Our revolutionary, fearless founder D.D. Palmer once said: "The purpose of chiropractic is to unite man the physical with man the spiritual." That's a radical notion with regard to a health care modality, but its time has come. Herbert Benson, the Harvard MD who pioneered mind/body medicine, believes 80 percent of doctor visits are attributable to mental and psychological stress. A cardiac surgeon I once interviewed felt that was a conservative estimate; he believes 100 percent of his cases are stress-related.
A new stress-related diagnosis is now appearing in medical literature: "time sickness," a feeling of being overwhelmed with our lives and of not having enough time, coupled with sleep deprivation. Our culture is sick with stress; our way of treating it, rather than to reduce the sources of our stress, is to numb ourselves with psychotropics. Between 1996 and 2005, antidepressant use doubled in the United States, according to a study published in the Archives of General Psychiatry (August 2009). We are even drugging our children in alarming numbers: The Food and Drug Administration estimates that production of Ritalin, used to treat children with ADHD, increased by 700 percent between 1990 and 1997.
A Culture in Need of Relief
I don't wish to suggest there is never an appropriate time for psychotropic medicine. I am suggesting, however, that we are a culture in need of relief from feeling overwhelmed. Drugs are not the solution, but we as chiropractors can be. Our practice is based on the understanding of how mind and body interrelate. Therefore, I am proposing that we become body/mind specialists of the 21st century. When I say "body/mind specialists," I mean that we need to train in cutting-edge discoveries and techniques aligned with our chiropractic heritage: psychoneuroimmunology, brain and nervous system approaches, Chinese medicine and mindfulness meditation. To integrate these approaches with chiropractic, we need different training in our colleges; training that will require cultivation and long-range vision.
Of course, we should not stray into the minefield of promoting religious beliefs. Due largely to the work of Jon Kabatt Zinn at the University of Massachusetts, mindfulness-based stress-reduction techniques have been divorced from spiritual or religious connotations. There is now scientific evidence that these techniques can mitigate diverse conditions including chronic pain, lower back pain and even psoriasis. Mindfulness meditation, which simply develops an awareness of presence and breath, is already mainstream; it's being used by the military to treat posttraumatic stress disorder (PTSD) and in business. It's being applied to help professional athletes, students, incarcerated criminals, pregnant women and parents. This gem of health care wisdom - that the mind and body are related - has always been central to our philosophy and the foundation of our approach.
Although these techniques are already being taught by a variety of professions, no profession has made it a basic tenet of its practice. We can be the first. We are uniquely positioned to apply and build upon this model of body/mind medicine. There is a need (and frankly, a huge market) waiting for health care professionals to lead the way.
Fulfilling Our Mandate
Body/mind medicine has always been our mandate, and I am proposing that we make it official by developing a diplomate program in body/mind medicine. No other health care profession is as prepared to deal with the elephant in health care; no, not skyrocketing costs, but the fact that health care in our culture is frequently not addressing the underlying causes of dis-ease.
I realize that this may sound overly ambitious, even radical. But we have always been adjusting minds through chiropractic. Do you wonder why chiropractic techniques get results? It can't be simply a result of moving bones; some techniques don't move bones, and yet they still produce results. It's commonplace in our profession to say the results are because of the body's innate intelligence; well, there you have it. Whether or not we're aware of it, we're innate intelligence specialists, so let's train in approaches that take advantage of this innate intelligence.
I believe we are at a crossroads as a profession; we need to have a vision in line with our philosophical roots. As much as body/mind intelligence has been our philosophy, claiming this and providing services beyond the adjustment is revolutionary.
As if we need to be reminded, D.D. Palmer and his son B.J., were not exactly ordinary 19th-century Midwesterners. One only needs to visit the mansion in Davenport, Iowa to sense the breadth of their interests. There is, of course, the collection of twisted spines along with other fairly bizarre items B.J. collected; but he also had the largest stone Buddha in the United States, which he purchased on one of visits to Asia. Keep in mind that it's from Buddhism that mindfulness meditation comes to us. Few readers may know that in 1922, a Chiropractic Psychopathic Sanitarium was established in Davenport. Even more evidence that chiropractic and mental health - the body/mind connection - are part of our history and philosophy.
Even if you've never consciously applied body/mind medicine in your practice, undoubtedly you've seen it in action: How many of us have adjusted someone, only to have an outpouring of emotion follow? As has been said, "The spine is the back of the mind." It's not just a glib saying. Candace Pert's book, Molecules of Emotion (a must-read for all chiropractors), demonstrates research in biochemistry connecting the brain cord to hormonal release. Another must-read is John Sarno's Healing Back Pain: The Mind-Body Connection.
The foundation of body/mind medicine is relationship. This is an area of patient care in which we have excelled for over a century. We have never forgotten to treat the patient before the illness. In follow-up studies in which DCs are compared to medical doctors, we invariably receive higher scores for overall satisfaction. We have built and maintained relationships as a high priority in our practices. In essence, we have earned our patients' trust, the bedrock of body/mind health care.
We are also the front-line caregivers for the most common form of body/mind manifestation, neuromusculoskeletal problems. Muscle-skeletal tension and subluxation arise with mental stress. Again, we are well-positioned to intervene.
Embrace Mind/Body Protocols or Risk Marginalization
The need is clear and the demand is there, but if we don't expand both our understanding of body/mind and our protocols, our profession could be marginalized in the next two decades. One vision for the future of chiropractic pigeonholes us as musculoskeletal specialists; in another vision, we're little more than high-volume adjusting machines. In either scenario, we become a victim of our own success. Adjusting the spine helps the body heal irrespective of the particular style of adjustment. Whether our profession is reduced to mere adjustment or we try to assure the profession by treating people in high volume, we devalue ourselves.
Other professions are learning to adjust the skeleton in weekend seminars. Add to that the growth of high-volume practices and prices will be driven down, essentially "Wal-Marting" chiropractic. The market will respond by reducing reimbursement and lowering our status as doctors.
Quite frankly, we do not have the money, the lobbying power or the market recognition to secure our future by legally protecting the adjustment. We risk being marginalized by the medical deities, DOs and PTs if we limit ourselves to the musculoskeletal approach; and by machines or virtually anyone who can perform an adjustment with the volume approach. We stand on very tenuous ground by relying on legal and lobbying efforts to protect the adjustment as the entire scope of our practice.
We cam not only secure our professional future, but also lead the way for body/mind medicine in our culture. Modern medicine will evolve and technological miracles will occur (and thank God they will), but unless we address the body/mind connection, we will continue to know less about inhabiting our bodies and be further dis-eased. We will lose the wisdom of innate intelligence. We can offer an almost unimaginably valuable service if we help people ease their stress in body and mind; if we help people be present. We would also fulfill the dream of our founder to unite man the physical with man the spiritual.
This growth for our patients would follow growth in ourselves as individuals, not simply as doctors. We would not be intellectual bystanders and clinicians in this endeavor; we would lead by example. What an extraordinary way both to earn a living and to further our personal growth by becoming more present and loving. Expanding our range of protocols makes good economic sense as well; insurance companies are beginning to reimburse for stress reduction. More importantly, people are paying cash to become more sane.
Some of you will scan these words briefly and forget them. Others will roll your eyes and mutter a dismissal. But some of you, maybe only a few, will consider seriously this heartfelt invitation to better yourselves, your patients, your communities and your profession. It can be done and the benefits for both patient and practitioner could create a cultural shift. I look forward to talking with you.
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.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
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.
