What makes a person a good citizen? What attributes of a profession define it as being a benefit to the community and make it noble? While there are many possible answers to both of these questions, most of them will boil down to "livin' and givin'" in ways that go beyond meeting your own personal needs and toward helping others in your community. This was very evident earlier this spring when our local news channel here in Minnesota showed video of our neighbors in North Dakota helping each other in an attempt to hold back flood waters from the Red River. No one person could have placed enough sandbags to hold the waters at bay, but by working together, they were able to get the massive job done.
Unfortunately, most community needs are not so high-profile, and the lack of apparent urgency means fewer people volunteering and those few volunteers doing more work. Before you read any further, I would like to have you consider all of the organizations with which you are involved and how your actions influence your community. Are you currently involved in helping the chiropractic community by giving financial support to organizations that further the chiropractic profession? Do your actions and that of your chosen organizations help to form a public image of chiropractors as more than just "back crackers"?
After graduating in 1988, I worked in private practice and learned early on that community involvement leads to many new connections and life-enhancing experiences. These days, some of my community services involve my second career as an assistant professor at Northwestern Health Sciences University. My duties include intern supervision at our student clinic, methods instruction and teaching the ever-popular "Public and Preventive Health" course. Many students seem to think this course is unnecessary, yet I feel it is vital for giving students a more global view of issues they will encounter when they begin the journey of clinical practice.
Part of my reasoning is that if we are truly interested in the future of the chiropractic profession, we need to take a step back and look at population-based treatment strategies. How can chiropractic most effectively be utilized and accepted within the health care system and, more importantly, within the minds of the public? This applies to its current state and, with luck, a future system that is not unduly influenced by Big Pharma, special interests and insurance "claims adjustors" (an ironic twist of words, don't you think?). Major changes to the health care system are cooking, and chiropractors need to be one of the main ingredients.
I believe very strongly that the only way that this will come to pass is through continued efforts by all chiropractors to provide services to our respective communities. Chiropractic has survived to this day only because we had pioneers with such passion and conviction that they were willing to literally be convicted for that passion. I am not going to get into the factions and infighting that our profession seems to lovingly embrace, and would ask you to forget about the straight/mixer thing for a few more paragraphs.
We survived the medical assault on our profession only because we had patients who were willing to fight alongside of us while we struggled to retain the right to treat patients, even though we were not considered "real" doctors. We survived and gained a bit more respect, but most surveys suggest that after 100-plus years of continued efforts, we still only treat between 8 percent and 15 percent of the population on a regular basis. In my clinic, most were middle- to higher-income patients, at least high-school graduates and Caucasian. While this had something to do with the area in which I live and the fact that they had some form of health insurance, I believe these patient demographics are likely representative of the U.S. profession as a whole.
Northwestern, like most other chiropractic schools, has several outreach clinics that focus on underserved populations. A major theme that is emphasized in my public health course is the relationship between education, poverty and health policies, and how they connect to global health measures and outcomes in communities. This time last year, I was heavily involved in getting the chiropractic portion of a multi-disciplinary project called the Pillsbury House up and running. This project is a collaboration between University of Minnesota medical school students, nurse practitioners, psychologists from the Adler Institute and students from our chiropractic, acupuncture and massage programs. This project had its beginnings in a conversation between a medical student and the dean of our chiropractic program about how we could work together to provide services to this neighborhood.
I must note that there is a huge difference between simply having these separate disciplines available in one building and truly integrating the experience for all involved. As a matter of fact, there are many organizations that will teach you how to "integrate" MDs and PTs into your office, with the sole intention of increasing your ability to charge higher prices for those services. Sounds like a great way to show the world what we are truly interested in, isn't it? There is no way that I know of to force a student to become altruistic and want to provide community service, nor do I think it should even be considered. Service comes from a sense of belonging and a belief that your efforts will have an impact. I would hope that we can do better than using the almighty dollar as the primary motivator.
In my opinion, the easiest way to integrate your practice is to become involved in your community. This can mean working with other health care professionals in both clinical and nonclinical settings. There are hundreds of existing organizations that can be the springboard for diving into community service. I sincerely hope that most of us have passions and causes about which we care other than chiropractic. You need only find an organization that reflects your personal ideals and goals.
The Pillsbury House clinic would not be possible without the assistance of the Pillsbury Foundation, which provides the clinic space as well as the needed community tie-ins to spread the word about our services. We have another program that uses connections with the Salvation Army. In Costa Rica, we have an international program that works with the Christian Foundation for Children and Aging. These local promontoras give the necessary local assistance needed to provide high-quality continuing health services to the 10 communities that are currently served. I found it quite disappointing that during my most recent trip to La Clinica Mariposa, we were being fought by the local chiropractors who somehow felt threatened by our presence.
This is what I tell every student: I truly believe that chiropractic is the best and brightest hope for improving the health of not just your chosen community, but for the health care of the nation and (dare I say) the world. The only way that a grassroots movement can be effective is to influence as many roots as possible. For students, this means thinking about how they are going to fit into a system that is often times unfair and medically biased. For practicing chiropractors, this means getting out of your office and changing the community perception of chiropractic by being good role models and mentors.
For what it is worth, the most impressive thing that I noted during my time at the Pillsbury House was the dedication and enthusiasm of the student volunteers and the way that they interacted with the other disciplines. You might be surprised how open the medical community can be after they see chiropractic in action.
To paraphrase Gandhi, "We need to be the change that we want to see in the world." The unfortunate thing about coasting is that it only works when you are going downhill. Make new connections this year. Contact your local chiropractic college and see if they have opportunities for you to become involved in their existing programs. Plug into your communities and work on issues that you feel passionate about improving. I also strongly encourage you consider helping yourself and your profession by joining the American Public Health Association (APHA). It is the oldest, largest, most diverse and most politically relevant organization with a focus on preventive health care measures. While you are taking these steps, I think you may just find that you really do make a difference.
Chiropractic is a part of public health, and public health is a part of chiropractic. Serve your communities with chiropractic and public health together. Please join your chiropractic colleagues in the APHA now at www.apha.org or contact Dr. Jonathon Egan, membership chair of the Chiropractic Health Care section of the APHA, at j.t.egan@gmail.com with any questions.
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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A central challenge in creating our identity is that chiropractic is a method of care, not a technique or procedure. This is an important concept for us to promote. Our patients are treated with lifestyle modification, exercise, nutritional supplements, diet and a whole-body approach to accelerate the natural healing process. We are not simply CMT providers.
The results of a global survey released late last year (2023) unveiled some startling findings among medical and nursing students. The “Clinician of the Future: 2023 Education Edition” surveyed 2,212 students, of which 446 were in the United States, from 91 countries.
