New Challenges

For some time now the focus of the chiropractic profession has been changing. No longer is this profession "circling the wagons and shooting in." Instead we are looking outside ourselves in an effort to build links with the rest of the world. This is not an effort to necessarily change who we are, but to allow chiropractic to establish itself as a critical aspect of health care in the minds of the public and policymakers.

These new challenges bring with them the need for change. Not just change for the sake of changing, but in response to new opportunities. Dynamic Chiropractic and I personally have also been called to grow into new areas of responsibility. This does not lessen the need for continued quality chiropractic education and research, but is an expansion to meet the demands of a maturing chiropractic profession.

As I see it, the three biggest challenges facing our profession are:

Public Policy -- Whether it be elected officials, specific legislation, or policy administration, the chiropractic profession must have a strong united voice in Washington, D.C., and at the state, county and city levels.

Public Relations -- We must inform the world about the benefits of chiropractic care, fully using all forms of media. Would we be dreaming to consider a National Chiropractic Advertising Council?

Managed Care/Health Care Delivery -- Chiropractic has a rightful and prominent place within the health care delivery system. Chiropractors should be first contact, direct referral providers.

During the election primaries, a chiropractic state association contacted "DC" to request support for a legislative effort they were conducting in their state. While this was a critical issue to the ability of patients to obtain chiropractic care, our answer was the same as it has been since our inception: "Unfortunately, our non-profit status prevents Dynamic Chiropractic from becoming involved in any political activity."

While many DCs don't even recognize that Dynamic Chiropractic is the publication of the non-profit Motion Palpation Institute (MPI) it has been at times a hinderance. MPI's mission is, on occasion, in conflict with that of "DC", particularly in the area of postgraduate education. Some chiropractic colleges, and other organizations that offer very fine chiropractic seminars, can't help but feel some concern about one of their competitors (MPI) owning the most widely read publication in the chiropractic profession.

Conversely, MPI has at times been taken to task for an article in Dynamic Chiropractic that it had nothing to do with. Dynamic Chiropractic is an open forum for the entire chiropractic profession, not just motion palpation. For these reasons, effective May 1, 1996, the MPI Board and Dynamic Chiropractic have decided to separate (on a very friendly basis) to allow each to seek their own vision without any hinderance by the actions of the other. (To read MPI's views on the separation, please see "MPI and Dynamic Chiropractic: Going Their Separate Ways" by MPI's chairman of the board, Keith Innes, DC, on page 19.)

The chiropractic Rose Parade float and the chiropractic documentary were just the beginning of increasing the public's awareness of chiropractic. This a goal that both Dynamic Chiropractic and myself will be working very diligently on with a number of chiropractic groups and organizations who are making a similar commitment to spread the message of chiropractic to the people who need to hear it. There is already a small group beginning to plan for another television event.

The chiropractic documentary was a real learning experience, but it was only a start. To allow chiropractic's contact with the general public to slip back to occasional news items and "20/20" segments would be a giant step backwards. People are listening for our message, all we have to do is continue to tell it until they understand it.

Health care delivery, on the other hand, and managed care in particular, is a completely different animal. A number of state and national organizations are attempting to address the problems managed care is causing many DCs. But most of the underlying issues remain unresolved:

• How can chiropractic become integrated within managed care plans, and not just an "added benefit"?

   

• How can chiropractic keep from being relegated to musculoskeletal care only?

   

• Where does chiropractic fit in a managed care algorithm?

For the past two years, a team of DCs, MDs, researchers and business people have been meeting in an attempt to drastically change the way chiropractic is perceived and utilized in managed care. The evolving concept recognizes chiropractors as first-contact members of a multidisciplinary team. Because of the large amount of funding needed, each member of this team has invested a substantial amount of their own money, myself included. This group ultimately incorporated itself into "Multi-Disciplinary Care" (MDC).

The time has now come to test these concepts in the real world. To do that, MDC is purchasing an existing chiropractic managed care organization and will begin a metamorphosis towards a full and fair integration of chiropractic. If all goes well, a new opportunity in managed care will emerge for chiropractors to evaluate.

Some see only the challenges. But every challenge brings opportunity. Our goal is to assist chiropractors and chiropractic organizations to meet these and other challenges, to seek their greater potential. If we work together, we can awaken exciting opportunities to kick off chiropractic's second century.

DMP Jr.