Should 21st-Century Chiropractic Leadership Be Any Different?

"Leaders take people from where they are to where they need to be."

- Henry Kissinger

Would-be leaders of the 21^st century, take note. Today, leadership means rendering public service, irrespective of the profession or occupation in which you are engaged. Of course, all chiropractors are leaders in the sense that they provide the patients they serve with what they need to help them regain, sustain and maintain one of their most priceless possessions - good health. But the chiropractic profession lacks leaders willing to move from sellers and defenders to the greater issues of health care financing and delivery, and where the chiropractor offers solutions.

"Captains of industry" in the 19^th and 20^th centuries, such as Henry Ford, Thomas Edison, John D. Rockefeller and Andrew Carnegie, ruled a dynamic and unique period of American history. Their paternalistic and authoritarian leadership style is no longer helpful in today's patient-empowered society. Today, information is the great leveler, and patients can and do exercise a new, informed decision-making prowess and authority. Information from credible sources has broken the stranglehold of knowledge from the monopoly of medicine and placed it in the hands of the masses. Patients will be less and less willing to blindly comply without explanation. This knowledge shift is also the bane of would-be aspirants to elected office.

Just look at the 2008 presidential candidates. As it stands, we may once again vote for the "least worse" among a lackluster group feigning compassion and snorting bravado. The public is acutely aware of the need for genuine leadership, even if they cannot yet find it and end up settling for less.

In times of conflict and change, people seem to choose a leader of yesteryear and select leaders with too many glib answers and way too much confidence. With the stresses in health care today, practitioners may take changes and difficulties more personally, and be more easily swayed by unethical leaders. Perhaps we followers are focused solely on our own survival and welfare, and take little time to notice just who is leading and what they are saying.

What about chiropractic leadership today? Chiropractors need more than anything to discern real leadership from the multitude of charismatic salesmen and self-anointed saviors of the profession. In chiropractic, perhaps more than other professions, too many "leaders" are trying to sell you their future, not your future.

By knowing what to look for in a chiropractic leader, perhaps we can identify those among us who possess the leadership qualities that we are willing to follow, as opposed to those who would lead the profession into oblivion. Let's examine a few concepts.

Service above self. Leadership requires service to those we serve. A chiropractic leader should empower chiropractors. With good leaders, chiropractors find themselves in a better world, not constrained or isolated in a smaller one. Selling seminars or goods to chiropractors while representing them is an obvious conflict of interest. You can be a persuasive salesperson or you can be a leader - not both.

If a would-be leader is involved in ethical conflicts or the appearance of a conflict, they must pass on a leadership role. It is time to understand this ethical concept that is so basic to other professions.

Be generous with praise and attribution. Evidence of professional immaturity is that many chiropractic leaders think they deserve their leadership role; that somehow they are genetically selected. Achieving leadership by longevity is not leadership, but merely endurance. Some chiropractic leaders today have arrived in their position not by leadership skill, but by political prowess or by ascending to the position because it is their turn.

Remember, leaders serve at the pleasure of their colleagues. Personal privilege and gain are of no interest to constituents. To be leaders today, you need good advice. The self-made person is a myth. Including and acknowledging followers invests them in the future of their profession and engages the next generation eventual for leadership.

Listen and learn. Chiropractors do not need an ideologue to lead them to the Promised Land. Followers want to be comfortable that elected leaders are listening more than talking. Real leaders set the space and pace of change, but do not dictate it. They simply cannot. No one person has a clear idea of what the future holds. Empty, unimaginative and unattainable campaign promises about subluxations merely echo the "good old days" that never were. Careful listening and exchanging ideas plant seeds for novel solutions never before considered.

Do not trade on "fear of medicine." Chiropractic is not the un- or anti-medicine. That is to say, chiropractors should not cast their identity as "over and against medicine." That turn-of-the-century mindset has no relevance in today's world. To demean any profession is to demean oneself and reduces whatever credibility and cultural authority the profession has.

Chiropractors have good reason to assert that people take too many pills and have too many unnecessary surgeries. But overall, medicine practitioners are just as concerned and committed to their patients as you are. Remember, more patients have family MDs than family DCs. You probably have an MD. If you don't now, you will someday. Leaders who bad-mouth MDs in their fire-and-brimstone sermons are hypocritical.

A willingness to rationally discuss and advocate medicine at the appropriate time builds trust with patients and the community. Chiropractic leaders will work against the profession by continuing animosity among allied health professions.

Stop thinking small. The chiropractic sandbox is small. Chiropractors and their leaders have been borrowing and stealing ideas from each other since the beginning. Worse, chiropractic leaders tend to grab an incomplete or unformed idea out of context and before it is fully fitted into a comprehensive strategy.

Thinking small leads to selecting leaders who "defend" chiropractic. This perpetuates pandering to fear, grabbing the small ideas instead of the big ones and shooting for the quick kill, while abandoning real and lasting opportunities for professional growth. Defenders choke off the future. Artificially achieving a greater market share for the next month is not an enduring strategy, but leads to the perception that chiropractors will do anything for money.

Only magnanimous generosity in our leaders will overcome chiro-practic's limited role in health care. While immature leaders seek personal recognition and group hugs, true leaders see to it that others reach their potential.

Don't lead from "belief" in chiropractic. Chiropractic as a "belief system" should be carefully set apart from results. Believing in your profession is good, but arguing about belief leads to arguments over who is right and who is wrong based on opinions. Chiropractic is not a cause or a movement. Leaders should communicate with the rights, responsibilities and confidence of a profession. Appealing to chiropractors only as a philosophical raison d'être has enriched the coffers of some chiropractic leaders, but it has not helped the profession overall.

Articulate a bigger future to a broader audience. For some time now, I have encouraged a few in chiropractic leadership roles to grow into health care leaders - to articulate issues and solutions to the general public and policy-makers for the future of health and healing. So far, surprisingly, there have been no takers. Selling chiropractic to chiropractors must be highly addictive.

To do this, leaders need to have something fresh to say. Chiropractic leaders should plug into every university and non-chiropractic professional health conference they can. Particularly, they should seek allies in departments of pharmacy (gasp!) and health policy, both of which know where health care is going.

You can't please everyone. As strange as it may sound, leaders can represent the many and the diverse simply by keeping information flowing. Leadership is not about popularity, charisma, position, perks, position or ego. Leadership does not please everyone, but rather offers an incorruptible vision clear enough to make room for a better one. Such a magnanimous capacity ignites a loyalty in the hearts and minds of those who follow.

When leadership creates a culture of trust and integrity, honesty flows. As the profession experiences leadership integrity on a continuous basis, uninterrupted by scoundrels and characters lacking in character, it becomes easier to identify good leaders.

Leadership is about dedicating yourself to the task of servant leadership. Chiropractic has a long history of leaders using their positions to feed their own economics and egos at the expense of the entire profession. It is time to closely listen to and carefully "read" those who would be leaders to uncover their real motives and decide if this is the kind of leadership that leads to a better future for all or most.

Maybe someday chiropractic leadership will dispense with the rhetoric, the emotionally charged words and philosophical-sounding phrases that may be intended to motivate and call to action, but which actually obscure real issues. When the smoke clears, maybe we can then identify leaders whose voice of reason is louder than the old cacophony of confusion.