It was noted in the June 28, 1999 issue that the combined membership of U.S. chiropractors in our two national chiropractic associations is less than 16 percent. The question was then posed: Why are you (or are you not) a member of a national association?
The question was also the topic of a recent ChiroPoll (www.chiroweb.com/why ). Already over 100 DCs have responded with their comments. And while the comments continue to come in, there is enough of a sample to begin to see a trend.
Who Responded?
• Over 30 percent of the respondents are members of a national chiropractic association, perhaps indicative of how important this question is to that population.
• Over 40% of the respondents are members of a state chiropractic associations, a figure in line with the percentage of U.S. chiropractors belonging to a state association.
• Over 50% don't belong to either a national or state chiropractic association, a figure that underscores the magnitude of the problem for chiropractic in the U.S.
What Did They Have to Say?
Here is a representative sample of the comments we received. Each comment is prefaced by the type of association membership the DC has:
National and State Association Member: I believe that professional associations attract professionals. In general, the chiropractic profession is comprised of a small professional segment and a large trade/retail minded segment. Academic requirements have been too low, clinical experience minimal at best, practice isolation a reality.
Our professional associations are comprised of amazing people of dedication that are able to perform miracles with pennies. Professionalism begins with high academic standards, a mature collegiate manner, broad-based internship, and ongoing strong federal and state licensure requirements that must include professional membership involvement.
National and State Association Member: I have been a member of the ACA and the CCA for 20 years since graduating from school. Managed care has cut my practice in half over the past several years. I have cut my overhead to the bone but continued my membership in both the state and national associations. I continue to pay substantial alimony and child support and will have a child entering college in the fall. I can no longer justify $600 to the ACA and $800 to the CCA. When I was making a large income, I thought it reasonable. But just as I and many other chiropractors have had to tighten our belts, the state and national associations will have to reduce membership fees or continue to lose more members.
National Association Member Only: I am currently a member of the ACA and a new graduate. Every time I write my dues check, my wife says after paying $50,000 in tuition and struggling to thrive, you don't owe your profession anything yet. I can't even get health insurance through my association and my patients in their own carpenter's and plumber's unions can. I am starting to believe she is right.
Neither a National Nor a State Association Member: I am not a member of either a state or national organization. It all has to do with money. Full membership in both a state and national association would come to $1,200 a year. I live in a small Midwestern town of 12,000 people. When I first came here, I was the fourth DC in town. Now we have six, plus many additional DCs in surrounding small communities. The patient pie is now diced up so small that no one here in town is doing well, even those that are willing to overutilize insurance, give free services or scare patients into coming for treatment. I could never do this with a clear conscience.
I have been in practice for nine years. I will be paying on my student loans for the next 22 years. With taxes so high and so much competition for patients, there isn't any money left over. Possibly if the national organizations could state a plan of action, or at least let us know what to expect for our membership dollar, it would help people to know the benefits of membership. Although, when you are making hard decisions each month such as which bills you will pay on time, membership in various organizations takes a back seat. Please don't tell me that I only need to cut my overhead or do without cable TV. I work by myself, I just bought a computer in 1996, I don't have a fax machine or copier, and I don't have cable! There just isn't enough money to go around.
National and State Association Member: Being a member of a national association, as well as a member of my state association, creates community for this profession and provides another opportunity for personal responsibility. It may seem easier to be isolated from communication, but nothing is ever created in such a vacuum. I would rather live for what is possible than for what is obvious. Membership, then, is a statement of my commitment to my community and a way of being responsible to others in the community. It also contributes to the dynamics of the dialogue among us all that creates the profession. We evolve and the profession evolves within the community. Otherwise, all that's left is the act of complaining to oneself, which, of course, is something that a lot of us love to do.
State Association Member Only: With state assoc. dues at $600, another $600 per year is excessive. A good friend of mine who is a dentist tells me his ADA dues of around $800 also include his state dental assoc. membership. This could be an option for DCs. Another reason is two national associations related to philosophical differences. It's time to unite and work together. Just think what we could accomplish. I have been in practice for 20 years and could easily afford both state and national association dues, however, I am so disenchanted with our national associations that until they unify, I will not become a member. I know many of our leaders feel this is no excuse, but many of our nonmember DCs who I have talked to feel strongly about this and unless the current situation changes memberships will continue to decline.
