Dr. Louis Sportelli has served in many capacities throughout his 37-year career in chiropractic. He served as chairman of the board of The American Chiropractic Association in 1989. He has ser\>ed as President of NCMIC Group, Inc., since 1995, as well as President of TRIAD Healthcare, Inc., a chiropractic specialty managed care network, and a wholly owned subsidiary of the NCMIC Group. Another NCMIC Group subsidiary, NCMIC Insurance Company, provides malpractice insurance to more than 52% of the practicing doctors of chiropractic in the USA. Dr. Sportelli is the author of an educational booklet, Introduction to Chiropractic, which is the most widely used patient education publication in the world. He has, also, served as Trustee to the Foundation for Chiropractic Education and Research and currently serves on the Advisory Board of The Chiropractic Report and on the Board of Trustees of the Palmerton Hospital. He has served as one of the country's outstanding spokesmen, being involved in more than 1,000 radio, TV and newspaper interviews. His involvement in chiropractic nationally and internationally has resulted in his being elected to the Presidency of the World Federation of Chiropractic in 1998, an organization having NGO status with the World \ Health Organization. 1 In a brief interview with The | American Chiropractor, Dr. Louis I Sportelli gives us his perspective on the future of chiropractic: The future of chiropractic is challenged. Not because the value or the legitimacy of the profession is questioned, but because the economics and consideration of how to incorporate chiropractic and all other non-traditional medical services is under siege. The medical establish- I ment, having control over the health | care delivery system in this country for j almost 100 years, is desperately trying I to hold on to that control in every pos- i sible way. j Yet the system of healthcare delivery j has so radically changed in the past j decade that control has been lost by ] the medical establishment. Now the j challenge will be to provide enough I data to support the inclusion of chiro- ; practic services into the "core benefit" '' program of every government and private insurance plan. The chiropractic provider is faced with a formidable task of having to demonstrate cost effectiveness, therapeutic effectiveness, documented outcomes, and patient satisfaction. The entire evolution of healthcare has never before placed those demands on | practitioners. Fortunately for chiropractic care, there has never been a study that did not provide "satisfaction" percentages higher for chiropractic than for medical providers, even if the other data was not overwhelming. | Yet, as practitioners, we know that j chiropractic care is fundamentally less !• expensive and, particularly for those j conditions where evidence is signifi- I cant, the therapeutic effectiveness is validated. The outcome measures appear to be equally as compelling in those limited studies that have looked at issues of functional restoration and long-term disability. Therefore the future of chiropractic will be impacted by research to validate the components which are being looked at by payers, government, and employers, who are ultimately funding the healthcare costs. Chiropractic, as a profession, must concentrate much of its effort on providing accountability and demonstrating responsibility to those who pay the bills and, finally, to those often-forgotten patients who use the services of chiropractic. What's being done to get us there? There are many who have contributed to the advancement of chiropractic. Many of our researchers have been maligned and unfairly castigated by a small segment in the profession who do not wish to accept the responsibility that accompanies the professional title of doctor. So, for starters, the researchers are enabling the profession to advance because of the studies and evidence they are providing with their research. Additionally, I will take a moment to perhaps be a bit specific. NCMIC Insurance Company has contributed more than 6 million dollars in the past 6 years to chiropractic research. These funding grants made through The Foundation for Chiropractic Education and Research (FCER) have enabled significant coloration and interdisciplinary research efforts to advance. It is only through these kinds of efforts that Continued on Page 10 ...from page 8 the profession will throw off the blanket of mysticism surrounding chiropractic and enter into the world of meaningful dialogue with those empowered to advance the profession. Additionally, there are efforts to address the division within the profession, and that is, perhaps, the single most problematic issue confronting the profession today. I am convinced that the vast majority of this profession are honest, capable, competent and dedicated doctors who are simply sick and tired of the internecine warfare. They have become the silent majority and have allowed a small vocal minority to appear larger than they truly are. Additionally, the eternal bickering has caused a shut-down in the desire to participate as a member of state and national associations. I am confident, however, that the young professionals (those in practice 15 years or less) are about ready to make their voices known, recognizing that, if they want to be included in programs of substance, they must have a ] message of substance, and they must j demonstrate their willingness to be j held accountable for their actions. ! Finally, the ultimate arbiter of what will happen to chiropractic is the consumer. This new force of 77 million baby boomers, who understand and want "choices" and control over their health care, is about to take over. These boomers are pro-alternative care, well educated, affluent, and committed to taking care of their health. They will, however, demand a professional rationale for the care they receive; and it is time for chiropractic to remove the voodoo mask it has been hiding behind and provide the face of competence with evidence it has to support the care provided. I am convinced that chiropractic will, in the next few years, go from being an "afterthought" to a "core benefit"; from being "unorthodox" to emerging as a "standard of care"; from being considered "alternative and complementary" to "mainstream and primary"; from being viewed as "archaic" to being called "cutting edge"; from the "last resort provider" to the "first provider sought" in many of the areas of intervention. Likewise, I see a model of maintenance and wellness being adopted by the boomers of tomorrow, which will result in new demands being placed upon doctors of chiropractic as holistic providers and healthcare coaches It is evident that what needs to be done to "get us there" will depend largely upon the willingness of the profession to see itself in the same capacity as those who seek our services. The expectations and confidence in chiropractic of those we serve are often greater than the profession has of itself. We need to emerge from the dark ages of history and enter this new millenium not just meeting, but exceeding, the demands, expectations, desires and needs, of those who will require our services. ♦ Editor's Note: We want your perspective! TAC invites your feedback on this article. Be sure to fill out our Fax Back Survey on page 3, and fax or snail mail to us (see our contact info on page 2). Or, now you may fill it out and send it to us online at vmw . anchi rooractor. can.
