First of all, Western States Chiropractic College follows a science-based, medical approach to health care and chiropractic, for that matter. The school advocates a musculoskeletal/primary care approach. This means the worst case scenario is ruled out before an adjustment is given. From an objective point of view this makes perfect sense. If a person presents with upper back pain and you as her practitioner know upper back pain could be associated with other things such as a heart problem, you may choose to refer her to an MD or DO who is qualified to treat her ailment if needed. This is a perfect transition to help explain the 'other' side of chiropractic.
Too often, from personal experience, I have seen cases that were not referred to other more qualified doctors because of ego or shame the chiropractor holds deep inside. Instead, the DC tries to manage the complicated case and ends up mismanaging the patients needs. From my experience this type of management usually has a lot to do with the type of approach the chiropractor has with his/her patients. The chiropractor I referred to above would be the type that has a more 'straight' approach in treating patients. The straight approach advocates treating ALL health care problems with an adjustment to the spine because a straight spine will allow the nervous system to flow properly to organs and the like and prevent disease from ever happening.
If you are an objective, science-minded person you too would say this approach to health care is completely fraudulent. Many new DC's enter the field with literally no patients and have huge overhead that forces them to adhere to the straight approach to chiropractic in order to cover their bills. If you have 5 patients and you see them twice a week for "prevention" you have 10 visits. Add up the revenue and you will soon find out it is way easier to 'believe' in the straight approach then to actually be a physician. Don't get me wrong, I believe in prevention, but I do not believe in manipulating the spine in hopes of good total health. Prevention is a balance of proper nutrition, regular exercise, a positive mental attitude and a body free of biomechanical abnormalities. However, biomechanical abnormalities can still exist in a person who is living a life of wellness. Chiropractic is a small portion of what I consider prevention. It is prevention of orthopedic problems and a way an ACTIVE person can stay active while minimizing injury from being active. If a person covers their nutritional needs, follows a workout routine that gives their body a new stimulus to adapt to each month and lives life PROACTIVELY, Chiropractic will benefit their way of life.
Where straight chiropractors get into trouble is by trying to manage complicated health problems with manual therapy. For instance, I heard of one chiropractor trying to manage a persons diabetes with spinal manipulation. That is a big NO NO. If fact, that is such a disrespect of the human body I would say that person should surrender their license. We don't go through all the years of chemistry, pathology, physiology and the like to behave as if it doesn't exist. There is so much known about the body that medicine has uncovered and to be an ethical DC you have to know where your role ends.
My future practice will be prevention based and performance based. That being said, if a person has a complicated medical problem that chiropractic has not been shown to improve I don't intend on managing their ailment, particularly if there are medical treatments available that have shown adequate results. I will send them away to a qualified doctor who knows their role in health care. That doesn't mean I haven't studied their condition or understand their problem, that means I hold the patient's best interests as my number one concern. If there are services provided that help people take steps to be the BEST they can be, to live PROACTIVELY, Chiropractic is by far the best choice for their way of life. Now if the person above is cured of their ailment after you promptly referred them, they will trust you and most likely your services will be utilized later.
In my opinion, I think we have to have patience as new Doctors of Chiropractic and adhere to the preventative approach to health care rather than approach our patient care from a self-centered, money driven perspective. If you focus on prevention, you will set yourself up for the future.
As far as the schools that support the "other" side of the chiropractic world, they get away with this by meeting technical standards set forth by the accrediting bodies. In the classroom, passionate subluxation theorists stand there preaching the pulpit on how chiropractic is the answer to everyone's problems, no matter what they are. This is exactly why the public views chiropractors as weirdos. The public is smart. Most understand what it takes to get better when they are sick and they've had experiences (many) where western medicine has brought them back from near death. They trust medicine. Where it gets a bit dicey is the wellness continuum. Western medicine has traditionally and historically been used to bring the sick back to homeostasis.
Death--------------Sick--------Homeostasis--------------------Wellness
(start Tx) (stop Tx)
Where does chiropractic fit on the wellness model? I'd say it fits in conservative care for musculoskeletal conditions and minor health problems and it could be an access point for patients to begin living PROACTIVELY. Understand that professional athletes, pro dancers, musicians etc., use chiropractic all the time. They demand a lot from their bodies and the chiropractic approach is best for them. If a DC uses their conservative care properly I truly believe there is a lot that can be done without the patient entering the western medical model and ending up in the hospital from a preventable disease. The US is riddled with disparities associated with chronic, preventable diseases and most of the leading causes of death are ones that could be avoided by living PROACTIVELY. If a DC fulfills this role and offers services that I explained above with the intention of taking patients/clients to the wellness end of the health care continuum, they deserve the title Physician. I cannot say the same for the other half of the profession.
Hi Nate,
ReplyDeleteGreat entry. I'm very excited about Philosophy this quarter. Have you read the required articles yet? They are great. I'm so glad you have stuck this out. You are going to be a great doctor.
Your friend,
Megan