Patient Media

« Monday Morning Motivation | Main | Monday Morning Motivation »

Should Chiropractic Remain Drug-Free?

Do drugs and chiropractic mix?
"If the chiropractic scope of practice were broadened, chiropractors would be more successful."

"If the chiropractic scope of practice were broadened, patients would be better served."

If either one of these statements were true, I’d lead the parade to the statehouse to amend the practice act laws. But neither is.

This past weekend I sat in on a one-hour presentation by a proponent of broadening the chiropractic scope of practice in Colorado to include prescription rights. I heard firsthand the flimsy arguments for doing so. There were seven of them. Allow me to refute each one.

Thankfully, it's an easy task.

1. Health care continues to evolve and so must chiropractic.

Really? It must? This is a favorite of progressives who are quick to discard the Bible or anything else that has a couple of years on it. True, when compared to 1895, we know more about the body, vitamins and even the human genome. However, that doesn't change the fundamental truths on which the chiropractic profession is founded.

Those embarrassed by the colorful characters of the profession's past, or who see subluxation as some "historical artifact," probably see chiropractors reluctant to budge on scope of practice expansion not only as less enlightened, but card-carrying members of the Society for the Creative
 Anachronism.

The fact is, more than a century later, the principles of chiropractic still hold true. The body still heals from above down inside out. Drugs merely slow things down or speed things up. And doctors (of any ilk) don't heal; only the body can do that if there’s no interference to its innate capacity to do so. And yes, since D.D. Palmer’s time, we’ve added drop tables, adjusting instruments and computerized decompression. But the body still heals the same way it always has.

2. Chiropractors should become the musculoskeletal experts.

Notice it's not neuro-musculoskeletal specialists. Just bones and muscles, please. Apparently, if principled chiropractors were to just abandon the neurological implications of this thing they call a "subluxation," it wouldn't be seen as such a kooky, isolationist profession with "imaginary whole-body implications." This, as the thinking apparently goes, would encourage more medical doctors to refer to chiropractors, increasing patient volume and life would be wonderful.

However, what this small cadre of chiropractic expansionists overlook is that chiropractic was never about bones and muscles. It was founded on tone, mediated by the nervous system. Remove the nervous system component from chiropractic, and you have a profession of overeducated physical therapists.

3. Prescription rights would be a natural brand extension for chiropractic.

When academics put on a marketing hat, stand clear! The argument Friday evening was that adding the ability to prescribe medication to the chiropractic scope of practice is just like "…McDonald's adding salads to their menu."

I'm not making this up.

Ever heard of Welch’s apple juice? Or Tropicana grape juice? In spite of the evidence that brand extensions don’t work, the annals of marketing history are replete with attempts at failed brand extensions that seemed perfectly natural. Here are some actual examples:

  • The Life Savers candy people thought Life Savers gum would be a hit.
  • Coors brewery thought Coors water was an easy slam-dunk.
  • Heinz ketchup brought out Heinz baby food and it promptly failed.
  • Adidas running shoes took an expensive write off by offering Adidas cologne
Hard to imagine an onslaught of new patients at chiropractic practices when the slogan becomes: "New and Improved Chiropractic—Now with Drugs!"

4. Our country needs more doctors.

This argument suggests that there are areas of the country underserved by doctors. This, along with the fact that medical schools aren’t graduating enough general practitioners, implies that if chiropractors could be pressed into service as primary care physicians, the world would be a better, healthier place.

Purveyors of this argument often cite the growth of osteopathy colleges and the growing numbers of their ranks, while chiropractic college enrollment declines. How about this. If there’s a shortage of medical doctors keen on being the lap dogs of the pharmaceutical industry, either the free market will answer the need or big pharma will step up with a plan to rectify the situation.

Turns out, fewer medical practitioners can be a good thing:

  • According to the Jerusalem Burial Society, a month-long doctors’ strike in Israel in 1973 lowered the country's death rate by 50%.
  • When Canadian physicians went on strike in the 1960s, the nation’s mortality rate dropped.
  • In Bogota, Colombia, doctors only treated emergency room cases for 52 days in 1976, and the death rate fell by 35%.
Keep in mind that medical care isn't health care. It's sickness care. It's reactive, not proactive. It treats symptoms and frequently ignores cause. The beauty of chiropractic is the interest in the person with the problem, not the problem in the person. Chiropractic is holistic and vitalistic, while medicine is atomistic and allopathic.

