Just Do It!

Before we begin 1992, it might be a good idea to look back and assess at 1991. What we have accomplished and where the profession is now will help direct our efforts for the future.

From the beginning of the year, two issues have consistently remained in the limelight. The first is the reality that national legislative events are impacting our profession in a way that must be addressed with every ounce of effort possible. In the January 4, 1991 issue, Dynamic Chiropractic was selected to collect data for the new Medicare fee schedule being developed by the U.S. Department of Health and Human Services (HHS). This information ultimately resulted in a new Medicare physician fee schedule that is expected to increase payments to chiropractors by a total of 122% over the next five years (please see "New Medicare Fee Schedule" in the December 20, 1991 issue). This is a result of the emerging Resource-Based Relative Value Scale (RBRVS) that was discussed in the March 1, 1991 issue.

In that same issue, the concept of chiropractors being eligible for commissioning in the U.S. military was discussed by Sid Williams, D.C. This has become an issue that has drawn broad-based support thanks to the efforts of the International Chiropractors Association (ICA) and the American Chiropractic Association (ACA). Each of these associations have been working separately and together on many issues of national importance (please see "ACA and ICA Keep Profession Informed through Joint Legislative Column" in the February 15, 1991 "DC").

ERISA continues to be a very important part of the chiropractic national (U.S.) legislative agenda. The issues surrounding the profession's problems with ERISA are closely linked to the issues raised by the ever increasing use of managed care, both allow employers the option of excluding chiropractic care from their employee benefits program. It will take the efforts of both the ACA and the ICA working together to even have a chance to solve this problem. Perhaps this is an issue that research will ultimately solve (please see ERISA and managed care articles in the January 4, 1991, March 29, 1991, April 12, 1991, April 26, 1991 and June 7, 1991 issues of "DC").

There is still much concern over the CHAMPUS pilot project. But until the results are compiled, it remains to be seen if Washington and Colorado chiropractors have worked diligently at demonstrating the cost effectiveness of chiropractic care, or if they have used CHAMPUS as a get rich opportunity (please see "CHAMPUS: Pilot Project Crashing?" in the May 24, 1991 issue).

HEAL Loans are another area where a great deal of effort has not only kept chiropractic students eligible, but has also helped eliminate some of the discrimination that was instigated against the chiropractic profession. This is a good example of what can happen when a number of organizations (the Association of Chiropractic colleges [ACC], the ICA and the ACA) work together (please see articles in the March 15, 1991, July 5, 1991, November 8, 1991 and this issue).

The second major issue for 1991 is that of chiropractic research. From the Utah study to the RAND study, this is an area that has made major headway in the reputation and acceptance of chiropractic care. The RAND study (October 11, 1991 issue) has almost single-handedly resulted in an article in Time magazine, a look at chiropractic manipulation on the nationally televised "CBS This Morning", a special "CBS News Nightwatch" segment on chiropractic with Louis Sportelli, D.C. and Scott Haldeman, D.C., M.D., Ph.D, representing the chiropractic profession, and an edition of "20/20" which will feature an in-depth look at chiropractic.

In addition, a number of other very significant research developments occurred which greatly benefitted the chiropractic profession: A chiropractic cost comparison was presented at the Agency for Health Care Policy and Research (AHCPR) Conference (please see the March 1, 1991 issue); the first World Chiropractic Science Symposium occurred in Toronto, Canada on April 29, 1991 (please see June 7, 1991 issue); the Utah study showed chiropractic care in a workers' compensation setting to be significantly more cost-effective over medical care (please see October 25, 1991 issue); and the North American Spine Society's Ad Hoc Diagnostic and Therapeutic Committee gave chiropractic manipulation a top rating (please see November 22, 1991 issue).

Linked closely with chiropractic research has been the issue of chiropractic guidelines for a standard of practice. Standards have been developed in various states (such as Ohio) already. Obviously, the third party payers, the courts, and even the general public have been in the process of establishing informal standards for our profession for some time.

Finally, all of the major chiropractic organizations in North America have come together to sponsor the establishment of our profession's first attempt at developing our own guidelines (for the United States), with the Canadian chiropractors not far behind (please see "Canadians Move toward Establishing Practice Guidelines" in this issue and related articles in the February 1, 1991, July 19, 1991, and December 20, 1991 issues).

But there are still many big issues ahead of us.

Not the least of these issues is that eventually the United States will see some form of national health care. Looking back, our accomplishments occurred because of two very important reasons:

1. Someone was willing to dedicate their time to make it happen. Usually a group of individuals, sometimes an association, decided to dedicate themselves to making something happen without concern for how they would be reimbursed for their time. They did it for the love of chiropractic.

    

2. Either a foundation, a college, an association or private individuals and/or companies donated the necessary funds to make the project a chiropractic success. The RAND study was predominately funded by the Consortium for Chiropractic Research (CCR), the ACA, and NCMIC.

Here is where you come in. If you aren't a chiropractic researcher or a chiropractic legislative lobbyist, then you aren't really involved in the important events that are shaping and changing our world. You also aren't a part of the chiropractic profession's efforts to develop and flourish in these changing times.

But there is one way you can get involved, and it won't take any time away from your practice or your family. Put your money where your heart is. Make a financial commitment to a chiropractic college or a research foundation. This will further the kind of research that will get chiropractic in the media and into the insurance plans. If you need the address or phone number of a particular college or foundation, just call us.

Then join a national association. No, you won't agree with everything they do, but what difference does that make? Both the ACA and the ICA have more than demonstrated their commitment to national chiropractic legislative issues. Their efforts, along with your dues, will be the difference between chiropractic inclusion and extinction.

No excuses, no pretending, no bringing up old arguments....

JUST DO IT!

DMP Jr, B.S., H.C.D.(hc)