April 2007

The real bait & switch

by Dr. Matthew McCoy

I've heard it for years from practice management groups and from individual leaders in the profession: "I know chiropractic is about much more than back pain but that's why they come in the door and once they do, you can educate them about what chiropractic really does."

We see it again now as a more formal movement through the so‑ called "Identity" movement and the profession‑wide advertising campaign. We are told that the public thinks we're back doctors, or spine fixers, or neck and back pain specialists ‑‑ so that's how we should market ourselves and lure more of these people with cricks, backaches and strains into our practices. Then, once we have them in our web, we can "educate" them about what we really do: wellness.

If that isn't the biggest bait and switch going, I don't know what is.

Don't get me wrong. I agree that the public thinks we're neck and back pain doctors. But whose fault is that? I also agree ‑‑ and have been stating adamantly ‑‑ that this so‑called "paradigm shift" is more of a series of fits and starts. You can't tell me that a culture that just embraced the trillion dollar "free drugs for baby boomers" plan is sprinting towards a wellness lifestyle.

It's also plain to see that everything has become wellness and the term has become diluted. Prostate exams, mammograms, laser hair removal, cellulite reduction and vaginal "rejuvenation" are all marketed as wellness. Again, whose fault is it? Whose decision was it to squander the limited resources of our profession for a niche in the back pain market and why did we listen? Better yet, why are we still listening?

What if our research infrastructure and the collective mindset of the profession had decided 30 years ago that instead of getting our foot in the door of back pain treatment we were going to look at the effects of subluxation reduction on immune function and quality of life? While you might like the eight danger signals and lightening bolts shooting out of people's backs, what would our yellow page ads look like today had we taken that other fork in the road?

According to Paul Zane Pilzer [1] wellness is the next big thing and it's going to be a trillion dollar industry within 10 years. Pilzer maintains it's currently as unknown as the auto industry in 1908 and the computer industry in 1981.

According to the International Foundation [2] "...the most dramatic and longest term cost reduction in health care benefits will result from employee health management or wellness promotion."

In a study of 464 companies their researchers found that 62% of respondents offer wellness initiatives and another 15% plan on offering them within the next 12 months.

The most prevalent initiative offered is wellness education, followed by health screenings and health risk assessments. On site massage therapy was offered by 24% of respondents.

Improved employee health followed by improved morale were cited as the most frequent benefits of a wellness program. Lower health claims, reduced workers comp claims and absenteeism ranked lower.

Here's the kicker: 87% of the companies do not know the return on investment for dollars spent on wellness programs. Maybe we could help them figure that out? Or, should we keep telling them how good we are for back pain?

As we debate this issue, it's important to understand that the wellness industry has clearly not defined itself. And while that might be true, the chiropractic profession has gone a long way to define wellness and the chiropractic lifestyle.

In his studies on chiropractic, wellness and quality of life, [3] Dr. Blanks has shown compelling evidence for the existence of a chiropractic lifestyle and that this lifestyle confers significant health benefits.

Not only have his studies shown that people report improvement in their physical, mental and social well being from subluxation‑based chiropractic care but more profoundly his studies show that this type of chiropractic care leads to changes in lifestyle that have an added effect on self‑perceived wellness and quality of life.

It's time for those of us who recognize we've been led down the wrong road by the sensible shoes and Sansibelt crowd to not just turn around and go back. We need to cut through the woods! There is no time to double back. And, continuing with the bait and switch practice management scheme is a death trap for this profession.

References

1. Paul Zane Pilzer. "The Wellness Revolution." John Wiley & Sons. 2003.

2. Wellness Programs 2006. International Foundation. Brookfiled Wisconsin.

3. "A Retrospective Assessment of Network Care Using a Survey of Self‑Related Health, Wellness and Quality of Life." Robert HI Blanks, PhD, Tonya L Schuster, PhD, Marnie Dobson, BA Journal of Vertebral Subluxation Research [Vol.1, No.3, p.1]

(Dr. Matthew McCoy is one of the founding members of the Council on Chiropractic Practice and has been instrumental in the development of the profession's most widely accepted set of chiropractic guidelines. He's also editor of the Journal of Vertebral Subluxation Research and has extensive practice, research and educational experience. He gained international acclaim when he helped introduce chiropractic to the Russian medical community by developing a chiropractic spine treatment, teaching & research center in Vladivostok, Russia. He is currently the Director of Research at Life University. Dr. McCoy is vice‑president of RCS, serves as a member of the WCA Board of Directors, chairs the WCA Chiropractic Advocacy Council and was a liaison member of the National Academy of Sciences and Institute of Medicine's Committee on Alternative Medicine. He can be contacted via e‑mail at editor@jvsr.com)