July 2008

Down on the farm in Iowa

by Dr. Jeffrey Shay

The story line from Orwell's "Animal Farm" is well known. The farm animals, angry at being mistreated and having their complaints ignored by the farmer, stage a revolution and take over the farm.

A new credo appears on the side of the barn: "All Animals Are Created Equal." The new regime is operated by the pigs, while the horses and other animals get to…well, they get to do all the work. The pigs amass more power, with Napoleon becoming the most powerful. While the farmer is represented as a dictator, it didn't take long for Napoleon to usurp control of everything, eventually assuming many of the farmer's old habits, which, of course, had led to the revolt in the first place.

One morning the animals woke up to see that a new slogan had taken place of the old one on the barn: "All Animals Are Created Equal, But Some Are More Equal Than Others." One by one, all of the principles they began with disappeared, and the animals soon had less freedom than ever before.

Welcome to the Iowa Chiropractic Society.

ICS was formed in 1964 on the premise that having more than one group of chiropractors in the state was a bad thing, that chiropractors needed to speak with a unified voice. If this sounds a lot like the arguments the proponents of a national merger are making, it is.

So, the new organization was formed from elements of the old Iowa Chiropractic Association (ICA), the Chiropractic Society of Iowa (CS of I), and a third group of unaffiliated DCs. The ICA, in essence, was the more liberal of the two groups, while the CS of I represented subluxation-oriented doctors. On the surface, this was a fairly even balance.

It didn't take too many years to pass before the old ICA group became prominent, while the straights assumed the posture of ice castles in Florida, and their power melted away. This does not mean that there are no subluxation-oriented doctors in ICS. It does mean that their canoe runs the rapids without a paddle.

I was a member for more than a decade, heading their Medicare and Medicaid committees, and handling associated duties. It was an important period, as there were a lot of changes that occurred, particularly in Medicare. There were times I could work with Medicare officials, and other times they ran over the top of the profession, especially with their chiropractic audit programs.

The real problem came when I investigated a connection between certain insurance companies and some professors at Palmer College. Palmer officials who met with me admitted the existence of the program, but refused to stop it or allow me to write about it. My attitude was, if it's such a good thing, why not tell doctors about it?

Shortly afterward, I was contacted by ICS officials, warning me that they wanted the article stopped, and that action would be taken against me if I wrote anything further. They claimed to have veto rights over any article I would write. When the story appeared in The Chiropractic Journal, I was removed from my committee. Later, ICS officials informed me that I could pay membership dues, but would not be allowed to hold any position in the organization, or express an opinion.

I was also informed that this also applied to the World Chiropractic Alliance as well. The WCA was out of step with what they called "real" chiropractic.

It has been my understanding that the ICS is supposedly not affiliated with any national chiropractic organization. But, at least while I was a member, ICS had an official liaison to the ACA, but not to any other national chiropractic organization.

In other words, ICS has the same relationship to the ACA that lead paint has to the Chinese toy industry.

Why bring this up more than a decade later?

Recently, the ICS Board of Directors created an initiative to convene a "consortium of national and state member organizations, educational institutions, and other appropriate professional representatives." The purpose of the conclave is to discuss issues such as Medicare, as well as the future of chiropractic participation, in essence, studying the status of the program and our participation in it. It's possible, although not stated, that the discussion may include analyzing the possibility of a national health program being touted by some Democratic presidential candidates.

It's a good idea. I've talked about the need for this kind of symposium several times in my column, especially toward inclusion in any new national program. I even mentioned this to the ICS back in 1992, but was told by some of the gauleiters that it was impractical.

So, what's my problem with the "consortium"?

It's the definition of who gets to attend. The ACA and the ICA obviously have to be there. Palmer College won't be skipped over. And you can bet Dynamic Chiropractic will miraculously appear on some level. But what about Sherman College? And the two Life Colleges?

The WCA has received no notice of this. In fact, even though it's one of the largest publications in the profession, no notice was sent to The Chiropractic Journal. I didn't even get a Christmas card from these guys, and I'm in the same state. Apparently, old habits die hard.

In fairness, I should point out that we have been able to work with the International Chiropractors Association (ICA) on such matters, and we were even invited to attend their April meeting on Medicare and other issues.

The problem goes back to the ICA apparently. A national meeting should be exactly that, with all groups invited to attend. The release to the chiropractic media should be general, and not selective. If, as the ICS states, the meeting is of such importance, the only reason for handling the matter in this way is to control the attendees, a handy way of eliminating unwanted opinions.

It appears that some animals really are more equal than others.

(Dr. Jeffrey Shay, a graduate of Palmer College of Chiropractic and the WCA's 1996 "Chiropractor of the Year," is the World Chiropractic Alliance Director of Insurance Relations. He welcomes comments or questions regarding any insurance-related subject appearing in this column. Dr. Shay is available to speak to your state or local organization. Contact him at 1501 Mulberry Ave., Muscatine, IA 52761, or the WCA offices, FAX 480-732-9313.)