Chiropractic is alive and well in California, but managed care is soaking up chiropractic left and right. Just as chiropractic colleges are graduating record numbers of chiropractors, the opportunity to establish a practice in the private sector is diminishing. Rumor has it that unless you are on a managed care panel, you will have a hard go at maintaining a traditional pay-as-you-go practice.
Is this good news or bad news? Well, the incorporation of chiropractic into managed care is good news in that there is more opportunity than ever for the average person to see a chiropractor. However, it is estimated that it takes 10 times fewer chiropractors to service the managed care population. Ugh.
One hardly has to read but a few articles to know that the average chiropractor is upset and fearful of the future of chiropractic where managed care is concerned, and rightly so. However, the field chiropractor's concern and fear should not be directed to the managed care outfits (although there is plenty of fodder to do so, but this is the subject for another time). The real problem lies with the failings of organized chiropractic leader (leaderless) ship.
Evidence of Leadership
Look around for evidence of real leadership in the chiropractic profession. Name the president of your local state organization or the president of the ACA. Chances are you do not know. (I don't, and I consider myself well-informed.) Can you cite the position or mission statement of a state or national organization? When was the last time you read something encouraging, insightful, or helpful on anything from a state or national organization? Tell me the mission statement a state or national organization takes on controlling chiropractic's destiny for education; mangled care; protection of the private sector; out of control student loans; increasing default rates?
Chances are very high that you cannot do so. This is bad -- very bad.
The Rhetoric
Who is at fault? Of course, the leadership in chiropractic inevitably blames you and me, the average field doctor. We are told that we are apathetic and do not read or stay current with the relevant chiropractic literature. This rhetoric goes on to proclaim the great deeds of the leadership and how rosy they view the future of the profession. Leadership
Is this rhetoric reflective of leadership? No, it is not! Leadership identifies problem areas (e.g., poor communication to the average field doctor). Leadership finds solutions. Leadership recruits and excites its membership in good times and bad. Leadership forms a vision for the present of the future of chiropractic and makes certain that this vision is communicated to everyone. Leadership, more than anything else, instills confidence about the future. Why else should we have leadership?
Leadership is not a boys/girls club of comrades and cohorts. Leadership represents a cross-section of interests from every member of the profession. Did you know that chiropractic faculty are not allowed to hold office in our national organization even if they maintain a practice?
So What?
Well, what is one to do about all of this? Frankly, given the recent history of so-called leaders within the profession, one cannot hope for great changes. So far, no one has surfaced with the charisma, strength and vision to proclaim leadership of the entire profession.
Oh sure, there are lots of little leaders running around their corners of the profession, and for them we are somewhat thankful. Unfortunately, their interests are often too specialized to suit the everyday needs of the field doctor.
Again, the question remains. What is one to do about all of this? Perhaps the answer will come from a true leader? Shall we wait and see if one surfaces?
Yes, this is a good idea. Let's wait awhile.
With each article I encourage you to write the questions you may have, commentaries on patient care, or thoughts to share with your colleagues, to me in care of Dynamic Chiropractic. Please include your return address.
Darryl Curl, DDS, DC
Norco, California
Tel: (310) 947-8755 x. 680 (Campus phone)
Fax: (909) 278-3885
Doc_curl@sowest.net
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