George McAndrews

A patent lawyer from Iowa

George McAndrews spent his career in patent litigation and took the chiropractic case because his father was a chiropractor

McAndrews was born on July 29, 1935 in Clinton, Iowa. He was the fifth of seven children of Patrick McAndrews, DC, and Ruth Pellegrin McAndrews. His father had chosen chiropractic after chiropractic care improved his own asthma. The children grew up watching him ridiculed for it. His brother Tom told the Chicago Sun-Times in 2023 that medical doctors in the town warned patients away from chiropractors as quacks. The children heard the same thing at school.

Clinton, Iowa, and a father who was called a quack

The ridicule is the documented reason McAndrews took the case three decades later. Every account of his decision, from the peer-reviewed history to his own obituary, traces it to his father. He was a patent trial attorney by training and by preference, with no interest in health care litigation. Chiropractic was the exception, and it was the family exception.

Notre Dame, the Navy, and Operation Redwing

McAndrews graduated at the top of his class at Saint Mary's High School in Clinton and captained its basketball team to the 1953 Iowa state championship as a 6 foot 3 center. He entered the University of Notre Dame, then broke off his undergraduate studies for a two-year enlistment in the Navy with his brother Tom. The brothers served during Operation Redwing, a series of 17 nuclear detonations at the Enewetak and Bikini atolls, and were later designated Atomic Veterans. He returned to Notre Dame and took a mechanical engineering degree with honors.

Notre Dame Law and a Seventh Circuit clerkship

McAndrews entered Notre Dame Law School and served as editor in chief of the Notre Dame Law Review and chairman of the National Council of Law Review Editors. He graduated in 1962. He then clerked for two years at the United States Court of Appeals for the Seventh Circuit, the court that would hear the chiropractic appeals twenty years later. He went into patent trial practice in Chicago and stayed in it for fifty-five years.

Two brothers, one profession

Two McAndrews brothers shaped chiropractic, and only one of them was a chiropractor

The name causes confusion in the profession's records, so the distinction is worth stating flatly. George P. McAndrews, JD, was a lawyer and never a chiropractor. His brother Jerome F. McAndrews, DC, was a chiropractor and never a lawyer. They worked the same problem from opposite sides for decades.

Jerome McAndrews brought the case to his brother

Jerome McAndrews served as executive director of the International Chiropractors Association. In 1975, after extended conversations with him, George agreed to take the antitrust case. Howard Wolinsky, the former Sun-Times reporter who interviewed McAndrews at length, recorded Jerome's version of the argument that settled it. If George did not stand up for the profession, their late father would crawl out of the grave and haunt him.

The rest of the family

Chiropractic ran through the household. Patrick McAndrews, the father, practiced in Clinton. Jerome practiced and led the ICA. A sister, Virginia Clark, DC, practiced as well. One of George's own daughters became a chiropractor. The American Chiropractic Association counted a father, two siblings, one daughter and several other relatives in the profession when it wrote his memorial in 2023.

What he had to prove

The AMA formed a Committee on Quackery in 1963, and McAndrews had to prove its purpose from the AMA's own files

The conduct McAndrews litigated is set out in the court's findings. In 1963 the AMA hired as its general counsel the author of the Iowa Medical Society plan to contain chiropractic in Iowa. By September 1963 the AMA's objective was the complete elimination of the chiropractic profession. In November 1963 the AMA authorized the formation of the Committee on Quackery under its Department of Investigation. By 1964 the committee's primary goal was to contain and eliminate chiropractic.

Principle 3 turned an ethics code into a refusal to deal

The instrument was Principle 3 of the AMA's Principles of Medical Ethics. It read that a physician should practice a method of healing founded on a scientific basis, and should not voluntarily professionally associate with anyone who violates that principle. In 1966 the AMA House of Delegates passed a resolution calling chiropractic an unscientific cult. In 1967 the AMA Judicial Council issued an opinion under Principle 3 holding that professional association with chiropractors was unethical. The circle closed with no enforcement required.

