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The "Sleeping Giant" or the "Good Loser"?

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DOWNLOAD VIDEO PRESENTATION HERE.

In the recent 2015 Gallup-Palmer Inaugural Report: Americans' Perceptions of Chiropractic, several things jump off the page at me. According to the study, over half of all U.S. adults have seen a chiropractor, and over one-quarter of all U.S. adults would choose chiropractic first for neck or back pain. What’s even more exciting is that the majority of U.S. adults (61%) think doctors of chiropractic are effective at treating neck and back pain. Couple these stats with the overwhelming research that shows the safety, effectiveness, and cost savings effect that chiropractic has to offer, and this is a "no-brainer." It sounds like a huge opportunity to me! Yet, when you look at the profession as a whole, listening to the "beat on the street," it’s not screaming opportunity.

You hear stories from good doctors selling their practices and seeking another career. There are many doctors struggling financially in practice, many even defaulting on their student loans. DCs today are graduating from chiropractic colleges with enormous student loan burdens and are weighing their options of "rolling the dice" by building a start-up clinic, or accepting a position as an employee in a clinic for a meager salary. These factors may contribute to why enrollment in chiropractic colleges isn’t exactly at an all-time high. And in Texas, with a law that doesn’t allow you to practice to the level of your education and training, not to mention numerous attacks aimed at narrowing your ability to practice, the struggle may be even more real. We have DCs being paraded in front of the medical board for "impersonating a physician" like it was the 1950’s. Some Texas DCs are even moving to other states for fear of what may be in store.

One healthcare consultant shared this with me a few months ago. "Doc, in Texas, an average MD who gets out of school and gets a job at a hospital can in 10 years make an extraordinary living. He can know nothing about business at all and still do quite well. That’s how the system is set up for them. That just isn’t true for your profession. You have to be extraordinary at practice and business to make a decent living." While I think this consultant underestimates the resolve of most chiropractors, I think he has a point. Then, when you add in the intra-professional bickering, and DCs attacking or even suing other DCs, it can get to be a little much for most of us.

So what do we do? Some choose to ignore it, others put their head in the sand, while others whine and complain, a few may even give up all together. See that’s the thing about losing, it can become a habit. If you’re not careful, you can get good at losing.

But for some, the turmoil can act like a smelling salt. It can wake us up. We know that chiropractic is the answer to so many healthcare problems, and the public wants it. As Dr. Jim Parker used to say, "It’s Naturally Right!" It sounds crazy, but what if I could help make this better? What if WE could make a change for the better? Crazier yet, what if we had some success doing just that and the profession began to believe it?

During the 84th Texas Legislative Session (as it seems is true most sessions), we fought for our legislative lives. We were attacked on our ability to perform basic exams on school children. Sounds like a pretty insignificant fight on the surface, but, if the opposition could take away our ability to do these most basic exams, then every other type of exam could then follow suit. Our message was simple. "Here is what we are trained to do. Here is how our education compares to other doctors/providers. And here is our track record...not one complaint from a student or parent." It began to be like a drum beat, hearing after hearing. You don’t think we should be doing Department of Transportation physicals? "Here’s our education and training." You don’t think we should be assessing concussion? "Here’s our education and training." You don’t think we should be able to use an "ear-looker?" "Here’s our education and training... and it’s an otoscope, doctor."

What became crystal clear is that, although the public needs us and wants us and can’t wait to see what we have to offer, the public still doesn’t understand the level of education and training that a DC receives. They don’t get it. And remember, the Legislature is filled with members of the public. Unless someone has spelled it out for them, shown them the physician-level training that DCs receive, they assume that it is nowhere near that of even a mid-level provider. We cannot minimize our doctoral and post-doctoral training; it’s extraordinary. And until the public is fully aware, we will continue to struggle with the public perception that we went to some sort of vocational tech school and made a choice between chiropractic and TV/VCR repair.

Palmer’s study and research goes a long way, but it’s up to us to spread that message. We are not technicians. We are not "adjustors." We are not "back poppers" or "quacks." We are doctors of chiropractic. All of us. And, while we may choose different methods, specialties, techniques, styles and payment models, our patients need every one of us and THEN some. It is crucial that we wake up and rise to the task. The future of our profession depends upon it.

In Texas, it’s no secret that our law needs some work. It’s time that we modernize our chiropractic act. With the constant attacks in the Legislature, numerous lawsuits over the last decade, multiple attacks of our board, it’s time to fix the problem. Our law doesn’t provide clarity for licensees, the public or for regulators. The terminology is more than 30 years old, and, while it worked for many years, it doesn’t meet the need of today’s healthcare world. Our law needs to address our doctoral and post-doctoral education and training, using modern terms that everybody understands. In 33 other states, DCs are physicians. At one point, so were Texas DCs. So, we have some real work to do.

