The Biggest Challenge
Have you ever wondered why the most popular seminars attended by chiropractors are practice-building programs where they are taught tricks of the trade to attract new patients with assurances to double, nay triple, their income?
Indeed, no other topic fills the meeting rooms as does the smell of money.
I witnessed one such event at the Florida Chiropractic Association years ago when a well known speaker teased the audience with his promise how to create a “million dollar practice.” It certainly got my attention and everyone else who crowded into the room.
His formula for success was simple—get 50 new patients monthly by offering bait in the Yellow Pages of a “free massage” for each new patient, then retain them for 50 visits @ $50 per visit, and you’ll make a million dollars; actually $1.5 million. Such a deal!
The lecture room was packed with hundreds of eager DCs lapping up his advice. But if you wanted to know how to achieve such instant success, of course, you had to pay for his management service to learn his secret tips. I wonder how many today are millionaires?
Certainly practice gurus teaching such tricks of the trade have been around since the days of Jim Parker and Sid Williams who captivated their attendees with the keys to professional fulfillment, financial prosperity, and a lasting purpose spiced with “motivational” chirovangelism.
I contend the biggest practice building factor of all time would be to get the medical stigma off our backs and rebrand our collective reputation based on the latest guideline recommendations that have never been disseminated to the public.
Transforming skeptical people into loyal, knowledgeable patients continues to be a huge challenge for chiropractors, and for good reason—no other profession has suffered a similar character-assassination by the AMA and no other health profession is missing in the media as we are.
Let me suggest we are going about it in the wrong way with superficial methods rather than addressing the underlying causes of this problem.
Apparently some are satisfied with our typical PR modus operandi—WOC testimonials, newspaper and Yellow Page ads, social media, Twitter, websites, bumper stickers, or word-of-mouth (WOM).
While these may attract attention to an individual practice, none will work to create this paradigm shift in public opinion on a national level that we desperately need.
We don’t need more ads or tweets, but we do need to integrate these with the next level of “earned” media, which, by the way, is free!
Unquestionably, there is no bigger drama in medicine today than the scam in medical spine care with the clinical scandals, patient deception, and outright fraud by doctors and hospitals.
Never before has this plot thicken as in the last few months with a series of breakthrough events in the news:
- the recent arrests of ‘neurosurgeons gone wild’,
- the numerous articles about the Hillbilly Heroin epidemic,
- the HHS investigations into medical fraud,
- the Mayo Clinic systematic review debunking ‘bad discs’,
- the CMS denial of payments for fusions,
- the call for transparency by HHS and DOJ, and
- the ‘best practices’ guidelines such as AHCPR, NASS, Oregon Health Plan and Optum.
Yet, where is the chiropractic voice in the news warning Americans of this huge medical melodrama? We know full well if our profession had as many issues of fraud and deception, we would be dead in the water, flooded by medical critics in the news as we witnessed last year with the bogus stroke issue.
There is no longer any doubt patients are railroaded into ineffective medical care by inept primary care and ‘pain management’ providers pushing opioid painkillers like Halloween candy, then to so-called ‘spine interventionalists,’ aka ‘needle jockeys,’ doling out ineffective ESIs @ $900 a pop, and, when that fails, patients are railroaded to surgeons using the debunked ‘bad discs’ diagnosis as reason to do unnecessary fusions @ $100,000 each.
Richard Deyo, MD, in his book, Watch Your Back, admits to the poor results in medical spine care:
“For back pain, here are the results: steadily increasing use of imaging tests, opioids, injections, and surgery. Costs that are rising faster than the rest of medical care. And at a population level, worsening patient function and work disability. We’ve perfectly designed our health care system to produce these results.”
It’s past time to stop this runaway train. Never before in the history of the medical war has the arsenal of information aligned with our profession, yet no one is informing the public or the media of a change of course.
This is now our biggest PR challenge—how to convince a skeptical public and media that research and guidelines have now fallen on our side and the medical melodrama must come to an end.
The Big Lie Must Die
If we were to have the opportunity to tell our story without medical interference, the most important factor the public and press must understand is the disgusting history of the quackery stigma against chiropractors never came from state or federal health agencies or researchers; nor did it originate from public opinion or legal authorities.
The ‘unscientific cult’ image came solely from the sadistic and illegal effort of the AMA to destroy their main competitors—those pesky chiropractors—in order to corner the spine care market and escalate costs, which it did, allthewhile leaving a trail of addiction and disability behind.
Whistleblower William Trevor in his book, “in the Public Interest,” revealed the origin of the stigma that became a treasure trove of evidence used in the Wilk case illustrating the antitrust activities and the illegal propaganda strategy used by the AMA’s Committee on Quackery to destroy the reputation of the chiropractic profession:
Time and time again the AMA’s Merchants of Misinformation have subverted the truth for their own fascist ends. Using these tactics to “build up a case” against chiropractic they have taken objective reports, studies, and individual opinions in favor of chiropractic and reversed them into what appears to be anti-chiropractic views coming from many “non-medical” sources. Done enough, this tactic would give the appearance that “everybody knows that chiropractic is an unscientific cult.”
