Who Are We Trying to Please?

It's always distressing to me to have to wade through the mire of self-deprecation that seems to shroud the chiropractic profession. On the one hand, we have had the nuts running around preaching the good old-time chiropractic theology, while the rest are sitting around trying to pretend they're "real doctors" by currying the favors of MDs.

It seems a pity that there always has to be such extremes. The reason seems to be the ingrained, second-rate complex we have from the constant drone from the media on how wonderful the medical profession is -- and always shall be -- amen. No matter what some may say, this has had a pronounced effect on the fabric of our profession and on our families. Many DCs have told me, with some painful amusement, that a common question from moms and dads and aunts and uncles is, "Why didn't you become a real doctor instead of a chiropractor?"

Right now we're going through a much needed spasm of research and professional soul searching. On the face of it, this is good. My personal problem is with the extent to which we sometimes go to prove a point. It's like the old ad that used to say that because we're in second place, we try harder.

The result of "trying harder" has led to a superior education and more successful doctors. That's the plus side. On the negative side are the constant comparisons we place on ourselves using medicine as the benchmark.

To emphasize this, we are always inviting MDs to lunch and then sit there hyperventilating as we're "allowed" to hear them lecture to us on everything from clinical matters to our professional inadequacies.

The first thing we should realize is that being an MD is no big deal. That's right -- they put on their pants the same as everyone else. The only thing that makes them different is that they've fostered some phoney image that they're in some way superior to the rest of the groveling masses. It's human nature for the majority of people to have some kind of icon in their lives. Most people are followers. Within chiropractic, it's the unhealthy worship of B.J. With the general public, it's the equally unhealthy worship of "modern medicine."

Then there's the most unhealthy chiropractic condition of all -- terminal mediphilia. The symptoms are as follows:

1. bragging to others that you have an MD friend.

    

2. subscribing to and believing that everything that's printed in JAMA is "official" and correct.

    

3. inviting medical leaders to luncheons and then applauding them as they denigrate what you do. And worse -- feeling honored that they accepted the invitation.

    

4. inviting MDs to sit on committees and boards that are meant to define the standards under which you, the DC, should practice.

   and the worst of all --

    

5. searching vainly in TV Guide for old Dr. Kildaire movies

A perfect example of "mediphilia/chirophobia" found within our own ranks was sent to me recently by one of our readers. It was a large newspaper ad that just listed the name of the individual and the word "chiropractor" after it. This was followed by a brief statement about the character of her practice. About x-rays she stated, "On those rare occasions when I do think they (x-rays) are required, I use the services of an independent outside laboratory, which also provides me with a written report by a radiologist, who is a licensed medical doctor."

The mistakes are obvious. First, this particular chiropractor doesn't emphasize that she is a doctor by listing either "Dr." or "D.C." around her name; she then goes on to assure her wary public that she defers to the presumed medical expertise in reading x-rays -- totally negating the certified chiropractic radiologists we should be proud of. A perfect example of professional insecurity -- reinforced for public consumption. Who needs the medics for "chiro-bashing?"

What fascinates and horrifies me at the same time is this inbred need for medical approbation. A profession that is forced to admit before the Congress of the United States its "embarrassing ignorance about the efficacy of health care practices"; the lack of "professional consensus on the correct way to practice medicine"; the "intellectual crisis" caused by the confusion; the admission that "perhaps one-quarter to one-third of medical services may be of little or not benefit to patients"; that the "uncertainty about the most effective diagnostic and therapeutic approaches is pervasive"; and testimony from the Congressional Office of Technology Assessment that "the link between the process of care and patient outcomes has been established in relatively few procedures."

What this all means is that medicine should start cleaning its own house before it starts taking a broom to others; that the chiropractic profession should be instrumental in handing them some of the needed utensils.

Please remember -- that we are a product of medical failure. We exist only because medicine couldn't satisfy the health needs of its patients; we continue to grow only because they continue to compound their stupidity.

Use them as a role model? Put them on committees that judge what we do? Pander to them for their approval? Never -- with a few qualifications -- that they use us as a role model; that they use us on committees to judge what they do; and that they pander to us for approval.

Until that day comes (don't hold your breath) we should -- and must -- have confidence in what we do and that we are superior diagnosticians and specialists in the diagnostic and therapeutic implementation of specific manual palpatory and adjustive procedures.

We need to prove the value of what we do to only one group -- ourselves. After that the public will get the message.

RHT