January 2008

Reply to Dr. Jeffrey Shay's 'National health and chiropractic'

by Dr. Robert J. Sinnott

Having just read Dr. Shay's Chiropractic Journal column, "National health and chiropractic" (November 2007), I am pleased to see there is SOMEONE in the profession interested in dialogue about how chiropractic will be viewed in the oncoming National Health Care era. As Dr. Shay aptly pointed out, the 1993 effort was overwhelmed by the special interests of corporatists. What is more important to note is that the majority of Americans were against a National Health Care plan in 1993 and today the country is in such dire need of a different course for health care that the percentage of Americans FOR this initiative is now at 71% ‑‑ and climbing.

One would think that spontaneous discussions would spring forth among chiropractic leaders, setting a course for our future in such a system. That is to say, one would think. On the contrary, other than Dr. Shay's column, the profession is outside the flow of traffic yet again. Many have even said, "It won't happen, so why worry about it?" I have approached this subject with several of our 'leaders' in the past months imploring them to get their organizations involved in the dialogue of the individual presidential campaigns. On a recent phone call of chiropractic leaders, I brought up the subject and asked what course we needed to set as a profession. Complete silence greeted such curiosity. Why? Because in chiropractic we, too, have corporatists who are more interested in their personal agendas than that of the profession.

We cannot let the pressure off of chiropractic leadership to do the right thing for the profession.

Several things can be assumed in a National Health Care system. First, it may be very likely that if chiropractic is included it will not be on an anything goes basis. It would be unlikely that therapies will be covered, for instance. Machines that go "ping" may be going for pennies on the dollar on eBay. It is not unlikely it may closely resemble Medicare. They cover the adjustment and little else. Many practices may not survive the transition to a chiropractic‑only style practice and will perish.

The other scenario is that a National Health Care system will not include chiropractic care. Much like the before the insurance‑milking days, patients will pay out of pocket for the privilege of coming to your offices. Do you think they will pay for a $20 hot pack, then a $20 ultrasound, not to mention another $20 for the muscle 'stimulation' machine? Be serious. You will have to be good at what you do as a chiropractor. This is just as likely to be chiropractic's future.

It has long been my opinion that the third party payers are the only ones capable of making changes in chiropractic practice. There is no chance of change or improvement from within given the monetary motivations of status quo. Those who can deliver a real chiropractic (the big "C" kind) service will survive and the profession will shift in that direction as a matter of necessity.

What's that? Be better at what we do? That's right! All the practice management gurus out there had you convinced it was about "seeing" 500 patients a day. They will have to re‑gear their programs to actually make bad chiropractors good before they make them busy.

I applaud Dr. Shay for having the temerity to open this discussion in a broad format. Today, we should all call the home offices of our associations, whether they be the ICA, WCA or FSCO and inquire what steps are being taken for the future of chiropractic in this National Health Care discussion.

Before you ask, I did not forget the ACA. As they told me in a recent mass mailing, they will stop National Health Care if only I join and send them the $600 they need to do it. Really? All the might of the drug factories combined with the insurance industry machine can't kill this movement, but if only I would join the ACA...

It's time for the three organizations that are reality‑based mentioned above to join forces and approach these candidates' platforms as a united front to protect the interests of the profession and the patients who depend upon them. Kudos, Dr. Shay!

(Dr. Robert Sinnott is from Frankfort, Illinois)