I do not consider this unusual. I am not making any claim to longevity nor claiming any special privilege as a result of my fortune. I do enjoy a unique perspective, though, having lived so close to the profession for so long. After returning to private practice two years ago, I have made some observations, reflected a great deal, and concluded some very personal feelings about the nature and scope of this thing we call chiropractic.
I can easily see, as most of us can, where we've been as a profession. It is, however, more difficult to divine where we are going. Every chiropractor I know has ideas. Some directions I can endorse; others I find more difficult to envision and accept. From this vantage point, I would like to share my observations, thoughts, and conclusions concerning our direction and where we as a profession, and most of all our patients, will benefit the most. I constantly ask myself, "Where are we going?"
Is there a single thing that will bring us together, shape us and dictate our future? What will it be? How will we get it? And, if and when we discover it, will we use it wisely?
Will technique be the unifying force behind our profession as we forge ahead into the new century? No. I have come to the conclusion that all techniques work. And all of them fail. No single method is so overwhelmingly successful and universally accepted that it will govern our growth. Technique is too innately personal and too widely diverse to unify us as a profession and dictate our future.
Technique is high art and I shudder at the thought of a stifling world where all chiropractors practice with strict conformity. It would be a crime on the scale of restricting Albert Einstein to one field of physics or Beethoven to one musical form.
Will practice management be our guiding force leading us to prominence and our true place in the order of professions? No. Better business practices, from marketing to finance, may free us to be better doctors and insure that we are financially able to pursue a more secure and promising future, but it has not the glue to hold us as one.
Is our continuing battle with mainstream health care, public acceptance and government parity the force that will drive us into a new and brighter future? No. Like it or not, we have arrived. Many prominent people from both sides of the issue refuse to accept it, but we are considered part of mainstream health care delivery. Without debating the merits of this situation, it still stands as a secondary or tertiary rallying point for the profession and a very weak position from which to launch a driving, unifying movement.
Is it style? No. As long as chiropractic exists, individualism will remain one of its true strengths. Diversity is one of the key elements of our collective success, and I refuse to suggest we compromise, even at the expense of unity.
Where, then, can we find direction, unity and a positive force for growth and acceptance? Where does our destiny lie? I firmly believe it is with our institutions, the colleges of chiropractic that are busy preparing the doctors of tomorrow. Specifically:
Clinical Education. Are we educating and training new practitioners responsibly and in the spirit of true pursuit of knowledge? We must allow students to question, learn and train under the widest possible umbrella, careful to avoid the restrictions of politics, dogma, and ego. Only then, will we gain honest, competent, dedicated, caring, and informed doctors who will practice in a responsible and ethical manner.
Clinical Research. Are we prepared to seriously question, hypothesize, test, and articulate our own ideas, and then use this information to modify the way we think and practice? Only then can we perch upon a foundation strong enough to withstand external challenge and move forward in a positive direction.
Every one of our institutions and organizations dedicated to pursuing these principles deserve our support. If we elect to support our colleges and in their pursuit of these standards, we stand to benefit more as a profession than at any time in our history. If we take an active role in making this happen, we may even find chiropractic assuming a positive of leadership and prominence. The alternative is to be dragged along behind, forever playing second fiddle.
We cannot depend upon the other professions, specifically allopathic medicine, to dictate our training and validate our practices. Even as they posture, we know they have yet to scratch the investigative surface of the human condition as it relates to health.
Alternately, we cannot tolerate second rate, he-told-me-so, quasi-religious statements of faith to explain chiropractic principles and outcomes. We must know what we do so that we can effectively communicate with future generations of chiropractic doctors and the millions of patients who may depend on them for their health and well-being.
How can we accomplish this? First, we can pressure the colleges and institutions with our dollars.
We witnessed a tremendous basic science explosion in the 80s that helped us understand more about basic biological function and its relationship with chiropractic. Now we must meet the same challenge in the clinical sciences. We have to find the incentives to bring the best of our profession back to the campuses to teach what only chiropractors can teach. There is no substitute for practical and applicable clinical experience; it is the art and soul of chiropractic.
In the last two decades we've also seen a welcome interest in research, but we've been much too quick to accept poor research as the norm. We must advance chiropractic with sound, scientific, accepted research practices and willing to change and challenge our theories and principles in light of the research experience. It is in the entire profession's best interest and every individual's responsibility to influence the colleges and others in a position to conduct good research. There is no substitute for practical and necessary studies to further explain and solidify chiropractic science.
Money still remains the most powerful influence we have. With dedicated funds, we can demand the institutions perform. With a collective voice we can make change happen. I challenge all chiropractors to look beyond their own self-interest and short-term gain and dedicate something back to the profession. Once the wheel is in motion (and it has never really been set in motion -- we remain a self-interested, selfish profession with a very narrow view of the world), future generations will learn positive, altruistic lessons to be relearned again and again. Collectively, we can have a voice. Make a difference and take an active role in a college, any college, where there is hope for the honest pursuit of truth.
Are we ready to join the 21st century? Are we ready to accept the truth and let it shape and form us? Are we truly ready for the challenge of honest, critical insight, and scientific investigation? Are we ready to acknowledge the best among us and reward them for their excellence? Are we ready to pursue knowledge unfettered? Are we ready for a rationale that can be accepted under the strictest terms? Are we ready for the 21st century.
Dennis Spurgin, D.C.
Editor's note: Dr. Spurgin received a B.S. in biology from Indiana State University, his Doctor of Chiropractic from Logan College and an M.S. in Health Care Education from College of Osteopathic Medicine of the Pacific. Dr. Spurgin received a fellowship grant in roentgenology from the FCER. From 1980-89 he held the academic rank of clinical professor at LACC. From 1988-89 Dr. Spurgin was a committee member of the Task Force to establish hospital privileges in California for DCs at Pacific Hospital of Long Beach, Buena Park Doctors Hospital, and Coast Plaza Medical Center. Dr. Spurgin has been published in JMPT and by the Consortium for Chiropractic Research.