Policing the Profession

Yes, but only 15% of all medical procedures have valid research behind them.

"Why should we regulate practice management consultants, the medical profession doesn't?"

"Why must we have practice guidelines, why can't we just practice the way we always have?"

"First the AMA tries to eliminate the profession through antitrust, then we do it to ourselves by restrictions through regulation."

"We shouldn't be telling the world about out problems in the pages of our chiropractic publications. Our publications should only be printing the positive things about the chiropractic profession."

The list goes on.

There is one basic code that a person in the publishing business must always live by:

Act and speak as if everything you do and say will be made public, because eventually, it probably will.

As long as chiropractors were considered "quacks" without insurance reimbursement and public respect, we could virtually do anything we wanted. Oddly enough, it seems that the intensity of the attacks against our profession maintained the purity of purpose that has brought us to where we are today. What we do today will obviously dictate where we are (or aren't) tomorrow.

We are in a new era.

We have gained a position in society that demands standards and ethics of the highest degree. We no longer have to worry about the AMA sending spies into our offices in an effort to convict us of practicing medicine without a license, as my grandfather had to. We now have to be concerned whether this new patient is part of an insurance company's "Fraud Squad", an investigator for a law enforcement agency or, worse yet, a reporter from "60 Minutes."

Look again at the above list of reasons why we shouldn't police ourselves, or consider a few that you may have heard.

Some of these attitudes can be answered by the age-old query in logic, "If Johnny jumps off a bridge does that mean you have to?" Other attitudes fall into the "If I just ignore it, it will go away" category. Another approach is the "how dare they think they can tell ME how to practice" snobbery.

There are a few facts we all must face.

First, we are independent. We are not followers of medicine or any other profession. We are the leaders of our own future. We have every right and obligation to act differently, and we hope better, than any other health care profession. Just because medicine hasn't yet decided to pursue a certain course of action is a ridiculous justification to choose not to do it. Why have we fought so hard for our independence if only to follow medicine's lead?

Second, we are being watched. Third-party payers, legislators, law enforcement agencies, television investigative teams, the general public, and your patients in particular, are all watching this profession. If we keep trying to hide our problems like so much dirt under the rug, it won't be long before we will need a ladder to get over the rug. Every profession has problems. The question is are we going to address them, or does someone else have to? It is one thing to discipline our own and quite another to watch another organization do it and make examples of the entire profession in the process.

Third, this is a profession. We are all in one big family, a fraternity, if you will. What a few of us do has the potential to affect everyone. If a large enough percentage of this profession chooses to ignore the ethical mandates placed upon all health care providers, it won't be long before no one will seek chiropractic care because they can't be sure whether you are one of the "few good chiropractors." A few can spoil it for the rest. If we don't deal with those few, the rest may perish with them. Those who don't stand up and show themselves to be different are assumed to be the same.

Finally, we must police ourselves because its the right thing to do. This may be an old-fashioned concept, but it is one the public expects. Part of the chiropractic profession's commitment to serve the public includes protecting the public from dangerous and fraudulent actions by our members.

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