Chiropractors in general have long thought of the medical profession as their primary competition for health care recognition and revenue. For the better part of the 20th century, that was certainly true when we consider the slanderous attacks they directed against chiropractic.

In recent years, the medical profession has lost, in part, its primary benefactor: the pharmaceutical industry. In Part 1 of this series, I discussed the advertising blitz by the pharmaceutical companies that started in 1997.

Because of increased use of so-called alternative health care providers by the American public, the pharmaceutical industry decided to market prescription drugs directly to the American public instead of to the medical doctors to regain market share. The resulting media blitz has been intended to force medicine to do a better job of pushing prescription drugs and to reduce the public's desire to seek your chiropractic services.

This campaign has been successful and has increased drug revenues. It is easy to become disenchanted with the state of American health care today. Chiropractors do not (yet) prescribe drugs, so how do we effectively compete against the multi-millions of dollars spent by the pharmaceutical industry? Has this really hurt the individual chiropractor?

When patients get sick or develop symptoms, what is the first thing they do? Buy an over-the-counter drug to relieve the symptoms. In other words, your primary competition comes not from medicine but from the pharmaceutical companies and, in particular, the individual pharmacy in your neighborhood. Let's take a look at your friendly neighborhood pharmacist and see what it is he or she sells that reduces your income.

The top three over-the-counter sellers in any pharmacy are: 1) pain relievers and anti-histamines; 2) laxatives; and 3) antacids.

If you turned your attention to diagnosing specific digestive problems before they became major health issues and if you normalized bowel function, you could relieve allergies and prevent associated painful inflammatory processes. For example, if you limited your practice to the diagnosis and treatment of fibromyalgia using this methodology, your financial and professional success would be assured!

You can do this quite easily by incorporating within your existing practice a systematic examination of viscero-somatic reflexes. Find the cause and the treatment becomes obvious. Better diagnosis and preventative health care, with a lower price tag. All of this is well within your scope of practice and area of expertise.

Let me say the same thing in a different way.

I take the position that there is no such thing as preventative medicine. Either you're treating disease or maintaining health -- you can't be doing both at the same time. Sound contradictory? I don't think so.

The sick care approach focuses on pain relief, laxatives and antacids. The health care approach involves: removing the source of stress; improving diet and digestion; and detoxification and improved elimination.

The definition of allopathic medicine according to "Dorland's Illustrated Medical Dictionary" (27th edition) is: "A term applied to that system of therapeutics in which diseases are treated by producing a condition incompatible with or antagonistic to the condition to be cured or alleviated." Where is the health maintenance in that definition? Substituting one condition for another is akin to standing on a patient's toe to relieve a headache.

Let's consider a woman having her breasts removed to avoid breast cancer. Admittedly, the possibility of breast cancer is alarming and statistics show that a woman with a family history of breast cancer has a 2+1/2 times greater chance than other women of being diagnosed with breast cancer. I guess surgical removal of the breasts could be considered preventing disease, but did you know that women who suffer from constipation have an even greater chance of getting the disease -- four times greater? [1,2]

You might ask yourself why that statistic is not widely reported to the public? Could it be that medicine does not effectively treat constipation other than by inducing diarrhea? It would be difficult to include that approach, effective as it may be, under the label of "disease prevention" or health maintenance.

I believe chiropractors have no competition in the field of health care. I believe this profession has within its grasp the potential to become recognized as specializing in health care and disease prevention. I think we must educate the public in the difference between health care and sick care. They presently believe that prescription drugs can keep them healthy. But, consider the following facts concerning the state of so-called health care in this country:

*** According to the World Health Organization, the United States ranks as the 37th most effective health care system in the world, behind Costa Rica and ahead of Estonia.

*** Despite recent improvement, the U.S. ranks 27th in infant mortality.

1. Micozzi, Marc, Christine Carter et al. "Bowel function and breast cancer in US women." American Journal of Public Health, Jan 1989 79:73-75.

2. Petrakis, Nicholas and Eileen King. "Cytological abnormalities in nipple aspirates of breast fluid from women with severe constipation." The Lancet 2: 1203-1205, 1981.