What's the Motivation?
Dear Editor:
Over the years, I've always found it ironic that the chiropractic profession will fight tooth and nail (and rightfully so), for the ability to utilize diagnostic assessment tools under the guise of being discriminated against and not being allowed to properly diagnose their patients. The mantra generally goes something like: "It is dangerous to put a force into a spine without knowing the status of the underlying vertebral column."
That, of course, makes good sense. At the very least, one would like to know, say, the orientation of the facet joints before subjecting the patient to a traditional lumbar adjustment. The majority of chiropractors I know and have known would not touch a new patient without, at the very minimum, obtaining radiographs of the anatomical site of interest - for the very reason of knowing the condition of the vertebrae prior to subjecting the spine to a focal outside force. That's what we all learn in chiropractic college. As a health care provider, that's the responsible, ethical and proper thing to do - one would suppose!
But then they will go to Haiti, Guatemala, Nicaragua, India, Africa - you name it - and nonchalantly, indiscriminately and casually adjust anything and everything that moves without any semblance of objective diagnostics whatsoever. If anything, it is even more imperative to exercise the utmost of care when dealing with these poor and disadvantaged peoples. It is they, more than anyone here in the U.S., who may be suffering from some esoteric bone disease or pathologic process that could mean serious injury if adjusted.
I cannot agree more with Dr. Feise when he points out: "[S]electing the most effective and accurate tests is a fairly sophisticated process. It requires diligence and critical appraisal competency. However, it is the duty of every practitioner to select the most appropriate assessment tools and therapies in order to achieve optimum outcomes. It is our obligation to our patients, our profession and society."
What is it with these DCs? Is it a "money thing" when home in the U.S., and an "ego thing" when in some far-off land? Witness similar mindsets at chiropractic conferences, where chiropractors give each other adjustments without knowing a darn thing about the person they are adjusting. Under these circumstances, liability is very real, but for some reason, the brains of these DCs turn to mush as their egos compel them show off their particular technique on someone they have never attended to before professionally.
However, come Monday morning, all new patients must go through X-ray and the usual impressive physical examination ritual. Why? To "find out what's wrong with you," that's why. Or is it just to pad the good ol' wallet?
Peter G. Furno, DC
Indianapolis
When I graduated from chiropractic college in 1981 and started practice, I heard it all, and very little was positive. “You are a quack; you do not know what a subluxation is; you couldn’t get into a real health care program, so you chose the one that is slightly above a mail-order degree; you have no proof that chiropractic works; Are you really licensed?”, and so much more.
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