In the July 2007 issue of the ACA News (okay, I admit, I occasionally read it), William Morgan, DC wrote an article entitled, The Collapse of the Railroads (What Business Are We Really In?). His article which laments the demise of the railroad industry suggests that the railroads failed because they saw themselves in the railroad business, not the transportation business. Had they integrated other aspects of transportation, like cars, highways, and service stations, they could have survived. I am sure there is some truth to his theory, however, there are likely many reasons for the railroad’s demise. People wanted more freedom of travel both in time and direction (trains pretty much moved either north-south or east-west). The automobile solved both of those problems. As people moved out of the cities, other forms of transportation were needed. Actually, if the railroad had integrated other forms of transportation, they would have closed down the railroads themselves, sold the trains and rails for scrap, sold off the land and focused on more profit-making aspects. As it is, the railroads feed out of the government trough and somebody is making all the money. I am not saying that is good but where would we be without railroads? Look at the buggy companies that got into the auto business. They don’t make buggies anymore.
As Dr. Morgan goes on to relate his argument to chiropractic, he says that most people come to us for musculoskeletal care. That is what they want. He says “Society does not know the difference between subluxation and subjugation” and implies that they do not care either. Unfortunately, he insults the intelligence of many people who come into my office and the office of many other practitioners I know. He says what people want from a chiropractor is “mobility, relief of pain, increased athletic performance and hope for a more fulfilling and healthy life.” A decided majority are coming for the relief of “musculoskeletal complaints.” He says people want relief, not to learn about “the philosophy of chiropractic and wellness” even in a practice which he observed that was, “a very conservative, subluxation-oriented practice replete with all of the associated patient-education material.”
Having noted this, the doctor advocates comprehensive wellness and “integrated care.” We use to call that mixing. “Instead (practice) can encompass combining chiropractic with an active lifestyle, weight control, exercise, prudence, temperance, smoking cessation, proper nutrition and hydration, proper sleep habits, stress management and routine wellness examinations.” From his brief biographical sketch we learn he does all this in “his hospital-based chiropractic clinic and a Washington, D.C., executive health clinic.”
I think he has a very reasonable approach to mixing chiropractic with everything else except drugs and surgery. The problem is that, for most people, drugs and surgery are part of integrated care. In fact, they are a vital part, the one part that he will never integrate no matter how many hospitals he gets into. So he will likely never be a portal of entry or a primary care doctor, just taking those people and conditions the hospital’s admitting doctor believes he can help. Are not the physical therapists currently trying to get out from under that restriction? I guess we could serve in that limited capacity, but we better start limiting our numbers. How many chiropractors are needed on staff at a hospital?
His analogy between product orientation, (i.e., railroads and subluxation correction) and consumer orientation (i.e., transportation and wellness care) breaks down in one very important way. Railroads began to suffer when more efficient, more economical means of transportation developed. Airplanes, cars and buses became alternative competition for the railroads and some of them were more desirable means of transportation. However, there are no alternatives to having your subluxations corrected. Exercise, weight reduction programs or any other aspect of wellness care may be good and beneficial, but none of them take the place of subluxation correction. They cannot and never will. We provide a unique, irreplaceable service. What’s more, we do not have any competition in that service. No one else is doing it. We do have to convince the public of the value of that service, but that is not an impossible task. Thousands of chiropractors have been able to do it for over a hundred years. When the dust settles, I believe it will be those chiropractors, not the integrated ones, that will be successful. V23n1