Looking Forward to the Future of Chiropractic

Who was it who said, "The best way to plan the future is to look at the past"? History points out what has been done right, but also what has been done wrong. It gives us a good picture of accomplishments, but it also points out shortfalls. Whether it's world affairs, politics or professional relationships, it seems there is no better learning tool than experience. Somehow, time gives one the ability to analyze and bring into focus reality without the distractions of wishful thinking.

In the long run, success can best be judged by subtracting the losses from the gains and comparing the bottom line. That gives us a historical picture of true worth - a balance sheet, so to speak. As I look at chiropractic in retrospect and superimpose the experience of the past over the challenges of the future, I realize that only the names and faces have changed, not the work that needs to be done. This is not to say that specific issues have not been addressed or there has not been accomplishment. Chiropractic has made giant strides since I was first introduced to the profession three decades ago. But core challenges still remain and will continue to remain, for they are the forces that drive progress.

Too often the continuing need to overcome challenges is interpreted as failure when, in reality, they are the source of energy giving birth to remedial action. In the short term, progress seems slow; in the long term it's sure-footed and impressive. So it has been with chiropractic.

Reflecting a bit, I remember being asked to attend a special meeting in the 1960s at the American Chiropractic Association's (ACA) headquarters, located at that time in Webster City, Iowa. The session was called by Executive Director Dr. L.M. Rogers and attended by some of chiropractic's most distinguished leaders and college presidents. They were concerned about the profession's image, the media's non-coverage of chiropractic, and the general public's lack of recognition of the benefits of chiropractic care (many of the same concerns still with us today, although perhaps dressed in other forms and expressed in other ways).

I don't know why my company was contacted, other than the fact that Dr. Rogers had learned I had succeeded in carrying out an effective communications effort for the American Optometric Association, which at that time was having similar problems. (I had been able to write and place a story in a national publication about optometry, which impressed him). As I look back, I realize what a daunting challenge I took on at the time in trying to duplicate the effort for chiropractic. But I was young and fearless, and the mere opportunity to work with such a group of forward-thinking leaders excited me. These were the movers and shakers; the "greats" of the profession. Their names will forever live in chiropractic's annals of progress.

I jumped naively into the tasks, thinking my "creative brilliance" would enable me to change things overnight. And likewise, they jumped into the relationship thinking their expectations could be reached overnight. Of course, we were both wrong. I was wrong about what it would take to change the public's attitude. They were wrong about what it would take to change the profession. We all soon learned that progress is not made quickly, nor does it come easily. It's much easier to mold a clever phrase than to mold public opinion.

Rolling forward, I spent the next 30 or so years deeply involved with chiropractic. As most of the "old timers" know, I spent most of this time as public relations consultant to the ACA. My company, Clayton-Davis & Associates, developed the media strategy, handling everything from media relations to crisis management; everything from internal relations to external relations; everything from graphics to publishing. We wrote and put into production many of the programs of councils and committees, and we put into words many of the ideas, statements and speeches of chiropractic leaders. Some tasks we asked for, some we grew into, some we inherited and some we did only because there was no one else available to do them at the time.

Over the years, my company and I had a wonderful relationship serving seven ACA executive directors and their staff, a succession of presidents and boards, and many of the colleges, commissions, councils and state associations. We developed some outstanding PR programs, basing our thrust on developing methods, tools and materials that would open media doors. Our objective was to get as much free exposure as possible through the utilization of highly creative programs focusing on health issues. Our strategy was to identify chiropractic with current events wherever possible, so as to induce media interest and tie-in coverage. One of our methods was to sponsor a continuum of events and distribute supporting materials.

Every measure of public relations success proved that the program was highly successful, whether judged in numbers by the amount of press clips and radio/TV features carried, media inquiries, usage of chiropractic-generated subjects or the numerous awards won (Emmys and others). I am proud to say the ACA's program under our direction became a role model in the industry of an effective PR program on a modest budget. Within the communications profession we were lauded; within the chiropractic profession we had our supporters and our detractors, our friends and our critics, but that is par for the course. The important thing is it laid a strong PR foundation chiropractic never had before, upon which, public consciousness, understanding and respect is continuing to be built even today.

