FULL FRONTAL LOBE

An uncontrollable pressure relief valve for the questionably sane.

Chiropractors should drop all the “Doctor” bullshit

with 7 comments

I went to the chiropractor this morning for the pain in my neck, shoulder, and lower back.  I’ve been dealing with Psoriatic Arthritis, a.k.a. “Phil Mickelson’s Disease,” and it’s really becoming a pain in my ass, sometimes literally.  But we all suffer, so I’m looking for healthy ways to alleviate it.  The Buddha says all suffering, or dukkha, stems from desire.  Which is bullshit.  Big fan of the Buddha, naturally, but I think something is lost in the interpretation.  Translated from Sanskrit, dukkha means something more like “unfulfillment,” or “disquietude,” the incessant wanting that Henderson struggled with: “My heart was saying again ‘I want I want I want.’’’  So what about the suffering that stems from pain?  This is a very natural form of suffering, not brought about by the disharmonious desires of the ego (maybe).  What is the difference, then, between physical suffering and emotional suffering?  Perhaps I’m missing the link, I know I get depressed because of physical pain, but I have a sneaking suspicion that I’m in pain because I’m depressed, or ‘suffering’ emotionally.  If I take care of my spine and my heart (both literally and figuratively), I should be able to alleviate a lot of my physical problems.

But this isn’t a philosophical or religious argument, I want to talk about chiropractors.  I’ve been to six separate clinics, and I’m starting to figure out their game.  The practice has been around for about one hundred years, and chiropractors have taken a lot of shit over the last century, mostly from the medical community at large.  Chiropractic is a beneficial form of therapy, but chiropractors are not doctors, despite their self-appointed titles and initials before and after their names.  I think the whole industry would benefit greatly if the competition with accredited AMA doctors ceased.  My experience with each of my six chiropractors has seemed relatively standardized, there were few differences or exceptions between my treatments.  Each clinic was set up like any other clinic I’ve ever visited.  A spartan reception area with crappy magazines, the receptionists wearing scrubs (for reasons I’ve never gathered), the ubiquitous copying of drivers’ licenses and insurance cards, and six or eight stark exam rooms peppered with a few yellowed and peeling medical posters outlining the spinal system, etc.  At first glance it looks like any other doctors office, but again, chiropractors aren’t really doctors.  There are no chiropractic surgeries or pharmaceutical prescriptions. In each clinic, respectively, x-rays were taken, I received an electric stim treatment (used in hospitals and physical therapy clinics everywhere), a spinal adjustment (the delicious cracking (they don’t like the term “cracking,” but that’s exactly what it sounds like) of the spine and joints, which each of my chiropractors performed uniformly, and brief therapy in the form of light exercise, stretching, etc.  Then you go home and listen to your neck crackle like Pop Rocks for a week until your next scheduled session.

At first I was skeptical about the rehabilitation schedule; anyone in business understands the benefits of convincing clients they have to come in bi-weekly for thirteen weeks.   After enjoying the benefits of chiropractic I’m less skeptical about the scheduling–if I haven’t been in a long time I’ll need a few extra visits to get me back in shape, then I’ll only come every few weeks for a tune-up, which is similar to any other kind of physical therapy or exercise.  Despite my opinion that they’re not really doctors (an opinion shared by the American Medical Association) I find chiropractors to be valuable,  and they provide services rarely found in the traditional American medical community.  Every orthopedist I’ve seen ultimately recommends surgery, after a three-minute exam (I’ve been to seven or more).  Chiropractors, unlike the majority of our western doctors, focus on preventative medicine rather than cutting you open when things have gone too far.  Which is refreshing.  I don’t want to be myopic, there are legions of genius doctors and surgeons in our country, but medical care is a business here, and like most businesses, physicians are concerned with throughput time:  finding the most expeditious route to take a sick person and make them well.  In my experience the expeditious route has a way of taking precedence over fully conscientious care.  We’re all trying to make a buck after all.

