I recall Reverend Robert Schuller's famous saying: "Tough times never last, but tough people do!" Any doctor of chiropractic has to admit that it's very tough being a chiropractor in today's health care delivery system: managed care, chiropractic exclusions/limitations, and medical racism, to name but a few of the problems our profession faces every day in the marketplace. Despite these problems, DCs have fought for over a century to find their niche and have succeeded in creating a loyal following of satisfied patients. While our profession may be tough, there is also much to be admired and enjoyed.
Unfortunately, for the most part, our public image is still poor. Not only do we have unfair accounts of chiropractic in the electronic media, such on "20/20," but the written media has been just as unkind: defaming articles in Consumer Reports, Woman's Day, and numerous articles like the New York Times editorial, which always find a way to embellish the anecdotal cases to embarrass our professionals. And with the total lack of a national on-going PR campaign by the ACA, ICA or state associations, our image is mainly the result of medical misinformation rather than a result of proactive chiropractic information. Indeed, chiropractic's message is a hard lesson for the public to learn since it is buried beneath years and volumes of medical propaganda.
Not only is our downtrodden image the result of inadequate national PR on our part, combined with medical misinformation, our own colleagues seem to add fuel to the fire with tacky, dumb marketing that only adds to the poor imagery. Whether it's free chicken dinners, discount prices, NOOPE or free spinal exams, the public must think how sad our state of affairs must be when they see such dumb ads. Reasonable people must think to themselves when they see such ads, "If chiropractic is so great, why do they have to give it away?" Indeed, if we're not taking cheap shots from the medically-tainted press, we're shooting ourselves in the foot with our own dumb marketing.
For example, recently another rookie DC opened an office in our town, and immediately began with the classical chiropractic dumb ad: "Free Spinal Exams." I realize that many DCs have been taught to use such ads by practice managers, but in reality, these ads merely draw the cost-conscious bargain-hunters who are looking for a good deal and a "quick-fix," and not necessarily a good doctor. After using such ads, don't be surprised with the frustration you may feel when you see most of these bargain-hunters leaving out the back door as fast as they came in the front door, especially when you mention a treatment plan. Believe me when I say that you will not build a practice of value-conscious patients with such ads. Indeed, these dumb ads will taint your image and position you in your community as the "cheap" chiropractor, not necessarily the best one.
Not only did this particular dumb ad not contain the mandatory disclaimer required by our state board of examiners ("Any further treatment must be agreed upon in writing and signed by both parties.") The ad also contained other spurious statements which could be easily interpreted to mislead the public. Foremost is the claim made by many DCs of "specialties" which usually don't exist: sports injuries, scoliosis, and whiplash/rehab, to name just a few. The recent rookie ad also listed as "specialized training" many adjusting techniques that are normally taught in school anyway.
Just as other recent articles have exposed the use of phony PhD degrees used by some DCs, the same accusation can be made about the use of "specialties" by uncertified practitioners.
According to this dumb ad, this rookie DC is an expert in every aspect of chiropractic. While this DC may beam with pride over his ad, to the public I think this ad is not only misleading as to the actual qualifications to handle these "special" conditions, much of the public must look upon such outlandish claims with suspicion. Is this any different than an MD saying he is a specialist in orthopedics, geriatrics, obstetrics and oncology? Rather than being impressed by such claims, I believe many must think of the old adage, "Jack of all trades, master of none."
Not only do these dumb ads mislead the public and taint our image, for those DCs who have worked long and hard to master these subjects and attain real certification, these ads must make them furious. As the operator of a certified spinal rehabilitation facility, my blood boils when I read these dumb ads when I know for a fact that the rookie DC has not one piece of rehabilitation equipment. And if this rookie DC thinks a nonforce adjustment alone will stabilize a cervical acceleration/deceleration injury, this again serves as an example of misleading patients as to proper treatment for these most serious spinal injuries.
And we wonder why the public holds our profession in suspicion when nearly every new DC places such dumb ads. They are misleading, unethical and just dumb. The sooner our profession regulates dumb ads, the sooner our image may improve. Indeed, dumb ads are the bane of our professional image.
Another eyesore that has crept into our profession is the use of "gentle" chiropractic ads promoted by the nonforce elements within. These ads mislead the public by implying that traditional adjustments are painful and that their method is not. Excuse me, but a proper, traditional joint manipulation by hand is not painful whatsoever if done correctly. For these "gentle" practitioners to imply otherwise is sheer nonsense and an insult to the historical foundation of our profession. For 101 years, chiropractic's great results have been a function of hands-on joint adjustments, not on adjusting instruments, massage therapy or holding pressure points.
Ironically, while these "soft" practitioners promote their gentleness, why is it that I've had many patients transfer to my office complaining that the instrumentation method actually was painful? Perhaps these practitioners should re-evaluate their claims of gentleness before they cast suspicion on other methods. As well, many other transfer patients come to my office seeking "real" adjustments. They don't want "new" methods disguised and advertised as chiropractic care. I believe these "gentle" ads also mislead the public by claiming to be chiropractic adjustments. If we are to include these "gentle" instruments as chiropractic care, why not also include massage or any technique that involves the spine? Just where do we draw the line on what constitutes a "real" chiropractic adjustment? Or is this situation actually a "bait-and-switch" situation where their ads draw in patients who expect traditional chiropractic spinal manipulation done in a gentle fashion, but instead are given an instrument treatment that has little resemblance?
While the "gentle" practitioners may complain that their treatment should be considered chiropractic, I must question if their methods have really withstood the test of time and clinical evaluation. The great clinical results mentioned in the AHCPR, RAND and Manga report about spinal manipulative therapy most likely did not include these methods. Before our profession is accused of misleading the public with unproven claims of "gentle" adjustments, I suggest we scrutinize the clinical effectiveness of these methods. Even if these methods are helpful in some cases, does that qualify them to be considered "chiropractic" adjustments? Just because a DC administers a technique does not make it a "chiropractic" method.
The use of "gentle" chiropractic ads along with the dumb ads, like free spinal exam ads, and ads containing misleading "specialties," have become the bane of our profession. Someone in our profession must draw the line on indiscriminate use of misleading ads that confuse the public. Again, let me restate that the great clinical results of chiropractic care have been based on traditional spinal adjustments done by qualified chiropractors. I suggest that before you place an ad in your paper or telephone book, please be accurate in your description of your method; please be honest about your credentials and your "specialties"; and most of all, please don't give it away. Again, if chiropractic care is so great, why do you have to give it away?
Lastly, I've have a newspaper ad that was developed by a professional graphic artist that I will give to any DC who sends me a self-addressed stamped envelope. Perhaps if our professionals use such ads and stop using the dumb ads, the public might have a better image of our profession. When our profession finally employs a professional PR firm to develop a comprehensive marketing campaign, I imagine our image will be left in the hands of dumb advertisers using whatever gimmick they can. If Andre Agassi was right in his ad that "Image is everything," then chiropractors still have a lot to learn.
J.C. Smith, DC
1103 Russell Parkway
Warner Robins, GA 31088
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