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John A. Amaro L.Ac., Dipl.Ac.(NCCAOM), DC

In case you haven't realized it yet, we in the chiropractic profession are without a doubt facing perhaps the most monumental challenges of our survival. I say this only because of my personal observations. As I travel and lecture throughout the world, I am constantly reminded of the fact our great profession has undergone a major reconstruction due to numerous factors which I personally find disgusting.

We are involved in an extremely dynamic profession as shown by the accelerated changes we are witnessing on a weekly basis and unfortunately, many of these changes do not appear to be positive. Or is this the voice of an old veteran of chiropractic who is resisting change and wishes to see things stay status quo? Am I a person who is no longer "dynamic" but would rather see our profession stay "static" with no growth towards the future?

Quite the contrary, I cannot help but notice the vast numbers of DCs around North America and the world who are changing careers at an unprecedented rate due largely to the redefining of chiropractic and a shift in attitude by the typical graduating chiropractor that "chiropractic is primarily a treatment for low back pain."

We have become "goo-goo eyed" over the fact the AHCPR has recognized "spinal manipulation" to be effective in the first 30 days of acute low back pain as long as leg pain is not involved. Keep in mind it was also brought out that the majority of these cases would resolve on their own anyway. Talk about throwing this profession a bone! We took their bone, and protectively buried it in our backyard.

I have been witness to a multitude of DCs throughout North America who have felt forced to change practice locations, or who have simply been forced out of practice by their communities' involvement in managed care, which they were not or could not, become a part of.

The bottom line:

1. Managed care is the present and the future.

2. The chiropractic leadership is enthralled by the AHCPR guidelines.

3. Graduating chiropractors in general are unaware that chiropractic is effective in anything other than musculoskeletal conditions.

4. Chiropractors can feel good knowing the government has finally recognized "spinal manipulation" as a viable means for treating acute non-complicated low back pain in the first 30 days, which would probably resolve on its own anyway.

5. Alternative medicine (acupuncture, nutrition, reflex therapy, massage, reiki, qi gong, homeopathy and a host of related treatments) has more acceptance now than ever in the history of the modern world.

6. While the chiropractic profession is rolling around in its own backyard chewing on the bone the AHCPR threw us, people who suffer from a host of maladies (which chiropractic has always been effective for, well for 98 years anyway), are seeking those practitioners who are in a position to help them. Unfortunately, chiropractic is slipping way down the list.

7. Regardless of managed care, there are millions of patients who just want to get well and they are more than willing to seek out those practitioners who can help them.

8. These sick and suffering patients are now seeking acupuncture, nutrition, etc., as a means to assist their conditions.

9. Acupuncture, is growing at a phenomenal rate. It's practitioners are thriving; their patients are benefitting, and they are happy and satisfied. Patients are seeking acupuncture practitioners today for the same reason they sought chiropractors years ago. They were quick, effective, and affordable.

10. If the only reason you learned and incorporated acupuncture was for your own survival, even if it were noninvasive to comply with an outdated state law, I cannot think of a better motivation to do so now!

John A. Amaro L.Ac., Dipl.Ac.(NCCAOM), DC
Carefree, Arizona
DrAmaro@IAMA.edu