonderful. Chiropractors refer to our chiropractic neurologists as do other practitioners and our specialists also refer to the general chiropractor and to their medical counterparts. Our graduates are well trained and contemporary in their knowledge base.
TAC: Can you tell us about Board Certification in neurology for chiropractors?
Carrick: Board Certification in neurology for chiropractors is through the American Chiropractic Neurology Board (ACNB). This autonomous agency is recognized by the American Chiropractic Association as the sole authority for credentialing in neurology for the chiropractic profession. The ACNB is fully accredited by the National Commission for Certification Agencies (NCCA) of the National Organization for Competency Assurance (NOCA). Chiropractors who have completed our program of study are eligible to take the written and practical portions of the examination. The standards of Board Certification have been elevated to the level of NOCA/NCCA and are designed to protect the public and assure all stake holders of the quality of the certification process.
TAC: What kind of conditions would have the best likely outcome when being treated with some of the concepts you teach?
Carrick: Customarily conditions involving human posture and gait including disorders of movement, such as dystonia, seem to have superior outcomes with the drugless approaches we utilize. Falls are the greatest cause of accidental death in almost all age groups and our approaches to fall prevention appear to be superior to any other modality. Learning and behavioral disorders show promise as do a variety of pain syndromes. A Functional Neurological approach to neurological syndromes may have a varied outcome, such that the individuality of the patient has a great deal to do with the consequence of treatment. Two individuals with the same syndrome might not have the same results; however, a neurological approach will enable the practitioner to know if the patient is not progressing or is getting worse so that a change can be directed.
TAC: How is it that you would interpret the vertebral subluxation complex, based upon your research?
Carrick: My research is brain based and not specific to a vertebral subluxation complex. I can tell you, however, that angulation of joints is a consequence of brain activity. An individual who has suffered a stroke with an angulation of his arm and leg has that posturing because of his brain situation. Quite simply, the joint angulation did not result in the brain pathology of the infarct; it represents a state of the nervous system that already exists. It is a window or marker of a pathological process. I would suggest that angulation of joints in the spine is similar and might act as an observable marker that something is wrong in the nervous system. Applications that are specific to brain function can change the angulation of joints due to their effects on soft tissue tensions, just as they might change what is referred to as a vertebral subluxation complex. I measure extensor tone and activity in spinal, trunk and appendicular muscles and observe changes with environmental stimuli of a variety of modalities, including chiropractic adjustments. It would appear, from a brain based perspective, that the subluxation reflects a functional view of the nervous system and exists as a result of the soft tissue tensions produced by segmental and super segmental neurological integration similar to other joint angulations. It does not appear to be the cause of syndromes but the consequence.
TAC: Is there any diagnostic or therapeutic equipment that you would recommend to the average chiropractor?
Carrick: Absolutely. The CAPS force plate by Vestibular Technologies provides data that allows the clinician to predict the probability of a fall. It is a computerized force plate that measures human stability and sway and gives a statistical report that does not have to be interpreted by the doctor.
Falls are the greatest cause of accidental death and most fallers have no signs or symptoms before a fall. In fact up to 70 percent of the population is at risk of falling and might be helped by those individuals who can identify their pathology. We recommend that the chiropractor not charge for the test, even though there are CPT codes for the procedure. Our rationale is simple. This testing is necessary and is a public service. If the test is free, then people will get the testing and pathology will be identified. If people have to pay for a test, the probability increases that they will not have it done. With 70 percent of the population having pathology of stability, we find that people who are in need of care will customarily choose the provider who gave them the test. The treatment of pathology of human stance and stability is by a drugless non surgical approach and is in the armamenterium of the chiropractor.
Both the doctor and patient have an outcome measurement in the post tests which will indicate an improvement or worsening or even no change, so that they both can understand the direction and consequence of their care. Since neither I nor any of our faculty or the Institute accepts any royalties or commissions for recommending a modality, we feel comfortable in talking about it. We also have several registered studies utilizing the technology.
TAC: Are you personally teaching the seminars currently?
Carrick: I rarely teach anymore, spending the majority of my time involved with brain research, although I do present papers at a variety of scientific meetings throughout the year. I will be the instructor for our Alpine Neurology Symposium in Zermatt, Switzerland, this coming April. We couple neurology with a ski week and our symposium is specific to human posture and movement disorders. We have participants from around the world who have registered to participate and it is difficult to say no to such meetings.
TAC: What is the biggest opportunity you see in the chiropractic profession today?
Carrick: Chiropractors are uniquely positioned to serve a greater percentage of the population due to advances in clinical procedures and outcome measures. Our society is embracing a more intimate relationship with our environment and demands for a drugless approach to health care are exploding. Our patients are better educated than ever before and demand a superior knowledge base from their health care providers. Those doctors who increase their knowledge base and skill levels will enjoy an opportunity that will facilitate the service of their practice. The neurological consequences of chiropractic care demand a superior knowledge of clinical neurophysiological applications. Chiropractors might consider higher education as the biggest opportunity they have if that education is specific to their job. I can think of no opportunity superior to the chiropractor than an increase in their clinical knowledge of the nervous system and the applications that they might use to evoke change. . Managed care has affected both patient and provider satisfaction and many providers are forced to obtain the skills which allow them to escape the boundaries of such management. A large majority of our learners are able to establish a reasonable fee for service and establish practices that allow them to escape the bonds of third party relationships. The demand for a Functional Neurological approach to health care exceeds the number of our specialists and promotes an opportunity for those doctors who desire to raise their knowledge levels and abilities to a higher level.
TAC: Where do you see the future of chiropractic headed?
Carrick: The role of all health care providers is changing. Chiropractors utilize a patient based paradigm that demands a higher level of training for the health care professional. Chiropractors are being directed to additional training beyond the DC degree because of the public interest. We have seen an explosion in the number of chiropractors who enroll in our Graduate School Programs in Clinical Neurology and we understand our role and responsibility in our training. We train chiropractors that have many years of experience in practice and they become better doctors. We train debutante practitioners and they are able to enter practice at a superior level. The future is very bright for those chiropractors that continue their education and obtain a superior level of mastery of their profession. The chiropractic profession is based upon a neurological approach and I see that we have little choice but to embrace it; our future is bright.
TAC: Any final words for our readers?
Carrick: We have trained chiropractors who are skilled in a variety of techniques and philosophies. Ours is not a program of technique but a process by which the doctor might be able to do his/her job in a superior fashion, regardless of their techniques. We have trained the majority of the technique gurus in chiropractic and, at the end of day, we find that we have been able to promote a mélange of so many talented people. Chiropractors who speak the same language and can communicate within and beyond our profession have skills which are better and their role as part of a global health care team is ensured. I have been blessed to have been associated with so many talented people in my life and I am very proud to have played a part in their training; they have taught me much.
You may contact Dr. Carrick at Carrick Institute for Graduate Studies, 203-8941 Lake Drive, Cape Canaveral, Florida 32920. Phone 1-321-868-6464; Fax 1-321-868-6468; or visit www.carrickinstitute.org.
1. Carrick FR, Oggero E, Pagnacco G, Brock JB, Arikan T. Posturographic testing and motor learning predictability in gymnasts. Disabil Rehabil. 2007 Dec 30;29(24):1881-9. Epub 2007 Feb 9. PMID: 17852265
2. Carrick FR, Oggero E, Pagnacco G. Posturographic changes associated with music listening. J Altern Complement Med. 2007 Jun;13(5):519-26. PMID: 17604555 [PubMed - indexed for MEDLINE]