Our Problem Is What We Offer, Not What We Don't
Dear Editor:
I just finished reading the articles written by Drs. Winterstein and Clum [June 3 DC].
That having been said, here's my take: Empirical evidence would seem to suggest that we in the U.S. are the most heavily drugged society in the world. Whether that's a good or bad thing is for somebody else to decide, but, clearly, more drugs seems not to be an issue here. And so it seems that more access to more drugs isn't necessarily what the public needs, it's simply what the public wants. The public also wants them, by the way, without paying for them.
My medical provider has never given me what I wanted, but always what he felt I needed. We need to do the same thing. I honestly can't speak for the osteopathic profession as a whole. The DOs I have visited practice no differently than MDs. I once asked one of them (my current doctor) about manipulation, and he told me that if he felt any of his patients needed any, he would send them to me. While I've known this doctor since we were both children, that was 20 years ago and it hasn't happened (a referral) yet.
There is now a course offering that allows for and teaches prescriptive rights for all drugs. It's called medical school. If chiropractic physicians are anxious to get into the practice of medicine, limited or otherwise, they should make the decision to get their MD degree,sit for the board and do the job right. And if Dr. Winterstein is so hell bent on these rights, then perhaps he should open a legitimate school of medicine on his campus and offer that degree. It seems fairly obvious that National has dropped all pretense of being a chiropractic school, and it would at least create an entity with some integrity.
The same should hold true for those who wish to include psychological, nutritional or other guidance. Those who practice in those fields need to be licensed. Play by the rules.
There are many, many places where I can find somebody to recommend drugs, get reasonably good dietary advice, massage therapy or any number other number of approaches and/or modalities so necessary to health. To the best of my knowledge, there is only one place where I can get a good adjustment. If I need drugs, only drugs will help me. If I need an adjustment, only an adjustment will help me.
I believe that the reason for chiropractic's struggle now has nothing to do with what we don't offer, but more with what we do offer. If 20 patients were to walk into 20 "chiropractic" offices, each could report a different experience. How would each of them describe chiropractic to the other? In what other profession does that occur? Let's just be clear about what chiropractic is.
Whether or not we as a profession choose to believe in the subluxation, the fact is that chiropractors have been adjusting and saving lives for well over 100 years now. Whether or not one chooses to believe it, history seems to be unequivocal, for instance, that people who got adjusted during the flu and polio epidemics of the early 20th century stayed healthier. Do we need research? Sure we do. But meanwhile, we have over a century of experience that says the adjustment is useful and necessary in its own right.
People need drugs on occasion. And they need to be adjusted to help them live better. Let's give them the latter.
I know, I know. Just my thoughts; nobody asked me.
Michael M. Ward, DC
West Bridgewater, Mass.
If We Do Not Move Forward, We Will Die as a Profession
Dear Editor:
I happened to read the two opposing opinions about enlarging scope of practice by adding prescriptive rights [Clum and Winterstein articles], and as a doctor of chiropractic since 1989 who is from a family of MDs, and who has a great friend of 20 years who is an osteopathic physician, I have a definite point of view. I agree wholeheartedly with the excellent article by Dr. James Winterstein and could not be more opposed to the stance of Dr. Gerry Clum.
If one surveys the various systems of health care in this world, ours seems to be singularly bent on avoidance of giving nostrums, potions, medications, and the like.
I happen to practice full time in a state in which chiropractic, as a health care delivery art, is being attacked by a combined effort of the American Medical Association and the Texas Medical Association. It appears to be the clear intent of the AMA and TMA to completely eliminate chiropractic from the face of Texas. Their attack is on our ability to even diagnose our own patients.
Now, since Dr. Winterstein brings up osteopathy (and properly so), it is quite instructive to see that the DOs are not being attacked in any way by the allopaths. It is also instructive to think that, as a profession, we are seeing (on a good day) about 10 percent of the population. The osteopaths (who, by the way, can call themselves "physician" in Texas, while doctors of chiropractic cannot) have become integrated into the mainstream health care system, and are not being discriminated against as are we. A perfect example is that if I have a patient on Medicare or Medicaid who needs an MRI or CT scan, only an MD or DO can prescribe these, although I can regularly prescribe these as needed for other insurances.
I can tell you what I am seeing. I am seeing our patient numbers dropping, incomes dropping, and chiropractors quitting this profession to go into other occupations / professions where they can earn a living and not be so afraid that their occupation could suddenly be eliminated by a bad court ruling.
I am proud that with my hands, I can help someone. I am proud that as a doctor of chiropractic, I have helped patients when other doctors have given up, and that patients came to me as a last resort and found help. However, I am not proud that it was only as a last resort that they came to me, because they wanted to try painkillers and NSAIDs first.
Are medications occasionally dangerous? Of course they are. Paraphrasing Paracelsus, "All drugs are poisons; they differ only in their doses." That said, are we suddenly going to be able to cure a virulent infection or set a broken bone with a great adjustment? To be a true primary care provider, there are a lot of traumatic injuries, infections and other health problems that are not going to be easily corrected with spinal or extremity manipulation.
This country needs more primary doctors; we are crying out for more primary care providers. But to truly be a PCP, one must be a generalist, and this means able to prescribe and yes (shudder), even do minor surgeries. If we do not move forward, we will die as a profession.
John Raymond Baker, DC
Longview, Texas
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