I was looking through a popular magazine in the convenience store checkout line, particularly because I wanted to read an article about "How to Cure Your Own Back Pain!" You know the type of article ... the one sandwiched between others, like "Six Ways to Lose That Chicken Neck," or "Be Debt-Free in 10 Days!" Most of these articles are designed to be read while one is actually waiting in line, or during a trip to the bathroom.
I was not surprised to note that no doctor of chiropractic had been interviewed for the piece. This is not unusual. Much of the time, these articles quote orthopedists or physical therapists. Why? Because they often achieve "cultural authority," which is the phrase used now to indicate "who trumps whom" among health providers for any given problem. We DCs don't always get the positive media attention we obviously deserve when it comes to spinal conditions, let alone anything else. In fact, being a chiropractor is sometimes like listening to Aretha Franklin's song, R-E-S-P-E-C-T, but sung by Rodney Dangerfield.
When some health event does prompt television reporters to interview a chiropractor, I pray it will be a DC skilled in the ways of the media and sound bites, and not just some guy with the biggest Yellow Pages ad. When I hear the anchor person on the news say, "More on this story at 10 tonight," I get nervous and imagine Larry the Cable Guy or Bozo the Clown, as the chosen chiropractic spokesperson - or I have the nightmarish specter of a man in a Hawaiian shirt wearing sunglasses and several gold chains around his neck, pointing to a chart of the nervous system.
It's easy to be insulated in our offices and not encounter the many faces of social discrimination concerning chiropractic. We have admiring and appreciative patients who affirm our success as a profession. We are respected in the community. We get medical referrals. But there is that pesky feeling many of us share: Chiropractic has never been able to educate the general public about who we are or what we have to offer.
There are several categories of "no respect" that I can identify. One is ignorance, pure and simple. Surveys have warned the profession that we are not as well-known as mortgage brokers or the Salvation Army.
The ignorance category is fresh on my mind. A lot of new people have been born since I started practice. Perhaps chiropractic has not gained much attention among younger people, since they are supple and elastic. But I think it's because health care is confusing for everyone, not just them. A recent graduate of a medical assistant school came to my office to apply for a job. She eagerly shook my hand and said, "Mr. Hanks, so nice to meet you!" It wasn't her fault; she just didn't know. And she was a "graduate." Most people younger than age 21 probably don't know the differences among osteopaths, orthopedists, optometrists, opticians, obstetricians or oligarchs. A DC friend of mine, while giving a talk to insurance adjustors, was asked by a new, young employee, "What is the difference between a chiropractor and a massage therapist?" My friend was speechless, and to this day, he visibly shakes when he discusses the incident.
Ignorance is not the only reason for a lack of respect. A second category is the "business" of medical/legal stuff. Attorneys have the right to ridicule doctors as much as they want. I was an expert witness in a personal injury case once, testifying on behalf of my patient. The defense attorney rose to start his cross-examination with, "Chiropractor Hanks, could you tell me when you first met the patient?" I don't know where the indignation came from, but I turned to the judge and said, "Your honor, I consider that a denigrating remark, and I prefer to be addressed as doctor." The judge agreed. Score "1" for the chiropractor and "0" for the jerk lawyer.
A third category is the "medically confused" patient. I will give you an example. A woman came to my office to seek treatment for lower back pain. Thankfully, I have had some experience with this condition. Her X-rays showed moderate degenerative changes at two lumbar levels. I told her she had some "wear and tear," and explained that treatment could increase motion, and consequently, decrease pain. She seemed to understand.
After two visits, the patient said she had 20 percent less pain and was better with most domestic activities. However, I did not see her again for three weeks. Then she called and informed my receptionist that she wanted to "talk" to me first, before having any more treatment. When we met in my office, she looked a bit depressed. "John, (she liked a familiar relationship), I went to my primary care physician, and he finally diagnosed my problem." I'm sure I just sat there with a blank look and she continued, "I have a disease called osteoarthritis!"
I was "trumped" by the family doc. For this patient, the primary care doctor had "cultural authority" concerning all diagnoses. Some days, you're the doctor; some days, you're Rodney Dangerfield.
