The field of chiropractic and those who practice it get hit from all sides. Those of us trying to actually help our patients with problems beyond the Holy Chiro Trinity of (say it with me now) “back pain, neck pain, and headaches” are under attack from multiple angles, and for different reasons. This post is meant to openly call them out and launch a little fire in return.
I’ll address each group individually.
Open Letter #1: To the Medical Mafia
I’m speaking here to practitioners of conventional medicine who have all the power and glory forever and ever–the self-proclaimed cultural authority on all things medical. This does not include all conventionally-trained practitioners; it is aimed at the most narrow-minded who seek to obtain and maintain a monopoly on the practice of medicine.
Medical Mafia, by helping patients with their metabolic problems and chronic conditions, we’re not trying to do what you do. We’re trying to do what you’re FAILING to do, which is care for people with chronic conditions. The 3-minute visits that result only in prescriptions for symptom-based drugs do very little for those with chronic, multifactorial problems. I dare say in many cases that approach does NOTHING. I have the luxuries of time and energy and would like to simply have the legal and uncontested right to serve the suffering public out there by picking up the slack and trust me–there’s a lot of slack to pick up. I am properly educated to do what I’m doing and I supervise my patients properly and frequently and because of that, what I’m doing isn’t harming anyone. Of course, there’s the possibility that it could–hell, too much water can kill you–but my methods pose no greater harm (nor anywhere near the harm) that one of the almighty prescription meds do. And I see my patients every 2-4 weeks (on average) instead of every 2-6 months, in order to supervise them properly. So move over and leave a little room for the qualified, licensed holistic healthcare approaches and practitioners out there because they’re keeping what you deem “problem patients” anyway OUT of your office. Don’t worry–given the state of healthcare in general Western society, you’ll have plenty of med-seeking patients left. You’re not hurting.
Open Letter #2: To the Chiro Mafia
This is aimed toward the many people with whom we went to school who bemoaned having to take Biochemistry and Neuroscience because they “just wanted to adjust”. It’s also aimed at the “above-down-inside-out” “Principled” DCs who cry and pout that “(nutrition/acupuncture/homeopathy/other) is ‘not chiropractic’!” and that we shouldn’t be doing those things. These folks continue to hang onto the outdated idea that all someone needs is an adjustment and that an adjustment will cure any ailment.
To those DCs, I say, if you don’t feel confident in yourself to do more than find the high spot and knock it down (known in fancy terms as “detect and correct subluxation”) (a feeling which is understandable given the sorry state of some of the schools out there), and you feel that my kind of “intellectual elite” (your term) is, underneath, a threat to you or the field, then I call upon you to focus on yourself and not me. If you are truly comfortable and confident in what you do, then what I do does not matter to you. You’ll be too busy to pay attention to me. Sharpen your own skills. Develop your own niche. Don’t try to silence us, outvote us, bust us, or otherwise eliminate us just because deep down, you’re afraid we’ll look better than you or increase the public’s overall expectations of you. You hold the doctor title and with that title come expectations; so grow a pair and act like one. If you’re lazy or have a poverty/inferiority complex, seek professional help. I can’t help you and getting me to go away won’t help you either. I know you’re against DCs prescribing medications. I know you don’t think people need nutritional supplementation. I know you failed to show up for 7am Biochemistry and you squeaked by with a 72 in Neuro class and promptly dumped all that info because you “just wanted to detect and correct subluxation”. If you don’t want to prescribe meds or recommend supplementation or do neurological rehab, that’s fine–don’t–but cease and desist with the *death threats* that some of you lobbed against some of my more-educated, progressive colleagues who have testified as expert witnesses in court that these modalities could arguably fit under the umbrella of chiropractic practice.
Open Letter #3: To the Texas Medical Association (and others pulling the same crap)
You’ve taken the Texas chiropractic board to court, attempting to sue to whittle down our scope of practice into practically nothing. You’ve been ruled against again and again. Truth be told, this all started with the infamous Wilk vs the AMA case in 1976, a case in which five “lowly” DCs took on the monstrous American Medical Association and ultimately kicked your ass. You didn’t learn. Did you get that memo? So now the AMA wants to take things to the state level, using Texas as a prototype through which to set a dangerous precedent. The TMA is powerful, one of the more potent state medical associations in the country. The AMA figures that if they can win here on a state level, that a victory here will open the door to utilizing the same strategy in other states until they fall like dominoes, one by one, into the original goal to which they’ve clung all along.
I fail to see the legitimacy of a private professional association bringing a lawsuit against the regulatory board of another (that would be like the Texas Chiropractic Association suing the Texas Medical Board to take away your Manipulation Under Anasthesia rights–which should really have been kept under chiropractic, because we’re the manipulation experts, after all), but you keep doing it. Even after the last judge said, to paraphrase, “knock this shit off”, you keep appealing. Which is NOT appealing.
Open Letter #4: To the Chiropractic Schools:
NOT all educational institutions are created equal, and this holds doubly true for chiropractic schools. Some are cutting edge and extremely sophisticated, while others have firmly planted themselves in 1895 and refuse to budge. This open letter is intended for the latter.
