Need An Adjustment, Doc?

As I was leaving a recent state chiropractic convention, I noticedthat his face was red with anger as he leaned against a wall withhis arms crossed over his chest and his head hung low. I said,"Come on, Harry (that's what I'll call him here), let's have adrink. You appear as if we need to talk." He said nothing inreturn but communicated with a slight nod and followed me into thepub.

We found a quiet booth in the back, and I ordered a glass ofchablis. He ordered a double Crown Royale on the rocks -- to mysurprise. "I don't remember seeing you have a lowball before," Icommented. "Don't you usually order a Virgin Mary or gingerale?"

"Yep," he said. That was his only reply.

I wanted to say something funny to break the spell. But nothingfunny seemed appropriate. I wanted to get him to open up, to seeif I could be of help in some way. But the key to his mental doorcould not be imagined. We both sat in silence for many(uncomfortable for me) minutes. Me staring at him trying to findsome clue to his problem. His eyes fixed downward toward the tablecloth and his drink untouched. His eyes became watery.

"Is Helen OK?," I asked.

"Yes," he muttered.

"Kids OK?"

"Fine," he whispered.

I didn't ask about his practice because everyone knew he had the most enviable reputation in his community, drawing patients from a 150-mile radius. Through shrewd investments from his practice income he had earned great wealth. He wore custom-tailored suits and shirts, imported ties, yet refused to purchase an expensive European sports car or clutter his skilled hands with gaudy rings or a multi thousand-dollar Swiss watch though he could easily afford them.

Harry is a highly successful doctor; and as a true professional, he does not flaunt it. He is quiet dignity personified. He has a way of having people envy him for what he is and what he can do, not for what he has.

Several more minutes of silence passed. I sat there feeling stupid in not being able to offer at least some encouraging word to an old friend.

He then looked me straight in the eyes and said, "Dick, am I your friend?"

"You know you are," I replied.

"Then would you do me one favor that would be in your best interests?"

"Of course," I answered.

"Are you sure," he repeated?

"Yes, certainly, of course," I reaffirmed.

"OK, here it is," he said: "If you need an adjustment, never go to a chiropractor -- as a chiropractor. No DC would treat a stranger as ineptly as he treats a colleague."

"That's crazy," I answered.

"Is acting as a professional crazy?" he said sternly.

"Of course not, but---," I replied but was cut off by the release of what was on his mind.

"Witness this state convention. Open your eyes to almost any large chiropractic gathering. Did you see all the DCs giving each other adjustments on the exhibitors' tables in the hallway?

"There's no privacy. No history is taken. No physical examination is conducted. No reflexes are evaluated. No stethoscope, no otoscope, no sphygmomanometer anywhere in sight. No lab work or films to confirm a diagnosis. There goes six to eight years of expensive education flushed down the toilet. Just, 'What's the problem, Doc?' Lay down prone, check leg lengths, boom -- boom; turn supine, crack the neck; assume the lateral-recumbent position and receive a million-dollar roll. Turn over on the other side. Crack! Recheck the leg lengths. 'Anyone else I can show my expertise to?' That's the routine I saw over and over and over again with one 'supposedly doctor of chiropractic' in a flowered sport shirt treating another in jeans. Absolutely no concern is given to whether or not a fixation exists, why it exists, or how it correlates pathophysiologically with the patient's problem. And all this is being conducted in a public hallway -- in full view of exhibitors and the passing public.

"No DC would last very long in practice if such disregard for clinical principles and professional decorum were habitual. A chiropractic adjustment is a precise surgical procedure. Look up the definition of 'surgery' in any medical dictionary. As a clinical procedure, the what, where, when, and why of any structural or functional aberration must be determined before any type of significant treatment is administered.

"Besides this, the public expects to go to a doctor who looks like a doctor and acts like a doctor. Some DCs, apparently, have no such expectations of themselves -- which means they must have an extremely low self-image of themselves. Patients and the general public pick this up immediately. 'What you portray speaks louder than what you say.'

"People tend to express their true natures when in private or in a group in which they feel 'safe.' Thus, according to what I see at conventions, I suppose they continually 'fake' a different image every time they enter their office. That continual act must be hell! Yet it explains why they must spend most of their income on advertising. They need a steady flow of new patients because previously treated patients refuse to return. When I want the services of a doctor, I need a doctor -- not a technician; or, more closely, I want a doctor, not a manipulating therapeutist.

"Someone has to set an example of professionalism. Every chiropractic convention should have a professional dress code and a private room where DCs can obtain a thorough examination. Better yet, examination and treatment should be left to the private office environment, not the public area. Can you imagine medics giving each other shots in a public hallway or dentists pulling colleagues' teeth in a lobby of a motel? Don't our colleges teach professionalism anymore?

"I've learned one thing, though. If I need an adjustment, I won't go to any DC who knows I'm a colleague -- unless I'm sure he will treat me in a professional manner."

As we left the pub, he turned to me and said, "Dick, can you believe that some DCs treat patients without wearing a clinic coat or at least a white shirt and tie?"

"I'm open-minded," I said, "but I just can't believe that. The next thing you'll be telling me is that some DCs give 'demonstration' adjustments to strangers at social gatherings or on television talk shows."