Big $id Williams
JC Smith, MA, DC
"I feel sorry for you," the local newspaper editor once told me. "Whenever I see the TV ad of that guy from the chiropractic college, all the good PR work you've done here locally is undone in one fell swoop."
More than once I've heard similar statements from other patients who’ve told me the same sort of skeptical comments. In fact, a few actually have referred to this TV spokesman as "Lurch," the large-skulled, deep-set eyed, low-brow character from the old Addams Family TV show. When I exchanged a series of letters with "Lurch" about the poor quality of his TV ads for his college, he vehemently defended his tacky ads with the assertion that his ads were recruiting patients for me! Apparently, his delusions of grandeur were obvious to everyone but himself!
If it's not Lurch in tacky TV ads, it's the local DC who still uses the "Free Spinal Exams" that also taint our collective professional image. The paradox of the free ads is obvious to everyone but the DC--If he's such a good chiropractor, why does he have to give it away? And he's done so for the last 15 years! Of course, when I asked this K-Mart chiropractor why he still uses these tacky newspaper ads, his response was quite vitriolic, to say the least. After he ceased with his swear words and personal attack upon me, the most he could conjure up to justify his "blue-light special" was these ads helped more people to experience the “wonders of chiropractic.” Do I hear an Amen?!
When I mentioned that no one else in town needs to use free give-aways to attract patients, he tried to convince me his practice was twice as large as anyone else's (which is highly debatable), as if volume overcame all other concerns, including our collective professional image. I countered with the logical question: "If your large practice is so great, why don't your existing patients send you enough referrals to stay busy?" He had no answer. Then when I asked him how many cases he completes, he asked me, "What's a completed case?" Then I realized I was in a spittin' contest with a greedy fool.
And if it's not Lurch on TV or advocates of Free Spinal Exams, then it might be another DC who recruits new patients by using Free Chicken Dinners as his lure. He leaves a fish bowl at the local restaurant with a sign that says: "Leave your business card and win a free chicken dinner." Of course, everyone wins a dinner, and during their meal, he gives his sales pitch. He walks around the table, palpating everyone's neck, telling them they definitely need his care. And if they sign up right then, he'll also give them a free spinal exam! Such a deal! Another example of a bait-and-switch gimmick to soil our image.
And if it's not Lurch, the freebie DC or the Chicken Chiropractor, it might be the local Scientologist chiropractor who feels compelled to recruit his patients into the L. Ron Hubbard school of thought. Although the rest of the civilized world considers the writings of this science-fiction writer to be a bunch of bunk when it comes to religion and psychology, for some strange reason his followers have found a niche within the chiropractic profession. Being a former client of the Silly Singer Seminar, I did my own homework on L. Ron himself only to find a biography, "The Bare Face Messiah", that tells the truth about this charlatan. (By the way, you will find how to be a success in chiropractic on page 49 in Dianetics, his fictional account of mental health.) For those brainwashed advocates who write me letters telling me not to attack this so-called religion, my response is simply: Who do you pray to? L. Ron? Gimme a break! A cult is a cult, and don’t ask me to buy into it.
Speaking of cults, then there's the local Jehovah Witness chiropractor who sends religious tracts in her bills to patients, leaves the Awake and Watchtower magazines in her waiting room, and has stopped practicing full time in order to go door-to-door selling salvation. Her goal is not just treating patients' ailments but, more so, to recruit them to their higher calling and to save their souls (and sell a few magazines along the way!).
And if it's not Lurch, the freebie DC, the Chicken Chiropractor, the Scientologist or the Jehovah Witness chiropractor, then it might be the super-straight "pop and pray to Innate" chiropractor who tells his patients that all they need to be cured of "dis-ease" is his HIO adjustment. Forget about diet, exercise, spinal rehab or any other healthy regimens, all that is needed is to turn on this Innate Power.
And if it's not Lurch, the freebie DC, the Chicken Chiropractor, the Scientologist, the Jehovah Witness chiropractor or the Innatist, it might be the wannabe “high-volume” DC who has a sign in his office that says "The doctor is too busy to talk with you. If you want a consultation, please schedule a separate appointment." Ugh. Now we have DCs who operate on the 28 second office visit and won’t talk to his patients. Ugh, ugh.
And if it's not Lurch, the freebie DC, the Chicken Chiropractor, the Scientologist, the Jehovah Witness chiropractor, the Innatist or the high-volume DC who is too busy to talk to his patients, then it might be the "Let's make a deal" doctor who offers free spinal exams and $10 office visits, free care to children, discounts to cash-paying adult family members, NOOPE to insurance patients, TWIP with attorneys, and any other spurious method to recruit patients with financial wheeling-dealing. Or it might be another “let’s make a deal” DC who has a triple fee system for the exact same service: $20 for cash, $30 for group health and $40 for PI cases (just don’t tell your insurance company, please).
