Student Chronicles - 12/2/18

Periodically I will respond to some of the numerous questions I get from students. Sometimes they ask more sensitive and harder hitting questions that will require me to blank out names and protect identities so that we can discuss issues that are important to students without repercussions. All responses are my own opinions. And I hold every right to change my opinions over time with further insight and education.

Speaking of education, this entry revolves around that same subject. Chiropractic college education. Question is long, so the response is long. All feedback is welcome.

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Question from Student:

“I have been listening to the (FTCA) podcast a lot (and I love it, thanks so much for doing it!) and the main thing I hear over and over is that students aren't being taught to think critically or clinically. They are either taught a ton of scientific facts, heavy philosophy, or a ton of techniques but not being a master of anything. I hear over and over that there is a lack of systems in school to clinically assess someone and that you and others believe that the profession needs to start becoming more systematic.

I agree with everything above. I am a XXXXX chiropractic college student and we definitely get a lot of science here and we do really well on our first boards test but we seem to struggle with our later boards that are more clinical.

I have had 3 teachers that work here tell me in a one on one conversation that they think XXXXX is drifting away from what chiropractic should be and that we are getting caught up in becoming primary care docs, PT's, and scientists rather than proficient adjustors. That is pretty disheartening to hear from the staff of a school that you thought was going to prepare you the best for your future career.

I have been struggling to know what I should do as a student to become a good chiropractor when and before I graduate. I struggle with this especially because one of those three teachers that I mentioned before told me that if they had to redo their education somewhere now-a-days that they would do it at another school that wasn't XXXXX.

I don't see the point in leaving XXXXX to go to another school because I am just now finishing my 1st year and I might as well finish the basic sciences here at XXXXX before I go somewhere else... but should I go somewhere else once I pass my 1st part of boards?

I met a student from ZZZZZ chiropractic college that says they see a patient every week starting at trimester 1. Another friend of mine is at YYYYY chiropractic college and seems to be much more clinically aware than I am and we have an equal amount of schooling.

I want to do something before it is too late but I don't really know what to do. To make this questions more difficult another 1 of the three teachers told me that a doc who jumps to learning clinical stuff before they have a solid foundation in the basic sciences won't be as good as they could be but if you are just a pure scientist who dabbles in clinic practice then you won't really be a good clinician because a lot of the job is just figuring it out as you go. So where is the balance and how/where do I get it?

I am not against learning science but if the science is not going to help me be a better clinician then I really don't care to learn it. This trimester we did Head and neck anatomy, neurophysiology and neuroanatomy and I really liked a lot of neurophys and neuroanatomy but I didn't find a lot of clinical pearls in Head and Neck anatomy. For instance, we just finished a lecture about the layers and names of TEETH OF ALL THINGS and during that lecture I was replaying the many times from the podcast that I hear you and others say that students just learn a bunch of facts that aren't really helpful and then they get thrown out into the job market and struggle.

I know I am going to struggle when I graduate either way, but I want to prepare for it now.

I also want to know if I am wanting to run before I can walk. If I have that attitude and I just need to chill out because everything will be okay in the end then I would like to hear that too.”



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Thank you for listening to the podcast.  I started it to begin conversations out loud that I felt were going on quietly in the profession.  So many of us tend to graduate and then go off and practice on islands. We do that for many reasons, and not all of them are good.  And some of them are downright detrimental to ourselves, our professions, and most importantly our patients.

Systems, or having solid systems in place in your practice, was a very strong theme in season one of the podcast.  Think of your practice system as a practice “philosophy”. In reality, that’s what chiropractic philosophy serves as; a system for how to deliver care to people.  There is really no chiropractic philosophy. There is a philosophy of chiropractic, and if you want to break it down, in truth there are thousands of different philosophies of chiropractic.  One for each and every disparate doctor on their own island doing their own thing.

We have to be very careful when criticizing our educational institutions.  I for one am not an educator. I don’t and never have taught at a chiropractic college.  Most of us haven’t. They are a completely different entity with completely different responsibilities to the world, compared to the boots on the ground patient care world most clinicians live in.  They have different masters to answer to. They also have alumni to answer to, but that might be a completely different story in itself. So I am not always comfortable discussing what a chiropractic school “should” do, or how they “should” change. All things can improve though, and there’s no doubt room at our educational institutions for improvement as well.

