But as critical as the struggle for licensure was, it did not give rise to the union. This was not a solidarity movement against chiropractic's opponents. Unionization came about in response to a point of contention among those working towards licensure. The issue was whether certain individuals would be grandfathered in as doctors of chiropractic under the proposed statute. The majority of those working towards licensure were against the grandfather clause. The smaller group, those who favored the grandfather clause, were the ones who formed the chiropractic union.
From 1971-74, the newly-formed union relied on the strength of the AFL-CIO to thwart any attempt at licensure that did not include the grandfather clause. Finally, in 1974, the Louisiana legislature passed a law licensing the practice of chiropractic. That law contained the much contested grandfather clause.
Was the AFL-CIO a contributing factor in the profession obtaining Louisiana licensure? Without a doubt. Was it the primary factor? Not likely. Under the circumstances, to attribute either the delay (for three additional years) or the final passage of the Chiropractic Act solely to the involvement of the AFL-CIO would be to drastically oversimplify the matter. During those years, Louisiana had the dubious distinction of being home to Joseph Sabatier, MD, a member of the AMA's now defunct Committee on Quackery, and vocal opponent of chiropractic. And while they may have worked tirelessly and with 100 percent devotion to the cause, chiropractors initially were no match for the more organized and politically astute medical association. Over the years, chiropractors improved their communication skills and expanded their campaign, not only becoming more politically active, but also increasing grassroots pressure through their loyal patient base. When they approached the 1974 session, they faced a democratic legislature not only predisposed to expansion of health care services, but now mindful of their constituents support for chiropractic licensure and a pro-chiropractic governor (for whom they had vigorously campaigned). The moment was ripe for victory.
Since its inception, the union has existed as the smaller of two chiropractic organizations in Louisiana. And like in other states with multiple organizations, Louisiana suffers from all of the problems inherent to dual leadership.
In the early '80s, partly because we had hopes of resolving the problems associated with multiple organizations, and partly because we bought into the union's propaganda, my own state association, the Chiropractic Association of Louisiana (CAL), moved toward unionization. The chiropractic union was proposing that we merge the two groups. Working towards that end we entered into a memorandum of understanding with the union. The memorandum called for a two-year "courtship" during which time our two organizations agreed, among other things to: amend our bylaws to provide for representation on each other's board; to require our respective members support of the other organization through payment of dues; and to form a committee to work towards the draft of a final set of bylaws which were to be ratified at a joint membership meeting on a pre-determined date.
Although the idea for the merger had originated with the union, and their president had been the primary spokesperson for consolidation, in the end they balked. The problem was that CAL was insisting that chiropractors be the ones to make decisions regarding issues and actions impacting the chiropractic profession. In short, we wanted the final say in what was best for the chiropractic profession. Union leaders were satisfied to relinquish that right to non-DCs.
With the joint meeting date only weeks away, the union president called a special meeting of the membership. The call was designed to inhibit participation. Members received only a few days' notice. The meeting was scheduled to take place in New Orleans on a week night, approximately one hour after close of business, effectively denying access to the vast majority of CAL/union members who would have to drive hours to attend. (The majority of the original union members were based in an around New Orleans.) At that meeting, we learned that the union had never restructured its bylaws as required in the memorandum of understanding; that even though they had been accepting dues from the CAL membership, CAL members had never been added to union rolls. The vote that night was to disband merger efforts. I am not the only one who remains confident that this was the best thing that could have happened for the state association.
A few years ago when the leadership of the Louisiana union decided to expand nationwide, I had occasion to read some of the promotional pieces sent to the other states. The propaganda presented the union as the great "equalizer" for chiropractic in the legislative arena, and offered promises of seemingly boundless power. But that's not reality. Here in Louisiana there have been times when the union has called upon the AFL-CIO to assist in either passing or killing certain pieces of legislation. They have swayed some votes in our favor, but there have been any number of times when that assistance by choice has been withheld.
I suspect that the current interest in unionization has little to do with legislative prowess, but a great deal to do with organized labor's image as a tough negotiator. As managed care continues to penetrate the market place, more of us find that we are no longer 100 percent self-employed. Each contract that we sign draws us into an employee/employer relationship where we no longer control how we practice or even what we make. Chaffing under these constraints and eager to strengthen our position at the negotiating table, it is easy to see how thoughts might turn to collective bargaining. But will it work for us?
The concept of collective bargaining is based on "strength in numbers," yet our profession is still a very small entity. Even if we band with other health service providers, we will remain the minority within that group. Is there enough strength in our numbers, or will someone else decide what is best for us?
Louisiana has had a chiropractic union for 26 years, yet health care packages in union-negotiated contracts are some of the worst when it comes to chiropractic benefits. And all are exempt from insurance equality reforms that apply to other forms of insurance and benefits packages. Twenty-six years -- and no progress.
Donald E. Marx, DC
Crowley, Louisiana
About the author: Dr. Donald Marx, a Palmer graduate, has been in private practice in Crowley, Louisiana since 1976. He served on the Louisiana Board of Chiropractic Examiners (1988 to July 1995), first as an appointee of Governor Romer, and then a second consecutive term at the request of Governor Edwards. He was the president of the Board from Aug. 1991 to July 1992, and chairman of the Peer Review Committee from its inception in 1990 to Sept. 1994. He was also appointed by Governor Edwards to the Allied Health Professions Supply and Demand Commission (1992 to Dec. 1994).
Dr. Marx was on the FCLB's Resolutions and By-laws Committee from 1992-95. He's been a member of the Chiropractic Association of Louisiana (CAL) since 1975, and served as president (1989-91) and as a member of the board of directors (1982-1993). He was the CAL "Chiropractor of the Year" in 1993. He presently serves as the CAL chairman of the Government Relations Committee.
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