Is Chiropractic Success a Race to the Top or the Bottom?

W hen we graduate from chiropractic college and receive our degrees, just like doctors with medical degrees, we must realize that we were taught basic sets of skills and knowledge sufficient enough to pass both national and state boards. What we then do with that degree and skill set is purely dependent upon each of our own desires. Currently, states are trying to encourage doctors to increase their skills with mandatory continuing education and. for the most part, it is working. However, too many doctors do not take that as a challenge to become better, but view it as drudgery they must endure. They seek to do no more than the minimal to the detriment of all. The good news about chiropractic, which also happens to be the bad news, is that it works so well that even the most basic ad­juster can help many patients get well despite a limited know ledge or skill set. Too many in our profession believe the arbiter for success in chiropractic is simply gaining new patients, and they have a strong philosophical base or belief that it will only take a few adjustments or manipulations to relieve patients of pain. They believe they simply need more new patients to maintain their success. In practices run by chiropractors with this men­tality, only a slight decrease in new patients per month often means bankruptcy, and. unfortunately, too many arc at that level. Therefore, a vision of success has been shaped by the month-to-month fear of failure. Many dogmatists preach that if there is no evidence, then chiropractic should not be exposed to further ridicule, and we should keep our scope as narrow as evidence allows. If we adhere to an "evidence only" policy, where will that leave inno­vation and breakthrough? Another set of dogmatists go through life wearing blinders and believe tliat we should only adjust and "innate will take care of the rest." Both extremes arc dangerous and place chiropractic on the "slippery slope" of failure. A very talented doctor who consults in the profession recently shared with me that credentials and an increased knowledge base, although admirable, arc not required beyond the basic chiropractic degree and skill set we all were confirmed with upon graduation. All that is required to be successful is strategi- cally altered documentation and nothing more. Another very talented chiropractic consultant previously preached that all that was required to be successful was to accept the principles in full faith and even-thing else would follow. Docs that mean tliat every doctor of chiropractic has to be mired in the 1895-modcl and ignore all of the advances tliat technology, research, and the totality of the healthcare community can offer? Currently, the addictionology and family practice depart­ments at the State University of New York at Buffalo. School of Medicine and Biomcdical Sciences have reached out to chiropractic as a potential "first line" solution for spinal-related problems and as a tool to help eradicate opioid addiction in the US. Their decision to include chiropractic was because of the evidence through scientific literature and a five-} car-plan of strategic positioning that was "steeped in basic chiropractic principles" of subluxation care. Chiropractic is now at the epicenter of mam solutions for healthcare dilemmas tliat our society currently faces because of its collaborations with mam medical specialists and healthcare providers, as well as the widely published studies and research about chiropractic. Because of research, innovation, and creden-tialed doctors, the profession is being seen and heard. Doctors in New Jersey. Utah. California. New York. North Carolina. Florida, and mam others have had ncurosurgcons and ncuroradiologists seek their opinions on MRI nomenclature and findings. They arc requesting that chiropractors educate them and arc referring patients to them. These doctors are reaping the rewards of a post-doctoral education in MRI spine interpreta­tion. Lawyers arc seeking doctors nationally with certifications in MRI spine interpretation and spinal biomcchanical engineer­ing, as well as credentials from the Department of Transpor­tation and arc seeking these doctors to refer to. This is just a sampling of winning through clinical excellence. Games of creating strategic documentation or putting blind­ers on to implement advances in technology arc a race to the bottom. Ignoring the potential benefits of chiropractic care because the scientific community has not yet recognized it is also a race to the bottom because we arc ignoring what will help the profession expand and solidify our current utilization numbers of 3% of the population vs. 7% more than a decade ago. What is mandated in the short nin for your practice and in the long nin for the profession is a race to the top. This requires that you increase your credentials and know ledge base. It also requires that our researchers go beyond the "purely musculo-skclctal" paradigm for chiropractic. In addition, practice con­sultants must encourage practicing doctors not to simply accept the minimum for success, but mandate clinical excellence with the credentials to back it up. Our academic institutions must do better to provide research platforms and have, at the very least, minimal publishing requirements for its full-time faculty, while instituting research programs and requirements for our students to earn their DC degrees. Winning for our own sake and the profession as a whole is a "race to the top" and starts with choices. What courses am I going to take for continuing education? What certifications am I going to earn? Wliat schools am I going to refer my potential students to attend? For me. I must know as much or more than every other person in my world so that I can be a tmc expert. It requires studying, asking questions, and not resting until I get answers and fully understand what I am doing. For some, that is personal injury, and for others it is sports injury, pediatrics, etc. You get to decide and the only choice you cannot make is one that puts you in a "race for the bottom." Dr. Mark Studin is an adjunct assistant professor in clinical sciences at the University of Bridgeport College of Chiropractic and a clinical presenter for the State of New York at Buffalo, School of Medicine and Biomedical Sciences for post-doctoral education, teaching MRI spine interpretation and triaging trauma cases. He is also the president of the Academy ofChiropractic teaching doctors ofchiropractic how to interface with the legal community (www.LcrwversPII'rogram. com) and teaches AIRI interpretation and triaging trauma cases to doctors of all disciplines nation­ally (www. TeachDoctors. com). He can be reached at DrA lark@ TeachDoctors.com or at 631-786-4253.