Editor's note: While Dr. Andersen's column topic is nutrition, once a year he devotes this column space to discussing other issues relevant to the practice of chiropractic. Such is the case with the following article.
Every three years chiropractors are included in the annual Gallop Poll on Honesty and Ethics in Professions, in which adults are asked to rate the honesty and ethics of various professions. In 2012, 22 professions were included in the poll, six of which were in health care.
The December 2012 survey contained both good and bad news for DCs. The good news is that it was the best showing we have had in the survey. (Table 1) The bad news is that we continue to be the least trusted health care profession (Tables 1-2), far behind nurses, medical doctors (except psychiatrists) pharmacists and dentists. We are just behind psychiatrists (the only type of MD Gallop considered as a separate profession). To be fair, nurses and pharmacists are not fee-for-service like doctors, dentists and chiropractors.
| Table 1: Percentage of Adults Who Rank Ethics as High or Very High | ||||
| Profession | 2003 | 2006 | 2009 | 2012 |
| DC | 31% | 36% | 34% | 38% |
| MD | 68% | 69% | 65% | 70% |
| DDS | 61% | 62% | 57% | 62% |
Look at the tables and two things jump out: 1) The general public has an obvious trust gap between DCs and other health professionals. 2) Although DCs may be classified as "alternative" in academic circles, when 96 percent of the public has enough knowledge on a subject to have an opinion, that subject is mainstream.
| Table 2: 2012 Rankings by Profession (Health Professions Only) | ||||||
| Profession | Very High | High | Average | Low | Very Low | No Opinion |
| Nurse | 27% | 58% | 12% | 2% | 1% | - |
| RPh | 19% | 56% | 21% | 2% | 1% | - |
| MD | 14% | 56% | 26% | 2% | 2% | - |
| DDS | 11% | 51% | 33% | 3% | 1% | - |
| Psych MD | 6% | 35% | 43% | 8% | 3% | 6% |
| DC | 6% | 32% | 46% | 8% | 3% | 4% |
The Obvious Cause of the Trust Gap
I started this article on a Thursday night. I wrote the first paragraph and compiled the tables. I had some time in my schedule Friday morning and was preparing to finish it when my office manager said a new patient had just walked in. A few minutes later I was taking the history of a woman, who just happened to be an RN. When I asked her if she had ever been to a chiropractor before, she said yes. That triggered more questions:
How many? "Two." Was it a good, bad or so-so experience? "One good, one bad." Tell me about the bad experience. "It hurt more than it helped." And the good experience? "The treatment didn't hurt and it eliminated my pain." So, why are you here and not there? "Because he kept insisting I return"
So, the good chiropractor eventually needed you more than you needed him? "Exactly … and it happened with every problem. I would feel better and they would keep calling. I would eventually stop answering or returning their messages. This time I just didn't want to go through that because it felt like a 2-3 adjustment problem."
Her response to treatment was excellent and as we were walking up to reception, I asked her if she had seen the Gallop poll on professional trust. She had no idea what I was talking about, so I showed her the results. Then I asked her how she would have rated her first two chiropractors:
"The bad one is easy: I didn't trust him when he kept insisting feeling worse after every treatment was normal. The second one – whom I am no longer calling good – rates as average." I asked if she thought he was more concerned with getting her back instead of fixing her back. "No, he was genuinely concerned with fixing me, which is why I called him good, but once I was better he insisted I still had a problem when it was obvious that I didn't."
I told her, "We'll just book your next 87 visits now so we don't have to call you." I would have had her, but my CA burst out laughing and ruined the joke.
The Easy Cure
When a patient is better, acknowledge it. You make yourself look better, you make your profession look better and you do your part to improve our word-of-mouth reputation. After all, no one is saying, "I would trust my chiropractor more if they would stop trying to release me when I'm better."
The Gallop Poll on Honesty and Ethics
Gallop began surveying the public's opinion of professional honesty and ethics in 1976. It repeated the survey four more times from 1977 to 1988. Since 1990, the poll has been conducted annually using 21-23 professions each year. Twelve professions appear annually, while the other 9-11 rotate from a pool of approximately 30.
Chiropractors first appeared in the poll in 1999. We were next included in the 2003 poll with five other health care professions, and have been in the survey every three years since that time. Nurses also made their first appearance in 1999 and have been judged the most trusted every year except for 2001, when they placed second to firefighters.
The latest edition was conducted with USA Today from Nov. 26-29, 2012, when 1,015 adults (ages 18 and up) from every state were asked the following question: "Please tell me how you would rate the honesty and ethical standards of people in these different fields: very high, high, average, low, or very low." DCs placed 10th overall (Table 3), down from 9th in 2009, when psychiatrists finished in 10th place.
| Table 3: 2012 Rankings by Profession (All Professions Included in Survey) | |||
| Profession | Very High / High | Average | Very Low / Low |
| Nurses | 85% | 12% | 3% |
| Pharmacists | 75% | 21% | 3% |
| MDs | 70% | 26% | 4% |
| Engineers | 70% | 25% | 3% |
| Dentists | 62% | 33% | 4% |
| Police officers | 58% | 32% | 10% |
| College teachers | 53% | 34% | 10% |
| Clergy | 52% | 33% | 9% |
| Psychiatrists | 41% | 43% | 11% |
| Chiropractors | 38% | 46% | 11% |
| Bankers | 28% | 48% | 24% |
| Journalists | 24% | 45% | 30% |
| Business executives | 21% | 50% | 27% |
| State governors | 20% | 48% | 31% |
| Lawyers | 19% | 42% | 38% |
| Insurance salespeople | 15% | 49% | 36% |
| Senators | 14% | 39% | 45% |
| HMO managers | 12% | 52% | 27% |
| Stockbrokers | 11% | 48% | 39% |
| Advertising practitioners | 11% | 50% | 36% |
| Members of Congress | 10% | 34% | 54% |
| Car salespeople | 8% | 43% | 49% |
Click here for previous articles by G. Douglas Andersen, DC, DACBSP, CCN.