The Obligation of DCs to Write

Many of the doctors attending seminars I give on head pain and TM disorders bring in difficult head pain cases for discussion. Invariably, we are able to sort through the difficulties to establish pathways toward solutions and successful outcomes. As a clinician, I find these cases genuinely interesting and each deserves to be reported into the literature.

Write, Doctor of Chiropractic, Write -- Why?

Ultimately we, as doctors, are teachers to our patients. We deliver to them the knowledge of wellness. Doctors convey this knowledge through either the spoken word, the written word, or more commonly by demonstration through treatment in our office. The duty of doctors to teach, however, is not confined to our patients. Doctors must teach each other -- why else do professional journals exist?

Dr. B.J. Palmer surely knew of the power of the written word. Dr. F. Illi, considered to be the first chiropractic researcher, certainly followed the teaching example. They, and many others like them, understand the power of knowledge. More importantly, I suspect they knew that a young profession, as is chiropractic, thrives on incoming knowledge.

Who Can Report to the Literature?

All of us can contribute to the pool of chiropractic knowledge. Somehow I think you knew that much. But have you considered all the options at your disposal? Here is a list of options for you to consider.

a) Find an article parallel to your idea. Use this article for its "example" format. This technique answers most concerns that go something like this: "I don't know how to make my clinical insights appear 'scientific.'"

b) Find a colleague with experience in reporting into the literature to help you. This idea is more available than most clinicians think. I've met many clinicians experienced in reporting into the literature, including myself, who are willing to help someone report their clinical insights. This technique answers most concerns that go something like this: "I don't know where to begin."

c) Co-author the article with someone with experience in reporting into the literature. This option is similar to the previous one; however, the co-author will be more involved. For instance, you may provide the data supporting your insights and the co-author will put it together in a written format. This technique answers most concerns that go something like this: "I can't write. I don't even write letters to my mom."

d) Find a colleague also without experience. Here, the axiom "two heads are better than one" applies. The division of labor and the ability to cross-check ideas will make the task less formidable and more enjoyable. This technique answers most concerns that go something like this: "I am apprehensive about this whole idea of professional writing."

e) Read this article. Contributing to the professional literature is not difficult, as you will see. Believe me, after your first article appears in a journal you're itching to do another. The idea is contagious.

What Formats or Types of Articles Do I Have to Choose From?

Essentially, every insight we have which we feel would contribute to the pool of professional knowledge can be placed into one of several formats. This is quite fortunate because it makes writing all that much easier. Once the format is matched to the clinical insight, all that needs to be done is write the words. The following formats are the most commonly used.

a) Research style. Namely, randomized clinical trial and cohort study. Many clinicians falsely believe scientific writing is limited to this format.

b) Literature review style. Of all the formats available, I believe this one to be the easiest of them all to use. For instance, suppose you were presented with a patient diagnosed with Bell's palsy. Your first thought, no doubt, is "what therapy is available for this patient and how effective is each one of these therapies?" Already, you have a title or theme for a literature review. Perhaps the slant you may want to take on this theme is a comprehensive review of all techniques or a specific review of just chiropractic techniques.

c) Case control study. Generally, this format follows this method: In patient group (A) the following procedure was used to produce effect (X). Patient group (B) served as the control group and the following procedure was used to produce effect (X). An example of this might be: Patient group (A) received manipulation, ice, and rest. Patient group (B) received ice and rest. The results showed that patient group (A) returned to work earlier (effect [X]) than patient group (B). This format, surprisingly, is not that difficult for the clinician to use in their practice.

d) Case report study. Everyone can do this one. Basically, this format is one used by clinicians to report their unique insight into specific patient care. We will spend more time on this one in a future issue.

e) Anecdotal/opinion report. While everyone can do this one also, this is considered by many to be the least preferred format. Its use is very limited in the clinical sense and does very little to add substance to the pool of professional knowledge. But before we case final judgment, let us consider the following points: Anecdotal/opinion reports have two essential uses. First, anecdotal/opinion reports serve as excellent vehicles for debates conducted through the literature. Second, submissions to the editorial section of Chiropractic Technique or to the commentary section of JMPT are, indeed, anecdotal/opinion reports.

Next month we will discuss writing a case report and much more. Also, I want to thank those DCs in advance for making their contribution to the chiropractic literature after reading these articles.