We do know that there are some really good chiropractic colleges out there, there are quite a few in the middle, and then a few more at the end of the spectrum that just do not produce a quality product on the average.  Not the product we would want as a whole representing the profession. Everyone seems to be afraid to say that. And then to add another layer to that, the great schools can also produce horrible clinicians, and the less than favorable colleges can also produce great clinicians.

So I say, it is not a correlation equals causation argument.  The school you go to isn;t nearly as integral of an issue on the outcome of your future success. I say it’s much more dependent upon the person matriculating in the program. The student.  They are responsible for their own success. Yes, a school can sort of nudge you one way or another, it does have some importance. But overall, if a student has the makeup to be a winner, all things being equal, they have a better chance of winning.  And the opposite for a student who is not, regardless of the college.

Here’s the thing about chiropractic colleges:  Their job isn’t to help you be successful in chiropractic practice.  You are paying them to matriculate you through a program that will prepare you to pass your boards and make you legally competent to practice within the profession of chiropractic.  Anything else is gravy. Hopefully they teach you how to operate in the profession. Introduce you to ideas. Stoke your passions. But they don’t make you successful It’s that simple. There’s no “Harvard of chiropractic” where everyone who graduates wins. Even Harvard has its “unsuccessful” graduates.

So when you see the colleges focusing on certain topics, it should be taken with reflection that those are the things that will be potentially tested on in a board environment.  They teach the things that will keep you legal and keep you from harming the public. They by no means need to formally introduce the concept of clinical MASTERY into your education.  And when you discuss systems, you are discussing steps towards mastery. That happens after school.

First of all, they cannot teach mastery.  Mastery is a journey that takes time. It takes a long time. Experienced DCs, throughout the span of time, get a good chuckle out of the fresh DC graduate’s The ones who think that now they have a diploma and a license, that they know all there is to know and are completely as equal clinically as an experienced DC.  Your college can only teach you competency, and then initiate you into the profession with a nice push out the door and hopes that you make the best of it you can.

So let’s talk about the adjustment.  You would think that the college would have the impetus to make adjusting proficiency the most important topic in the education, since chiropractors bank on it so much as a therapy.  But with the thought process laid out above in mind, the reality is that the colleges don’t need to do any such thing. They need you to pass the adjusting portion of the boards, AND not hurt anyone in the process.  Mastery of the technique itself is up to you. And it will take time, a long time, to reach it. Some faster than others of course. And that goes for any technique or approach.

One thing that students may not consider is that colleges have to present a program that prepares all students from all states, provinces, and jurisdictions, to be able to practice in their states.  So while some states may have pretty straightforward requirements for practice, preparing a student to practice in states like Oregon, for example, require extra focus on meeting those needs. Oregon has quite a wide scope of practice, compared to its neighbor Washington, which is relatively narrow.  The school has to prepare both students equally.

How many of us perform pelvic or rectal exams in our daily practice?  Seriously, it is practically no one (there are a few though). In chiropractic college, in oregon, they taught the requirement, because there was a requirement, that would meet the needs of all 50 states and canada.  Except one, California. Asterisk for those students planning to practice in the golden state. Even though I am nearly positive absolutely zero california chiropractors perform rectal or pelvic examinations, that states requirement was DOUBLE everyone elses.  So the school had to make those resources available to student to meet the requirement.

To you, and many students, what the college does can seem absurd.  It seems that it has nothing to do with you. And it would seem absurd if it didn’t directly benefit you.  Or directly benefit what you think are the most important things you need to know to succeed in practice.

So let’s break some of these down.  Students are taught “a ton of scientific facts, heavy philosophy, or ton of techniques without being a master of anything.”  Well, that’s right. The scientific facts are absolutely required. And if you are going to build a healthcare profession that gains respect, the clinicians are going to have to be built upon a foundation of science.

Heavy philosophy is a bone of contention.  I think historically that has been the vehicle to help the student apply what they were learning.  Should the colleges teach a philosophy? Well they have to because it’s on the boards for one. Second, students do need a system for interpreting the education and then to begin practicing to apply it.  “Chiropractic philosophy” has been the vehicle for that. The debate is for many of us, is that necessary anymore? I don’t think that debate will fit this article.

The irony of chiropractic colleges I find is that in order to allow more “philosophical” content on their campuses, they cling to an idea some of them term “academic freedom”.  They have to allow academic freedom on their campuses in order for students to explore different ideas as they form their professional journey towards mastery. The irony here is that when it comes to “chiropractic philosophy”, there is no academic freedom on that subject allowed.  It is rigid, dogmatic, and not to be questioned or obfuscated. So yeah, there’s a big logical crevice that needs to be navigated there. It’s one of the elephants in the room.

