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Dear Bill

titanic.jpgPlease stop sending me E-mails. I do not need any motivation. After 20 years in the chiropractic profession it is quite evident to me that it is dying. The people in my state organization are likened to the band on the TITANIC; they go to parties and meetings, drinking their fine brandy, wearing their best attire while the chiropractic ship slips slowly into the ocean of obscurity. The only way to squeak by a living in my state is to be a personal injury or workers compensation attorney’s bag man.

I would appreciate you stop e-mailing Monday Morning Motivation to me. Nothing you can tell me will change the fact that the insurance companies are paying less than the price of a cup of Starbucks coffee and pastry, not to mention not letting me do my job. Thank you,

Dr. Had Enough

Dear Dr. Had Enough

I have unsubscribed you from Monday Morning Motivation.

There’s no question the chiropractic practice environment has significantly changed in the last decade or so. More telling is your response to these changes! Apparently, you have chosen to become a victim rather than a victor. It sounds like you’re preparing to withdraw your valuable skills from the marketplace. Too bad you seem so resigned at a time when we’re so close to the revolution that will make chiropractors indispensable.

I know we’re getting close because…

Drug scandals. It seems that a month doesn’t go by that a major drug manufacturer doesn’t have to pull the plug on one of its wares. The public is wising up to the side effects and incestuous relationship between the FDA and the pharmaceutical cartel. Today, more and more people are questioning knee jerk prescription writing and want better answers.

Organic foods. Virtually every major grocery store has an organic produce section now. Even Wal-mart is getting into the game. This trend is bound to continue. And there’s no third-party reimbursement in site! If you’ve limited your practice to back pain, you’re going to get left behind.

Emerging wellness. The Creating Wellness Centers that the Chiropractic Leadership Alliance is advancing is just the tip of the $1 trillion wellness industry. This is all cash. But it means showing up relevant and having the skills and services people want. You may cringe at the growing popularity of acupuncture, emotional work, smoking cessation programs, weight loss, massage and other “alternative” treatments. However they all work better when the patient has a better working nervous system—a fact that is obscured if you’ve been seduced by CPT codes the last 20 years.

Baby Boom generation. This is all being driven by those born between 1946 and 1964. These are the folks who drove VW vans with “Question Authority” stickers on the bumper. Now they find themselves in positions of authority! They haven’t forgotten their “If it feels good, do it” mantra and their preference for natural fibers. Chiropractic sings their song. But they may not know it. Yet.

Bankrupted nation. In fact, if the Baby Boom generation doesn’t turn things around, they will bankrupt our nation with their expensive symptom treating. In fact, the next president and congress will have tremendous pressure to do something about this growing problem. My guess is they’ll make it worse. That will be good news for chiropractors if they have the wisdom to stay out of any forced nationalization scheme.

Positive media coverage. Just within the last month or so we’ve had positive press from Montel Williams and Good Morning America. Not to mention the story about the fellow in Iowa who regained his sight and was picked up by the media around the world. The tide is turning. Rather, the tide has turned.

Tragically, if you attended a so-called chiropractic college that promoted a mechanistic, recipe book approach to treating back pain, I can see how you might feel unresourceful and a little angry at having to adapt to changing market forces. I’m sure buggy whip manufacturers resented the automobile and ice merchants resisted the refrigerator. Take it personally if you wish, but it’s not about you.

If your practice philosophy is based on serving insurance companies and your understanding of chiropractic is limited to local effects along the spine and your communication skills have atrophied or were never developed, you’re feeling the squeeze. And there are others with you, clinging to the last flotsam and jetsam of the Titanic.

Never mind the hundreds of chiropractors who went to jail so that you would have the right to practice. Could be that you became a chiropractor because it was seen as an easy way to become a doctor and make a lot of dough. No problem. However, this would be a great time to find out what are the common traits among those chiropractors with cash practices who are flourishing as the reimbursement model implodes around them.

Leave if you wish. But I’m staying.

Comments (2)

Bryan Siegel, DC:

Excellent commentary on this Bill. I'm curious as to why "year plans" are seen as "manipulative", "negative", etc. I think it's a great opportunity when you educate people properly to give them choices for care participation; one of the choices can be a year of care to show that chiropractic care is a process. It also gets people to think of chiropractic in more of a long term, lifestyle mode, rather than participating visit by visit, which tends to reinforce symptom care mentality. After all, don't most chiropractors plan on getting spinal/nervous system care for the rest of their lives? I do.

WDE: Because many chiropractors recognize chiropractic as a lifestyle decision and not merely a short term "diet" for pain relief, many of the most dogmatic will often impose year long care plans. I explore this in more detail here.

Michael Soucy:

Dear Bill,

I can sympathize with Dr. Had Enough, as I've recently gone through a transition from a mechanistic, hard-sell used-car salesman year plan approach to a vitalistic, respect the patient and innate intelligence approach. Amazingly enough my small town wasn't quite ready to accept a my-way or the highway, and by the way please pay for a year up front type of chiropractor. All it took was a 90% drop in patient visits and a little help from you and Greg Stanley to figure it out. Oh well, live and learn.

I certainly don't deny that we have many challenges to face as a profession. At the same time, (and I know this has become a cliché), I do believe it is a great time to be a chiropractor. When compared with our chiropractic forefathers of a hundred years ago, think of the advantages that we have. We have the choice of whether we want to operate a cash practice or an insurance based one, or a mixture of the two. Our predecessors in chiropractic certainly didn't have that choice. We also have many choices of how we would like to practice clinically. And basically all we have to do to stay within the law is to keep good notes, and tell the truth. For all the problems that we could list, think of all our advantages.

We are definitely going through transition, and transitions can be difficult, but they are also purifying. I believe that in the end our profession will be the better for it. The difficulties we now face will weed out some of the negative facets of our profession, like the year plans and manipulative sales tactics, (my small market already weeded these out of me). We will be more in touch with our roots philosophically, and yet at the same time more scientifically advanced at a time when our country will need us the most.

The glass is definitely half full, so belly up to the bar!

Michael Soucy, DC

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From April 3, 2008 3:17 PM

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