Expansionists aren't merely proposing an evolution of chiropractic; they're proposing a betrayal of the very foundation that makes it a separate and distinct profession.

5. Just because the scope is enlarged, it doesn't mean you have to change.

In other words, "…please don't hold us back just because we're more enlightened than you. You may cling to your primitive subluxation model if you wish. Just support us in our efforts to expand chiropractic to its fullest potential."

This creates a two-tiered profession and confuses the marketplace. Adding this additional level of complexity to a profession that is already misunderstood is a luxury no chiropractor can afford.

6. Prescription rights gives chiropractors a seat at the big table and on the bus.

This is a retread of the civil rights movement of the 1960s. Back of the bus. Separate water fountains. Nice metaphor, but misused.

Chiropractic is doing quite well where it is NOT under the big tent of mainstream medicine. Pick virtually any commonwealth country and chiropractors are doing pretty well. Granted, there has been some slipping and checking in Canada as chiropractors, who were previously included in the provincial government health care schemes, have been delisted. However, turn to the United Kingdom, Australia and New Zealand, where chiropractors have never “sat at the adult table,” and you’ll generally see massive cash practices filled with patients who consciously choose to avoid the medical version of the Department of Motor Vehicles and pay out of their own pockets for the privilege.

7. Chiropractors will be able to help more people.

While this argument hits below the belt, since most chiropractors would like to help more people, the ends simply don't justify the means.

Here, if memory serves, if you’re more respected and part of the establishment, singing an inclusive tune, you’ll see more patients.

This argument might actually be true. Granted, the price to be paid for this acceptance is to forsake the unique difference chiropractic offers to the world, but it might eventually increase patient volumes.

However, consider these other strategies that could similarly increase patient volume:

Chiropractic car wash. Your car gets washed and detailed while you get your spine adjusted.
Chiropractic comedy club. Comedians tickle your funny bone in the reception area before the chiropractor finds which bones are out of place.
Chiropractic Starbucks. Turn your reception room into a “third place” by adding the popular coffee franchise to your practice. (Waiting becomes a feature, not an annoyance!)
I’m kidding of course. The point is, mixing chiropractic with other services might increase traffic, but at the cost of diluting or damaging the reputation and limited identity that chiropractic enjoys.

It seems relatively easy to neutralize the arguments put forward by the chiropractic prescription rights crowd. What proponents of this incursion into chiropractic medicine rarely reveal, is that their real motive for adding prescription rights is the fact that their practices are floundering and they are struggling to make a living.

There. I said it.

“If I could do more stuff like real doctors, I’d be respected and see more people,” I’m imagining the thinking goes.

Meanwhile the busiest chiropractors, relying on nothing more than their adjusting prowess, communication skills and clarity about their purpose, have little time to attend association meetings or court legislators, begging for an enlargement of their scope of practice.

Chiropractic does not need to evolve. Chiropractic does not need to become something else. Chiropractic merely needs chiropractors who understand the principles of chiropractic, who apply them with confidence and explain them with consistency. If that’s too challenging, if the hard, difficult, narrow path is too arduous, I recommend a career change.

I hear that enrollment at medical schools is down and opportunities abound.

Comments (21)

Anonymous:

Chiropractic is a garbage profession. I am one. The student default rate of chiropractors is an embarrassment. Vast majority of people who graduated from chiropractic school want to earn money and helping people. They get out, and they run into a whole of obstacles put up there by the crazies in the profession who block opportunities, such as an increased scope of practice, for these individuals to have gainful employment. Shame on all of you. I have never been disrespected by anyone as I have by so-called fellow chiropractors. Disgusting the lies and innuendo you characters spread against MDs and other allopathic professionals. We are not professionals. We are a joke.

Great article. I liked Brian’s comparison with the Gandhian movement. If they want to prescribe drugs what then sets them separate from normal physicians? This conflict is unnecessary.

