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Forgive me in advance if I go off on a rant but I’ve had dozens of chiropractors forward me the latest diatribe from Edward Ernst claiming that 26 people have died as a result of chiropractic care in the last 75 years – frankly, I thought his poorly written paper was old news at this point.  

I will refrain from picking it apart here because I believe any first year undergraduate student could do so. More people have probably died at Disney World and from ball point pens than from chiropractic - but where is the outrage about that?

What I do want to address to all those chiropractors who are so viscerally upset about this trash is why do you wait until there is a crisis to get all worked up?

If you don’t know already – let me point out that we only have about 70 full time researchers in the chiropractic profession and only about 7% of you subscribe to a peer reviewed research journal.  Probably even less donate any money every year to a research cause.

I’ve said this before and I’ll say it again – we have a serious problem in this profession and it centers around a dearth of research supporting our fundamental tenets. (I’m in full rant mode now)

Worse still is the cause of this embarrassing lack of research – apathy and disdain on the part of chiropractors. Its one thing to not really care – I can actually understand this. I don’t like it but I can understand it. So many chiropractors are operating at the lowest levels of Maslow’s hierarchy of needs (Food, shelter, basic survival) that they can’t even begin to think about the higher levels of self actualization.  

Others simply don’t care. They got into chiropractic as a career choice and are focused on making money, enjoying their pool and cars and vacations. Whether or not the profession exists after this third generation passes on is not a concern of theirs. I get that.

What I have serious trouble accepting is the group that simply has a disdain for research. I’ve heard speakers stand up in front of large rooms filled with chiropractors and proclaim that “We don’t need no stinkin’ research!”

They are not simply apathetic – they are against it. Imagine that. Against the exploration and confirmation of ideas. Against the testing of a theory. Against providing evidence that what we believe about chiropractic is actually true.

Well, I have news for everyone: That ain’t gonna cut it.

Historically chiropractors had some things to attend to during our formative years. First we had to stay out of jail. So, I can understand why that generation didn’t focus much on research – though some actually did.

Next, we had to gain licensure in all 50 states. That took some focus and effort – don’t you think? So, I can understand why we didn’t focus much on research during that time.

But what happened after that?

The fight for insurance equality – which we got for awhile for the most part. It was during that battle that the obvious decision had to made about where to put our precious few resources. Short term gain won out over long term planning. Easy insurance money now won out over changing a culture for the long term.

I believe this will go down as the biggest failure of leadership in the history of the profession.

Because once we got insurance equality the profession rolled right into the Mercedes 80’s. A time of no deductible, no copays, unlimited care – the profession got drunk off the insurance cow.

And in that drunken stupor paid no attention to the wave of reform heading our way like a runaway train. It started with the outcomes movement in the late 70’s and slowly but steadily, gained traction as practice guidelines, standards of care and now best practices and evidence based healthcare.

The bottom line: Accountability.

Chiropractors have actually gotten what we’ve been screaming about for over a hundred years. The problem is that we were screaming for accountability in medicine – what the leadership failed to realize is that accountability was coming to all of healthcare not just allopathy.

Unfortunately, the controlling faction of our profession that did embrace research was focused on neck pain, back pain and headaches. Many work within and for the insurance industry. Some went and started managed care groups and insurance products that pay only for this kind of care – not lifetime, subluxation, family wellness care.   

So next time Ernst or any one of several dozen anti chiropractic zealots writes something negative about chiropractic instead of becoming rightously indignant about it – do something instead.

What you definitely don’t want to do is support groups, associations, research efforts, and businesses who promote or support research that does not explore the fundamental tenets of the profession.  I hope you also will not support those political activities that are stuck in the Mercedes 80’s. Look at how much of the current leadership in this profession is trying to bring that back. Everywhere you look your leadership is still fighting the 80’s game. If we can just be included in the insurance game we’ll be OK. If we can just bill for more codes we’ll be OK. If we are just included in Obamacare we’ll be OK. If we can just prescribe some drugs we’ll be OK. If we can just call ourselves physicians we’ll be OK.

How utterly sad that a once great profession is reduced to this pathetic groveling for survival. The profession needs a collective visit with a psychotherapist to address its self esteem issues.

But ultimately what would that therapist tell us after holding our hand and listening intently while inserting the occasional “I see” and “Uh Hum”

I suspect a good one would tell us to get off our asses and take some action toward raising our self esteem and get back some measure of control of our destiny.

“But what can I do doctor?”

How about:  

• Subscribe to a chiropractic research journal that supports your values
• Send a check to support chiropractic research that is consistent with your values
• Send a check to support political action that is consistent with your values      
• Join a chiropractic association that supports your values
• Respond to groups and organizations that seek to destroy that which you value

Or you can go back to bed and put the covers over your head for the next 20 years – either way it’s going to be a bumpy ride.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor - Journal of Pediatric, Maternal & Family Health - Chiropractic
www.chiropracticpediatricresearch.net />