The number of phone calls and emails we receive from new DCs is on the increase. Many are questioning why they can't seem to be able to make a living in their chosen profession. They graduate with high hopes, but also with the heavy burden of a substantial student loan debt, and are facing a very challenging health care marketplace. They contact us looking for answers to several questions. Here are some of the questions the leaders of our profession need to address:
Is it time for the chiropractic profession to regulate the number of new DCs that enter the profession in the U.S.?
The medical profession has been doing this for as long as I can remember. Each medical school graduates so many MDs every year. By doing so, students must vigorously compete to matriculate into medical school. Imposing higher standards, of course, are based on the supposition that these high achievers will become outstanding doctors.
However in a report issued on October 8, 2001, Moody's Research noted: "We still believe that enrollment in chiropractic colleges across the country...has yet to stabilize and could decline further."
Is this a policy our chiropractic colleges should consider?
How can we continue to survive when some DCs are willing to accept as little as $10 per visit?
Is there a level below which an adjustment should never be priced? In the business world, this kind of activity only serves to drive providers out of the market until the limited number of survivors can raise their prices back to an acceptable level. Is this what future graduates have to look forward to?
Who will survive when new graduates are expected to work as associates for as little as $25,000 per year, while carrying $120,000 in student loans?
The "horror stories" we hear from associates are very disheartening. Some complain that the only doctors hiring associates are the "big hitters" that new graduates don't always feel comfortable working for. Others relate terrible working conditions and ask how this profession can expect to grow when we treat our associates so poorly. While hiring an associate is partly a business decision, there is also a responsibility to mentor and shepherd new DCs to help them further develop their skills.
Are we forcing our new doctors to "expand their scopes" to survive?
Many graduates are adding acupuncture, homeopathy, physical therapy, and other modalities to their practices to provide more billable services. If these additional modalities fit into a doctor's health care philosophy, that's his or her decision. But if they're adding these just for the money, we may be encouraging the dilution of chiropractic through economic incentive.
Are we short-changing our patients when doctors are expected to spend no more than a few minutes on a patient?
As the impact of managed care continues, will chiropractic care ultimately become only marginally effective under tighter and tighter time constraints? Can complete chiropractic care be rendered with a quick adjustment, then on to the next patient? Where do we draw the line?
What seems to help?
When asking new DCs what their former classmates are doing to become more successful, here is what they say:
I admit that not being a doctor of chiropractic I may be getting a distorted picture. Are these recent graduates just whining about the challenges that have always faced new DCs, or are they serious issues that threaten the growth and success of our profession?
Are we avoiding talking about the tough issues? If so, how much is our avoidance hurting us?
The first requirement to solving problems is identifying them. To do this, your voice needs to be heard on these issues. DC will be publishing the responses of all those who would like to provide input for these challenges.
Donald M. Petersen Jr., BS, HCD (hc), FICC(h)
Editor / Publisher of Dynamic Chiropractic
don@mpamedia.com
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