The same idea applies to teaching tons of techniques without a mastery of any of them.  It’s exploratory. Introductory. This is why I personally, PERSONALLY think that chiropractors on the whole should have nothing to say whatsoever when it comes to vaccinations.  Just a cursory introductory course in immunology does not make one expert enough on a subject to guide health care and public health decision making. Your few courses in physiological therapeutics will not make you an expert in rehab.  Your few courses in soft tissue work will not make you an expert manual therapist. Your few courses on history taking will not make you a master interviewer.

Your professors that say your school is “drifting away from what chiropractic should be”...  

…”should be”...  That is extremely subjective.  The truth is they feel it is drifting away from what THEY THINK chiropractic should be.  Chiropractic, like many professions, should be and is is liquid. It has to be open to change.  Unfortunately it is not as liquid as other professions, which can leave it stuck in the mud of the past, feel outdated, and have difficulty with change.  But it does change. If it didn’t, it wouldn’t be a profession, it would just be an application of a technique. And we’d be technicians. Not doctors. Your professors are giving personal opinions.  Take them as that.

“I have had 3 teachers that work here tell me in a one on one conversation that they think National is drifting away from what Chiropractic should be and that we are getting caught up in becoming primary care docs, PT's, and scientists rather than proficient adjustors…” - GOOD!!!  Good for your college. Chiropractic is a profession, not a procedure. The colleges should be educating the profession and all of its professionals. Not just clinicians. That means it has to cover a wide array of subjects. And yes, adjusting is still an important tool in the chiropractors tool bag, but it is not everything.  And let’s be very very honest here, you aren’t going to learn to be a good adjuster in school. Just not going to happen. Not even proficient. Consistent practice and experience does that. Could the school provide experiences? Practice opportunities? Sure. But not the years it would take. Because it’s just a hard truth, some things take time.

Yes, you need a scientific foundation before applying clinical approaches.  There is no way around that. Will you “use” every single aspect of your scientific education in your clinical life?  No, of course not. But without a foundation to stand on, based on science and reason, it is quite possible you will fall for anything.

There are very few “pure scientists” in our profession.  And that’s bad. But most of us should endeavor to be scientist-practitioners.  Clinicians well studied in science and research based subjects, possibly even participating in research projects when possible, but primarily clinicians.  For a professor to even intimate to a student that if you focus too much on the sciences you won't be a clinician, that should be a damned crime. It’s an opinion.  But if I was a college president I’d be hauling that professor into my office for a discussion. It’s just not true.

However it is true that if you don’t come out of school well balanced and well actuated, you are going to have some challenges.  But I know for a fact some professors say, in essence “don’t worry so much about that science stuff, just get through it.” Another elephant in the room.  And usually a hint you might be at a school coming to struggle. The irony is, you and these professors seem to think you are at a bad school, based on what the school is teaching.  I say from experience you might be at a bad school because of these professors. Let’s not make it because of you too.

“A lot of this job is figuring it out as you go.”  Yeah, that’s called practice. That’s called pursuing mastery.  And without a solid foundation you will be a lost ship without a rudder, ready to sign on to any guru’s program who can promise you easy success, just as long as you do exactly as they say and they do, and the credit card is on file.

“I am not against learning science, but if the science is not going to help me be a better clinician then I really don’t care to learn it.”  I take it back, you might be part of the problem as well. The science WILL help you be a better clinician. There’s no way around that. Is it going to make you a better day 1 out of school adjuster?  No. Is it going to fill your practice because it gives you an edge in marketing? No. But it will make you a better clinician far and above the fold.

I am getting the impression that there is an instant gratification element to how you are approaching your educational process.  These are the most important 4 years of your career. And I’m not trying to get down on you, but once you started to question the importance of head and neck anatomy…  Well im starting to get a little pissed. You aren’t supposed to get clinical pearls out of every aspect of your education. But how could you appreciate a clinical pearl, without a foundation to draw on it from?  You are waaaaaay too early on this journey to understand how your education builds on itself and doubles back and revisits items in year 3, that you learned in year one.

Do you think if a medical center asked you to come to their docs and do a lecture on vertebral artery dissections, that an anatomical understanding of head and neck anatomy won’t be important?  To digest what another professional says about the subject? To identify nonsense. You would have no clue as to what is or isn’t nonsense, without the understanding itself.

