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Why We Can't Get Along

Is it a matter of apples and oranges?
After 26 years as a non-DC attempting to serve chiropractors by advocating the patient's point of view, it still astonishes me how much this profession is held back by its fractured in-fighting. And no wonder. After a recent seminar, in which I heard chiropractors using sloppy language while asking questions, it prompted me to identify some of the many distinctions that chiropractors make—either consciously or unconsciously, that produce the bifurcation in chiropractic:

D.D. or B.J. Are you more comfortable with the fundamentals advanced by the founder of chiropractic, with its metaphysical tenets and century-old philosophy, or are you aligned with the charismatic developer of chiropractic and his strange writings, thots and innate philosophy? Or neither, because these historical figures embarrass you or you prefer making chiropractic what you think chiropractic is?

Upper cervical or full body. I wasn’t around in the early days as B. J. Palmer attempted to herd this profession of cats, but way back when, chiropractors had to choose sides. Is the atlas/axis subluxation the only one worth attending to, or could you venture further down the spine, even to Logan Land in the sacrum?

Straight or mixer. Should you do anything other than reduce subluxation? Or can you provide other supportive services to enhance physical, mental or social well-being? Is heat, cold, electricity and light legitimate healing modalities? Or should chiropractic be limited to adjustment only?

Hands or instrument. You’d think that the word chiropractic, which comes from the Latin meaning “done by hand,” would be clear enough. But what if the hand is holding an instrument? What if your hands are so beat up after 20 years you need an instrument to assist you?

Subluxation or dysfunction. Does chiropractic address a neurological phenomenon or merely a mechanical dysfunction? Every chiropractor has to choose. Are you okay with the s-word” or would you prefer to see it disappear?

Manipulation or adjustment. Generally defined as less specific than an adjustment, will you use the term manipulation instead? Many of the research articles affirming chiropractic-like interventions use this term. Language matters. Are you being specific or general? Are you intentioned or hazy? Focused or unsure?

Bones or nerves. Is the goal of chiropractic to “fix” patients and restore alignment, balance, symmetry and ideal curve? Or does chiropractic concern itself with the integrity of the nervous system? This is a huge distinction that is often lost on chiropractors who use adjusting techniques that they think put bones that are “out,” back where they belong—virtually ignoring why the body might have put the bones there in the first place. Have you considered going spineless?

Force or tonal. Can subluxations (or whatever you call your particular bogyman), be reduced only by applying force along facetal joint planes, or can you use a touch or sustained pressure? Can you talk them out? Can you pray them out? Is one way superior to another? Are both approaches equally chiropractic?

Local or whole body. Is chiropractic merely a way of reducing the obvious symptoms local to the spine, or is it a discipline that mediates the integrity of the nervous system, which can have visceral, organic and whole-body effects? Is chiropractic appropriate when there are no symptoms present? Or must one wait for symptoms to manifest first?

Episodic or lifestyle. Is chiropractic allopathic or a lifestyle decision? In other words, is chiropractic merely a short-term diet to deal with bouts of obvious neuromuscular-skeletal problems, or a healthy, life-long habit? Is it appropriate to reduce non-symptomatic subluxations? Is it okay to adjust children even if they don’t yet have a “bad back”?

Patient or practice member. What will you call the people who show up in your office? The word “patient,” which comes from the Latin word meaning, “to suffer,” is probably where most people start. Or, do you have people who begin care observing that they’re “feeling great and want to be even better?” If you see people with these two different motives, you may need to make a clearer distinction with your language.

Treatment or care. Treatment, which is defined as a procedure to relieve illness or injury, is clearly medical languaging. The term “care” implies giving attention and direction, yet recognizing that the patient is the one doing the healing. Which one will you use?

Compliance or follow-through. This choice reveals the “headspace” of the chiropractor. Compliance suggests surrendering power; submitting to the wishes of another. Therefore, compliance is a doctor-centric view of the relationship. Follow through acknowledges the sovereignty and free-will choice of each patient and reflects the degree to which the patient chooses to complete or finish the suggested recommendations.

Self-pay or third party. And who will be your boss? The patient with whom you actually have a relationship, or a distant third party who doesn’t understand, respect or even like chiropractic and sees reimbursing for your services as a needless drain on corporate profits?

Diagnosis or analysis. This is where brushing up against the allopathic third-party industry has rubbed off onto many chiropractors. Analysis is defined as procedures designed to reveal the presence, location and character of a vertebral subluxation along with any contraindications to chiropractic adjustments. Diagnosis is a medical procedure to identify a disease by its signs and symptoms. Which is fascinating, since most state chiropractic licensure laws specifically prohibit chiropractors from engaging in the treatment of disease.

Mechanism or vitalism. Are the people who show up in your office merely mechanisms and chemical reactions with a limited number of cellular replications and they die, or are they greater than the sum of their parts, respond to prayer, are self-healing and regulating and have nervous systems that learn and adapt?

Anecdotal or evidence-based. What will you choose to believe about chiropractic? Is the linear, double-blind “gold standard” used in medicine, especially drug testing, appropriate when judging chiropractic? Or will case studies and anecdotal reports be sufficient in proving the value of chiropractic?

