By Kevin A. Creswell, DC

1991 — In 1995, the chiropractic profession will celebrate its 100th birthday. Throughout the years it has experienced many changes, both positive and negative. In many ways, the growth of the profession parallels that of many small businesses that mature into recognized leaders in their field.

Having passed the initial stage of gathering the concepts of art, science and philosophy within its substance, the profession finds itself entering a new era of health care. This new era encompasses changing attitudes of the practitioner and patient alike on the efficacy of chiropractic. With well-documented increases in health care costs both allopathic and chiropractic, the patient is faced with the decision of having to assess the affordability and cost-performance of one vs. the other.

Taking a pragmatic and purely “business” point of view, let us consider the business of chiropractic and how it can best be managed in order to help the subluxated patient realize the benefits that chiropractic care can provide.

In their acclaimed best-seller, In Search of Excellence, Thomas J. Peters and Robert H. Waterman, Jr. study the most successful American companies and deduce that eight basic principles are employed to develop and maintain successful businesses. Drawing a comparison of the chiropractic profession to these companies I suggest that in order to prosper in the new era of cost-performance, the profession should invoke the following concepts:

Our recognition as a viable alternative to allopathic case was built on the fundamental belief in the profession that the health of the patient must remain the top priority. As with all successful businesses, satisfaction of the needs of patients or customers is vital to continued survival. The system of accredited colleges, increased enrollment standards and growing research efforts will continue to support this concept.

To ensure that our patients, in effect our market, develop an awareness of our presence, concept number two of defining our service though effective advertising is finally being addressed. Two major advertising efforts directed through the Reader’s Digest magazine have introduced chiropractic in a professional and tastefully presented manner to millions of readers. The strength of our profession will grow as long as a unified effort is maintained. The danger lies in separate local advertising that may be directed by selfish motivation, geared towards practice volume increases at the expense of the profession’s overall image. The public could develop an impression that this type of advertising is more serving to the chiropractor that to his profession.

Effective coordination of support services and resources is our third concept. Through effective mobilization of those resources necessary to solve health-threatening conditions of the patient, the chiropractic profession will establish its value to the patient. We need only consider the growing emphasis in our colleges on teaching basic diagnostic skills to realize that this concept is being aggressively pursued. Coordination of resources is a value-proven skill, best illustrated within the real estate business. The effective coordination of lawyers, surveyors, banks, etc., has placed the real estate agent in the position of a trusted and necessary consultant to the public. Proper coordination of laboratory services, CAT services, hospital admissions, etc., will likewise enhance our position of “portal of entry” physician.

The fourth and final concept the profession should adhere to is the search for simple answers to seemingly complex problems. We have seen how, as the complexity of our society and its technology increases, the problems arising from this complexity increase significantly. Simplicity of management of the profession, with a bias for action rather than talk, will allow us to draw on our own resources faster. Consider the McDonald’s restaurant chain. Its mandate of providing a service in the simplest, most efficient form has led to its national if not world domination in the fast-food business. Think of the problems the ICA and ACA have encountered addressing the question of a merger. One wonders if a simplicity-based system of decision making would have led to rapid resolution of the problems. Albeit the question is itself complex, but can it not be simplified? Action is what reduces subluxations and builds practices, not discussion and controversy. How long can we afford the luxury of indecision on many key issues, unification being only one?

This fourth concept may prove the most challenging of all, but if Peters and Waterman are accurate in their appraisal of the top companies of the nation, it may prove pivotal in the future business success of our profession.