February 2007

Putting your money where your heart is

by Dr. Matthew McCoy

This isn't easy, but it has to be said. Too many chiropractors think the world ‑‑ and the profession ‑‑ owe them a living. They're cheap and, frankly, just plain selfish.

Not everyone, of course! In fact, the majority of doctors realize they only get as much out of life, and chiropractic, as they're willing to put into it. They're responsible members of our community who actively look around to see where they can make things better for others and how they can improve their own skills and competencies.

The ones I'm referring to make up that small but annoying minority who think the rest of us can carry them on our backs. They want everything chiropractic has to give, but refuse to pull their fair share of the load. When they look around, it's not to see where they can contribute but to find out what's in it for them.

I've been coming across more and more examples of this type of person lately and I'm concerned that it's a growing part of the chiropractic culture, just as it is in the general society.

In the "outside" world, the "something for nothing" mentality is why gambling has proliferated, frivolous lawsuits clog the court system, the Internet is saturated with ads (users refuse to pay for content), as much as 25% of all music and software is pirated, and people wait around for the government to take care of problems.

In chiropractic, these freeloaders constantly gripe about the cost of seminars, expect research publications to be provided free of charge, and don't understand why organizations won't help them out in a jam ‑‑ even though they're not members! Their motto seems to be "I want it all ... I want it now ... I want it for nothing."

Over the years, I've heard from a number of doctors who want access to copies of research articles published in the Journal of Vertebral Subluxation Research but think the $125 annual subscription fee is too high. I've actually had some argue that we should provide this material for free just to help the profession. These doctors would never consider providing adjustments for free just to help their patients!

Oddly enough, they know research is critical not only for their own edification but as defense against board complaints and malpractice accusations, and for public education purposes. They just don't feel they should have to pay to help support research or even compensate the doctors who spent a great deal of time and effort to do that research.

Recently, I received a letter from a doctor who questioned why the Journal of Vertebral Subluxation Research is charging for the newly published "Independent Evaluation of Chiropractic Care: Guidelines for Peer Review." He felt the fee for this extensive and important document was "too expensive" and noted that the Mercy II documents were free.

I wanted to tell him that the developers of the Mercy guidelines obviously recognize the value of their document, but instead I tried to explain why he and his colleagues need to look at the cost of such things as an investment in their profession.

I explained what went into creating a document like the IME Guidelines. It starts with the actual research ‑‑ which is a complex and time‑consuming undertaking. Then, the research reports must be written and repeatedly rewritten to meet exacting scientific standards. They have to be submitted to a complicated and equally time‑consuming peer‑review process.

Finally, the report is finished. But we're not done yet. The technical staff then has to step in to properly format the document and convert it into an electronic file that most doctors can easily access via the Internet. Maintenance of the website ‑‑with all the costs associated with that enterprise ‑‑ adds to the final bill.

By the time it's all totaled up, thousands of dollars have been spent to bring this document to the profession, yet some DCs think it should be given to them for free. I wish these doctors would apply the "latte factor" into their thinking before complaining about the cost.

How many of them spend $3 a day on a cup of Starbuck's mocha latte (or their coffee of choice)? That's more than $1,000 a year but they'll shrug that off as "necessary." They probably spend hundreds of dollars on magazines for their office waiting room (which, by the way, are filled with drug ads). They'll pay $75 to get their hair styled or $100 for a pair of loafers. But pay for guidelines that could help them improve their quality of patient care or allow them to successfully defend themselves against an IME in court? Too expensive!

In talking with leaders of several chiropractic organizations, I know I'm not alone in my frustration about this type of doctor. Organizations get calls all the time from doctors who need information or assistance, but who aren't even members! They really like the organization, but couldn't "afford" the membership dues, they say. What they really mean is they didn't make dues a priority because they figured they could get the benefits for free. They want (and expect) the organization to fight for chiropractic and help them when they need it, but they want everyone else to foot the bill for them.

Right now, we're in a battle for the very survival of subluxation‑based chiropractic and all the talk in the world isn't going to save it. We need doctors who put their money where their heart is, who will put chiropractic ahead of their lattes and their haircuts. They need to support subluxation‑based research and organizations not only with their words but through action, money, time, effort and sacrifice.

(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)