Saturday, August 16, 2008

Cynnical Hour

"Hello all, my name is John..."
response from the crowded room..."Hi John"
"...and I'm a chiropractor."
a cautious yet somehow friendly grumbling arises from the room
"It's been 12 years and 6 months since I officially entered the chiropractic profession."
the crowd cries out its supportive Sundays best..."at a boy John...good for you sport...one day at a time kiddo!"
the lights dim on this dream and on the other side of the id-ego-super ego border arises the morning traffic report as the alarm clock spews forth it's 4:45 am rooster imitation.

I figured that my first article/expounding in the world of blogging could be used to address one of my favorite newly developed pastimes from the past year. Cynical Hour!
First let me present you the reader with some background. In our multidisciplinary clinical setting the space is shared amicably between chiropractors (mixers of course), personal trainers, physical therapists,acupuncturists, massage therapists, and traditional Chinese medicine practitioners. Strangely enough we all get along. From the outside it may resemble a meeting of Israelis, and Palestinians, with a smattering of Buddha and Vishnu...but on the inside we get on like "peas and carrots". Multiple practitioners from varied backgrounds working hand in hand towards a common goal...outstanding patient care!
We start early and end late. Similar to many other professions in the highly stressful and, lets face it, expensive northeast. So we work a lot. So what you say, everyone does. You are correct, everyone does. Doesn't make it right. Kind of like paying $3.94 a gallon for gas and thinking "gosh that's low". conditioned response. Insanity warmed over.
So we have the 5 pm hour to look forward to, to become cynical regarding the "topic of the day". 8 am to 4:59 pm, good times and good vibes. 5 pm to 5:59 pm cynical. 6 pm to close, sailboats and puppy dogs all over again.
Topics range from conspiracy theories regarding pro athletes retiring and un-retiring at the last moment to avoid drug testing scrutiny, to blaming children for their childhood obesity (shame-shame parents!).
So why bring this whole cynical hour (CH) thing up in an article. Good question. As a chiropractor and especially as a chiropractor who is over and over again embarrassed by his own profession (hence the dream regarding CA, chiropractors anonymous) one topic of CH came up which particularly ruffled my bloomers and transitioned my cynicism into mild anger.
Enter the players...Dr. Tim Morgan (outstanding chiropractor, cyclist, and center ice man), Patient A (cyclist, avid gym bull, salt of the earth guy), Dr. Melrose Neurologist (even though he is a jackass he deserves his privacy respected).
Patient A suffered a cycling palsy as diagnosed by Dr. Morgan. Even though the majority of these syndromes are self resolving with conservative care, Dr. Morgan still felt Patient A should be further evaluated by a neurologist to utilize further testing should the need arise. Chiropractors in Massachusetts have great difficulty ordering specialized tests (impossible actually) and the patient should not suffer due to our biased image. Patient A went to his appointment with Dr.M Neurologist and was met coldly and suspiciously. Dr. M Neurologist then asked the patient "you look like a smart guy, why are you going to a chiropractor?". This line of questioning went on for 30 minutes without Dr. M Neurologist even evaluating the patient for his presenting complaint. The patient was infuriated with the doctor and voiced his disdain to Dr. Morgan on his next visit. In our therapeutic setting the room is open with curtains if privacy is needed as well as multiple private rooms if further privacy is needed. Patient A entered the therapy suite after 5 pm. Good timing. Our discussion went on for the majority of the hour and involved shock, anger, disdain, sadness, and eventual acceptance that "it's just the way things are". Gas prices too high, pro athletes in trouble, "I just can't keep my 5 year old from eating junk"...just the way it is I suppose. You can get used to just about anything I suppose...insanity warmed over.
Well, at the end of the cynical hour I wasn't able to let it go. I kept thinking about it and thinking about it. The chiropractic profession is over 100 years old and it is still looked upon as borderline quackery.
Can we place the blame on the medical profession? Can we place the blame on the pharmaceutical profession? How about the media, they defecate on everyone! We have to blame someone don't we? It can't be our fault!
One of my favorite movies is "The Shawshank Redemption". In it was the phrase "get busy living or get busy dying". Pretty soon chiropractors will be sitting on the park bench next to Spuds McKenzie, Jim Thorpe, John Adams, and Leonardo DaVinci feeding the bleeping pigeons and listening to Jim talking about winning the decathlon again, or John reminding us that kicking out the British was HIS idea.
This writing is primarily meant for chiropractors as a wake up call. It is our fault! No one else's. Our fault. Dr. M Neurologist was the extreme case, but nonetheless I get tired of hearing from the supposed approving MD's "well, if you feel it helps you, then you can keep going, but I cannot medically justify the care. Just don't throw away your wheelchair" (true quote from very well known MS specialist in Boston).
So Dr. Know It All, what do you suggest? Any pearls of wisdom?
All journeys begin with a first step.
What may this first step be you ask?
In my first month, in my first year of practice I encountered a patient who was evaluated by my boss at the time, and re-evaluated by me for a specific extremity issue (another straight numbers game DC in the area called me "that extremity guy" because his 3x/wk patient for 6 months had knee pain that didn't go away after being "adjusted" the same way on every visit..."I guess if you feel it helps you..."). After his evaluations he went to the front desk to schedule his report of findings visit, did so, and came back in for his flip-chart presentation (10 minutes) on chiropractic and rust on the bones, stalagmites in a cave (or were they stalactites?), etc., etc., 3x/wk for 6-8 weeks...initial intensive phase of care...OK lie face down. He got his first treatment (about 1 minute of contact time with the doctor) then I went in to do "that extremity guy thing". The patient was an old timer from the neighborhood I grew up in, a hardened Italian American laborer, who in his hay day may have been able to palm a Volkswagen Beetle. Before I could get to the business at hand (or in this case foot) he got one of his swollen, leathery meat hooks on my wrist and grabbed me, pulled me over to him and said "that guys full of s--t, you hear me, that guys full of s--t. Don't you be full of s--t." Never saw him again. But never forgot him or the words he spoke to me. Also I still cannot feel my fifth digit on my left hand.
Every journey begins with a first step.
I propose that the first step for the chiropractic profession going forward in the future is "don't be full of s--t"
So next time you as a chiropractor are telling a patient a canned treatment plan, spending 1 minute "adjusting" the same segments over and over again not knowing why except that those are the easy ones to get when employing the "flying seven techniques". Stop and think what you are doing to your profession. You DON'T have to see 1500 people a week. As a matter of fact you shouldn't.
And especially don't brag about it in the multiple "full of s--t" publications that pass for our professions societal magazines and newspapers. Just stop, think, and change.
Get busy living or get busy dying. Besides, Spuds keeps scaring the pigeons away!