Ethics -- At Your Own Risk

"Chiropractic theory and practice are not based upon the body of basic knowledge related to health, disease, and health care that has been widely accepted by the scientific community. Moreover, irrespective of its theory, the scope and quality of chiropractic education do not prepare the practitioner to make an adequate diagnosis and provide appropriate treatment." -- 1968 Report, U.S. Department of Health, Education, and Welfare.

Things have come a long way in chiropractic since 1968. Even though the "scientific" community still disagrees with what we say health is (more than the absence of symptoms), we are becoming more accepted as physicians on equal footing with our medical counterparts.

Progress is a funny thing, however. Things can be moving at a good pace and then, WHAM! We're at a dead stop. I think our profession is on the verge of one of two fates: total acceptance or total denial. It's up to us to decide which we want. Straight or mixer, ICA, ACA, or WCA, etc----we have to make some important decisions about our profession. I call this decision making process "cleaning house."

The first quote in this article can be found on the back of a book entitled At Your Own Risk -- The Case Against Chiropractic. It was penned in the late 1960s before our education was as it is today. In this book were several sordid tales of deaths from chiropractic adjustments, of money swindlers, gadgeteers, and other assorted quackery. After finishing the book, I thought to myself, "How could any one human being be so completely and entirely ignorant?"

He (the author) went on in the book to discuss all of our weaknesses and none of our strengths. In his opinion, there is nothing good about chiropractic. It scares me to think that a lot of people have read this book and believe it. Before I go on, I must admit something. A lot of what the author said was, and still is, true today. Let me give you an example.

He went to a seminar in 1968 and got a procedure and practice building manual and read it cover to cover. Being a layman and a skeptic (like most Americans) he found a lot in the book that made him think that chiropractors are uneducated swindlers. Quotes from the book follow:

"From the time the phone rings until the examination starts, you are working towards one goal; Mr. Jones, there is most definitely something wrong with your spine that could absolutely be causing almost all, if not every bit, of your trouble."

Doctors are told to memorize and quote this verbatim.

The author was appalled that someone would use a "canned" speech to convince patients that they needed a series of adjustments to heal their diseases. He felt it was unethical to do such a thing. Here's more:

"First, the 'yet disease.' If the patient has pain in the left shoulder, ask 'Has the pain started in your right shoulder yet?'" Also, "Build fear of more serious trouble if necessary---"

The author felt, and I agree, that building fear was unethical. I thank the Lord that the author hasn't seen some of today's practice building ideas for new doctors. Here's my remembrance of one -- (The idea is to make people in town think you're busy when you are not.)

One idea was to go to several restaurants and coffee shops in town every morning for a cup of coffee. The wife was to call the coffee shop disguised as a CA and have the doctor paged. "Never answer on the first page -- always let them hear your name twice," was the advice. Further advice was to go to the phone and act as if it was an emergency and say something like, "Oh boy, okay put her on an ice pack and I'll be there as soon as I can." Of course you were supposed to speak loud enough for all to hear so they would know you were in great demand. Then when leaving, a generous tip was left with a comment like, "Boy, I can't even get a cup of coffee without interruption."

Now I know that new doctors need business and that chiropractic can work wonders with just about everyone, but where do we draw the line? Do we lie, cheat, beg, borrow, and steal in the name of getting patients in the office so we can "help" them?

A practice consultant's client said that he was told to open an office in a certain town and secure financing, etc., and then to perform a "survey." This survey served no purpose but to make doctor contacts and to secure an emotional "bond" with the prospective "patient." The doctor is to tell each home and business owner that he was "thinking" of opening an office in town, was "thinking" about a certain location in town and was "thinking" that the good citizens of that town would be able to help him make this difficult decision. Of course the decision has already been made months ahead of time and the only thing left was to actually open the doors -- and let the people know that their opinions helped in the decision and as a way of saying "thank you" could come in for a free spinal exam. They would of course be found to have a problem -- need a full exam and x-rays at full cost and need a series of treatments.

This is just plain lying. It's unethical and if anyone wanted to make a case that chiropractors are unethical, this would be a good place to begin the argument. Can't a practice be built on honesty and truth? I can hear the answers already. "Everyone needs chiropractic so we should do whatever we can to get them in -- after all, it's going to help them to say healthy." Let me ask you this, if every patient could read your mind or if your thoughts were projected onto your x-ray view box, would you still say the same thing? If they knew your desires would they be appalled? Would they continue care? Would they refer others to your office?

It seems incredible that anyone, in the name of "health," could be so deceitful and think that by lying he could be helping someone.

It's time to "clean house." Life is not about 300 patients a day, $1,000,000 dollars a year. I heard a man say that the "people that say that money can't buy happiness have never had any money!" Sure, that's why lots of rock stars and millionaire athletes kill themselves with drugs and alcohol every year. Don't fool yourself. Life is about serving God and your fellow man. It's about patient care. It's about getting sick people well while maintaining integrity. It's a dis-service to the profession to psychologically manipulate people into accepting care. They should accept care because they need it -- not because you "motivate" them to believe. Doing anything out of greed is wrong. We need to stop backbiting the "straights" and "mixers"; we need to stop milking insurance companies (NOOPE's) and upgrade our education to gain more self, public, and yes, medical respect. So stop, stop, stop. Don't cheat, don't look for magic formulas to success -- you'll be successful when you work hard. Be honest and do no harm (physically or emotionally); guard your reputation and treat your patients like you would like to be treated. Serve your patients, not their pocketbooks.

It's time to clean house. My prayer is that this article will not only be read but that its message will be heeded.

If we don't clean house now, our own children may not be able to practice in the 21st century and beyond. If medicine gets a hold of some of our tactics of practice building and they are published, we ourselves may be headed for careers in physical therapy. So heed my warning doctors, focus on your patients -- one at a time -- treat them like you'd like to be treated -- and don't worry about practice building -- with time, patience, and the right attitude, your practice will grow to the size that was meant to be. Clean up your house while there is still a house to live in!