Chiropractors have created a lot of enemies and skeptics in their attempt to legitimize their occupation within the medical community.  A great many of those enemies have advanced medical degrees. Chiropractors are highly educated physical therapists, and many of them can give you results you won’t get at a typical doctor, who will most likely prescribe you a bottle of pills (with serious side effects, manufactured by pharmaceutical companies who are more profit-minded than any rehabilitation service requesting your presence on a bi-weekly basis, pushed on the doc by sexy saleswomen in sultry business suits, armed with briefcases full of free samples)  without actually looking at you and trying to figure out the problems with our mechanics. Which is what it all boils down to; if the frame is compromised all other systems will suffer, leading to systemic poor performance, just like an automobile (or anything with a skeleton for that matter, animated or otherwise).

We are now, if not always, amidst a cultural revolution.  We used to look to ivory towers and authoritarian enclaves to validate our titles, but this reliance  is fading.  We’ve needed it, honestly, over the past few centuries, most of us were too ignorant or segregated to navigate the world of professionalism.  The self-proclaimed authorities did what they could to regulate chaos, to standardize our ideas of what we considered “healthcare,” or any other profession for that matter.   And they did a commendable job at it, but we’ve traveled far enough now past the need for more regulation and have arrived at a time where all the professionalism in the world can’t help all of us.  Ironically, we’re going to have to look to our smaller, local groups for appropriate care, despite the enormous wealth of medical information at our fingertips.  There used to be a village healer or medicine man in every social group, but we’ve done away with all that in favor of validated professionalism.  It’s time to judge what we see in front of us and stop relying on higher authorities to tell us what’s best.  Chiropractic eases suffering, the physical form of dukkha, and that has incredible merit.

In a time when our conventions are being challenged on every front, the chiropractors need to realize their unique place in the medical community and and make it their own.  They don’t have to dress like a doc, their reception area certainly doesn’t have to be uniformly bland  like every medical waiting room I’ve ever been in, their exam rooms don’t need all the medical accoutrements, and they don’t need to put “Dr.” in front of their names, which is misleading and a little bit sad once you figure out why it’s there.  Doctors’  offices are boring at best, scary at worst, so why would anyone outside the medical establishment want to emulate them?  I go to the chiropractor to feel better, hopefully as a preemptive measure against visiting a traditional hospital. The poor bastards are so hung up on convincing everyone they’re “real” doctors that they’ve completely missed the mark and created tension between themselves and the rest of the medical community.  Their paychecks would look the same if they didn’t have the “Dr.” in front of their name, right?  Heck, even massage therapists can file with health insurance companies now. And of the six or seven chiropractors I’ve visited, each of them have introduced themselves using the “Dr.” followed by their first name:  “Hi, I’m Doctor Mike,” “Hi, I’m Doctor Lisa.”  AMA accredited doctors don’t do that, it’s more of a kindergarten teacher thing (Hi, I’m Ms. Lisa!  We’re going to have a wonderful year!).  Medical doctors typically don’t say much of anything with social value, they’re too busy treating our diseases and forgetting that we’re human beings (Sorry all you fun, social docs with a good sense of humor, I know you’re out there and we appreciate you).

So drop the bullshit and just let me call you Mike, Dr. Mike, my lower back is killing me and I need you make it crack like a celery stalk.

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Written by billlobe

July 12, 2011 at 3:58 pm

7 Responses

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  1. Re: “doctors” and chiropractic… I’m torn. To my mind the prestige carried by the term “doctor” hasn’t been earned by the average chiropractor (or the average lawyer, who, after all, has a “J.D.” — a juris doctorate) the way it has been by the average physician or, frankly, by the average Ph.D.

    On the other hand, and speaking as one of those average Ph.D.’s, the only people I expect to call me “doctor” are my own students, and even then only up until the time they graduate. I want them to call me “doctor” in order to help establish the social distance that’s appropriate between professor and student. I need to be able to evaluate their work and assign grades in as impartial a manner as possible, and no matter how friendly and warm our relationships might be, I’m there friend. I don’t socialize with my students, I don’t ask them to dog-sit or pick up my dry cleaning… our relationship is purely professional one, and having them address me as “doctor” (or “professor”) helps to reinforce that fact for both of us. Now, I can understand that view that says that the relationship between a chiropractor and his or her patients (should they really be called “patients”? or just “clients”?) is similar: because of the physical intimacy involved in chiropractic–with the one person grabbing and tugging and otherwise manhandling the other–it may be appropriate to create a similar social barrier between the chiropractor and the patient, one that emphasizes the purely professional nature of their relationship. Calling one’s chiropractor “Doctor Mike” instead of just “Mike” could help to instantiate and maintain that barrier.