Yes, students learn a lot of facts.  Teeth is somewhat absurd. But someone is going to get a teeth question on the boards somewhere.  Also, someone somewhere who was paying attention on that day is going to invent a device that helps with neck and TMJ pain derived from tooth related dysfunction.  Some of my peers have created new approaches and ideas, from the same program as me, and I didn’t even see it. It’s like I wasn’t there on that day when they talked about XXXXX.  Now Dr. XXXXX has a million dollar XXXXX business. It’s not all for you and your clinical pearls.

Where the colleges fall short, and my main point in regards to the podcast, is the colleges do a poor job telling you, the student these things.  Some of you are destined to be absolute brilliant minds in the profession. Let’s be honest here, some of you are mental potatoes and i’m shocked a few are in practice.  And then there’s the middle. The huge middle. Colleges have to play to all of them. So there’s no place for the brilliant, of any subject, in chiropractic college. It will never be enough.  The potatoes, they end up sort of taking care of themselves.

Professor Stu McGill endeavors to create MASTERS in the treatment of the low back through his course series.  Stu will say one of the ironies of clinical science is the idea that the only way for a test to be valid is for it to be reliable/reproducible.  But in order for a test to be reproducible, a master must be able to do it, as well as the middle, AND the potatoes. How valuable is that in giving outstanding feedback clinically?  What if a test gave a master exceptional information, but the middle and the potatoes couldn’t generate equal result? Science would say that test is not valid… Mastery is not the subject matter of chiropractic colleges.  You have to regress to the mean.

So it’s not about you, or me, or any of us individuals on the whole.  Colleges have to educate everyone. The problem I have with the colleges is that they don’t tell you.  They don’t say “hey guess what, you’re paying us to teach you to pass the boards, be legal, and maybe pique your interests in some various topics.  But you’re not going to use all of it, you’re not going to like all of it, you’re not going to always see how any of it applies, and by the way it has nothing to do with making you successful in your actual career.  You’re just here to get permission to have a career. Education is for a time period, mastery is for a lifetime.”

Students struggle because many of them think that what they learned in school was “it”.  And then they stop. And then when the results are bad, they blame the school or the profession, but not themselves.  And then they hire gurus to teach them easy ways to fix it.

Look, I’m not down on the profession.  I love the profession. I think some people who choose it have some personality traits that attract them to the profession.  Just like other professions. Except one of them is expedience. I think some people choose chiropractic as a profession out of expedience.  We’ve been told its easy. Easy money. Easy schools to get into. Easy living. And then the real world walks up and kicks you in the shins.  Nothing worth doing and doing well is easy. Potatoes are easy. Masters choose the hard road.

“I know I am going to struggle when I graduate either way, but I want to prepare for it now.” - Well you are prepared, by admitting it.  And as well, you cant prepare for it, because you just have to experience it. You can read book after book about your first kiss, or anything that you don’t actually own until you do it.  I suppose you can take a kissing class, practice kissing the back of your hand. But it’s not until you do it, fumble with it, realize you’re actually not very good, get feedback, and practice and practice…  and have some PASSION for it (even the foundations), then you will approach mastery. Confidence.


“I also want to know if I am wanting to run before I can walk. If I have that attitude and I just need to chill out because everything will be okay in the end then I would like to hear that too.” - Yes.  You need to chill out. That’s easy. Don’t go jumping schools and looking for greener grass elsewhere. You will find the same gripes no matter where you go. Each college does it a little different. They all have their shortcomings and their strengths.  They all produce great DCs, and potatoes. It’s not the schools… It’s what you put in and get out of it. They will not complete you.

I’m sorry to say it, maybe i’m becoming an old fart.  But sometimes you just have to sit down, listen, do your work, enroll yourself in being part of the process and not work outside it, and admit that some things take time.  Patience grasshopper. You have a lot you have to learn, learn it and discover for yourself where your passions within that lie, and go after them vigorously…

Bobby Maybee DC

The Problem with Educating Patients - By Chris Chippendale DC

"I find new patients frustrating. All they want to talk about is their pain. Why don't they get that there's more to health than being pain-free?"

“It’s so annoying that people only think of us as ‘back doctors’ ”

If you're a chiropractor, you've probably had thoughts like this cross your mind at some point. And you've probably spent a good deal of time trying to come up with a way to explain the other benefits to chiropractic to your patients, or why they shouldn't just focus on their pain.

