A few years ago, a friend of mine and I were hiking up a mountain in the British Columbia wilderness. It was a steep climb that took us up quite high, but it didn't require any special equipment.
As we hiked, my friend related his experience the year before when he and several companions ventured upon this trek. They began the hike in the sunshine, but the weather abruptly changed into a snowstorm and ever-increasing poor visibility. Still desiring to reach the top, they pushed on. Coming upon a small pond, they paused to rest and reassess. After a short break, they decided to turn back.
As we reached that same pond, a curious look crossed my friend's face. I followed his gaze. The summit was in plain sight, only a short hike away. Now I understood his look. Had he and his party had decent visibility the year before, they would have continued the climb and easily made it to the top.
The chiropractic profession has taken chances before to make things happen. Chiropractic history is filled with stories of sacrifice and determination that ultimately paid off in great gains. Not all the battles have led to victories, but chiropractors have a reputation as health care professionals that will go to great lengths to make a point or win a lawsuit.
In the 21st century, chiropractic enjoys the position of being the most accepted "alternative" health field in the U.S. Many believe that we are now mainstream. There is an unmistakable feeling of accomplishment as we enjoy almost constant attention from the public and the media. The news isn't always good, but being constantly thought of seems to take some of the sting out of any bad press.
But have we gotten too comfortable?
Is the fear of losing what we've gained keeping us from moving forward?
Are we still willing to take risks, or are we content where we are?
In many ways, the going is getting tougher. Like my friend's first climb, it is taking more determination to effectively address our current challenges. Are we willing to settle for less? Are we afraid to speak up for fear of ridicule or "another lawsuit"?
When we hesitate, someone else takes the lead. Here are three examples of actions that should have been lead by chiropractic:
Suspend Their License to Practice
On February 22, 2000, the Texas Medical Board suspended the license of a MD who was the medical director for a local HMO. He had denied care for a dying 13-year-old boy. The medical board wanted to establish that denying care was a medical issue and that they would act accordingly. A lawsuit is in progress, but win or lose, the Texas Medical Board has sent a message to MDs, managed care companies and legislators, that the medical decision/benefit-determination shell game has to stop.
Some question whether the Texas Medical Board has the authority. Whether they do or not, they didn't ignore the situation. The board took action and it made front page news.1Why can't our chiropractic boards take such bold action?
Antibiotic Abuse
It's only been a few years since the American Public Health Association (APHA) included a Chiropractic Health Care section. Two years ago, when all of the research was being published warning of the consequences inherent in the misuse and abuse of antibiotics, the suggestion was made for the Chiropractic Section to champion this cause.
But being new in the APHA, no one really felt comfortable leading the charge on this controversial issue. A year later, another group within the APHA proposed policy language addressing this topic. An overwhelming majority of APHA members support this issue. The opportunity to lead was there, but we chose to wait and then follow.
Defining Ourselves without Fear
A paper recently published2 presented the results of a survey of Boston-area DCs about the care of pediatric patients. The paper was a descriptive article, rather than a scientific study. It gave a fairly accurate assessment of chiropractic pediatric practices.
However, because this article was presented from a medical point, it discussed chiropractic care for children as some sort of plague. Even the journal's editor, Dr. Catherine DeAngelis, felt compelled to add her own little cheap shot at the beginning of the article:
"When I contemplate a chiropractor treating a 2-week-old neonate with fever, I get a gigantic headache."
Why didn't a chiropractic research chiropractic for children? Then instead of sounding the alarm, the article would have encouraged greater understanding and cooperation between health care professions. It takes courage to put yourself on the line. Such action is usually met with respect.
These are just three recent examples of instances where the chiropractic profession has either missed an opportunity or settled for second place. There is greater risk in leadership, in doing something that's never been done (thought to be impossible) or that is not well supported. For this profession to remain a viable contender in the health care arena, we will have to take some chances.
Sometimes, we will lose. Still, I would rather put up a tough fight and be defeated than lie down and let someone else win without a contest. In the end, we may lose either way. But in the first case, we'll earn the reputation and respect as worthy opponents. In the latter case, we reap nothing.
References
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
