"In the beginning there were Dr. Greg Nelson and myself answering the questions," Dr. Best recalled. "As far as I know, my name was obtained from one of the doctor's forums. After Dr. Nelson left, Dr. Manison and I handled the forum ourselves for possibly a year or so."
"I wanted to be a moderator because I found it important to help others," Dr. Manison explained. "And I love addressing the surgery-related questions, because many times surgeons do not inform their patients about chiropractic care, and many times this care can keep people out of surgery. I see this in my office every day!"
Part of the appeal of the forum was that questions would be promptly answered, but by 2001, the two doctors were being overwhelmed with email questions and requests for information. In Dynamic Chiropractic we asked for more volunteers, and were encouraged by the positive response.
We narrowed down the list of volunteers to just over a dozen seasoned professionals from varying backgrounds and locations. "We had several well-qualified doctors volunteer," Dr. Best said. All are still serving. The moderators are:
- George Best,DC - Dallas, Texas, Parker College of Chiropractic
- Allen M. Manison,DC,CCEP - Columbia, Maryland, Life University;
- David Ahrend,MS,DC,CCSP - Westover, West Virginia, Palmer College of Chiropractic;
- William Carbary,MBA,DC - Little Rock, Arkansas, Life Chiropractic College West;
- C.E. Cleere,DC - Tulsa, Oklahoma, Palmer College of Chiropractic;
- Chad Freeman,DC - Riverdale, New York, Life University College of Chiropractic;
- Brian Gray,DC - Bridgeton, Missouri, Logan Chiropractic College;
- Christopher Hyde,DC - Kennesaw, Georgia, Life University College of Chiropractic;
- Jason Ingham,DC - Chicago, Illinois, Parker College of Chiropractic;
- Sunny Kierstyn,DC - Eugene, Oregon, Cleveland Chiropractic College, L.A.;
- Joseph Koshes,RPT,DC,CCSP - Sarasota, Florida, Palmer College of Chiropractic;
- Nicholas Palmieri,DC,MPH - Linden, New Jersey, LACC
- R.D. Pendergraft,DC - Redondo Beach, California, LACC;
- Donald Ringer,DC - Tracy, California; Palmer College of Chiropractic
- Kevin Tomsic,DC - Richardson, Texas, Texas Chiropractic College
"I like the quality of the practitioners that are on the panel. I think it truly represents the diversity of the profession," observed moderator Dr. Nicholas Palmieri. "These questions have reminded me to spend a little more time talking with my patients to make sure that they understand why I am doing what I am doing, and to be sure that something I did or said is not being perceived the wrong way."
"Working for the last year as a moderator has helped me organize my thoughts when discussing reports of findings with my own patients," reported Dr. Joseph Koshes, who appreciated becoming "more skilled" as he encountered different patients, situations and questions.
Dr. William Carbary's comments were similar. "I see things in a broader scope now, and I have more pride in being a chiropractor - but it's not the charged-up zealotry I had as a new doctor."
"You always learn when you talk to patients," added Dr. Palmieri.
Dr. Chad Freeman mentioned what many other DCs have discovered: "I have learned how little so many millions of people know about chiropractic, even with all of the increased media and numbers of chiropractors."
Typical posts the week of August 28-September 3 included questions about sciatica; scoliosis; arm, wrist, neck, shoulder and upper back pain; anatomy; terminology; headaches; otitis media; vitamins; sleep disorders; polymyalgia rheumatica; and chiropractic education.
There were several unusual problems posed to the moderators. "I don't have any sex drive,' wrote a woman from India," recalled Dr. Carbary; Dr. Donald Ringer remembered the question, "Can chiropractic help with anxiety and panic attacks?" and scrambled for information after one person asked about Tourette's syndrome.
"Moderation has definitely sent me back to my books," admitted Dr. Jason Ingham. "I'll commonly look up information for questions not usually seen in everyday chiropractic practice. I also enjoy finding new web-based resources for myself and passing them on to consumers."
Other posts are downright absurd: "The most unusual questions are those that sound like somebody might be poking fun or wasting your time," noted Dr. Christopher Hyde. "They use funny, made-up names and ask what are silly, even ridiculous questions. The challenge is to not fly off (the handle) with a gut-response, knee-jerk answer. Stepping back and saying to yourself, 'It is possible this person just doesn't know' is required. Then I answer the question as if I were speaking to my son. It can be challenging sometimes, but definitely prudent!"
Regardless of the poster's motivation or the complexity of the posting, the ultimate result is usually referral, according to Dr. Freeman. "About 85 percent of the questions are referred to chiropractors."
Some posts hold grave implications, as Dr. Best recounted: "One woman wrote in about her friend who was experiencing classic signs of a stroke, including slurred speech and partial paralysis. The writer had taken her to an emergency room, and after a cursory examination, was sent home! It seemed the ER had ignored the obvious stroke signs because of the youth of the patient, in her late 20s, as I recall. I advised the writer to get her friend back to the emergency room - a different one, if possible - immediately, and to refuse to leave until she was seen by a neurologist. I'm waiting to hear the outcome of that one."
The focus is on spreading the word of chiropractic through access, confirmed Dr. Best. "Regardless of whether the technique is the best or not, if the patient moves to an area where it is not available, the patient often chooses to go without chiropractic altogether. I believe this is a disservice to the patient."
Dr. Ringer concurred. "Chiropractic still is very underutilized. I think we still suffer from an image problem, as the "Rodney Dangerfields" (of "I get no respect!" fame) of health care."
"People are looking for doctors like us," Dr. Freeman noted. "I definitely see a trend toward a search for nonallopathic, drugless treatment, and people are thinking of chiropractors. But there's a lot of competition and you need to find your niche."
"These people have questions about whether chiropractic treatment can help a set of symptoms, and we provide general information about examination and treatment, so they can make intelligent decisions without being pressured," explained Dr. Koshes. "I really believe that a forum like this is the best way to build respect for our profession within the public eye."
"There is not much modern medicine can do for joint and soft-tissue problems," observed Dr. Manison. "A mechanical problem needs a mechanical resolution. Drugs just mask a problem, and surgery many times does not work. Chiropractors, in my opinion, are best suited to deal with such issues."
The Ask a Doctor of Chiropractic Forum moderators are practicing DCs who have generously made the time to answer people's questions. For many of the moderators, their "payment" is gratitude: "On a few occasions I have received personal email replies thanking me for my help. It makes me realize that you can make a difference and help people who live thousands of miles away," said Dr. Ringer.
"Both in my practice, and in my life in general," Dr. Carbary agreed, " I have experienced people I barely remembered coming back and telling me what a profound impact something I said or did had on them."
Dr. Freeman recalled his greatest lesson from moderating: "One thing I can say with total authority and confidence: If you don't respect your patients and give them your time and honesty, you will never be successful. You must show consideration for their opinions, wants and needs and figure out how to 'soft-sell' them with skill and expertise. Do this, and your practice will thrive."
"I am happy to be on a team that gives to the profession without expecting anything in return," reflected Dr. R.D. Pendergraft. "That kind of altruistic attitude makes the world a little better - and I am glad to have such people with me."
The Ask a Doctor of Chiropractic Forum continues to be a great resource for the public seeking information about chiropractic. That success goes to the dedicated DC moderators who have the sincere desire to help direct people in their health care choices, and have the passion and willingness to share what chiropractic offers.
Jim Harrison,
associate editor