You just need to find the right metaphor, the right script, or the right mentor to teach you how to explain chiropractic so your patients "get it"... right?

Saving You from Documentation Disasters, An Interview with Dr. Gregg Friedman

Dr. Noah Volz has volunteered the content he produced from his DC2Be Podcast. He did great work while he endeavored to discover all he could about chiropractic as a student. Although most likely an exercise entered upon for his own benefit/learning, the content he produced was also quite valuable, so we will be sharing it here. Enjoy!

Saving You from Documentation Disasters, An Interview with Dr. Gregg Friedman

By Noah Volz

https://www.youtube.com/watch?v=7ZkqQNqqJ3k

Getting in Front of a Complaint - by Chris Chippendale DC

None of us like getting complaints. Hopefully they’re pretty rare, but they’re inevitable in clinical practice. Whether it’s something whispered to the front desk, an off-hand comment to our face, or - worst of all - a bad online review, negative comments have a way of ruining our day. Nevermind the fact that all the other patients that day were enthusiastic, positive and making great progress, that one complaint is probably all you’ll think about when you get home.

 

Not only that, but you’ll probably have a good case of l’espirit de l’escalier (French for “staircase wit”, or thinking of the perfect reply too late). “I should have said this, that would have shown them!” I’ve been there, it’s not a fun way to spend an evening.

 

Whilst there’s no simple quick fix for ruminating all night over a complaint, a better use of your energy would be to ask yourself “What could I have done to prevent this?” If your immediate reaction is “Nothing, they’re just unreasonable” - which I totally get - you might want to think a bit harder.

The Nordic Maintenance Care Program, a Long Journey That Is Starting to Bear Fruit! - Andreas Eklund, MSc(Chiro), PhD

The Nordic Maintenance Care Program, a Long Journey That Is Starting to Bear Fruit! - Andreas Eklund, MSc(Chiro), PhD

Maintenance Care (MC) has been around for a long time within the chiropractic profession and has become an issue of great debate and conflict. Headed by Professor Charlotte Lebouf-Yde a serious research effort was made to study the procedure. Over the past decade a series of publications under the name the Nordic Maintenance Care Program has been published [1-11].  The purpose of the program has been to identify indications for care, treatment content, frequency of care and to understand the clinical reasoning process among chiropractors in the Scandinavian countries.

Introduction to the FTCA Research Committee

Here is a brief introduction of the FTCA Research Committee and an update on some of the projects they are working on for FTCA members!

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Greetings,

The FTCA research committee, Dale Thompson as chair, desires to help bridge gaps between the chiropractor and their patients, the public, healthcare providers, and researchers. We plan to produce monthly “newsletters” for the website which provides a list of the top 10 published research papers in the last 30 days.

We want to organize a student poster presentation for our annual conferences. These may be formal or informal projects. Awards will be given to the best presentations. We plan to produce brochures that members can give to patients on a specific condition. Wall posters that can be used to help educate the patient. Posters that provide more doctor centered information to help the FTCA member understand the condition and help guide their treatments.  A brief summary of pertinent research and educational materials on a topic that can be given to other healthcare providers. Media products that members can use on their web pages or for the purpose of public education.

A few other possible future projects include being an avenue to help connect researchers with the appropriate clinicians when they wish to conduct clinically-based research. Also, a publication of a differential diagnosis for “red flags”. Hopefully these projects will help The FTCA member to better transfer research into everyday clinical use.

Dale Thompson DC,
Research Committee Chair

Introduction to the FTCA Political Action Committee

Please take time to read the following introduction from Jonathan Parham DC, the Chair of the FTCA Political Action Committee.  A lot of people are very excited to see what may come out of this committee.  Myself, as the founder of the FTCA, all I could really hope for was that their actions will encourage someone, anyone to be involved in their professions political activities in any way possible.  Get out there and represent.  I promise you good things will happen.

Bobby Maybee DC

Introduction to the Critical Thinking Committee​​​​​​​

The FTCA has moved in a new direction recently.  That new direction is the creation of committees who will work for the benefit of the members of the FTCA and the chiropractic profession as a whole.  Each of these committees will be undertaking tasks and producing content that they themselves have felt is important to FTCA members.  They are all volunteer, they are using their own resourcefulness to accomplish these goals.  And they have my utter thanks and gratitude for stepping up.  This letter is an introduction to your CRITICAL THINKING COMMITTEE.  Having a foundation of critical thinking skills is a hallmark necessity for a Forward Thinking chiropractor.

