THE CHIROPRACTIC CRUSADER
A ROADMAP TO BECOMING A MAJOR PLAYER IN HEALTHCARE BY FRED BECK, D.C.
CHIROPRACTIC PHILOSOPHY GONE AWRY – COLUMN 3
IT IS TIME TO END OUR ISOLATION AND CLAIM OUR RIGHTFUL PLACE IN THE AMERICAN HEALTHCARE SYSTEM
I’m sure that you have had patients that were experiencing infertility problems. Quite frequently, this problem is quickly eradicated with Chiropractic care. The next day, was your waiting room full of patients with fertility problems seeking care? I sincerely doubt it. When that asthmatic patient entered your office and their condition was quickly and permanently eliminated, was your waiting room full of asthmatic patients seeking care the next day? That didn’t happen either. When you adjusted that patient and his hearing returned, and the event was even confirmed by the local audiologist, was your waiting room full of patients experiencing hearing difficulties the next day? I’m sure that your success with these disorders and many others had a negligible effect on your practice. Your patient may have tried to refer a friend or two that had similar health problems but they probably never showed up at your door. Chances are that the patient went back to their primary doctor and to their specialist and reported the positive results of your treatment to them. Did their doctors ever contact you to ask about the treatment? Most likely not. After hearing about your miraculous results did these allopathic doctors refer similar patients to you? That never happened, did it? Not in this world. We are so isolated, and so far outside the healthcare system, that this profession lacks credibility, even when we obtain consistent results with certain conditions.
I’ve stated before that it is our responsibility to determining a proper medical diagnosis as well as a proper Chiropractic diagnosis. Lets face it people, our strategy of isolating ourselves from the other healthcare providers and increasing public awareness of our profession is not working. We are not expanding our patient base and very possibly slowly losing the miniscule percentage of population that seek our care. Keeping ourselves isolated from the rest of the healthcare community is just plain stupid and suicidal. Our isolation has prevented us from receiving huge amounts of research dollars we could be receiving. We have lost hundreds of millions, if not billions of dollars by allowing ourselves to be locked out of the health system and the United States hospital system. If we were part of the American healthcare system, we would easily be getting a vast number of referrals from the allopathic profession. It seems only fair when you consider the vast number of referrals we send in their direction while the medical profession rarely refers in our direction. I believe that we can position ourselves so that we will receive referrals from allopathic practitioners that will far outnumber the referrals that they are now making to physical therapists. And all this without giving up our identities or our practice rights as physicians.
I’ve mentioned in prior articles that we may have very easily obtained hospital privileges in almost every U.S. hospital. A Chiropractic department in each and every hospital in the United States should be mandatory for hospital accreditation. The Joint Commission on Accreditation was willing to meet with the ACA to discuss this proposal by me, but the ACA was not interested. The positive press of having Chiropractors in our nations hospitals would have increased the number of patients seeking our services tremendously. We would not have had to give up any of our practice rights and would have practiced according to the scope of practice laws in our state. This would have ended our isolation from the rest of the healthcare community. This would have resulted in a very positive public awareness of our profession. Thousands of professional workplace opportunities for Chiropractors across the country would have been a consequence of such action. Our leadership for some reason believes that twenty something job opportunities for Chiropractors at Veterans Hospitals, with limited privileges, and care provided under script of a Medical doctor is the only way to go. I hate to say this, but I believe that our trade organization leadership has a very low regard for the professionalism, ethics, diagnostic skills, and clinical effectiveness of the average Chiropractic practitioner. Unfortunately, these leaders are thinking the same thoughts as many of the 95% of the community that never seek the services of a Chiropractor. As crazy as it may seem, I believe our own leadership has such a low regard for the average Chiropractor that they believe they are protecting the American public from us. Maybe a crazy thought, but then again, I’ve run into brick walls when handing potential practice opportunities to our leaders on silver platters. Hospital privileges, new professional sport opportunities, Social Security Disability Examination opportunities, all of no interest to our Chiropractic leaders. All handed over on a silver platter to the organizations that represent us. Each and every opportunity handed over at the end stage, where a minimal amount of time, financial support, and effort would be necessary to close the deal. All opportunities allowing us to practice within the full scope of our present State laws, and never under medical supervision.
