Who awakens in the morning and proclaims, "Today, I want to be less significant. I want to be less important. I want to play a smaller role on the stage of life!"
No. For most of us, the reverse is true. We want a larger business. We want to play a more significant role in the lives of others. We desire greater impact, more influence and to contribute in more meaningful ways to those we touch.
Then why are some chiropractors so bent on minimizing chiropractic? Why are so many willing to reduce chiropractic to a localized therapy to improve spinal biomechanics? Why do so many decry the value of chiropractic for whole body health? Or its value for children? Or its use by those who are asymptomatic?
Why do they desire to make chiropractic small?
Perhaps they are the cautious type, preferring that chiropractors toe the line, under-promising the possibilities of chiropractic. They appear to be waiting for sufficient randomized controlled clinical trials published in peer review journals before suggesting chiropractic could help anything beyond headaches and back pain. Rallying behind the self-imposed condemnation of "evidence-based medicine," they are embarrassed by their chiropractic colleagues who regularly report success with colic, ear infections, asthma and dozens of other health problems manifesting from correctable subluxations.
The "let's-get-small" crowd finds the word subluxation problematical. Perhaps because the definition attributed it by traditional medicine differs from the one generally used in chiropractic. (Or is it that insurance companies don't reimburse for its reduction?) But, every discipline has its own lexicon. The word "enamel" means something different whether you're a painter or a dentist. The word "bridge" has different meanings whether you're a dentist, engineer or a musician. Need I go on?
But perhaps it's the "approval" or acceptance by medicine that's really at work here. Ironic, because downplaying what reducing nervous system tension could do, is lost on a profession that has become lap dogs to pharmaceutical interests and turned disease mongering into a fine art.
Perhaps what fuels those aspiring to second-class citizenship are those situations in which chiropractic doesn't appear to work. Every chiropractor has had cases in which appropriately applying chiropractic principles don't seem to produce the expected outcome. The question is, will you fall for the trap of seeing that "failure" through the linear, cause-and-effect, recipe-book lens of the medical mindset? Those who do, have probably fallen for one or more of these popular deceptions as well:
Chiropractic treats disease. You can treat your redwood deck to repel water. You can treat your child to an ice cream cone. And you can treat water so it's drinkable. But chiropractic doesn't treat anything.
Treating suggests lack; that something is missing and must be added to create wholeness. For example. Those with headaches aren't suffering from a lack of aspirin. Yet, those who take a pain reliever for the purpose of reducing pain are in fact, treating their headache.
Chiropractic doesn't treat headaches or anything else. And this isn't merely semantics! Reducing nervous system tension, usually along the spine, can often relieve headaches and countless other unwanted symptoms. But that would be a possible effect, not the cause. If you believe your chiropractic care is a treatment for headaches you are practicing medicine. For which you are not licensed.
"But patients come in thinking I can help them with their headaches!"
Sure. That's what most people, weaned on a medical approach to symptom-treating their entire life would naturally believe. So you have a couple of choices:
1. You can commit to educating patients about the truth.
2. You can ignore their preexisting beliefs and take credit for the results chiropractic so often produces. But then you must also take blame for the occasional failures.
Clearly, if you want to show up with integrity you have some significant communication obligations!
Chiropractic is about the spine. Chiropractic is no more about the spine than buying a car is about the color you choose.
Chiropractic is about the integrity of the nervous system. The spine is involved only because physical, chemical and emotional stress that exceed the nervous system's ability to accommodate is often exhibited by malfunctioning spinal joints. Which are merely symptoms, since bones are static structures that only move when commanded by muscles. And those muscles only contract when commanded by the nervous system. Chiropractic is a neurological discipline, not an osteological profession.
There's a contingent within chiropractic that believes getting the bones to line up properly will permit the nervous system to function as designed. At first glance, this makes sense and appeals to the most analytical segment of the profession—until he or she is confronted by a gorgeous cervical curve—yet the patient's headaches remain unresolved.
Like the electrician focused on the circuit, not necessarily the color of the wire's covering, effective chiropractors recognize it's all about the brain's ability to faithfully control and regulate the body. Everything else is an effect.
Pain is the problem. While patients often seek chiropractic care because of an ache or a pain, pain is not the problem. It's a symptom. An effect. A signal. A sign. An indicator. A warning. Pain can be distracting, debilitating, irritating or annoying. Pain can be chronic, acute, intense or intermittent. Pain can be sharp or dull. And pain can be localized or general. But pain is not the problem.
It's bad enough when patients are misled into thinking their most obvious symptom is the problem. What makes it worse are the empathetic chiropractors who think the patient's problem is their problem; that the patient's headache is their headache. These are the chiropractors who then fall into the trap of "treating" the patients symptoms—again the practice of medicine for which they are not licensed.
For most patients, being pain-free is their only objective. Which is why many chiropractors may indulge this exploration as merely an intellectual exercise. Yet, these are the same chiropractors who complain of a lack of new patients, whine about abuse at the hands of insurance carriers and never really enjoy a stable, emotionally-fulfilling practice. They disconnect from the philosophical implications of what they do and overlook their patient communication responsibilities and then can't figure out why the world conspires to make their path so difficult.
