Sociological Studies of the Role of the Chiropractor

An Exercise in Ideological Hegemony?

Published In: Journal of Manipulative and Physiological Therapeutics, v. 14, no. 1, Jan 1991, p. 51-58

Posted on on January 01, 1991

by Ian D. Coulter

This article presents a critique of the concept of marginal role as applied to chiropractors by examining the area of structural role theory from which the concept has been drawn. It suggests that the concept role was itself a reified concept and that its metaphorical extension to cover chiropractors constitutes a double jeopardy for health scientists. However, since all concepts are initially metaphorical ones, a methodology is required for distinguishing illegitimate from legitimate usage of metaphors, and reified from nonreified metaphors. Such a methodology establishes that: the metaphorical basis of the concepts has been lost; Researchers are using the concept role in realist terms; the metaphor has a related set of assumptions that are undefended and unexplained by role theorists and that have therefore gone underground; and the metaphor leaves out (suppresses) readily available evidence about the individual and society (i.e., is ideological in motive). Further, the article relates this process of theoretical reification to the broader social process of reification. It suggests that a sociology that proceeds in this way contributes significantly to the process of ideological hegemony, and in this instance, to medical dominance.

This report is part of the RAND Corporation External publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

Our mission to help improve policy and decisionmaking through research and analysis is enabled through our core values of quality and objectivity and our unwavering commitment to the highest level of integrity and ethical behavior. To help ensure our research and analysis are rigorous, objective, and nonpartisan, we subject our research publications to a robust and exacting quality-assurance process; avoid both the appearance and reality of financial and other conflicts of interest through staff training, project screening, and a policy of mandatory disclosure; and pursue transparency in our research engagements through our commitment to the open publication of our research findings and recommendations, disclosure of the source of funding of published research, and policies to ensure intellectual independence. For more information, visit

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.