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Health is an inside job ...

After over ten years in regulatory and association organizations in chiropractic both provincially and nationally, there are some remarkable gifts that I am grateful to have received. I have had the great privilege of working with a diverse group of chiropractors and chiropractic supporters. There may be those who see diversity as a weakness, but as in Darwinian evolutionary theory, I have seen it in action as a fantastic strength.

Lately, one unfortunate trend that I have observed in many areas of the profession is an increasing level of negativity towards ourselves. In bemoaning our woes, there also appears the tendency to lay blame. Like a symptom-focused health care system that doesn't always seek the cause of the problem, we seem to be falling into a trap of looking outside and not focusing within the profession. I have increasingly seen fingers pointing at other health care professionals, governments, third party payers and other chiropractic critics ... but when one finger points outward there are three others pointing back at us.

I would like to suggest that health is really an inside job. I know that at times we need some assistance in removing the interference or managing acute crises, but at the end of the day it is up to us to do the work. If we are able to make the inside healthy and strong, we will dramatically increase our immunity to any outside forces that may be against us.

I emphatically believe that we already have all we need as a healthy and vibrant profession. This is the most caring, dedicated and enthusiastic profession that I can imagine. Unfortunately we also suffer from chronic "low self-esteem" and we often react with fear, paranoia, and belligerence when we perceive a threat to our practices or our profession. I hope that it is time to leave this behind and grow with confidence in chiropractic as a credible, valuable, and essential service for all Canadians.

In the current business and success literature there is a trend to focus on strengths and utilize them to move forward effectively. Let's take a look at ourselves and discover our strengths so we can maximize them:

1. Results

We have 110 years of satisfied clients, raving fans, and ongoing positive word of mouth. Our public opinion surveys repeatedly show high public support for chiropractic. We know how valuable we are to our patients as many of them tell us every day! Whether we are seeking to relieve pain, provide support to athletes, or influence the long term health and well-being of our patients, we all get fantastic results. We offer a wide variety of valuable services to those who choose to put us on their health care team and we do it efficiently, cost-effectively and safely throughout their lives.

2. Research

Due to the ongoing diligence of the CCRF and others, we are increasing our skills in research with dedicated and capable individuals, despite our financial limitations. We can improve our inside skills and influence even further to maximize this aspect of chiropractic. This is the interface for our results to shine. As clinicians, we see our miracles every day and we need to help our research community show that to the world. We must foster a culture of research from within and encourage the pursuit of new information and continued education. I can imagine that there will come a day when a chiropractic research professional is established in all educational and research venues and s/he will be the genius who discovers the next level of research to move the health care paradigm to the level beyond the current RCT model. The chiropractic researcher is key as they are able to better appreciate the value of our care and develop unique ways to examine and demonstrate our models of health.

I hope that the Clinical Practice Guidelines project of the CCA and CFCRB will also be a valuable tool in collecting and communicating the clinical relevancy of chiropractic research and provide a guide post for research to develop in step with our patient services. Let's work to develop a stronger link between our patient care and our scholar community--it's an unbeatable team and an undercapitalized strength.

3. Responsibility

I know that the regulatory functions of the profession are usually the least welcomed by many chiropractors. I hear about the red tape, the restrictions and the costs of self-regulations. But at the end of the day, this is unquestionably one of our most valuable assets. Although we are mandated by respective provincial governments, we are able to bring our inside knowledge of the profession to our role in public protection. The regulatory boards across the country take their responsibilities seriously and have a continued drive to serve the current and future public by providing a competent and capable profession to the multi-faceted population served by chiropractors.

We also have a caring group of professionals in chiropractic who take their responsibility for patient care very seriously. Whatever their individual model or specialty of practice may be, I have been consistently impressed with the sincerity and passion of that chiropractors are blessed to share.

Whether regulator or practitioner, when we are first and foremost focused on the needs of the patients, our internal immune system is at peak strength.

4. Relationships

Our associations are key players in the relationship-building arena. Member interactions are our opportunities to stay connected in the chiropractic family. Like all families, each member is unique, and all have a role to play in balancing the dynamic of the whole group. We can find within our profession all of the skills and experience to serve as experts for a wide spectrum of our practice activities. No one of us can be masters of all, but together we are phenomenal.

Our associations are also charged with relationship building outside of the profession. They help others understand and see value in the care and knowledge we provide for all in the greater health care arena.

As practitioners we cannot abdicate relationship building to our associations alone. Each practitioner builds strong and vital relationships with patients, other health care providers, political parties and others who are key elements to our future. Most importantly, we build relationships with our peers. Internally linking in mastermind groups, referring for second opinions or specialty consults, and sharing our experiences with other chiropractors are some of our most valuable assets.

I have been fortunate to observe many incredible chiropractors over the years. Many of the "practice management" concepts I have learned over these past twelve years have often boiled down to one thing--credibility to our patients. I know that a successful practice is an inside job. To build credibility with patients and your community there is a no quick fix, no outside PR or advertising "pill", and no way to force people to see you as credible. Credibility comes from being capable in delivering your service, confident in your ability to do what you promise, and congruent in your words and actions. It is who you are and what you do ... from the inside out.

These concepts are equally valuable in "profession management". I hope that each chiropractor will take ownership of the profession's success as well as their personal practice success. To build credibility we need to be capable, confident and congruent on the inside. We have the tools already at hand so let's maximize our results, research, responsibility and relationships to bring chiropractic to ever higher levels of patient service and success. If health is an inside job, then we are going to be invincible.

Thank you for the invitation to share my personal opinions as I prepare to complete my term as President of the CFCRB. I'm sure these musings will generate both support and challenge, and I hope some healthy introspection and debate!

Dr. Wanda Lee MacPhee, BSc, DC

President, Canadian Federation

of Chiropractic Regulatory Boards
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Title Annotation:Commentary
Author:MacPhee, Wanda Lee
Publication:Journal of the Canadian Chiropractic Association
Geographic Code:1CANA
Date:Jan 1, 2006
Next Article:The Institute of Musculoskeletal Health and Arthritis (IMHA) Knowledge Exchange Task Force: an innovative approach to knowledge translation.

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