This one’s been weighing on me for a while.
Time to get it off my chest.
It will probably rub many the wrong way, however that is not my intent. It comes from my personal experience with the inner workings of chiropractic politics, first hand experience with the multiple scopes of practice and my analysis of the current culture and climate in chiropractic practice and politics.
Where do we go from here? Our “New Normal”
The profession is facing major crisis.
Declining enrollment in our colleges, closure and impending closure of others, assaults from within as some pursue drug and surgical rights, and practitioners struggling in the field are just a few pressing issues.
We’ve heard a lot from our leaders lately on where we are and where we should be going.
The American Chiropractic Association (ACA) has offered their “new normal”. A profession that becomes duplicative, fully integrated/absorbed into the medical model and of course, minus the “unscientific cultists.” Their new normal involves us becoming Pseudo Primary Care providers and they have the full support of their creation and heavily influenced Council on Chiropractic Education.
The International Chiropractors Association (ICA) also has a primary care vision, albeit minus drugs and surgery and including subluxation. Some in influential places tells us that the Medical Home Model is our future whether we like it or not. With new leadership at the helm of the ICA, my hopes are they will see why pursuing a primary care designation is not in the best interests of the profession.
Chiropractors are portal of entry providers. There is a huge difference. A difference that could mean a sustainable future or not.
Chiropractic’s New Normal
Chiropractic’s new normal should look a lot like its old normal. You know, the one centered on our only unique service to mankind: the detection, correction and management of vertebral subluxation.
Now before I start getting called a “straight hate” or some other term we are so fond of throwing around when our ideas or political positions are challenged, let me stress that I am not against chiropractors performing services beyond the correction of subluxation. While I prefer and promote a focused scope of practice, I realize that many fine chiropractors provide great service and value to humanity through the incorporation of other services in their practices.
With that said, that can not be our new normal.
Let me try to explain the significance of this.
When something becomes the new normal, it soon becomes the standard. It’s like the game of telephone. Pretty soon the original message makes no sense once it has gone through multiple generations. As we identify chiropractic’s core as subluxation plus x, y and z, we soon lose our focus, identity, uniqueness and effectiveness.
Are we just natural primary care doctors? I don’t think so.
Chiropractic’s Identity Problem
The chart below is a simple one but one chiropractors should review with serious consideration. It does not claim superiority of any model or association, however it does clearly demonstrate the danger in centering around other objectives and procedures besides vertebral subluxation.
As more procedures are added, the value, message and quality of vertebral subluxation corrective care naturally becomes more and more diluted. As demonstrated by the holes infiltrating chiropractic’s borders, the risk of completely losing our core values becomes readily apparent.
The graphic does not deny the value of any procedure, paradigm or discipline, but only wishes to place emphasis around where the profession should be centered.
- If the new normal becomes primary care with all things healing, we are now no different than our medical, osteopathic or naturopathic counterparts. For some that would be just fine.
- If our new normal becomes primary care, without drugs and surgery and with all things natural including subluxation correction, we have become diluted, confused and confusing to the public.
- If our new normal becomes extreme vitalism with an overt spiritual overtone and vertebral subluxation correction, we equally run the risk of diluting and damaging our ability to effectively serve more people. People want a doctor/teacher, not a minister.
Chiropractic’s new normal should be centered around its old normal minus its overtly spiritual roots. This does not mean removing our core vitalistic paradigm, but rooting it in the defensible critical vitalism that the majority of the world already has as a core belief. It does not need to be our banner, but it should serve as a compass for our educational system as well as the application of our art.
Vertebral subluxation could and should be our banner. It should be our “new” normal, our focus and our rallying point. It serves as our unique selling proposition and greatest offering to mankind.
Does our research currently center around vertebral subluxation? How about our public education campaigns?
Our New Normal = New Levels of Tolerance and Acceptance
While vertebral subluxation should be a core identifying value of the profession, this doesn’t mean other health promoting services can not be offered by the chiropractor.
As I stated before, I prefer and promote the focused scope of practice. I am also familiar with the other models and understand their value as well.
It’s about time that we realize that none of the models are going away. Use of derogatory terms such as mixer, medipractor and hate straight have no use in the profession and are harmful to our global vision.
With that said, tolerance and acceptance does not apply to those movements and ideas that are contradictory and damaging to identity of the profession and in direct opposition to the views of the overwhelming majority of focused, middle and broad scope practitioners.
Drugs and surgery have absolutely no place in the practice of chiropractic. It’s time for the leaders of our colleges, associations and field to put that topic to rest once and for all. If we don’t handle it, others will handle it for us.
Becoming the New Normal
Our new normal can be amazing. With cooperation and recognition of the multiple models of practice centered around our core values, mission and objective, we could become the new normal in the lives of the public we are here to serve.
It would require a new culture centered around dialogue, commonality and the unique value of each model. However, as long as direct and indirect attacks continue on values and the ability to promote, propagate and proliferate each model academically and in practice, we will continue to stagnate and contract instead of naturally flourishing as we should.
The New Normal begins with each chiropractor and student and what they choose to focus on. Choosing to promote versus attack. To advance their positions and practice style versus bringing down those of others.
The New Normal is coming.
Principle #6, focus, tolerance, hard work and diligence will make sure of it.
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Steve Tullius, D.C., ACP
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