While this column is mainly concerned with the actions of individuals, it is obvious to everyone that the chiropractic profession is at a critical crossroads. The choices are painful, and involve ethical considerations.
John Hofmann, DC, reported in his March 13, 1995 article "Apathy" that at a convocation he attended, it was advocated that the number of practicing chiropractors be decreased by limiting students accepted into our professional schools. The chiropractors in practice would be left with a greater market share.
I was happy to see that chiropractors were discussing their economic problems openly. Too often our difficulties are buried in "happy face" talk, i.e., unwarranted, overly optimistic babble that obscures reality.
However, the proposed solution was clearly unethical. Denying access to degrees and licensure for monetary gain for the currently practicing chiropractors is contrary to basic morality.
Let's admit that chiropractic colleges are involved in a financial conflict of interest with potential students, which presents an ethical dilemma. The conflict of interest should be carefully counteracted by admissions office policy to make potential chiropractors carefully understand the consequences of their vocational choice, and the expenses involved in loan repayment. Since the colleges are run on current students' tuition fees, the admissions officers are part salespeople, unlike admissions officers in publicly funded schools.
I suggest an expanded extern program given to every chiropractic student their first year in school. This program would mutually benefit the students, the school, and the community chiropractors. Should students invest in an expensive chiropractic education without experiencing chiropractic, collecting on an insurance bill, or working a spinal screening? Potential chiropractors should clearly understand the costs involved in capitalization, professional advisors, promotion, and the overhead of an office. They need to understand about financial resources available to them.
Dr. Hofmann writes, "Can you be overly passionate for the profession?" I say, yes. "Think-and-get-rich types" deny this, often to the detriment of people.
Field doctors and leaders in our profession can help potential chiropractors by asking them the tough questions: "Are you sure the expense and debt involved in getting the degree will be worthwhile for you? Have you worked out some game plans for your first five years after you graduate? Do you know what resources you'll need?"
Potential chiropractors need to get access to data about the job market in their potential locations. Local and state associations and the national associations can help the profession, and people who think they might want to become chiropractors, by providing this data. They could provide local market research and sample practice budgets for new and potential chiropractors. They can also keep accurate records of the attrition from the profession, explore the reasons, and widely publicize their findings.
Field doctors can help potential chiropractors by giving them the truth about their own finances. Tell them about practice ups and downs, and types of financial binds to look out for. Tell them about what it takes to get and keep patients; how to get and repay loans after graduation.
The successful new chiropractor of the future may have to be a special person. A potential chiropractor may need many financial resources besides the personal qualities of love of chiropractic, intelligence, enthusiasm, will power, and the ability to convince others.
Rather than limit the number of students in chiropractic school, we should make sure that people who might choose our profession understand what they will need to do and to have.
The ethical principle involved is full disclosure. Full disclosure about something is often an ethical principle that get violated when someone is getting sold something.
The profession, at this time, does not need to sell people on chiropractic as a vocation. Like other professions in America, notably attorneys, a large percentage of people who are accepted for the professional education may not be able to make a living in their chosen vocation.
The clock has turned back for chiropractic. Once again, being a chiropractor may mean risk and hardship. Chiropractic may not be the road to riches it was. Let's just be glad we're no longer being sent to jail.
Our profession is for special people who have what it takes and feel a true calling to heal people, our way.
Linda Elyad, DC
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.
On Feb. 1, 2024, two more legislators – John R. Carter (R-Texas) and Robert “Bob” Good (R-Va.) – co-sponsored the Chiropractic Medicare Coverage Modernization Act of 2023, bringing the co-sponsor total to 155, two more than the total achieved over the entire two-year congressional cycle in which identical legislation last appeared (2021-22).
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.
