Competency in Chiropractic

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                            Being a competent mixer chiropractor is 90% medical skills and 10% chiropractic skills.  Being a competent straight is 90% communication skills and 10% chiropractic.

          To be competent as a mixer chiropractor, like a medical doctor you must be able to correctly determine the nature and the cause of the patient’s illness and then determine what is the appropriate treatment for that illness.  The medical skill of diagnosing is probably the most difficult aspect of medical care, with the possible exception of highly technical surgical procedures.  The mixer chiropractor has a further complication in the area of medical skills.  Whereas the physician only has medical treatments to choose from, the mixer must determine whether the diagnosed condition is best treated by a medical procedure or one of the many “chiropractic treatments” (e.g., physical therapy, acupuncture, nutrition, adjustments, etc…).  Further he must determine whether medical procedures may also he helpful to the patient while he is treating the person “Chiropractically”.  For example he must determine whether a patient being treated for a back problem might also benefit by taking some type of prescription drug.  He must 

then refer that patient to the appropriate health care professional.  To deny the patient that procedure just because chiropractors at this time are not allowed to utilize them is poor patient care.  But to determine whether the patient can benefit from other treatment necessitates a degree of medical knowledge about the effec4ts and side effects of, in this case, the pharmaceuticals.  Clearly, the greater degree of knowledge in the practice of mixing chiropractic must be in the medical area.  The chiropractor must diagnose a medical condition.  He must then determine the severity of that condition and whether medical care is called for (i.e., referral), or whether chiropractic alone can best treat the condition and if so how long is a reasonable treatment period before referral is appropriate.  Further if medical treatment in addition to chiropractic treatment is needed as in the example above, the mixer must know enough about the medical treatment to make that determination.  Only after chiropractic care as part of the treatment program or as the entire treatment program is determined to be the appropriate care must the mixer chiropractor exercise a degree of chiropractic skill to administer that care.  Judging from the amount of time spent in the education of a mixer chiropractor and the amount of time with the patient performing the medical procedures compared with the chiropractic procedures, chiropractic skill makes up at most 10% of the chiropractor’s technical expertise.

          The straight chiropractor  does not treat diseases, their symptoms or their causes.  He corrects vertebral subluxations, a cause of DIS-EASE within the body.  Not being associated with medical entities, he has no need for medical skills.  However, because many chiropractors relate chiropractic to medical conditions and because the general public including the people who come in a chiropractor’s office are medically oriented, it is important that the straight chiropractor clearly communicate his objective.  This is the most difficult aspect of running a straight practice.

          The uniqueness of the straight chiropractic objective must be explained to the patient.  The fact that straight chiropractic is not in any way an alternative or substitute  for medical care must be communicated.  The patient must be taught the Above-Down-Inside-Out philosophy of life and health so he has sufficient knowledge to make intelligent, correct decisions regarding his health.  The chiropractic philosophy must be inculcated into the thinking of the patient.  Many straight chiropractic college students do not get it after hundreds of hours of instruction over a four-year period.  Trying to give the Big Idea to patients is a formidable challenge.  The adjustment takes only a few minutes, it is a simple thing.  Communicating the philosophy takes much more time.  It is a simple principle, so simple  that people too easily forget it or do not grasp it.  The straight chiropractor must develop his or her communication skills to the highest degree to enable the patient to understand the principle.  That is the challenge and 90% of the work in a straight practice. v9n2

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