Your post has so many truths but lack perspective on the other side. Currently I worked in medical clinic with 2 MD's, 1 DO, 2ND's and 10 NP. Back pain is 2nd reason the patient base of 8,000 come to this clinic. As a chiropractor, I have so many resources for them. Even though, chiropractors preformed manipulation the best many other professions also do manipulation with less restrictions. So being able to prescribe opens whole new world to chiropractors. I cannot over state how powerful an adjustment can be. I am here for patients not the chiropractic dogma.

Melanie:

Yes! That, and that as chiropractors we still have no ability to diagnose or treat any condition other than subluxation. We won the cases of not practicing medicine without a license for this very reason. Now some fools are trying to go back on it? Ridiculous.

After 25 years in private practice this discussion continues. If you want to prescribe drugs you're in the wrong profession. Do the work to get M.D. behind your name and have at it. If you think your patients need prescription drugs, develop a relationship with some good local M.D.'s and send them out. If your patients need a lawyer does that imply you should become an attorney?

Wise words Bill! It amazes me that you being a "lay person" and not a chiropractor "get it" yet some of the DC's in our own state are so duped and fooled by the medical society that they still feel like second class citizens and less than the medical doctors. We definitly do not want or need drugs in our profession. Those who do should go back to school and become an MD prescription drug pushing-surgery recommending alopathetic doc. Leave our great profession and those of us who want to stay drug free alone and go off to do something else!

Gianluca Rossetti:

Very nice article. Thank you.
If some people holding a chiropractic degree wants to prescribe drugs, they should be allowed to do so, however they should found a new profession or join to an excising profession and leave ChiropracTIC alone. This people should look inside themselves and try to understand why they have the need to change chiropractic, but more than anything else why do they not want to leave the chiropractic path, since they have views and they want to take actions that are not congruent with chiropractic? It would be the same if some people in the Gandhi’s peace movement were saying, “let’s blow some bombs , so we can move forward with peace” and they wanted to change the movement according to their views without caring why the movement was born in the first place and with which objectives. If they wanted to blow bombs they had to do it from outside the Gandhi’s movement, period.

This is so true! I just don't understand people who don't like what chiropractic is, just don't change for an another profession!

Great conversation and thank you Bill for articulating my sentiments. I have worked in the arena of menopause and osteoporosis for years. It is more than a drag for me to send them back to their, "doctor" regarding Fosamax or other medications that are misused or overused. While other DCs may not want to have privilege of using bio-identical hormones and a limited access to medications, I do. Presently, doctors refer their patients to me anyway, to help with the patients who are severe and who are not responding with chiropractic care alone. I send those patients right back to their DCs. I see adjusting, nutrition and gastrointestinal health as the core treatment of any disease process. Osteoporosis can be caused by so many things including parathyroid tumors and sadly, a case I had today, metastatic prostate cancer. His doctor did not bother to order the lab work to properly assess bone health.

Would a DC rather get a prescription from me or from a medical doctor? Wise use of western medicine is worth supporting.

Warm regards to all!

Well said! The reasons are well stated and consistent with the health care philosophy that chiropractic has always represented. There is so much we are able to accomplish within our turf, but only when the practitioner isn't conflicted about who he is!

Alan Dinehart, DC:

In the computer business, there is an old saying "Garbage in = garbage out" Since the author of the above story starts with a false premise, he can only finish with a false conclusion. Chiropractic is not and never has been drug free! So, if we start with that premise, then what we have to determine is should we be incorporating an unrestricted license or a restrictive license. Since the 'Straight' mentality doesn't even allow for diagnosis, then I say that they don't need a license at all. That leaves us the ability to diagnose and treat any way we feel is right. And, it allows members of our profession (Chiropractic Medicine) to expand into other specialties like surgery, Ob/Gyn....I have no problem with practitioners who want to only manipulate, as long as they adequately inform the patients that you won't be diagnosing ANY ailments they may have and that they will have to see a licensed chiropractor if they want a complete work-up.

