I'm sure ihat. just before the fateful maiden voyage of the Titanic, someone found some last minute tickets to sail aboard her. It probably seemed like a lucky break to that person as they boarded the majestic vessel about to sail across the Atlantic. But, in just a few short days, history would prove that having a ticket for this maiden voyage was not the fortunate way to travel. And. to be sure, after the tragic event, no one purchased a ticket lor Titanic's second voyage. The difference between the Titanic and the medical paradigm approach to health care is that we can see the allopathic model sinking well in advance. Despite the advance warning, there are still those in the chiropractic profession who want to buy tickets.The sinking of the medical model is certainly not a secret. It is widely publicized every day in every major publication throughout the country. We constantly hear of the failure of antibiotics against new "super resistant bacteria". We hear statistics such as 180 thousand deaths each year attributable to medical malpractice, or 9(),()()() deaths due to properly prescribed hospital medications. For years chiropractors have been touting the dangers of vaccinations, and now we finally begin to see more articles questioning the efficacy of these toxins. Day after day. more people are reading about and questioning the failure of a system that they dared not question just a few short decades ago. Even the government now recognizes the need for chansie in medical care. Politicians are continually sponsoring new bills for health care reform. II the medical model worked, why would they he speaking about reforming it. Despite the glaring failures, the cost of medical care continues to rise beyond what the consumer can afford. Costs for this failing system have gotten so out of hand that corporate business cannot even afford it anymore. Thus, we have the advent of Managed Care, where businesses try to run their own health care companies. Despite all the attempts at refinancing or reform, the medical paradigm is sinking just as surely as did the Titanic. The hole in the side of the Titanic is nothing compared to the hole in allopathic health care through which a trillion dollars and hundreds of thousands of lives spill each year. The medical system is sinking, the water is freezing, and there aren't enough lifeboats to go around. Even as the allopathic vessel is becoming submerged, chiropractors are rowing out to hitch their dinghies to its listing hull. Many individuals in our profession are attempting to solve the onslaught of managed care, with the establishment of multidisciplinary practice groups for inclusion into managed care programs. This is where a chiropractor ties his practice to an MD or some kind of medical professional in order to offer what they call "complete service". In this setting, the chiropractor gives the chiropractic care while the MD gives the medical care and diagnostic services. This hotlv debated issue has created much fervor in our profession, as some tout this as the way to adapt to the managed care situation, while others see this as getting into bed with the enemy. To better understand this issue in context, we need to look at the business of chiropractic practice. The history of our profession To understand what I am about to explain, one must realize one fact: The past three decades of chiropractic ' and insurance have actually been a j "glitch" in our history. During our 100 years in existence, the first 75 knew j nothing of third-party reimbursement. | Only in the last 30 years have we had ; to deal with issues of insurance cover- j i as:e. Unfortunately, most of our practi- | tinners today were bom into this insurance era. and now do not see other alternatives. We must also realize that all of the big gains we have made in our history have been due. not to ourselves, but. rather, to our patients. The fact that we have licensure at all is a testament to our patients. The reason they did this for us was because our energies were aimed toward them. Our time, efforts and love have been geared toward every patient we cared for. The patient was the consumer, and the product was aimed at and offered to only them. Continual on Page 52 ...from Page 33 The Health Care Marketplace Make no mistake, the reason health care delivery is in a crisis situation and has undergone this mutation into managed care is NOT because of us chiropractors. It is because the medical system is an expensive failure. No longer can society afford to pay for a system of questionable effectiveness with a huge price tag. The once mighty medical express train has. in fact, derailed. Do we really believe that insurance companies and managed care organizations could wield so much power if the consumer were able to afford medical services? Of course not! The only reason we have insurance is because people are convinced that they cannot afford medical health bills, should a health crisis arise. The Patient If we look around at our consumers, the patients, we can see trends. Today, more than ever before, patients are health and fitness conscious. They read the labels on the products they buy. they avoid chemical additives, when possible. They exercise more. And. unlike anytime in the past thirty years, people are willing to pay for health and wellness. This is evidenced by the number of flourishing health food stores, health clubs, and health products sold that are not covered by insurance. More people are searching for health and wellness. which just happens to be the forte of chiropractic. So. if we review the history of chiropractic practice, we can see that we have a profession that has grown, due to its direct patient contact. We have a consumer looking for health and well-ness and willing to pay a reasonable sum for it. And we have a medical profession entering an era of implosion. What this adds up to is that we, as chiropractors, are in a stronger position in the upcoming marketplace than the medical profession. This translates simply into. "They need us more than we need them."' The failure of the medical paradigm is not going to be solved simply by refinancing the same programs through managed care or any other health care reform. The medical model is inherently flawed. We chiropractors have been right for the past 100 years when we have said health is an inside-out phenomenon, and not an outside-in treatment. Add to this the fact that the managed care model is also flawed. This system bypasses the consumer and attempts to set up an agreement between big business and doctors. In this arrangement the consumer is only a commodity to be herded like sheep from one plan to the next. A system such as this, that does not market directly to the consumer, is not going to last beyond initial fear sales. To sum things up. what we presently have is a medical system that is failing and a managed care system doomed to ultimate failure. This sure doesn't sound to me like the kind of a system I want to hitch my wagon to. This, indeed, is the Titanic setting sail. And, while this is happening, there are those in chiropractic scrambling to hop on board. Really, what we have in chiropractic is so special, so unique, and so timely, all we need is to rethink our marketing and remember that we got where we are through the strength of our relationships with our patients. We are the most consumer-oriented health care profession in the market today. This, and our unique system of health care, is the reason we will survive and flourish in this new managed care era. All we need to do is re focus our energy, marketing and individual practices away from the third party payers, and back toward our consumers, the patients. mis is not to say mat we snouiu an give up insurance and convert to cash only practices. Some have done so very successfully. But. no matter how we choose to practice, our effort and energy in practice must be geared toward the patient. Our service must be affordable to the ever-increasing legion of those with no chiropractic coverage, or inadequate chiropractic coverage. Let us not forget that chiropractic got where it is because we can help the helpless, return the worker to work faster, and care for people with quicker results at less cost than allopathic care. Many chiropractors have recognized this situation and have acted on it. Today, in the midst of managed care, there are doctors functioning outside the system who have some of the largest most successful practices we've seen in years. By focusing on the patient, they are seeing volumes of people, while others who cling to the practice concepts of the past are crying poverty and failure. The choice, as I see it. is simple. We can, as some have suggested, jump on the medical Titanic in the hopes of securing the last remnants of a failing medical care system. Or. we can proudly and independently step up and proclaim our rightful victory, serve our patients based on their needs and abili- ties, and reap the bountiful harvest. To answer the original question, "Is the Multidisciplinary Approach the Answer for Modern Practice?", it may be for the medical profession, because they have much to gain by being associated with chiropractic. But for us...we're better off without them! Dr Robert Bra He is a 197X graduate ] of New York Chiropractic College. He practiced in Florida for 17 years and, has practiced in Georgia for the past 5. The President of 1CA from 1995 to 1999, he is also the founder and President of Now You Know, Inc., an Internet company providing websites and email newsletters for chiropractors. www.nowvouknow.net. ■
