The runway glittered with coruscating lights and commotion. The timing was orchestrated to prevent a head-on collision or pile up. No, it was not the airport, but a local amateur fashion show. One of the types put on by civic groups, which are often supported by us chiropractic-types. It was also the sort of show to involve babbling babies, cacophonous children, and the "Big-but-Beautiful" set. My mind wandered alternately between the boom box tunes, the squeal of the microphone feed-back and the couple quibbling over affordability. Suddenly one of the introductions caught my attention:
"Be not the first by whom the new are tried,
Nor yet the last to lay the old aside."
The announcer quoted Alexander Pope. It was clear however that the quotation contained greater gems of wisdom than the simple expounding of the clothing/fashion industry. It is also a statement of moderation. Keep up with the times, but do not discard quality simply because it is not the latest thing.
Simultaneously (at least to my memory) two thoughts crossed my mind -- one regarding the practice of chiropractic, the other a Salada tea bag tag line. To quote the tea bag first (only because it is shorter) "The well-dressed man of this year will be wearing what he wore several years ago" (paraphrased perhaps). If only my thought about chiropractic was as pithy.
Doctors of chiropractic are bombarded with new equipment, new techniques, new HMO projects or managed care programs, new findings, new gadgets, new toys (oops, we're not supposed to call them that). These bombardments are an incursion into one's territory, an attack on what is familiar and comfortable, and a step away from "Keep It Simple Stupid." Furthermore, you can not employ every new thing that comes in to fashion, nor are all things even worthy of acceptance. How about the new adjustment that maintains dental hygiene, the new TENS unit that removes calluses from extremity malleolus or processes, or the percussion unit that aids the action of spermatocides? Okay, you caught me. They are not on the market -- yet. Some new products or techniques can sound equally as bizarre or fallacious.
Conversely, some new, fashionable changes can transform lives, reduce patient pain, speed healing and improve your practice. These are many of the blessings that technology and new discoveries can bring. Even products which appear designed with the mastery of slight-of-hand, may become invaluable. "Any sufficiently advanced technology is indistinguishable from magic," says author Arthur C. Clarke. It is rather nice to pull a rabbit out of the hat now and then.
How do we discriminate? How are these necessary choices made? "Scissors cut Paper, Rock breaks Scissors, Paper covers Rock," is probably not the most appropriate answer. Research, while seemingly the obvious solution (and indeed the best method we have for evaluation) can also be limited, contradictory or specious. Jumping on the band wagon is another favorite method of making choices, but as George Bernard Shaw mused, "Fashions, after all, are only induced epidemics." Our business is geared more toward curing than creating epidemics. Unlike "Monkey-in-the-Middle" games, the solution is usually in the middle ground. Remember that the "monkey" ultimately looses only if he wears himself out flitting from one extreme to the other.
Quality does not go out of fashion (as we learned from the Salada tea bag). Values, purpose, service and caring (to name a few) are lasting qualities for a doctor. They need no face lift or fanny tuck because the face you present to the world and what you have behind you is consistent with who you are. Technology and its trappings may go out of fashion, or more typically are re-fashioned drastically. You may discover that what you once believed in strongly you now question. This is as it should be. We should question what we do. We need to expand our education and methods of practice while maintaining our personal values. This demands an open mind with thoughtful decisions regarding modifications, not frivolous attachments to new toys (or treatments) that fizzle out in a few weeks.
A general rule for acceptance of new technology in chiropractic may be summed up by combining the ideas of the above Alexander Pope quote with some fractured Shakespeare: "Neither a first, nor a final be" (Mild blasphemy, I know.) Whereas the virtues of the original sentiment "neither a borrower nor a lender be" may sound familiar and be quite clear, such is not always true with innovation. The "first" (as in the first doctor to incorporate every new therapy that comes along) can unwittingly expose patients to costly or bogus treatments, or worse, harmful iatrogenic problems. Being the "final" to accept a technique, method or therapy can cause a delay in proper care, virtually withholding appropriate treatment.
At the same time that we juggle these choices, we can recall that quality and values simply do not go out of fashion (whether you are a Democrat or Republican). The synergistic benefit of old quality and values coupled with new ideas and technology is powerful.
Keep quality always!
Keep technology always beneficial!
Choosing what is consistent with your own values combined with the best of fashionable technology creates an atmosphere of confidence and comfort in your practice. Perhaps when regarding this "what-is-in-fashion" issue, we could follow the advice of Gilda Radner: "I base most of my fashion taste on what doesn't itch."
Just a thought.
Barbara Klein, BS, MPS, DC
Waterbury, Connecticut
