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The Profession of Chiropractic

profession.jpgFrom time to time, I encounter chiropractors who fear for the future of the profession of chiropractic. Ironically, these are often those who do not actually “profess” chiropractic.

If your notion of chiropractic is limited to joint mobilization, improved biomechanical function, spinal alignment or the treatment of localized neck pain and back pain, you have every reason to fear that massage therapists, physical therapists or even newly enlightened osteopaths will usurp your small vision of chiropractic.

The profession of chiropractic is not entitled to exist. It has a right to exist; even the privilege to exist, but no guarantee to exist. In fact, as a profession it won’t exist if fewer and fewer chiropractors profess and deliver the principles of chiropractic.

Most modern day chiropractors forget that the very right to practice the profession of chiropractic is based on the assertion that chiropractic is a separate, distinct and nonduplicative healing art that is different from medicine. The “let’s have unity” bunch often overlook this pesky fact written into the practice act in their state or jurisdiction. Instead, their dreamy-eyed notion of being accepted, assimilated, respected and embraced by their medical counterpart’s drives them onward, against the restrictions of their state’s practice act.

So, it’s no surprise that those in the chiropractic profession who lack critical thinking skills or intellectual discernment often overlook that they are practicing medicine, not chiropractic.

Huh?


  • If you regularly use the word treatment, as in “I have two treatment rooms,” then you’re likely practicing medicine.
  • If you often use the word manipulation and adjustment interchangeably, then you’re probably practicing medicine.
  • If you tend to adjust your family members only when they are suffering from some obvious ache or pain, you’re probably practicing medicine.
  • If you see yourself as a fixer of patient spines, then you’re likely practicing medicine.
  • If you focus on the patient’s spine rather than the patient’s body and overall life experience, then you’re likely practicing medicine.
  • If you try to eliminate subluxations with the same drive that oncologists tries to eliminate cancer, then you’re likely practicing medicine.


The distinction between chiropractic and medicine is considerably more than merely the difference in the intervention used. Instead, one must examine the intent and hoped-for outcome from the intervention. Reducing, ameliorating or eliminating symptoms is the domain of medicine. Enhancing, restoring or reviving a person’s ability to self-heal and “right themselves” is the practice of chiropractic.

I know. The insurance companies seduced many chiropractors into practicing medicine. I’m guessing the money was very persuasive, making it easier to look past the inability to use the word subluxation in your assessment and reducing your domain to spinal strains and sprains. It was a great run, but it’s time to get back to practicing chiropractic. If you can.

The profession of chiropractic will continue only if enough chiropractors profess chiropractic. As in, health is normal. That the nervous system is the master system that controls and regulates everything. And that a lack of health, known as dis-ease results from the brain losing touch with parts of the body due to interference to the nervous system. And that restoring vital communications between brain and body invokes their innate ability to self-heal, based on the limitations of matter. That all processes, including healing, takes time. That the patient does the healing, not the chiropractor and certainly not the adjustment. That what the patient brings to the table (their ability to self-heal) is more important than what the chiropractor does on the table, regardless of technique.

Using the chiropractic franchise to broadly promote “things natural” risks placing these adjunctive services and procedures ahead of the adjustment and the acknowledgment of the body’s ability to self-heal—if there is no interference.

If enough chiropractors profess chiropractic, there will be a chiropractic profession. If not, the profession of chiropractic will be contained, eliminated and will rightfully disappear.

Comments (23)

Bill,

Bravo! Thank you for your article. I have never quite understood why people become chiropractors only to be assimilated into the medical paradigm which presents NO PLATFORM for the practice of chiropractic all. There is a strong difference between chiropractic and medicine: medicine is repressive and chiropractic is expressive. Medicine controls the body; chiropractic puts the body back in control. Very simple; very different. It is time that chiropractors embraced the difference of the paradigm and philosophy they operate under and allow chiropractic to express itself freely. The confidence that it would instill in chiropractors and consequently our culture, would allow the profession to claim its intended place in this society resulting a tremendous breakthrough of health and wellness through the world.

Dr Steven V Ray, Doctor of Chiropractic:

I explain to my patients that a manipulation is a long-lever maneuver designed to mobilize as many joints as possible.