Integrated or separate. Is chiropractic something that should fit into the mainstream health care paradigm or is it an entirely different healing discipline? Before you answer, be sure to check the language of the practice act that grants you the right to be a chiropractor. (Clue: chiropractic wouldn’t even exist if it weren’t for B.J.’s foresightedness to make it separate and distinct.)

Sorry to burden you, especially since you probably got into chiropractic because you just wanted to help others—not be a pawn in some esoteric philosophical battle! But you are. In fact, your inclination to keep your head down, use sloppy language and ignore its implications, not only blunts the impact of what you do, but your carelessness could jeopardize the profession!

My guess is that no other healing art offers so many choices of what to believe. And while there are strategies currently in play to eliminate many of these choices in an effort to bring unity to chiropractic, my fear is that the result will be more mechanism and less vitalism, more spine and less nervous system, more Newtonian and less quantum and sadly, more therapeutic and less chiropractic.

Or have I missed something?

Comments (10)

Arthur Rehe, D.C.:

Bill,

Your article is very good as far as it goes.

However the real problem imo is that the various state licensing laws require Chiropractic students to study medical subjects out of medical texts in order to pass the boards.

This requires the student to study antiChiropractic subjects and/or useless subjects for most of their schooling, and unless the teachers constantly point out this fact and show how a Chiropractor should think, (diametrically opposed to medical thinking), the students get a very poor Chiropractic education.

I had the president of a Chiropractic college actually tell me, in private, that they couldn't teach Chiropractic in the schools, and that it was up to us in the field to teach the young doctors after they were licensed.

We need to get to the cause of the diversity, not just agonize over the symptoms.

Bill, your writings are a pleasure to read...you hit the mark. Your wisdom will endure many future decades. I encourage all our colleaques to "stick to" and "tell" their individual story to any one who will listen. We must pick the side that is right... our position must be clear and purposeful. The future is bright only if we resolve to shine the light of truth that chiropractic brings to our sick and dying world. Vitalism, quantum principles, nature, above-down, inside-out, life, inteligence, God-given abilities/capabilities and so many other possibilities are all nestled within the beautiful realm of chiropractic.

Diane M. Kramer D.C.:

You are terrific and hit the nail on the head! Separate and distinct.Too bad more D.C.'s don't have your amazing understanding and outlook on chiropractic. This article just about said it all.
Thanks for all your efforts.
D.M. Kramer D.C.

Dorothea McCallum:

Hi Bill, and everybody else,

I've done a lot of locums and I've noticed that no matter how many categories WE divide ourselves into and no matter what WE call ourselves, most of us are all doing about the same thing! In every office I've worked in, unless the chiropractor didn't have a good opinion about themself, pretty much the same thing is going on. Patients are being taken care for by people who care about what they do and who are doing the best they can do at that moment. The techniques, paper work, educational tools, and things like that will be different, but the purpose and results are the same.

I think WE are what gets in our way. If We could stop sorting information for differences and what is "wrong", instead of what is similar and "working" We, and our adoring patients, would all be further ahead.

So, everybody, get out of your own way!

Dr. Wanda Lee:

Hi Bill...as usual, I LOVE your thinking and the way you make us all think. One thing that might be missing is "calling or job". Might address some of the other issues along the way... For the record... I love the diversity.
Thanks.

D C Wallace:

No, Bill, you haven't missed anything!

Tony Rusoo:

Bill,
Right on, man! But this doesn't bode well for our profession at all. Everyone, like myself, are all out there trying to bring a square meal home to our families. And we're all doing it, "our way" (Frank Senatra). You are right on. But I don't like where I see this profession going at all. I'm doing IME's to stay afloat while the practice is honestly doing better and better. But I don't like what I see out there. Is it fair for 80% of the chiropractors in Ontario to be going to a bank to borrow money to stay in practice? Or making less than part-time McDonald's wages and they're doctors? When is enough, enough? Bill, I don't have to tell you that these are real hard times we're heading into. My dentist's son went to Parker 1st Trimester. Dad sent him back home after hearing that Physio's are fighting to do "manipulations." Where this will go, I don't know. But I have my fears.
Very well written,
Tony Russo

It seems to me that almost all chiropractors are looking for unity at this point, but the fractures go all the way to the top. Which orginization do you choose to represent you ACA, ICA, WCA? Where should the unity begin? Grassroots upward (as it seems to be already) or from above down inside out. Chiropractors are a unique bunch, and until the diversity is embraced rather than rejected, the profession will be fractured. There are too many passionate people about what they do for one thing to dominate over all others. The only option is acceptance and the realization that more can be accomplished together than divided.

Justin Pellow:

Thanks Bill, these are great questions to ask oneself as a review of one's "mission."

Justin Pellow

Diana Galish-Frasier, D.C.:

Have I told you lately that I LOVE you (and all that you do to have us be the very best we can be)??????? Thank you, and no, you haven't missed a thing; I don't think I've ever known you to miss much, if anything at all!

Do you ever feel as though you're preaching to the choir? The people who need to read this those who likely avoid you and your sage like the plague. So sad; their loss, and as well, the people they 'service'.

Keep up the great work. We, and the people we serve, have benefitted from your perspicacious insight. Thank you.

WDE: Thanks! But I had to look up perspicacious first!

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From May 4, 2007 3:32 PM

This page contains a single entry from the blog posted on May 4, 2007 3:32 PM.

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