Injury Prevention Tips for Our Troops - Dino Pappas DC

Dr Pappas was generous enough to share a slideshow he has prepared in regards to our tactical athletes, our troops.  This presentation is not placed behind a membership wall so that as many people can access it as possible.  The FTCA does hold dearly the conviction that our active duty soldiers, and veterans, receive the highest quality care possible.  It is our hope and the hope of Dr. Pappas that this presentation contributes to that conviction.

Reconciling Order and Chaos in the Chiropractic Profession

Reconciling Order and Chaos in the Chiropractic Profession

Last night I attended a lecture from Dr. Jordan Peterson, a PHD and Clinical Psychologist. Some of you are aware of him through numerous avenues and through his recent thrust into politically divided spheres. Not the point right now.  This post is focused on his lectures and his clinical perspective specifically.

He recently wrote a book "12 Rules of Life, and Antidote to Chaos", which yes, '12 rules' is kind of a cliche, however the depth he goes into in "An antidote to chaos" is not. It is a deep book.

At Forward KC I gave a brief lecture styled after that book. I called it "10 Rules to Chiropractic Life" (Because 10 rules are better than 12).  I recommend the Peterson book, I learned a lot about our profession and even ourselves in FTCA through the book, the ideas, and last nights lecture.

Lets combine that with an anonymous survey Kevin Christie and I just recently did. A survey where the NUMBER ONE AND NUMBER TWO RESULTS absolutely shocked me. The question was essentially "What do you fear the most?' 

Number one response to the question was something akin to responses like fearing how "the other side of the profession is ruining it" or "we dont have any respect because of the straights" "MDs not respecting us" "DPTs encroaching on our territory" and a multitude of these types of answers that can be summed up as "other people ruining it all for me"

Well, this completely contradicts the points that Dr. Peterson makes in "12 Rules..." and makes in general in lecture and elsewhere. First and foremost... "Other people" cannot ruin your thing for you. And that same sentiment goes for straights who feel that "mixers" or nontraditional chiropractors mess up their paradigm.  To me so many people were blaming the crux of all the professions problem on the wrong thing.  Outside themselves.  The bigger problems, and the ones you can tangible do something about, rest on the inside and directly around us.  

Dr. Peterson writes about the concepts of Order and Chaos in his book. A lot of times he's referring to the political spectrum, but I saw immediately how this fit into the chiropractic spectrum. Representatives of Chaos within our profession tend to be the "straights". They favor less rule, they favor less organization, they favor less evidence also less science. They favor less answers and more "freedom" to act as they feel fit. They essentially like to act as if they are molding from a lump of clay. They like to take from nothing (Universal intelligence or quantum? Language they use) and make something. 

The irony here is that if chaos is on a far left of a scale, they must always make SOMETHING out of that NOTHING, so they have the proclivity to create order out of their chaos, up to a limit. That limit appears to be within their specific belief system. That is why the 33 principles is so important to them, Before that, any level of chaos is warranted. But it stops once it meets the Hadrians wall of the 33 principles. Then there is a political refusal to cross that line.

Progressive chiropractors (mixers) tend to favor more order, more rules, more legislation, more regulatory intervention, more science. They tend to be agents of order in the profession. The irony here is that as they do that, many within their own ranks destroy that order or hierarchy, and then try to create their own "chaos". Usually in the form of trying to create new seminar series', new explanations or newly wrapped explanations for old concepts. 

However, they only create chaos up to the line they meet with their ethos, which is science. OR at least biological plausibility. Just as straights will create order until they meet the 33 principles, progressives will create chaos up until they violate the lines of science (most of the time).

Take for example, from our progressive end of the scale, "Pain Science". The Biopsychosocial concept of pain has been talked about and researched for decades.  Leonard Faye has been involved with it for 30, 40, 50 years.  Craig Liebenson has written about it in his texts. Waddell wrote about it. We've had it on scientific record for decades. Yet what have we found? New "Pain Science" gurus have sprung up talking about the new concept and idea of pain science. Its not new!

There are multiple examples of this, but it would be difficult to cite them without making reference to specific names of specific people who made this move to create chaos in the orderly side of the profession. Even if for personal gain or notoriety.

However, is creating Order out of chaos bad for straights? Is creating chaos out of order bad for progressives? Not entirely. It is known that too much order can lead to tyranny. It is known that to much chaos can lead to absolute destruction. In our case, the straights are CORRECT to fight against too much order. The progressives are RIGHT to fight against too much disorder in our profession.

