This column has had one persistent theme over these months - namely, that we must unify to increase patient utilization, boost chiropractic college enrollment and improve media coverage. The grim facts are these: With chiropractors seeing only one-tenth of the population, with our college enrollment down 34 percent in the past six years, and with press portrayal of chiropractic so often negative, our profession's future is uncertain.
In April, Newsweek had a story about treatment for low back pain that gave chiropractic only passing attention, and in May, chiropractic again was barely visible in Newsweek's follow-up letters to the editor. Likewise, a recent survey in The Spine Journal revealed that chiropractic has lost market share for treatment of low back pain. According to the study, patient visits for chiropractic care from 1987 to 1997 fell from 40.5 percent to 30.6 percent, while visits to medical doctors and physical therapists increased significantly during the same period. Folks, we're losing what we assumed was our franchise. We should be considered experts, and we're increasingly less likely to be considered at all.
To get more patients, we must tell the public who we are, what we do and how well we do it. We need a common identity. The guest authors who have written in this column, and others who have sent e-mail to me, argue that professional unity is the key: "United we stand, divided we fall." Everybody agrees that our profession's schizophrenia and factional infighting present a confusing picture to the public and government. That blurred identity will prove lethal if we don't change our ways. Unify or die!
"Only peril can bring the French together," Charles de Gaulle said. "One can't impose unity out of the blue on a country that has 265 different kinds of cheese." And one can't impose total unity out of the blue on chiropractors with 265 kinds of philosophy, technique and political ambition. Still, a gun has a way of getting our attention, especially when we are staring down its barrel. Yes, the peril of extinction can pull us together, whatever our cheese.
But what does professional unity in this context require of us? I offer some ideas on what this unity campaign does and doesn't mean. It requires less of us than we might think.
The unity we seek is primarily in the public's perception. It does not require that all doctors use the same adjusting techniques, chant the same philosophy, support a particular college or join a particular professional association. If you're licensed, you're a chiropractor, and the public needs to grasp that licensed chiropractors all offer a valuable service. In short, in hiring a public relations agency and sending out a focused message, we're looking at what marketers call "branding." We want a brand identity for the chiropractic profession.
Sergio Zyman, a Coca-Cola marketing executive who wrote a fine book called The End of Marketing as We Know It, says: "The purpose of branding is to differentiate our product in the marketplace and to get consumers to identify it as different, better and special. ... The aim is to develop a unique selling proposition."
Well, chiropractors believe chiropractic is different from and usually better than medical approaches to spinal care, because it's natural, drugless, noninvasive and relatively inexpensive. It's also special because it takes a holistic and long-term wellness approach, emphasizing prevention over pathology. Our "unique selling proposition" involves the fact that chiropractic offers more gain, less pain - physically, emotionally and economically. We all agree on that, right?
Wouldn't it be great if our unique selling promise could be articulated so that prospective patients act on it? Once the positioning concept is in place, it will begin to shape a consistent image of who we are and what we do. When the public relations people give us that - having proven it's on target with their market research - we'll be called upon to support it, on both the national and local levels.
Let me illustrate: The farm equipment manufacturer John Deere has, as its logo, a silhouette of a leaping deer on a yellow and green plaque. Deere's brand slogan, also on the plaque, is "Nothing Runs Like a Deere." People at the factory in Moline, Illinois, or at a John Deere dealership in Butte, Montana, may wish the slogan were something else. One guy prefers "John Deere Pulls Plows Better." Another likes "Deere Has Better Engineers Than J.I. Case." You know what? Nobody argues with John Deere's slogan, and no dealer changes the logo from yellow and green to purple and pink. They all know that accepting "Nothing Runs Like a Deere" on a yellow and green plaque means that at a glance, the public calls to mind the company's quality engineering and great tradition in agriculture. They all support the brand identity, and everyone who makes, sells or drives a John Deere product is better off because of it.
Suppose the public relations firm (we expect the selection of an agency to be announced in August) comes up with a positioning line that isn't your personal choice. Maybe the brand promise turns out to be something like: "Your Chiropractor - Keeping You in Line for a Healthier Life." Couldn't we admit that aligning the body is what we do? Must we make it an issue that some chiropractors treat neuromus-culoskeletal conditions and others have subluxation-based wellness practices? Does the public care about those nuances? Not hardly, but people would care about a promise that keeping their bodies in line helps them enjoy life to the fullest. They get the importance of frame alignment for their automobiles, and they will get its importance for their bodies.
If the unique selling proposition rings the bell with the public - bringing us more patients - wouldn't we keep ringing it with money for public relations and advertising? Wouldn't we put posters with that promise in our offices? Wouldn't we drive down to our local newspaper and offer a PR packet or place a co-op ad to promote our common identity? Wouldn't we tell prospective chiropractic students that a career that helps people to a healthier life is worth pursuing? Wouldn't we share with the media any research that proves our proposition?
The national PR campaign is not asking for abolition of all our differences. Indeed, our differences represent the breadth of our experience, ingenuity and successful practice. Rather, we're asking to unite around what we hold in common. Robert F. Kennedy put it this way: "That which unites us is, must be, stronger than that which divides us. We can concentrate on what unites us, and secure the future of our children; or we can concentrate on what divides us, and fail our duty through argument and resentment and waste."
In its 109-year history, our profession has all too often concentrated on what divides us, and we have limited our market share, and thus partially failed our duty to humankind through argument, resentment and waste. Let's articulate what unites us and invites people to seek us. Let's shout our united message from the housetops. This is who we are. This is what we do. This is how we help.
Let's show the world we can change it for the better. United in this (even if it isn't everything) we can stand. We can make this work.
Kent S. Greenawalt
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