    But in the chiropractic context, using “doctor” as that barrier-making-title just blurs the line between what chiropractors do and what physicians do. So maybe the solution isn’t simply to call your chiropractor “Mike.” He needs a honorific title, just a different one. “Shmoctor Mike”?

    Regardless of the “doctor”/”shmoctor” issue, when I go to my first chiropractic appointment I will heed your warning about the crummy waiting-room magazines and take something of my own to read.

    Dr. Bob

    July 12, 2011 at 5:35 pm

    • Agreed, I lack the initiative to come up with a new designation for them, but it’s the “hey hey, look, we’re doctors too” attitude that makes me critical. I’m all for an appropriate level of professionalism, but the times are weird and we need new definitions. And your chiro just might have great magazines.

      billlobe

      July 12, 2011 at 5:43 pm

      • And you’ll always be Dr. Bob to me, Dr. Bob.

        billlobe

        July 12, 2011 at 6:26 pm

  2. Wow-my chiropractor’s name is Dr. Bob! Oh-and he’s amazing. (read: good-looking)

    My thought on the whole chiropractor/doctor thing: I am more than happy to call you whatever the heck you want to be called if you are going to take my neck, twist, and yank. As long as I come out a) alive and b) feeling better, you name it and I’ll say it. I think my chiropractor has more of a chance of killing me over my primary care physician. So, doctor it is. And if I wasn’t married, Bob could be a possibility! 🙂 (I love you, Peter!)

    mrs. bracci (sometimes pronounced bratch)

    July 12, 2011 at 9:21 pm

    • I agree. They need to be called something, I’m more concerned with the fact that they’ve desperately tried to belong to a group that ridicules them, instead of forming their own alliance. I doubt they’ll take my advice.

      billlobe

      July 13, 2011 at 12:45 pm

  3. I don’t normally take the time to respond to these types of articles, but I would say that at the very least you have a strong case of superego with a touch of superiority complex and a potty mouth to boot. Yes, that is an initial diagnosis from a chiropractor – one which I hope you take with a nice cup of chamomile tea. Please feel free to have it confirmed properly with the appropriate “real” psychiatric physician.

    FIRST, it is quite obvious that you know very little about chiropractic, let alone its history. As a chiropractor, I don’t mind if people have negative opinions on chiropractic – but you need to at least come from an educated perspective. Frankly, this article does not do so. So here’s some help for you, my dear author:

    I’m not sure where you got it in your mind that chiropractors are looking to be accepted by, or compete with medical doctors. In fact, our practice was purposely segregated from medicine, ever since its creation in 1895. I won’t disagree that we are looking for INDIVIDUALS to embrace our care and help. After all, we are in the people-serving business – whether they are in pain, or if they simply want to maintain a healthier spine.

    To be fair to some of your points, chiropractors from about 1900 to 1965 were looking to make the case that the adjustments they gave, superseded and far exceeded the benefits of surgery and drugs. Sort of a head-to-head treatment competition. Obviously, this doesn’t pan out for most diseases, especially organic ones like diabetes, heart disease and cancer. As a result, these early chiropractors were labeled by the AMA as quacks. In my opinion, rightly so. Since people look to doctors as knowledgeable and ‘pseudo-godlike’, that made chiropractic drop in reputation, for many years.

    I don’t believe that it is today’s physicians that are the problem, but more the medical teaching schools. Most physicians will see a case of back pain or neck pain and either drug it, refer it to therapy or send it to an orthopedist, who then drugs, refers to pain management, does surgery, or tells the patient who ‘falls in the cracks’ to live with it. Physicians and surgeons DO help many people with spine pain, but I believe they are used far too often and chiropractic far too little.

    SECOND, the titles of chiropractors are NOT “self-appointed”. They are considered a “Doctor of Chiropractic” under Federal and State law, in the same way that a Doctor of Podiatric Medicine (DPM), Doctor of Dental Surgery (DDS) and Doctor of Osteopathy (DO) are. The term “Doctor” actually means teacher, which is why the doctorate is also given in non-medical fields such as education.