I offer this background information as a preface to providing my "take" on the future, hoping it will add validity to my opinions. I see myself as an "insider/outsider"- someone who is professionally involved in the world of communications, but at the same time emotionally attached to chiropractic. I think I understand better than most non-chiropractors the sensitivities and the conflicts that burn within. After so many years, the profession is like family to me, and I have chiropractic's best interest at heart. On the other side, I know what makes public opinion; what influences it; what makes media tick, what turns people on and what turns media off. Since I am a public relations/marketing person, I will limit my discussion to communications.

The New/Old Challenges

What are some of the future challenges as I see them? Obviously there are many, but let's talk about those I would classify as "new/old." The challenges in terms of communications are not new. I was faced with them during the long period I was engaged with the ACA, and I continue to see them plague the profession even now, many years later. To be fair, I must admit they are not unique to chiropractic. They are mistakes common to many unsophisticated marketers of products, services and ideas. Nevertheless, they are debilitating and wasteful.

Challenge #1: Lack of Long-Term Resolve. I've often said, "Ideas are a dime a dozen, and everyone has ideas." One of the greatest problems chiropractic has with communications is it's looking for a quick fix. As a result, chiropractors tend to listen to everyone, buy the most ridiculous promises, jump in and out of campaigns faster than they can pay for them and let themselves be motivated by emotion instead of good judgment. The profession must come to the realization that there are no quick fixes.

Challenge #2: Involvement. Supporting the misdirected quick fix attitude is the desire to "leave the driving to somebody else." That is, let somebody else do the work or, better yet, put your entire budget into an easy-to-buy and easy-to-track media purchase, and then sit back and reap the rewards; except it just doesn't happen that way. One big splash or even a few smaller splashes don't make an effective communications program. It takes organization, involvement and a supportive effort (even if you engage an outside organization to direct it). It takes a well-coordinated effort. Even if you do place some advertising, you've got to support it with a grassroots marketing effort to make your campaign truly effective.

Challenge #3: Budget. Nobody likes to talk about money, but it does take money to conduct a communications campaign - even if the plan is limited to seeking free coverage. If nothing else, you need the creative and marketing tools with which to solicit time and space. That means press kits, radio and TV spots, graphic materials, exhibits and audiovisuals. Yes, even printing and postage can be big-ticket items.

For some reason, chiropractic groups tend to have a David and Goliath mentality. They visualize themselves as David overcoming the giant with a slingshot and pebbles. Too often, they don't understand how insignificant their $10,000, $25,000, $50,000 or $100,000 is (a sizable amount, but puny in terms of budgets) when attempting to gain recognition going head-to-head against national advertisers.

I remember, for example, the criticism the ACA's PR committee encountered from a few misinformed DCs who thought the ACA had deeper pockets than they had. The critics couldn't understand why the committee preferred to use public service spots and other types of free exposure instead of buying spots on national television like, for example, the Super Bowl. What they couldn't (or wouldn't) understand is that one single 30-second Super Bowl spot at that time cost $1.5 million, and our total budget for the year, including production, was $200,000. Budweiser's budget that year for television alone was $100 million). These days, that same spot costs more than $2.5 million, which is multiplied by the number of spots an advertiser uses in its campaign. (Incidentally, that's the cost of time only. The budget allocated by Budweiser for producing the message filling that 30-second slot is purported to be in the neighborhood of $1 million.)

Next time you see some of the extensive campaigns on television for Viagra or other pharmaceuticals, think about the money being spent to win brand support. All this doesn't mean the challenge is fruitless or that chiropractic has to give up its quest to grow or improve its position and prosper. Rather, it points out the need to be realistic, to use its budget prudently and wisely, and to be creative and consistent. And last but not least, to be patient.

