When I graduated from chiropractic college some 19 years ago I was young, naive and idealistic. I had just become a chiropractor and was ready to go out and change the world by helping people through my new found profession. I grew up around chiropractic – real chiropractic. I grew up around chiropractic when and with people who considered it a movement – not so much a profession. I remember as an 11 year old listening to Reggie Gold tell the story of the Valley of the Blind and going to “meetings” with my brother to hear people tell their stories about chiropractic. These eventually turned into “Philosophy Nights” – good luck if you can find one today.
In fact, good luck – period. I recently gave a lecture attempting to summarize the historical stages of our profession in the United States following it’s founding to the present day. Most are familiar with the general theme. The profession made a decision (BJ made a decision that is) that chiropractic would not become a religion but would instead become a licensed profession and keep chiropractors from going to jail for practicing it. Staying out of jail – that was our first big battle. Imagine that. After a lengthy battle to gain licensure in every state (the last being not so long ago!) we turned our attention to equality. Insurance equality that is. After another long battle we got that too and soon enough the “Mercedes 80’s” rolled around and you saw chiropractic in full bloom here in the states.
Life was good. The Blues would pay you for every visit, for every member of the family – oh and they would even pay for your x-rays and diagnostic tests. Notes? We didn’t need no stinkin’ notes! Send in the bill and voila – get a check – a big check. Then the inevitable happened here in the states – managed care. The gravy train stopped. Luckily many of those who grew their practices in the 80’s had built a foundation of committed patients who got the big idea and their practices survived. Young chiropractors getting out of chiropractic school in the late 80’s and into the 90’s and now, find themselves in a completely different environment. More likely than not, the patient will be paying for their care or at least a big part of it out of their own pocket.
At the same time we see the emergence of evidence based health care so that where third parties are still paying for chiropractic it is based on the literature. And that my friends is a sad story indeed. You see, while we were fighting to stay out of jail, fighting to gain licensure, fighting for insurance equality and then getting drunk off the insurance tap – we completely ignored research. We ignored the one thing that will save us now.
The responsibility we shirked has far reaching implications. My work defending chiropractors in regulatory actions and malpractice cases has taken me far outside the confines of the US. I’m very familiar with the events unfolding in the UK, Australia, Canada and other countries where chiropractors who are practicing as if chiropractic is a movement and are attempting to change lives, their community and the world are being persecuted – and prosecuted. Many of you know this. Typically they are prosecuted for the big three: Pre pay plans, correcting spines and taking x-rays. In other words – anything beyond short term manipulation for back pain, neck pain or headaches.
And our friends overseas are not alone. We have the identical problem here in the states. And here is the fundamental issue: Subluxation based chiropractors do not get involved in politics or research – the two largest pillars of the necessary components for protecting ourselves. On the other hand, those in the profession who advocate chiropractic as a limited specialty for the treatment of neck pain, back pain and headaches do get involved in politics and research. They get onto regulatory boards, they run state and national associations and they get involved in the political machinery of the profession i.e. accrediting agencies, regulatory groups, national certification organizations etc.
They also do things like start managed care companies designed to deliver inexpensive, short term chiropractic care for the treatment of musculoskeletal complaints. They then market this to big insurance companies who revel in the thought of not having to deal with chiropractors any more and being absolved of any responsibility for the denial of care. In the states we have 30,000 + chiropractors who willingly sign up with these companies. That is how desperate the marketplace in the states is.
We could spend time talking about the reasons why subluxation based chiropractors don’t get involved but there is no point – the bottom line is they don’t and they have to. They have to right now. Personally I don’t believe our brand of chiropractic can sustain any more marginalization. There are deep cracks in the foundation and the Dark Side has more money and skin in the game. The time for action is right now.
What can be done?
First – if you are not a member of the association in your state, region, province or country that has a mission consistent with yours you need to become a member today.
If your state, region, province or country does not have an association whose mission is consistent with yours then you need to think about starting one or getting together with others to join the only association if you think there is any chance of changing it. Be careful with that one. Don’t underestimate how difficult it is to change an entrenched power.
Secondly, you need to get on your state, regional, or provincial regulatory board. You need to have a seat at the table where issues regarding the practice of chiropractic is taking place. Imagine if you were brought before the regulatory board and accused of misconduct and there was not a single like minded chiropractor who would be judging you on the board.
Third, you need to support subluxation based chiropractic research. There are two immediate ways you can do this. You can subscribe to the only peer reviewed chiropractic research journal dedicated to the elucidation of vertebral subluxation – The Journal of Vertebral Subluxation Research (www.jvsr.com). The second way you can support chiropractic research is by making a donation to the Council on Chiropractic Practice www.ccp-guidelines.org The CCP is in its third round of guidelines development solely directed at the care and management of vertebral subluxation. I cannot count how many chiropractors have relied on this document when battling a charge of misconduct before a regulatory board.
Finally, your next step is to recruit others of like mind and get to work wresting the profession from the death grip of those who would destroy it. I look forward to your feedback, comments and suggestions.
As always I look forward to your feedback, comments and suggestions.