On many levels... BOTH SIDES ARE RIGHT!

Now theres another dichotomy working as well in this battle. Straights represent the "old way of doing things", progressives represent "the new way of doing things" Now the roles of order and chaos are flipped. Straights represent the ORDER of doing it as things were designed and not changing the status quo. Progressives represent a new disorder to them of chopping down their old ways and building anew. 

Its really a fascinating mix we have going on here. Both sides essentially play multiple roles in the battle between order and chaos. Most of the players doing it completely subconsciously. Most people dont entirely do this because of money motivations or ethical considerations as we might assume, they actually do it (based on Peterson's interpretation of the data) based in their own personality temperment.

You are on any side of this battle because of who you are. What you believe to a core. I personally believe you can argue anything with anyone in this world. You can debate, you can rationalize, you can appeal to emotion. However, once you begin to discuss core beliefs or ideologies, you can no longer argue, because that is what the person IS, and that will never change and they will defend it to the grave.

Peterson was asked in his lecture, paraphrasing "So how does one side win the battle over the other?"

They dont. THEY DONT. Both sides are essential to one another. To maintain balance. It is an existential tug of war where, if you do it right, everything comes out okay in the wash. That is where we find ourselves. Straights NEED progressives. Progressives NEED straights.

Or as Peterson put it, we all think politically "If we as democrats could just get rid of those republicans, we would have the utopia we've always clamored for", or vice versa. But thats not how it works. Its a checks and balances. The USA has voted 50/50 essentially for these two parties over the last 20 years. It doesn't matter in an overall sense. Politically, if you wish your opponent would "disappear", you're really wishing half the population would disappear? Friends, families, loved ones, colleagues?

The same goes for chiropractic. 

If progressives were successful in removing every single "straight" from the profession, would it make for a better profession? You might think yes, but of course the answer is no. And vice versa. They need each other. Otherwise they teeter towards the tyranny that would choke this profession to non existence with too much order. Or they would evaporate completely with no structure and complete chaos/disorder.

We always say, an entrance exam sure would fix all of our problems. It might or might not. Maybe an entrance exam that focused on personality profiles, sure. Profile types that tend to become straight in thinking, and types that become progressive in thinking (Research project idea for any out there willing to tackle it!). So yes, you could eliminate half the profession based on core values, but would you want to?

Peterson outlines in more ancient marriages the symbolism was meant to show that a man and a woman, when married, entered into a relationship with a third "higher ideal". And depending on your culture that higher ideal could be many things, God, Jesus, Yahweh, Truth, etc. Whatever it was. And then the man and the woman, through marriage worked together to uphold that higher ideal. Thats why people stand under an arch when married, or under a candle, or at an alter. Its a triumvirate. A team of push and pull to work towards an ideal. Checks and balances with an end goal in mind.

Is it the same nowadays? Well thats a different cultural discussion. I'm an online "ordained minister" and Ive married close to a dozen couples. Almost all of them are shocked at the symbolism of the ceremony I expose them too during their marriage. Man would do man stuff, woman would do woman stuff, and for better or worse even that has dissolved from our culture. My point being, not to make cultural commentary, that even us as chiropractors have lost that relationship in our marriage of both sides with a "higher ideal".

The straights do straight things, the mixers do mixer things, and never to they interrelate. And neither of them are focused properly on the higher ideal.

Does that mean we need unity? NO!! The husband and the wife argue. Thats what they do. They constantly battle on how they do things the right way or the wrong way, and they compromise, oriented towards the higher ideals.

What we need are higher ideals!!!

Now, the straights will tell you that we already have higher ideals, the chiropractic principles. Nope sorry, we are telling you, those no longer apply (or maybe never did) as the higher ideals of the profession, as a whole. It is not accepted.

The progressives will tell you the higher ideal is science. Nope, that too is wrong. NOt that science doesn't play an important role in helping us understand the world around us and how we should act within it, it is not a higher ideal for how people should behave. It is merely a powerful tool.

We need, as Peterson stated last night in his lecture, better language towards each other, more specific spelling out of roles. We need to identify the the times and moments we spend the most time TOGETHER, and make those moments as peaceful as possible. While still maintaining our individuality. We dont need "unity" as so many people seem to define it these days, where we all get along and there are no problems. We need better communication and higher ideals to pursue together.

