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Identity Crisis

identity.jpgI just got back from a speaking gig at a chiropractic college. I had the privilege of spending two hours with students who are about to complete their college studies and, with the end in sight, have a heightened interest in the implications of actually applying what they’re learning.

Many are confused.

And no wonder. Not just because my presentation usually interrupts their left-brain dominated existence, but also because much of their education has a decidedly medical fragrance. The philosophy of chiropractic and its metaphysical foundations have been suppressed in favor of a more limited, mechanical perspective. Is subluxation real? What do patients want? What if chiropractic doesn’t work? Should I wear a lab coat? What will the insurance companies pay for?

Ah. Follow the money!

The path of least resistance has been to transmute chiropractic into that which is reimbursable. And of course, this is the slippery slope chiropractic ventured on to when the cry was for “insurance equality.” The insurance industry is based on an allopathic model, so chiropractors quickly learned to jettison their subluxation for “sprains and strains.” And rather than advance the whole body effects of subluxation correction, chiropractic was reduced to a spinal therapy quantified by the regions given attention.

Why was the philosophical foundation of chiropractic so easily relinquished? I’m sure there are other reasons, but I can’t help but think it has something to do with the dimension that chiropractic shares with medicine.

I believe that patient interventions delivered by doctors, therapists, chiropractors or any other type of healer can be divided into two categories. Interventions that ameliorate pain, suppress or reduce unwanted symptoms, remove unwanted body parts and artificially stimulate or depress bodily functions can be rightfully called Sick Care because they are only rendered when patients are obviously sick. Other interventions serve to advance one’s health and well-being, enhance our ability to adapt, improve longevity and remove barriers that prevent us from our complete expression. Regardless of whether this is self-administered or delivered by a licensed practitioner, call this Life Care. Sick Care when you’re sick. Life Care when you want to optimize your life. Chiropractors, unlike medical practitioners, have the choice of offering Sick Care and Life Care and even Sick Care or Life Care.

This is probably one of the sources of the “Tastes great!” “Less filling!” argument that dogs chiropractic and part of the confusion I sensed in my student audience this morning.

There’s no shame in being a Sick Care chiropractor. And there isn’t any superiority granted chiropractors who aspire to offer Life Care. Each delivers tremendous value and serves their constituencies based on their beliefs, intentions and skill sets. But it seems to be producing an identity crisis hobbling our newest chiropractors.

Comments (2)

Tony Russo:

I'm with Mike on that one. And I'm in Canada. They come in for sick care, otherwise my Office would be empty, but for about 75 "once a monthers". And then we work on, if you will, converting them to Wellness Care. That's how my practice grew, very, very slowly. But at my age, thankfully very stably.
Frankly, they, as well as I was, are scared. They don't want to seem "dogmatic" (referring to the cross in every room thing which I won't get into again), yet they embrace with open arms, the very dogma that brings each and every patient to your Chiropractic Office's front door. Why? I begin to self realize, because it's accepted, it's OK, it's the way things are. And it's the way they believe they should be in order to realize the final reward...getting paid. Do this, get paid, do that, don't get paid. Let's see, hmmm, student loans, rent, equipment, buildout,utilities, gas, car...OK I'll do this. I don't blame them, I probably would have also. Now I've come full circle and don't have a clue as to what the solution to this would be. Is there one?
Thanks again Bill. You put it in a very new and unique perspective. Very unique.


Excellent post with some very thought-provoking points.

What's frustrating to me is that only about 8% of Americans have ever used chiropractic -- for Sick Care or Life Care. This is a discouraging statistic, and one that needs to be remedied.

I think that Sick Care is the way that new patients need to be approached, unfortunately, because that's the model we have for "health care" in the US.

Maybe once these patients have seen the benefits of chiropractic, they will see the benefits of Life Care.

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From November 20, 2007 6:20 PM

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