What’s the Difference Between Greed and Ethics?

OMG - that's the new "texting" communication method used today to express the phrase "Oh My God," as if saying the complete phrase is somehow too arduous. Yes, it is even difficult to believe the word God is mentioned, and it is in a newly created millennial foreign language called texting, which will, I'm afraid, soon come to dominate and replace eloquent prose.

Speaking of new language and new words, unless you have been in a cave in Afghanistan looking for bin Laden, you have been following the ongoing crisis on Wall Street. Worldwide turmoil has been caused by the near failure of AIG (the largest insurance company in the world); the largest bank failure in U.S. history (Washington Mutual, which was taken over by J.P. Morgan); Lehman Brothers filing Chapter 11; Merrill Lynch being purchased by Bank of America; Fannie Mae and Freddie Mac in a catastrophic meltdown; and the Goldman Sachs turmoil enriching none other than Warren Buffett.

Among the recent chaos, it is rumored that Congress may have to approve the purchase of 535 copies of The Rosetta Stone® software to learn a new language! The new language will contain words heretofore unheard in the hallowed halls of Congress; words such as ethics, accountability, responsibility, standards, morals, oversight, transparency and a few others that are only available in the more advanced 3.0 software version. Yes, I am being humorous (and a bit caustic) because in times of crisis, our so-called leaders always seem to begin speaking a new, previously unknown language that incorporates these words.

Frankly, the entire mess is almost too far gone to save, and the country may simply need to clean house and start over. If Congress cannot pass a bill without 150 billion additional pork-barrel provisions in a time of crisis, there is no hope they can or ever will change. Unfortunately, we cannot do much about the crisis in Washington except to let our legislators know we are displeased as individuals and as a nation. It seems that when they hear from constituents who are angry (and lots of them are), it is the only time the fear of God is placed in them. These elected officials have forgotten one simple fact: They are there to serve the people, not the other way around.

Before I digress too far, let's get back to chiropractic, because that is something over which we have some control. I have been writing for decades now about the ethical void that exists in some areas of chiropractic. This is analogous to the man falling from the very top of the Empire State Building, passing the 60th floor and hearing someone ask, "How are things going?" To which he responds: "So far so good." We can all talk about the crisis caused by a lack of moral and ethical values on Wall Street, in large corporations and in the halls of Congress (perhaps a larger number here than other places), but that does not help the chiropractic profession much.

What we need to talk about is: How can this current crisis of confidence and ethics we are experiencing as a nation become a learning experience for our profession here in the U.S.? What can we begin to incorporate in our colleges, associations, governing boards, suppliers and, most of all, the 60,000-plus chiropractors who make up this great profession?"

Undoubtedly, we have groups that have exploited unsuspecting new graduates and naïve and fearful established practitioners. These groups are enticing their prey with the lure of high incomes, oftentimes using questionable schemes and scams. We have seen the expansion and explosion of new and untested devices designed (primarily) to increase income under the guise of providing some health care benefit such as face lifts, hair restoration, hair removal and allergy cures. We have those who promote research projects that are nothing more than scams ultimately designed to attract new patients.

We have some who are urging DCs to set up corporations as little more than "ambulance-chasing" leads to market their practices. We have some touting the benefits of a DC/MD partnership, which if done correctly is wonderful. However, many have lost the mission and use these enterprises as a means to increase billing. We have those who, even in the 21st century, lure the consuming public to lectures using the same high-pressure tactics as timeshare salesmen. We have multi-level marketing schemes disguised as health services promoted to our patients. There are those who strongly advocate that doctors write "books" to gain credibility and add to their resume. With the help of ghostwriters, the so-called book is produced, allowing them to advertise they are an author and enhance their credibility. The list of dubious exploitations in the name of making money is never-ending, limited only by the imagination of the perpetrator.

When confronted with the simple question of why these activities are allowed to go unchallenged, there is a litany of reasons regurgitated on cue, analogous to the "talking points" of those never-ending television talking heads. No matter the question, it's the same response. The reasons given by some to justify their actions vary, but for the purposes of this article they are not relevant. They are what they are, and using this kind of ploy to try to justify what chiropractors do based upon what another profession has done is simply not going to resolve anything. We are judged as chiropractors.

