Moving the Profession Forward
What is the difference between a doctor of chiropractic (DC), doctor of osteopathy (DO) and physical therapist (PT)? All three can perform physical medicine modalities, rehabilitation and yes, manipulative or manual therapy to the spine or extremities.Then what is all the fuss about? Well, ladies and gentlemen, if you must know, the difference is that DOs and PTs are well-respected in the medical community, while we have to struggle day in and day out just to fight for our rights and respect.
Here in Texas, chiropractors have been sued and challenged by the Texas Medical Association over our right to "diagnose" as a health care provider. [See "Diagnosis: Is Some Better Than None?" in the Oct. 21 issue.] It is a grim reminder for all DCs that the discrimination against us is very much alive and full steam ahead.
So, what must we do? I applaud Robert Walls, DC, of Azle, Texas, for his letter, "Enough Is Enough," in the July 1, 2010 issue. Until we broaden our scope of practice to include prescriptive rights, we will forever be fighting for our right and respect not only from the medical community, but also the general population. Our so-called "leaders" keep praising us and putting up statistical numbers of growing DCs nationwide and worldwide, but what they fail to do is provide stats on the number of DCs who are struggling in practice, closing practices and unemployed. You would be amazed by how many DCs are struggling on a daily basis just to provide food on the table for their family.
Many of my colleagues are now fighting over a $14 to $20 associate position (I'm one of them). Many of my colleagues are seeing less than 10 patients a day. Many of my colleagues are closing down their practices due to lack of interest from the public. Most importantly, many of my colleagues are obtaining additional degree to broaden their scope of practice or switch to a different career. Can anyone name a $100K-plus health care professional education that requires you to basically become your own salesman once you graduate? We all know the answer to that question.
At a weekend seminar, I sat at a table with old-school DCs, middle-ground DCs and newbie DCs. I asked them, "What do you think about prescriptive rights for the chiropractor?" Overwhelmingly, they supported such rights. Don't believe me? Just look at the ChiroPoll results in the July 1, 2010 issue of this publication. Two out of three chiropractors want to have prescriptive rights with proper training.
But we all agree that it will never happen due to the power being held by the leaders within our profession; they would prevent such rights from becoming a reality nationwide. Why can't we have a mandatory vote by all the practicing chiropractors to determine once and for all the direction of profession? I am sure the leaders would scoff at this and generate an article denouncing such thinking and going deep into philosophy of chiropractic. That is why, ladies and gentlemen, we only see 10 percent of the population in our office year in and out. That is why, ladies and gentlemen, we're constantly being attacked by other health care professionals.
I believe tiering of the profession is the right way to go in order to move the profession forward. If you want to stay philosophically straight, then by all means keep doing what you're doing. If you want to broaden your scope of practice, my question is, why not? Additional education in advanced diagnostic skills, pharmacology and clinical rotation internship would more than prepare the chiropractor to practice in public. With prescriptive rights, Medicare and insurance companies would have no choice but to recognize us as physicians and accord us better reimbursement rates. Respect would come from other professions, as we would now be on the same level playing field. Certainly there wouldn't be doctors fighting over a $14-$20 associate position anymore; they could open their own offices and serve the public.
Last, but not least, an experience in Tri-3 forever changed my perspective on chiropractic. My professor's wish was for the allopathic community to "think differently" about chiropractic and understand that the vertebral subluxation complex is the centerpiece of all dis-ease. At that moment, a classmate of mine raised his hand and said, "If we ask the allopath to 'think differently' about chiropractic and the VSC, then why not the same for the chiropractor? Shouldn't we 'think differently' as well?"
It is time to rise up and fight for the rights and respect we deserve.
Alexander Pham, DC
"We Should All Be Angry"
In the July 29 issue I saw what I consider to be a great deal of good news. First was the "Good News, Bad News for Connecticut DCs" article. Honestly I saw this whole thing as good news. Yeah, the lawsuit sucks, but considering that the official word suggests there is simply no evidence to prove that chiropractic adjustments cause stroke tells me this lawsuit is merely harassment, the last swing of a lost fight.
I'd like to see the Connecticut DCs counter-sue VOCA for punitive damages, considering that they tried to smear the chiropractic profession with false and unsubstantiated claims of an exaggerated and imaginary syndrome. Lies, lies and more lies, just like the AMA.
In regard to Dr. Gatterman's call for a revolution - hear, hear! ["Lasting Health Care Reform Requires a Health Care Revolution."] It is time that the chiropractic profession go on an offensive of our own. We have taken abuse for unsubstantiated "concerns" that the medical community has for the most part invented to keep us from competing in what it perceives to be "its" market. The tools are available for us to use. For example, Oprah Winfrey has started her own network, OWN. The chiropractic profession needs to contact OWN and air programming that has long been suppressed for its pro-chiropractic stance.
It is time we take an aggressive stance and start kicking in doors, throwing chairs and making a huge stink to let the world know we aren't going to accept being second- or third-class practitioners anymore. We need to throw off the chains and turn them on those who put us in them. When we won the Wilk case in 1987, chiropractic took a noble stance and did not pursue punitive damages from the AMA. Chiropractic should have gutted its holdings and stripped the AMA of hundreds of millions of dollars for 14 years of crap. Had we taken that seemingly petty step then, we may have avoided the 25 years we have had to endure as a result being noble.
We need to revisit the Wilk case and include the state medial associations in that injunction, as it seems the state medical associations have attempted to carry on what the AMA had intended. Revolution! Isn't that what B.J. would have done if he were here? He would have taken it to the streets and lit fires. He would not have stood still with this kind of asinine behavior coming from the "medical men," as he would have named them.
We have the law on our side! We have precedents being set every single day! We have the juice to take the reigns of our own destiny and whip our detractors into submission. Once they have been subdued, as they should have been long ago, I propose we take punitive reparations from every source of income the AMA and every state medical association has, including the pharmaceutical industry and insurance industry. I believe that we should make it hurt and hurt bad. Put them in the financial hot seat for a change. Let them deal with a bad reputation and the subsequent inability to get adequate compensation as a result of a bad reputation earned through bad behavior, versus their detractors paying the media to write hit piece after hit piece to screw over their better-trained and more competent competition.
I'm sorry, do I sound angry? Good! We should all be angry and we should all damn well use that base emotion to our advantage. Fellow chiropractors, we need to "take" our destiny, because we aren't going to be given our due unless we take it for ourselves.
Richard Bend, DC
Dynamic Chiropractic encourages letters to the editor to discuss any issue relevant to the profession, including response to articles that appeared in a previous issue of the publication. All letters should be e-mailed to with "Letter to the Editor" in the subject field. Submission represents acknowledgement that your letter may appear in a future issue of DC, but does not guarantee publication.