For too long we’ve been burdened with a bad rap that we didn’t deserve, but one that continues to harness our potential to help patients and to earn our fair market share.
Nevertheless, this stigma remains embedded in the court of public opinion because, outside of the Wilk courtroom or the New Zealand Inquiry into Chiropractic, no one has heard of the origin of this smear campaign.
Without question, overcoming chirophobia is the Biggest Idea that must be embraced by this profession as its main PR goal if the public, press, politicians, or payors are to understand why they think the jaundiced way they do about chiropractors.
In the back of most people’s minds remains the ‘click/whirr’ of medical bias that they’ve been force-fed for decades. Like racism in the South, it’s just bred into their core values of social tradition. Indeed, medical bias remains the last bastion of “acceptable prejudice” in the minds of many people and a huge cultural obstacle to overcome.
The parallel between racial bigotry and medical bigotry is an enormous task to explain and overcome to those who know nothing about these social and historical issues, and that includes most DCs.
For example, explaining racism would require a minimal understanding of the following:
- the origin of slavery before the Civil War,
- the aftermath of segregation and lynching by Jim Crow and the KKK,
- Brown v. Topeka Board of Education of 1954,
- MLK, Jr. and the Civil Rights Act of 1964,
- Voting Rights Act of 1965, and now
- the issues of ‘Black Lives Matter’ and the pushback over the Confederate flags flying in public arenas.
Without this minimal understanding of historical events, ignorant people might assume racism was just a natural part of society, never questioning its validity. White supremacy and the buying, selling, and breeding of Africans for slave labor was just a part of the old Southern culture taken for granted because it was good for the economy.
This is exactly what we face in chiropractic—a long-standing prejudice taken for granted by the public instilled by a medical supremacy, the AMA, over the last century that people assumed was simply judicious medical advice to follow without question when, in reality, it was political medicine at its worst.
For example, an accurate explanation of medical bigotry and chiropractic vindication would include:
- The 25-year tyranny of Morris Fishbein, the unabashed Medical Mussolini from 1924 to 1949 who “converted a panty-waist professional society into the most terrifying trade association on earth.”
- 1962 to 1980: The defamation and antitrust campaigns waged by the AMA’s Committee on Quackery to “contain and eliminate chiropractic.”
- 1976 to 1989: The milestone Wilk v. AMA antitrust trial, chiropractic’s equivalent to Brown v. Topeka Board of Education.
- 1978: New Zealand Royal Commission on Chiropractic
- 1990: RAND study on appropriateness of spinal manipulation
- 1990: Meade Study (UK) comparing manipulation vs. hospital care
- 1993: Manga Report Ontario (Canada) Ministry of Health
- 1994: AHCPR Acute Low Back Pain Guideline
- 1994: Clinical Standards Advisory Group (UK)
- 1995: Council on Chiropractic Guidelines and Practice Parameters
- 2003: Ontario Workers’ Safety and Insurance Board
- 2003: Norway Spine Study
- 2004: European Back Pain Guidelines.
- 2004: The UK Back Pain Exercise And Manipulation (UK BEAM) Trial
- 2004: Swedish Lumbar Spine Study
- 2007: Guideline on Back Pain: American College of Physicians
- 2008: Decade of Bone & Joint Disorders: CLBP
- 2008: The Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders
- 2009: The National Institute for Clinical Excellence (UK-NICE)
- 2013: Optum Report: “Conservative Spine Care: The State of the Marketplace and Opportunities for Improvement.”
- 2014: The Oregon Health Plan that recommends conservative care before medical spine care.
Considering this extensive list of events, studies, and guidelines, it is peculiar the medical media reporters have failed to expose this medical melodrama and the positive chiropractic issues during this pandemic of back pain.
This is the Big News Boycott that must be exposed if we are to progress into the future as America’s primary spine care providers.
Louis Sportelli, DC, noted after the AHCPR guideline:
“If the doctors of chiropractic only cornered the market on one condition, back pain, there would not be enough [chiropractors] now to handle the volume.”
Log on to Headline News for the second part of this PR proposal.
 RA Deyo, Watch Your Back!, Cornell University Press, 2014; pp. 171.
 W Trever, “in the Public Interest,” Scriptures Unlimited, Los Angeles, Calif., (1972):p. 11
 M Mayer, “The Rise and Fall of Dr. Fishbein,” Harper’s Magazine, 199/1194 (Nov. 1949) p. 76.
 G McAndrews, “Plaintiffs’ Summary of Proofs as an Aid to the Court,” Civil Action No. 76 C 3777, Wilk, (June 25, 1987) Throckmorton, Howard, Taylor, and Monaghon Deps.
 L Sportelli, “AHCPR: It Did Not Happen By Accident,” Dynamic Chiropractic 13/2 (January 16, 1995).