The real issue does not involve the merit of chiropractic or medicine. They are both well established as worthy professions in their respective roles in health care. The issue involves the people who make up those two professions and whether they add to their profession and health care as a whole, or whether they detract from the goal of serving humanity.
It is easy to be critical of the outside influences that have injured our profession, but it becomes more painful to look at ourselves objectively and have the professional courage to address and correct the problems. There are four general areas that need improving. We owe it to ourselves and chiropractic to attend to these matters as a mature profession celebrating its centennial.
Issue #1: Practicing with Honesty and Integrity
Every professional group will have individuals who resort to dishonest tactics. This should not be construed as a weakness in the therapeutic merit of the profession, but as a human weakness found in all professional groups. The solution to this problem lies in how the professional leadership chooses to deal with these indiscretions. If there are to be any condemnations it must be of the individual violator and not the profession itself. Our leaders must take a stand and commit themselves to enforcing its policies in a logical and democratic manner, cooperating with individuals and agencies to insure ethical and honorable conduct. Failure to do so will justified criticism of the entire profession and everybody suffers. This can't be allowed to happen. We need strong, principled leadership.
A fine example of the unprecedented effort on the part of our leadership taking a serious step to insuring that our profession conducts itself ethically and honorably, came when our chiropractic leaders got together and drafted the Mercy Center guidelines. Is it a perfect document? Of course not! It has its warts and blemishes. But we've got to start somewhere. Henry Ford's first automobile didn't have a reverse gear, but it was a step in the right direction -- and so is the Mercy document. It is a noble and honest attempt to see to it that patients, insurance providers and ethical chiropractic practitioners are all protected. We've got to start somewhere. How can anyone fault this? The document will be amended in much the same way Ford kept refining his automobiles. One thing is for certain, if we don't do it ourselves the government will most assuredly do it for us. It sure beats having some outsider, ignorant of chiropractic, doing it for us. That would prove disastrous for doctors and patients alike. We must support this document.
Issue #2: Isolating Dogma and Cultism from Health Care
No health care profession is without its zealots. I would certainly include the "orthopractic" movement in this category as well as some extremists to the left and right. We cannot allow this small, lunatic fringe in health care to intimidate our colleges with fears of losing alumni support. Nor can we allow them to intimidate our state and national organizations by worrying about loss of membership. We must isolate ourselves from this lunatic fringe or the entire profession will suffer. We must have the commitment to take a stand. It's been said that a nation that does not stand firmly for something will ultimately stand for nothing. Let us not make this mistake.
Issue #3: Dichotomy in Chiropractic
This is probably one of the most emotionally based issues that we need to face and correct. Everyone who knows me realizes that I am passionately nonpartisan and candidly speak the same words to any group of chiropractors. I have great respect and appreciation for the old International Chiropractors Association because without its initial endorsement and support, chiropractic's successful lawsuit against the AMA would have been doomed to failure. The ICA's endorsement of the suit was a classic example of an unselfish and heroic commitment to right a wrong at all costs, and we all stand taller and prouder because of it. However, sentimentality and affection for an organization's past selfless act and contribution to chiropractic and the patients it serves cannot serve us in the '90s. We can't divide our economic resources in this highly competitive and aggressive era in health care. We are talking about the survival and growth of chiropractic. Let me give you an example of what I mean.
When I was in Washington, D.C., I went to the house and senate buildings, literally going door to door speaking with legislative aides from many different states. It's great fun; you should try it sometimes. Occasionally, if I got lucky, I'd get to speak with a senator or representative. When I mentioned the word "American" in front of "Chiropractic Association" I got immediate recognition from virtually everyone. However, when I used the word "International" in front of "Chiropractors Association" I got mostly blank expressions and responses like, "Who, what, huh? No, I'm not familiar with the organization." This was depressing. For one thing, they are American legislators not international legislators. I'm sorry but I cannot change what happened. I can only report on it.
I thought, what a tragedy that we chiropractors are dividing our economic resources and supporting two national groups when most of the legislators and their aides did not even know that one of them exists. But don't take my words for it, try it yourself next time you are in Washington, D.C.
