Donald M. Petersen Jr., BS, HCD(hc), FICC(h), Publisher
Like the left and right wings of an airplane, both philosophy and science are critical to chiropractic. And while there are many points of contention between science and philosophy, it is indicative of how greatly the two areas impact our practices and patients.
A particularly fitting analogy for building a successful practice is to see science as the bricks and philosophy as the mortar. Perhaps this will shed some light on how we can use each in the continued development of chiropractic as a modern health care profession with profound historical roots.
A group of studies on a particular topic may suggest what specific forms of care may work better than others for specific complaints with specific patients under specific conditions. But like a pile of bricks, their utility is very limited.
We only have partial knowledge and will always have only partial knowledge. Much of what we believe now may eventually be shown to be in error. That is where philosophy comes in.
Philosophy fills in the gaps between the bricks (studies). It provides us with direction when the studies don't address the situation or are inconclusive (which is much of the time).
A doctor starting in practice has a concept of chiropractic philosophy, but only after treating a certain number of patients with real problems does this philosophy become refined. This is when the chiropractor begins to "walk the talk."
Likewise, as DCs new to practice read the latest scientific literature and continue their chiropractic education, they learn the lessons of others. In this manner, their philosophy is challenged by science. This does not reduce or eliminate their chiropractic philosophy, but the philosophy does begin to be shaped by what is being scientifically demonstrated.
This is where philosophy becomes the mortar. If it is too thick, too full of itself, it will not be able to adhere to the relevant science and thus prevent growth of the practice. If it is too thin, having little substance, it will not stand up to the science and will leave DCs wavering in their practices at the whim of every half-baked study published.
Either way, the chiropractic practice will not be built firmly and will only be able to develop to a certain point. Caring for patients and working with other health care providers will be hampered by the weaknesses inherent in the two extremes.
It is mandatory that DCs develop an understanding of the scientific literature, so as to refine and strengthen their chiropractic philosophy. While this is very challenging, this is what is required of a health care "professional." It is why you patients come to you (for a fee) rather than getting information online (for free) and "treating" themselves.
The hard part is finding the time. Today's practice environment, especially under managed care, does not appear to reward you for spending 2-4 hours a week refining your knowledge and philosophy. The number of visits appears to be more important than the quality of those visits.
But becoming a better DC is even more important than the number of patients you see. It is not only one of the secrets to a more successful practice, but a secret to a more fulfilling practice. Learning and growing brings a satisfaction that exceeds monetary gain.
Are you are better DC than you were a year ago? If I asked your patients the same question, what would they say? And what evidence would they provide to support their answers?
Are you the best DC you could be? Is your philosophy strong or weak, that is, is your philosophy well developed? Are you keeping up on the science of chiropractic? When did you last read a chiropractic study?
To be your best and continue to have your practice thrive, you may have to begin to work more than 40 hours per week some weeks. You may not want to hear this, but in today's economy, depending on where you live and your years in practice, more hours may be a requirement.There is a saying that many fall back on: "If it ain't broke, don't fix it."
But for your practice to grow, there is another saying that may have more relevance: "If it ain't broke, break it and make it better."