Or it might be the non-force adjuster who tells his patients that traditional, classic chiropractic adjustments are out-dated, painful and dangerous. Or it might be the DC medical wannabe who refuses to adjust patients whatsoever, instead doing modalities exclusively and, when that fails, refers them only to MDs for back surgery with the attitude that if his treatment didn’t work, then no other DC could help either.
Despite what seems like an epidemic of eccentricity in our profession--these innumerable examples of questionable practices in chiropractic--hopefully they comprise less than 10 percent of our profession, although that may be wishful thinking on my part. As George McAndrews admitted at the ACA convention in Vancouver last summer, “5% of you are freaks, 5% of you are cultists, and the rest of you…keep your mouths shut!”
And with the flood of new practitioners from certain chiropractic diploma mills who are ill-prepared in practice management and clueless about professional behavior, these tactics and newer ones will probably continue to soil our collective public imagery. After all, their tacky methods are done in the name of “principled” chiropractic. It reminds me of the Jehovah Witnesses who lash out at their critics, justifying their anti-social beliefs with the explanation that they solely know the “Truth.”
My message to the remaining chiropractors who are playing by the rules, trying to make a livelihood using ethical practice methods is simply: How are we to improve our PR when these fringe groups continue to soil it? Is there room for a discussion about ethics in chiropractic? I realize we have an abundance of so-called philosophers who speak about their version of "principled" chiropractic, but I rarely read about anyone writing about ethics in practice management. Recently Dr. Joe Keating has challenged our profession to clean up its act in regards to unfounded claims and the lack of scientific research, but few have spoken about the mess in the realm of chiropractic practice. Oddly, Singer and other Scientologists have exploited this call for ethics by giving L. Ron’s version of this. I guess next will get the Jehovah Witness chiropractor’s version of ethics too. What’s next? Reverend Moon’s version of how to operate a chiropractic clinic?
Even the discussion of these controversial issues usually results in the typical character assassination of the messenger. In the past when I have written articles on this issue, the response is just as interesting as the subject matter. The Freebie doctors shout at me that their tacky methods are helping turn more people on to chiropractic care. The Chicken Chiropractor tells me that his financial success speaks for his inane, "Greed is Good" methods. The Innatists decry my lack of chiropractic philosophy (more aptly, chiropractic dogma). The NOOPE and TWIP doctors committing insurance fraud want me to shut up, hoping their illegal methods won't be exposed. The high-volume (low quality) "Show Me the Money" practitioners tell me I'm jealous. The non-force technicians tell me I'm outdated. The upper cervical practitioners tell me my full spine care is non-specific. The super-straights tell me I’m a mixer and a “chiropractoid.” The "gentle" advertisers tell me I'm rough. The Scientologists want to sue me. The Jehovah Witnesses tell me I'm a pagan. And Big Sid continues to do the Money Hum, laughing all the way to the bank with his student loan money.
On the other hand, the silent majority of "normal" practitioners who use classical spinal adjustments without gimmicks or con-jobs to recruit patients tell me to keep writing. They decry the direction these fringe groups (the Oiuji Board chiropractors as one DC told me) are taking our profession. They're as embarrassed as I am about these tacky antics, but few have the ability to expose these frauds. For example, Dr. Garth Aamodt, in response to an article I wrote titled "In Search of Excellence or Excess," wrote to me and said, "It is a catch-22. Because we are left last in line at the health-care table, it is harder to make a living. Since it's harder to make a living, we attract a large element of unethical and shady ways to balance the playing field which gives us an unsavory reputation. And since we have earned an unsavory reputation, we are justifiably left last in line at the health-care table... Sadly, the real problem demonstrates that not only does the greedy element thrive, but they have lost all ability to even understand what you and I are talking about. It is beyond their comprehension. Many have so rationalized their greed that they actually think THEY are the 'altruistic' doctors within the profession."
Even when there is a vocal spokesman for upgrading the ethics of the chiropractic profession, it still usually falls on deaf ears. In response to the same article, "In Search for Excellence or Excess", Dr. Jerome McAndrews sent a fax to me stating, "Bravo! Right on Target. It's very discouraging to see the unlikelihood that the reasonable practitioners can ever overcome the mess. .. The low-brow marketing--mostly by peddlers--has always hurt us and continues to be our largest problem. But we have to remember, they keep finding many of us willing to pay their fees and adopt their practices. Too bad since we all are the 'collective chiropractic,' each of us seriously tainted by those who practice the unethical. My brother [George McAndrews, ACA legal counsel] wondered why--in the face of all of the trash advertising that was (is) out there--the leadership of the profession didn't at least speak out against it. At the height of the Wilk trial he could find NO examples of such speaking out."
