Who Defines Us?

Whether you call yourself chiropractic physician, doctor of chiropractic or chiropractor, the definition of who you are and what you do is largely determined by the services that you are trained and tested competent to provide. Although the 50 states and the territories have different enabling acts created at varied times, the thread that binds us is that we are physicians/doctors of chiropractic. We are trained to take a history, perform an examination, render a diagnosis and treat, co-treat, manage, comanage or refer our patients. The standardization is largely due to upgrading our education over the years and the creation of the Council on Chiropractic Education (CCE) and National Board of Chiropractic Examiners (NBCE).

The recent Gallup Poll released by Palmer College reveals information that relates to our education and public misconceptions. What struck me was that family and friends were most likely to discourage patients from seeing a chiropractic physician. We all might remember the “Committee on Quackery” established by the American Medical Association to wipe out our profession and the antitrust lawsuit resulting in a permanent injunction against such behavior. Yet it appears this prejudice lingers not only with family and friends who have been educated to be sometimes fearful of chiropractic but also with decision makers, third-party payers and in the medical establishment. [See “Wilk v. AMA, 25 Years Later: Why It Still Isn’t Over,” March 2012 ACA News, Page 10, at http://mydigimag.rrd.com/publication/?i=101171.]

While this is discrimination, we can’t entirely blame others. Many are ignorant of the level of our education. Our forefathers recognized the need to establish the CCE and the NBCE to clearly define, standardize and regulate what we are trained and tested competent to do. They understood the importance of being educated as a physician. This required a great deal of planning and a gargantuan effort to move the chiropractic profession to its rightful place as one of the leading physician-level providers in the world. It helped give DCs a consistent first-class education, and it ultimately gave patients a choice.

Kudos to those with the drive and willingness to finance the expansion of our education and the creation of the CCE and NBCE. We must ask ourselves, who will define us? Will it be public opinion tainted by years of misinformation? Will it be the medical profession in exchange for participation in integrated settings? Will it be other professions that seek to take over the chiropractic profession, define us as a single service and marginalize us in their efforts to broaden their scope? Or will we lead this profession into the future, diagnosing and treating our patients while promoting health and wellness and overall public health? Will we accept being defined by others, or will we continue to build our professional expertise?

We have the best environment in decades to move our profession forward. Other professions are busy changing core curriculums and redefining themselves with an eye on the future. Now is the time to continue to evolve our education and competencies and change our laws to reflect the same.

There is a famous quotation from the great Dr. Joseph Janse that goes something like, “Legislate broadly and practice as narrowly as you wish.” I would expand upon that and say, Legislate and educate broadly, and ensure the highest standards, quality care and unfettered access to those services. I also like to say, Teach it, test for it, own it. The process of constantly upgrading the quality of our education must continue. Our teaching institutions, the CCE and NBCE, are integral to these efforts.

We are physicians who treat conditions. We have high patient satisfaction, and I believe this satisfaction is largely driven by positive outcomes. I look forward to expanding scrutiny of the profession — especially evidence-advised practice and data analysis — because I believe we will continue to show that DCs are cost-effective and safe, with high patient satisfaction and positive outcomes. I look forward to the day when we can practice our full scope and patients no longer have barriers to choosing our professional services. We have a bright future if we have the forethought, strategic planning and fortitude of our forefathers.

ACA continues to fight for that dream, and it’s up to us and the new generations of chiropractic physicians to upgrade our education, bring our enabling acts in line with the modern practice of chiropractic and ensure that our patients have access to our services. Thank you for being members of ACA and this great profession and being part of this evolution.