Has anyone written a letter to Consumer Reports thanking them for their critique of chiropractic? Think about it. Had chiropractic commissioned a blue ribbon committee of independent scientists to give us their unabashed opinion, it could have cost millions of dollars. They did it for us for free. We really should thank them.
Much of their criticism was, in my opinion, factual reporting of the widely differing views within the chiropractic profession. They echoed the two most vocal wings of the chiropractic spectrum. One extreme claims that we are trying to act like "real" doctors when our primary goal should be only pure, simple, unadulterated adjusting. The other extreme cries that we must renounce outdated "philosophical" concepts and become orthopedic specialists who manipulate.
The article was negative in tone, but still contained a lot of objective reporting. Chiropractic must avoid the tendency to rant, scream, and cry foul about this report. Too much griping may obfuscate our ability to learn from its inherent accuracy. As they mentioned in the first page, "the problems we identified two decades ago still exist." Will they again write this two decades from now? I hope not.
As DCs throughout the '80s progressively lost most group health care reimbursement, they could blame the bias of the HMO. The Wall Street Journal article on pediatric chiropractic was labeled by the profession as an inside hit job by the AMA. When the Clinton administration told chiropractors that the new health plan included generous physical therapy benefits without chiropractic coverage, DCs screamed, "Bias, as usual!" After the "20/20" show bashed the profession's unscientific, rag-tag minority, chiropractors in droves claimed biased, distorted journalism. And the chiropractic profession undoubtedly had a right to criticize the recent newspaper articles extolling the dangers of stroke from cervical manipulation. But DCs will have a hard time producing more than hollow howls against Consumer Reports.
Consumer Reports is well known as being a fair and unbiased magazine. Yes, they have their faults and prejudices. But the majority of lay people, lawmakers, and health care professionals view their findings as credible and objective. Too much public criticism of their magazine may backfire. The public could see chiropractors as a childish profession crying about an article that accurately describes the public's general attitude. The public sees chiropractors as family back and neck doctors who also teach preventative health care. They do not see us as being a substitute for their family physician.
The idea that DCs will compete in the near future with the family care physician and internist is a pipe dream. The basic principle of primary care involves the diagnosis, testing, and risk assessment of many serious and acute diseases. With this responsibility will go the baggage of high technology, and the mastery of the physiological and chemical basis of disease.
The likelihood that chiropractors will have the diagnostic technology, the hospital exposure, or the pharmaceutical knowledge to compete with medical school education in the near future is ridiculous. Consumer Reports is correct in asserting that the diagnosis and management of serious health problems has never been part of the chiropractic practice and naturally falls within the allopathic domain.
The rising incidence of cancer and HIV infection means that DCs would be responsible for screening and understanding the areas far beyond their historical area of expertise. Understanding the actions of hundreds of drugs and being well versed in the values of different types of surgeries are foreign to the doctor of chiropractic. Being able to safely draw blood would be an important part of the primary care doctor's domain. I doubt if all chiropractors and colleges have the desire to develop nationwide, uniform protocols for drawing and preserving disease blood and urine samples.
It is my opinion that the majority of the profession see themselves as being specialized in the biomechanical treatment of the musculoskeletal system with a secondary emphasis in the treatment of early-onset chronic, degenerative disease. Treatment of musculoskeletal injuries and the prevention of disease has always been the mainstay of the chiropractic profession. This holistically oriented, biomechanical practice has almost no resemblance to the allopathic practice of the present day primary care physician. And it bears little resemblance to the super straights of our profession who refuse to diagnose disease. Seizing the middle ground may be the only possible tack to preserve our reputation and navigate the treacherous waters of health care reform.
Most of the "allied" health care professions have only survived because they have not battled medicine. Podiatrists, dentists, physical therapists, optometrists, etc., are all able to thrive only because they have carved out a niche which is not a historical strength of the medical doctor. When homeopaths battled the medical profession their destruction was inevitable. When faced with the possibility of years of struggle or a golden parachute, osteopaths abandoned their roots in natural healing and joined the allopathic fold.
Someday optometrists may be considered primary care doctors of the eye and podiatrists primary care doctors of the foot. Dentists may be allowed this status as regards the mouth and chiropractors, if they play their cards right, could be allowed primary care status for the musculoskeletal system.
Professional survival depends on chiropractic's unique practice of providing manipulation, exercise and high level wellness care. Chiropractic has a niche which will probably become more important as our society moves away from costly drugs and surgery and begins to stress the benefits of prevention and wellness. It must be realized that a profession cannot be composed of holistic musculoskeletal specialists and primary care generalists simultaneously.
It is my opinion that chiropractors must maintain their portal of entry status and strive to be considered primary "health" care providers or primary musculoskeletal providers. But we must avoid trying to be seen as primary "medical" care doctors. We need to be grouped with doctors of acupuncture, naturopathic physicians, holistic medical doctors, wide scope physical therapists, etc., and not with primary care physicians and internists.
By maintaining our historical practice rights we will be more likely to solidify our place in the health care system. To try to compete with physicians presently specialized in primary care medicine, internal medicine, and infectious disease will be futile. Continual battles will only rob us of our limited financial base and splinter us into super straights, mixers, and orthopractors mortally wounding our present professional status.
Chiropractic must have five primary goals to heal the profession and prepare for success in our future health care system:
Doctors of acupuncture and naturopathic physicians are licensed in many states. These professions are slowly, steadily adding new schools and gaining improved right to practice laws in all parts of the country. Unless DCs continue to develop their historical foothold as the primary practitioners of wellness and preventative health care, they may see these professions rapidly surpassing them in strength and popularity.
In summary, I would like to propose that we all write Consumer Reports and thank them for helping to define our weaknesses. Hopefully, in 20 years, the unscrupulous management gurus, hustlers, hucksters, and unscientific cults will be only a footnote in the history of chiropractic. I plan to be around for the following article and expect a much better report card next time.
Curtis Turchin, DC
Palo Alto, California
When sports chiropractors first appeared at the Olympic Games in the 1980s, it was alongside individual athletes who had experienced the benefits of chiropractic care in their training and recovery processes at home. Fast forward to Paris 2024, where chiropractic care was available in the polyclinic for all athletes, and the attitude has now evolved to recognize that “every athlete deserves access to sports chiropractic."
It is estimated that 61% of patients with CTS avoid taking surgical options due to postoperative complications and costly surgical procedures. Chiropractic care offers a comprehensive and effective treatment for carpal tunnel syndrome, addressing the condition from multiple angles. Recent studies also have unveiled a game-changing adjunct to chiropractic treatments for CTS: nerve flossing.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
