Dear Editor:
I am responding to Dr. Stephen Perle's recent article, "Teach What They Will Pay For" (www.chiroweb.com/archives/22/01/14.html).
I appreciate Dr. Perle's zeal. It would be lovely to know that everything we learned at chiropractic school and afterward had been run through clarifying screens, to assure us of their purity. How marvelous to know that we were taught in a way that balanced substance and entertainment, and that we could all share that information with the world in a riveting fashion!
But in fact, we live in a world that measures our excellence by multiple choice. We've all taken National Boards. Do you feel that your ability to answer those questions made you a good doctor? Do we know the credentials of the teachers who wrote them? Further in that vein, who appointed the members to our state licencing boards? What credentials did they have? Inevitably, we find that we belong to a "club," and that the "elder" (and potentially politically motivated) individuals are the ones who decide what standards we shall be measured by. That aside, the PACE recommendations are an excellent step forward.
The sad fact is that less than 20% of our profession are supporting members of any national association. Sadder yet is the fact that until recently, the bulk of research about chiropractic was paid for by our own profession. And now, those who review that (paltry) research for an evidence-based review have to say that there's not much "proof" in hand. It all sounds so depressing ... but the fact is that medicine, with their monstrous yearly funding from NIH, has yet to evidence-base most of what they do, either!
So, what should we do to improve the situation? I choose to support research! This year, I personally commit to tithing a portion of my income to FCER (www.fcer.org) so that there's more evidence to review. I will ask my peers and associations to do the same!
Dr. Perle points toward the future. We will be asked to show our evidence if we are to be paid. Now, more than ever, it's time to put our money where it will do the most good. Support research.
Frank M. Painter, DC
La Grange, Illinois
Does the AMA Still Control Chiropractic?
Dear Editor:
I just had the opportunity to vote and comment on the ChiroPoll that asked, "Do you believe that the American Medical Association's efforts to boycott chiropractic are still causing MDs to be reluctant to refer to DCs?" At the time of my vote, there were about 645 respondents. What is amazing to me is that 47.2% responded "No." At the risk of sounding condescending, on what planet or better yet, in what universe, do these 47.2% live? Now, this percentage is bound to wax and wane as more votes are cast.* But for 47% of this profession to believe that the medical boycott, arbitrary arrest and jailing of chiropractic doctors, destroyed businesses, wrecked home lives, ruined reputations, stagnated chiropractic educational advancement, community alienation, political indifference, and the virtual branding forever of the letter "Q" (for Quack, for those 47% who just can't imagine what I am referring to) on our foreheads is no longer causing MDs to be reluctant to refer to DCs is simply incredible.
It is interesting that this 47.2% closely parallels the 45.7% who indicated that chiropractors should not have the right to prescribe OTC medications. (Editor's note: See "Nonprescription Drugs: Should We or Shouldn't We?" Nov. 17, 2003 DC.) Is it possible to conclude a correlation between the same statistical respondent base to the OTC question and the question of MD's referrals and the medical boycott? By the way, if that 47.2% is listening, it is still going on! I would like to pose another few other polls or surveys: How many DCs have read either of Dr. Wilk's books? How many DCs know when the last chiropractor was jailed in this country for practicing chiropractic (or for practicing medicine without a license)? What was the last U.S. state to jail chiropractors? How many DCs know the name of the judge who handed down the final decision in the Wilk anti-trust case? What was the stated purpose of the "Anti-Quackery Committee," and which major organization supported and funded its efforts? Who was Joseph Sabatier, MD? Who was H. Doyl Taylor? It would be interesting to know if the same 47.2% of our profession could answer even a few of these questions. These questions are at the very heart of our existence and an integral part of our profession's history; they have shaped what and where we are. But pitifully few understand today.
I will be the first to admit that interprofessional cooperation between chiropractic and medicine is infinitely better today than it was 25-30 years ago. Compared to the abuse doled out to both us, as practitioners, and our patients, we have indeed come a long way. But to remotely believe that the past boycott and actions of the AMA do not still affect interprofessional referrals and cooperation is to believe the world is still flat and that we really never did go to the moon! Or that the abolition of slavery by the Emancipation Proclamation has left no lasting effect on civil rights and ethnic discrimination. In spite of clear evidence, there are those who just choose not to believe ... or are so caught up in their narrow worlds that they cannot see!
I responded to the Nov. 17 editorial in DC calling for field commentary on the issue of chiropractors using OTC medications. In my response, I cited a recent statement by a patient of mine, who is an ER physician and very "pro-chiropractic." He clearly sees, believes and has experienced the benefit of chiropractic, and the failings of allopathy in the musculoskeletal arena. Yet, years after the settlement of the anti-trust suit, a pro-chiropractic doctor like this still finds it hard to refer patients for chiropractic care because, as he puts it, "the political climate just won't allow it." Now, that does not mean that medical physicians like this one, and many others, are not making referrals. In fact, they are! But that is not the question. The question is whether the past does not still have an effect on MDs referring to DCs. The answer is a resounding "Yes!" If after all this, the "political climate" is still not good or open, then the actions and attitudes of the past still affect the present. Now, I am clearly not in the leadership in this profession. But I wonder, if a poll was taken of just the "leadership," those who are in the trenches every day; those who have to deal with politics, lawsuits, public policy, government and institutional policy - would the response still be virtually split?
- Editor's note: Final poll results: 51.8% Yes; 48.2% No.
Steven R. Mooring, DC
Pueblo, Colorado