As a professional chiropractor, I can attest that one of the two worst things that has ever happened to my profession is, first and foremost, the AMA's decades of slander and illegal interference that ended only after a 12-year federal anti-trust trial. Nevertheless, the damage was done. Americans were tainted about chiropractic care.
The AMA's objective to eliminate our profession took many forms, the least of which was the injurious misinformation constantly fed to the press. As long as every television announcer describes every back injury as a "slipped disc" the message of the chiropractic profession takes a step backwards. Although the poor public image we must bear has been partly our own doing, it was mostly the effort of the AMA that tainted our proud, albeit downtrodden, profession.
Hopefully as the discrimination against our profession ends, as more DCs succeed in practice, as more DCs join hospital staffs, as DCs are commissioned as officers in the military services, and as chiropractic, as a whole, is welcomed into the mainstream health care delivery systems, only then can we improve our public image. As patients benefit from our valuable care, the more chiropractic will grow. But for the moment, our public image is poor. Indeed, the medical propaganda was effective in damaging chiropractic's image and ability to compete in the health care marketplace. It may take another decade before we can expect professional equality on a level playing field.
But I can stand for a good fight, as all chiropractors have had to learn to do. You certainly can't have thin skin and survive for long as a DC. Our profession is no place for lightweights. It's tough being a chiropractor, and only chiropractors know how tough that can really be. I don't mind the competition, or the uphill struggle of the battle itself; it's the price one must bear to carry the chiropractic torch.
But it's one thing to fight an external enemy; it's another issue to fight an internal foe. I know this internal fight must occur because I believe that the second worst thing that has ever happened to chiropractic was the advent of the free spinal exams. The medical slander first labeled us as "quacks," now these ads label us as "free quacks." Talk about shooting yourself in the foot. The rapid onslaught of these ads has given our profession an entirely new ad image -- now we are cheap, too. Instead of marketing themselves as good doctors, these discount doctors choose to project their image as a good bargain instead. Meanwhile, our entire professional value is degraded in the eyes of the public.
"If chiropractic is so great, why do you have to give it away?" This thought permeates everyone's mind when they see a free spinal exam advertisement. No other health professionals so easily give away their services. And they must look upon us as a bunch of starving, greedy, and unsuccessful professionals who must give a discount to attract buyers for their services. The hidden agenda behind these tacky ads leads to one conclusion -- they are dumb and degrading.
I know what type of practice comes from this approach to new patient acquisition. You will create a high volume, high turnover, high stress practice where patients are leaving out the back door as fast as they are coming in the front door. The staff becomes exhausted and burned out while the doctor loses good health in the pursuit of wealth. Free spinal exam ads generally attract people who need a discount and usually are poor patients, literally and figuratively. Indeed, I liken these patients to K-Mart type patients who are looking more for a good bargain than a good doctor.
Maybe a good bargain is an asset when purchasing an identical item from different vendors, but when it comes to health care, people generally don't go bargain hunting. They want the best doctor when it comes to their health, not the cheapest. A doctor's reputation is a priceless asset that can attract or repel prospective new patients. Value conscious patients who are willing to invest in their health go shopping for the best -- nothing is too good when it comes to their life, health, and happiness.
I think we ought to attract people looking more for a good doctor than just a good bargain. We ought to project the idea that, in the end, a good doctor is the best bargain. But before we can get this public image across, we need to stop the dumb marketing that degrades our reputation. Every DC, including the 90 percent who don't advertise, are branded by this vocal minority who screams at the public -- free spinal exams. Our profession is debased to its lowest common denominator -- price.
I can recall a discussion with a DC who was still using the fee ads after years in practice. He said these ads were the best thing that ever happened to chiropractic because it brought in patients. While he admitted he would rather not have to do them, it did pay the bills and put dinner on the table. He had a large practice, but again it was a high turnover, low retention, high stress, highly disorganized practice. He admitted he should develop a patient education program to stimulate referrals and retention, but he didn't know how, so he resorted to these dumb ads because it was profitable. In other words, if he made money, it was okay that his ads degraded our profession.
As long as the good bargain doctor makes money, he thinks it is okay to lower our professional image. What this doctor fails to understand is that for every one patient this dumb marketing attracts, it probably turns off 99 other people. The tone of our public image now becomes a factor of these ads rather than the clinical results we are capable of. No one will take seriously, with their health care, anyone who comes across as a "free quack." Dumb marketing soils our image while it teaches the public nothing truly informative about our profession.
I applaud George McAndrews, ACA general counsel and the Wilk, et al., attorney, who called for the "deweirdization" of our profession. He criticized the yellow pages advertisements where DCs looked more like financial advisers than health professionals with their discounts, freebies, and insurance gimmicks. Even though the general public agrees with Mr. McAndrews, the good bargain doctor will argue and defend his usage of this dumb marketing. "If it brings in just one person who otherwise wouldn't have come, it was worth it." In other words, if he profits by it, any means is okay -- even unethical, degrading means. Unless it is absolutely illegal, he will not cease doing free spinal exams. Consequently, our professional image takes another step backwards every time this ad appears.
Let me assure these bargain doctors that there is a better way, and it's called smart marketing that focuses on the features, benefits, and the validity of our clinical methods. Besides, blind faith and free ads are difficult ways to build a practice. I prefer to develop patients who understand chiropractic rather than relying on patients who can only "believe in" chiropractic because they truly don't understand it.
The "pop and pay" practice paradigm is not operated on patient education, case management, and ethical marketing as much as it is built on charisma and discounts. In their search for business, bargain chiropractors are willing to degrade their professional image with quick-fix solutions in exchange for a very small piece of the small chiropractic pie. Indeed, these practitioners seem willing to cut off their noses with dumb marketing to spite the face of chiropractic's image as a whole.
Trying to convince the bargain doctor that his fee ads are degrading is a real threat and invariably meets a cold reception. Since he has no smart marketing to rely upon, the bargain chiropractor defends his tacky ads with any reason he can think of, none of which are truly justifiable. The bottom line remains clear: These free ads are an embarrassment to our profession and they degrade both our value and image in our community. If my rational professional criticism won't persuade them to stop, perhaps I can end with one thought that might:
"Let each of you look out not only for his own interests, but for the interests of others." Philippian 2:4.
James C. Smith, D.C.
Warner Robins, Georgia
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