Articles by JCS
The Bane of Chiropractic
JC Smith, DC
I recall Rev. Robert Schuller’s famous saying that “Tough times never last, but tough people do!” Any doctor of chiropractic has to admit that it’s very tough being a chiropractor in today’s health care delivery system--managed care, chiropractic exclusions/limitations, medical professional racism, to name but a few of the problems our profession faces every day in the marketplace. Despite these problems, DCs have fought for over a century to find its niche and have succeeded in creating a loyal following of satisfied patients. While much may be tough about our profession, there also is much to be admired and enjoyed.
Unfortunately, for the most part, our public image still sucks, to put it bluntly. Not only do we have unfair accounts of chiropractic in the electronic media, such as the 20/20 News articles, but the written media has been just as unkind with defaming articles in Consumers’ Report, Woman’s Day, and numerous articles like the New York Times, Journal of the AMA and The New England Journal of Medicine editorials which always find a way to embellish the anecdotal cases of abuse or iatrogenic problems, or print sham studies in order to embarrass our profession. And with the lack of an effective national on-going PR campaign by the ACA, ICA or state associations, our image is mainly the result of the medical media’s misinformation rather than a result of proactive chiropractic information. Indeed, chiropractic’s message is a hard lesson for the public to learn since it is buried beneath years and volumes of medical propaganda.
Not only is our downtrodden image the result of inadequate national PR on our part combined with medical misinformation, our own colleagues seem to add fuel to the fire with tacky, dumb marketing that only adds to the poor imagery. Whether it’s Free Chicken Dinners, Discount Prices, NOOPE or Free Spinal Exams, the public must think how sad our state of affairs must be when they see such dumb ads. Reasonable people must think to themselves when they see such ads: “If chiropractic is so great, why do they have to give it away?” Indeed, if we’re not taking cheap-shots from the medically-tainted press, we’re shooting ourselves in our own foot with our own dumb marketing. And it’s only getting worse as new practitioners enter the field, in debt with huge student loans as well as their professional overhead. On top of this dire situation, most graduates are clueless about an effective operating system for their offices, so they’re equivalent to cooks who don’t know how to operate their restaurants! Definitely, this mix creates a desperate situation for desperate chiropractors resorting to desperate gimmicks to stay afloat.
For example, recently another rookie DC opened an office in our town and immediately began with the classical chiropractic dumb ad -- “Free Spinal Exams” along with NOOPE (no out-of-pocket expense) operating a “Let’s Make a Deal” Chiropractic Life Center. While this youngster may attract a few new patients, on the other hand, his tacky ads will also serve to demean every chiropractor as well as devalue chiropractic care in the eyes of the public. Never do we see dentists or MDs doing anything like this, but it seems to have become the standard protocol of many new DCs. And we wonder why people take a jaundiced look at our profession when they see such tacky methods?
I realize that many DCs have been taught to use such ads by many practice managers, but in reality, these ads merely draw the cost-conscious, bargain-hunters who are looking for a good deal and a “quick-fix,” and not necessarily a good doctor. After using such ads, don’t be surprised with the frustration you may feel when you see most of these bargain-hunters leaving out the back door as fast as they come in the front door, especially when you mention a treatment plan or maintenance care. Believe me when I say you will not build a practice of value-conscious patients with such ads. Indeed, these dumb ads will taint your image and position you in your community as the “cheap” chiropractor, not necessarily the best one.
Not only did this particular dumb ad not contain the mandatory disclaimer required by our state Board of Examiners (“Any further treatment must be agreed upon in writing and signed by both parties”), it also contained other spurious statements which could be easily interpreted to mislead the public. Foremost is the claim made by many DCs make of “specialties” which usually don’t exist, such as Sports Injuries, Scoliosis, Whiplash/Rehab, to name just a few. The recent rookie ad also listed as “specialized training” many adjusting techniques that are normally taught in school anyway. Just as other recent articles have exposed the use of phony “Ph.D.” degrees used by some DCs, the same accusation can be made about the use of “specialties” by uncertified practitioners.
