Thick Skins


Thick Skins


JC Smith, DC

 SOMETIMES I WONDER IF 15,000 MEDICS OR DENTISTS WOULD GO TO JAIL for practicing their healing arts like chiropractors did in the first half of the twentieth century. I once asked an orthopedist here in my town that question, and he flatly said, “I doubt it.” And I agreed because their motivation is completely different than ours.

When one thinks of the plight of chiropractors, few realize the many adversities our predecessors experienced and still today most DCs are bombarded daily with issues of slander, abuse, and disrespect. If it weren’t for the many patients who “love us to death,” as they say down South, few DCs would still be in practice. Indeed, one of the main prerequisites for any potential chiropractic student (aside from having a heartbeat, a minimum GPA, and a student loan) should be to have a very thick skin.

In fact, little is known about the sociology of being a chiropractor. While our researchers focus on clinical sciences, scant little is said about the socio-psychological aspects of practicing as a second-class practitioner in a medical monopoly.

Of course, ol’ timers can tell you plenty of stories about the abuse and discrimination they’ve been through, but the public is unaware of this struggle. The media has been strangely silent on making heroes of us chiropractors as the first civil libertarians in the healthcare field fighting for the public’s right to choose. Indeed, the public’s freedom of choice about the treatment of their own bodies is a topic that few in the press seem to think is important.

Their answer to healthcare reform has been simply to throw more drugs and more surgeries at them. Our legislators have yet to learn in order to be healthy isn’t taking more drugs and having more surgeries—it’s learning healthy habits that most DCs teach!

Not only is much of the public unaware of the medical wars, so are most chiropractic students. Whenever I’ve spoken at chiro colleges and mentioned such notables as George McAndrews, Chester Wilk, Mike Pedigo, Jerry McAndrews, or Lou Sportelli, few students know who they are and what they’ve done to shape our profession.

On the other hand, these kids know all about the “characters” in our field, such as Big Sid, Rev. Reggie, the many practice gurus, the Scientologists, and the other flim-flam artists like Fast Eddie promising to make them all millionaires. Personality over character seems to rule the roost, or so it appears.

As a practitioner for over 20 years now, and as a former sociology major in grad school, I’ve often thought the chiropractors story, as opposed to the chiropractic story, is an interesting lesson in the on-going struggle of human rights that has never been taught to the mainstream public. That’s why I wrote my novel, Poisoned Love: When a chiropractor and an orthopedist fall in love… I wanted to clearly illustrate to the public the inside story of being a chiropractor, and to show the trials and tribulations of this unique profession. My goal was to personify this troubled profession by making real the plight of carrying the torch of natural healthcare in a medicalized society. Indeed, I want to make heroes of chiropractors.

Just think of the many issues we face daily—patients who are skeptical due to incessant medical propaganda that continues to this day; people who are seeking quick-fixes to chronic problems; health negligent folks who would rather pop a pill than learn lessons on preventative measures; insurance discrimination; a slanted media more likely to report about our extreme brethren committing fraud or doing the Money Hum than mention the good deeds done by most DCs daily to save patients from unnecessary back surgeries as well as the medical skepticism of innate healing of some organic problems via correction of the VSC. I could continue, but you understand the many inequities we all face daily.

Few, if any, other health providers face these problems in their daily practices. How many times has a patient said to their MD, “First of all, let me tell you I don’t believe in medicine”? How many MDs can see and feel the skepticism in patients, or hear patients say, “My husband says you’re a quack.” Few indeed. How many insurance companies exclude medical care? None.

So, what is the consequence of such constant negativity on the hearts and minds of most chiropractors? What has this discrimination done to the self-esteem and respect of DCs? These are questions rarely asked in our profession by researchers although they play heavily on our collective psyche.

We know this stress accumulates daily and impacts every DC who has half a brain. Perhaps this explains why the “rah-rah” seminars like Parker and DE are so popular in our business. Just as oppressed people throughout the world have always turned to religion and opiates for relief, so too have chiropractors sought uplifting experiences with comrades-in-arms. Instead of drugs for relief, many DCs turn to positive mental attitude methods, “pop-psychology” like Tony Robbins for quick fixes, or to the religion of Innate with the many charismatic chirovangelists. And, recently, some have turned to L. Ron Hubbard, but don’t get me started on cultism in chiropractic.