We must remember that even some of our professions own representatives may just be doing their jobs. They may never have been to a Chiropractor. Their immediate family and friends may never have been helped by a Chiropractor. Even worse, they may have had a negative experience with a Chiropractor. They may do a terrific job trying to keep the status quo. But down deep they may be so medically oriented and medically indoctrinated themselves that they themselves feel this profession lacks credibility. As many other outsiders, they may lack trust and question the integrity of the Chiropractic profession. Down deep they may believe that an expansion of practice opportunities may be a bit too much. Expanding practice opportunities will result in us seeing a greater proportion of the population. Some leadership that may doubt the integrity, safety and clinical effectiveness of the Chiropractic profession, may attempt to do the minimum work necessary to keep the status quo and avoid any opportunities that would expand the role of Chiropractic in the American healthcare system.
We must clean house. We cannot continue to allow the small but vocal portion of profession that preaches ignorance is bliss to steer this profession toward oblivion. Unscrupulous practice building techniques needs to be addressed. Our leadership needs to be held accountable. The profession needs to strive to be the best that they can be. We should be concentrating on techniques to help more patients with their health, not on techniques solely designed to procure more money out of a patient’s wallet. We must hold our leadership accountable. If they refuse to follow through on improving practice opportunities, and are interested in only keeping the status quo, we need to find new leaders. If our leadership is willing to have us give up practice right and allow an allopathic physicians to act as gatekeepers for our profession, we must find new leaders. If our leadership appears to sabotage negotiations on practice opportunities on a routine basis, we must find new leaders. We’ve always been quick to blame the allopath as the enemy. We blame them for holding the Chiropractic profession back from obtaining our rightful place in the U.S. healthcare system. Maybe they are not as much the enemy as the enemy within.
Our research must obtain a much higher level of intra-examiner reliability. Our institutions must do a better job of researching and integrating techniques into a workable treatment model.
Research must be conducted to determine the effectiveness of Chiropractic care with various non-musculo-skeletal conditions. In addition, research should help us determine in advance, which patients with a named health condition are most likely to respond to care.
We must put claim to our rightful place in the American healthcare system. We no longer can stand on the outside looking in. No matter how bad the American healthcare system is, it is not going to collapse anytime soon. If you really believe that you are going to wake up one morning to find that the allopathic healthcare system has collapsed, you are sadly delusional. If you believe in addition that once the allopathic healthcare system collapses all those patients are going to flock to your doors, you really indeed are living in a fantasy world!
When you know what you are doing as a Chiropractor you can achieve long lasting, very good to excellent clinical outcomes, on the vast majority of your patients with neuro-musculo-skeletal conditions. Treatment results should be quick and effectively. If this is not the case, you must improve your knowledge and your skills. If you keep good clinical records you are aware that many internal conditions also respond well to the care that we provide. If you are of the mindset that Chiropractic care is only effective for some musculo-skeletal conditions, then your record keeping may be deficient. If your care is not having an effect on substantial number of internal disorders than you probably are also not achieving a positive outcome on many of your musculo-skeletal patients. When we help a patient we must scientifically document it. We should not rely on the allopathic profession to document our clinical results. That is something we must do ourselves.
You’ve heard me state that we need to make a medical diagnosis in addition to a Chiropractic diagnosis. Why do we need to make a proper medical diagnosis? First of all our institutions taught us how to make a proper medical diagnosis. It is crazy to pass the buck and expect an M.D. or D.O. to make a medical diagnosis that you yourself should be making. If you believe that the average allopathic physician is making a better medical diagnosis than you are, you really have been practicing in isolation.
When indicated we must perform imaging studies, laboratory testing and other proven, accepted diagnostic testing modalities necessary to arrive at an accurate differential diagnosis. To document a patient’s response to care, clinical testing is also necessary. It is ludicrous to rely on an allopathic physician to arrive at a correct differential medical diagnosis, when you’ve spent about as much time in class learning differential diagnosis as he has. Granted, he may have had more clinical experience than you considering he is seeing close to 100% of the population and you are seeing only 5% or so. He also may have more experience seeing patients in the hospital where you’ve been locked out of as a Chiropractor. But you know what? You have textbooks. You can always open a book and refresh your memory on a condition. This may actually give you the advantage over the allopath at arriving at a correct diagnosis considering you are willing to do some research and he may rely entirely on his memory.
