A. The treatment of disease without drugs or surgery.
B. The adjustment of vertebral subluxation to improve health.
C. The adjustment of vertebral subluxation to enable the innate intelligence of the body to better express itself. D. The removal or reduction of the vertebral subluxation and its component parts (VSC).
E. All of the above.
F. None of the above.
If A is the answer we might as well pack it in. We have no chance of maintaining a unique identity.
The problem with B is that to everyone health has a different meaning. It is a confusing term. Is it simply an absence of symptoms? Do we use Dorland's or Webster's definition?
If D is the correct answer then we very well may have relegated chiropractic to the treatment of a disease. Just because that disease is a unique one that no one else is treating and because we are confining our efforts to only one disease does not make it any more philosophically acceptable. Disease is the presence of something manifested by certain symptoms. V.S. on the other hand is the physical representation of the absence of something ease, health, harmonious function, the full expression of the innate intelligence of the body.
Understanding V.S. as the physical representation of the cause of dis-ease is important to our understanding. An analogy may be helpful. A wedding band is a physical thing. However it is much more than just a band of gold. It is a physical representation of the absence of something. It says that the individual wearing it is no longer a member of the pool of available people for marriage. (It represents much more than that, but for the sake of our analogy that is sufficient). Here is the point. Our emphasis is not on the band of gold. It does have intrinsic value (whatever the price of gold), but its real value is in what it represents. To the broad scope practitioner and some so-called straights the V.S.C. is a physical entity like other diseases. But one which chiropractors regularly treat. It is a band of gold more valuable than some, less valuable than others. But to the philosophical D.C. it is not the V.S. that is important but what it represents the absence of life expression in the body. When we begin to look at the V.S. as an entity to be addressed it loses its uniqueness. It is like seeing a wedding band as merely a piece of jewelry. The V.S. is a symbol if you will, a visible representation of an invisible reality DIS-EASE. The invisible reality is more important then the visible symbol. The marriage relationship is more important than the piece of metal on the finger. V.S. is an entity, but it is not our reality. DIS-EASE, lack of expression of the innate intelligence of the body is. Disease on the other hand, including the V.S. and its component parts, is the reality of medicine. It is not our reality. That is why from a chiropractic perspective we do not recognize the existence of disease as an entity. (If you do not understand this concept you need to read Chiropractic Philosophy). It is merely a manifestation of an absence of ease. In first semester philosophy we use darkness and light and heat and cold as the analogies. Because disease is not a chiropractic reality or entity we do not treat it the practical application of the philosophy. When we begin to address V.S. or the V.S.C. as an entity, as something more than just the physical representation of the cause of DIS-EASE, we are dangerously close to compromising our philosophy.
CONSERVATIVE HEALTH CARE I recently saw an interesting advertisement for a book by a chiropractor relating to the therapeutic and diagnostic aspects of conservative health care. Across the page was an ad for a book on conservative treatment for urinary tract infections. It had never struck me before. (Probably every other chiropractor has thought of this), but there is no such thing as conservative health care, conservative medical care or conservative chiropractic care. There is only good care and bad care. Good care is accomplishing your objective (providing it is a worthwhile objective) with little or no harm to the patient. Bad care is when the treatment or procedure does less good than it should or more harm than it should. It is not necessarily good care if it does more good than harm which is a philosophy of much of allopathic medicine. It is bad care if, whatever good it does, it does more harm than it should. If two procedures both accomplish the same objective but one does so with more harm than the other, it is not a matter of one being conservative. One is a good procedure, the other is not, therefore, one is the procedure of choice. To perform the other is irresponsible. There may be two ways to accomplish an objective, but if one is better, that is the procedure of choice. "Conservative" does not enter into it. If an aspirin treats a headache, but does more harm than an adjustment in relieving the headache, the aspirin is irresponsible care, the adjustment good care (though not necessarily straight chiropractic care). Conversely, if an aspirin effectively relieves the headache and the adjustment does not, the aspirin is the procedure of choice. That the adjustment is more "conservative" is not an issue. It comes down to what is right for each patient and what is wrong. An adjustment, no matter how much less traumatic, is wrong for a patient when open heart surgery is called for. Good health care, then, is doing whatever procedure is best for the patient under the circumstances, be it medicine or chiropractic. If we are primary health care providers then we must make the judgment for every patient on every visit what is the best procedure (accomplishing the objective most effectively with the least amount of harm) and then perform that procedure or at the least refer them out to someone who can. Here's the problem: to do that you must have full knowledge of the condition, the effectiveness of the adjustment versus the effectiveness of all medical/therapeutic procedures, the danger of the adjustment versus the danger of the therapy in addition to knowing all the variables and factors specific to that particular patient. To do that would necessitate having all the knowledge of a medical doctor. Anything less would be incompetence and merely a matter of luck if you decided upon the correct procedure. Let's look at the other side of the coin. If the M.D. is a primary health care provider, and we surely would not want to deprive him of that title, then is it not incumbent upon him to have full knowledge of the same things we learn in chiropractic school? If we deny him the ability to perform those procedures then he must, in good conscience, refer to us the conditions that can be best treated by, not conservative, but proper care for that particular patient. He must be able to determine whether chiropractic is the best care for a particular problem. Getting kind of confusing, is it not? How about the poor patient who spends half his life running back and forth between doctors. It comes down to this, there is no conservative or extreme approach to health care. There is only good and bad. If that is the case, then medical doctors are going to have to incorporate chiropractic into their armament for the treatment of disease and chiropractors are going to have to incorporate medicine, drugs, and surgery into theirs. Anything less would be bad care. In most patients, for most conditions, it may be that the best care includes a combination of both. It is impractical for numerous reasons for two doctors to be treating the same patient for the same condition with different procedures. What, then, is the logical conclusion to this discussion? The objective of the chiropractor is the correction of vertebral subluxations. A chiropractic adjustment is always the procedure of choice in accomplishing that objective. Anything else, the treatment of disease by whatever the most appropriate method, including manipulation, should be left up to another provider.
FAILED EXPECTATIONS
Whenever someone pays for a service or product they have certain expectations. When you take your car to the dealer or service station for repairs, you expect it to be running properly when they have finished. When a service or product does not meet our expectations, we naturally are upset. The legal and the health professions are unique with regard to expectations. When you utilize the services of a litigation attorney you may have expectations that are different than what you should have. You of course expect to win your case. However, the attorney's expectations are different. He or she expects to argue your case as effectively as possible. Attorneys hope to win a case but they know that there are factors out of their control. Their client may not have a good case. The judge and jury are variables that always have to be considered. These factors and many more are why attorneys don't give guarantees. In the health field a very similar situation exists. The doctor, whether medical or chiropractic, would like to see you get well. There are factors, however, over which he or she has no control. Most of them are rather obvious. With chiropractic it is even a more unique situation. The chiropractor's objective is not to cure or relieve any condition, but to enable the patient's body to work at maximum efficiency. The problem arises when we make the treatment or relief of a condition our objective. That is quite obviously communicated to the patient. If that objective is not attained we have failed, the patient is disappointed or worse, and problems arise and we all know what kind of problems to which I am referring. The only safe approach is to have a clear objective, one that can be attained, and which is known and agreeable to the patient. In a litigous society it is even more important than it was in the past. Fifty years ago chiropractors could be unclear or vague regarding their objective. That is no longer possible.