What the boycott shut

The court set out the purpose in the injunction order. The AMA set out to stop medical physicians referring patients to chiropractors and accepting referrals from them. It set out to keep chiropractors out of hospital diagnostic services and off hospital medical staffs. It set out to stop physicians teaching at chiropractic colleges or joining chiropractic research. It set out to prevent any cooperation between the two groups in delivering care. Four channels, closed at once.

The witness the court did not believe

H. Doyl Taylor chaired the AMA's Department of Investigation and described the committee's prime mission through the 1960s and early 1970s as the containment and elimination of chiropractic as a recognized health service. At trial he denied it. The court recorded that it found his video deposition denials and his explanation incredible and unworthy of belief. That finding is the kind of result that comes from document work, and document work is what a patent litigator does.

October 12, 1976

McAndrews took the case in 1975 after larger firms refused it, and the complaint was filed on October 12, 1976

Wolinsky recorded that top law firms wanted nothing to do with suing the AMA in antitrust. McAndrews took it. The complaint was filed on October 12, 1976 in the United States District Court for the Northern District of Illinois. It was docketed as case number 76 C 3777 and charged violations of Sections 1 and 2 of the Sherman Act.

Five chiropractors filed and four finished

The plaintiffs at filing were Chester A. Wilk, Patricia B. Arthur, James W. Bryden, Steven G. Lumsden and Michael D. Pedigo. Lumsden later withdrew for personal reasons. The four who remained through both trials were Wilk, Arthur, Bryden and Pedigo, and those are the four named in the reported opinion. Sixteen defendants were named at the start, among them the AMA, the American Hospital Association, the American College of Surgeons and the Joint Commission on Accreditation of Hospitals.

Why an antitrust theory and not a defamation theory

McAndrews framed the case as commerce rather than as medicine. Section 1 of the Sherman Act makes every contract, combination or conspiracy in restraint of trade illegal. Framed that way, the question before the court was whether an ethics rule suppressed competition, and the AMA's internal memoranda became the evidence. A defamation theory would have put chiropractic theory on trial. The antitrust theory put the AMA's conduct on trial instead.

The line his father gave him in 1940

McAndrews traced his career to a single moment. He was five years old in 1940, and his father was listening to war news on the radio. His father turned to him and said that kings and queens and presidents do not run the world, and named lawyers as the ones who do. McAndrews repeated the story for the rest of his life.

The first trial

The first trial ended in a defense verdict in 1981, and McAndrews won a new trial on appeal

The case was tried to a jury before Judge Nicholas J. Bua beginning on December 9, 1980. The jury returned a verdict for the defendants. Johnson and Green record Judge Bua's assessment of the plaintiffs' opening statement in their 2021 history of the case. He called it the finest opening statement he had heard in his entire career. It still lost.

What the Seventh Circuit held in 1983

McAndrews appealed and won. In Wilk v. AMA, 719 F.2d 207, decided in 1983, the Seventh Circuit reversed the judgment and remanded for a new trial. The court held that the legality of the defendants' conduct had to be judged under the rule of reason rather than treated as a per se violation. It also held that a professional association can be found party to an illegal refusal to deal even without coercive enforcement of its guidelines, because professionals comply with ethical opinions to avoid discrediting themselves.

The patient care defense the appeal created

The same 1983 opinion built the defense the AMA would have to establish on retrial. The defendants had to show four things. First, that they genuinely held a concern for scientific method in the care of their own patients. Second, that the concern was objectively reasonable. Third, that it was the dominant motivating factor behind Principle 3 and the conduct implementing it. Fourth, that it could not have been satisfied in a way less restrictive of competition. McAndrews had to defeat one of the four.

The cost of staying in

McAndrews carried the case at personal cost for more than a decade against a defense many times his size

Paul E. Slater of Sperling, Slater and Spitz served as co-counsel. Slater told the Sun-Times in 2023 that their side walked into court with four attorneys and a paralegal, and that the other side probably had a hundred attorneys. He said he turned to McAndrews and asked how they would keep up.