Already, there has been a considerable amount of work done drafting language that helps solve the problems, provides clarity and models laws that work in other states ... for DCs, for patients and for everyone involved. We don’t claim to have all of the answers, so it is important that DCs provide their feedback as we go through the process and the preparation leading up to the 85th Legislative Session in 2017. We are assembling a team to get the job done. There will be an opportunity for TCA, the Texas chiropractic colleges and various chiropractic groups and the profession at-large to have meaningful discussion and prepare for what is ahead.

In the upcoming months, there will be plenty of discussion about how chiropractic is regulated. Next session is our "Sunset" session. If you’re not familiar, every state agency in Texas is subject to what is called a "Sunset Review" about every 12 years. The committee meets, reviews the relevant agency (in our case, the Texas Board of Chiropractic Examiners) and determines if it serves its purpose and is doing its job, or if it can be lumped in with another agency.

Here’s the rub this session. There are many other healthcare agencies up for sunset at the same time as our board.  The danger here is that the Legislature could see this as an opportunity to create a "super board." When you look at some of the federal implications to licensing boards, like what went on with the Federal Trade Commission investigating North Carolina Dental Board, there could be a real push in the direction of a "super board." Now, you can imagine if that "super board" was comprised of 15 MDs and one DC, this would be a "super bad." And, you can imagine that the Texas Medical Association (the most militant, anti-chiropractic, anti-competitive organization around) will throw every bit of its energy into trying to limit our reason to exist. However, if we had a board with equal representation for all healthcare professions, this may be an opportunity as it has been in a few other states.

So, what will it take? A serious strategic change must occur as we prepare for the 2017 session, because this will affect us all for many years to come. In years past, we could always say, "Well, worst-case scenario, we’ll have the act we currently have and we can live with that." This time around, it’s likely to be more of a "perfect storm" or a "perfect disaster." If we sit back, are apathetic and don’t come together as a profession, disaster awaits. On the other hand, if we wake up with "terrible resolve," what we do right now will make a positive difference for many years to come. Now, this will take some serious team work! Many may have to just agree to set their differences aside until we emerge victorious as a profession. Although this could be one of the largest challenges our profession has faced in many decades, I have no doubt we can do this and we are assembling the team to get it done. Now, what can each of us do?

  1. Engage in the process and help engage your friends, colleagues and patients in what is going on. Stay informed and share the information with your friends.
  2. Ensure that every DC in Texas is a member of the Texas Chiropractic Association. Numbers speak volumes and we need to crank up the volume. If you are not a TCA member, join today!
  3. Stand up, show up and speak up! No one is going to do the work for you. Your patients need to know how this affects them. Your legislators need to hear from their constituents that chiropractic is important to them. And, you need to show up at certain times to stand up for your profession.
  4. Contribute. This will take money. Lots of money. And, just like a building campaign for a church or a school, one-time contributions from rich benefactors are great, but they just don’t come that often. It is the sustained donations from membership that pours the foundation and ensures completion of the project. Many already contribute regularly to TCA’s Chiropractic Development Initiative (CDI) and have for years. We thank you, but ask that all of us do more if we can. Donate to CDI today! If you don’t have money to contribute, you can contribute your time and energy, but everyone can contribute something. 

Why do I NOT doubt that our profession can do this? Because I know the heart of our profession. I believe we are the most loving, heart-filled profession in healthcare. We love what we do, and our patients love us! Chiropractors do tend to be a little rebellious by nature. We don’t mind going against the grain. That’s what makes us great! Why else would DCs throughout history be willing to go to jail to protect their rights and their patients’ rights? It’s because in their heart, that was the right thing to do.

The Rev. Billy Graham said "I can tell you where a person’s heart is if you let me spend five minutes with their check book." At this critical point for our profession, I want to ask you, doctor to doctor, "where is your heart, Doc?" Are you doing everything you can to ensure the "perfect storm" vs. the "perfect disaster?" Doc, are we waking up as a "sleeping giant" or are we a "good loser?"

It is a pleasure to serve as a member of Team TCA. Thank you all for making this profession great!

Sincerely,

Tyce Hergert, DC
TCA Vice President

 

"I fear all we have done is to awaken a sleeping giant and fill him with a terrible resolve."

-Isoroku Yamamoto

 

"Show me a good loser, and I’ll show you a loser."

-Vince Lombardi


 

 


 

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