On that note, subluxation. Stay or go? It most certainly is a very POOR way of communicating. To our partners, to the professional public, and on some levels the way it is used, to the general public. Its akin to asking your spouse how they're doing and they say "fine". What the hell does fine mean? WE may have accepted subluxation as lexicon, but it is a BAD lexicon because it has no solid definition. Accepting subluxation as lexicon as we have is akin to just letting your spouses "fine" comment go on. Ignore it, she said she was fine, she must be fine whatever that means, not my issue.

So ive addressed "unity" and ive addressed "subluxation", whats next? How do we make our marriage better?

We sit down together, use better language towards each other. We recognize that we need each other and no one is going anywhere. We demand more from each other. We would want our spouse to be ethical. We would want our spouse to be fair. We would want our spouse to be the best they could be. Because, as Peterson stated, you could win an argument, and your spouse lose, but then youd be married to a loser, and what would that make you?

If we treat our professional relationship as a marriage, and people come to this table honestly, we could win as a whole. If one of the spouses is irreconcilable, then the only logical next thing is divorce. Real talk.

This is not a unity message. I hope people can see the subtle difference between the rainbows and unicorns stylized "unity" that seems to be tossed around these days, and a stable functional marriage or relationship.  Billy Demoss is the equivelent to your spouse chewing with their mouth open at dinner. I dont have to accept that. But me n Billy do have to come to an agreement on a much higher ideal, one that allows me to tell him to quit chewing with his mouth open, or bop him on his bald head and say "knock it off", or one that encourages me to just let it go, so we can get to that higher place together. 

So I apologize if I have very little tolerance for poorly formed "unity" messages. We need better language, we need to do better, together. Neither of us are going anywhere, so don't let that other side own you. Dont be afraid, be involved. And remember as an FTCA member, you ARE an agent of order, but chaos has a place and deserves some respect. Not unity. Just respect.

p.s.  And I know that the relationship between the two sides of this profession is not a marriage.  Its called a metaphor.  Its probably closer linked to a family situation.  We are two brothers or sisters that have to live in the same house together, but really can't stand each other.  That doesn't matter.  The chores still have to get done, we still have to go to all the big celebrations together, we still have to get good grades and take care of each other and our neighborhoods.  Whether we like each other or not, we are bonded, and we might as well suck it up and try to make something good of it.  That takes two to tango however...

Fireside Chat 4/30/18

This fireside chat is hopefully one of many.  These videos are for members, by members.  FTCA Members hang out and shoot the breeze.  We never know what might happen!  There is no agenda.  There is no script.  The format that worked today was that a post is made in the facebook group, and whoever shows up, shows up!  As you can see, some people roll in and some people roll out.

In this episode I am joined by Gregg Friedman DC, and then Blake Kalkstein DC takes us for a ride.  Then at the end Kurt Kippenberger DC jumps on the call to chill.

Now our first fireside chat should be available to all...

https://youtu.be/sA2u8LHWsw0

Rebuttal to Dr. Beau Pierce's Article "Getting Adjusted Can Make You Smarter" -- Drs. Michael Lovich and Mehul Parekh

In this guest blog post, Dr.'s Lovich and Parekh politely dismantle the false claims put forth in Dr. Beau Pierce's article linked below.  We in the FTCA find that there is a serious disconnect in some corners of our profession between what evidence says, and what some colleagues say it says.  The root of that problem - whether it be a poor scientific foundation, inability to properly read a scientific paper, or just plain personal motive and unethical disregard - the root of that problem only fuels the divide between some elements of the chiropractic profession and the rest of the evidence based world.  

While some "straight" chiros will say that is fine, and even attack the merits and importance of evidence, they will also parade any poor evidence around as codified fact if it even hints slightly towards their preconceived beliefs.  My contention is that you can't have your cake and eat it too.  If you are "anti-evidence", and by that I mean not only ignorant of what the evidence is and how to interpret it, but also unable to accept it when it doesn't support your beliefs, then you can't use evidence in your favor at all.  And if you do wish to utilize evidence to support your practice (as we all should), then you better take the professional responsibility to understand how to interpret it properly, utilize it correctly in a clinical setting, and properly disseminate it to the general public without spreading nonsense. - Bobby Maybee DC

Members Only Podcast - New Doc "Quickstart"

Join me and Dr. Brandon Langerude as we discuss some specific tactics to get a young doc started off quick in the realm of getting new patients into their fledgeling practice.  We discuss issues related to prospecting and relationship style marketing, which sometimes is the more applicable (and more affordable) approach for a new doc who hits the ground running.