I have heard chiropractors from our smaller organization rationalize that joining the larger and more influential one would result in their views being "diluted and lost." I strongly disagree with this thinking because being right and believing in yourself is where the strength lies. To suggest one's views would be diluted is an open admission to a weakness and lack of confidence in oneself and one's principles. To reject the larger organization because you may or may not believe in some of its policies (often because of mistaken beliefs) guarantees a continued dichotomy and plays right into the hands of our enemies. It should be all the more important to join the larger organization and modify its direction toward your mode. There are eight governors for the ACA and each is responsible to a handful of states. We can contact these governors and advise them that if they don't represent you that you can see to it that they are eliminated by election. We've seen a clean sweep of the politicians in Congress because they were not listening. We can do the same thing with our governors. It certainly beats forming another organization, "dropping out" or supporting an "empty shell" of an organization. A more logical approach is to insist that our leaders "shape up or ship out." Now that makes a lot more sense.
I know that this appraisal will outrage some, but we need to get out of our comfort zone and have the courage to face up to it and the wisdom to correct it. On this highly volatile issue of unity we have clearly been our own worst enemy. What a fitting tribute it would be during our centennial to unite as one great force. Let the few zealots within our profession isolate themselves; let it be their problem. Dynamic Chiropractic clearly has the answer when it says, "Unity without uniformity -- through increased knowledge and tolerance." Our profession would do well to listen to these words of wisdom.
Issue #4: Assertive Public Relations
A couple years ago the ACA and ICA had a joint legislative conference in Washington, D.C. What would be a more positive and powerful impact upon the legislators at that time than to train as many chiropractors as possible to learn to speak effectively on their feet and then converge upon every radio and television station and newspaper with a proper delivery of the facts that we have going for chiropractic? What if during the legislative conference we had planned to have chiropractors approach all 535 legislators, and had chiropractors back home contacting their legislators? We would have had a total media and legislative blitz. They would have gotten it from all sides.
The worst advice that I have heard in over 15 years (since being advised not to sue the AMA) came from our public relations firm when I received their letter suggesting that going to the media with our facts was "knee jerk fluff" and "making news when there is no news." I couldn't believe that the people we pay to advise us on public relations were advising us against taking our powerful message to the media. Meanwhile, I heard about another public relation's firm from the east coast telling its state members that now that we won the lawsuit we should not rub their (the defendants) noses in it.
It is important to note that this is not a case of chiropractic versus medicine. It is a case of honest interprofessional cooperation, using the most therapeutically effective, safest, and cost effective state licensed health care. If we aren't effectively getting the message out because we are listening to the wrong experts then its time they changed their policies or we change them for more progressive experts.
If you think about it for moment, we have almost everything going for chiropractic. In the legal arena we have retained a brilliant lawyer. In the legislative arena we have retained the finest award winning legislative strategist. We've won some legislative battles but they have been uphill battles. At our national headquarters we have the administrative genius of Dr. Jerome McAndrews who quietly and without fanfare has accomplished more "firsts" for chiropractic than any living person. Finally, we have the arena of public relations or public education and I give us a big, fat "F." You might say, "Oh well, three out of four isn't bad." But that is the real problem. Without appropriate PR it makes legislation much tougher. It makes us more vulnerable to abusive TV shows ("20/20") or articles (Consumer Reports); it makes our problems with insurance companies more difficult; it makes shaping public opinion, an area so critical to our very acceptance and survival, more difficult.
As I speak with chiropractors across this nation, I have yet to find one chiropractor who says our national organization is doing an adequate job of public education. Shouldn't this be a clear "wake up call" to our leaders that they are not doing enough? There is a mistaken attitude that if we had more money we could do a better job. You can't buy with money what this profession needs. The only cost effective and logical approach is in forming a national network of speakers in all 50 states, learning our facts and how best to communicate them, then converging on the media in massive numbers. This will get the job done. We can't rest on our laurels and ignore the pressing issues. We owe it to chiropractic and the millions of people we serve -- and could potentially serve -- if they only knew the truth.
Chester Wilk, DC
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