If I have my way, hospital privileges will be available to all Chiropractors in the near future. Hopefully our own trade organizations do not try to sell us out and prevent this from happening. There should be some oversight in regards to hospital privileges to assure us that our leaders do not unfairly negotiate restricted privileges, which keeps us from practicing within the full scope of State practice laws. An allopathic referral should not be necessary to receive Chiropractic care. We should take responsibility of documenting our clinical results ourselves and not expect someone from another branch of healthcare to do this for us. We must end our isolationism, and stake claim to our rightful place in the American healthcare system.
THE CHIROPRACTIC CRUSADER
A ROADMAP TO BECOMING A MAJOR PLAYER IN HEALTHCARE BY FRED BECK, D.C.
My new column may upset many Chiropractors. Our profession is driving blindly without a roadmap. We appear to be clueless as to which direction to choose.Without knowing where we are supposed to head to will guarantee we never get there. Eventually we will run out of gas and our journey will end. I hope that the ideas presented in my articles will eventually result in positive change within the Chiropractic profession. A prevailing theme that you will notice is that we are our own worst enemy. Quite a lot of time and resources have been expended to fight among ourselves. Our time and resources should be utilized to draw a detailed map; choosing a destination; and then map out the best route to get there. We need to know where we are going before we can get there. Our profession is presently lost. I’m hoping that this column helps our leadership find its way.
We must stop our internal bickering and make it our goal to become the number one natural healthcare profession in the world. You should not be calling yourself number one when you are only seeing a minuscule 5% percentage of the population. We should and could be the doctors that a very large segment of the general population decides to go to as their primary doctor. I will give you a roadmap and solutions to becoming a major player in the healthcare market.
None of the recommendations that I have made require a change to the Chiropractic scope of practice laws. By the time I am done, I hope my efforts will result in our leadership becoming more responsive to the doctors that they purport to represent. We will discuss how poor leadership has resulted in many missed opportunities to expand practice opportunities. All hospitals in the United States should have Chiropractors on staff and I will present documentation demonstrating that this could already be a reality if we had stronger leadership. Chiropractors should be routinely performing Social Security Disability Examinations and I will present documentation that this is not the case due to poor leadership. Missed opportunities to expand our involvement in sports will also be discussed.
The ulterior motives of practice management firms and Chiropractic organizations that attempt to transform the profession into a pseudo-religion will be discussed, as well as the negative impact these organizations have had on the general populations perception of Chiropractic. On the positive side we will discuss the need for a unified profession and a national association responsive to the present needs of the field practitioner and the future of the profession. The survival of Chiropractic requires that we get our act together immediately or there may not be a future for this profession.
I will discuss our educational institutions failure to adequately research many of the Chiropractic techniques to determine which work and which do not. We need to determine which theories of determining the location and spatial orientation of subluxations actually hold water.
The Chiropractic profession needs to finally integrate the most effective components of Chiropractic techniques by way of research and the scientific method. Only then will there be some consistency of clinical results among field practitioners. This will result in a profession that can rely on the “science of chiropractic” more so than the “art of chiropractic” to achieve better and more consistent clinical outcomes.
Finally, I will discuss the dynamics of the subluxation complex. I will present my own theories on how to determine and correct spinal subluxations. I will integrate many of the present chiropractic theories and techniques into a universal model. This will help the field practitioner choose from a vast array of chiropractic techniques to accomplish the same goal. Utilizing an integrated model can help achieve conformity among physicians when determining an effective treatment strategy to correctly determine the spatial orientation of a subluxation and its correction.
The majority of past and present thought on the subluxation complex do not hypothetically allow for a unified theory. Chiropractic theory usually assumes a randomness of subluxation and then attempts to determine the correction of such subluxations by way of different signs, symptoms, indicators, mathematics, imaging techniques etc. I will present my own theoretical model of the subluxation complex, developed over the years utilizing the scientific method. It is my opinion that subluxations are predictable and do not occur randomly. I believe that we can have close to 100% agreement among field practitioners as to determining the abnormal position of the subluxated segment(s), while still allowing the field practitioner a multitude of techniques and treatment strategies to achieve such correction.
