In our last issue we offered to you a way of explaining the patient's options under chiropractic care. Because of your overwhelming response we have decided to print it in the Pivot.
Every patient who walks into a straight chiropractor's office experiencing symptoms is confronted with four options. It is important that the chiropractor present these options to the patient in a clear manner. It does not matter whether the condition has been previously diagnosed or whether it is still undiagnosed, the responsibility is still there. It is more important than ever for the chiropractor to explain these options because of the increase in malpractice litigation and because so many in our profession are saying that chiropractors must diagnose. If diagnosis is not part of straight chiropractic then it is necessary to explain these options. Aside from the protection of the chiropractor, it is simply part of good procedure and proper care to educate your patients. For the sake of brevity we will present these options in an outline format. They are meant as a guideline for the chiropractor to adapt to his/her presentation. These options should be explained to the patient, along with the possible ramifications of each. I. Ignore the symptom(s) or the disease Simply do nothing about it and hope it will go away. In this case the patient would discontinue chiropractic care and not seek any other care. It seems like a poor option (and usually it is), however, most people choose this option most of the time in lieu of any professional care. The common cold is the best example. Many people will do nothing and just wait to "get better." What they are saying, in effect, is that they will ignore it and let the body "heal itself." It appears that deep down inside almost everyone understands this concept. A. Ramifications 1. Positive - the condition may go away on its own and never return. This is possible whether it's the chicken pox, a cracked rib, the common cold or a musculoskeletal condition. Patients need to know that the body often is able to heal itself without the help of anyone. 2. Negative - the condition or disease may worsen. If it does, by the time the patient chooses to do something about it, it may be too late. (I don't believe we need to take up time and space giving examples here, however, there are dozens and some of them may be explained to the patient. Almost any condition could be used as an example.) II. Treat it medically or therapeutically This is a commonly chosen option ranging from taking aspirin and on to physical therapy to "major" surgery. The patient needs to know that this option is not available in your office. A. Ramifications 1. Positive- a) The treatment may relieve the symptom(s) while the body heals itself or the cause is removed. e.g. headache caused by lack of sleep, aspirin relieves symptoms, night's sleep corrects cause. b) The treatment may remove an interference to the healing process. e.g. iodine killing the microorganisms of a cut finger. 2. Negative- a) The symptoms may be relieved while the condition worsens (fill in the examples). b) The treatment may cause irreparable harm or even death. The patient needs to know that in choosing this option, he may not necessarily know what the ramifications will be until they occur. Also he needs to know that the chiropractor does not make judgments regarding this option, nor provide it and that if a patient is to choose this option, the finest expert advice is a necessity. III. Chiropractic care A person choosing this option is saying, "I am going to have my spine adjusted and see if my body has the ability to heal itself. A. Ramifications 1. Positive - the body with a good nerve supply may be able to heal itself. Many people do get well. 2. Negative - here is where limitations of time and matter must be explained to the patient. The patient needs to know that he is dealing with the symptoms of a medical problem and that chiropractors do not make judgments concerning medical problems. The decision to begin chiropractic care and allow the body an opportunity to heal itself or to consider the possibility that the body is past limitations of time and matter and that another option is needed, is entirely up to the patient himself. IV. Medical (therapeutic) care, and chiropractic care The objectives of both professions are different therefore both can take place coincidentally. This option is open from the beginning of care and at any time during the course of chiropractic care (which should be for the rest of the patient's life). A. Ramifications 1. Positive - These are the same as for medical care alone and chiropractic care alone. 2. Negative - The same as medical care alone and chiropractic care alone. However, there is an added negative ramification. Medication may interfere with the ability of the body to heal itself and the ability of the chiropractor to remove the interference.
The above options should be part of every straight chiropractor's educational program. It is our hope that the brevity of this presentation does not lead anyone to think the subject is unimportant or to be treated in a cursory manner. Explanations like this need to be presented in an expanded, detailed, and complete manner in the form of a straight chiropractic position paper. Perhaps one day it will happen. Meanwhile we hope these brief comments are helpful to practitioners.
WORLD CHIROPRACTIC ALLIANCE: A GOOD IDEA?
Many exclaimed "It's long overdue!" upon hearing of the formation of a new "national" chiropractic organization. Admittedly, it was this writer's initial reaction also... simply because chiropractors just naturally start a new organization every few years and we have not begun a new one since the mid-70's! Humor aside, perhaps most of our profession responded negatively to the news. The majority probably feel that there are too many chiropractic organizations already and that the last thing we need is another. Do we need a new national organization? The purpose of the new organization is ostensibly to unite all factions: mixer, straight and any combination thereof, for the purpose of working for chiropractic. But don't we already have a national organization dedicated to that idea called the American Chiropractic Association? It was formed many years ago for the purpose of uniting straights and mixers. It resulted in a tremendous weakening of the straight organization (I.C.A.). The ACA has always been an "all things to all chiropractors" organization. There are many fine straight D.C.'s in that organization. Apparently these chiropractors feel that the organization has their best interests at heart. Even as this is being written there are wholesale defections by straight chiropractors from the I.C.A. to the A.C.A. These men are not stupid. They believe it is in the best interest of their brand of chiropractic to belong to the ACA. They do not see it working against them. As long ago as eleven years an I.C.A. survey demonstrated that many of its members used all kinds of modalities. So the mixing/straight lines are not drawn in the I.C.A. either. Within a few days of the announcement in a chiropractic tabloid of the new national organization, another paper was announcing "The Chiropractic Summit." Apparently someone has decided on a meeting of the profession's leadership in response to a survey recently taken seeking the problems that the profession perceives. These two announcements have something in common for we see that the second major issue concerning the profession, according to the survey, is "unity in chiropractic political action"...the apparent goal of the new national organization. However, the first concern of those responding to the survey was "A Chiropractic Standard of Care." It appears that the major concern of the profession is that we have some sort of parameters, some guidelines by which to practice. What the profession realizes is that, without a system, any organization, company, country or profession degenerates. In straight chiropractic we carry that idea a little further and say that without a systematic standard of thought, your thinking will degenerate. In chiropractic we call that standard of thought, the principles and the philosophy of chiropractic. History has shown us what happens when every man does what he thinks is right in his own eyes, ignoring a set of principles. Chaos reigns. In this writer's estimation we need a number of new national organizations. We need one to represent those who believe chiropractic is part of the practice of medicine. We need another to represent those who maintain that chiropractic is drugless therapeutics. We need another to represent the "only musculoskeletal conditions" position. Another to represent the 1920 concept of chiropractic. We have one already that represents straight chiropractic. It identifies itself as such in its name. We need others, as many as there are different schools of thought in the chiropractic profession. What we do not need is another organization that says "We don't care what you believe. What you think chiropractic is does not concern us. It doesn't matter what you think or how you practice. That's not important." We do not need another national chiropractic organization coming from that position. We've got too many like that already! Editor's Note: A number of good friends and good straight chiropractors are members of each of the above organizations. This is an area where we agree to disagree professionally.
