First School of Thought: Our profession should concentrate on educating the public on the many positive advantages of chiropractic, while avoiding any criticism of organized medicine, even if what the AMA is doing is detrimental to our public health.This view says that it is all right to respond to any unfair criticisms or attacks against chiropractic by our detractors, but that we should not initiate any criticisms against them. The feeling is that even if our motives for criticizing are just, they will be perceived by the public as bashing medicine, and that it will backfire on us.
Accompanying this school of thought, is that if we provide rebuttals to unfair attacks against chiropractic, or if we want to educate the public on the benefits of chiropractic care, it should come primarily from paid advertisements. This school of thought emphasizes that it takes paid advertising to educate the public and fight misinformation, and attributes our lack of funds to our failure to get the message out.
Second School of Thought: While we must stress the many positive advantages of chiropractic, it must be combined with assertive constructive criticism of the existing medical polarization and dishonest tactics that isolate people from these advantages. Combining the positive advantages of chiropractic with the negative conduct of political medicine provides a tough, hard hitting and effective approach. This approach subscribes to the view that treating medicine like a sacred cow tends to reinforce the credibility of the misinformation, and serves to enhance the negative public stigma that already plagues chiropractic.
Raising Ethical Questions: Withholding honest criticism of organized medicine unless attacked raises moral and ethical questions. Are those of us who knowingly refuse to speak out against medical dishonesty any better than those persons committing the act? Does this make us less guilty? Isn't this a conspiracy of silence? This school of thought believes that we have a moral obligation to speak out against inappropriate patient care regardless of who does it, whether it is medical or chiropractic.
The second approach is more honest and compassionate, and being champions for truth in health care. But we must constantly keep reminding our listeners that the real issue is not chiropractic or medicine. The real issue is honesty, integrity and objectivity in health care. Medical dishonesty can be so outrageous at times that many people have a difficult time accepting it, especially if they have put the medical profession on a pedestal. However, I believe that the public will generally agree with us and the public perception will be accurate if we present our facts correctly. Is there a chiropractor among us who thinks that the current direction of health care is totally honest? If anyone believes this then they need to take their heads out of the sand and learn the facts. Although many people may be ignorant of chiropractic, they are not stupid and can be reached with solid facts if they are appropriately presented by the speaker.
The Leaders and Rank and File Chiropractors: As I speak to chiropractors from all over America, I find that the hard-line approach is the overwhelming attitude among the rank and file chiropractors. But as I read the literature from our leadership and listen to the PR firms who have been guiding us, the soft line approach prevails. Perhaps this is why our combined national organization membership is less than 25% of our profession, and why I constantly hear complaints that our leadership is failing us in public relations. Maybe our leadership should start listening to the rank and file doctors.
I've been a chiropractor for more than 40 years and it seems that being aggressive toward our detractors has never been the fashionable thing to do. We need only to look at how our antitrust law suit was in the courts for two years before both of our national organizations finally endorsed it. We've been known to express more anger and outrage against each other than at our detractors. The financing of our antitrust lawsuit came from the rank and file chiropractors. Doctors Joe Mazzarelli and Jerome McAndrews, then with the ICA, did a heroic thing when they convinced their organization to endorse the antitrust lawsuit. But for their courage and foresight they were criticized and ridiculed within their own organization. Meanwhile it took two years before the ACA finally supported our antitrust lawsuit without financial commitment.
After winning our antitrust lawsuit against the AMA, an eastern PR firm representing a state chiropractic organization advised us: "Now that you won the suit, don't rub their noses in it." Can you imagine that? Where would our noses be if we had lost? I wonder if any PR firm representing the medics would still have a job if they gave out that kind of outrageous advice to their clients. Our chiropractic leaders are good people. They wear their hearts on their sleeve and have great compassion. Most of them are successful practitioners and need the thankless and frustrating long hours of work that goes with their leadership role about as much as they need the mumps. But maybe they are trying to be too kind and gentle toward our detractors. Perhaps if they took off their white gloves (and their blinders) and told it like it was the impact of this honest candidness toward medical abuses and interprofessional polarization hurting the people might awaken our medically programmed society. After all, we tried it their soft way for 102 years and where did it get us? We are isolated from many HMOs and more than 99% of the hospitals, we only treat 15-20% of the population, chiropractors are struggling more to survive economically today than in 25 years, and the combined membership of our two national organizations is less than 25%. Putting it another way, about 80-85% of the public has not used chiropractic care, and many of them could not be dragged into a chiropractic office with a team of horses. This is the kind of public ignorance and prejudice that exists, and it was foisted upon us by the pompous and arrogant attitude of the medical leadership toward chiropractic. This is humiliating to us and tragic for patients. Chiropractic and the public certainly deserve more.
It's Not Money. It's Doing the Right Thing. When the rank and file nonmembers are asked why they don't support a national organization the answer is always the same; that the leadership does not educate or create a public awareness of chiropractic. In all fairness, what our leadership has accomplished with legislation, our colleges, in research, ethics, taking the lead in standard of care and quality of care guidelines, is phenomenal and unparalleled in history. We have no doubt earned some major bragging rights. But when it comes to public relations and creating a public awareness of our great profession, we are a glaring and dismal failure. Whether we like to face up to it or not, it's a painful fact.