Dr. Richard Vincent, a former chiropractic executive, also faxed to me a similar response to the same article. "Until our colleges and its leadership speak out loud and clear on these issues, it will continue to be a major problem. Keep expressing your opinion." Unfortunately, those charlatans and peddlers who are profiting from this charade within our profession don't agree with Drs. McAndrews or Vincent. As Dr. Aamodt mentioned, these fringe practitioners and peddlers fail to understand what he, McAndrews, Vincent or I are talking about when it comes to raising the ethical standards of our profession.
For example, after I wrote a letter to the editor which appeared in the April/May 1997 edition of The American Chiropractor magazine in which I railed against the fringe elements within our profession, Dr. Peter Fernandez, the disgraced seminar guru who popularized the "Free Spinal Exams" among his PMA clients, wrote a letter in response to my criticism in which he said, "He also criticizes seminar gurus, illiterate chiropractors, Scientologists, Innatists, metaphysical beliefs, your advertisers, your literary staff and phony Ph.Ds. I'm surprised he didn't criticize African Americans, Catholics and Jews."
His exaggeration of the truth and portrayal of me as some type of chiropractic Nazi illustrates the ridicule any whistle-blower can expect when discussing these ethical problems within our profession. As Fernandez mentioned, any criticism of the charlatanism within our profession is cast off by him as "condemnation without investigation." He quickly discounts these misfortunes that he was partly responsible for with nothing more than a few quips of sarcasm, exaggerations of the truth and ridicule of the messenger.
As a matter of fact, I am guilty of condemnation after investigation--you don't have to be a rocket scientist to know about the many illicit practice management methods that he and others have used to profit by and that have soiled our professional image. Some of us still remember in the early 1980s the "60 Minutes" segment with Mike Wallace and the National Enquirer’s article about Sid Williams and his DE dudes. More recently, the Atlanta Constitution newspaper did a two-part article about the iconoclastic Williams and his students’ high default rate of their government student loans. While Williams reportedly beamed at being the center of attention of these exposés, the entire professional face was tarnished by this anachronistic charismatic who now operates the largest diploma mill in the profession and whose school song seems to be his infamous Money Hum.
Unfortunately, it is just this type of denial by those fringe elements which masks the real ethical issues at hand and hides behind accusations of bigotry--if you don't like what Fernandez, the Scientologists, the Innatists and the like have done to our profession, then you must be a racist, sexist, anti-Semitic or bigot of some type. To me his message is clear: Kill the messenger if you don't like the message that our professional image is being ruined by the likes of these fringe elements and eccentrics.
Democracies are messy because they allow a pluralistic viewpoint. But that doesn't mean everything anyone says or does must be agreed to by everyone else, especially when it taints our collective, professional image. Chiropractors have long been the butt of prejudice within our society, much of it due to medical propaganda as well as due to the antics of these fringe elements. While we can't control the covert misinformation disseminated by political medicine, we surely can attempt to censor or control the antics of these fringe practitioners who will gladly ruin our professional image when they do their Free Spinal Exams and as they chant the Money Hum with glee.
Just where do we draw the line between ethical and unethical practice methods? As it stands now, anything goes regardless of whether or not it taints our professional image. As Dr. Chester Wilk wrote about this situation--it's time for our Boards to put some teeth in their bite when it comes to these unscrupulous methods. Unfortunately, our associations seem to tolerate almost anything that is nothing less than totally fraudulent or illegal. Ethics seems to be a subjective matter that is open to a very wide interpretation. And, if it makes money, with the prevalent “greed is good” mentality, practice management has become less a function of offering a quality service at a fair price than it is a matter of offering gimmicks, discounts and free services. And then we wonder why the public, the medical profession and the insurance industry looks at us with a jaundiced eye? Go figure!
It's time for the silent majority to speak up and protect their profession instead of remaining quiet as the charlatans run our collective image into the ground. Just where is the ethical line drawn in chiropractic? I fear it may never be drawn and our future image will remain more a function of the fringe groups than it will be that of our good services. It’s time to draw the line in the professional sand. If you have any suggestions, please drop me a note. Either way, I would love to hear any and all comments. Perhaps a dialogue about ethics (or the lack thereof) will result in some common agreement before our image is soiled any more.