Philosophy

It Ain't Happening

Donald M. Petersen Jr., BS, HCD(hc), FICC(h), Publisher

People who value honesty and fairness often have very specific expectations of other people. They assume that life should be fair, and that other people should be honest too. In the chiropractic profession, one might call this, "The Search for the Level Playing Field."

But alas, not everyone is honest, and life isn't always fair.

One of our greatest misconceptions seems to be the belief that the media should be unbiased. While this is the ideal, it doesn't always play out as we would like. The media is a focused mirror of society. It takes pieces from here and there, tries to organize it into a meaningful story, and presents it back to society as information.

So too, the world of politics holds many possibilities, but has no guarantees of fairness. Just because you represent the third largest health care profession in the world doesn't mean you will get any respect on Capitol Hill. This is especially true when politicians hear from a number of different chiropractic organizations, each claiming to represent "the chiropractic profession."

Many of us thought that we would finally be vindicated when the "Chicago Four" vanquished the AMA in the 13 year Wilk, et al. suit. But the evening news just ignored it. The newspapers, when they covered it at all, buried it in the back pages with a half column of type. It was front page in Dynamic Chiropractic, but most of the public never heard about it. Interestingly enough, it was the AHCPR's guidelines on acute low back pain that gave chiropractic our biggest media boost.

In this world of increasing managed care, many of us expect the HMOs and PPOs to not only include chiropractic, but encourage utilization. We have this fantasy that every gatekeeper will suddenly recognize that the vast majority of spine cases (not to mention extremity and somatovisceral ones) should be referred to a DC first.

Just in case you haven't noticed, IT AIN'T HAPPENING!

Nothing has made a significant impression in the minds of the public. We won the Wilk, et al. case after review in the U.S. Supreme Court, but we are losing in the highest court in the land:-the court of public opinion.

Do you ever wonder why the Dairy Council has maintained such a huge advertising campaign? What are they worried about? Dairy products are one of the five food groups; they have their own section in the supermarket. Dairy products are omnipresent, yet the Dairy Council still spends millions of dollars to ask you, "Got milk?"

Do they know something we don't? Maybe they've figured out that no matter how satisfied their customers are (patients), they don't expect them to become milk proselytizers that convert the masses to unrefrained milk imbibing.

Let's face it, chiropractic has yet to become a household word. We're not the hot ticket in the minds of most people. It's not what everyone's talking about.

When the media sees that an issue catches the attention of its viewers, listeners, readers, they present it. When politicians see that an issue is important to their constituents, they address the matter. And if policyholders demand it, insurance carriers will cover it.

While I have always been a firm believer in the value of research, it has only limited value in the world of marketing. Patient satisfaction is what really matters in this arena.

Have you looked at the drug company advertisements lately? Slogans like, "It works for me!" are being trademarked. Commercials are downplaying the research angle in favor of patient testimonials. When research shows negative findings of common headache remedies, e.g., aspirin, Tylenol, Ibuprofen, the advertisers present testimonials: "I just know it works ..."

So where is chiropractic in all this?

We seem to be sitting on the sidelines waiting for someone to discover how good we are. We are putting the blame for low public utilization on everyone from the AMA to managed care.

The dairy farmers aren't blaming the soft drink bottlers. They understand that soft drink manufacturers are a dominant force in the marketplace. But the dairy farmers are out to win and willing to spend the money to increase their share of the consumer dollar.

When will we wake up and recognize that the preferences and spending habits of the public are the driving forces of our market economy (society)? It's public opinion that largely dictates what the media reports; it's public opinion that moves the politicians; and it's public opinion that directs what services the HMOs offer.

With the increasing competitiveness within health care, it's time we stop trying to achieve total scientific acceptance and focus on market share.

DMP Jr.

November 1996
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