Meeting our Professional Mission or I Have a Dream

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          The quality of chiropractic education is, or should be, the sole concern of an accrediting agency.  How the accrediting agency determines that quality has always been a rather difficult thing to ascertain.  Consequently certain minimum standards are developed and are expected to be reached by the institutions desiring status with the agency.  The ultimate objective of the accrediting agency must be that the college’s graduates go out into society and practice as safe, competent, effective chiropractors within the laws of their state.  With that in mind perhaps we would do well to examine the two approaches to the practice of chiropractic and how one accrediting agency impacts on both.

          The successful (safe, competent, effective) practice of mixing chiropractic is dependent upon choosing the proper diagnostic test or tests, accurately performing those tests and then coming to a correct diagnostic conclusion to determine the appropriateness and safety of chiropractic care and also which modality or modalities are best suited to meet the chiropractor’s treatment objective.  It is obvious that in principle what the mixer chiropractor is doing and what the medical doctor is doing differ very little up to the point of treatment.  It also seems clear that the differences in treatment approach will become less and less as medicine looks to become more holistic, less invasive and chiropractic treatment looks to become as effective as possible.  Because of the almost imperceptible difference in approach, at least up to the treatment of disease, the education of the mixer D.C. and the M.D. should pretty much mirror one another.  Apparently the CCE believes it does for they sanction the educational programs of the mixing schools as being adequate to meet the above stated professional objective.  It might be interesting to see if the professional accrediting agency that accredits medical colleges would accredit mixer chiropractic colleges.  I would expect they be able to because I would hope that the CCE does not take the pragmatic attitude that “our college graduates really do not have to be as good as M.D.s because in practice they will never actually see the type of medical conditions that M.D.s see and in reality will only ever be treating minor musculoskeletal conditions.”  If that were their unspoken attitude then their credibility as an accrediting agency would be seriously called into question.

          Let us look for a minute at the successful ( safe, competent, effective) practice of straight chiropractic.  Straight chiropractic care does not address disease or its cause in any manner.  I believe that educators and authorities in the straight chiropractic community would universally agree that making that point perfectly clear to the health care consumer (patient) who walks into the office is the single most important aspect of straight chiropractic care.  If the patient does not understand this vital point and in fact believes that the straight chiropractor is diagnosing and/or treating a disease, its symptom(s) or its cause(s), as much harm as a mixer making an incorrect diagnosis could occur.  It is vitally important that the straight chiropractor clearly convey his unique objective to the patient.  Therefore, and here is the important point, to perform tests associated with the diagnosis of disease processes would undermine that objective, thereby rendering the straight chiropractic care less than adequate.  To do these procedures is detrimental to the patient’s understanding of straight chiropractic and hence dangerous to their health. 

          Here is the dilemma that the CCE is in.  If they accept our mission statement, that is our professional objective, which is totally unrelated to disease, its treatment or cause, and they have said they should and they would, then they must mandate our students do not perform procedures, especially in a clinical setting, you are saying to the patient by your actions that these procedures relate to the diagnosis and treatment of disease, something which you have previously explained was not your objective.  You have confused the patient about your care, which is the ultimate transgression against straight chiropractic standards of care.

          You almost feel sorry for the CCE.  They have claimed that all they ever wanted was to get us “in the fold” (something many of us have a difficult time believing).  Now it seems they have backed themselves into a corner.  Accepting us will give credibility to our professional objective.  If they accept our professional mission, then they must forbid us to perform medical procedures which undermine that mission.  Now the plot thickens.  An accrediting agency functions as a quasi-arm of the federal government to help insure the protection of the citizens.  Students at straight chiropractic colleges deserve consumer protection.  Is the education wasting their money on courses (e.g. diagnosis) that are unrelated to their practice and even forbidden by CCE to be practically applied in the clinical facility?  If so, the CCE must demand that the straight colleges stop teaching these courses.  If a chiropractic college was requiring and charging students for a course in automobile repair, the CCE would be will within their jurisdiction to require its removal.  When it comes right down to it, chiropractic practice as is automobile repair.  However, if we stop teaching these courses, students will still have to pass state and national board exams.  But from an educational standpoint that is hardly justification for teaching those courses.  The state boards should reflect chiropractic education, not dictate it.  Professional educators should determine what is appropriate chiropractic education, not politically appointed chiropractors, or worse, state legislators.  Therefore the straights will have to petition the states and the national board for separate licensing and testing procedure to reflect our CCE- mandated education.  And who will have to so they are consistent with their state purpose.  Maybe they would have been better off just leaving us alone.

          Of course the entire above scenario is base upon the CCE and the rest of the mixing community acting in a logical manner.  If the entire profession thought and acted based upon logic, we would not even have mixing in the profession.  Oh well, they can take away our accrediting agency, but they can’t take away our dreams. v9n5

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