Chiro Cleanup – Part 4: Dirty Laundry

It certainly seems that the millisecond some of us walk across, the stage, out the door, and into the great wide open, we start accumulating some.  Indeed, in time, each of these items will warrant–and receive–its own post, but for now, I’ll provide the Cliff’s Notes, which are by no means a complete list.

(I’ll preface all this by acknowledging that there are a few bad apples in every profession, and that the field of chiropractic is not in any way unique in that regard.  I also wholeheartedly agree that most DCs get sick people well on a daily basis, without breaking laws or resorting to unflattering schemes.  However, over the years, my dismissal of extreme stories as simple urban legends, horror stories, or exaggerated rumors gave way to a realization that we have a few more bad apples than we care to admit to.  And it’s time we did some admitting, followed immediately by some cleaning house.)

We have closet perverts in our midst.

Shortly after she graduated high school, my mother was rear-ended and experienced whiplash.  Intelligently, she sought chiropractic care.  Unfortunately, she was met with a weirdo who put her in side-posture…in a gown.

Another DC I personally knew went out of business just as he was getting started because he made too many female patients (also all people I knew) feel uncomfortable.  Whether it was an inappropriate conversation topic or subtleties in the way he handled patients during the adjustment, these ladies got creeped out, and he had to close up shop in less than a year.

We have cults in our midst.

It’s easy to get blind-sided by these freaks.  It’s especially easy when you’re new or otherwise struggling, and naive.  These people, most of them linked strongly in some way to the “Church” (Cult) of Scientology, swoop in and appear to rescue you, with promises of doubling or tripling your practice.  In reality, their tactics are old, tired, and failed high-pressure sales tactics that I would expect more from used car salesmen than doctors.  Worse, many of these companies are merely front-groups for these cults and many eventually attempt to sucker you and/or your patients into the cult, where they (and/or you) subsequently runs the risk of financial, social, professional, mental, and physical ruin.

Practice management groups aren’t the only thinly-veiled predators; others include certain chiro-specific tools (beginning with “Pro”, ending with “Adjuster”), as well as a few suspected nutritional supplement companies.  Additionally, I constantly see my friends and colleagues post links to natural health-oriented articles on Facebook that, with just a Google search or two, prove to be sponsored by these cultish front-groups. While we may agree with the message, it’s dangerous to post links from those sources, as they are dangerous people.

We have tacky slackers in our midst.

The same people who wore shorts, ratty T-shirts and flip-flops to school are the same people who dress down too casually in practice as well.  With any luck, they’ve ditched the flip-flops for real shoes, but these are the folks who swore off the white jacket and/or a button down shirt with a tie within seconds of checking out of outpatient clinic.

It’s all well and good that you want to be comfortable (both in terms of physical freedom and congruency with who you are), but the fact is, we’re still doctors and people look up to us to set certain examples and fill certain preset roles with certain expectations.  A simple mention of the word “doctor” conjures up a certain image.  The question is, how closely do you resemble that image?  The next question is, are you having trouble with patient acquisition and/or retention?

I’ll let that one stew a while.  Think about it.

We have simplistic mental slackers in our midst, too.

You know the type.  They endlessly complained about having to learn Biochemistry or Neuroscience because all they were going to do is adjust.  They didn’t see the need to learn all this Physiology or Pathology because it’s “too medical” and all they were going to do is “detect and correct subluxation”.

Well, I hate to pop your bubble or shatter your utopia, but being a doctor is a lot more than that.  Those who never fully grasped their Neuro will also fail with several patients because the type of adjusting performed by the typical chiro (Diversified, flying 7-style) will literally make some of these people worse, because it provides aberrant (unhealthy, unbalanced) information to their (already wrecked) nervous system.

I should know.  I was one of those people.  I’ve been adjusted in ways that agreed with my nervous system, and I also spent a several-year stint getting adjusted in a way that my nervous system did not like and my health deteriorated as a result.