What it cost him at his own firm

Wolinsky recorded that some partners at McAndrews' firm opposed the case and pushed back by withholding his bonuses and his secretarial support, and that some of those partners had children who were medical doctors. To hold down expenses through years of depositions McAndrews slept in his car and ate peanut butter and jelly sandwiches on the road. He carried the case for the profession that had raised him.

How he prepared

Patent litigation is document litigation. McAndrews had spent his career mastering technical records under time pressure, and he turned that method on the AMA's own files, reading the campaign in the defendants' memoranda. The trial record that resulted ran to 3,624 pages of transcript, approximately 1,265 exhibits and excerpts from 73 depositions.

The 1987 retrial

The 1987 bench trial produced a 101-page opinion and a permanent injunction against the AMA

Shortly before the retrial the plaintiffs waived their claim for damages and asked only for an injunction. That turned a jury trial into a bench trial and shifted the question from what the AMA had done in the past to what was still true. The case was reassigned to Judge Susan Getzendanner on May 4, 1987 and tried in May and June of that year. Findings and conclusions were entered on August 27, 1987, and the opinion dated September 25, 1987 was substituted for them. It is reported at 671 F. Supp. 1465.

The finding

The court found that the AMA and its officials instituted a boycott of chiropractors in the mid-1960s by telling AMA members that chiropractors were unscientific practitioners and that professional association with them was unethical. It found the purpose of that boycott was to contain and eliminate the chiropractic profession. It held the conduct a conspiracy among the AMA and its members and an unreasonable restraint of trade under Section 1 of the Sherman Act. The American College of Surgeons and the American College of Radiology were found to have knowingly joined it.

Why the patient care defense failed

The court accepted two of the four elements. It concluded that the AMA held a genuine concern for scientific method in patient care and that the concern was the dominant factor motivating its conduct. The defense failed on the other two. The AMA could not show that the concern was objectively reasonable across the whole period of the boycott, from 1966 to 1980, given testimony from both sides that some chiropractic treatment was effective. It also could not show that the concern required a nationwide campaign to eliminate a licensed profession.

The terms of the injunction

The permanent injunction binds the AMA, its officers, agents and employees, along with anyone acting in concert with them. It bars them from restricting, regulating or impeding the freedom of any AMA member, institution or hospital. The freedom protected is the individual decision whether to associate professionally with chiropractors, chiropractic students or chiropractic institutions. The AMA was directed to mail a copy of the order to every member and employee within thirty days. It was directed to publish the order in the Journal of the American Medical Association, indexed under chiropractic. It was directed to report compliance by January 10, 1988. The order ran in JAMA on January 1, 1988.

Fourteen years

The Seventh Circuit affirmed on February 7, 1990, and the case ended fourteen years after it was filed

The AMA appealed. On February 7, 1990 the Seventh Circuit affirmed the judgment against it in Wilk v. American Medical Association, 895 F.2d 352. The appellate opinion describes what the district court found as a lengthy, systematic, successful and unlawful boycott. The Supreme Court denied review on November 26, 1990 in American Medical Association v. Wilk, 498 U.S. 982.

The arithmetic of the case

The complaint was filed on October 12, 1976 and the last appeal closed on November 26, 1990. Just over fourteen years separate the two dates. Two full trials, one reversal, one bench judgment, one appellate affirmance and one denial of certiorari sit between them. McAndrews was 41 when he filed and 55 when it ended.

What the judgment opened

The four channels the boycott had closed reopened as a matter of law. Medical physicians could refer patients to chiropractors and accept referrals from them. Hospitals could grant diagnostic access and staff privileges. Physicians could teach at chiropractic colleges. The two groups could do research together. Every subsequent collaboration in the field runs through that ruling.

Three more decades

McAndrews represented the profession for three more decades, and the profession attached his name to its awards

McAndrews co-founded the Chicago firm McAndrews, Held and Malloy in 1988 and built a fifty-five year career on patent trials. He kept taking chiropractic work alongside it. He appeared in Chinnici v. Central DuPage Hospital Association, 136 F.R.D. 464, decided in the Northern District of Illinois in 1991, and in American Chiropractic Association v. Trigon Healthcare, 367 F.3d 212, decided by the Fourth Circuit in 2004.

