In my last column [Aug. 26 DC], I asked a few questions: Where would you be if you had not become a chiropractor? Where would you be today without the dedication of those who came before you? What is something you can do to make a difference? My article struck a sensitive chord with quite a number of you who read it, because I received a sizeable number of e-mails from readers telling their individual stories, complaining about leadership, seeking clarity, asking even more questions, looking for answers and searching for a way to get reconnected. If only a small number who read that column were in some way encouraged, I feel the message resonated. Many of you indicated that you were moved to rethink your current participation and energized to take some action.
Here are a few of the actual comments from e-mails I received. To protect the identities of these doctors, I have sanitized their names and in some instances condensed their thoughtful, but often lengthy e-mails. [Editor's note: Comments also have been edited for space and grammar where necessary.] I am certain some organizations will be offended, some individuals will be insulted and some groups will be defensive, but what I am hoping is that those leaders who want to make a change will listen to the voices of those they serve. The fact that these folks were motivated to put their feelings, positions, frustrations, opinions and suggestions in writing – and believe they have an outlet to vent – is a strong indication of their desire to reconnect.
What Your Colleagues Think
A DC in Iowa: "An especially timely and appropriate article. Seems that a sense of entitlement exists. Once, when asked to support the profession and join ACA, a DC's response to me was, 'I paid my tuition.' Things don't 'just happen' and now we must continue to reinforce the gains we have made, [yet] lacking the support of too many of our own who benefit."
A DC in California: "You asked the 'why' question, about why someone would not participate. Not sure if you wanted to hear my answer to your question. Most of what I have seen from chiropractic organizations asking me for money or membership has been poor communication and lack of being in touch with the membership. When I was a student, I was a SACA and SICA member, hoping to do my part by being a member. But there was nothing from either group that made me feel proud or that I was valued as a member; nothing that would help me grow as a young professional. They took my money and that was about it.
"This has been the same for CCA (the California state association), ACA and ICA. They are good about sending me invoices for the annual dues, a few low-quality publications in the mail or by e-mail (none of which has helped me in practice or my professional career path), and still nothing that shows value to me as a member. These organizations complain about how bad things are getting, life is going in the toilet, but they do nothing to show that they are working to get us out of this mess. They have a tendency to take credit for work that others are doing and bang the drum as if it were their own. They do not do a good job with communicating to the membership or to the public and political community. Talk about a gap in leadership. Boy, are we experiencing it now.
"Here are some of the problems as I see them: 1) disconnect between what the membership needs and what the organization is doing; 2) few mechanisms for input or feedback from the membership to the leadership; 3) leadership not thinking about the larger picture: long-term gains (instead, they are short-term players); 4) image and cultural authority are lacking; no pride in being a member of these organizations; 5) poor communication; when anything good happens, not communicated back to the membership; and 6) lack of appropriate personnel and infrastructure to be a successful organization.
"Add these together and they result in members feeling hopeless, undervalued and disconnected. How long will someone contribute to an organization that is performing poorly? They need to take lessons from organizations that are successful. Not just mimic them, but actually do what it takes to make it work."
A DC in the Midwest: "Dr. Sportelli, I was sitting here at home, reviewing my notes for a meeting, and decided to glance at the Dynamic Chiropractic that just came in the mail. After reading your article, I felt it was important to send you a short note. Without going into detail, the existing association is being run by a couple of individuals who only have their personal agenda at heart. Using your words, I am 'losing it.' I have a great practice and an incredible life, and I have chiropractic and our leaders from the past to thank for it. I will be making a lot of noise, all for the protection and progression of our beautiful profession."
A DC in South Carolina: "I read your recent article in DC over lunch today. It was just the Monday motivation I needed. Thank you for your insights and dedication to the profession. As a second-generation DC, I share your concerns. I hope that history treats us kindly."
A DC in New York: "I thought your recent article was on the mark. It reminded me of the action steps I ask my fellow members to think about and implement using metaphors: i.e., draw a line in the sand, sticking your head in the sand only leaves your glutes exposed, a candle loses nothing by lighting another candle and makes the word brighter, etc. Being in practice since 1981 has shown and taught me the marvels of chiropractic, and the great work and healing our profession offers the public. Chiropractic is at the crossroads of its very existence. Our profession needs to get up, stand up and be heard. If not us, then who? Please continue to speak out and challenge our DCs to do more, as our collective survival depends on it!"
A DC in California: "Your article is inspiring and helpful; we need to stay involved. And yes, when we do not hang together, we will hang separately. Because of the dire circumstances of most practices I know of in California – and that could include my own, having retreated to a home office to stave off expenses as my income dropped – I sometimes feel that we are already hung. Hung by the culture of corporate profiteering, insurance profiteering, pharmaceutical profiteering; reminds me of the Madoff and Enron scams. But your article makes we want to get up and brush myself off one more time. A graduate of LACC (1976), I am one who remained an active ACA and CCA member for years, but like so many others, dropped off disillusioned. I have written many a chiropractic article to my local papers when provoked by printed distortions and lies directed at us over the years, but not lately. Thank you."
