ICA, ACA and the Future of Chiropractic
By Brandy Mychals, Life West student; student member of the ACA and ICA; SACA President - Life West SACA National Legislative Vice-Chair.
Chiropractic is constantly evolving. If you want to predict the future of our profession, look no further than the chiropractic colleges. There are approximately 15,000 chiropractic students in this country and the numbers are growing. Therefore, before you dismiss the student perspective as irrelevant, please realize that within a few short years, we will be your colleagues; our sheer quantity makes us a significant portion of the chiropractic profession.
In my experience, I have found that most students are demanding a unified association to represent us. I speak for a large percentage of students when I say that I am not interested in the old battles, politics or propaganda. Those of us who have done our homework know that the ICA and ACA stand for the same thing, and have almost identical bylaws and mission statements. Furthermore, we want a safe place to convene and express differences regarding the science, philosophy and art of chiropractic followed by the presentation of a unified and intelligent front to the rest of the world. This is the realm in which we operate as students.
Everyone starts chiropractic college eager to learn, share and support one another. Later we adopt our own ideologies, and challenge one another's technique, philosophy and science. When we are done fighting we adjust one another and go home. Occasionally some students become narrow-minded and refuse to work with one another. However, this is the exception. Most students want to deliver the best possible quality care to patients and are willing to cooperate with their colleagues in that learning process.
Eventually I see the profession working together to examine our various talents and study what is best for different types of patients, how it should be delivered and at what time. However, we will never have that kind of collective collaboration if we can't step into the same room. As students, we are tired of this. We want to see egos checked at the door and experience a cross-section of the brilliant minds in our profession working together.
I assume that most of you became chiropractors because of the desire to help others, or because of the positive healing you experienced as a chiropractic patient. If this is merely a job and income, there are much easier ways to make a living. I can tell you that most students have a passion for chiropractic that supersedes the downside of joining this collective group of unorganized and grouchy doctors who refuse to get along!
As students and future leaders in this profession, we ask ourselves "What are we really about?" On a personal level, I envision seeing chiropractic advance, prosper and become available to every person on the planet. Of course, this means we must stay committed to delivering quality care. The best way to do this is to police ourselves, challenge our protocol and make sure we are the leaders in chiropractic research. In this way, we will dictate the future of chiropractic care. This may seem like a great challenge, but once the hurdle of a single national organization is met, we can begin the process. If we don't circle the wagons and create our own future, someone else who isn't as emotionally attached will, simply because they are more efficient.
As an ACA member, I am proud that my organization is responding to our cries and is pushing for a merger. As an ICA member, I am disappointed that my organization keeps turning a deaf ear. As a student, my comment is that we all need to get over ourselves and get on with it.
The new generation of chiropractors is creating an era where we are organized and supportive of one another. The environment will be one that celebrates chiropractic philosophy, researches and promotes scientific advances, examines our varied techniques in the atmosphere of respect, tolerance and integrity-while having one hell of a good time. This may sound farfetched to the more cynical docs, but students are already making it happen. If you want to know what is going on in this profession, what challenges we face and what the opportunities are, then I would like to make the following suggestions: Peruse the Institute for Alternative Future's summary on chiropractic; read the ACA vs. HCFA lawsuit; read the article from the CEO of Kaiser regarding iatrogenic deaths; read any natural healing book, by authors such as Pert, Weil, Northrup and Chopra; read the "Four Biggest Lies in Chiropractic" by Dr. Edwards; read all of the ICA and ACA bylaws, mission statements and master plans; ask your patients what they want in chiropractic healthcare; and then talk to a chiropractic student.
A revolution in health care is occurring at this moment, and chiropractic can help shape that future if we can only enter the same room. The public is ready, the students are poised, and my question is, "Would you care to join us?"
There Is a Difference
By Maxine McMullen, DC, FICCP, special advisor to the Palmer president.
If the ACA and ICA are the "the same thing" (as Dr. James Edwards states), then why does one choose to belong to one association over the other? As an officer of ICA and a postgraduate educator, I have spent many hours in conversations with graduate DCs from all areas of the country and from varied alma maters. The feedback I get from the field is that there is a difference, regardless of what the bylaws say!
Leadership
How members of the board, representative assembly and officers are empowered in their membership representation is quite different in each association. This is most distinctive at the presidential level, where in one (ICA) the membership votes for their president, compared to the other (ACA), where the board chooses him/her. This creates a more democratic style of leadership and keeps the membership and elected officials on their toes.
Global Chiropractic Support
By their very names, the level of representation for chiropractors in practice is different within each association. In this era of "global economy" and the superior ability for worldwide communications, only the ICA extends itself beyond the borders of the U.S. This nation has a tremendous impact on health care trends throughout the world. If the profession wants to assume a "separate and distinct" presence in the health care arena, it is imperative that we extend beyond our borders and embrace the cultures throughout the world.
With the development and growth of chiropractic educational institutions in far-off countries, the need to provide a sense of "roots" and professional stability from its country of origin has become exceedingly important. To be concerned solely with the needs of the graduates within our own borders is not only selfish, but folly, if we wish to ensure that the purpose and principles upon which this profession was founded are to remain paramount.
We also have students graduating from American institutions and return to their homeland, where they find little or no support for their profession. Only the ICA has an arm to proffer them. Why has the World Federation of Chiropractic become so powerful? It simply fills a void.