An adjustment is a focused and carefully controlled short-lever maneuver designed to return a misaligned vertebra as close as possible to its original position while disturbing the surrounding structures as little as possible.

The majority of my patients who have experienced both say they can tell the difference.

Todd Hackney:

"Why do we assume that a "patient" wants only pain relief when they enter our office?"

I don't have to assume that at all. I KNOW it! The majority of people DON'T UNDERSTAND HEALTH to begin with, so they're not walking into my office saying, "Will you make sure my innate intelligence is flowing correctly?" If someone EVER does, I'll take their picture and frame it as being THE MOST intelligent patient I've had!!

If you want to "explain what it means to live ADIO and how being subluxation free factors into that" to your patients who are in PAIN, and let them determine their own "destiny" in your office, knock yourself out. When you're done "educating", you'd better be able to get the job done and in a timely, cost-effective manner. PERIOD.

kreso Jug:

Why do we assume that a "patient" wants only pain relief when they enter our office? They have never been told what chiropractic is really about. And that is OUR fault, not the guy down the street. Why don't we first explain what it means to live ADIO and how being subluxation free factors into that. Then ask then what they want.

It seems that assuming everyone only wants pain relief is just as silly as assuming everyone wants life time family maintenance care.

Liz Tully:

Well, I feel like I am back at Life University, listening to the endless debates between the "ICA" students and "ACA" students. Let's face it Bill, any DC who takes money from an insurance company is practicing medicine from your perspective. And I'm sure that today, in this climate of the Dread Post Payment Audit, a lot of us are moving over to the "Medical" side, at least when it comes to documentation.

As a former student of foreign languages, I find the semantics interesting. An "Adjustment" is a thing of beauty, loftily separating us from the "spine plumbers' I was warned about at school. A "Manipulation" is done by medical doctors, poised to ruin your health and distract you from wellness.

How is that possible, if both 'procedures' realign spinal segments and allow the body to heal?

Is the Flexion-Distraction and Drop table 'procedure' I just 'preformed' on the hot disc/sciatic patient really different in intent from the Full Spine 'procedure' I just preformed on the 7 year old girl who has no symptoms, but whose mom wanted her checked because she got hit in the head with a ball??

Isn't the intent to clear the spine of subluxation and allow inate to flow? Shouldn't we expect the outward appearance of the physical body of a 65 year old woman with disc degeneration to be different from a lovely fresh faced 7 year old whose spine isnt yet mature? And wouldn't those two beings see the world differently and want different things from me?

It looks to me like you are speaking about the difference between cash and insurance practices. As I stated earlier, anyone who takes money from an insurance company is playing in the "medical field", at least in terms of terminology, documentation and compliance.

Is is better to call yourself "principled" because you don't use modalities, but scare patients into long term care, lie to them about their insurance benefit, and penalize them financially if they drop out of care early??

Or to be a "Mixer" who addresses a patient's pain concerns when they are new, but treats them with respect and fairness, trying to educate them about the benefits of chiropractic while accurately explaining the terms of their insurance coverage, and giving them ethical options for payments.

I would rather be the latter and build long term relationships with patients who see me as a health care option. If you actually love what you do and respect your patients, you will allow them to make their own decisions. Sound familiar?

Some of my new patients decide they don't want the care I recommend and leave my office. That is their choice also. We all know they are not going down the street looking for a more "principled" doctor, they are following thier own priorities on finances and what they want to spend their time on.

My practice is booming in a down economy, because for the first time in my career I am not conflicted about what my patients come in for. They come in for pain relief, not wellness. So it is my job to offer them pain relief first and TEACH them about wellness along the way. If THAT philosphy makes me 'medical', so be it.

Moises Hernandez Leon:

Hi Bill! Right on target, as usual. Writing from Mexico, I can tell you we have several Medipractors that even change their titles (illegally) to "Medical Chiropractor" because as they say "patients and MD´s treat us better.” That occurs while the ones practicing Chiropractic (myself included) are booming (only 120 chiros in the country) and enjoying life and a happy practice. In the end is a matter of emotional maturity and being a Doctor of Chiropractic for the right reason. Saludos!