Whenever our profession receives negative press, the first thing our leadership talks about is purchasing advertising space, sometimes within the same paper which just attacked us. We reward their attacks. We have put too much emphasis on the importance of money as a prerequisite for good PR and responding to propaganda. We blame our lack of money as the reason why we are not doing better with our public relations. Dependence on advertising may provide good finder's fee commissions for our PR firms, but how can we successfully compete dollar for dollar with a billion dollar a month drug advertising industry? The truth is that we not only can effectively compete with medicine, but we can even prevail in the process, but not with money.
We need to eliminate the fallacious belief that our lack of money is the primary reason for our lack of good PR. While it is essential to the overall PR program, it takes more than money. The American Marketing Association says that the average cost of launching a new consumer package goods product is $20 million, and that there is a 90% failure rate. These figures speak for themselves. We already have the most important ingredients for success. We have truth and a superior contribution to health care that cannot be denied. It is priceless. When you consider what our adversaries were able to accomplish with a lie, imagine what we can do with the truth!
Our profession's public relations success will come when our leadership realizes that money is not the real problem. We are the problem. Furthermore, money is NOT the solution for obtaining good PR. We just need to do the right thing by forming speaker bureaus in every state, and giving them top priority. I doubt that a handful of state chiropractic associations currently have speaker bureaus, and if they do, they are on the bottom of the priority list. This is our biggest failure. We must have the ACA and ICA endorsing and enthusiastically supporting speaker bureaus in every state. Their support will motivate the states to put more emphasis in this vital area, which has been tragically ignored. I've approached our national leaders on numerous occasions and asked them to put their support behind my program, but to no avail.
The Ultimate Solution. We need to start a major recruitment program in every state. Start training chiropractors on how to approach the media, speak accurately, effectively and with impact. We have the facts, but we need hundreds of well-trained chiropractic speakers nationally converging on every radio, TV, newspaper and legislator in the country. This will more than adequately do the job. We'd have patients swarming on chiropractic offices if they knew the truth.
Perhaps if our leadership got the message on how to obtain total professional success, more chiropractors could afford to pay the membership dues to their national organizations. Being properly prepared to speak publicly is extremely important to prevent serious misunderstandings and backlash which frighten some chiropractic leaders from encouraging the rank and file chiropractors from going to the media. They prefer to keep the spokespersons limited to a small group, but we need larger numbers to be effective. We need to stop living in fear and give some credit to the high caliber of doctors graduating from chiropractic colleges today, and simply demand equally high caliber of preparation for talk shows. State associations could handle the training and certification of qualified speakers for the media.
Overcoming Public Stigma. We are dealing with a public stigma that if medicine doesn't accept us as a worthy partner or ally in the health care field that we can't be any good. And as long as our soft policy continues toward the medical leadership, and we don't topple that arrogant and misguided medical pedestal and bring them down to reality with constructive criticism, an interprofessional dichotomy will remain and our growth will continue to suffer.
The Turbulence of Change. There will very likely be some volatile medical reactions to an aggressive hard line posture if our leadership chooses to adopt it. Hypocrisy doesn't die easily. In light of our existing facts, however, those MDs who react against objective and honest interprofessional cooperation and medical abuses, will have to join us or appear quite foolish or dishonest. And when all is said and done WE will prevail because we are right and they are wrong. We need the courage of our conviction and the wisdom to adopt some hard-line policies toward the abuses of the medical leadership.
A Challenge to our National Organizations. I would be more than delighted to work with any state or national chiropractic association in setting up speaker bureaus. This includes my offer to speak and present my case at national and state conventions and seminars, and discuss the elusive and ultimate formula for chiropractic success on a grand scale that encompasses the entire profession. We have frequently focused on individual success of chiropractors, but that is not the ultimate answer. To be a totally successful program it must encompass the success of the entire profession. We can accomplish the ultimate success for the entire profession. Who can accomplish this task if we don't take the initiative? The drug houses? The AMA? Only we can do it.
I urge the state and national associations to embrace my program and offer to help set up speaker bureaus. I believe that our state associations need strong encouragement from our national organizations to be motivated to take the initiative. As an example, our antitrust lawsuit never got off the ground until after a national endorsement came from the ICA. It appears that we need the same thing with the speaker bureau program. If this profession and its members ever wants to grow both collectively and individually, it must adopt this program. The approach that I advocate is nonpartisan, and the material I have compiled has passed the grueling test in the courts facing our nation's finest trial lawyers in our antitrust lawsuit. Let's start a speaker bureau program in every state. If we accept this challenge we might even see the day when chiropractors will hire MDs to work as CAs. Now wouldn't that be something?
Dr. Chester Wilk may be contacted at 5130 W. Belmont Avenue, Chicago, IL 60641, Tel. (773) 725-4878 or toll free at (888) 905-WILK.
Chester Wilk, DC
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