I'm a member of the Association of Chiropractic History. It isn't a big group - just about enough people to fill up a wagon for a hayride - but bless all of these members for helping to keep "the story" alive. I like to study chiropractic history, since it is one of the most classic American stories out there, with passion, self-sacrifice, David-and-Goliath imagery, tribal intrigue, and the mythology of "one cause, one disease." There is not much I haven't heard of in our profession, so when I come across history repeating itself, I pay attention.
It seems there are some "gentlemen" who own an insurance company. They offer really cheap malpractice insurance, but the catch is that a chiropractor must agree to have all patients sign something called the "terms of acceptance." The agreement says, "We do not offer to diagnose or treat any disease." The agreement goes on to say that the chiropractor will diagnose only "subluxations or neuro-musculoskeletal conditions" (all right, that sounds a little better). But then it states, "Our only practice objective is to eliminate major interference to the expression of the body's innate wisdom." The patient is required to read and accept these terms before starting any treatment, even if they aren't particularly concerned about the status of their body's innate wisdom.
My initial reaction when I encountered the "terms" was: Is this a good idea? Most DCs know the story of B.J. Palmer defining chiropractic in this way, so that courts in the individual states would not arrest chiropractors for practicing medicine without a license. Many state chiropractic laws still are haunted by language such as that used in the "terms." However, times have changed. Chiropractors usually are considered bright enough to make a diagnosis. I, for example, have even been trained to take a patient's blood pressure!
In my state, I am required to record a diagnosis, and sometimes I find things that deserve discussion. So, I don't know how I would handle a practice ruled by the "terms." What could I say if a patient asked, "Dr. Hanks, do you think I'm overweight?" Maybe I would be allowed to say, "Well, Mrs. Kopopkins, you look fat to me, but our terms of acceptance say I can't suggest you may be suffering from obesity." And what about that blood pressure reading? "Dr. Hanks, was my blood pressure high?" "Well, Mrs. K, the numbers were high, but our agreement says I can't tell you what that means." Saying that a DC does not diagnose anything except subluxations is like a psychiatrist saying, "I treat tics and annoying quirks, but I do not treat neuroses," or a podiatrist saying, "I don't treat fungal infections of the toes; I just trim toenails."
If this picture of chiropractic practice is the goal for the profession, why require all the education? Why rack up a $75,000 student loan? Surely, one could be trained in subluxation detection and correction much more quickly and cheaply. We could go back to 1905, when the Palmer School course was only nine months. In fact, according to Joe Keating in his book, B.J. of Davenport, the Palmers were strongly against increasing the length of study, since they felt that would call for "instruction and practice in subjects considered beyond the scope of chiropractic." So much for that boring biochemistry.
Perhaps the company that thought up the "terms" could offer a new malpractice insurance product to chiropractors who choose only to adjust the first two vertebrae in the neck. It seems logical. If just saving money and reducing one's scope of practice are the goals, then a return to the "hole-in-one" days of the "upper cervical specific" makes sense. A policy covering a practice like that shouldn't cost more than $100 a year.
I understand the philosophy behind, "We don't do diagnosis." But wait a minute! Wasn't the whole point of lifting our profession up from our humble beginnings the achievement of a highly educated and competent profession? Didn't hundreds of our leaders give up big chunks of their personal and family lives to work for the betterment of the profession, primarily for the chiropractors of the future? Didn't they want to build confidence in the minds of future patients that chiropractic is valid and responsible? Then, I would have to say that this "terms" trend is promoting the "dumbing down" of the profession.
What would the educational pioneers in our profession think? I think they would be rotisserizing in their graves if they read the "terms." "Wake up, Drs. Janse, Nugent and Napolitano! You've got to look at this! Wake up, Dr. Homewood and Dr. Dave Palmer, you're not going to believe it!"
In the early '80s, there was a rock band called Devo, whose name was based on the theory of de-evolution. The theory states that mankind and nature are actually "de-evolving," or going backward in complexity - getting simpler, rather than more complex. The idea is based on the concept of entropy, which can be defined in Webster's as "the steady degradation or disorganization of a system."
Reductionist movements pop up in all sectors of society from time to time - but do we really want to return to the status of barefoot bonesetters? Is the past really a good model for the future? I think not. To quote a line from Devo's most popular song, "Crack that whip, give the past the slip."
John Hanks, DC
Denver, Colorado
jwhanksdc@earthlink.net
When sports chiropractors first appeared at the Olympic Games in the 1980s, it was alongside individual athletes who had experienced the benefits of chiropractic care in their training and recovery processes at home. Fast forward to Paris 2024, where chiropractic care was available in the polyclinic for all athletes, and the attitude has now evolved to recognize that “every athlete deserves access to sports chiropractic."
It is estimated that 61% of patients with CTS avoid taking surgical options due to postoperative complications and costly surgical procedures. Chiropractic care offers a comprehensive and effective treatment for carpal tunnel syndrome, addressing the condition from multiple angles. Recent studies also have unveiled a game-changing adjunct to chiropractic treatments for CTS: nerve flossing.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