Todd Hackney:

I'll just start with the definition of the word MEDICINE, as defined by Merriam-Webster: (I capitalized some interesting words)

1 a: a substance or preparation used in treating disease b: SOMETHING that affects WELL-BEING
2 a: the science and art dealing with the MAINTENANCE OF HEALTH AND THE PREVENTION, ALLEVIATION, OR CURE OF DISEASE b: the branch of medicine concerned with the NONSURGICAL treatment of disease.

DISEASE (which has the same definition as "dis-ease"): 1 obsolete : trouble
2: a condition of the living animal or plant body or of one of its parts that IMPAIRS NORMAL FUNCTIONING and is typically manifested by DISTINGUISHING SIGNS AND SYMPTOMS.

From these definitions, I guess I practice Chiropractic "medicine," and I'm proud of it! I don't try to scare my patients nor do I tell them that MD's are the "devil" (A little reference to the 'Waterboy' movie). I educate my patients about what I can do for them and the wonders of Chiropractic that can occur beyond their initial symptom relief.

How many DC's have had someone walk into their office WITHOUT an initial symptom or complaint?! I'd even bet that 90% of Chiropractors were immunized, took medicine and saught the care of an MD at some point in their lives. And I'd also bet that they didn't grow a second head or other appendages as a result!! As a matter of fact, I'd bet that most DC's don't THEMSELVES seek the care of another Chiropractor, UNTIL SOMETHING HURTS!

But THE BIGGEST, MOST OBVIOUS problem with Chiropractic can be defined by the "crabs in a barrell" analogy. With numerous "techniques" and "management ideas" in the profession, it is ABSOLUTELY RIDICULOUS when Chiropractors attack EACH OTHER!! If I see another "crunchless chiro" or "DANGER! BEWARE OF (XYZ) technique" ad, I'm going to that chiro's office and asking them HOW that is supposed to be of benefit to this profession!

ENOUGH in-fighting! Do you see any ads like that from ANY OTHER healthcare profession!?! It's absurd!!

"I have seen the face of the enemy and" they are the Chiropractors who can't seem to figure out how to treat their patients as THEY would want to be treated....

Kreso Jug:

Christopher

Just because the innate intelligence of the human body does the healing doesn't mean that it will always do the healing.

Read Joe Strauss' blue books especially "Chiropractic Philosophy"

Also Look up Reggie Gold, CMCC might have some of his stuff in the library and have a listen. Reggie took chiropractic philosophy to the next level.

When I graduated from NYCC I had the same type of problems with "philosophical" chiropractic as you seem to be having. Reggie and Joe helped me get some answers.

Hope this helps

Travis Pillipow:

Christopher, as a CMCC grad just last june, we are cut from the same safety blanket. 15 reasons not to adjust, rule out the pathologies first, refer for "medical" opinion, ease them in with mobs, then maybe start adjusting, but only their area of complaint. It is a constant uphill learning curve in the way we need to re-educate ourselves. Hang out with like minded, always remain positive. It is called "Practice" for a reason, you are practicing.

For those practicing medicine, there is nothing wrong with that, a "manipulation" for a headache, is far better than an advil. But for those fixing low backs only, there is a neck, and that neck might have subluxations, so how can the back heal when there is intereference at C1 not being corrected.

To those that practice to improve health, life, nervous flow, innate inelligence,we don't fix colitis, headaches, back pain, or GERD, we remove interference on the nervous system, or add life to the body - the body heals itself. The medical studies that say Chiropractic fixes ear-aches, colic, etc, they are making claims the Chiropractic heals. The body does all the work. Chiropractic optimizes your chances to heal from the above symptoms.

The medical field does not make people healthier, it it is there to artificially save lives or stop the immediate offending source. So there is nothing wrong with treating headaches, just as long as that patient is informed that symptoms, are not a great indicator of your true health. And for most DCs, this education of patients, is where it all falls apart.

I hope that we can all unite, because it is not about our selfish egos, but about healing the person. Labelling other Chiropractors as "quack subbies" (cmcc's perspective)and lying to patients that abberrant curves cannot be restored is purely incorrect, and obviously said out of ignorance. Give them their best chance, educate them about what Chiropractic truly is, and let the person decide after that.

Christopher:

I am currently a student at NYCC. We are taught chiropractic medicine. We are taught adjustments. We are taught how to treat a given pathology. We are taught to adjust in the area of a given pathology. They fail to teach us the effect of a given adjustment on a pathology. They briefly mention the possible science behind how an adjustment can affect health, but only by a doctor here or there.

