On Jan. 15, while attending the Parker Seminar in Las Vegas, my wife and I were grabbing a quick bite to eat and playing quarter slot machines. Then something wonderful happened: She hit her first-ever royal flush and won 4,000 quarters! To say she was excited would be an understatement.
During the celebration, our eyes caught the television screen in the corner of the room, where we saw a U.S. Airways airplane in the water. Assuming many lives were lost, our glee turned to sadness for the passengers as we headed back to the seminar. Only later did we learn of the heroic and skilled actions of Captain Chesley Sullenberger, who glided the plane down to a perfect watery landing without a single fatality in what is now known as the "Miracle on the Hudson."
In an interview on the CBS television show "60 Minutes," Captain Sullenberger (Air Force Academy '73 and former fighter pilot) stated, "It was a normal climb-out in every regard. Then, about 90 seconds after takeoff, I noticed there were birds filling the entire windscreen - from top to bottom, left to right - large birds, too close to avoid. It felt like the airplane was being pelted by heavy rain or hail. It sounded like the worst thunderstorm I'd ever heard growing up in Texas."
Captain Sullenberger said that after the flock of birds hit Flight 1549 like a meteor shower, "I felt, heard and smelled the evidence of them going into the engines. I smelled a burned bird smell being brought from the engine-air into the aircraft's conditioning system." He added, "It was obvious to me from the very moment we lost thrust that it was a critical situation, losing both engines at a low speed over one of the most densely populated areas on the planet. The airplane stopped climbing and going forward and began to rapidly slow down."
Then, in what I consider the most graphic example of poise under pressure I have ever heard about, Captain Sullenberger said, "That's when I knew I had to take control. I put my hand on the side stick and I said the protocol for the transfer of control, 'My aircraft,' and the first officer Jeff immediately answered, 'Your aircraft.'"
"My aircraft." What a powerful comment! When the chips were down and the 155 passengers and crew needed him to save their lives, he accepted full and total responsibility.
Threats to Our Professional Survival
So, you may be asking yourself, "Great story, but what does it have to do with chiropractic?" I am so glad you asked. Right now, "geese" are pelting the chiropractic profession, and we are taking them into our engines. Here are six geese that literally have the ability to "crash" this profession at any moment:
Goose #1 - Blue Cross Blue Shield adopted a policy in several states that considers surface electrical stimulation and traction unproven and investigational, and subsequently will not cover the services. If allowed to stand, these restrictions will likely "migrate" to other states.
Goose #2 - The Chiropractic Stroke Victims Awareness Group continues to press its agenda, despite the misrepresentations at the heart of its claim. They recently promoted a bill in the Connecticut legislature that would have required DCs, and only DCs, to provide informed consent materials to all patients before treatment. The ACA and National Chiropractic Legal Action Fund (NCLAF) continue to work closely with state chiropractic associations to fight this ongoing anti-chiropractic campaign.
Goose #3 - The ACA recently reacted with alarm to proposed changes to UnitedHealthcare's policy on the coverage of chiropractic services, which, in my view, would effectively negate the role of a doctor of chiropractic as a physician. UHC's coverage pronouncements are perhaps the most influential and widely utilized policy adopted by any health insurer. The proposals constitute an immediate threat to patient care in the view of all the organizations and would relegate chiropractic care to a medical backwater.
Goose #4 - Aetna has issued a new policy guidance that effectively describes a number of common chiropractic procedures and related treatments as "investigational and experimental." Primary concerns included Aetna's failure to cover previously covered services and major recoupments of past payments. ACA continues to discuss these concerns with Aetna and is also formulating possible legal approaches through state agencies and federal remedies.
Goose #5 - A recent report by the ACA Medicare Committee described a troubling trend with Medicare contractors. In essence, these contractors are misinterpreting national Medicare standards for coverage of services performed by chiropractors. ACA has initiated contacts with CMS in hopes of resolving this growing problem.
Goose #6 - This is the most dangerous one of them all. When ACA legal counsel Mr. Tom Daly recently commented on the seriousness of national health care reform, his powerful words vividly illustrated the imminent danger this profession is facing:
"The profession has never seen the types of challenges we see today. Proposals are now being considered in Congress and the Administration that will set the framework for America health care system for generations to come. The President says he wants to use the federal health care plan as the basis for coverage for the uninsured in which physician status is paramount; and yet Blue Cross Blue Shield recently decided, arbitrarily and without notice, to strip away the physician status from chiropractors under this crucial federal health plan. We are told that 'essential services' will be the focus on national health care reform and yet UnitedHealthcare and other insurers and managed care companies are all busily rewriting their policies to diminish the role of chiropractic as an essential service. Let's also not forget that the AMA, as early as last summer, adopted policy that would make it a felony for anyone other than an MD or DO to refer to oneself as a 'physician.'
"There was a time in this profession when joining the ACA or other national association was viewed as an essential obligation, just as essential as obtaining a license to practice or malpractice insurance. It was only through joining a national organization, working with the state associations, that the profession was able to defend itself and not only survive but thrive in our early years. The challenges that faced our predecessors are much the same as the challenges that now face us. The decisions that will be made in Congress and in the courts in the next year or two will be vital to our very existence as a profession. I would urge all of you to spread the message that today's doctors of chiropractic must rise to the same level of commitment and obligation that prior generations ascribed to ... as a matter of primary professional duty and obligation.
"So doctors ask yourself, 'How do I serve my patients if two years from now I find that I am no longer considered a physician, that my services are no longer viewed as essential, that I am now relegated to a medical backwater to provide my service only under the order of another provider?' Ask also, who can stop this, who has always fought for the profession and who has the only chance of prevailing against the powerful interests now aligning against chiropractic?"
A Call to Action
Like it or not, as a practicing doctor of chiropractic, you are a steward of this profession. Are you going to abandon that responsibility and allow this profession to "crash?" Or are you going to follow Captain Sullenberger's example by adopting the attitude that this is "my profession" and that you will do everything necessary to protect and defend it? I urge you to put your hand on the "side stick" of this profession today. There has never been a greater need, and now is the time for every DC to take responsibility.
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