Adjustments "fix" patients. With the treatment mentality so sloppily taught at most chiropractic colleges, chiropractors often emerge with belief that their thrusting is actually repositioning spinal structures! If the "bone is out," so they reason, "thrusting here and here will put it back where it belongs."
This is fraught with so much ego and hubris I don't know where to begin!
But here goes. Again, bones are static structures that only move when commanded by muscles. Muscles only contract when commanded by the nervous system. And the nervous system employs this defense strategy when it is overwhelmed by physical, chemical and emotional stress. Tragically, many chiropractors see the effect (bone out of place) and start visualizing what direction their thrust needs to be applied to put things back in their proper place. They forget to ask two important questions:
1. What were the likely physical, chemical or emotional overwhelms that produced the survival strategy showing up as a subluxation?
2. Is that physical, chemical or emotional stressor(s) still present in the patient's life? (Otherwise, adjusting the patient will be ineffectual!)
Instead, the adjustment adds energy to the body at opportune places and the body decides how (or if) it will use the energy to "right itself." This starts to explain situations in which chiropractic doesn't appear to "work." You can do everything correctly but neglect to...
...find out that the patient is drinking a six-pack every night.
...discover whether their boss is still threatening to fire them.
...uncover that they suspect their oldest son is on drugs.
...learn that the patient only gets four hours of sleep a night.
...ask about the ergonomics of the workstation they sit at all day.
Messy? Sure. But it's essential if you have any hope of emerging from being a mere spine mechanic. Considering the spine, isolated from the patient's life is convenient, but sets you (and the patient) up for disappointment.
Technique matters. The profession is just about mature enough to accept the fact that virtually all the named techniques, when masterfully delivered, can produce a positive result. Oh sure, there are still some who believe that tonal and emotional techniques aren't really chiropractic. And then there are the misunderstood "experimental" techniques that sully the reputation of chiropractic. But that's mostly ignorance.
Chiropractic history is replete with examples of those who thought the X approach was superior until the developer of the Y approach came along. Who was supplanted by the new and improved Z approach to spinal adjusting.
Turns out that how you adjust is less important than why you adjust.
Results are predictable. Those who would prefer a cookbook approach to chiropractic care would probably tire of it after a month or so. Thankfully, every human is a dynamic, constantly changing organism. To think of patients as identical canvases on which Intervention A should always produce Result B might be comforting, but flies in the face of reality. This is why the gold standard used in researching drug efficacy is misapplied when used to measure chiropractic outcomes. We're each an experiment of one!
Every person has a varying capacity to adapt to physical, chemical and emotional stress. For one person snakes are docile pets. For others an evil reptile. Same snake, different response. Same with chiropractic. This is the danger of making chiropractic about chiropractic, rather than making it about the patient.
Chiropractic should be uniform. With the metaphysical all but excised from the curricula of most chiropractic colleges, there will come a time when the practice of chiropractic will likely be more uniform. Whether it can be accurately called chiropractic remains to be seen.
The medicalization of chiropractic is happening at the same time that the Bernie Segals, Deepak Chopras, Wayne Dyers and Andrew Weils are enjoying incredible attention as they talk about intention, innate healing, energy and other subjects that have practically become recessive genes in the chiropractic DNA.
Those who chose chiropractic as a shortcut to becoming a "doctor" or who saw it as a way to make a lot of money can be forgiven. But chiropractic has always been about the feral, the renegade, the rebel and the outcast. Chiropractic is different. This difference has produced results when other methods have failed.
Those who believe chiropractic is merely a low-tech strategy relegated to the correction of back and neck problems have bought the first right answer. Sure, chiropractic is good at helping these types of problems. And yes, if medics would drug and cut less on these types of cases, chiropractic could help such patients faster, less expensively and with fewer unwanted effects. But that is hardly the highest calling to which chiropractic can aspire!
Minimizing chiropractic may be a pragmatic way to convince those who hold the purse strings to invite chiropractors to the health care dance. But it downplays the significance and potential of chiropractic. Could it be that this is what stirs the "principled," "philosophical" and "zealous B.J. wing" of the chiropractic profession? To those who became chiropractors because of a personal experience that transcended the narrow orthopedic model, making chiropractic small is seen as a sell out. It's seen as self-deprecation; a bait and switch strategy that will entrap chiropractors, reducing them to neck and back therapists.
Does that mean I condone chiropractors who run advertisements promising a cure for acne? Or a treatment for any other named disease? Of course not. Chiropractic is neither a cure nor a treatment.
"WELL THEN, WHAT IS IT?!?"
Great question. If you're not sure what chiropractic is, you might be inclined to believe those who say it's small. But of all the things chiropractic is, it's not small. It can be practiced small, but it's a big idea. Huge, actually. Get the huge idea and all else follows.