Utilizing my theoretical model of the subluxation complex should achieve quick, very good to excellent clinical results in a vast majority of your patients. The typical patients should see dramatic improvement within the first few visits. My system should significantly help prevent the patient with acute symptoms from becoming chronic. A unified adjustment model will help achieve effective stabilized spinal mechanics. My theoretical model should also help eliminate negative outcomes due to manipulating vertebrae in the wrong direction. I will discuss my theory that even an adjustment in the wrong direction can give temporary relief of symptoms, but that such treatment can eventually result in the condition becoming chronic. Treatment plans should provide for manipulative treatment that is consistent from visit to visit. Patients should demonstrate consistent improvement over the entire course of treatment. You correct the subluxation, stabilize the spine, and the patient in most cases will not need additional care for the same complaint since symptoms have been eliminated or at least stabilized at maximum medical improvement. Care based on my subluxation model will result in better, more consistent outcomes. But it will also result in fewer patient visits, which is contrary to the teachings of many practice management firms. Some progressive, debilitating, chronic, neuro-muscular conditions may require ongoing care to maintain optimal results.
I hope that my biomechanical model will help establish a starting point for future research. I look forward to correspondence from other Chiropractors in the field who have come to the same conclusion that subluxations do not occur randomly and are therefore predictable. If you have data that disagrees with my findings, or data to add to my findings I would love to hear from you. There is always room for improvement. Research on the dynamics of the subluxation should never become stagnant.
PRINTER FRIENDLY PHILOSOPHY
ARTICLES IN FILE SHARING SECTION
QUESTIONS & ANSWERS
FEEL FREE TO SUBMIT YOUR QUESTIONS TO:
Q - Every organization there is within the profession seems to alienate one group
of Chiropractors or another. Do you believe a progressive organization such
as yours will be able to attract Chiropractors of the straight philosophy?
A- We understand that many chiropractors are afraid that Chiropractic Health
care will lose its identity such as what happened to the Osteopathic profession.
I do not believe that there is any organization, whether it is the ACA, ICA,
WCA, AACP etc. that does not believe that the primary goal of each and
every chiropractor is to adjust subluxations to remove nerve interference.
Just as most every other chiropractic organization, the U.S. Chiropractic
Association (USCA) believes that the most important thing that a Chiropractor
offers to patients is specific spinal manipulation/adjustments which usually results in
patients regaining their health, maintaining their health, or at the least improving
their health. Their are no other health professions that understand spinal
biomechanics to provide this service. This is what makes us unique and this
is something our organization would always protect.
Q - So I am a straight Chiropractor. Why would I be interested in the U.S.
Chiropractic Association? We already have plenty of organizations such as
A- If you have viewed the rest of the website you will see that Dr. Fred Beck
has an excellent ability to deal and negotiate with major health organizations
such as the Joint Commission on Hospitals. He is well prepared, and clearly
knows how to get his points across when negotiating. He knows how to take
a hard line on a subject yet keep negotiations friendly and professional.
He would never ever sell out the profession. Nor would he ever agree to
negotiate a settlement that would give up any practice rights. He would never
agree to anything short of direct access.
The USCA believes that organizations such as the ICA do not have
the know-how or sufficient membership to negotiate improved opportunities for
Chiropractors. The straight organizations many times also have a religious
overtone that may alienate those not familiar with the Chiropractic profession.
The USCA believes we should have the opportunity to have hospital privileges
if we wish. It does not mandate that you must seek hospital privileges. The
USCA believes that we should be able to perform Social Security Disability
Examinations. The USCA believes that Chiropractic care should be available
in all sectors of the health care market. We also believe that we should be paid
on an equal basis as other health care provider classes.
We believe that we are presently not being everything that we can be.
We are not seeing a vast majority of the population that can benefit from our
services. We are not improving, researching and integrating our techniques to
result in improved end results. Our research is much too limited in regards to
non-musculoskeletal conditions that respond to our care. It would be nice for
instance to have a better idea of which cases of asthma will respond to care; or
which cases of infertility will respond to care; or which cases of
hypertension will respond to care; or which cases of seizure disorders are most
likely to respond to Chiropractic manipulative therapy/adjustments.