What the judge said afterward

Susan Getzendanner left the bench and addressed the American Chiropractic Association House of Delegates in 1993. The ACA reported that she credited the outcome to the testimony of the plaintiffs and to McAndrews for what she called his brilliant presentation of the case. The ACA gave him its Humanitarian of the Year Award in 1998.

What carries his name

The ACA established the McAndrews Leadership Lecture in 2015, honoring George and his brother Jerome together, and it has been delivered at the association's annual meeting each year since. Greg Kawchuk, DC, PhD, gave the 2016 lecture and published it in the Journal of Chiropractic Humanities. The NCMIC Research Foundation renamed its Jerome F. McAndrews Memorial Research Fund the George P. and Jerome F. McAndrews Memorial Research Fund after George's death.

April 7, 2023

McAndrews died on April 7, 2023 at the age of 87, after eighteen months with cancer and Alzheimer's disease. He married Kathy on April 11, 1964. She survived him, along with five children, 21 grandchildren and five great-grandchildren. His obituary records that he counted the family he and Kathy raised as the crowning achievement of his life.

What the ruling did and did not settle

The judgment secured the conditions for the work, and it made no finding about how an adjustment works

The 1987 judgment is often read as a scientific verdict on chiropractic. It was not one, and the court said so in the injunction order: None of the court's findings constituted a judicial endorsement of chiropractic. The court recorded that all parties, the plaintiffs included, agreed the historic theory of a single cause and a single cure of disease was wrong. It recorded evidence that the subluxation theory as then stated was unscientific. It declined to decide whether chiropractic theory was scientific, because that question was not the one the Sherman Act asks.

What the model claims for itself

The Unified Model of Tone does not take its authority from that vocabulary or from the research that accumulated around it. The model's account of the distortion it treats is built from established neuroscience and advanced as its own synthesis. It names a persistent distortion of recursive self-registration, locally stabilized and globally consequential, in which a region's tone stops updating against the body's present needs. That claim stands or falls on evidence, and it would stand or fall the same way if Wilk had never been filed.

The channels the injunction reopened are where the evidence comes from

The honest connection between McAndrews and this library runs through supply. The boycott the court described blocked hospital diagnostic access, teaching at chiropractic colleges, and joint research between medical physicians and chiropractors. Those are the exact channels that produce trials, imaging studies and physiological measurement. Work on low back pain and on the response of the autonomic nervous system to spinal input required hospitals, funded laboratories and mixed research teams. The injunction of September 25, 1987 is what made those collaborations lawful.

The honest size of the claim

McAndrews added nothing to the understanding of tone, and nothing here pretends otherwise. He was a patent lawyer who won an antitrust case. What he secured was the condition under which the understanding could be pursued at all. A licensed profession gained the right to compete, to be referred to, to stand in a hospital and to publish alongside anyone else. Every other page in this library assumes that condition. He is the reason it holds.

Where he sits

McAndrews belongs with the figures who secured the right to practice rather than with the figures who built methods

The Legends section holds technique founders, institution builders and defenders. McAndrews is the one figure in it who came to chiropractic as its counsel rather than as its practitioner, and the defense line is where his work belongs.

The people his work runs through

Chester Wilk raised the money, wrote the books and put his name on the complaint in 1976. Herbert Reaver went to jail in Ohio through the 1930s and 1940s so that there was a licensed profession left to defend. Joseph Janse built the academic standing that made the AMA's unscientific cult resolution untenable. The three of them and McAndrews solved the same problem in four different rooms.

Where the case sits in the wider record

The history section follows the profession from its founding through the licensing fights to the modern research era. Wilk v. AMA is the hinge in that account. The peer-reviewed history of the case runs to eight parts in the Journal of Chiropractic Education, published in 2021, and the reported decisions are public documents that anyone can read in full.