Why Degrade Our Profession by Obtaining a Nursing Degree?
Dear Editor:
Then I saw the cover story in the Dec. 2, 2008 issue: "Advanced Nursing Degrees for DCs: How Would It Impact Your Practice and the Profession?" I am outraged that this was on the cover. I hereby request that DC stop all future advertisements from Mid America Learning for nursing degrees. Or perhaps we, as a profession, can begin a boycott of all your advertisers. Either promote the profession or improve it, but do not degrade it.
Larry Basch, DC, CCSP
Sun City, Calif.
Let's Promote a Model the Public Buys
Dear Editor:
I read with dismay the article by Christopher Kent in the Jan. 1 issue ("Chiropractic: Designing Our Future"). He dismisses our professional role as musculoskeletal specialists, attempting to use the rationale that science supporting spinal manipulation for musculoskeletal conditions is equivocal; and then ventures off into the ethereal land of the spinal subluxation. Might I suggest Dr. Kent read the writings of Dr. Joe Keating?
There is no testable, quantifiable model of the subluxation. There is no test with a known sensitivity or specificity to identify the subluxation. There are no reliable methods to determine the presence of a subluxation and there certainly is no known valid, gold standard to identify the subluxation. The definitions commonly accepted for the subluxation are political in nature, certainly not testable models. I want nothing more than to have a valid and reliable methodology to identify the subluxation, but I assure you, we are not scientifically able.
There are several reasons to consider chiropractors as musculoskeletal specialists. This is exactly who the public perceives us as, and to clarify the research issue, spinal manipulation/adjustment is as effective as other commonly used treatments for musculoskeletal pain in the lumbar and cervical region. Chiropractors do more than manipulation/adjusting joints - hopefully we are also educating our patients on healthy lifestyles and functional restoration.
Dr. Kent wants to promote a model of care for the chiropractic profession that the public just doesn't buy. Might I remind him that chiropractors rank rather low on a scale of public trust - somewhere in the vicinity of lawyers and used car salesmen; and this is typically because "chiropractors make you keep coming back forever," which is the very subluxation model that Dr. Kent is promoting. How ironic that the model he wants us to follow as a profession is the very reason that 92 percent of the public stay away from us, while he derides the very role the public sees us in: as musculoskeletal specialists.
John M. Ventura, DC, DABCO
Clinical instructor, family medicine,
University of Rochester School of Medicine
Assistant clinical professor, New York Chiropractic College
Point Your Finger in the Right Direction
Dear Editor:
In a recent article (Dec. 16, 2008 DC: "What's the Difference Between Greed and Ethics?), Dr. Sportelli warns our profession of the perceived ethical dangers posed by those in our ranks who engage in such actions as writing books, selling multi-level marketing products, and any promotion that can be perceived to be masked as research, to name a few. I have no doubt that there are scams aplenty out there in the big, bad world, and that there are more than a few of our compatriots who engage in, shall we say, questionable behavior. But at the same time, I am confused at the aim of this blow by Dr. Sportelli.
Of course, we should not be tolerant as a profession of any activity that can bring shame upon us all. However, I find it difficult to get worked up over a doctor who has co-authored or ghostwritten a book on a health-related topic with which they are familiar as a way of garnering more attention for themselves and their practice. The last time I checked, almost every book cranked out by the latest slew of money-hungry politicians has been ghostwritten.
The current economy is making us work harder to begin with, and thanks to criminal elements in our profession and the insurance industry, we are making less than at any time in the past 30 years. We have more of our earned money confiscated at higher rates by a bloated, arrogant, corruptly run government. And Dr. Sportelli wonders why there are those in our profession who might think to look toward other areas of income production. Am I missing something?
There is little ethical mystery that I can discern in certain doctors looking for ways to help pay their bills, as long as they do not involve the sale and distribution of controlled substances or other humans. In fact, I am quite pleased that given the second or third-rate status our profession enjoys and the subsequent howls of derisive laughter that accompany any suggestion that what we do might be good for more than the occasional mild lumbar strain/sprain, there are not more of us gracing the covers of periodicals and tabloids doing the handcuffed perp walk.
If I might be so bold, I would like to point out to Dr. Sportelli that the reasons our colleagues are actively pursuing extra-practice sources of increased income are tied to problems that are far more deleterious to our profession than the occasional multi-level marketing nutritional product line. If Dr. Sportelli wishes to examine the causes of his colleagues' entry into what he evidently perceives to be various levels of Dante's Chiropractic Inferno, perhaps he might investigate the insurance industry's panting, lickspittle lap dogs who happily deny payment past the most ridiculous initial number of visits, coupled to fee schedules which were insultingly low 15 years ago and are preposterous now. Perhaps Dr. Sportelli's furrowed brows, clucking disapproval and indignant ire might be better directed in the following fashion:
- helping to eliminate the various hindrances his colleagues experience in dealing with third-party pay and working toward insistence on parity of payment with our medical brethren;
- seeking to work toward professional unification by eliminating state restrictions to practice;
- engaging in action that would force the insurance carriers to pay us for conditions that have been shown to have a beneficial response to chiropractic adjustments, such as asthma, otitis media, dysmenorrhea, high blood pressure, and colic; and
- promoting our profession to the public without looking toward the medical profession or their willing accomplices in the mainstream media for approval.
We have patients coming to our offices who gladly pay us for our services, even when lacking insurance coverage. We see on a daily basis what we can do for children, adults and senior citizens; yet, as Dr. Sportelli correctly points out, many of us are casting about for alternate sources of income to keep our doors open and our lights on. The fact that there are chiropractors who find it necessary to engage in secondary or tertiary activities to maintain their lifestyle should be the focus of our anger and concern. Given the amazing benefits of chiropractic adjustments, why should these activities even need to be considered by members of our profession? Why are we not so busy that the average chiropractor is unable to find the time to contemplate selling Amway out of their office? Perhaps if Dr. Sportelli and his ilk aimed their energies at solving these problems rather than their symptoms, we would be in a position to eliminate both.
Charles A. Krieger, DC
Astoria, N.Y.
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