See me.....not the DC.

I had two situations recently which put me front and centre before other more "mainstream" health professionals shall we say- one situation was social in nature...the other, in a more professional setting.  The social setting was the introduction dinner of a prestigious social club my wife and I just joined.  Our friend, who pledged us to the club, was given the task of introducing us to the rest of the new members with a "bio" she put together.  So as she reeled off a list of our "credentials" both academically and in practice....I happened to glance over to the table of "prominent" physicians, surgeons and anaesthesiologists.  Need I say more?  Rolling eyes, snickering, the arrogant "get a load of this guy" smiles to each other and so on and so on.  The second situation was much more covert and subtle in its "vibe".   The other professionals and I shared a common patient, so they called and wanted to get together and discuss... really.... just what they were doing for my patient.  So out came the laptop and powerpoint and I got a long "evidence-based" presentation on their approach.  Then the real reason came for their call.  They had a small "concern" about a recommendation I had made to the patient's mother (the patient is a child) as an at home strategy for the child- apparently I had tread on their "territory" and "caution" and "concern" was needed on my part.  As it turns out, after some "clearing the air", they were utilizing my recommendation anyways because the "opposite" recommendation was not working but far be it that it would come from lowly ole me.  Nonetheless, I bit my tongue keeping the EQ hat on and a calm, cordial demeanour.

How did it affect me, you might ask.  Well,  the childhood, limbic part of my brain felt no differently than anyone else whose felt discriminated against because of race, religion, sexuality, gender, age, appearance etc.- hurt, alienated, inferior, low self-esteem, rejection and of course.....anger.  The nice clothes I had on, the car I was driving, the money in my bank, the success and joy my practice brings me....all those things on the "outside" that would seem to portray "this guys has got his shit together" is no shield for those feelings of "disaffection" and "estrangement" that, in my opinion, no one should have to feel.  Can we grow stronger from it?  Sure....but it doesn't change the fact that it is unfair and in direct opposition of each and every human being's inalienable right to equality and love.

SEE ME......NOT THE DC.

Anyways enough about "woe is me", lets talk big picture for a moment.  Lets extrapolate my individual situations, which perhaps could be just isolated incidents or a figment of my imagination (but I venture to say its common), to that of the chiropractic profession.  

First an everyday metaphor of sorts.  

When I was in university we used to play a card game (usually involving a beverage or two) called "Asshole".  I'm sure many of you are familiar but for those who are not, a brief description-  It's a game of hierarchy whereby (in the case of 4 players) there is a President, Vice-President, Secretary and Asshole...the lowest on the hierarchical chain.  The idea, by process of eliminating your cards first, is to not be Asshole and move up the chain to the Presidents spot.  The reason?  Because the beginning of each new game is never a level playing field.  The President always gets the best two cards from the Asshole and the Vice President gets the Secretary's best card.  Distinctive advantage.  I've been in games where the same guy was the "Asshole" for many hours and, when we played, we took our positions seriously- the President or Vice President could order the Asshole to do anything he/she wanted....get me a beer, order the pizza, bring me my slippers...basically you were a slave.  Fun game.  

So what's my point?

Equal opportunity in the health care marketplace does not exist.  The plethora of practice management groups are a testament to that. Unlike a new medical school grad, we just can't hang a shingle outside our door and expect the flock of patients to come in the door or have a hospital position waiting for us when we're done. They have the two best cards- Cultural and Sapiential authority.  When we graduate we need a plan.  We need to be business entrepreneurs as well as "doctors" to put food on our families' table and carve out a living for ourselves.....never mind the student debt.  Any wonder why franchise places like The Joint have materialized.  They are born because the marketplace of starving, struggling chiropractic grads demanded it.  That's capitalism.

