Chiropractic (General)

Unity 101

Guy Riekeman, DC, President, Life University

I want to use this column as a place for different leaders of the chiropractic community to express their various points of view. These leaders not only have impressive accomplishments, but they also share a true passion and dedication to our profession. I am pleased to announce that Dr. Guy Riekeman, president of Life University, is the author of this month's column. Dr. Riekeman previously served as president and chancellor of the Palmer Chiropractic University System. In addition, he has promoted the chiropractic message through award-winning television, video, and audio productions.

- Kent Greenawalt

Unity - the word produces an immediate and automatic visceral response in every chiropractor. You can read it in their body language immediately after they hear the word. Although others may become excited and jump at the opportunity to offer their thoughts and plans for unity, the chiropractor's body stiffens and their eyes glaze over, because they are tired of hearing about the notion, knowing that no action will be taken. They no longer believe unity will happen in this profession. And although there appears to be greater concern for this issue among the professional leaders than among DCs who work daily in the trenches of patient care, it is an issue of grave significance to the future of the profession.

At a recent chiropractic conference, I sat on a panel of 15 of the profession's more visible leaders. As I looked out over the attendees, including members of the national and international professional organizations, a few college presidents, and several active entrepreneurs who support the profession, my first thought was that we were really out of touch with the profession. Here we sat: 15 white men in business suits, all with personal agendas that ranged from influencing membership to attracting alumni and students, to soliciting support for some specific project or another - and among us, not one woman, minority or active chiropractic practitioner. The disconnect was so obvious that at the end of the session, 15 women came on stage to sit in our chairs and have their picture taken - a quiet protest, yet a strong statement reflective of a deep commitment to get women into positions of power and influence in the profession. Perhaps that is the best plan for unity devised to date. If unity is ever to occur, we must first have unified action and an agreement of basic common values.

Unified Action

I believe there is a critical role here for the leaders of the profession. It is a role that, while often not immediately applicable to the practicing DC, must be handled. My old friend, Dr. Fred Barge, had an acronym for these issues: He called them PILES, which he explained as follows:

P is for Public Relations - too expensive for an individual to produce.
I is Insurance - mass representation to organizations like Medicare and Wal-Mart.
L represents Legislation - lobbying for inclusion in government programs like the DoD, the VA and HHS.
E is Education - creating professional standards and accreditation.
S is for Standards of Care - issues of scope and regulation.

Common Values

So, while our national associations and state leaders address these issues, what about the practicing chiropractor? As we all know, all politics are local. Simply put, we are most concerned by those issues that affect us personally. This is where the debate over common values is most often played out. The state of Georgia is a perfect example. There are three players in this Georgia scenario: two state associations with differing philosophies and resulting scope-of-practice needs, and Life College. The recurring issue for this group was to write a new law defining the practice of chiropractic, one that would replace an outdated practice act written in the 1920s. The irony of this was that the only common value between the three players was that nobody liked the old practice act. And in the ensuing months, it was going to take much more than common dissatisfaction to produce a new practice act that everyone would accept.

However, in the end, after an open dialogue of strongly held principles, and with a heavy dose of mutual respect, came the adoption of a document that included values that could be embraced by all. From this document came a proposed practice act, which all three groups are now jointly supporting through the legislative process. Who knows what may come next; some members of the two organizations are talking about a single state association. What a phenomenal example they would be to the profession!

So, what are the values of this unifying document? They are too lengthy for this article, but here are some highlights:

The Association embraces the concept that chiropractic philosophy, chiropractic science, chiropractic art, chiropractic technique, chiropractic diagnosis and spinal subluxation complex denote areas of ongoing research, continuing intra- and interprofessional dialogue, and growing understanding.

The Association embraces the philosophy that life is intelligent; the human body possesses the inherent potential to maintain itself in a natural state of homeostasis through its innate/inborn intelligence.

The Association maintains that the science of chiropractic emphasizes the relationship between structure, primarily of the spinal column and the nervous system, and how that relationship affects function and health. Implicit within this statement are the significance of the nervous system to health and the effect of the spinal subluxation complex upon the whole body.

The Association holds that all chiropractors should recognize the value of all phases of patient care, including condition-based care, health care and developmental care. ... They may also choose to become a certified specialist in one particular facet of chiropractic. Such specialization should require advanced, postgraduate training.

The Association further holds that the right of any individual practitioner to practice within the full extent of his/her jurisdictional practice act or within a narrower interpretation of that act should and will be defended equally, vigorously and proactively.

The Association recognizes the following:

The primary clinical objective of chiropractic is the enhancement of human health through the adjustment of the spinal subluxation complex.

Diagnostic expertise in chiropractic should focus on differential diagnosis of spinal subluxation complex, with other conditions assessed at a level of diagnosis appropriate for chiropractic management, or intra- and interprofessional referral (referential diagnosis).

The spinal subluxation complex involves at the least biomechanical and related neurological dysfunction.

"Adjustment" in chiropractic refers to a specific maneuver directed toward the objective of the reduction or correction of spinal subluxation complex.

The Association recognizes that procedures ancillary to the core chiropractic competencies of patient assessment, diagnosis, adjustment of spinal subluxation complex, patient education, management, referral and co-management are/should remain optional components of the practice of chiropractic.

The Association does not accept as appropriate certain practices or procedures as forms of chiropractic care. These include but are not limited to the following:

drugs
surgery
obstetrics

In closing, I will tell you that the lesson to take away from "Unity 101" is not only about taking action, but also about finding commonality in our values. As a good friend of mine once said, "I think we have more in common than not." Let's build on common values.

Guy F. Riekeman, DC
President, Life University
Marietta, Georgia

May 2005