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So-Called Continuing Education

continuing_education.jpgI’ve noticed that the chiropractic leadership in California is contemplating plans that could up the number of continuing education hours from 12 hours per year to 24. I’m sure there’s a good reason for this. But I can’t think of one.

Ostensibly, continuing education was instituted in an attempt to bring field doctors the latest breakthroughs and innovations that have occurred since their formal education. If you’re a medical doctor who has successfully shunned the office visits of drug reps, then sure, getting to the convention center might be valuable. Or maybe you’re a surgeon who could benefit from learning the newest techniques at limb prosthesis derived from success with veterans returning from Iraq. In medicine, these annual updates probably make sense.

What’s so new in chiropractic that it requires an additional 12 hours of post-graduate education every year? Newly discovered vertebrae? More accurate orthopedic tests? Advances in intra examiner reliability of motion palpation skills?

What’s so ironic about expanding the CE requirements for chiropractors is that the new, cutting-edge stuff in chiropractic is usually too controversial for the sensibilities of those who set the requirements for continuing education programs. Instead, organizers must rotate through a limited number of speakers who can address risk management, CPR, HIV instruction, radiology, extremity adjusting, sports taping and the rehash of other topics that appear to qualify as continuing education.

Most of these programs are legendary in their irrelevance and lack of day-to-day applicability to the real-world needs facing today’s practicing chiropractor. Programs with even the slightest whiff of content that might help chiropractors run a more successful practice are shunned. Seemingly, the drier, more esoteric, left-brained, the better.

This prompts many chiropractors to fight over the back row seats and come armed with sufficient paperwork, newspapers and portable TVs to engage their minds as their bodies are exposed to the prerequisite number of lecture hours mandated by the licensure board.

So excruciating are these programs, many chiropractors find ways to avoid, or at least reduce, their attendance. Some pay their enrollment fee, stay for the first 20 minutes until the sign in sheet is passed, tickets stamped or badges punched and leave, returning at the end of the morning session in time to sign out. In fact, I’ve been to several programs in which there were more people in the exhibit hall (where, for better or worse there is a little innovation), than in the lecture room.

I’m sure there are some among the low self-esteem crowd and the “we-want-to-be-accepted” delegation that believe that more education will somehow produce better chiropractors or will garner greater respect from the medical fraternity. I doubt it. Chiropractors that are more “educated” will not remove the perception among many MDs that chiropractors think they can cure everything and that chiropractic, while enjoying high patient satisfaction, is nothing more than a placebo, barely appropriate for the least serious low back pain cases. If the intent of increased continuing education is to improve the standing of chiropractic, educating medical doctors might be a better place to start!

Don’t get me wrong. I’m not anti-education. And I do think that flushing out every chiropractor once or twice a year, especially those inclined to hide under rocks, is probably a good thing. But adding still more hours, even if they can be obtained online, is likely to produce little change in the skill set, tableside manners or public perception of chiropractors.

Usually when confronted by the unexplainable, I contemplate the age-old truism: “Follow the money.” Yet, in most states, between the marketing costs, speaker’s fees and mushrooming hotel expenses, most associations hope for little more than breaking even by holding their obligatory continuing education seminars.

So, what is it? Do you know the motive for more continuing education? If you do, would you please share it with me by leaving a comment below?

Comments (11)

Mha Atma S Khalsa, DC:

In theory at least, its worthwhile to get out of the office once or twice a year and go to a seminar that might expand my brain, teach me something new, or just refresh my perspective on what I've been doing. I've gotten this benefit at time from Parker (where you can get CA relicensing credits), Lenny Cocco's seminar, an activator seminar, rehab seminars with Craig Liebenson, and Dr. Malik Slosberg's seminar on research and chiropractic. On the other hand, I find myself this year coming up against the deadline and casting around for any seminar not too far from home where I can sacrifice a weekend to renew my license.

So, Bill, how about establishing a blog where doctors can give feedback about relicensing seminars that really gave them something valuable besides the credit--something that made them feel that their time and money was well spent. My suggestions above are my contribution--I'd love to hear more! Let's make the lemon of CE requirements into some lemonade that can fuel our aspirations to be better people and better doctors!

Melanie Carr:

I have heard many comments from various chiropractors that they wish they would have taken the time to learn more when they were in school. Well, this is their chance!

I think there are several things that are wrong with the idea of not continuing education:

1) Just because we get the fancy letters behind our name does not mean we know everything there is to know about chiropractic. The day we stop opening our minds to new things (or even re-learning the basics we may have put aside or forgotten in daily life) is a sad day indeed.