When a government or insurance company makes a decision to cut us out of publicly or privately funded health services some of us yell hooray for the "gift" of "freedom".  I used to think that.  But as I reflected on it more over the years, I realized this isn't about philosophy or practice styles.... its about professional discrimination, defined eloquently by Paul Lell as, ""Any state tax-supported facility providing service for a common condition that denies employment to a licensed professional qualified to deliver that service as has been determined by agreed research".   The war cry of "we don't want to be a part of the "system" anyways, it prevents us from doing our thing, correcting subluxations and I don't want to play by their rules!"....again been there and done that but again we miss the glaring injustice before us....THEY ARE SAYING WE ARE NOT WORTHY OF SERVING PATIENTS BECAUSE WE ARE DIFFERENT OR SOMEHOW INFERIOR!....and yet our patients still come to us...not enough of them....but they come.

Let me remind you of the definition of racism,

Racism can be defined as “an oppressive system of racial relations, justified by ideology, in which one racial group benefits from dominating another and defines itself and others through this domination. Racism involves harmful and degrading beliefs and actions expressed and implemented by both institutions and individuals.

Now lets make a play on words,

"Professional"-ism can be defined as "an oppressive system of inter-professional relations, justified by ideology, in which one professional group benefits from dominating another and defines itself  ("we're not real doctors") and others through this domination.  "Professional"ism involves harmful and degrading beliefs and actions expressed and implemented by both institutions and individuals.

*As an aside, I, as a white Caucasian male want to in no way to offend those who may feel that my parallels are in any way at all like the civil rights movement of our earlier times.  It is true, we have not suffered overtly in the way the black community had in the past and I am deeply respectful of that.  I make the distinction between overt and covert discrimination quite clearly.

I believe many chiropractors are not perhaps considering the consequence of how this greater "ism" further isolates the profession and increasingly unlevels the playing field for the health care consumer dollar.   If the playing field is rigged unfairly and stakes are high, it may force those with the disadvantage to perhaps "cross" the line in terms of ethical business practices (whether they are consciously aware of it or not), forcing those among us charged with regulating our brethren to step in to maintain the right to regulate ourselves (or we will have that privilege taken away) which in turn, turns our brethren back against us calling us "traitors", "sell outs" and a whole host of other names.   It denies the opportunity for the profession to grow financially, as a profession, which leads to both decreased patient experience for all its individual practitioners (as opposed to a select few) and decreased pools of resources to fund its own research, handcuffing its own ability to serve the marketplace.  Continuing down the domino line, our schools face increasing challenges to recruit new talent to "pursue" our dwindling piece of the pie and fund its operations.  Perhaps forcing them to lower standards to keep numbers up.  Further weakening our status.   

If you were ever to hatch a plan to create chaos within a faction of a larger society, rule number one is to isolate them and deny them the ability to ever win the game you're playing...then just sit back watch the infighting and implosion ensue.  Straights vs Mixers, anyone?  Have you been on any chiropractic facebook pages lately?  The plan is working.  Now, instead of working together we just try and impose our "wills" onto to each other....looking for the same domination that's being covertly imposed on us.  Almost comical......almost.

Now some of you reading this may think I am suggesting a conspiracy of some kind against our profession.  Actually no, I look at it as a form of natural selection in process.  Our extinction, if it ever occurs (not my preference), will ultimately  be as a result of what we do to ourselves not what others may or may not do to us.  Like nature, the environment and our response to its demands will determine our worthiness, if you will.  

Chiropractic is not ordained any privilege from up above....we have to work for it.  I am more committed to serving humanity than the term or word or practice of Chiropractic.  If Chiropractic in its current form, ceases to exist or changes its form and function, than I have a decision or "evolutionary adaptation" to make and.....ME...NOT THE DC.....will make it.

I conclude this non-pessimist, non-optimist but "realist" essay with this statement,

I DO NOT HAVE THE ANSWERS.....BUT ADAPT WE MUST... IF NOT FOR OUR GENERATION BUT FOR THE FUTURE GENERATIONS OF CHIROPRACTORS THAT COME AFTER.