In the Court of Public Opinion
Louis Sportelli, DC
Putting an End to Terminal Apathy: Your Chance to Change Our Future
This article was triggered by an online discussion between the producer / director of the recently released documentary, "Doctored," and several organizations and individuals within the chiropractic profession. As I read the exchange, I began to think back over my years of involvement in the profession and wonder if some "fatal dis-ease" has insidiously overcome us. My objective in writing this article is not to be negative or attribute blame, but rather to raise questions I hope will generate some positive dialogue about why we seem to be almost indifferent, and certainly less passionate, about what needs to be done and whose job it is to do it.
The very essence of the questions I am asking may be answered by: "How many will not read this article?"and an even bigger question:"Why will they not read it?"From my observations, there seems to be a growing professional disassociation, an alarming ambivalence, between what is happening to our profession and what we individually and collectively feel obligated to do about it.
As if by divine providence, as I was writing this article, along came a note in the mail from a DC, whom I do not know, but whose message was so on-target it seemed eerily coincidental. I was so taken back that I actually called the doctor, thanked him for his candor and sought permission to use his note in my article. I elected to remove his identity because it did not advance my message, and I am certain this note speaks for thousands of my colleagues.
In his note, the doctor admitted that he was not involved in organizational activities – not because he did not care, but rather because initially when starting out, he was "focused" on building his practice, providing for his family and doing community work. All praiseworthy activities, but on deeper introspection and reflection, he recognized that he genuinely did, in fact, "owe something" to those colleagues, individuals and organizations who took the time and energy to participate in activities designed to advance the very profession he practiced and enjoyed the benefits of for many years.
This doctor is indeed an honest man who recognizes that perhaps it is his time to repay, in some way, by participating in the profession; by giving back monetarily and with his most precious and limited commodity: time.
With the energy boost I received from those humble words from a doctor I did not know, I took a few moments to reflect on "where we were," "where we are" and "where we're going."
Supporting a Cause: Wilk and Reader's Digest
Reflecting on the history of significant events our profession has experienced, several have, of necessity, required the participation of a large number of doctors of chiropractic. The most compelling example is the Wilk vs. AMA litigation, which ignited a firestorm within the profession. There was outrage, a sense of defiance ("We are not going to take this any longer"), and an attitude of validation and vindication that seemed to connect all aspects of the profession. This common cause united opposing factions of the profession to coalesce and fight a common cause.
Make no mistake, even then there were those who did not want to litigate against the AMA for fear of upsetting whatever relationships existed within their personal communities, or upon the advice of more conservative attorneys. Fortunately those groups against were smaller in number, and the majority of the profession was in "fight mode." The litigation was launched and thousands of doctors eagerly participated and willingly contributed their dollars to make it happen ... and the rest is history.
Along came the Reader's Digest project, launched in 1988 as one of the first national educational programs ever undertaken in a major publicationbecause of an adverse article, published in that trusted magazine, that influenced millions of Americans. Again there was opposition from those who did not want to support (contribute to) the program because it would not do anything to bring patients into their offices.
But to the surprise and chagrin of many who said it could not be done, 5,000 doctors of chiropractic gave $200 each toward the program's goal of raising $1 million ... and the program was marketed in Reader's Digest not once, but twice. Many who supported the program felt there was an opportunity to help undo some of the previous negative articles which had appeared in this very same publication and, because of its consumer readership, had irreparably harmed the profession. The program was launched, thousands contributed and the rest is now discussed in historical terms.
These are just two of the events that required considerable participation by large numbers of doctors of chiropractic in order for them to be successful. There are more that could be used for illustrative purposes, of course, but the era I am talking about was pre-1990. Most of the sophistication and availability of instant communication (e-mail, Facebook, Twitter, LinkedIn, blogs, YouTube, etc.) were not available. To obtain information, you had to physically go to a meeting or open and read your snail-mail. The sense of personal involvement in meetings and the developing camaraderie engendered a feeling of brotherhood that bonded chiropractors together at a time when it appeared the world was out to get us (and it was). That personal relationship was comforting.
Managed Care: Setting the Stage for Non-Participation
Enter the transforming decade of the 1990s and the world of managed care. I have written extensively on my feelings of exasperation at the manner in which managed care companies (some owned by doctors of chiropractic) were treating our profession. While it is unlawful for trade associations to advocate a "boycott," it was not and is not illegal for private doctors of chiropractic to simply decide not to individually participate in the horrible contracts being offered to them.
If the decision not to participate had happened spontaneously, managed care companies would have been in violation of their own contracts, which required them to "provide a network." Without a network, they would have been forced to renegotiate fees, revise treatment protocols and modify other egregious contract language.
But instead, the profession chose to docilely accept less-than-stellar agreements because doctors were fearful of the fact that their colleagues down the street would accept the contract and they would be out in the proverbial cold. Looking back, I ask, how did that strategy work out for our profession? Our acceptance of the "crumbs from the table" created a dual system in which we were reduced in fees, restricted in scope, curtailed in treatment and diminished in respect as we sat by as willing spectators in the health care debacle. It infuriates me that we allowed this to happen.