Challenge #4: People. As I stated earlier, "The challenges are the same; only the names and faces change." This particularly applies to people. You have to be careful whom you put into what position. Take into consideration qualifications for the particular job: abilities, attitude and presentation. Too often, it's merely a political decision and this can hurt. I'll always remember the person with the big ego who took a personal offense against me because I didn't make him the spokesperson for the entire profession. The fact that I did not have the authority to offer him that enormous position, and that his argumentative speaking style reflected poorly on the profession, didn't stop him from making an issue out of it.

He wanted the limelight, and who better to attack than the guy he saw as the person standing in the way of his quest .Apparently, he wanted to kill the messenger! For years I had to contend with his pointless vendetta. There still are people around like that - competent, dedicated, chiropractors, but loud mouths who don't do much for the image of chiropractic.

In dealing with the people challenges, we deal with governance. With governance comes politics. And with politics come elections, political appointments and special favors. Not unlike the political process in our nation's capitol, sometimes the best person is not always the person who gets the job. One of the big challenges for the future of the chiropractic profession, as it is for our country, is to elect and appoint people who are well-qualified in every respect: attitude and personality, as well as skills.

Some people are right for some tasks and not so right for others. The saying, "The squeaky wheel gets the grease" is not the best way of qualifying a person for a position; in fact, it can be disastrous.

Challenge #5: Attitude. The chiropractic profession has faced prejudice for more than 100 years. Chiropractors have been harassed, treated unjustly, kept out of the health services mainstream, and even jailed. The chiropractic profession's avowed enemy has been political medicine. The AMA's puppet has been the individual medical doctor, and its ploy has been the media. It's no wonder the typical chiropractor of past generations had a chip on their shoulder against medicine.

While there is every reason in the world for the chiropractor to be angry with anything or anyone that even smells of medicine, it's my belief that in this day and age, it's in the chiropractor's best interests to forget the past and look to the future. Go ahead and blame political medicine for its monopolistic ways, throw it in their face when debating legislative and benefit issues, fight them tooth and nail on an organizational level, market aggressively against them, but bury the hatchet with individual MDs. In my judgment, referring back to old misdeeds is about as productive as seeking reparations for slavery.

It always has been my contention that no single health profession has all the answers to the mysteries of illness, disability and quality of life. It's far more reasonable and easier for the public to accept the concept of the chiropractor being part of a team of qualified practitioners who are first and foremost dedicated to the health and welfare of their patients, whatever the procedure required. Likewise, I feel that if there is one big change we can look forward to in the crystal ball of health care it will be a future in which the patient will depend upon the health team, as opposed to the medical practitioner. It's going to be that way, because the people want it that way!

And while we're talking about attitude and the wisdom of burying the hatchet, for gosh sakes, isn't it time chiropractic stopped fighting with itself? Factions within the profession have been attacking each other for as long as I can remember, and I'm sure long before that. One of the real challenges is for the profession to stop its quibbling, get together, work together and speak with one voice.

The Greatest Challenge of All: Patience

In spite of all the challenges I've discussed, I have been privy to seeing a profession move forward with a great deal of strength and determination. I am proud to have been part of it, contributing whatever I could to its progress.

Unfortunately, I also have seen some very effective programs get started and then dropped; really great campaigns left on the shelf to gather dust, only because the participants became bored. For example, we covered subjects such as steroid use, athletic injuries, iatrogenic diseases, job performance, quality of life and problems of aging long before they were popular media subjects. Today, because of chiropractic's lack of follow-through, the medical profession, not chiropractic, enjoys the benefits of being the authority on these subjects.

Impatience can do more to undermine progress than any other shortfall. It's in itself a challenge to resist the temptation and lure of jumping from one program to the other; of swinging from one course of action to another without fully exploiting each opportunity. It's a challenge of self control. Let's stop trying to reinvent the wheel.

Am I optimistic about the future of chiropractic? Yes, I am! Am I put off by the challenges it faces? No, I am not! I see challenge as an incentive to reach greater heights. For challenges are part of the life of a living and breathing profession. Each generation has its new birth of problems to overcome. They may have a new "name" or new "face," but their care and feeding are the same, as are the people who have inherited the task of dealing with them.