It's a Really Small, Small World

No, this column is not about the magical ride that you take with your children at Disneyworld. It is, however, about how we are truly becoming a global family. I hope to titillate your thoughts with how our chiropractic world is growing and shrinking at the same time.

I recently returned from New Zealand, where I attended the World Federation of Chiropractic (WFC) conference and scientific symposium. I want to publicly express my appreciation to the New Zealand Chiropractic Association and Drs. Barry Rushton and Robin Taylor for being such wonderful hosts and seeing that everything ran like clockwork.

Attending the conference was an eye-opening learning experience about the explosion of chiropractic around the world and the many problems inherent in the growth of our profession. It was heartening to see quality research presented from around the world. The proceedings were published in a book and are available from the New Zealand Chiropractic Association.

Chiropractic is booming around the world. With that boom come many problems that have ramifications for the entire profession. We cannot live in isolation and expect our profession to grow with the respect and professionalism it should have and our patients deserve. This was demonstrated by the program dedicated to the New Zealand report 20 years later, which showed the impact of that small country and what significant conclusions were reached by the commission assigned to investigate chiropractic. Even though the New Zealand report is 20 years old, it should be required reading for every student and DC.

Space does not permit me to go into all the important things the World Federation of Chiropractic (WFC) does. Its role is increasing in importance each year. More than 60 countries now belong to the WFC. Many countries have less than ten chiropractors in the entire country. There are now more chiropractic colleges outside the U.S. than within its borders. The idea for the WFC began a decade ago, and ACA can be proud to have been one of the original organizations that helped give birth to a worldwide organization designed to meet the needs and challenges of an exploding chiropractic world in need of structure and function.

Chiropractic is not licensed in many countries. A major problem is that in some countries, chiropractors are teaching laypeople how to adjust/manipulate the spine at weekend seminars and giving those people a certificate. Those people then go out and call themselves chiropractors. In Japan, there are now approximately 20,000 to 30,000 such laypeople claiming to be chiropractors. They far outnumber the U.S.- and Australian-educated chiropractors who must meet CCE-type standards.

Japan now has a new chiropractic college. There is also a movement to raise the educational standards and stop those weekend diploma mills. This has been a major issue the WFC has been working on for the past two years. It is a complicated issue that has ramifications worldwide.
This is also happening in other countries on a much smaller scale. The world has an eye on Japan. If these diploma/certificate mills are not stopped, this problem will spread to more and more countries. The WFC is playing an important role in helping raise educational standards. Many countries that have started a new college have high standards. Many colleges are affiliated with a university system. In Italy, a new college has been started. To enroll, one must be an MD. There is a great interest by the medical profession and PTs in learning chiropractic. Many MDs from Russia have gone to other countries and practice as MD/DCs. The problems are many and complex.

There are great cultural differences that, if not taken into consideration, create more problems than they solve when outsiders go into a country, especially when they are uninvited. The WFC is aware of these problems and is invited into many countries to help gain licensure for DCs or give direction to new colleges to assure quality education standards are established.

We truly live in a small world. If the diploma/certificate mills are not stopped, our profession will become known as technicians rather than doctors. If MDs and PTs are allowed to take over the profession in some countries, it will inspire stronger efforts along those lines to occur in this country.

Why must we be involved as the ACA is? Simply because what happens in any country will reflect on any initiative we begin in the U.S. Mexico, for example, has no chiropractic college at this point. What would happen if our neighbor to the south, which has limited barriers at our mutual borders, decided to set up a two-week chiropractic school? The destructive press from our known enemies in the U.S. would be unrelenting. The quality of care issues, as well as the educational issues, would become a battleground for limiting chiropractic.

We like to think that since the vast majority of chiropractors live and are educated in this country, the rest of the world does not impact us. Such thinking is fatally flawed, narrow -sighted and can bring serious harm to our profession. With new colleges springing up every year around the world, it will not be long before there are more DCs educated outside the U.S. than within our borders. It is vitally important that educational standards be as high (or higher) than in the U.S.

The World Health Organization is playing an increasingly important role in health care around the world. Universal health standards are a possibility. If that happens, just think of the impact it would have on our country and the profession worldwide. The WFC plays an important role in the WHO providing input about chiropractic education and other issues.

I am just learning about the importance of the WFC and its impact in the world community, but I have learned enough to know that it plays a vital role in this profession's future. One problem many have in appreciating the importance of the WFC is that most DCs don't see what the WFC does. The old saying, "out of sight, out of mind" applies here. It's like the legislation which, if passed, would cause the loss of insurance coverage for chiropractic patients, but ACA gets it killed in committee before it ever gets a chance to be passed. What is that worth to the profession? Yet, so many DCs say, "What have you done for me that's worth the price of dues?" Well, the same is true about the WFC. If we don't see what the WFC is doing, it's easy to give it a low priority. That would be a mistake.

The WFC needs to communicate more with the chiropractic community so we can all be better informed and have a greater appreciation for the excellent job it does under very difficult circumstances.

The ACA and every state and national association in the country are grappling with domestic issues relating to limited budgets. The leadership must set priorities and decide which programs must be curtailed and which must be funded. While this is not an easy task, the priority of the budget must be the survival of the profession.

In this case, survival of the is inextricably linked to the viability and survival of the World Federation of Chiropractic. Having participated in the WFC, I can relate to the positive global impact generated by the WFC. All of the major organizations around the globe have participated in WFC, including groups from Canada, Australia, Great Britain, the European Chiropractic Union, and ICA and ACA. These organizations, along with increasing numbers of countries with only "one" chiropractor practicing under adverse conditions, are all linked together to the outside world through the WFC.

WFC is reflective of a new thinking. We are a global profession. Like the environment, if we destroy the rain forests in South America, the oxygen level around the world is affected.

In the chiropractic world, there is only one chiropractic spaceship, and we are all on it. Caring about our world today will ensure that the profession can and will survive and flourish tomorrow. As the president of the American Chiropractic Association, I am proud that we have stepped up to the world plate and supported the WFC with funds and resources. ACA has made a global investment in chiropractic's future.

We all need to expand our vision beyond the local community, state and nation to truly participate in the significance of the profession in the world. Colleges will continue to proliferate, and manipulation will continue to be offered by those of every variation of education. Will chiropractic - as we want it to be - continue to grow and prosper, or will it simply be relegated to a "nonessential" service that can be learned by anyone in a weekend? WFC, through the support of its member nations, can and will carry the chiropractic banner to every corner of the globe in a fashion designed to enhance the image, credibility and prestige of chiropractic.

As I listen to the haunting theme song, "It's a small, small world," I know first-hand that it is true. Our chiropractic world will only be as strong as the dedication, commitment and support provided by every member and organization.

My only wish as I left the conference in New Zealand was for each DC in America to see the vision, dedication, commitment and passion of each of the individual pioneer chiropractors entering countries from South America to South Africa, with only their love of chiropractic to sustain them. In a way I was envious, because we may have lost some of that desire as we live in the safety of our country.

I want to impart to each of you a sense of global responsibility which is perhaps summed up best in the phrase often used by Dr. Joseph Janse:

"Each snowflake must share in the responsibility for the avalanche."