President National University of Health Sciences Since The National College of Chiropractic \ granted James F. Win-j terstein, D.C., his doctor) of chiropractic degree in i 1968, he has dedicated i his efforts to the profes- j sion and one of its lead- \ ing educational institu- ] tions. Over the course of'> his career. Dr. Winter- i stein has been a success- \ ful practitioner, radiolo-' gist, lecturer, department head. Dean of Clinics, professor and president of NCC. In between operating practices in west suburban Chicago and Florida, he served his alma mater in various positions. Shortly after receiving his diplomate | in radiology in 1970, he was appointed Assistant Director of National's Department of Radiology and, one. year later, became director of the department. Following 17 years of private practice in Illinois and Florida, Dr. Winterstein became National's \ Dean of Clinics in 1985. Appointed | National's sixth President in 1986, he accepted the challenge of guiding his alma mater into the future. Under Dr. Winterstein's leadership. The National College of Chiropractic became National University of Health Sciences in September 2000. i In the following article. Dr. James Winterstein gives us his perspective on the future of chiropractic: There is a lot of talk recently in the profession about unity. It is ironic that this profession has not been unified from the very start and. still, we go on j and on about this idea. I wonder, I "after a century of this rhetoric about unity, has it not occurred to anyone that it is not going to happen?' A brief review ot" our history will tell anyone willing to spend the time to read it that this has been tried and tried and, always, on the Monday after any kind of unity event, there was a new organization, a new standard, or a new school. What is it about us, as a group of people, that keeps us from accomplishing professional unity? I think the primary reason is that we are normal humans who want to think of ourselves as progressive and open-minded. Think about this for a moment: What other profession can we look at, as a model, that began at least a century ago and remained exactly the same in its outlook, its purposes and its methods since its inception? Would it be allopathic medicine? Would it be podiatry? Would it be dentistry? Would it be optometry? Would it be law? Would it. even, be any specific religion? How about astronomy? The answer is that not one of the professions has remained what it was at its inception: and, yet, in chiropractic, that is at the crux of our lack of unity. The majority of people do not like change: but. eventually, even those who do not like change recognize the need for change as a mechanism of progress. Because the members of the profession, as normal humans, have a variety of interests and desires; and because there is a variety of educational opportunities; and because there is new knowledge always coming to the foreground, there is a natural tendency for normal people to want to do different things—and that leads to diversity rather than unity. On the other hand, how can a diverse group of people really be a profession which has certain definitional qualities? How can a diverse group of people function as a single unit? How can the chiropractic profession be unified? Perhaps we are seeking a vision with blinders on—which does not work very well. A number of years ago, I listened to a speech in which the speaker constantly exhorted the members of the audience to "think in different terms". I believe that applies to us in this new millenium. We should seek a different kind of unity in which we recognize our diversity as useful and valuable. We have a new opportunity—and we should use it—to think in different terms; so, here is what I suggest. First, let's review the facts: The fact is that we are a diverse group of practitioners, which has failed repeatedly to develop unity as a profession. The fact is that, within the 50 states, the practice statutes vary from those that proscribe nearly Continued on Page ll ...from Page 10 all therapies and restrict the chiropractor to adjustments of the spine by hands, to those that permit the chiropractic physician to treat a wide range of internal disorders, cast fractures, suture wounds, and utilize a wide range of therapies other than the spinal adjustment. The fact is that, within the 50 states, practicing chi ropractic doctors engage in all of the legally allowed practices, from the most restricted to the most broad. The fact is that every talk about unity does two things: it tries to move the broad scope practition ers into a more narrow scope, and it tries to move the limited scope practitioners into a more broad scope. The fact is that standards of education and practice are always in compromise, because of the desire to make them more restricted by those who practice that way, and to broaden them by those who practice that way. The fact is that some chiro practic doctors support immunization by vaccination and others vigorously fight the concept. The fact is that we have not yet demonstrated, through scientific evidence, that spinal subluxation is a causative agent in human disease, or dis-ease, nor that we can actually "correct" subluxation. Yes, we have demonstrated that some kinds of spinal joint discord produce pain, and other symptoms, and we have demonstrated that manipulation of those areas of spinal discord can relieve the symptoms; but that is not the same thing as validating subluxation of spinal vertebra and correction of this entity by, what we prefer to call, specific chiropractic adjustment. 8. All of the above are clearly recognized facts that affect any attempt to develop unity within the profession, and have always, sooner or later, subverted the process. With these facts in mind, how do we proceed, in this new millenium, to come together as a group of practitioners into a profession with common goals and interests. If we think in different terms, I believe there is a way, and it is called intraprofessional accommodation. Continued on Page 24 ...I-'nun Pai>c 12 How would this concept work? j Here is what I think. | Intraprofessional Accommodation The words have a clear meaning. ■ Within the profession of chiropractic, : with all of its diversity, we must learn to accommodate the diversity itself. Isn't that what our entire society is • struggling to accomplish on a broader scale? In our society, we don't like someone else because of his or her color, or habits of living, or ethnic celebrations, or peculiar language, and on and on. One would think that, as a minority profession that has experienced a lot of discriminatory persecution, we would have the good sense not to do it to ourselves and, still, we do. This intraprofessional discrimination needs to end first. Granted, because we are a health care profession, there are certain ethical and legal responsibilities that we owe to the people and its governing bodies. Those, we must agree to meet. Above that level, we can develop intraprofessional accommodation. We can agree to let those, who want to practice a limited or specific scope of chiropractic practice, do so. Likewise, we can agree to let those, who want to practice an expanded scope of practice, do so. In both instances, the practices must be determined within the profession, on the basis of education and experience, and not by outside agencies. It is exactly at this nexus that we have made our most significant mistakes in the past. If intraprofessional accommodation is to work, we must not make the same mistakes in the future! We have legislated the parameters of our profession—actually, lobbied to have the laws determine what we can and cannot do! No other profession has done this, as we have. Even the anatomically limited professions (of which we are not one), such as optometry, podiatry and dentistry, have worked to correct their errors by lobbying for, and obtaining expansion of their scopes. If we truly want to have intraprofessional accommodation, then we must agree to work toward removing practice limitations from the state statutes. Some would say that is not possible, but they are wrong. When we wanted the CCE Standards to be part of our practice statutes, we made it happen. When we wanted to move from the requirement for basic science examination and certification to a National Board Examination, we made it happen, and we can make this happen, too. if we agree to work toward and for intraprofessional accommo- dation. Some will say that this will be confusing to the public. Really? How would it be any more confusing than our current situation? Let's face the reality that we are a diverse profession and that is not going to change. We should use this to our advantage when we talk about chiropractic to the public. They will understand—that is the least of our worries. It is interesting how nothing is new. I have been writing about and promoting this idea, of working to broaden our legislation on chiropractic scope of practice, and allowing limitations within the law, as a matter of personal preference, for some time. Just the other day, I was reading some of Dr. Janse's writings, and here is what I found: "Always legislate as broadly as possible, so you can practice as narrowly as you choose." It did not happen then, but it does not have to be the end of the story. Now we have a new opportunity. Talk to your colleagues—try to persuade them to think about the concept of intraprofessional accommodation. It is only through this conceptual framework that our profession will be able to unify itself for the benefit of patients everywhere. Dr. Winlcrstein max be reached at: 630-889-6604.O