I love being connected to doctors who practice "ChiropracTIC." They are loving, positive, giving, happy people. But it is hard to buy into this philosophy having not treated people firsthand and seeing "health" as an effect of the adjustment. I consider myself a chiropractor who treats dysfunctions and educates on a chiropractic/wellness lifestyle. With knowledge of those who have died because a chiropractor who said he was going to help his cancer or those who are lost after their payment contracts are finished, this makes it even harder. I want to believe that "ChiropracTIC" is the right way, but I need to believe the truth.

Any responses would be greatly appreciated.

James Milliron, D.C.:

Bill, Great article but even greater, the passion of my brothers and sisters in chiropractic. All respondents were correct unto the person giving their opinion. I am going to add one word primarily which was not used - LOVE! Unconditionally, I love my patients and I will assume that everyone else does equally.
This is the starting line, to make this world a better place.
To go forward, a map is needed. The chiropractic map was conceived and developed by DD and BJ Palmer, then RW Stephenson like Cassini drew it up in the 1927 tome, The Chiropractic Text Book. Bill, you used "critical thinking skills" and "intellectual discernment" wisely but this cannot in my opinion be used until the chiropractor knows a bit of history and suffering which went on in the lives of our founders so many years ago.
Language is the foundation for our dialogue. Our unique form of communication has suffered. It has been compromised to appease insurance companies and Medicare, so chiropractors can be reimbursed. This is not critical thought. It is sell-out.
But let us talk and be colleages. Constant bickering is futile. Let us not forget where we are from.
I want to remain an example of chiropractic and her wonderful philosophy. I live my philosophy.

Tony Russo:

Wow!
I didn't think a few words were going to cause such an exchange. After re-reading my response, I don't think it came out quite the way I wanted it to. And after reading my colleagues' responses, I don't think I have the courage to clarify my point. Let it suffice to say that it takes courage to practice Chiropractic, be thee in Canada or the US or abroad. And any of us who are in the trenches, as we all are, do indeed possess that courage. Nothing wrong with being afraid every once in a while too. I'm concerned. But I'm still here. And I'm not planning on gong nowhere any time soon. So my complements and deep respect to all of you of like mind.

Dan Wallace:

The gist of Mr. Esteb's comment was his encounter with chiropractors who fear for the future of chiropractic who may in fact not only profess, but practice something other than chiropractic namely, medicine. I didn't feel Mr. Esteb was making judgements, but merely stating fact. The chiropractors that practice within the "domain" of medicine are certainly threatened by any other therapeutic endeavors that may practice within the medical arena. They have good reason to be concerned! A distinction without a difference is folly. For those of us with the "TIC" philosophy, we do need to be careful of implied promises! Does our practice truly reflect the philosophy?

rod handly:

Bill, thanks for keeping it real!
Any kind of treatment is medical therapy.
Is there nothing wrong with using manipulation and calling it adjustment to relieve symptoms? So many chiropractors have done manipulation calling it adjustment or treatment the public has accepted it as so. So many chiropactors don't get it and are soo confused the public does not have a chance or do they....?
When I was the only chiropractor in Egypt and explained chiropractic the way i learned it. Ministers of health and sport came to me and asked me to check and adjust their people so they coud express their full potential as beings. They said: "We have enough manipulators.. it is our understanding you do something different. You make adjustments to remove interferences to a persons full potential." Wow! If I was the last chiro on earth yes it would survive! Truth crushed to earth will rise again the eternal years of god are hers.
The great debate can be old and tiring yet we must hold our focus on what makes us chiropractors different. There is nothing bigger than life and the brand of chiropractic I learned.

Brian Deal:

People with medical problems go to chiropractors. Patients intent is to avoid symptoms. But what is the chiropractors intent? In my humble opinion you will go broke when you do not have a clear intent. There a a number of chiropractors that have a non medical intent. They do very well. There are also a number of chiropractors who have a medical intent. They to do very well. When you do not understand your own intent or try to make your patients intent yours you will not do well and get frustrated. Only when we are congruent with our intent will we find success.

