The profession of chiropractic is 100 years old. It has grown from a single college to an international presence. In spite of multi-millions of dollars used by our enemies to contain, eliminate and destroy chiropractic, we are alive and well. Then why is there so much demoralization and pessimism coast to coast? In face to face conversations with hundreds of colleagues, two out of three are openly depressed. I haven't heard this much gloom and doom in 30 years. The truth is that managed care has ravaged the profession, and what's worse, two out of three DCs I listened to, felt our organizations were failing us. Of interest to me, when I asked my colleagues what they were doing at the state level to help solve the managed care problem, I drew a blank stare. It's incredible for so many to be suffering major financial setbacks, yet remaining so lethargic and nihilistic. The rank and file is downhearted.
What does it take to change this plague of negativity which has enveloped our profession? The answer is not to imitate the ostrich and continue to put our head in the sand, nor to expect the end of chiropractic because of managed care: certainly, it is not to continue our petty organizational tribalism. What's the answer? Simple but tough -- we must become radicals! I can see some college presidents developing dysphagia with that thought and some ACA and ICA leaders shaking their heads with dismay. Well, before our savants dismiss my idea lets review my thoughts.
The word radical comes from the Latin, radix, which means root. I believe our solution is to go back to our roots. Radical means basic, natural, fundamental, innate, deep-rooted. I am not referring to fanatical conduct or extremism.
What is so difficult about presenting our chiropractic roots to the businessmen and the legislators? Are we ashamed of our education which teaches that chiropractic care is natural care which works with the innate recuperative ability of the body -- vis medicatrix naturae -- to effect fundamental changes in the body's physiology and thereby assist the body's homeostatic environment. Yes, we are radicals! We offer nondrug, nonsurgical, noninvasive care to the American citizen. Are you comfortable with that image of chiropractic? Are you proud of being a DC, or do you feel inferior to the MD and believe that the inclusion of pharmaceuticals will gain us entry into managed care? Don't you realize that our problems are within the profession, and including outside remedies (drugs/minor surgery) doesn't improve our marketability?
It is time for the profession to make a strong statement. We are here after 100 years in spite of our factionalism and petty egos. We started our development by helping sick people get well after medical care failed them. I and all DCs in practice 25 years or more built our practices on allopathic dissatisfaction. So, why are we so timid about saying that we do not have all the answers concerning sickness and health, but we are researching our natural care approach and we are dedicated to the role of alternative/complementary care. Instead, we send mixed messages to the public. Some of us want only low back problems; others want drugs; others search for the elusive subluxation; still others desire to be doctors of chiropractic who know they must be responsible and accountable for the care of the sick and embrace the cognitive skills of patient interviewing, clinical examination and referral to MDs when necessary.
Why don't we tell the world we are dedicated to integrated health delivery and can save the employers, the government and the citizens millions of wasted dollars by differentiating patient who need natural care versus allopathic service. Isn't it our fault for letting the public think we are spine therapists who are no better than physical therapists? Isn't it our fault that we don't proclaim the wonderful education offered by chiropractic colleges? Do our lobbyists know we are highly educated and not technicians? If they don't, lets fire them and get new lobbyists. How long will we sit idle and allow Health and Human Services (HHS) to permit chiropractic treatment in Medicare to be performed by non-DCs within the Medicare HMO systems? Do you think allopathic medicine would permit non-MDs to practice medicine? Why do we permit this fakery by HHS? DCs are licensed by state boards of chiropractic and as such they have responsibilities and are accountable to the state boards. DOs and PTs must maintain accountability to their respective boards. How can HHS allow "chiropractic treatment" in the Medicare HMO system by non-DCs? What have we done about this? Better yet, what are we doing?
Is it any wonder chiropractic is not respected and is regarded as an ancillary therapy? Unless we demonstrate that we are essential health care providers to the community, we will be relegated to secondary status below the MD/DO level. It is time for each of us from the state to national level to return to our roots and fight with passion and vigor for the health care principles which D.D. Palmer founded.
We need to tell the truth about chiropractic and shame on those of us who feel that allopathic education better prepares one to attend the sick. Keep in mind that allopathic education, infused with billions of taxpayer dollars, has resulted in more iatrogenic disease, in more patient dissatisfaction, and in more costly interventions than the good they have produced. Our present antibiotic crisis is due to allopathic care, yet they are the first to protest the services of a chiropractic professional being applied to children. It's ironic that those who are promiscuous with drugs and surgery and who are the product of modern medical education, sit in judgment of the natural health care services of the chiropractic profession. Now is the time for responsible chiropractic physicians to stand up for the public we serve and to responsibly and intelligently present the chiropractic paradigm for the nation's future health care.
Arnold Cianciulli, DC
Bayonne, New Jersey
