Out of the Closet

by William D. Esteb

I have the occasion to travel frequently, and when I meet people on airplanes the inevitable question of what I do often arises. It's a common question asked with sincere interest. I confess that my response has not always been complete.

During my early exposure to chiropractic, while I was researching and writing the Renaissance patient education videotapes, I would enthusiastically reveal my newfound understanding and appreciation for chiropractic. Excited by the simple logic of chiropractic principles and inspired by the improvement of my own health, I was quick to gush my endorsement for chiropractic.

It didn't take long before the polite "uh-huhs" and mild curiosity of my close circle of friends was replaced with hostile questions and raised eyebrows. My reputation and judgment were somehow in question by my association with "quarpractors." It was as if I had fallen prey to some charismatic, money-hungry cult! After submitting to enough abuse, I found myself couching my response with explanations like, "I work with doctors," or "I'm involved in patient education." Only if there were follow up questions did I reveal my chiropractic identity.

Now I'm ashamed of my avoidance. I'm sharing my experience as a cleansing confession and to help keep others, many others in chiropractic I'm discovering, from doing the same thing. No more side-stepping!

C.A. stands for Chiropractic Assistant, not "Closet Advocate." And D.C. stands for Doctor of Chiropractic, not "Defensive Crusader." Those who have created new paths and changed the direction of humanity have always been persecuted: Christ, Gandhi, Martin Luther King, etc. And regardless of the reception these leaders received, the truth has prevailed. By avoiding being identified with chiropractic, I was inadvertently admitting that chiropractic's detractors were right. Those who posses the truth have the obligation to do everything possible to share it. No one lights a lamp and covers it with a bowl!

Making a difference

I made this observation while reading Dedication and Leadership by Douglas Hyde, the leader of the communist party in Britain during WWII. Later he renounced his political stand to become a Christian. His book describes how a mere handful of communists (6,000) were able to make a significant impact on the world. He contrasts this with the huge numbers of church members who have made little impact.

The reason for this, Mr. Hyde suggests, is that communists get more from their supporters by asking for more. "He who asks, gets. He who asks for a lot, gets a lot." New communists aren't coddled and spoon-fed. They're immediately placed on the front line before they even have a complete understanding of the communist party line. Usually they were placed in areas of high visibility. Many were sent to sell the Daily Worker on London street corners where they had to fend off detractors, attempt to answer questions, communicate, and, most of all, reveal their identities. Of course, they made mistakes. Interestingly, though, this process served to strengthen the new communist's convictions rather than dissuade them. Ask for a little, get a little. Ask for a lot, get a lot.

Persecution does not automatically mean the cause is right. As I've revealed my chiropractic affiliation and commitment, so too have I been assaulted with the horror stories that sabotage this profession's image.

Turning the tables

Between interruptions from beverage and meal service on a recent cross-country flight, my seat mate explained his recent chiropractic experience. After receiving X-rays and beginning care for a period of time, he was improving, but not as completely as he had hoped. He asked the doctor if there was a way to take new X-rays to see his progress. Suddenly the tables turned. The rationalizations and excuses normally used by patients to avoid the radiation or cost of X-rays came from the doctor. The doctor's reluctance to document the progress of care made a big impression on my new friend.

Prima-facie evidence

Yet without offering patients this visual evidence of chiropractic's ability to make structural improvements, chiropractic will not be able to sufficiently convince the skeptical or the analytical. Those who want more than a "chiropractic aspirin" or who might be available for long-term reconstructive care cannot be identified or persuaded without more evidence. Without proof of an improved form/function connection, even patients who get great results can easily side with medical X-ray specialists who quickly point out that chiropractic doctors seem to find structural problems in every X-ray. Progressive X-rays or other incontrovertible evidence help discerning patients describe their chiropractic experience on more than symptomatic terms. Otherwise, there's an inclination to endorse chiropractic to their friends with nothing more than a half-hearted, "Well, it worked for me." This continues to relegate chiropractic to its current "bad back doctor" orientation, attracting only the intuitive or the desperate. Changing the world's perception of chiropractic to the cornerstone of a wellness approach to health (repositioning) requires successfully reaching the discerning, the analytical, and those who influence others. It will require more than an intellectual extrapolation from feeling better. It requires proof. The same kind of proof used to justify care at the outset of Initial Intensive Care. If we are to enhance chiropractic's image, dynamic X-ray views of the spine may be as important during the later stages of care as they are during the early diagnostic stages.

Interestingly, doctors I meet who regularly take progressive X-rays and perform post-examinations have successful, low-stress practices that don't require strong-arm management efforts to motivate patients. Post X-rays can be important clinical tools that also serve to motivate patients without hype or pressure. Not only feeling their improvement but seeing their improvement can speak louder than words.

Another person I met on the same trip had a negative experience, too. She had been on a cruise and had experienced throat problems. A doctor overheard her describe her condition to a friend and asked if he could help. Thinking he was a medical doctor about to examine her throat, she was taken by surprise when he unexpectedly administered a swift cervical adjustment. After three years she is still angry.

Many of the difficulties and challenges that chiropractic faces are not esoteric or even difficult to understand. Rethink chiropractic and approach patients from their perspective. What are their spoken and unspoken fears, concerns, and biases? If they wait until they can no longer stand the pain before calling for an appointment, what should be said and done to reduce apprehension? What can be done to over-communicate, volunteer answers to questions before they are asked, and clear internal dialogue? How can the delivery of chiropractic care be enhanced to reinforce credibility and expertise by anticipating the most frequently asked questions and supplying well thought-out answers?

My role in contributing to chiropractic is not limited to providing a layman's insight into the profession through articles, seminars, or consulting, just as every C.A.'s and D.C.'s role is not limited to providing administration and therapeutics that improve a patient's well-being. Our roles are to explain chiropractic and influence everyone we come in contact with. If we pull any punches, if we avoid our obligation to champion chiropractic in every way possible, with everyone possible, we deserve the condemnation our detractors are only too quick to supply.

Malpractice?

A patient may or may not see the Reader's Digest insert. A patient may or may not know about the Wilk's case. A patient may or may not have a wellness orientation. But one thing is certain. Every office, every doctor, and every staff member has the responsibility and the obligation to do everything possible to change a patient's outlook-physically, emotionally, and experientially--while they are in the controlled environment of your office. Anything less is a missed opportunity bordering on malpractice.

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A Patient's Point of View
Originally published in 1992
240 Pages
US $19.95

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