Craig Foote:

Henry Ford was quoted in saying, "If I had given people want they wanted I would have invented a faster horse." So don't give them what they want but what they need. They need chiropractic WITHOUT drugs.

Bill, I'm sorry, but you're arguments are from someone trying to prove your belief system.

Not sure what the rule change is on prescriptions that you're referring to, but let's look at New Mexico. They've only basically approved the same anti-inflammatories that everyone can gets from the grocery store, they okayed Flexiril. No antibiotics, no narcotics, no psych drugs, no chemotherapy drugs, no reflux meds.

So what did they ok? Injectible B12 and other vitamins and CoQ10. Intravenous saline bags. Lidocaine. Pig thyroid hormone. Bioidentical sex hormones. Caffeine. And one's own blood (autologous blood transfusion).

So to compare us doing chiropractic adjustments and then being a Starbucks is ridiculous. How about us treating chronic pain and hypothyroidism being a cause of chronic pain. Doesn't it make more sense to have us manage BOTH causes of pain than to have them have to see 2 doctors for the same problem?

As for tiering the profession... we've been tiered for decades with the straights and mixers. This would only widen the difference giving people a clearer choice.

I don't believe we SHOULD leave the holistic, natural approach. I'm not interested in "sitting at the big table". But having some prescription rights (or better yet the right to remove patients from their drugs when we've found a natural solution) is going to help us serve the patients better. Right now we have to send patients back to the doctor that just told them that they should stop seeing us.

The truth is that most chiropractors that are against this fall into 2 categories. The purists who believe unflinchingly that chiropractic should be practiced the way it always has been for no reason that it's the way we've always done things. The other DC's are (justifiably) afraid of following the osteopaths into obscurity. But if that's you, I think we can learn from their mistakes and put things in place that keep us as the only mainstream holistic profession that actually gets to the root of the problem.

Alright... I'm ready for my lynching now.

Bill, your big picture view of what chiropractic is and stands for and what it always has been, is expressed in such a clear manner.Your bebunking of the arguments of those in our profession who are attempting to destroy our essence and the unique offering we make to the community at large in the area of health care, is a master piece. Love and hugs from all those who love chiropractic and stand up for it as you so eloquently do. I APPRECIATE YOU!!!
Thanks for being on our chiropracTIC TEAM.

Fiona Glenn:

Brilliant, Bill. Thanks for your clear and eloquent words!
A must read for chiros and others.

Right on point and eloquent as always! Thanks Bill

Ghislain:

Great article. Would you have the reference about the following statement please: "When Canadian physicians went on strike in the 1960s, the nation’s mortality rate dropped."

Thank you.

WDE: This comes from Chapter 11 of Health and Survival in the 21st Century by Ross Horne, published by Harper Collins in Australia in 1997. http://www.soilandhealth.org/02/0201hyglibcat/020122horne.21stcentury/020122toc.html

Dr. Glen Peterson D.C.:

This is a glorious message. I am whole heartedly on board with everything posted here. As Chiropractors we need to stand up and rightfully claim what is OURS -- the ability to heal the body with all natural means.
Chiropractors need to understand that drugs are what make us who we are - THE ALTERNATIVE to that very PROBLEM!

Chiropractic with drugs is not Chiropractic. Palpation is the diagnostic instrument and adjusting is the treatment. I challenge the drug DCM proponents to a debate. Bring ten DCM-minded DCs to be the judges. I will bring 20 MD WRITTEN ARTICLES TO BACK UP MY CONTENT. ENOUGH IS ENOUGH. It's time to put up or shut up.

This is quite simply Bill's Magnum Opus! SO clear and on point! ALL CHIROS NEED TO READ THIS!

Outstanding Bill! Thanks for being such a chiropractic visionary.

Post a comment

(If you haven't left a comment here before, you may need to be approved by the site owner before your comment will appear. Until then, it won't appear on the entry. Thanks for waiting.)

From September 11, 2012 5:48 PM

This page contains a single entry from the blog posted on September 11, 2012 5:48 PM.

The previous post in this blog was Monday Morning Motivation.

The next post in this blog is Monday Morning Motivation.

Many more can be found on the main index page or by looking through the archives.