The second mistake too many of us make involves how we respond to those that don’t respond to our initial round of care.  If someone is getting worse over time despite regular chiropractic visits, this warrants further investigation, and it is utterly irresponsible to continue treating them, maintaining status quo, without first digging through textbooks or consulting with colleagues.

Too often, when the patient isn’t improving, we blame the patient without taking a look at ourselves or examining a possible mismatch between the treatment administered and the patient’s actual needs.  We initially admire chiropractic for its sheer simplicity, failing to realize that it is not simplistic at all.  Show me a DC who seeks nothing more than the detection and correction of subluxation and I will show you a lazy doctor who is covering for the fact that s/he didn’t actually understand Neuro and who simply does not know the first thing about actually getting a patient well.  It has a lot less to do with simply moving bones than the original founders thought.

We get stuck on old theories of the past.

Speaking of our founders, I see way too much Green Book (Chiro-Bible)-thumping.  Too many people want to reference DD and BJ Palmer and what they said and did.  Indeed, I have news: they were wrong.  DD came up with neurophysiological theories; as state of the art as they were for his time, they were each disproven in turn. BJ was a chiro-evangelical nutcase who was a genius at marketing the profession, dazzling the public with new gizmos, and little else.

Honestly, the whole bone-on-nerve scenario only actually exists in about 5% of the cases.  The true beauty of chiropractic exists at the central level and the potential Functional Neurological miracles attained therein, not simply removing some peripheral interference.  But since the beginning of chiro-time, DCs have had a very poor grasp on how the brain and nervous system actually work.  I find it both amusing and appalling that DCs have the “nerve” to call themselves “nerve doctors” and yet only a tiny sliver actually end up enrolled in the neurology program at Carrick Institute (the only approved post-doctoral neurological education) and actually go on to become proficient at nervous system disorders.

Very interesting indeed.

We get caught up in Multi-Level-Marketing (MLM) companies.

I have plenty of colleagues (and indeed friends) who have gotten caught up in MLM schemes.  As legit as they may appear on the surface, they’re all the same underneath: a few people at the top make the lion’s share of the money, and everyone underneath is scrambling to make their initial investment money back, meanwhile boasting (untruthfully) about how successful they are and how great things are going.

I’ve been approached by numerous Juice Plus distributors, several Kangen water distributors, Nikken, you name it.  Melaleuca and Monavie (especially the latter) have been the most persistent.  The answer is always (and always will be) NO.

We get caught up in money grabs.

Come on.  X-rays on every single patient?  I can understand why one would want to do this (you’ve got to know what you’re looking at, and it provides evidence for rendering stronger diagnoses and submitting longer treatment plans to insurance companies) but I hope that anyone taking x-rays on every patient would keep it clean and send them to an imaging center.  Better yet, provide a list of available centers and let the patient choose.

Or, we prescribe a gazillion supplements to patients (and here’s the operate phrase: ) without telling them what they’re supposed to accomplish and then checking up to make sure they’re working.  I know that I get more than a little suspicious when I see an entire wall occupied by bookshelves that contain an entire line of one or two supplement companies.  I start to wonder what the doc is going to attempt to sell me.

Or how about the time my parents were both ordered an MRI immediately when starting care under a particular DC?  They had no unusual complaints or symptoms.  They were never told why the MRI was necessary; the doc just sent them as part of his initial routine workup.  Really??  The best part was, he had part ownership of the MRI facility.  Can you say, conflict of interest?

As I mentioned, each of these will receive a lot of further discussion later.  We have many more stories to tell and examples to give about each topic.  We continue to receive other doc’s former patients without even trying to recruit them or “steal” them away.

But even though we personally benefit from other doctor’s screw-ups, the profession itself loses dearly as a whole.  This has a much greater effect across the entire population than the few patients who end up at our office after having made the choice to give chiropractic another chance.

I have a few possible solutions.  That post is next.

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