Where We Are Now: The Opportunity Too Many Are Ignoring
Simply put, why has there not been overwhelming support for the new documentary "Doctored"? This is one of the first exposés ever produced that tells the story of the tyrannical conspiracy chiropractic unwittingly endured for decades. It chronicles a story that unveils the deceitfulness of the AMA to destroy the credibility of chiropractic in the hearts and minds of the consuming public, and all opinion and policy-leaders.
The devastation – economically, socially and professionally – was horrible for the individual practitioner and even more devastating for the collective profession. Ultimately, the real tragedy of the conspiracy to contain and eliminate chiropractic was the patients who were never seen by chiropractors and could have been possibly helped from a lifetime of pain and suffering. The "results" personally experienced by patients has always been the driver of our limited success, and our market share has suffered because of the lingering effects of the AMA conspiracy.
My personal involvement in "Doctored" was by unintended chance. The filmmakers' interest was initially as a simple business venture: make a documentary, make some money and go on to the next project. Along the way, something happened as they crisscrossed the country, listening to and filming every segment of our profession and those miracle patients who wanted desperately to tell their stories. From their vantage point, they did not see a profession divided. They saw a profession hindered by a false narrative generated by the AMA; a fabricated story believed by millions who were influenced by that negative message. And they had the modern tools of communication to create a documentary to begin to help change that narrative.
So here we are, fortunate enough to have the documentary released near the end of 2012, featuring doctors of chiropractic who have a story to tell, and equally as important, exemplified by medical physicians who feel compelled to sound the alarm that our health system is not working and the paradigm needs to be changed. And yet, of the approximately 60,000 doctors of chiropractic in the U.S., more than half of our profession has never heard of the documentary, and of the other half who have been exposed to the documentary, just over 1,000 individuals have decided to purchase one or more copies and help spread the word.
Why has the profession become so apathetic and indifferent? Our college enrollment is challenging, our market share is stagnant, the climate in health care is less than optimistic for guaranteed inclusion in the new health care act ... and yet we sit idly by and either complain about our state of affairs or do nothing about it.
Is "Doctored" the be-all, end-all that will end the profession's struggles? Of course not! However, the documentary is something already available, already produced, already able to be distributed and already proven to challenge society's way of thinking. But rest assured that it will not be played on network television; it will not be referenced in an "Entertainment Tonight" discussion; and it will not be in all major theaters. If the documentary is to be seen on a wide scale, it will take the concerted effort of a larger majority of individual doctors of chiropractic, each doing their small part to advance the larger picture.
A Challenge to Change the Future
Assuming 50,000 practicing DCs as a fair estimate of our profession here in the U.S., the numbers become rather significant. Each DC, making a commitment to purchase only 25 copies, would guarantee sales and distribution of over 1 million DVDs. The net effect of proceeds would be enough to create even more powerful documentaries already in the works, currently titled "Undoctored" and "Bought." The themes of each of these new productions emphasize creating a mindset and paradigm shift in thinking about health and wellness.
Imagine if each of those million DVDs were seen by at least 10 people. Potentially, 10 million people could have a paradigm-changing experience. Is it doable? Of course it is. Is it too costly? Of course not. Will it get done? Only individual DCs who feel a commitment to do something now, like the doctor who wrote me about his experience, can answer that question.
A number of individuals have been working hard on getting this message out, and each may have a different motivation, but the bottom line is that the end result is the same: bringing the message to millions of patients who have been adversely influenced by the ongoing propaganda campaign and exposed subtly – and not so subtly – by the AMA and the pharmaceutical industry.
Just look to Texas and now a few other states that are blatantly attempting to limit doctors of chiropractic from diagnosing and even using the term doctor. The turf battle is not over ... it has just shifted in style and attack. I recall so vividly the anguish in the voice of "Sore Throat," who literally risked his very life to make copies of AMA internal documents available to the chiropractic profession during the Wilk case. He virtually pleaded with us to do something.
My appeal to you today is simply to do something. It does not have to be a lot; as Voltaire said: "No snowflake feels responsible for the avalanche." But in our case, every snowflake (chiropractor) must share in the responsibility. What happens to our profession in the next few years will determine the trajectory of our success and survival.
Will we simply watch helplessly and lament that we are losing the battle? I am not prepared to give up this fight easily, and I hope thousands of DCs will join me in helping to make "Doctored" and future documentaries a success. When is the time right to set aside all of the divisions within our profession and focus on the tremendous opportunity we have before us as the most cost-effective, conservative, and outcomes-driven profession able to truly impact the cost and delivery of health care? When? Now.
I urge you to visit www.supportchirotv.com, click on the Gallery tab and listen to the appeal from Jeff Hays on his latest project, as well as view a short trailer on the in-the-works television series, "Rescue 1-2-3." Please consider doing a small individual part in order to make the collective impact huge. We have an opportunity of a lifetime, and we can do this as we have done other seemingly insurmountable things ... together. My personal thank-you to the doctor who wrote to me with his wonderful letter of inspiration.