Selective Unity

United Healthcare's (UHC) recent announcement that it has rescinded its policy denying coverage of spinal manipulative treatment for pediatric and headache patients (see page 1 of this issue) reminds me of a remarkable yet far-too-uncommon occurrence that took place when UHC first announced its ill-fated policy change.

Essentially, every major chiropractic organization came together, presenting a united front in opposition to the policy. The American Chiropractic Association, the International Chiropractors Association, the Congress of Chiropractic State Associations, the Council on Chiropractic Guidelines and Practice Parameters, the Association of Chiropractic Colleges and the Foundation for Chiropractic Education and Research sent a joint letter to UHC that stated, in part:

"Attached is an analysis which demonstrates that [this] policy is not only flawed but more importantly, poses a threat to the health of children, adolescents and those individuals suffering with headache pain who may be insured or otherwise covered under UnitedHealthcare programs and policies. We view your recent policy determination to be a material denial of essential benefits and coverage paid for by employers and other insureds. The broad-stroke elimination of these important benefits is, in our view, not only unconscionable but is an abrogation of the promises made to cover chiropractic services to employees, individuals and their dependants."

That letter and the united opposition it represented made a clear statement that the profession would not sit idly by and allow UHC to limit patient access to chiropractic care. As the CCGPP asserted in a second letter sent to UHC, "Chiropractic physicians clearly possess more education and clinical skills in the area of musculoskeletal diagnosis and treatment compared to general allopaths and physical therapists. If this policy is permitted, young patients and those suffering will have nowhere to turn except to general medicine."

With this scenario in mind, why does so much division continue to exist within the chiropractic profession? Let me preface this by saying I recognize the positive steps the profession is taking - we report on it constantly in this publication. But two examples of disunity come to mind immediately: the failed (by all accounts) recent attempt to merge the ACA and ICA, and the observation that although chiropractic associations in four states have merged within the past several years (New Jersey, Pennsylvania, Colorado and Michigan), the overwhelming majority has yet to do so.

The lesson is simple. Unity cannot be selective or it really isn't unity at all - certainly not in the minds of legislators, other health care professionals and the public, all of whom will continue, in one form or another, to withhold their support and endorsement of the chiropractic profession until DCs prove they can work together consistently.

Why the ongoing struggle to facilitate unity? I can only speculate, but based on what I've heard and read, many chiropractors equate unity with a loss of diversity and opinion. Many seem to feel unity will require that you bury your unique perspectives and "agree" for the sake of agreement.

But unity would actually accomplish the opposite. It would allow the profession to function as a single, powerful entity while still retaining its wonderful variety of practice approaches. In short, it would allow chiropractic to at last define itself - not only internally, but also externally. Doing so would be invaluable, because the reality is that far too many people don't understand or appreciate you or what you offer.