What Do We Need?

These are difficult times for health care providers. The shift from "choice care" to managed care, a.k.a. employer-mandated care, has created an unlevel playing field. These changes have resulted in incredible financial setbacks for providers. So what do we need? We need leadership. What exactly does that have to do with health reform, you say?

A leader is a person with very high ethical standards, a person with moral values. It is not enough to possess technical skills and to do things right. A leader does the right thing and can be depended upon to always implement plans in a complex environment with the utmost integrity. It's time for chiropractic colleges to not only insure the finest academic education, but to develop within the student body an appreciation for health care leadership.

We need to educate our new doctors of chiropractic in communication skills. If we comprise the profession which offers non drug/non surgical care, then we need to be able to communicate our health values to the public. We have to train our students to be good public speakers who can organize, plan and mobilize public opinion in all areas which affect the individual's health and welfare. Without DC communication skills, the only spokesmen are MDs. Former House of Representatives' Speaker Tip O'Neil said, "All politics is local." If the political influence at the grass roots level respect DCs, how long would it take before Washington and the White House will respect DCs?

It's time for chiropractic colleges to change their teaching curricula to include communication skills and leadership training. We have broad knowledge of the many factors which have an impact on health. Unlike medicine with its narrow specialization and drug orientation, chiropractic is holistic. However, what good is it, if we don't share this with the public?

Our students must be educated to feel comfortable "thinking on their feet" with a journalist, or before a TV camera. We've got to expand America's opinion on chiropractic. If not, the next generation will be subordinate to a medical gatekeeper. How can we expect legislators to support us if we are ghosts (invisible) and fail to express a viewpoint? Is it any wonder that social authority rests with MDs?

Now is an opportune time for the profession to speak up. The nurses are stepping forth and releasing themselves from allopathic control, so why shouldn't we -- who have never been under the MD's thumb -- talk up or be heard? Our mission is to protect society's health, not only the welfare of our patients. To ensure this mission, we need to learn about today's health model and determine how we can offer a holistic-based plan which is rational and cost- effective for the community. It is urgent that we support the administration of those services which emphasize coordinated, comprehensive, and preventive services. But how can we achieve this, if our colleges don't teach health communication skills? The axiom, "Children should be seen and not heard," is okay for kids, but isn't it time for us to grow up?

Leaders are people with foresight, sensitivity, and uncompromising integrity. How can we motivate others if we don't have direction, discipline, and dedication? Chiropractic institutions must teach leadership skills now, or it will be too little, too late. We need role models for our students on all the campuses. Note, I said role model and not people who have a facade of honesty. We have had enough of phony gurus who mislead our young people, and confuse money-making talk with professional service. As general practitioners, DCs are constantly balancing the patient's welfare and their technical responsibilities to the patient, in an environment which is supportive of the community. While technical skills are basic to our health care role, these skills are temporary since we all realize that today's facts are tomorrow's fallacies. Thus, ongoing education becomes a necessity and an obligation.

Chiropractic care touches people in the most intimate of ways with its professional relationship grounded on moral and ethical conduct. We serve the values by which society lives. This relationship demands accountability and commitment. Our colleges must emphasize broad-based values, not narrow, fragmental interests.

In the final analysis, our colleges must turn out leaders, not graduates with a mere scientific background. Patient care is a social service, and society thrives on values.

Our leadership depends on individual DCs standing up, speaking up, and getting our message out at the local level. Public speaking is as critical as anatomy. The more integrated chiropractic becomes within the health care system of our country, the more communication ability with colleagues, allied health professionals, and other professionals gains in importance. In the 21st century, the information highway will reach everyone's home, giving the chiropractic profession an unprecedented opportunity. Our training demands leadership education.

Arnold Cianciulli, BS, DC, MS
Bayonne, New Jersey