Ever since chiropractors fought back the attempts by the American Medical Association to discredit and eliminate our profession, we have experienced a new era. The era is our opportunity to prove ourselves while the courts hold the medical profession at bay. This era has brought a public focus that at times has been decidedly uncomfortable.
From the RAND report to the Low-Back Pain Panel of the Agency for Health Care Policy and Research (AHCPR), chiropractic is undergoing a new kind of scrutiny. Consider the effects of Super Bowl endorsements from professional athletes, exposure in the New York Times, Washington Post, Wall Street Journal, Time, McCall's, Woman's Day, "Dear Abby," "CBS This Morning" (twice), "CBS News Nightwatch," "20/20," "Good Morning America," "World News Tonight," "NBC News," and "60 Minutes," as well as many cable and local television, radio and news publications. This has all taken place in just the past three years!
This doesn't even take into account the numerous papers which have appeared in the various scientific journals outside the profession: New England Journal of Medicine, Journal of Family Practice, Journal of Occupational Medicine, and Journal of American Health Policy, just to name a few. The public, scientific, legislative, health and third-party payer communities are taking a close look at what the chiropractic profession has to offer.
Eventually, you are the one who will answer the questions and address the issues raised by those in your community. Doubtless there is an MD waiting to debate you on certain issues: "So, what is this 'chiropractic philosophy,' and why do you believe it?"
In the area of behavioral research there are considered to be four "methods of knowing" that explain why we believe what we believe, or know what we know:
Method of Tenacity -- these are beliefs held regardless of the facts presented. The individual will reiterate these beliefs, indeed, repetition of their beliefs strengthens them.These methods of knowing have parallels in chiropractic. In chiropractic college, an authority told you what they believed. It appeared reasonable and intuitively you believed it. Now you attend seminars and meetings where you and others repeat these "truths" to each other. But how do we now communicate this to the outside world?Method of Authority -- If someone in authority says it is true, it is. While this influence is responsible for much of what we hold to be true (news media, government officials, experts, etc.), who we consider an authority becomes problematic.
A Priori Method or Method of Intuition -- If it seems right, it must be true. These are beliefs accepted because they appear reasonable, logical, or just seem to make sense. But clearly what makes sense to one person frequently is at odds with the beliefs of others.
Method of Science -- understanding the truth regardless of our opinions or prejudices. Demonstrating something scientifically may raise more questions, but it should establish facts that are clear to all.
As the public, legislators, and others begin to examine and ask questions about what chiropractic is and what you do, you will be asked to demonstrate your beliefs. Your methods of knowing will greatly determine how well your message is received.
While the vast majority of health care has not been researched, you as a chiropractor have a philosophical model of why you do what you do. When was the last time you subjected your philosophical model to some personal scrutiny?
What part of your chiropractic philosophy is based on what you learned in chiropractic college?
What part of your model has not been confirmed in your practice?
Have you subjected your chiropractic model to the truth contained in the latest research studies?
Do you simply repeat your dogma in the face of new information, afraid to examine and possibly have to rebuild your chiropractic model?
Chiropractic has a truth in and of itself. Most of that truth has yet to be revealed and confirmed by scientific study. Your philosophical model, albeit imperfect, must bridge the gap between what is known and what you believe.
In order to present the truth about the benefits of chiropractic care, your philosophical model cannot be ignorant of current information. You cannot merely repeat philosophical verbiage and then become antagonistic when some one "doesn't believe in chiropractic."
The truth of chiropractic will never change, but what you understand and believe must be examined in light of the truth revealed in science. You must be willing to adjust your philosophical model as new information is uncovered, yet retain the truth of chiropractic as revealed in your practice.
Don't be afraid to put your philosophical model constantly to the test and modify it as necessary. The world doesn't expect you to have all the answers. It only expects you to be honest about what you do know and willing to appreciate what has been discovered by others.
1. Kerlinger FN: Foundations of Behavioral Research, ed 2, ch 1. New York University, Holt, Rinehart and Winston, Inc. 1973, p 5-6.
DMP Jr., BS, HCD(hc)
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