We are living in the "Exponential Age," a time period of emerging disruptive technologies which forces industries and professions to change or disappear. One of the earliest signs of this impending time of rapid changes was revealed more than 50 years ago by Gordon E. Moore, co-founder and chair man emeritus of Intel Corporation. He first published what later became known as Moore's Law in a 1965 Electronics Magazine article called "Cramming More Components Onto Integrated Circuits":1
"Today Moore's law is also known as the law of exponential growth or the accelerating change law (also known as the accelerated change law). Yet despite its relatively wide publicity most people fail to comprehend its immense power and profound implications."
Opportunity or Threat?
Performance consultant Francisco Gomez says the term disruption embodies the opportunity as well as the threat inherent in this exponential era. Disruption is when some type of innovation (it could be a product, process or solution) turns an industry upside down by dramatically changing the way it does business.
He offers a few examples: Wikipedia disrupted the paper-based encyclopedia industry; Netflix disrupted Blockbuster; Amazon is disrupting the publishing industry; in the global transport industry, steamboats disrupted sail ships; and digital media that could be downloaded disrupted CDs and DVDs.
Francisco states that a company can intentionally disrupt itself by innovating and rapidly adapting to the change the business environment requires; or it can be disrupted by a competitor and become obsolete.2
Appreciating the Power of the Exponential Age
It has been my experience over the past 48 years that the chiropractic profession has been extremely slow to change. In fact, some in the profession relish the opportunity to fight expansion of our scope of practice as if change is detrimental to our future. Most chiropractors are independent practitioners who depend upon their clinical and entrepreneurial skills to stay in business. Historically, we can be proud of our successes and our ability to provide patient access to our alternative to allopathic medicine outside of the health care system. I believe most of us consider it our ethical and professional responsibility to make certain patients have access to chiropractic care.
If chiropractors are going to continue to make certain patients have access to our care, we must recognize the "Exponential Age" and the fact that changes are coming in health care. Our professional responsibility demands that we embrace changes in health care access, education, training and credentialing. If we do not recognize the need to change and enhance access to chiropractic care, others may eliminate the profession.
Autonomous cars are an example of a disruptive technology that might eliminate our automobile manufacturers, auto insurance companies, and the personal-injury business model. We already have cars that park without you controlling the car, and within the next two years, self-driving cars will be available to the public.
Within four years, the auto industry will experience the beginning of disruption. Car sales will diminish because consumers will no longer purchase automobiles. You will call for a car with your smartphone. It will show up at your home or business and take you to your destination. Consequently, human error will be eliminated from driving automobiles and 90 percent of motor vehicle accidents will be prevented. Whiplash injuries will reduce by 90 percent each year. Hence, the need for chiropractic care will decline significantly. he automobile insurance business model will disappear, along with the personal-injury business model.
Do You Have a Professional Responsibility to Change?
I pose a very serious and sincere question to all chiropractors: Do you have a professional responsibility to change if it enhances access to chiropractic care and prevents the elimination of our profession?
Since the signing of the Affordable Care Act on March 23, 2010, the health care system has been changing at a rapid pace. This is the most significant regulatory overhaul of the health care system in the United States since 1965. Under the act, hospitals and primary physicians are transforming their practices financially, technologically and clinically to drive better health outcomes, lower costs, and improve their methods of distribution and accessibility.
Chiropractic Change in Action: An Example
As a result of the astute and dedicated efforts of the American Chiropractic Association to include Section 2706, chiropractors and other non-allopathic professionals are eligible for Medicaid expansion of scope of reimbursement within Federally Qualified Health Centers. Currently, chiropractic care is covered by Medicaid, but not funded here in Connecticut. Hence, it was necessary to cause a change and petition the Health Resources and Services Administration (HRSA) to expand the scope of reimbursement to include chiropractic services offered within a Federally Qualified Health Center.
The University of Bridgeport recognized the need to change in order to improve access to chiropractic care for community health care patients suffering with chronic pain. As a result of significant investment in change, the University of Bridgeport now offers chiropractic services within 10 primary care sites in Connecticut while providing clinical training to students and chiropractic specialty training to full-time residents, which also offers research opportunities.
Now, thousands of chronic pain patients in Connecticut have access to non-pharmacological health care services as recommended by the Joint Commission within the Community Health Center, Inc., of Middletown, Conn.
I complete this article with one final question for all chiropractic professionals to ponder as a starting point in the change conversation: Are you ready to embrace change and make certain chiropractic services are more available to those in need of chiropractic care as an alternative to pharmacological care for the treatment of patients with painful neuromusculoskeletal conditions?
References
- What Is Moore's Law? Singularity Symposium; see www.singularitysymposium.com/moores-law.html
- Gomez F. "Thriving in an Exponential Age." PMeZINE: The Performance Management Magazine.
Click here for previous articles by James Lehman, DC, MBA, DIANM.