The Relevance of Joining

I hear it all too frequently: "I don't have the time to bother with a state association," or "Times are so tough ... I can't afford the dues." At a time when the profession enjoys greater status at many state houses than ever before, and when we are finally being invited to take a seat at the decision-making tables of government and industry, all too many chiropractors are following in the apathetic footsteps of our professional ancestors. We have a tradition of uniting under conditions of extreme threat, then fading back into our individual bunker mentalities when the danger has been met. All too often, the crises we confront are born of our own neglect of the professional and political contexts in which we all practice. We advocate an ounce of prevention when it comes to our patients' health, but seem to prefer a pound of cure when it comes to our professional lives.

"All politics," it has been suggested, "are local politics." How true for the professions in the United States, where our licensure and much regulation are determined at the state, rather than the national, level. To be sure, many federal decisions impact how we practice and how we are perceived (e.g., HIPAA, Medicare, the VA demonstration project). However, such basic issues as scope of practice, insurance reimbursement parity and business regulation are enacted and modified in the legislatures of the various states. Negotiations with industry and relationships with other elements of the health care system are more likely to take place at a local level. Our state associations are often the primary instruments for our collective interactions with the forces that shape the practice of chiropractic.

There is a troubling trend: "Let the other guy do it." We're all familiar with this; passing the buck is an unfortunate part of human nature. However, when we fail to develop proactive strategies in a state association; neglect to help the new doctors along the way; or ignore our responsibility to train the future leaders of our profession, we invite our own future misfortune. I'm reminded of Newt Gingrich: He was a great minority leader, but when he became speaker of the House, he didn't know how to perform his new role. Let's not make that mistake; we need to cultivate the leaders in our own ranks. As Carl Cleveland, DC, reminds us,* "We are all in this together!" We cannot afford a lapse in leadership at the state or national level; we have real enemies, and they will cram some sort of disabling legislation through when there is no one at the Capitol protecting our interests. In a very real sense, working with the state association is a way of guarding our individual practices.

There is a sadly mistaken rumor in our ranks that suggests belonging to - and heaven forbid, actually working in an association - will hurt your practice. I am living proof of just the opposite. (By now, you are probably saying, "Explain yourself!") First of all, active participation in state association work provides information that would otherwise take the uninvolved doctor in the field six months or more to obtain. Forewarned is forearmed; knowing the challenges we will confront before they are upon us provides individuals and groups the lead time to plan. Membership in our state association allows us to see trends that will eventually affect our practices (whether we like them or not).

Secondly, most of the doctors who are involved in state association work are successful (in the business sense of success), and the novice gains the opportunity of informal learning through example and discussion. Mingling with those who already have their "act" together, during and after the formal meetings, can yield insights that the new doctor can hardly expect to acquire from any practice consultant (at any price). And since most DCs continue to practice as solo clinicians, the state association offers an important opportunity to overcome the isolation that has historically plagued us. Real success is all about relationships - with your peers, your patients and other health care providers. The membership society is one great way to establish your social circle!

I started my membership in state associations almost 40 years ago. When I left Minnesota, I had 25 stickers proudly pasted on my wall representing continuous membership. When I moved to Arizona, joining our state association was one of my priorities. It's been an investment that has paid me back handsomely, and in many ways. Some of my most memorable experiences in chiropractic have occurred in association work. All in all, it has been a real growing experience- one that has impacted many other areas of my life.

Join your state and national associations, and help us overcome our defensiveness. Help us get past that attitude and begin to think more like a legitimate and accepted profession. Get involved and help us overcome our "bunker" mentality. Become a member and help chiropractic achieve that loftier position in society to which we aspire. Join, and I guarantee there will never be a dull moment. Cast your bread, your time and your money on the waters of association work, and be confident of the dividend we all will enjoy.

• Simple justice: defending your practice, your patients, your profession. Baltimore, Md: National Chiropractic Legal Action Fund, 2003 (videotape).