We do differ with the straight organizations as to your status when a patient
comes into your office for care. The U.S. Chiropractic Association believes that
you have a responsibility to the patient that is no less than a responsibility that an
M.D. or a D.O. has to their patient. You have the responsibility to properly
diagnose you patient. Does that mean referring the patient to an M.D. if the patient
has a medical condition? No, it means explaining the options available and
referring the patient if they request a referral. Very likely, if you know your body
mechanics, that patient will respond to your care. Then again it may be a
condition that will not respond to Chiropractic care. Since our own institutions
have failed to compare, research and correlate the various techniques available to
the profession, one practitioner may be more effective than another with certain
conditions. If a fellow Chiropractor down the street has a reputation for obtaining
excellent results with a given condition, we would hope that you consider
referring the patient to a fellow Chiropractor if needed. Complicating matters
even more is that the patient may benefit from the expertise of another
Chiropractor in regards to a condition that has more than a subluxation component.
For instance, if the patient has a nutritional deficiency, we would hope that you
handle that nutritional deficiency in your own office or send them out, hopefully to
one of your colleagues, to also handle that case nutritionally.
The U.S. Chiropractic Association is not here to dictate how you run your
Office or what services you provide. If you are trained and educated in providing a
service, and your state law permits you to provide that service, we believe you
have the right to provide that service. Of course, as long as that service is safe
and likely to benefit the public you serve. We have a live and let live attitude,
as long as a service may be of benefit to the community and is not being utilized
as a gimmick or money making scheme to defraud the public.
Q - So what is the bottom line? I'm a straight chiropractor. What can you
do for me and my patients?
A - We need your help. Whether you are a straight or a mixer, we would much
Rather see your practice crammed with new patients each and every day rather
than have you see a few patients a zillion times each. Let's get back to the
philosophy of helping patients regain their health quickly. USCA has the
ability to gets things done and help the profession obtain its rightful place in
Bottom Line: The last thing we want to do is "piss you off". We can use
your help. The organization believes that adjusting subluxations is the
primary goal of the Chiropractor regardless if you are straight or a mixer.
We can open many doors for the profession. Our goal is not to change the
scope of practice. Our goal is to gain our rightful place in the health system.
Let's stop fighting each other and fight to make sure Chiropractic is
representing in every segment of the health care market. We are here to
expand opportunities. You have been sold out by other Chiropractic trade
associations. We are not here for personal profit, or inflating our ego's. We
are here for each and every Chiropractor that understands the importance
of correcting subluxations. Give us a chance to help the profession. Give us
a chance to help you.
Q - I'm a mixer. What do you have to offer mixers?
A - We are here to represent Chiropractors. We want to make sure that our
profession is representing in every facet of health care. We have a live and
let live attitude. We believe that if you are trained and educated to perform
A procedure, and state law permits it, and it may be of benefit to the patient,
Then you should be allowed to offer that service. We want to expand
Opportunities for Chiropractors. We are not looking to change the scope
of practice in regards to Chiropractic.
It is not our goal to expand the profession into prescription pharmaceuticals.
Very strong cases can be made on the pro and the con sides of this issue. We
are not here to promote injectibles. Very strong cases can be made on the pro
and the con sides of this issue. This is not what the U.S. Chiropractic Association
is all about. We are here to expand practice opportunities for chiropractors
within the existing scope of practice laws.
Controversy is not our middle name. The last thing we want to do is "piss off”
the straights. The last thing we want to do is "piss off" the mixers. The last thing
we want to do is "piss off" the progressive mixers.The last thing we want to do is
"piss off" the middle of the roaders. Actually the "middle of the roaders"
probably represent the majority of the profession, but they are truly the "silent
majority". We need every Chiropractor backing us up that understands the
importance of adjusting patients to regain or maintain their health.
Please note that we are only asking for your support right now.
At this point, we are not asking you to join our association and
pay dues. At this time we are seeking your moral support. We
will indeed need financial backers in the future to turn our visions
into a reality. For now, feel free to contact us to show your
support or ask any questions. We do not post letters or e-mails
from anyone unless they give us express permission to publish
the correspondence. Please inform others about this website.