There is legal term used by judges to offer a lower burden of proof to juries in order to render guilty judgments. It is used in cases where the defendants consciously avoided knowing about wrongdoing. The standard goes by several names such as "conscious avoidance" or "deliberate ignorance" and is also known as the "ostrich instruction" – you know – as if sticking your head in the sand makes it all go away.  It was most recently used in the Enron trial.

I could not think of a more appropriate term for the situation we find ourselves in with regards to the chiropractic profession.  All of our greatest fears are coming true and in my humble opinion they all boil down to the dearth of research to support what we believe chiropractic can do for people.

Thanks to a research agenda led by those who were in a position to garner the scarce resources we had, we spent the bulk of our financial and political capital over the past several decades focusing on research to get our foot in the door of the back and neck pain market. And as Dr. Christopher Kent often remarks – all we have to show for it is a bloody and bruised foot.

While this strategy has destroyed what the average practitioner once thought chiropractic actually was - the strategy has paid off for certain individuals, groups and companies in the profession. For example, those willing to work for the insurance industry have the research they need to cut claims for anything other than short term care for the amelioration of a musculoskeletal symptom involving the back, neck or head.

Managed care companies owned and run by chiropractors also benefit by not having to pay for anything outside that narrow range of disorders and while they market themselves to consumers and the insurance companies as a wellness and preventive service – in reality they don’t allow chiropractors to provide that type of care. In fact, as many of you all know, they purposely pre-screen you to determine if you are a subluxation fixer or believe in such hokey things as wellness care. The scariest part about this is that tens of thousands of chiropractors willingly join these plans.

The foot in the door strategy has also paid off for the insurance industry in regards to care for children. While our research leadership was off studying the low back, the concept of the family practice was slowly being eroded through neglect. As much as Henny Penny screamed, the day has now arrived where most major insurance carriers and managed care companies consider chiropractic care for children under 12 to be experimental and investigational.

The research issue has become the profession’s dirty little secret that no one wants to talk about. Certainly, they say, we can’t start openly admitting that we have this problem, especially if no one is prepared to spend the money to do anything about it. 

After all, such talk might affect student matriculation, consumer confidence etc.  And with student enrollment already down 40% and market share down a few percentage points - those within the profession, who don’t practice but rely on products and services sold to students and practitioners, get a little uncomfortable talking about anything that might effect that bottom line. In the back corners and the bathrooms at conferences and the one on one phone calls - they will all admit the seriousness of the problem. But from the platform things just couldn’t be any better.

The problem is that the ostrich approach, conscious avoidance and deliberate ignorance is killing us. Its much like global warming which was denied for decades but we now see quite a remarkable turnaround in the consensus of opinion on the issue. Now the issue becomes whether or not it took too long to reach such a consensus and that perhaps it is too late for the planet.

I suggest that the chiropractic profession has the same question to answer.

As always I look forward to your feedback, comments and suggestions.

Dr. Matthew McCoy editor@jvsr.com

Editor – Journal of Vertebral Subluxation Research

http://www.jvsr.com