State Association Member Only: Thanks for asking reasons why so few DCs are in the ACA/ICA. Speaking for myself: cost. Bring the dues down to $150-$200 a year, and I and many others will join. There will be more voices and, I believe, more money to work with. For the past 11 years, I've paid up to 30 percent of my gross income to service my student loans. Take that, in addition to the taxes and overhead of running a practice, and there's not much free board for food, clothing and shelter. These are the facts of life, quite sobering for someone who got into the profession with the lofty goal of serving mankind and with the sincere wish to have a life filled with love, family and a secure future.
National and State Association Member: I am a member of ACA, ICA, the Massachusetts Chiropractic Society and the Greater Boston Chiropractic Society. At my school, Life West, we were taught and encouraged to support the voice of chiropractic best represented via our local and national societies. Furthermore, I feel compelled to give back to my profession for the countless blessings chiropractic has given to me.
Neither a National Nor a State Association Member: We will never be strong as a profession until we all work together as a whole profession. Why should I have to choose between the ICA and the ACA? There should be only one national association working for the advancement of chiropractic as a whole. Until we can get along and work for the same goals we will always be weak, which may ultimately destroy us.
I live in Nevada where there are two state associations who don't get along and just seem to attack each other on various issues. Then of course there are the straights and mixers who don't seem to agree on anything either. How can we accomplish anything or be taken seriously when we fight each other? It's time to have one organization representing the issues that are important to all chiropractors, an organization that will make us a major contender in the health care industry. We are our own worst enemy!
State Association Member Only: We need one national association that is so connected to the grass roots level they can smell it and see it grow.
Neither a National Nor a State Association Member: Too expensive! Too many associations! Both at the national and state level. One national association and one for each state. Please. Neither national associations represent my views on major political and/or clinical issues.
National and State Association Member: Having just finished reading your editorial in the 6/28/99 issue of DC, I find the "problem" to which you refer underscored by the unfortunate and almost pathetic necessity for you to have to detail and explain the manner by which you name the two national organizations.
This is not directed toward you, per se, but to all of us in this profession.
This inherent, deeply-rooted and long-term conflict which pervades our profession continues to promote not only divisiveness, but even more so, provides abundant fuel for apathy which sounds the death knell for any individual or entity.
Although I am a member of both state and national associations, I find most docs simply fed up with this constant battle (always between two or more groups of chiropractic associations or factions). It has become less than tolerable. Most docs prefer not to allow themselves to become part of it and thus, would rather go it alone. At one point, there were five distinct and separate associations in the commonwealth of PA alone. Even ACA in its own ranks in not immune.There are three separate and distinct board certifications for a chiropractic neurologist and another is attempting to insert itself. This is simply suicide by EGO within the profession!
The answer to your question ("how low must we go?") is grimly painted in the second paragraph of your editorial. Until each one of us stops worrying about how we will be labeled by becoming a member of one group or the other, or what the other guy's philosophies, motives, or insights are regarding chiropractic, or who may be offended by speaking one group's name before another, the nonaligned majority of this profession will choose to continue on alone, sadly forfeiting any unified direction and any significantly positive forward movement within and for this precious profession.
National and State Association Member: In school, I was a SACA member. After graduation, I joined the Texas Chiro. Assoc. When I moved to New Mexico, I joined the United Chiropractors of New Mexico. All along, I was a member of the ACA.
I understand the financial considerations, as I pay for three association memberships. Thank goodness, Texas out-of- state membership is very reasonable.
I believe that all the associations are doing their best with the support they have to make "our" chiropractic profession better. I am far away from any big city with local organizations, and I appreciate all the associations are doing to make chiropractic stronger.
I am amazed and saddened by the number of my classmates that are not members. I always look in the ACA and TCA directories for referrals.
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