Chiropractors will use therapeutic measures and justify it, saying they do not want the patient to leave without an adjustment, and the therapeutic measure helps to relieve the pain so an adjustment can be given. “The end justifies the means.” The same chiropractor will do a poor or inadequate job of educating to the need for regular care and thus allow the patient to walk around with subluxations, not for days, but for weeks, months, or years, between visits that take place only when symptoms appear. Dr. Doug Gates once said, “the major challenge to a straight chiropractor is always accomplishing his objective without compromising his principle.” It usually comes down to an issue of whether we act on principle or based on some other reason. If we act on principle, we must say, “I do not know what is normal for the patient. I do know that subluxation is abnormal. The muscle spasm, swelling, tension, or pain may be normal.” If we act on principle we will never add a therapeutic measure. If we act on some other basis, then our decisions will vary. If you act in your own best interest you may refer out, fearful of malpractice, or you may not, fearful of losing the patient. Often the chiropractor will try to justify a therapeutic measure, saying, “if I don’t give them some relief they will go to the M.D. and never have subluxations corrected.” I would suspect that most chiropractors are more concerned with monetary loss. But either way, the issue is acting on principle. Acting on principle is always in the best interest of everyone, yourself, the patient, and the future of chiropractic. If you treat their pain, even if it is to better facilitate the adjustment, you have still treated their pain. You have sent out a very important message to the patient: pain is important, it is directly related to health, it is treated by chiropractors and it is inextricably a part of the chiropractic practice. That patient will never see chiropractic as anything more than a means or more correctly part of the means to relieving pain, and that is the greatest disservice that can be done to any patient. v7n3
