I was recently asked about my chiropractic philosophy. My answer surprised my questioner. I said something that must have been in the back of my mind for quite sometime, because it came out quickly and as though I had been waiting for someone to ask. I simply said, "My philosophy is: Show up and show respect."
versity: Good, Bad & Ugly
One of the best things about the chiropractic profession is its diversity and freedom. The profession provides everyone involved the opportunity to decide what chiropractic is, how it works and how to practice it. We are a profession of entrepreneurs, mavericks and headstrong individuals. We march to the beat of different drummers and swim upstream like salmon against what is considered to be mainstream health care. This has been a necessary part of our profession. The strength of great individual thinkers, diversity and freedom has helped the profession survive for over a century.
Diversity and freedom are also two of the worst things about the chiropractic profession, often leading to an unhealthy amount of individualism. Unfortunately, too much diversity and freedom has prevented unity. Instead of being a single "chiropractic nation," we are but a multitude of "small kingdoms," each with its own king or queen, each with their own "philosophy."
We call ourselves and each other straights, mixers, subluxation based, philosophy-based, evidence-based, wellness-based and medipractors, just to name a few. I like to think of all of us as chiropractors.
Asking someone about their chiropractic philosophy is a loaded question. The questioner is obviously preparing to judge the answer against the correct response – their version.
I often see advertisements for associate positions that say the candidate must have a strong chiropractic philosophy or be subluxation based. I have also seen associate positions advertised that require a doctor who is evidence based. There are no consistent definitions of any of these terms. Again, it is all individualized.
I feel for new graduates who answer these job postings. They often enter an interview naively thinking they have a grasp on the profession; while the hiring doctor enters with the arrogant assumption that the new graduates have or should have figured it out according to their standards.
Subluxation-based practitioners should note that many things written and practiced in years past have been shown to be inaccurate or ineffective. These items should be moved from the realm of our philosophy and practice to the realm of our history.
On the other hand, evidence-based practitioners should note that we are not there yet. Many theories and procedures have not yet been studied adequately or the available studies are flawed. I saw a recruitment video from one of our colleges in which a member of the faculty was being interviewed. The doctor said he liked teaching at that particular college because it is strictly evidence based. He continued by saying only evidence-based care is used in the institution's clinics. The college must have a limited clinical repertoire.
Many of us seem to be overly influenced by the insurance industry's definition of evidence based: "A lack of evidence argues against clinical use." Lack of evidence is not evidence against or evidence for something; it is just a lack of evidence. We cannot throw the baby out with the bathwater and stop using clinical procedures that have always worked because we do not have a stack of double-blinded studies proving their efficacy.
My Experiences
When I entered Palmer, I showed up to class and studied in order to become the best chiropractor I could be. Not everything went my way while there and I did not agree with everything said or done, but I had to have trust that those who had come before me had figured out the best route from student to doctor. I showed respect.
In practice, I showed up for 17 years to do my best for patients. There is not a day on the calendar that I have not seen patients: weekends, holidays, etc. I showed up to see patients on Thanksgiving, Christmas, New Year's and other common "off days." I once rang in the New Year with a patient who was in severe condition. He was the last patient of 1996 and the first patient of 1997 during the same visit. I respected my patients' needs.
I also showed up while in practice to serve my community, state and national professional organizations. Be it through time, talent or funding, I showed up and respected the opinions and wishes of others who showed up in these venues.
I showed up by writing articles and books, as well as speaking at postgraduate and management seminars to help my colleagues. You never know who is in the readership or audience. I respected readers and participants in these arenas, whether or not they agreed or disagreed with what I wrote or said (which could happen with this article).
I showed up more than 30 times to consult for and defend chiropractors being sued for malpractice. Not once did I ever ask the question, "What is your chiropractic philosophy?" before deciding to help. It did not matter. A member of the brethren needed help and I wanted to be there.
I showed up twice to testify against chiropractors who committed egregious acts against patients, the public and the profession. In those cases, I respected the law and the needs and rights of those wronged.
I showed up at Palmer College of Chiropractic – Florida and Cleveland Chiropractic College – Kansas City to help teach the next generation of chiropractors. I showed up to work at Foot Levelers, Inc., to further chiropractic education and research. I respected the needs and opinions of those I served and served with.
I have showed up for these things and dozens more. But I am not alone. My curriculum vitae is long, but it pales in comparison to many other members of the profession. What I have done, and what others have done, is not the point; the point is that it can and should always be done. Show up and show respect.
This is in contrast to the many who do not show up and adhere to their own philosophy – to the point of isolation or dissension. Isolationists wither. The dissenters become the "flag burners" of the chiropractic profession, demanding their individual rights to practice their way while defaming the profession.
How to Make a Difference
Back to the beginning of this article. The doctor who asked me about my chiropractic philosophy is a member of the two groups just mentioned – strongly opinionated, argumentative; never willing to be involved or help, yet always ready to criticize.
It is great to love what you do and to have strong opinions about it. It is also nice to associate with those who think like we do. But there must be a higher degree of activity, cooperation, collaboration and tolerance among us.
So, how can everyone show up for the profession and show respect for others that do? Here are a few suggestions.
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