Many faculty members teaching in the classroom or performing research within academic institutions have earned doctorates and use the title of "Doctor" or "Dr." They are usually referred to as professor or doctor within the classroom by students.
Doctor, as a title, originates from the Latin word of the same spelling and meaning. The word is originally an agentive noun of the Latin verb docere: "to teach."1 It has been used as an honored academic title for over a millennium in Europe, where it dates back to the rise of the first universities. This use spread to the Americas, former European colonies, and is now prevalent in most of the world. Contracted "Dr.," it is used as a designation for a person who has obtained a doctorate-level degree. Doctorates may be research doctorates or professional doctorates.2
Doctor in the House?
So, if a medical emergency arises and someone yells, "Is there a doctor in the house?" who should respond? Obviously, a PhD trained in mathematics or political science, lacking in emergency medical training, should not respond in the affirmative. An allopathic or osteopathic physician certainly should respond; but should a doctor of podiatric medicine, doctor of dental medicine, doctor of naturopathic medicine - or doctor of chiropractic medicine?
The answer is actually simple: Any health care provider trained in emergency medicine or first aid should respond to assist an individual with a medical emergency. I suspect a medical doctor (MD), doctor of podiatric medicine (DPM), doctor of chiropractic (DC) or doctor of chiropractic medicine (DCM) available to assist an individual in need due to choking, would be capable of evaluating the condition and performing a Heimlich maneuver. After all, health care providers are expected to be trained in first aid and able to respond to a medical emergency.
At the University of Bridgeport College of Chiropractic, students are trained and certified by the American Heart Association to respond when an individual is experiencing a medical emergency, such as a stroke, myocardial infarct or asphyxiation due to choking. (As I write this article, I realize it is time to renew my first-aid training with either the Red Cross or the AHA.)
In my orthopedic and neurological labs, and differential diagnosis of neuromusculoskeletal conditions classes, all students are trained to identify a patient experiencing a myocardial infarct, a stroke or the neurological effects of a mild traumatic brain injury / concussion. Next semester, I will add a review of the Heimlich maneuver.
Thus, if a chiropractor is trained to respond to a medical emergency and is confident with the emergency procedures, the DC should volunteer assistance.
Always a Doctor of Chiropractic?
Next, I would like to discuss a different scenario regarding the ethical use of professional titles: When is it unethical to not identify yourself as a chiropractor, chiropractic physician or chiropractic specialist? When I am traveling or dining out, I often am asked what I do. At times, I do not state I am a chiropractor. Depending on the circumstances, I might respond that I am a professor at the University of Bridgeport or the director of health sciences postgraduate education at the university. It allows me to avoid the individual attempts at humor, such as, "Oh, my back hurts" or "I need my neck cracked." In addition, it permits me to avoid risky discussions regarding the individual's health status and requests for medical advice. I am certain all of you are familiar with these situations.
But recently, a New York television station reported that a doctor had hosted a seminar in a hotel with the intention of recruiting patients, without informing the attendees he was a chiropractor. According to the TV station, one of its producers attended a seminar offered by a New Jersey chiropractor focused on attracting patients for the treatment of metabolic diseases, such as diabetes. The station reported that some of the chiropractors patients felt they were misled by the chiropractor because they thought he was a medical doctor promising to reverse or cure diabetes.
While attending the 90-minute discussion by the chiropractor, the station producer could not recall the doctor informing the audience he was a licensed chiropractor at any point. In addition, the producer reported to have heard the chiropractor speak technically about medicine and claim he could reverse diabetes by fixing broken metabolism. The chiropractor mentioned at the seminar that not everyone could be cured, but he said he did not accept patients he did not believe he could help.3
It appears this is a marketing endeavor, one that offers treatment for certain diseases or conditions. Why would the chiropractor not state his professional credentials to this audience? New Jersey Chiropractic Law permits him to evaluate patients with metabolic conditions, treat with nutrition and co-manage with other doctors, provided he has completed the 45 hours of nutritional training.
The New Jersey State Board of Chiropractic Examiners Law4 states the following in section 45:9-14.5:
"'Practice of chiropractic' means a philosophy, science and healing art concerned with the restoration and preservation of health and wellness through the promotion of well-being, prevention of disease and promotion and support of the inherent or innate recuperative abilities of the body. The practice of chiropractic includes the reduction of chiropractic subluxation, and the examination, diagnosis, analysis, assessment, systems of adjustments, manipulation and treatment of the articulations and soft tissue of the body. It is within the lawful scope of the practice of chiropractic to diagnose, adjust, and treat the articulations of the spinal column and other joints, articulations, and soft tissue and to order and administer physical modalities and therapeutic, rehabilitative and strengthening exercises."
"A chiropractor licensed by the State Board of Chiropractic Examiners may, subject to the requirements of subsection e. of this section:
(1) Use methods of treatment including chiropractic practice methods, physical medicine modalities, rehabilitation, splinting or bracing consistent with the practice of chiropractic, nutrition and first aid and may order such diagnostic or analytical tests, including diagnostic imaging, bio-analytical laboratory tests, and may perform such other diagnostic and analytical diagnostic tests including reagent strip tests, X-ray, computer-aided neuromuscular testing, and nerve conduction studies, and may interpret evoked potentials;
(2) Sign or certify temporary or permanent impairments and other certifications consistent with a chiropractic practice such as pre-employment screenings. A chiropractic physician may use recognized references in making his determination; and
(3) Provide dietary or nutritional counseling, such as the direction, administration, dispensing and sale of nutritional supplements, including, but not limited to, all food concentrates, food extracts, vitamins, minerals, herbs, enzymes, amino acids, homeopathic remedies and other dietary supplements, including, but not limited to, tissue or cell salts, glandular extracts, nutraceuticals, botanicals and other nutritional supplements; provided the chiropractor has successfully completed a course of study concerning human nutrition, consisting of not less than 45 hours from a college or university accredited by a regional or national accrediting agency recognized by the United States Department of Education and approved by the board."
Since I am not a lawyer, I will not attempt to determine if the chiropractor broke the law by not identifying his professional degree. Yet I wonder why he did not state upfront that he was a DC. Did he feel the audience would not respect his credentials? It appears this type of marketing environment is the perfect time and place to proudly proclaim his credentials and explain his training and licensure as a doctor of chiropractic in New Jersey.
What is your opinion? I would love to hear from you.
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References
- Whitaker W. "William Whitaker's Words – Doctor." University of Notre Dame archives.
- Doctor (title). Definition from Wikipedia.com.
- Cheng P-S, Mamoun F. "I-Team: Some Patients Say New Jersey Chiropractor Duped Them Into Thinking He Could 'Reverse' Diabetes." NBC News New York, last updated May 15, 2015.
- New Jersey Chiropractic Board of Examiners Law.
Click here for previous articles by James Lehman, DC, MBA, DIANM.