Like any minority, we DCs find solace together in our shared experience as protectors of the holy grail of chiropractic. We swim upstream against a heavy current of medical ostracism and public skepticism. We fight to swim harder and harder against the current of disrespect, hoping someday to find a safe harbor. We attend the motivational seminars seeking respite from this onslaught and to recharge our weary psyches. We give credence to charismatic leaders who, otherwise to the uninitiated, would easily appear as charlatans giving quick fix answers to serious psychological doldrums. But many DCs do take them seriously because they make us feel good about being what we are.

So, how do our educators prepare students for this mental and social distress—the proverbial slings and arrows of outrageous fortune? Do they ignore it hoping not to discourage them? Do they sidestep these issues for fear of appearing negative and scaring off students with thin skins? I recall when I spoke at PCCW and broached these issues, a couple of students afterwards approached me upset about my appearing “negative” about our profession.

“Realistic” is the word I would have chosen, and my hope was to prepare them for battle in the medical wars as opposed to laying in a bed of roses. I guess to be popular I should have done the Money Hum instead? I felt like a weathered Marine vet fighting for 20 years on the frontline in the medical wars, wanting to give some survival advice to these young recruits. Instead, I felt like I was throwin’ pearls before swine. They just didn’t appreciate this hard-fought advice; instead, I imagine, they wanted to believe in the Tooth Fairy who would bring them hoped-for goodies, or the Pollyanna attitude, or what some may call the infamous Alfred E. Neuman, “What me worry?” attitude from Mad magazine.

The irony of developing a thick skin to withstand the emotional onslaught heaped upon DCs is the fact that some may appear simply as not caring. Obviously you can’t wear your emotions on your sleeve and be considered a professional, but on the other extreme, if you can’t feel some empathy for the sick or injured patients, this cold-heartedness can also be a problem. As the old adage says, “People don’t care how much you know until they know how much you care.” As trite as that may sound, it’s true.

So, on one hand, we need to care, but we can’t care too much on the other hand. We all have stories of patients we’ve helped out of their misery only to watch them run off with the PI check, never to return. We bend over backwards with family plans at reduce prices to help everyone get our care, only to watch them change to a PPO and leave, never to be seen again. There is a fine line somewhere between sanity and lunacy for every doctor of chiropractic.  Just where do you draw the line, and to what degree can we care?

And just how does one develop a caring attitude? It’s not something you can teach in chiro college, or is it? Is this Florence Nightingale attitude an intrinsic attribute, or can it be developed? If it weren’t for the money issue looming like a carrot at the end of a long stick, how many students would change professions? I’ve been told that enrollment is down in all healthcare colleges because the huge profit motive has been reduced by managed care, so some are going into the business or cyber worlds. Perhaps now we’ll have more doctors in practice primarily because they want to help people as they were with their own spinal problems as opposed to mainly helping themselves financially.

Not only do we need a thick skin, (but one not so thick we cease to care about each and every patient’s problems) but also how do we prevent the inevitable burnout from happening? Believe me, after 20-plus years turning the crank, giving over a million adjustments, fighting in the medical wars, and watching as PPOs drain our bank accounts with reduced fees, keeping a positive, caring attitude is a challenge.

Aside from the emotional stress, the physical stress from rendering real, hands-on adjustments is also wearing. Since many DCs have back problems themselves, adjusting thousands of patients for decades takes its own toll on our bodies. If I didn’t work out daily for 45 minutes, I’d probably be disabled by now. Indeed, it’s hard being a chiropractor even if you have a hard body.

And perhaps the largest frustration has been the internal warfare in our own profession. Hopefully the call for unity and a single voice aired by many of the intellectuals at WFC will be a start to solving this problem. But as long as we have the ol’ die-hards who profit by our factionalism, there will most likely be peace in the Middle East before we see unity in our profession.

But, despite all the troubles and turmoil of being a chiropractor, it’s worth the struggle and pain. There’s absolutely no substitute for what we do. Spinal care is essential for good health and to just feel good, a lesson much of the public has yet to learn. Even when the day comes that I can no longer practice, I’ll still be an advocate for good ol’ chiropractic care.

Nonetheless, it’s tough being a chiropractor, no matter how much you care. I just hope my skin stays thick enough for long enough. Who knows: maybe I need more opiates in my life too! Any suggestions?