Well one thing is for certain, Dynamic Chiropractic is being read by many practitioners. My previous article on the letter to Reader's Digest and the response from the reporter generated some interesting responses. Most of the replies were very positive, acknowledging the fact that while the response from the reporter was not proper or completely accurate, most did agree that it was our job to provide better information, produce convincing research, and communicate in a more professional fashion. These were the overwhelming majority of responses and for those, I am encouraged. I am delighted that there is a changing attitude in the field and that professional communications is being recognized as the vehicle of choice versus the hostile, ad hominem attacks of the past.
Additionally, there is also a new optimistic attitude emerging which realizes that the profession is moving toward the day when the media will have access to significant data on chiropractic and alternative health care, and when the Office of Alternative Medicine and other groups who have specific interest in the advancement of the alternative movement will be funded to enable them to carry out this research.
There were those doctors, however, who completely missed the point. Some faxes came through smoking, suggesting that obviously I did not do the proper job of educating the reporters, as if it were solely my responsibility to do so. Others suggested that there was "tons" of research "out there", and it was painfully obvious to them that a conspiracy exists to prevent chiropractic from getting a fair story in the media. Additionally, others sent in articles from past issues of Dynamic Chiropractic, several copies of the Harvard Medical Newsletter, and a few from other journals in the profession which were not peer-reviewed. These were sent to make the point and substantiate the fact that research is "out there" and this is what should be sent to the reporter, or for that matter, anyone that asks.
To those who believe that someone else could have done a better job of responding, I have no problem. That is a matter of personality and style rather than availability of data. The real issue comes when this very newspaper that you are reading is used as hard, irrefutable evidence of research to send to reporters. The issue becomes clear: "When you don't know you have a problem, you really have a problem."
It is the lack of understanding of what constitutes research and a true appreciation for what is really "out there" that becomes the crux of the issue to discuss. Chiropractic has advanced significantly over the years and has been involved with a number of research projects, most of them dealing with the low back. There is very little research to document, substantiate or validate chiropractic's claims for many of the other conditions it claims to treat.
That is not to say chiropractic should not be engaged in the treating of other conditions, because we know that the clinical application of a procedure almost always precedes the research which can validate or refute the procedure. There are many procedures which have incomplete data or no available studies, and clinicians are left to decide whether to take an approach to treatment which is minimal or to aggressively treat a patient based on their own beliefs and experience. Data is often conflicting, and decisions are often made based on clinical reasoning. The understanding of the data and what it truly means becomes critical to the advancement of the profession.
What is equally important, however, is the fact that the chiropractic community is recognizing the need for accountability in research, in education and in the use of the media. The evidence, as viewed by the responses to the media article, demonstrates that attitudes are changing, albeit slowly.
While there is a tendency to think of the media as critics and adversaries, this is not necessarily true. Obviously, a program built on sensationalism seeks scapegoats to make an issue out of anything. Programs of special interest and exposes are as likely to beat up on lawyers, MDs and dentists as they are chiropractors. Proof on the positive side has been recently demonstrated by several major media feature stories and exposes of other professions. Reader's Digest just did one on dentists.
Charles Grodin became a chiropractic patient, indicated that he went to a DC and did not want x-rays. He was examined and the DC took the time to educate him. As a result, he became a much better, informed patient and stated so. The viewing audience of the Charles Grodin show is getting larger each year, and those who watch him obviously feel a comfort level with his advice. This is almost an "endorsement" resulting from a conscientious DC's effort to patients.
Visa, the "you can take it anywhere" card, has embarked on a major campaign. In the February centerspread ad in Glamour Magazine, Dan O'Brien (the world's greatest athlete) has his wallet opened and Visa indicates what he purchased with his Visa card. You guessed it ... a visit to the chiropractor listed at $155.75, a deep tissue massage for $75.00, and a host of other items purchased with the card. Reader's Digest, which in the past has had more than one negative article, depicted the word chiropractic to launch a new ad campaign for its cutting-edge technology computer search directory "Look Smart." How many of you saw the auto ads discussing the Honda, in the "ask your barber, accountant, chiropractor, etc." series? What would be the cost of attempting to imprint the word "chiropractic" into the millions of minds viewing the new series of ads if we, as a profession, had to pay for it? It is the dawning of a "we have arrived" era.
