Perhaps if we abandoned the 19th century philosophy which teaches that "natural" treatment of disease is an alternative to and always superior to the treatment of disease with chemicals we could then look a little more objectively at our future. Science has learned much since the turn of the century when eclectics, naturopaths, drugless healers, and chiropractors were advocating "natural healing." Disease is not natural. It is an unnatural state, therefore, if and when it needs to be treated it always necessitates unnatural attention for its proper treatment. Drugs, heat, cold, even manipulation and chiropractic thrusts are unnatural applications of natural forces. Chiropractic is not a treatment for disease (or should not be). If it is a treatment, then it is unnatural like any other (perhaps not as unnatural as others but nevertheless unnatural). If all treatment is unnatural, to what degree any particular procedure is unnatural is purely subjective. Are drugs more unnatural than ultrasound? Is heat more unnatural than cold? We have yet to fully explain the effects of electrical stimulation. Perhaps it is far more unnatural than drugs. Many chiropractors justify mixing therapeutic procedures with chiropractic adjustments because they want to give the patient some relief while the body is healing itself (the healing process aided by the adjustment). In other words they will employ an unnatural but drugless procedure to give temporary relief while the only natural healing possible (the body healing itself) is taking place. Is it mere coincidence that they choose to do anything short of medication? Do we really believe that the administration of medication is never in the best interests of the patient? Come on gang, if you are really interested in giving people immediate relief while the body is healing itself then the discreet use of medication is a must in almost every case. Mixing physical therapy and chiropractic but refusing to mix medicine and chiropractic rings a little hollow. It reminds me of the anecdote concerning George Bernard Shaw. He approached a beautiful young actress and asked if she would have his baby for a million dollars. When she responded affirmatively, he then asked if she would do it for five dollars. Indignantly she answered, "Of course not, what do you think I am?" Shaw, smiling, responded, "Miss, we have already determined what you are, we are now negotiating the price!" We have arbitrarily set our price at drugs. Many chiropractors employ multiple treatments for a condition, the procedures varying from the spinal adjustment which is the least invasive to whatever else they decide to do. Only a few diehard, monocausal, disease-theory practitioners still hold to a single cure or treatment for everything. But more importantly, very few practitioners of any kind hold to a single cure or treatment for anything. Science almost universally agrees that there are a multitude of causes for the production of any disease process and there are a multitude of effects. If you are to effectively treat the disease then treating all the causes and all the effects is necessary. Consequently, the treatment of a disease process almost without exception should include to a lesser or greater degree, chemical substances. Put aside the arguments that "we chiropractors are drugless," or "drugs are unnatural" (we have already seen that all therapeutic procedures are more or less unnatural). What condition treated by a chiropractor would not respond better with the added use of medication? You may be hard pressed to find one! The major problem is that the drugless practitioner is under the delusion that some conditions are best treated by drugless therapeutics and some of course necessitate drugs and surgery. The medical physician is under no such delusion. Whatever else is helpful such as manipulation, physical therapeutics, vitamins, rest, rehabilitation, exercise, most patients respond more quickly (remember we are discussing symptoms) with the use of medication. To think otherwise is to ignore the way the vast majority of society and science thinks, and puts chiropractic in the realm of an unscientific religion akin to Christian Science. This is why the M.D. cannot understand the drugless physician's rationale.
Society and science accepts the chemical alteration of drinking water. Society has accepted recreation chemicals (cigarettes and alcohol), chemicals in the workplace, chemicals in the air and chemicals in our food. Basically, society has a philosophy that says that the good or pleasure that we get from chemicals is worth the few side effects and does no real harm as long as the chemicals are used intelligently. (It is not my contention that that is a correct philosophy). The drugless physician then comes along and says that he has an alternative. That is simply not reality. Here is the principle that every chiropractor should burn into his thick little skull. Any condition that can be treated effectively with drugless procedures can be treated more effectively with those same procedures plus the judicious use of drugs and that with no apparent side effects. But then that goes without saying for every therapeutic procedure. The drugless practitioner (D.C.) is in a precarious position. He must move into the practice of medicine, that is, utilize chemical substances in conjunction with his drugless procedures for the alleviation of those conditions he determines are within his area of expertise. This has prompted a small segment of the profession to logically call for the right of chiropractors to dispense certain drugs. There is yet another alternative. The chiropractor may work in conjunction with a physician who can dispense drugs, the chiropractor utilizing drugless procedures for the alleviation of the ailment and its symptoms and the medical physician utilizing chemical substances. This, of course, would put the chiropractor on the level of a physical therapist. These then are the two alternatives we have mentioned: The chiropractor can begin to dispense drugs and be a general practitioner as the osteopath has become or he can become a limited treater of a limited number of conditions just like a physical therapist. The physical therapist cannot dispense drugs when drugs are often helpful in the treatment of a condition. Perhaps that is why our profession is so frightened of the physical therapist manipulating. When you strip off the diagnostic-doctor veneer, mixers are nothing more than physical therapists who have an added tool, manipulation, and now the physical therapist is acquiring that tool. There is an obvious third choice. Stop treating symptoms. Inform the public clearly that the treatment of disease and alleviation of symptoms is the practice of medicine with or without the use of medication. That is not the chiropractic objective. Chiropractic restores health by removing nerve interference thus increasing the expression of the innate intelligence of the body. These, then, are the choices - become a "full-fledged" medical doctor, a physical therapist or a straight chiropractor who understands his objectives clearly and practices accordingly. There is no merit in referring to oneself as a drugless physician. There is also no future in that type of practice.
