One way for a speaker at almost any chiropractic gathering to get certain applause is to make a plea for unity. Some even go so far as to suggest that a chiropractor should join any organization, rather than forego membership in something. Obviously, ethical and moral considerations require that you only join an organization whose policies are congruent with your core values. Just as clear are two disturbing facts: The majority of chiropractors are not members of any national association; and lack of an effective, unified voice has served as a barrier to realizing our potential to flourish as a profession, and to serve those who need our services.
No, I'm not going to beat the tired drum of merger. For 35 years, I watched competing factions within the profession engage in self-destructive behavior. This began when, as a student, I was hired by the ICA to develop its Medicare seminar program after unsuccessful negotiations with the ACA. This was followed by the struggle between the former ACC and the CCE to obtain recognition for their respective accrediting agencies. I have at one time or another been a member of the CA, ICA, FSCO and WCA. The failed ACA/ICA merger effort in the late '80s is a vivid memory, as is the accreditation struggle involving SCASA and CCE.
During these years, I have been privileged to work with committed passionate chiropractors, all sincerely believing that their course was "what's right for the profession." I have seen the profession from many perspectives: as a chiropractic college faculty member, field practitioner, researcher, and politico. I've seen chiropractors pitting themselves against other chiropractors in classrooms, state board meetings, political meetings, and even the U.N. In the words of diet guru Susan Powter, "It's time to stop the insanity."
The chiropractic profession is at a critical juncture. American culture is embracing our philosophy and crying out for leadership. Economist Paul Zane Pilzer has predicted that the wellness industry will become the next trillion-dollar player in the marketplace. We have an installed base of 60,000 licensed practitioners. An opportunity of this magnitude has never presented itself, and the next such opening may not occur in our lifetimes. Only we can screw it up. And that's precisely what we are doing.
What can be done? Will mindless chanting of the "unity, unity, unity" mantra solve the problem? Will each organization's attempt to outmaneuver the other work? Will rants from bully pulpits win favor with field doctors and legislators? How about one organization attempting to devour the others? Been there, done that - for more than 100 years.
We are living with the results of these failed strategies. Who is right? Who really knows what's best for the profession? Well, the majority have already voted with their feet: no one. The overwhelming majority of practicing chiropractors do not think any of our national organizations are worth their time, talent and money.
Our full potential as a profession will not be achieved by attempting to force the entire profession to adopt a single practice style, technique or organization. I believe it is possible for the interests of all but the most extreme chiropractors to be accommodated, provided there is tolerance, respect and dialogue. If we stop talking to each other, we are defeated before we begin. Instead of expecting an overnight miracle, let's commit to a few things:
Celebrate our diversity. In my communications with other health organizations in the U.N., the issue of chiropractic identity often arises. When asked about schisms and apparent contradictions, my answer is simple: "Some chiropractors specialize in caring for patients with musculoskeletal problems. Others focus on wellness and quality-of-life issues. Our unique contribution is the adjustment of vertebral subluxations, which disturb the function of the nervous system." Thus far, no one appears to be confused by this, any more than they find the fact that some dentists fill cavities while others specialize in orthodontics to be confusing. Confusion only comes into play when one brand of chiropractic is represented as the one and only, with everyone else branded as wrong.
Communicate. We must continue meaningful dialogue and have the maturity to realize that we are not going to agree on everything. The question we must ask is, "Can other points of view be accommodated without compromising my constituent's interests?" There will be contentious moments, and raised eyebrows and voices. The process will not be easy or painless. Yet the alternative remains unacceptable.
Seek to define core values. True unity will occur naturally when common core values are defined and embraced. We've taken a few baby steps in this direction, such as adopting the ACC Paradigm. We still have a way to go.
Do not confuse goals with strategies. Confusing a strategy for a goal means closing the door to the consideration of other strategies that may be more effective. Merger is a strategy, not a goal. "One unified national organization" is a strategy. What is our goal? How do we define unity? What are the most effective strategies to achieve our goals?
Remember the patient. This is not about ensuring the employability of chiropractors or even "what's best for the profession." It's about working to ensure that chiropractic's unique contribution to human health is disseminated as broadly as possible. What's best for the profession is what's best for the patient. Once we realize this, our market share will explode.
Seize the wellness opportunity. Assume the leadership role of the wellness revolution. Ensure that chiropractic's unique contribution to unleashing human potential is at the core of wellness strategy. We need not copy the medical models of early detection and disease prevention. We can command the proactive wellness movement, which is not competitive with medicine in treating disease.
Get over the past. The more we rehash moot issues and perceived failures, the less energy we can devote to creating a positive future.
Create a positive future. We must determine how we can create value for those who see no compelling reasons to invest in a national organization.
We can have our wants and needs effectively addressed. Legislation can be crafted that provides for the needs of chiropractors specializing in neuromusculoskeletal disorders, and chiropractors who offer subluxation-based wellness care. In fact, I have heard of patients who have two chiropractors; one to treat an injury and one for wellness care. This is no stranger than synergy between an orthodontist and an endodontist.
Wouldn't it be wonderful if chiropractors with different perspectives, practices, techniques and talents referred to one another for the benefit of the patient, rather than vilifying one another and referring only to medical doctors? Instead of reworking the failed strategies of the past or closing the door to strategic alternatives, let's look outside the box for the solution that is "naturally right" for everyone.
Thankfully, there is some progress being made. The Foundation for Chiropractic Progress has launched a program of advertising and public relations that has placed the chiropractic message front and center in mainstream publications. It has also issued news releases and targeted specialty publications that serve policy-makers in the health industry. It deserves your enthusiastic support.
As Gandhi wrote, "We must become the change we want to see in the world."
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