Chris Sande:

Well stated Dr. Shiraki. People go to chiropractors because of "medical problems". A few may stay for wellness, maintenance, or preventative care. But their intent is to avoid symptoms and conditions (medical reasons), not because they want innate flowing ADIO. Chiropractic principles are great and I encourage each chiropractor to understand them, but if you want to "practice" chiropractic in a truly "non-medical" model, get a part time job. Because you will go broke tying provide a service few people actually want.

"The distinction between chiropractic and medicine is considerably more than merely the difference in the intervention used. Instead, one must examine the intent and hoped-for outcome from the intervention. Reducing, ameliorating or eliminating symptoms is the domain of medicine. Enhancing, restoring or reviving a person’s ability to self-heal and 'right themselves' is the practice of chiropractic."

According to what you've written here, I would say that all chiropracTORS should, at times, be willing to practice medicine.

When a new patient starts chiropractic care, most of the time they are in our clinics for the sole purpose of reducing, ameliorating or eliminating a symptom. If a doctor of chiropractic uses the desperation of the new patient to promote chiropractic, giving little or no thought towards what the patient really wants (eliminating pain symptoms) it is disrespectful at best and unethical at worst (as in those times when a patient's fear and anxiety are used as tools to get a hold of thousands of dollars in pre-payment).

For those principled doctors who state that they do in fact address the elimination of pain symptoms by promoting the principles of chiropractic, I ask if the promises of "self-healing" and "righting themselves" for pain relief are then, not in fact, medicine. It is the intent which defines, right?

For those principled doctors who state that they do not identify or treat symptoms at all, I would ask them to scrutinize carefully their marketing efforts, entrance forms, patient education materials, exam and report procedures to see if they are truly FREE from direct or implied promises which uphold that chiropractic can eliminate specific symptoms.

With all due respect, Mr. Esteb, many of the products that you sell focus on symptoms, caused by subluxation, with which people have a great desire to reduce, ameliorate and eliminate.

I am a chiropractor who practices medicine, according to your definition. I am not ashamed of this even though many other chiropractors may look down on me with disdain. Ironically, many of these colleagues who would condemn a chiropractor who practices medicine, probably do the same on some unidentified level to which they are blind to.

My first purpose, as I see it, is to eliminate suffering by relieving symptoms. This my FIRST hoped-for intention of my chiropractic "treatments."

After the symptom is gone, I am then ready to continue my relationship with my patient on a different, higher plane by teaching them true principles of healing and wellness through chiropracTIC.

A chiropractor who practices medicine (as defined in your post) is not necessarily a hypocrite or incompetent-- just as a medical doctor who incorporates chiropractic principles into his or her practice should never be deemed less of a healer.

Thank you for considering this perspective.

Karen Bisesi:

Thank you!!! Thank you Bill for making this so crystal clear. I made the switch from "medical chiropractic" to Principled Chiropractic thanks to Dr. Ben Lerner who is out there in the trenches saving the Chiropractic Profession as envisioned by DD and BJ!

Travis Pillipow:

Education in Canada is so backwards. They graduate DCs so sure that "treatment" of the painful area is the only way in Chiropractic; that practicing neurological, wellness, lifestyle, lifetime Chiropractic is a) unethical and b) purely a money grab. So it is easy to be dis-illusioned in your message to your patients. Thank goodness, for great colleagues in my area, great blogs, and great outlets to forget all that I learned and re-learn what is important. Chiropractic! Thanks Bill, and to the rest of us for being upfront and honest.

Travis

Kreso Jug:

Great post Bill!! I wish the preseidents of the chiropractic schools could read it and then use some introspection

Brian Deal:

Amen. I am a little afraid that our collegues have only a vague understanding of what you are saying. As my personal mentor Dr. Joe Flesia used to say (paraphrased) "remove the subluxation and get out of the way, the body does not need help, just no interference."

Tony Russo:

Hi Bill,
In reading your excerpt I couldn't help but feel uncomfortable with what you have to say. My discomfort comes in the form of someone daring to suggest that I practice medicine. But if I set aside my Canadian arrogance for just a moment, I might see that is indeed what I'm doing. I guess then that is the question. And that is the answer. Who has the courage to walk it? Humbly, I don't know if I do.

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From April 8, 2009 7:05 AM

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