A STRAIGHT POSITION PAPER IS NEEDED
The chiropractic profession is at a unique stage in its history. The objectives of both aspects of the profession (straight and mixing) have been clearly realized by the leadership. However, it appears that those objectives and their results have not been adequately communicated to the profession at large. It is clear (to me at least) why the mixing leadership of the profession has not elucidated their position. Without doubt 90% of the profession would reject it. Occasionally a spokesperson for the broadscope mindset (mixer) of the profession will present their position too clearly and will create a stir (as in the case of a certain legal counsel recently). Once in a while a rational thinking mixer will suggest that chiropractors use drugs or perform minor surgery. Everyone will rise up in protest. However the poor fellow is only carrying out broadscope chiropractic to its logical conclusion. But for the most part the objectives and direction of the mixing element of the profession are clouded in secrecy, if, in fact, they do have direction. On the other end of the spectrum is the straight mindset of the profession. They have clearly defined objectives. The only problem is the vast majority of the profession, while knowing the objective, do not know the rationale behind it and why it is sound. Perhaps it is time we communicated the rationale! The time is right to explain it on many fronts. The straights provide for the consumer a non-duplicating approach to legislative situations. It presents, not something that will confuse the legislator as to whether we are trying to infringe upon the practice of medicine, but a clear approach that is different. It can be clearly shown that it is not an alternative to medicine and gives the legislator the opportunity to support and pass chiropractic legislation without offending the strong medical lobby. The problem of malpractice is facing every chiropractor. The straights claim (and I believe correctly claim) that the straight approach is the safest, most easily defendable way to practice chiropractic. We need to communicate to the profession what we do, what we don't do, what we say to patients and how that gives us greater protection from possible litigation than if we practiced broadscope chiropractic. In this case I am told there are even statistics to substantiate this. As previously mentioned, 90% of the profession do not want to see chiropractic go the way of osteopathy. The straight approach prevents that, the broadscope approach guarantees it. It can be logically shown. I am told a number of the leaders in chiropractic education who have left the straight position within the past twenty years have suddenly awakened, looked around and seen that they are traveling the "osteopathic highway." Contrary to popular belief, the straight approach is a more professional, more respected approach. The doctor, by being able to clearly explain his objectives to the community at large is considered a legitimate member of the health care community and not some flim-flam, con man. The majority of our profession, mixer and straight alike, is sick of this type of chiropractor and the practice management programs that breed them. They have no place in professional chiropractic. Unfortunately, the free x-rays, volume practices, low or patient-determined fees, heavy advertising that many straights have done in the past cause the straight movement to be associated with this type of practice which is not compatible with straight chiropractic. The profession needs to know the difference. Increased service with the straight objective in mind is professional, not gimmicky. That distinction needs to be made. Third-party overutilization is also a problem. The straight position does not allow for the dishonest bilking of insurance companies. The broadscope approach actually encourages this by adding on unnecessary procedures. Almost everyone in our profession is concerned with this and how it can hurt chiropractic inclusion in further health care programs. The straight rationale is pro-scientific research. It is research which will demonstrate the detrimental effects of the vertebral subluxation and the valuable service of correcting them and thus enhance chiropractic recognition and respect. The research being done by the mixing element of the profession is merely duplicating the tired, old medical research into disease conditions and their treatment. Research in the straight arena is exciting. Practice success is a difficult area in which to communicate the superiority of the straight approach over the mixing approach. Quite frankly, you can make a lot more money mixing than you can practicing straight. But you can practice straight chiropractic and make an awful lot of money, more than you need. Perhaps I am naive (that's been suggested before) but I believe money is not the most important thing in life for most chiropractors. The practice rewards of fulfillment, self-esteem, helping people, contributing to society in general and your community in particular are much greater when practicing straight chiropractic. It's more fun, too! We need to communicate this idea to those who don't make the dollar number one. Even those who are primarily interested in money could be convinced to change their priority if all of these areas were adequately presented. The time is right for a position paper to be written by the leaders of the straight movement. These seven areas merely came off the top of my head. I am sure there are more. Some organization or individual should be commissioned to put together this information in a clear logical manner. No haranguing, no stone throwing, or nasty name calling, just a clear, concise explanation of the superiority of the straight philosophical approach to chiropractic. Perhaps for the first time in the history of chiropractic the entire profession is ready to accept it.