A DC in Pennsylvania: "Whether you asked rhetorically or not, I am answering the question you posed in your article this month in DC. 'What can I do to make a difference?' For me, what has inspired me to renew my ACA membership, and to also rejoin my state association after many years of being a non-member, was another question you posed in your article. The question was, 'Where would I be today without the dedication of those leaders who came before me, who paved the way for the profession to advance, often at great personal sacrifice and peril?' I am truly blessed today not only from God's presence in my life and the choices I've made, but I recognize even more now after your article that my wife and I would have never been able to pursue our dream had it not been for the men and women who fought for this wonderful profession I now call my life's calling.
"You are right in addressing a problem that we all sometimes not only fail to recognize as a problem within our profession, but many times, simply leave for the 'other guy' to fix. I for one will do what I can to help this profession continue to be a beacon of hope not only for future chiropractors, but for the many patients we serve; who look to us for answers no one else has been able to provide. Thank you, Dr. Sportelli, for igniting a sense of purpose in me once again."
A DC in Nevada: "I graduated from Palmer College in 1988. I have met some of the pioneers in chiropractic. I have been part of my state association and national association. I have been part of my college alumni association. But like your article states, I too have become distant from the associations. I fought the fight for so many years; at some point, you throw your arms up and say, 'Why?'
"I guess my most poignant concern is the split between our own profession and the various associations. Example: The medical profession has but one main organization, the AMA, and the same is true for the dentists and optometrists, vets, etc. But in our profession, we have two or three associations. We have split our own profession. I know you are all too familiar with the ACA vs. ICA, and then there is the WCA. Would it not be more advantageous to have one true organization? I do not have the answers, but I did enjoy your article. I am successful in my practice and have always promoted my profession. I too had to deal with a lot of hate from other professions when I started.; to the point that I almost decided to go back to school and become a medical doctor. I am glad I did not do that. I feel very confident in what I provide my patients, but I do recognize the need to support my profession. Thanks again for your recent uplifting article."
A DC in Illinois: "I feel a bit called out, but somehow I am happy about it. I have been a chiropractor for 16 years. I have six other chiropractors who work at my office and I love what we do every day. I would like to think that I know quite a lot clinically. I know nothing nationally or in my state. I have taken for granted that my profession will always be there because I know of its effectiveness. I have made assumptions that are not accurate and I am troubled by my lack of involvement. Today, I am making a conscious choice to do my part. It may be too late, but I still have strength. I also have the 16 years of experience that allows me to fight for a profession that wins every day. I have joined my state organization. Today, I join the ACA. I want to help; what can I do?"
A DC in Pennsylvania: "Your article was a bull's-eye. Now that you have identified the problem, I await your next article that will address the solution to the problem. In all of my discussions, I explain how DCs are now isolated not only from the health care mainstream, but also from each other. No one even knows the chiropractor next door, let alone across town. The online classes are not helping the situation, either. How to motivate and mobilize; that is the $65,000 question."
Brainstorming New Ways to Encourage Participation
Again, these are just some of the many comments I received. All were thoughtful, emotional, constructive, instructive and honest. You can understand why I have omitted names and other particulars in order to protect the identity of these individuals, but I am hopeful that they will continue to participate personally, speak out and influence the organization they elect to support; and that their comments, however critical, will inspire the organization(s) mentioned to improve and grow.
The Pennsylvania doctor (last comment) asks perhaps the most important question – the "$65,000 question," as they put it: How do we mobilize and motivate the large number of DCs who are not participating? For most national and state organizations, leadership changes occur during their fall conventions. I know the ACA just changed leadership, as was the case for the state association here in Pennsylvania [the PCA].
As many of you have heard, the definition of insanity is "doing the same thing over and over and expecting a different result." Perhaps all the new leaders of these organizations around the country will simply stop whatever they are doing for a few moments and concentrate on addressing some of the following questions:
- What are the reasons membership is down?
- How can we better communicate with our members?
- How can we provide the value our members are needing?
- How can we be more responsive to our members?
- What have we changed in governance and/or services benefits?
- Are we changing our model of business to meet the current needs?
- How can we improve services and improve efficiency?
- Are we meeting our membership expectations?
- When is the last time we did a real profession-wide survey?
- Have we brought in outside professionals for advice?
- Are we keeping up with new technology needed to communicate in the 21st century?
- Is there simply a "better way" to do what we currently do? If so, why aren't we doing it?
Moving Forward
Answering the above questions is certainly a first step in rethinking the accomplishments of the past, as well as those endeavors that were failures. The demographics, psychographics and biographics of the profession in the 21st century are certainly vastly different than just a half century ago. How many organizations have truly "reinvented themselves" to better serve their membership, the profession and the public?
The various organizations lamenting their lack of membership need to remind themselves that doctors in the field use the same decision-making process in electing to join an association as they do with most other business decisions. The thought process likely involves asking oneself: Which association will provide the best return on my investment? Which association has actually accomplished something tangible for the profession? Which organization has the greatest transparency and the same vision for the future that I do? Hopefully, organizations and leaders throughout the profession understand that we are at a critical time in our profession. Times are changing and new ways to communicate core values are more important than ever.
It is not only time to begin asking questions of the profession; it is also long past the time to engage "outside counsel and advisors," begin with a blank piece of paper and with no preconceived ideas of how things should be, and ask ourselves: How can we transform our organizations and our profession into a viable force with a strategic new direction for the 21st century? Unless we do, there are serious and perhaps grave consequences for the future of the profession. Thanks to the many doctors who took the time to send in comments; hopefully organizational leaders will read them and take action.
