4 Loyalty and Opportunity
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Dynamic Chiropractic – September 20, 1999, Vol. 17, Issue 20

Loyalty and Opportunity

By Arnold Cianciulli, BS,DC,MS,FICC,FACC
Loyal means faithful to a person, ideal or custom. If we analyze our profession today, can we say we are loyal? After many years of practice, I conclude we are not loyal.

In our early phase of development, we had loyalty to the profession.

We were united in our efforts to gain legislative approval for the profession, not just for certain groups within the profession: straights, mixers, etc. Our loyalty was inclusive and universal. Yes, we had our internal differences, but somehow we rose above our differences and grasped the big picture. As a direct result of our loyalty, we established the licensure of chiropractic in all 50 states. Later, we passed insurance equality legislation for patient reimbursement, thereby overcoming the insurance bias against our services.

All this was achieved because we were steadfast, constant and unswerving in our philosophy of health. We believed chiropractic care was very important to the welfare of patients and thus worked to improve our educational institutions. We established the Council on Chiropractic Education, which was then recognized by the U.S. Office of Education as the accrediting body of chiropractic education. Loyalty, faith in ourselves and persistence resulted in a dynamic profession. The opportunities to evolve and progress can be attributed to the intense loyalty we shared within the profession.

Today we are confronted by a new health care system. Thanks to managed care, we have been hammered, our services reduced and our utilization regressed. Why? Obviously there are many external business barriers imposed on us which have resulted in the diminution of our health care services. But what about the internal barriers to chiropractic in managed care? After all is said, I believe we have lost our loyalty to chiropractic. We are causing our problems and only we can correct them. As I see it, here are some obvious internal barriers. Internal Barriers

• DCs have dropped membership in their state organizations.

• DCs have dropped out of ACA and ICA.

• Some chiropractic leaders sold their services to managed care organizations in exchange for agreeing to unconscionable guidelines for chiropractic utilization.

• Some DCs spend their days attacking the Mercy guidelines without accurately quoting those guidelines.

• Some DCs want no oversight of their services. To these professionals, multiple weekly adjustments forever are warranted, and they expect reimbursement.

• Some DCs want to include prescription drugs.

• Some DCs want to adjust the subluxation and neglect their responsibilities to the patient.

• Some DCs make a living attacking the profession and joining with dubious MD critics.

• Some DCs fail to realize the importance of collaborative research and the reality that research costs money.

• Some DCs fail to recognize the extraordinary contributions the National Chiropractic Mutual Insurance Company has made to chiropractic colleges and chiropractic research. Without NCMIC, much of the research would not be possible. Instead of loyalty, some DCs get malpractice coverage from companies which do nothing and contribute nothing to our profession.

After reading the internal barriers for which we are responsible, let's push for solutions, because the public use of chiropractic will only result with a return to loyalty by our profession. The time is right for all DCs to regroup our economic efforts.

Opportunity

We should support only chiropractic organizations which contribute to our collective well-being and shun vendors who take their profits from us and laugh on the way to the bank.

Further, we should join chiropractic organizations which are focused on the entire profession, not divisive voices which proclaim chiropractic purity and have ulterior financial motives.

Let me give you an example. The ACA's attorney, George McAndrews, is leading the charge against the Health and Human Services for their discrimination against chiropractic in managed care of Medicare patients. A victory against this federal bias will benefit all DCs, not just ACA chiropractors. Loyalty demands support of the ACA's efforts. Incidentally, NCMIC contributed $50,000 to this effort. What did your malpractice insurance company contribute? Common sense demands we support those organizations which support all of chiropractic, not just a particular point of view.

Being faithful to the chiropractic philosophy of health demands loyalty from all of us. What's your opinion?


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