According to this dumb ad, this rookie DC is an expert in every aspect of chiropractic. While this DC may beam with pride over this ad, to the public I think this ad is not only misleading as to the actual qualifications to handle these “special” problems, much of the public must look upon such outlandish claims with suspicion. Is this any different than an MD saying he/she is a specialist in Orthopedics, Geriatrics, Obstetrics and Oncology? Rather than being impressed by such claims, I believe many must think of the old adage, “Jack of all trades, master of none.”
Not only do these dumb ads mislead the public and taint our image, but for those DCs who have worked long and hard to master these subjects and attain real certification, these ads must make them furious. As the operator of a certified spinal rehab facility, my blood boils when I read these dumb ads when I know for a fact that the rookie DC has not one piece of rehab equipment. And, if this rookie DC thinks a non-force adjustment alone will stabilize a cervical acceleration/deceleration injury, this again serves as an example of misleading patients as to proper treatment for these most serious spinal injuries. And we wonder why the public holds our profession in suspicion when nearly every new DC places such dumb ads. They are misleading, unethical and just dumb. The sooner our profession regulates dumb ads the sooner our image may improve. Indeed, dumb ads are the bane of our professional image.
Another eyesore that has creep into our profession is the use of “gentle” chiropractic ads promoted by the non-force elements within. These ads mislead the public by implying that traditional adjustments are painful and that their method is not. Excuse me, but a proper, traditional, joint manipulation by hand is not painful whatsoever if done correctly. For these “gentle” practitioners to imply otherwise is sheer nonsense and an insult to the historical foundation of our profession. For 104 years chiropractic’s great results have been a function of hands-on joint adjustments, not on adjusting instruments, massage therapy or holding pressure points.
Ironically, while these “soft” practitioners promote their gentleness, I’ve had many patients transfer to my office complaining that the instrumentation method actually was painful, and in many cases, just ineffective. When a transfer patient says, “All I want is a real adjustment,” you know he’s been under the care of one of these “non-force” practitioners. They don’t want “new” methods disguised and advertised as chiropractic care. I believe these “gentle” ads also mislead the public by claiming to be chiropractic adjustments. If we are to include these “gentle” instruments as chiropractic care, why not also include massage or any technique that involves the spine? Just where do we draw the line as to what constitutes a “real” chiropractic adjustment? Or is this situation actually a “bait and switch” situation where their ads draw in patients who expect traditional chiropractic spinal manipulation done in a gentle fashion, but instead are given an instrument treatment that has little resemblance?
While the “gentle” practitioners may complain that their treatment should be considered chiropractic, I must question if their methods have really withstood the test of time and clinical evaluation. The great clinical results mentioned in the AHCPR, RAND and Manga Report about spinal manipulative therapy most likely did not include these methods. Before our profession is accused of misleading the public with unproven claims of “gentle” adjustments, I suggest we scrutinize the clinical effectiveness of these methods. Even if these methods are helpful in some cases, does that qualify them to be considered “chiropractic” adjustments? Just because a DC administers a technique does not make it a “chiropractic” method.
In fact, the use of “gentle” chiropractic ads along with the dumb ads, like Free Spinal Exams ads and ads containing misleading “specialties,” have become the bane of our profession. Someone in our profession must draw the line as to the indiscriminate use of misleading ads that confuse the public. Again, let me re-state that the great clinical results of chiropractic care have been based on traditional spinal adjustments done by qualified chiropractors. I suggest that before you place an ad in your paper or telephone book, please be accurate in your description of your method, please be honest about your credentials and “specialties”, and most of all, please don’t give it away. Again, if chiropractic care is so great, why do you have to give it away? You’re only soiling your reputation and demeaning our entire profession.
Until our profession finally employs a professional PR firm to develop a comprehensive marketing campaign including television ads, I imagine our image will be left in the hands of dumb advertisers using whatever gimmick they can. If Andre Agassi was right in his ad that “Image is everything,” then chiropractors still have a lot to learn.