I’m pretty sure that my title is a Spiderman quote, but having read the blog article by James J. Lehman, DC, MBA, FACO, regarding the apparent ‘need’ for chiropractors to expand their scope of practice, this line immediately came to mind.
Here’s the scoop, according to Lehman’s post a group of patients from four chiropractic offices in New Mexico perceive their chiropractors as their primary caregivers. A large percentage of these patients have commented that they would prefer that their chiropractors be able to administer their medications, as well as providing chiropractic services. This has lead to a discussion as to whether chiropractors should aim to expand their scope of practice to include administering pharmaceuticals and perform some injection therapies to their patients. Lehman is of the belief that chiropractic needs to evolve in order to ‘become a viable member of the health care system…(James J. Lehman).”
So let’s back it up and start first by talking a little ChiropractTIC. Chiropractic was discovered in 1895 by DD Palmer, then later developed by his son BJ Palmer, who was among the first to explore the idea that the body has an inborn intelligence, which he called innate intelligence. Of course, this is where the Chiropractic philosophy stemmed from, and Palmer went on to develop the 33 chiropractic principles. These are principles that not only define chiropractic as a profession, but also established its connection with the bigger picture, the universe. The principles bring the metaphysical and physical realms of science together and ultimately tells us that everything within the universe that is in existence follows the laws of physics. Within these laws we come to know that human beings, like any other ‘chiropractically living’ thing has an intelligence within it. In human beings its called innate intelligence. Innate intelligence is always present and always working to keep in our best interest to keep us alive and well. Then there’s the S word. Subluxations become introduced by thoughts, traumas, and toxins, which cause interference within the nervous system. These intereferences distort mental impulses causing dis-ease within the body. Well, that’s the long and the short of it. This is a philosophy revealed to mankind by ‘old timers’, in an even older universe, which is still just as relevant today as it was back in 1895 when the Palmer’s discovered and began developing Chiropractic principles.
Primary Caregivers Defined
The National Academy of Medicine Institute of Medicine (IOM) defines a primary care as “the provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community.” The list of essential primary care needs are as follows “they receive all problems that patients bring – unrestricted by problem or organ system – and have the appropriate training to diagnose and manage a majority of those problems (Kent Primary Care?)” and of course treat patients accordingly.
Basically what this long definition tells us is that in order to be named a ‘primary caregiver’ chiropractors would need to number one, diagnose and number two, treat symptoms and diseases. ChiropracTORs do not do either of these. The task of the chiropractor is to simply look at the spine and analyze it and look to see if a subluxation is present, and finally correct it in order to bring ease back into the body system. Since there is no diagnosis or treatment in chiropractic, which is what medical doctors do, chiropractors can not be named a ‘primary caregiver.’ It is clear that the health care model that culture follows is a medical model of sickness. Medicine is supported by big pharma, which has allowed the health care system to design a care model that is centered around medicines diagnosis and symptom treatments. One which chiropractic does not fall under, since chiropractors believe in the bodies innate healing abilities. For those patients that believe that their chiropractors are their primary health providers, perhaps semantics needs to be defined or their chiropractors are doing a poor job of patient education and should better educate about chiropractic philosophy.
With great power comes great responsibility
Our scope of practice concerns the spine and nervous system. Our strength comes from knowing that the body does not need a outside assistance such as pharmaceuticals, micro surgeries, and therapies to heal, but rather just the removal of subluxation. Chiropractors like Lehman who believe that chiropractic as a profession needs to integrate with the medical profession and move forward into the 21st century either lack an understanding of the this philosophy, are interested in big pharma money, or perhaps are seeking cultural acceptance. The moment we ‘expand’ our scope is the moment we give up our stance and philosophy — that’s when we lose Chiropractic and start doing what every other medical health care profession already does. Rather than looking at ways to integrate into the ‘health care’ system we should be redefining it for society. The way to do this is by helping sick people get well and stay well. The focus of the profession should be shifted towards expanding chiropractic research, such as looking at way to measure nerve impulse and on improving quality of life. This comes from removing subluxations and by educating patients about the importance of of a healthy spine.
Our power as a profession stems from our philosophy and in our understanding of the innate intelligence. Chiropractors need to be strong in their principle in a culture that gives its health authority to medicine. It means going against the cultural norm and choosing to be rhinos among sheep and educating people about chiropractic and health. It means talking to patients about subluxation and about the bodies inborn intelligence. In Bruce Lipton’s book Biology of Belief he talks about how a cell can either be in a state of defense or growth, but not both at the same time. Like the living cells of an organism, the chiropractic profession can also only be in only one of these states at a time. Chiropractors need to work towards a state of growth. This does not come about by abandoning the chiropractic principles by prescribing drugs and performing therapies, but instead by focusing our attention on doing what we do best, striving for optimal health of the spine and the nervous system. Growth comes from sticking to what we do best, subluxations, and by spreading the word about chiropractic. In the words of Spider-man, this is “[our] gift, [our] curse (Spider-man).”