2) Even though chiropractic is about more than just technique, analysis, etc. it does not hurt to learn these things, and we can only serve our patients more by being more or better educated.

There could be a good reason behind this proposal. I wonder what the chiropractic leadership would say if you asked them. I doubt it has much of anything to do with being accepted by the medical community. California, from what I understand, is generally accepting of alternative views on health or wellness, more than a lot of other states.

My side-thought
Does it ever end? Since when do we go into a class and not give the presenter the respect or attention they deserve? I'm sad to hear the same crap happens with actual DCs as does with DC students. Just another observation of how the behavior and mindset needs to change in our profession. The question is: which way do we go... chiropractors to students, students to chiropractors, or both?

Nick Hansen:

I go to two seminars a year - they get me on track and usually improve my skills which have gotten sloppy. I know the people who complain and sneak out because they have closed their minds for the rest of their professional lives. There is always something to learn and we need that. Tell me insurance regulations haven't changed or that there is something a chiropractor can't do to get better! I've always liked your comments but in this case you are really in the dark.

Tony Russo:

Whatever happened to "Life Long Learning"? Continuing Education is an effort, no less, to get Chiropractors off their stagnant asses and stay abreast and current. That they choose the easiest and least expensive topics is a statement of their person and not that of the Profession's Boards. CE broadens our perspective if not at least for 1 weekend. Gives us a change to exchange and collaborate with our Peers and it's a great weekend away from the Office.
While I agree and have voiced my discontent to my "Device's"
recertification seminars being $425.00(what more is a proficiency rated Doctor going to learn at $425 that he can't at let's say $125), continuing education is vital, and I mean vital to our profession. Then put pressure on our Boards to reduce the price or we're not going. I say a cap of $150.
Or, better still, maintain a Professional Portfolio as we are mandated here in Ontario. In it, one enters all Journals, Seminars, Books that the Doctor has read or attended. This portfolio may be randomly reviewed by Peer Assessors or it may be suggested that faxes be sent to the Licensing Boards for review. This would easily supplant the need to attend an expensive (and as my colleagues have voiced) useless seminar. That's what we do in Ontario, anyway. And it's working here. No CE hours here. You'd be surprised as to how much Continuing Education you actually do in a year's time. With this system, all those Journals you subscribe to, would count.
And there lays the answer to the CE dilemma.

Bryan Siegel, DC:

Bill, i shared this blog entry with a DC friend of mine in Florida and this is what she wrote back to me "How true...Florida just passed alot of new laws for CE credits... Like we had to have photos and they scan you in for every section....and you can't leave...Everyone is complaining..."

So instead of making the CE seminars relevant and exciting for docs, they browbeat them with the same junk and do these photos; another example of symptom treating.

Bryan Siegel, DC:

From my experience, Continuing Education is really more about generating revenue from the doctors and exposure to vendors, which feed back into supporting seminar costs.

I have found very little to no innovation in CE seminars and quite honestly, dread that time of the year when it is to be done. Having spoken with some other colleagues, they base the obligatory event on the cost.

Mithra Green:

I've enjoyed most of my CE experiences, but I often have to travel to get to ones I'm interested in. Some have had a profound effect on the way I practice and a lot have helped in my shedding process. "Take what you need, leave the rest". In my expereince alot of attendees are so angry (at who knows what) that they are unable to pick the low hanging fruit right in front of them.

Dr. Brian Deal:

Thank God for online continuing education.

Dr. Dan Hestera:

I always try to have a grateful attitude no matter the situation. At continuing education seminars I am grateful for Sports Illustrated, i-Tunes, and good books that need to get finished.

More seminar teachers milking the chiropractic cow. Perhaps some of the people in the chiropractic leadership have started continuing education websites that do not require any time but still generate income. No hotels, no flight, no time invested, just cash in their pocket. Come to think of it, Bill can you make me a continuing education website?

Bob Wagner:

Bill is chiropractic's Sarah Palin! I love it. An outsider sees more of our underbelly than the people who profess to be the prophets of our profession. Sorry to say we have no prophets anymore. Chiropractic is now second rate in every prospective. Education has never been something that the colleges are able to do well. At best, they glide in and out of consciousness depending on who is watching. If someone doesn't start to listen to visionary people like Bill, the abyss can only deepen for the up and coming participants in this profession. Bill is trying to separate us from the pack because no one in the pack wants us! I just finished my 24 hours for PA and got a great belly laugh out of this Blog! Thanks Bill!

I'm thinking about another conversation just as a brain tune up. What do you think?

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From September 7, 2008 11:13 AM

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