Please Sir, I Want Some More
The evening arrived; the boys took their places. The master, inhis cook's uniform, stationed himself at the copper; his pauperassistants ranged themselves behind him; the gruel was servedout; and a long grace was said over the short commons. The grueldisappeared; the boys whispered each other, and winked at Oliver;while his next neighbours nudged him. Child as he was, he wasdesperate with hunger, and reckless with misery. He rose fromthe table; and advancing to the master, basin and spoon in hand,said: somewhat alarmed at his own temerity:
'Please, sir, I want some more.'
Oliver Twist - Charles Dickens
I received a large number of responses to my last Update where I confronted the delusion being bandied about by some in the profession that we really have a say in the national health plan being chiseled out right now. The majority of the responses were from those agreeing with me and thanking me for stating it.
There were a few however that wondered why it would be so bad to be accepted in a national health plan based on a Medicare pain based model. I’m familiar with this argument. It’s the one we’ve been swallowing hard on for decades and there are all sorts of rationales for it. They span the gamut from foot in the door promises to the old bait and switch – get them in for pain and then educate them about “real” chiropractic. One spine at a time. At that rate the world will end before it changes.
I have to wonder why our profession continues to believe that it must take the crumbs from the table. Where does this pathetic lack of self esteem come from? It’s almost schizophrenic. On the one hand we spout grandiose claims about changing the world through chiropractic and then on the other we beg for any acceptance that anyone is willing to give us – even if it’s on their terms.
While I can possibly understand this coming from the faction of the profession that has repeatedly painted us into the neck and back pain box I simply cannot understand why certain subluxation based organizations go along with it. I have simply not heard a reasonable explanation. For the sake of unity? Give me a break.
The latest example of this is: The Path to Change in the US HealthCare System: The Chiropractic Perspective. A Joint Policy Statement on Healthcare Reform Presented by a United Chiropractic Profession.
We even have a deep seated need to put “unity” in the title. Funny, I haven’t seen a “unity” document from the AMA on a national health plan – if anything the AMA is against it. They know the Medicare reimbursement rate is a dozen years old and aren't scrambling to be paid those rates for everyone. In fact there is a healthy and vigorous debate occurring within medicine on the pros and cons of national health care – not every doctor agrees with the AMA after all. Not so in the chiropractic profession. The leadership has spoken for us: We want in and we want in bad - we don't care what you pay us. I think there are scores of chiropractors lying awake at night praying for the return of the Mercedes 80’s.
And just what does this unified policy statement have to say to the President? To start, here is a breakdown of key words and phrases in the document and how many times they were used:
This document pushes the same old line that we can fill the gap in primary care providers by offering a cost effective approach to the sixth most expensive health condition – low back pain. And just to show we’re “unified” we also have this subluxation thing - discussed in two paragraphs of a 28 page document. A document mind you that is purportedly meant to showcase our unique contribution to health care.
As I've said before I don't believe the Obamas are under chiropractic care - including their children. And why would they be? The unified leadership of our profession is telling them that unless they have low back pain they don't need a chiropractor. And for the kids - this document tells the President and First Lady that unless their two girls have colic or ear infections - no need for chiropractic.
Judging by this document we have nothing unique to offer. In fact every single other service focused on in the document is already offered by several other health care providers. This includes manipulation and manual therapy (look how many times those words were used compared to adjustment).
Now I know we like to joke about the level of intelligence in Washington DC but does anyone really believe that these folks are that ignorant? Let’s review this once again. Remember those five pillars of health we educate our patients on:
1. Proper Nutrition
2. Proper Sleep
3. Proper Exercise
4. Positive Mental Attitude
5. Properly Functioning Nervous System
We don’t have a patent on 4 of those 5 pillars of health. The only one that’s uniquely ours is a properly functioning nervous system through the adjustment of vertebral subluxation. That is in fact our strategic competitive advantage. Marketing 101.
Now listen, I’m not some rabid hate straight who thinks anyone doing anything else is guilty of sin and doomed to burn in hell for eternity. In fact, I don’t think you can fully correct a subluxation unless you are addressing all of these other aspects. But let’s be real: diet, exercise, vitamins, wellness, prevention and any other intervention or health buzzword you want to throw into the pot is not unique to us.
Wellness is on its way to becoming a trillion dollar industry – with or without chiropractors. This is not about you or me – or even the profession. It is about those who are sick and suffering. They can get “wellness” from a gym rat or from their next door neighbor selling the latest multilevel marketing miracle juice - but they can only get a specific chiropractic adjustment to reduce a subluxation from a chiropractor.
Why aren’t we telling the government and the public that?
As always I look forward to your feedback, comments and suggestions.
Regards,
Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor – Journal of Pediatric, Maternal & Family Health – Chiropractic
http://www.chiropracticpediatricresearch.net
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