    In my office I go by Dr. A. Yes, it sounds quirky, but I like it and I do want patients to respect my position. Not because the patient is a ‘know-nothing boob’, but because credentials and respect do have some bearing on the willingness of patients to heed advice and recommendations for their care – especially when they have to put forth so much effort over so many visits. If patients call me by my first name, I don’t mind that and do not discourage them to do so.

    THIRD, it sounds like you are one of those patients who believe you know what’s best for your body in terms of chiropractic. Not very smart, because you are probably going more, less or not at all based on how “good” or “bad” you feel. BTW, this is not the determining factor on what your schedule should be. Sure, pain can match up with condition, but in many cases degeneration in the spine and discs remain asymptomatic for years – only to show up later in life in a worse way.

    A good chiropractor, in my humble opinion, should certainly help you to feel better, but should also make it clear that as you begin to “hold” your past adjustments longer, you should go less. In fact, you should go less if you are doing proper at-home exercises.

    FOURTH, I do like your statements on people having to rely more on themselves and not authority. However, we must be careful to forego two assumptions: the doctor’s intent is with malice/uncaring, and that the patient has the same education and experience, in order to properly ascertain the best health options.

    Educated patients are very helpful, but I frequently tell patients who want to be “their own chiropractors” that I will be happy to work with them, but I cannot be held responsible for the results or lack thereof. Apart from that, I do believe that educated patients that are empowered are the best patients.

    I will look forward to your response.

    Very best,
    Dr. A

    Dr. A

    July 25, 2013 at 3:19 pm

    • Dear A.-

      Did you read my article or another somewhere else and choose to comment on this site? I’m on your side, bub. I suggest you reread the essay carefully, and in the future read through things more than once before you get your pricklies up. If you go through it again you’ll find, I hope, that I am a proponent of Chiropractic, not one of its many misinformed enemies. But I’ll humor you for a minute; in response to your 4 points:

      1. If I come across as ignorant of the Chiropractic profession and its history, you assumed that, there’s no way to tell my actual knowledge from reading this article. I’m well versed in the practices, philosophies, and history of your field. I sympathize with the treatment your field has traditionally received from the AMA et al.(be it Morris Fishbein, the Committe on Quackery formed in 1963 by the AMA, or just arrogant docs who were biased against you based on their educational training), but my argument is not that Chiropractors aren’t valuable or legitimate, it’s that you and your professional kin have done the greatest disservice to the practice of Chiropractic by attempting to force your incongruent round peg into the rigid square hole of the Western medical establishment. I think you deserve your own place, your own identity, yet every Chiropractic office I’ve ever visited makes the same mistake of trying to look like my GP’s medical office. Either that or they show up in sweat pants and a fancy embroidered polo.

      2. I know what “Doctor” means. I also understand that your title is federally recognized. And yes, the title of Doctor is given in other fields outside the medical community, though they are typically academic, with the exception of attorneys, who receive a JD, or Juris doctorate. But I can’t remember the last time a lawyer requested that I refer to him or her as “Doctor.” I find it strange that a community that has such blatant contempt for Western medicine fights so hard to give its members the same title. I’m not saying that you, A., personally have contempt for anyone (perhaps maybe me), but you can’t deny your brethren-at-large’s attitude toward traditional docs. I’d be pissed too, it’s been a rough go. If you’d like I can send dozens of links to sites harboring defensive and pissed-off chiros.

      3. I don’t think I’m an expert on Chiropractic in regards to my own body. That’s why I go to a Chiropractor.

      4. Good for you.

      Your initial diagnosis isn’t too far off, but let me get a couple things straight. “Superego” is a Freudian term referring to a part of the psyche, along with Ego, and Id. I think you meant “Egomania,” and you’re likely right. Especially since every op-ed article ever written is at least a little egomaniacal, egocentric, self-centered, and subjective, by definition. As for the “touch of Superiority Complex,” you’re close again: a superiority complex is a secondary part of an inferiority complex, what we laymen like to call “little-dick syndrome,” basically acting tough because deep down inside you really feel scared and insecure. Yeah, that’s me. And the rest of humanity. My dick is huge though.

      Oh, and “potty mouth?” You bet your fuckin’ ass.

      Sincere thanks for the comment, I appreciate anyone who writes with vigor and intelligence.

      In health,
      Lobe

      billlobe

      July 29, 2013 at 3:57 pm


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