I have admired my Uncle Salvatore from Scranton, Pa., for more than 45 years for the many accomplishments he has achieved with only a high school education. "Unc," as he is known by all his nieces and nephews, is not a doctor of chiropractic.
Uncle Sal learned the trade of shoemaker from his dad (my grandfather), who traveled from Italy, "The Old Country," to Pennsylvania in the early 1920s. My grandfather could not read or write English when he arrived in America, but that did not stop him from opening a shoe repair shop, just as his two brothers had done. They all owned and operated similar shoe repair shops, only three to four miles apart.
But as the shoe repair industry changed over the first two decades of the 20th century, only one shop would remain in business. My Uncle Sal would begin what I now see as a wonderful continual reformation of his industry.
Upon his return from the Korean War, during which time he served as a Navy officer, he began working as a cobbler, applying what his father had taught him. But Uncle Sal had a greater vision for the shoe repair industry. At the end of the day, while I was sweeping the floor or emptying the trash as a 10-year-old boy, Uncle Sal would often share with me what he was thinking of doing with the business he was destined to take over from his dad. I listened with excitement and at times uncertainty, wondering if, after 20-plus years of repairing shoes for the local community, the shop would one day close and no longer serve the public.
In the 60s, shoe repair became a lost art, because plastic shoes and artificial leather and materials made it impossible to repair the products. In essence, it became cheaper to throw the shoes away and purchase another low-grade product. Yes, managed shoe repair had hit the cobblers of America, and rather than protest, many just closed their doors, one by one, similar to the corner candy store some of you can remember.
Uncle Sal, a man with no formal business acumen, knew that in order to keep the business viable, he would have to change his business model or go the way of many in the industry. And change he did: After years of repairing shoes, he started designing them, graduated to making them, and then to selling them. The day they tore down the shoe-shine stand was the day that saddened me the most. You see, I was one of the shoe-shine boys, and I had just lost my job at age 14. The 25 cent shines and 5 cent tips (which all of the shoe-shine boys shared) were gone.
That was the first change. Then came the major change - no more shoe repair in Uncle Sal's store. My grandfather did not speak for weeks, knowing that so much of what he had created was changing in his lifetime.
The tenant next door, a loan company that paid approximately $100 a month in rent, was advised it would have to move so Uncle Sal could expand his new vision. That vision would meet the void and fill the customer need in his community. This man knew that to stay in his beloved industry, he needed to make changes to "survive and thrive." What a man! He did not always succeed, but he rarely failed at anything.
Today, the business is in its fifth generation. Uncle Salvatore is retired, and his son and grandson now manage and run the business. Even though Uncle Sal is retired, he still visits and observes the work; and he still has ideas for growth that he shares with Salvatore Jr. and Salvatore III.
What message can we take from this success story? There are many! As doctors of chiropractic, you need to constantly reinvent and improve your scope of practice to conform to the times. Why? Because "these times are a' changing, my son, they sure are." What are you doing to meet the changes taking place in your office and your industry? Do you balk at change? Do you research your industry and wonder where your profession will be 10, 20 or 100 years from now? Otherwise, you may be headed the way of the cobbler - working until the industry changes without you and then realizing it's too late. Are you observing the competition; the people who think they can do what you do with less training and skill?
As I see it, the chiropractic profession is at a major crossroads. The road you travel will make a difference to your future and those who will follow you. The professional associations are your eyes to the future. The associations are constantly mapping and re-mapping the landscape so the doctor of chiropractic can continue to practice in the 21st century and beyond. Look to the state and national associations as your GPS system of sorts, to make sure you get where you want to be on time and safely. Do not allow insurance industry executives or legislators to map out your future. By working together as a unified profession, we chiropractors can control our own destiny.
If you continue to practice without involvement in your trade association, you will miss out on the many changes that are taking place, changes that affect your practice. You know what I am talking about: HIPAA, Medicare, CPT codes, malpractice, CEUs, and so on.
By being a member of your professional association, you have a voice and an ear. You have a comrade to share your concerns and your visions. So, next time you see an ACA or ICA volunteer, or any state association staff member, let them know you appreciate all they are doing for you and for this profession. Keep your dues current so the industry can stay ahead of the health care trends. If you are not yet a member in good standing, make the decision now to get involved! My Uncle Sal and I will both thank you for doing so.