If the issue surrounding the current scrutiny regarding reimbursement were analyzed, it would soon be clear that the entire negative connotation regarding chiropractic services was brought about by a very small percentage of individuals in our profession. Like it or not, we all suffer from the irresponsible actions of a few. This small group makes money teaching the art of exploitation and has pilfered and bamboozled unsuspecting DCs over the decades. Many in the profession know about these schemes and scams and remain silent.

Like the current exposé on the financial crisis on Wall Street, we are now seeing finger-pointing in every direction - except at the individuals responsible. Recently, the Inspector General of the United States made the statement that the Securities and Exchange Commission (SEC) missed "numerous potential red flags" leading up to the shotgun sale of Bear Stearns and failed to require the investment bank to rein in its risk-taking. This scathing report said it was undisputable that the SEC failed to carry out its mission in its oversight. The report went on to say that in 2006, the SEC staff identified precisely the types of risks that evolved into the subprime crisis, yet "did not exert influence to use this experience to add a meltdown of the subprime market to its risk scenarios." Why is it that only after the fact and when the crisis is upon us do we hear stories of "red flags" which were known and not acted upon? There is example after example of accidents and catastrophes that ultimately happen because no one said or did anything until the problem manifested itself in a crisis.

So, what is the solution to the challenges facing our profession today, and how can we use the lessons of the financial collapse of Wall Street to learn something? Perhaps it is now time to have some discussion about the responsibility each and every chiropractic practitioner has for the collective welfare of our profession.

Perhaps we can develop a STAR (Standing Together Against Racketeering) of the Month award. National and state associations can give this award to any individual who exposes fraud, corruption, illegal activity or unprofessionalism. The individual(s) also would be featured in a story on how and why they decided to expose whatever activity they disclosed. There may even be some kind of trophy or other form of recognition for these individuals to make the whistle-blowers the real heroes.

Perhaps with enough encouragement and profession-wide commentary and support, there may be just enough positive momentum to create that "tipping point" Malcolm Gladwell talks about in his book of the same name. Perhaps we can at least reveal the individuals and the wrongdoing Martha Stout talks about in her book, The Sociopath Next Door.

Will this stop our problems? No, but it will bolster and embolden our chiropractic journals and associations to expose these egregious acts of individuals. It may provide some reinforcement to our state and national organizations. If they begin to do this, they will not lose membership but, in fact, gainmembership by becoming the organization(s) a member can be proud of. Perhaps our colleges will look a bit closer at the entry-level requirements of those who wish to become doctors of chiropractic. Maybe our state boards and those who have authority concerning conduct will look all of these individuals in the eye rather than looking away. Conceivably, once armed via this kind of activity, our national and state association lobbyists and spokespersons can truly begin a dialogue with government agencies, insurance companies, research agencies and other health care organizations with which we are seeking cooperation.

Pie in the sky? Maybe, but if we do not take a page from the financial crisis that has hit Wall Street and a significant number of 100-year-old institutions with sterling names, we will not have utilized the lessons of today to advance our profession tomorrow. What we need is the courage to change what we know exists and the faith that doing the right thing will bring about the right result.It usually does.

Some who will read this will agree wholeheartedly with the concept; some will suggest this article is about controlling the direction of the profession; and still others will view this article as an impossibility because we are too far gone. I have no illusions that this will be misinterpreted by those who perhaps see themselves in the article and feel the heat and light upon them. To those I say, "Great!" There are others who will be squeamish about exposing colleagues; my suggestion is that without your personal intervention, we will never win. To those who think we are too far gone to repair the profession, I offer you this quote from Margaret Meade: "Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has."

While this topic may make some uncomfortable, I hope those who are passionate about the need for change will take time to reflect and perhaps become involved with your national or state association. If you are not a member, you may want to let them know you would join if there were a STAR award.