"Professionalism and Ethics" is the theme for the upcoming Association of Chiropractic Colleges Research Agenda Conference (ACC/RAC 2007), which will be held March 15-17 in Phoenix. (See www.c3r.org/accrac for more information and registration details.)
As the chiropractic profession has matured, it finds itself more and more integrated into the warp and woof of society. Its doctors are viewed as members of an honorable profession, one that has fought its way from relative obscurity and medical opposition to a position of pre-eminence in health care. With this growth comes a great responsibility. We find ourselves needing to define what it means to be a professional, and how we put our ethics into action in our day-to-day clinical, educational, political and research activities. This is a far more complex world we live in.
Brehm, et al.,1 note that professionalism is divided into three categories: professional parameters, professional behaviors and professional responsibilities. As they describe it, professional parameters deal largely with legal and professional issues; professional behaviors address knowledge and skills, as well as appropriate behaviors with patients and professionals, and how we present ourselves to the public in terms of appearance and attitude; and professional responsibilities pertain to our responsibilities to our patients and to all our various other constituent groups.2 A glance at this list will demonstrate that we are addressing these various activities in a wide range of ways. For example, there currently is debate about the development of best practices within the profession,3 and this directly addresses the issue of professional parameters. We are seeing a discussion of how we can best integrate into general medical care, which, in part, looks at the issue of professional behavior. And we are discussing ethical challenges such as informed consent, which addresses the issue of professional responsibility. Each of these areas will be addressed in sessions at ACC/RAC 2007.
Until recently, we gained a sense of professionalism largely by osmosis and common sense; we knew that to gain public trust, we had to earn it, and the best way to do so was to offer our clinical skills to the public as best we could. But the issue has grown so much in importance that our educational institutions are now devoting time and energy to adding professionalism to their curricula. For example, Dr. Stuart Kinsinger of Canadian Memorial Chiropractic College developed a manual specifically on this subject: Principles of Professionalism for Manual Therapists.4 National University of Health Sciences has an ethical business management track throughout its entire curriculum, and other colleges have done much the same.
Professionalism extends to working with other disciplines, such as medicine. Our graduates, along with the rest of our practitioners, need to be educated to best coordinate and communicate with others, both within and without chiropractic. One of the ACC/RAC sessions will address this very issue: "Understanding and Communicating Risk of Manipulation to Non-DCs." While this is a session directed more toward military chiropractors who will be in attendance, this also is timely for all of us who interface with other professionals.
At the same time, our growing research enterprise is confronted with ethical complexities almost unimaginable just a generation ago. Our researchers must address the protection of human subjects in all their clinical research, proper treatment and use of animals in some of our basic science research, and the challenges of confidentiality in our educational research. A number of sessions at ACC/RAC will examine these critically important issues. Included among those sessions are: "Ethical Standards in Military Health Care," "Professional Ethics in Chiropractic Education," "Ethical Conduct in Research" and "Ethics of Peer Review of Manuscripts, Abstracts and Grant Applications." We are being judged far more critically than ever before, as necessitated by our growing involvement in federally funded research, and sessions such as these will be of great benefit to the novice researcher or faculty member.
Moreover, we also have provided interesting sessions for practitioners, including discussions on sexual boundaries in clinical practice, informed consent in practice and management of the postsurgical spine. Finally, there will be sessions for educators on topics as varied as curriculum assessment, subluxation science, conducting systematic reviews, writing scientific papers and critically appraising them. And, as always, there will be a series of sessions in which researchers, academics and practitioners present their own findings.
We are pleased to note that the opening session will have three keynote speakers: Dr. James Giordano, past research director at Texas College of Chiropractic and a current member of the Kennedy Institute for Bioethics at Georgetown University Medical Center; Dr. Ian Coulter of RAND and the Samueli Institute for Information Biology; and a third speaker, who we are in process of confirming. The closing plenary session is sure to generate debate, as it will present the state of best practices development in the chiropractic profession. All of this will take place at the Wyndham Hotel in Phoenix, allowing many attendees to escape the winter cold.
This 12th annual ACC/RAC promises to be informative, educational and interesting. It has much to offer the attendee, whether that person is an educator, clinical practitioner or researcher. With its emphasis on professionalism and understanding of the ethical challenges facing the chiropractic profession, it cannot help but enhance your ability to work in an interdisciplinary environment and improve patient care, as well as expose you to the best our profession has to offer.
For more information, please log onto the ACC/RAC Web site (www.c3r.org/accrac) or contact Ms. Lori Byrd (byrd_l@palmer.edu) for further information. We look forward to seeing you there.
References
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