“Straight” schools, you’re LYING to your prospective students. Actually, that’s not *entirely* true; rather, you’re promoting/quoting chiro gurus who lie to your prospective students. Your rah-rah motivational speakers at the assemblies and “extravaganza” seminars sound encouraging to the naive and eager hopefuls who see chiropractic as the end-all-be-all of careers. Hell–to hear these gurus speak, you’d end up thinking you could walk on water…after you’ve turned it into wine. It’s not until people get INTO school that they realize that while there are a lot of encouraging and utopic claims out there and many of them are probably true (hell, I’ve lived several of them myself!), few have bothered to take the time/effort/energy to write them up and get them published in a respected journal. Few have taken the time to quantify the successes or explain them scientifically. And the insurance companies didn’t get the memo that we can help with things like ear infections or a sluggish immune system or high blood pressure or what-have-you. They still think we’re not good for anything but back pain, neck pain, and headaches (see a theme here?) and that it only takes six visits to cure and they’ve shrunk chiropractic coverage drastically in the last 20 years. Yet, you ill-prepare students for that. Sure, there’s a half-assed business class or three, but they don’t tell you what you really need to know or how to actually get it done. In one breath, you’re telling students that they shouldn’t “lose their identity” by merging with mainstream medicine and becoming more accepted, and in a second breath, you’re telling them that they can cure all that ails (way beyond the musculoskeletal system), and in the third breath, you’re teaching “business” (Medicare and insurance coding) classes that require a 739.x ICD-9 code in order to be legit, get paid, and keep your ass out of hot water. At this point, students scratch their heads, shed some frustrated tears, and wonder, “what happened to the ear infections? The high blood pressure?”
Other business classes talk about revenue and reimbursement, that Medicare only pays $34 an adjustment, and you’re imagining an office with way too much square footage dedicated to an office for your full-time insurance biller, and you’re wondering what happened to the guy in the 1930s in Montana who adjusted out of his cattle barn and had 1200 people lined up across his field (true story, if you went to the motivational seminars!)
Meanwhile, you’ve taken Lab Diagnosis and other scientific classes out of the standard curriculum and replaced them with yet more philosophy. Way to prepare us for being real doctors. I can form my own philosophy, thank you. Part of that philosophy is the observation that chiropractic boards in some states set their scopes of practice based on what the average schools are teaching, and limit DCs to performing those tasks; if Lab Diagnosis is no longer required, this provides massive ammo for the medical associations to push for the abolition of lab work freedom for DCs. You’re taking steps backward, not forward, offering the opposition more fodder along the way. Thanks heaps.
Open Letter #5: To the Vendors
Yes, makers of chiro-toys and providers of chiropractic practice management groups, I slither my cross-hairs over to you and let’s face it–you come into really clear focus through my scope. Because you’re the DCs who graduated and either never started practice or failed out of practice, went down into the basement or up into the attic, fiddled with some gizmos, maybe hired a college whiz-kid, and came up with a toy you can market to the struggling DC looking for the next revenue-generating buzzword. Or maybe you headed into your home office instead and dreamed up some way to rehash cornball 1950s hard-sales techniques into something that looks shiny and new and you PREY upon newly-graduated, uncertain, desperate, deeply-indebted, broke new grads or those without business sense.
I know that you’re in bed with the schools because I see you there, in paid seminar booths, or you’ve claimed naming rights to some building in exchange for a hefty “donation”. I also know you’re in bed with the trade mags that tout the chiro-only crap because I see you there, too, with all the full-page, full-color, high-gloss ads. Hell, some of you switch camps along the way–Ben Altadonna started out in chiro-advertising and then once he’d chewed up and spit out all of his customers on failed doorknob coupons-for-chiros, he took a sabbatical and invented the Vax-D machine that made a heavy commercial splash a while back and trained his salespeople to tell their prospects that the procedure was covered under insurance codes that it was NOT, sold the machines to docs for six figures a pop, and then dunked his head back underground when those docs got busted for insurance fraud. Who knows where he’ll pop up next, but I’ll be sure to steer clear.
Open Letter #6: Conventional Yes-men of the Medical Establishment who think that everything besides drugs and surgery is quackery
You’re going to get your own post. You’ve been warned.
A final thought…
I am purposefully trying to avoid making sweeping generalizations here. These rants are intended only for those who are guilty of being an asshat as described in each Open Letter. If the shoe fits, wear it (and then try to take it off, of course, by changing your ways). If the truth hurts, tough. If these Open Letters do not apply to you, please don’t take offense.
My intention is NOT to condemn all DCs with deeply-felt old-school philosophies, it’s to call out those who act against us within by seeking to limit the scope for all of us. It’s NOT to condemn all MDs or DOs at all, it’s simply to criticize those who seek to attack us such that we DCs “wither on the vine” like the AMA itself originally wanted. It’s NOT to punish all technological entrepreneurs or management services, it’s to nail those who provide dubious products or services that promise the moon and end up chaining us to a wall while the company’s owners and salespeople get off scot-free. It’s NOT to slam ALL schools, it’s to shame those who fail to prepare their students to be DOCTORS, or attempt to brainwash students into believing that resolving the Vertebral Subluxation is our only purpose and responsibility.
Last but not least, it’s NOT an attack on chiropractic. Rather, it’s a desperate attempt to save it and propel it into the 21st century, properly-adapted and well-respected.