I have recently been elected to serve as the 12th president of the International Chiropractors Association, an organization that was founded in 1926 by B.J. Palmer to promote the development of chiropractic worldwide as a separate and distinct health care discipline based on a unique set of principles and a nonduplicate approach to health and healing. Because of these deep historic roots, ICA has never lacked clarity as to its mission and purpose. Each generation of leadership, however, must face the daunting task of leading ICA in a productive direction, applying our resources to those areas that most directly and immediately impact the doctor in the field in ways that those practicing DCs feel to be relevant to them.
This may seem to be completely self-evident. Even in the context of ICA, where our prime mission is to promote a body of principles, service to our members that supports them in practicing according to those principles should be our chief aim. What we have seen in recent years, however, is a drift by most, if not all, chiropractic organizations away from the reality testing and direct member communications one wants and needs. Instead, we see leadership-driven models in which leaders simply assume that all members share their perspectives, values and strategic thinking; that what they are doing inherently has the support of members. We see it every day in initiatives and programs that often receive enormous hype, promoting legislative, legal or public education initiatives. It seems as if leaders feel that they have to put on a show to demonstrate to members that they have everything under control. A look at the track record, especially in legislation, tells the sad but irrefutable story.
The most significant single fact of our national chiropractic organizations is that the overwhelming majority of DCs do not belong to them. We hear from leaders of all parties and persuasions in chiropractic that there must be something wrong with the chiropractic mindset to have such a small participation rate. DCs must not care or be struggling financially. There is no end to the list of excuses why national organizations are where they are.
I look at the state of organizational affairs and, from somewhat of an outsider's perspective, have to find very different reasons for the situation national organizations are in. It is not good news, unfortunately, and to fix it, a lot of people (and many long-standing ways of doing business) will have to change. Change is urgently needed because chiropractic leaders and organizations have become so disconnected from the DC in practice as to call into question the validity of national associations.
We are fortunate that there are enough DCs with enough community support willing to continue to fund the national associations through dues and moral support. It shows that hope does indeed spring eternal. But the trend is down, and this is bad for chiropractic because in the years ahead, collective solutions to profession-wide problems can only come through a tuned-in, coordinated and reality-based web of professional organizations cooperating to accomplish very specific and carefully considered goals.
The first realization we must embrace is that we are a divided profession, with the largest group being non-association members. All organizations need to step back from the fiction that they represent the true voice of the profession, possess the only "correct" principles or have supremely wise leaders, etc., and be honest with themselves. The profession is not following us. We must ask ourselves: why?
Bombastic organizational self-aggrandizement seems to work in the short term and has thus been adopted by some groups as their primary means of functioning. Other groups, like the so-called chiropractic medicine organizations, have a grossly disproportionate impact on the health care marketplace out of sheer audacity. The fact that they have only a very small handful of disciples doesn't mean that they cannot do massive damage.
In recent years, a wide variety of techniques and methodologies have been employed by chiropractic organizations to get and keep members. Some groups like to use fear, calling on the profession to join this or that group before managed care sweeps us away; health reform puts us out of business; or the government changes our status so that we can only see patients on referral. ICA has been somewhat shy about using this approach, even though much of the frequently employed parade of imaginary horrors about the future of chiropractic might be true. There are practical limitations to crying wolf. I would like to build on something stronger than fear.
The other popular approach to membership relations is the big initiative. We see them all the time - the Alliance for Chiropractic Progress, legislative campaigns and lawsuits. All are accompanied by a steady stream of assurances that this is what you need; that only "our" group or groups could do this. The implication usually is, "Aren't you lucky. Better keep paying those dues."
If I seem cynical and a bit disgusted, I am. The things about which I complain are not questions of right and wrong. These are not moral or ethical imperatives that I am promoting. I believe that most chiropractic organization leaders have good intentions. It is just that the job does not get done. I am about results!
What can we do? Like any other complicated set of problems, simple answers are not likely to be forthcoming. I can tell you what we are doing at the International Chiropractors Association to reconnect our organization with its members. First, we have initiated an annual membership survey and policy study that seeks to determine what our members' top needs are and the priority in which they would like them addressed. Along with this comes a new and forthright disclosure to our members where our resources come from and how they are spent. We have to re-establish a trust in the various levels of the body politic of ICA. To do this, you ask, listen, and share the facts.
Based on the objective results of our membership information gathering, ICA, through very well-developed strategic planning, will determine the specific goals for one, two and three years out, publish these goals, and seek to mobilize the membership and, when issues of general concern are involved, the entire profession behind efforts to secure those goals. In this process, ICA will not presume to speak for all of chiropractic, but forcefully represent the needs and priorities of its members. You can be a part of this process through membership. It is up to you. I strongly hope you will become part of the solution and join today.
Honesty about outcomes and organizational accountability are two additional elements to ICA's approach to practical problem solving. If we adopt a goal and a time frame, we must be honest with ourselves about the effectiveness of our efforts and demand accountability from leaders on all levels. If a job is not getting done, it is because someone is not doing the job. Self-evident? Yes, but such frankness is not the norm in any voluntary organization.
ICA needs to trust the vision and judgment of its members. It needs to ask the big questions and listen to the responses. This is my commitment. For example, ICA has invested hundreds of thousands of dollars in the Alliance for Chiropractic Progress. The ICA, the American Chiropractic Association and the Association for Chiropractic Colleges, along with a number of corporate sponsors and private donors, have pooled several million dollars behind this effort. Is it reaching the field? Is this what our members want and need now? This specific item will be on the 1999 ICA membership survey and policy study. I am not willing to assume that I know better than the membership at large.
Finally, we at ICA want to be clear about the role of national associations in the big picture. We feel that organizations such as ICA exist to help member doctors accomplish goals that no individual practitioner or state or regional group can accomplish. This is the point at which chiropractic must come together in terms of function. It is the work that matters. What the job officers and leaders do is more important than who they are or the office they hold. It brings to mind an old fashioned concept, one that has been more or less squeezed out of many chiropractic organizations by office seekers pushing their own peculiar values, agenda, or worse, commercial product. Maybe you will remember this concept. It is called service. I am committed to outstanding service.
ICA understands that the organization belongs to its members. We also understand that we must operate in a greater context in which we are a small minority. To be effective, we must be focused, goal-oriented toward results and achievement, and honest with ourselves and our members.
Change is an unpleasant undertaking, even though it always comes bearing gifts. I believe that it is exciting to deal with new ideas, new methodologies and new people, and venture into unfamiliar territory. It takes courage and a strong sense of purpose to embark on major changes, especially when the old ways of doing business have become so familiar and comfortable. It would be easy to ride that status quo. That is not, however, the job of a leader. That is not in the vision of ICA. Throughout my campaign, I spoke of smashing the status quo. This is especially true because the zone in which we will find and secure chiropractic's survival is way beyond our current comfort zone. Whether you choose to come along or not, ICA will be there, protecting and promoting chiropractic.
I invite you to join and grow with us. Put these ideas to the test with me. Be a part of an organization that has made the decision to listen first, then act decisively. Put your vision to work with that of thousands of other DCs in the United States, Canada and around the globe. We need and want you. Give us the opportunity to earn your trust. Join the new ICA, a worldwide community of the most successful chiropractors on earth!
