Changing Minds

The January issue of the Spine Letter presented some preliminary findings of a study that was concurrently published in the January issue of the journal Spine. Noted researcher Daniel C. Cherkin, PhD, and a distinguished group surveyed the medical profession in Washington state for their approaches to back pain patients.

The survey presented the MDs with three hypothetical scenarios:

• a 28-year-old woman with acute low back pain for one week;

   

• a 35-year-old man with acute low back pain for four days; and

   

• a 50-year-old woman with history of intermittent low back pain.

Sadly, the responses showed MDs prescribing many of the nonsurgical treatments found ineffective by the panel who developed the acute low back guidelines issued by the AHCPR (Agency for Health Care Policy and Research).¹

In regards to chiropractic treatment, the mindset was equally discouraging:

"According to the researchers, less than 3% of physicians would order spinal manipulation for any of the hypothetical patients. Ironically, this is the one treatment for which there is substantial evidence for efficacy, especially with acute low back pain."

In the same issue of Spine Letter, Reed B. Phillips, DC, PhD, president of Los Angeles College of Chiropractic, was asked to give his reaction to the AHCPR guidelines. Despite the unfavorable results from the Washington state survey, Spine Letter recognized the need for chiropractic commentary.

There are many subcultures within our society: the research community, the medical community, the patient population, etc. Not all of them respond to information about chiropractic in the same way or at the same rate. Obviously, the efficacy of chiropractic (spinal manipulation) is beginning to permeate the scientific world, yet it has not had much impact on the medical community.

So What's the Problem?

Let's face reality. With ever-shrinking health care dollars, many MDs won't refer outside their profession until they have to. The patient population will have to ask and even demand the right to chiropractic care. Let's not forget the Eisenberg study2 reported that 72 percent of the respondents who used unconventional therapy (chiropractic included) did not inform their MDs that they had done so.

If passing along the proper message is the key to overcoming the bias within the medical (and associated) communities, how do we change the mind of society? Can we influence how society thinks and initiate our inclusion in all health care programs? Most assuredly.

At the rate we have been working at it over the past 100 years, it will probably take another 100 years to gain full inclusion, if we survive that long. While our patient base continues to grow ever so slowly, the chiropractic profession appears to be growing faster, but patient referrals and providence can only do so much.

If we are willing to wage a well-designed, sustained marketing campaign we could begin to see results much faster. At least 70 percent of the entire world has never tried chiropractic, and as much as 95 percent don't really understand how chiropractic care relates to daily health.

The Chiropractic Centennial Foundation (CCF) has done something incredible. First, the CCF unified the profession. Both the ACA and the ICA are CCF members, along with every other major chiropractic organization, almost all state associations, and many national associations of countries outside the U.S.

In less than six months, the CCF generated a public relations program that has reached over a half-billion "impressions" (an impression is one person hearing our message one time). This has not been advertising, but public relations. The public was made aware of chiropractic in newspaper articles, radio news spots, and on regular television programing.

It is now time to unleash the other half of our marketing campaign: telling our own story.

There are several steps to influencing the way people think. First, you have to get their attention. The AHCPR low back guidelines and the Rose Parade float have done that. Then, you develop interest. News about our centennial celebration and what chiropractic has to offer has appeared in newspapers and on radio stations across the country. Society IS interested in what we have and who we are, especially in the face of escalating health care costs.

The next step is to tell them our story. This is called advertising: we buy the advertising space; we design the message.

The CCF is launching a four-pronged attack:

• designing national print ads for USA Today and other publications;

   

• creating television commercials to air on national television;

   

• producing a chiropractic documentary to be aired nationally;

   

• developing a media kit available to associations and groups of responsible DCs to include all three components (plus additional PR materials) to be used on a local level.

Through this effort, chiropractic can improve its own image in the minds of patients around the world. But, as usual, its success is up to you.

Please consider how you can be a part of making positive chiropractic public relations happen. Our goal is for our advertising to take us to an unprecedented one billion impressions internationally in 1995 (not just the 250 million people in the US). Only with each of us doing our share, will we do it.

DMP Jr., BS, HCD(hc)

References

1. Bigos S., Bowyer O, Braen G, et al. Acute Low Back Problems in Adults, Clinical Practice Guideline, #14. AHCPR publication No. 95-0642. Agency for Health Care Policy and Research, Public Health Service, U.S. Depart. of Health and Human Services. Dec. 1994.

    

2. Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. Unconventional medicine in the United States -- prevalence, costs, and patterns of use. N Engl J Med 1993;328:246-52.