What we as chiropractors must be careful of is to not attack the well-meaning writers, journalists and media people for an innocent error. If Charles Grodin doesn't define chiropractic exactly as we would like it, it is NOT by intent. If the Visa ad shows $155.75 for chiropractic procedures, the intent is not to show that chiropractors overcharge. If chiropractic is used in a cartoon or humorous TV spot, we must not abandon our sense of humor. Our sensitivities should not be so close to the surface that we think everyone is an enemy. And even if we are criticized, we should seek to educate, not irritate or alienate.
I want to thank many of you who have sent in excellent ads and those which border on the outrageous. Please keep them coming so I can add to my collection and also write about them in this column. We had some great exposure with Visa, Reader's Digest and other great PR announcements, but the ugly side of the coin was also present.
It seems that, to my consternation, the "$10 adjustment" craze may be catching on. Ads are beginning to appear received from the clipping services, touting DCs using this low price advertisement of $10 to attract patients. Another takeoff of the $10 adjustment is the ad depicting the headline "$100 a month for unlimited visits." Just simply call anytime and get your unlimited maintenance visits for the low fee of $100 per month. What a degrading way to present chiropractic services! Think you have heard it all? No way! How about a lighted sign in February stating: "Wear your bathing suit and get a free adjustment!" I guess this would be making a big splash in the newspapers.
But wait, there are more examples of tasteless, tacky touting. One doctor sent me the flyer: "Welcome to Doc's Place, where you can get Amoco Gas, Live Bait, Fishing Tackle, Groceries, Camping Goodies, Tobacco Products, Keys Made, Grill, Fountain Drinks, Copies, Fax (coming soon) and -- you guessed it -- Chiropractic Care." The flyer goes on to say that chiropractic services will be offered in the office within the store, at the most affordable price available -- only $10.00! I wonder what's in "store" for chiropractic next?
I have heard the $10 debate and a response from one of the $10 docs who said: "It's impossible to put a price on something that's priceless." That may be so, but the flip side is that if it is sold at such low value, how can it ever be perceived as having an intrinsic value by society in general, or more specifically, our patients? We live in a society that recognizes "you get what you pay for," "if it's too good to be true, it probably is," and "don't look for bargains in parachutes, life preservers and health care." The list of cliches is endless. But the bottom line is quite simple: If we do not value what we do, how can we expect anyone else to place a value on it?
The court of public opinion recognizes quickly the value of the celebrity status of a Charles Grodin, a top athlete, a high priced performer, and certain value is attributed to the product or service by that spokesperson's endorsement. Chiropractic has certainly gained significant stature over the years by prominent individuals using the services of doctors of chiropractic.
The reverse of this phenomenon is also true for our growing profession. When one chiropractor is arrested for fraud and the headline reads "Chiropractor Arrested for Fraud," the profession sufferers because of the individual. When a chiropractor proclaims a cure for every disease known to mankind, the profession suffers because of the individual. When the profession out of desperation begins to "discount" their services to increase volume, not only does this effort usually backfire, but the profession collectively suffers. Image is difficult to create and so easy to lose.
In the often fickle court of public opinion, there needs to be an awareness among those attempting to influence the opinion that credibility is easily lost and difficult to regain.
The words of Mohandas Gandhi ring true: "The institution that fails to win public support has no right to exist as such." Or as Henry Ward Beecher stated: "Private opinion is weak, but public opinion is almost omnipotent."
We must begin to think before we blow off steam against the media. We must treat them as friends, not enemies. If they don't understand chiropractic, it's our job to educate them and if they do not get all the facts, it's our job to give it to them. Once we beat them up, call them names and spit in their face, how can we expect them to invite us in for tea?
Next month, more media madness and memorable moments.
Louis Sportelli, DC
Palmerton, Pennsylvania
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