If you could change the future for the chiropractic profession, what would it look like in 25 years? I just fired up the freshly polished, stainless-steel DeLorean. The flux capacitor is fueled and ready to take you to the year 2033.
Will the future prove that chiropractors have finally been accepted by the health care system as primary health care providers? Will chiropractic finally be recognized as the solution to the skyrocketing costs of traditional health care? Could it be that our government, through Medicare or some other socialized health care system, will determine that chiropractic is one of the best ways to care for the unexpected extra 30 million people still alive? Will full access to chiropractic care be available to every U.S. citizen? Will more new chiropractic schools be needed to meet the burgeoning demand for chiropractic services and the doctors of chiropractic to provide them?
Or perhaps the DeLorean door opens to a dark, sad future. The AMA and its partners-in-crime, the health insurance and pharmaceutical industries, have finally "contained and eliminated" chiropractic as a threat to their nefarious monopoly. Most states have now outlawed the practice of chiropractic, except by a medical doctor, of course. All chiropractic colleges have been forced to close their doors forever. Chiropractic as a healing art, science, philosophy and idea is now relegated to the history books.
From the early 1900s, as state chiropractic laws were written and passed, state chiropractic associations were formed to pass, nurture and protect the laws and rights of those early chiropractors and chiropractic patients. The history of the rise of chiropractic in each state is rich with accounts of the hard work, sacrifice, persistence and, in some cases, imprisonment endured by many of those chiropractic (and association) pioneers. That tradition of state chiropractic associations serving doctors of chiropractic and their patients continues to this day.
In 1969, the Congress of Chiropractic State Associations (COCSA) formed to become an "association of associations." The idea was to bring all of the chiropractic state associations together to share information, help each other with common challenges and solve some of the problems that were unique to state chiropractic associations. Over the years, COCSA's mission evolved to providing (as illuminated in the organization's the mission statement) "an open, nonpartisan forum for the advancement of the chiropractic profession through service to member state associations."
In the mid-1990s, COCSA member associations became frustrated with the lack of willingness on the part of the national associations to work together, much less unify. In some cases, the ACA and ICA actually worked against each other on national issues. The COCSA board decided to take a proactive role in attempting to get the national associations to begin some kind of dialogue that would at least lead to some kind of working relationship and, at best, unity itself. In 2000, COCSA hosted a planning meeting of all the major national chiropractic associations that eventually led to the formation of the National Chiropractic Leadership Forum (NCLF).
The NCLF made some considerable progress in getting agreement on some very sticky issues. For example, the NCLF agreed to adopt the ACC Paradigm of Chiropractic as its founding principle. To get chiropractors to agree that the sun rises in the east, much less on any model of chiropractic at all, was a significant accomplishment.
The NCLF also adopted a code of conduct for future meetings and a powerful document called the Declaration of Professional Responsibilities. The declaration calls for each chiropractor to:
maintain alumni membership;
exercise jurisprudence;
maintain ethical practice standards;
be an active member in a state chiropractic association;
be an active member in a national chiropractic association;
make regular contributions to chiropractic research;
engage in grassroots political activity;
financially support the political process;
live and practice a chiropractic wellness lifestyle;
demonstrate intra- and interprofessional cooperation and respect; and
participate in mentoring new members of the profession.
More on these professional responsibilities later. In 2001, COCSA went on to establish a task force on state unity to address the issue of multiple state chiropractic associations functioning in many states. COCSA membership adopted a resolution on state unity as a result of that effort. To address its members' growing dissatisfaction with the lack of unity in the profession and to reflect the direction COCSA intended to take, the COCSA board also adopted a new slogan for itself, "Promoting a More Unified Profession."
Ultimately, NCLF failed, mostly because - predictably - the national associations could not reconcile their differences, but the focus on unity has born much fruit. Today, Washington, Pennsylvania, New Jersey and Michigan have all combined multiple associations to form single, unified, stronger associations. Many others are currently in negotiations to unify their states. In all of these unified states, the chiropractic profession speaks with one voice to legislators and other decision-makers of all kinds. It is increasingly clear that chiropractic unity yields far better results than disunity; single associations are far stronger than multiple, smaller ones competing with each other for chiropractic resources.
Most recently, the 32 chiropractic organizations that make up the "Chiropractic Summit" committee have been meeting and working with collaborative effort on the major issues affecting our profession today. The summit began meeting in September 2007. After three meetings, it is still growing in membership and commitment. The summit is working to protect the future of chiropractic in the Medicare program and prospects for meaningful inclusion in any national health care reform that may come about. These public policy-related issues will require a carefully researched, developed and united response from the chiropractic profession if the interests of our patients are to be protected.
Looking around the room at the summit meetings, I see a passion and a determination to get it right. I no longer see the "me, myself and I" mentality, the unholy trinity that has plagued our profession through the ages. At this point in history, we can't afford to let any disagreements get in the way of our efforts.
The future hasn't been created yet. It's still very much in flux, if you will. As you lift the door on the DeLorean and look around at chiropractic in the year 2033, which future will you see? What part did you play in that outcome? Did you fulfill your professional responsibilities as listed above? Did you do the work that needed to be done or give the money that needed to be given to assure the best possible future? Or did you sit back and let others do the work and give the money that was needed to shape that future? Did you serve the profession by paying forward to the next generation of chiropractors ahead of you?
Doctor, you are responsible for which future will be realized in 2033. The biggest "association" in our profession today is the "NCA," the "No Chiropractic Association" members. If you are a member of the NCA, I have to ask you: What's it going to take? The future is going to happen with or without your support. The problem is the support you do or don't give will positively or negatively determine the state of chiropractic in the future.
State associations need you. The primary purpose of state associations is to protect and fight for your rights as a doctor of chiropractic. But they need active members who are willing to take the time to give to the process. If you are in the season of life that doesn't allow you the time to volunteer, then at least join and pay your dues. By so doing, you are empowering your association to serve and advance our profession in your state.
Unfortunately, the DeLorean that Hollywood fitted with a flux capacitor doesn't exist. There is no quick ride into the future. We will have to get there one day at a time. The future you find on that day, 25 years from now, will be determined by the responsibilities you fulfill today and every day until then.
Jerry DeGrado, DC is a 1985 graduate of Logan College of Chiropractic. He has been in private practice for the past 23 years in Wichita, Kansas. He is currently president and acting executive director of the Congress of Chiropractic State Associations (COCSA).