Personalities and Egos
There is a more jealousy from each member of the ICA and ACA of belonging to either, than most of us in our present leadership positions would like to admit! This caused division between the two groups during the merger fiasco in the 1980s. To me it was reminiscent of the sandbox attitude of kindergarten kids, "My daddy is bigger than your daddy," and "If you don't do it my way, I'm going home."
What happened to maturity, honesty and integrity? Jim Edwards said in his article, "Lets combine ICA's 6 percent and the ACA's 24 percent (of Dr. Klapp's estimated 30 percent of DCs that belong to both associations) into one large national organization." This kind of mathematical equation pulled leadership who may have voted for the merger away from that choice! ACA does have more members than ICA, but not four times the members. As long as we maintain that type of mentality, even a successful merger would become a "house divided against itself."
If we truly want one association, then one of the two groups has to volunteer to completely disband. Which group should it be? The smallest? The successor? How would the first leadership group be chosen? Personally, I like the way that the membership gets to choose the majority of the executive committee and main body of the ICA Board.
If the ACA sees "no difference" between itself and the ICA, what is stopping it from encouraging its membership to transfer their association dues to the founding institution (ICA), and running for office as each term expires next year, just as I did? That's how it should be. The membership votes for its leadership to represent and support them. For reasons previously outlined, I believe we should remain and expand our international status, thus keeping "international" in our title. It's that simple.
This probably won't happen, however. In the very short time I served with the "Alliance," which was an attempt to bridge the two groups, it became clear that the ideal would become lost in the pile of resentments and regrets based on history.
Look in the Yellow Pages under "Chiropractors." No wonder the public is confused. There are more "alternative therapies" on one page than animals on a farm. If chiropractic is "separate and distinct," it is not an "alternative." We are not "in competition" with allopathic care, but rather, a separate type of care. It's not "complementary" (resembling) but rather "supplementary" (added to fill a deficiency).
What "alternative" care program offers its patients a genuine wellness-oriented health care system, with a focus on all the symptoms with which patients present? Some may make attempts at "preventative" care by providing a series of exercises or encouraging improved nutritional programs. Very few approach it from the "wellness attitude" creating an awareness and sense of responsibility for maximizing the human experience. This encourages the empowerment of patients and the freedom to choose the health care style that best suits their individual needs. I know my peers are desirous of this type of system, but many are unaware of the chiropractic viewpoint on health because there is such a high degree of incongruency within the profession.
This was notable in our recent presentation to the VA, at which where the leadership of each association submitted reasoning for chiropractic care to be embraced for individuals who serve/have served in the armed services.
The ACA presented its case along the lines of specific conditions to be "treated" by the DC, backed by the Mercy guidelines. The ICA presented a "subluxation-centered case", regardless of presenting symptomatology. (In other words, growing children and nonsymptomatic patients would not be excluded from care). How can that be seen as "no difference?"
That does not imply that we cannot or should not take care of patients with symptoms, nor care about the problems with which they present. It's where we choose to place our focus that is important. Patients (and their attendant health care status) should not be reduced to the level of disease manifestation, but rather seen in regards to the overall exhibition of their health/life continuum. To do this, evaluation of their history, physical examination, special studies (e.g., x-ray) become part of the art form that allows us to accurately treat them. As these findings change, they are reflective of dynamic movement along this continuum: nothing more, nothing less. Unfortunately, results are too frequently used as the reason to "get" or "discontinue" care, and that is where we often fail them.
That is why the profession must remain "separate and distinct." This does not mean we have to be isolationists! To the contrary, we have much to offer our frequently frustrated counterparts. I was recently told by an MD friend: "Chiropractors don't realize how well-off they are! They attract patients that, for the most part, choose to want to be self-reliant, pay up front for services, and you don't have to deal with managed care." It certainly made me pause and be thankful, and to understand that the grass is not always greener on the other side of the fence.
What's in it for me?
It is not uncommon to hear, "I'm paying out all that money every year and what do I get in return? I'd rather do something positive with it like..." This selfish attitude permeates the profession as extensively as it does our general society. One might suggest that is the norm. I challenge that. As professionals, we are (and should be) held to higher standards (than the "norm") and by the three Rs: reason, respect and responsibility. These should be reflective in our three Ps: person, practice and profession. This is reason enough to belong to, be active in and advance the quality of our chiropractic organization(s). Anything less is irrational, disrespectful and irresponsible, and should be seriously evaluated by each of us, individually.
How can we expect respect when we don't give it? Can we become upset with others' lack of reason, when our own is limited? Can we call others irresponsible when our own exhibition of an ability to respond appears to be absent? If you don't like things as they are, change them, or at the very least, support those of us who do want to make a difference.
Stuck in Intransigence
We all need to see the "big picture"- that chiropractic is more than merely a "treatment" that we can prove (e.g., low back pain, headaches and colic); that it can and does improve the overall health and well-being of patients (per surveys and similar outcome measures); and that individuals under care, (living the "chiropractic lifestyle") excel in their endeavors, maintain effective relationships in their lives and enjoy some level of spiritual awareness. Until we realize these factors, we will remain splintered into all of the factions we presently have.
My answer to "what is chiropractic?" is very simple: What we do is adjust the patient to remove the subluxations that are impeding the "communication" of the functions within the body at 100 percent of its potential. We have an attitude and ability no other profession espouses and that is what makes us "separate and distinct." We are teachers; educating, guiding, affirming those patients we serve, and offering them freedom. This is simple. Everything else already exists in some other health care system.