Image Issues

man-in-the-mirrorDespite the inestimable good chiropractors have done in the world since 1895, when it comes to media and publicity, you know the drill. Whenever you see the words “chiropractor” or “Chiropractic” in the news, there’s the tingle of hope that it will be an uplifting, positive, good news story. But then it’s followed by the nagging feeling that it will be a negative news story about a chiropractor behaving badly. What you usually end up with is a classic “good news, bad news” joke—something like this:

The husband looks up from the breakfast table and says to his wife, the chiropractor:

Husband: “Honey, I have good news and bad news.”

DC Wife: “Really? What’s the good news?”

Husband: “There’s a story about a chiropractor in the New York Times!”

DC Wife: “That’s awesome! Oh … but, wait … what’s the bad news?”

Husband: “He ripped off Medicare, Medicaid, AFLAC, the VA, the VFW, Habitat for Humanity, Orphans of 9/11 and Girl Scout Troop 47, and he licked the red off a toddler’s candy. Oh … and, from the mug shot, it looks like he’s fat.”

When it comes to the “chiropractor’s image” or the public perception of chiropractors, the bad news is where DCs rank on the list of trusted professionals. According to a 2006 Gallup poll asking about professional practitioners’ honesty and ethics, chiropractors rate behind pharmacists, MDs, dentists and veterinarians. Interestingly, nurses came in first on that list, with 84 percent of nurses rated as “High” or “Very High” (chiropractors received a combined 36 percent on the two measures). The relatively good news is that at least chiropractors came in ahead of lawyers, politicians and car salesmen. The great news is that millions of patients who’ve benefitted from chiropractic care are spreading the word every day and creating an increasingly positive image of the chiropractors who’ve helped them.

Chiropractic is no different from every other profession; they all seem to have a certain image associated with them and their practitioners, both good and bad. Often, the image is somewhat stereotypical. For instance, accountants are thought of as smart, analytical, introverted, concerned primarily with the bottom line, maybe kind of nerdy, and are usually depicted wearing glasses. Sales people are thought of as outgoing, gregarious and good at making small talk. Of course, in the case of car salesmen, some negative characteristics also come to mind, such as pushiness and dishonesty. Medical doctors are thought of as some of the smartest professionals we’re likely to encounter, usually of average weight (we expect them to practice what they preach, don’t we?), too busy, often arrogant and always running behind.

The Good, the Bad and the Ugly

What’s the public perception of the chiropractor as a professional? On the “good” front, DCs have the reputation for helping their patients without the use of potentially debilitating drugs and surgery. Many people see them as a source of holistic evaluation of their heath-related issues and, at best, as partners in facilitating the body’s inborn, native ability to maintain health. As far as their personal image, the “good” chiropractor is often seen as healthy, trim, fit and into good nutrition and life balance. On the “bad” side of practitioner perception, it seems fair to say that DCs are thought of as less well-educated than their MD counterparts and that their work is not based in scientific observation. Chiropractors have the reputation for signing up patients for possibly unnecessary treatment plans that require multiple visits, often paid for up-front. As for the “bad” in personal characteristics, chiropractors (as well as other health care professionals) are thought of as hypocritical if they appear unhealthy, overweight or engage in questionable health-interfering practices like smoking, drinking or drug use (sometimes even for intractable conditions like asthma or diabetes that haven’t responded to Chiropractic or nutritional care).

Things in the public perception department can definitely get ugly in regard to the views of both the chiropractic profession and its practitioners. You don’t have to look very far online or in various forums discussing Chiropractic before finding statements that Chiropractic as a profession is worthless both as a treatment for various conditions (if one subscribes to that view) and as a wellness approach. At the ugliest, you see the repeated instances of the accusation that cervical manipulation by chiropractors causes stroke. As far as personal characteristics, the ugly perceptions range from chiropractors as greed-driven charlatans to dangerous quacks.

Perhaps even uglier is the tendency of chiropractors to denigrate their own or their colleagues’ commitment to their profession based on personal appearance. When Today’s Chiropractic LifeStyle first took on the idea of the challenges that face chiropractors who don’t fit the ideal physical image of the chiropractor, it was unexpectedly difficult to find any DCs willing to discuss the topic. Some felt they had “image issues” of their own. Some didn’t want to be associated with their former selves (e.g., before having trimmed down specifically to better fit the public perception of DCs) or with taking prescription medication for “lifestyle-related” conditions like high blood pressure.

Practice Coaches “Weigh” In

Well known chiropractic practice coaches Drs. Dean and Jen DePice believe, where profession and practitioner perceptions are concerned, DCs should be future-oriented in representing the profession. They say, because the public’s perception of Chiropractic is “laced with an outside-in crisis intervention model,” chiropractors should be “less interested in what the public’s existing perception is and more interested in living and giving the public a true chiropractic experience of the care and principles that are the benchmarks of Chiropractic.”

When asked how having an appearance that is outside the stereotypical chiropractor’s image—being overweight for example—might affect his or her practice, the DePices responded: “If your body is overweight, but your self-esteem is joy-filled, strong and disciplined, then your body weight really doesn’t matter. If your body is overweight and your self-esteem is broken, then your impact upon patients and your community is crippled. Likewise, if you are fit in physical appearance, but your discipline and self-esteem are weak, your outcomes are crippled for both patients and the community. As long as a doctor or lay person is in the process of improving, this is more important than what he or she looks like at a given moment. Doctors must not wait until they have it all together to begin growing and maturing [toward] their very best expression. Our experience [in working with other chiropractors] has proven to us that when chiropractors live as genuine and valuable servants of their communities, their success is far more dependable.”

Venus and Mars Biases

Marcia Krueger, D.C., owner of Innate Ability Chiropractic, came to the profession by way of an experience that she terms a “miracle:” a chiropractor was able to stabilize her daughter’s scoliosis in a way her medical doctors hadn’t. Because her own experience with chiropractors has been so positive, it’s especially bothersome to Krueger that the chiropractor’s image is as “second-class citizen.” She goes on to say that “MDs are seen as ‘know-alls,’ and DCs are viewed strictly as alternative care providers without well-honed expertise in their separate and distinct field.”

As for the personal image of a chiropractor, Kreuger definitely believes there are a couple of stereotypical images at work. In the public’s perception, chiropractors “should be thin, athletic and conscious of their bodies and, yes, patients will choose a chiropractor based on appearance. But it’s often more of a size issue and perhaps a male/female issue. Larger men are sometimes skeptical that a woman, particularly a smaller woman, can adjust a big man. Smaller women do have to find alternative ways to adjust larger people, especially in moves like side posture.”

When asked if she’s tailored her own image to better fit the chiropractor’s image, Kreuger says that she has. “Being a DC definitely helps me keep my weight in check,” she says. “How can I tell people to make healthy choices if I don’t? You should follow your own advice. It gives me more credibility. For example, in working to improve the functioning of a patient with multiple sclerosis, in addition to keeping her free of subluxations, I’ve started her using a balance board. So now, I’m using it, too, to improve my own proprioception. I have to live what I teach.”

Kreuger loves being a chiropractor and helping her patients “with their specific health goals, to get their lives in balance. I don’t have an idea of who I should or shouldn’t work on. I know that I’m not going to be able to help everyone with everything, but I know I can help them improve their health or something in their lives.” But, her love for her profession is tainted by her least favorite aspect of being a chiropractor—the image problem that some chiropractors create for the profession. “One of my classmates has already lost his license,” she says. “One person can make it bad for the rest of us. Some of us are far right, and some are far left, but if people hear about one DC not keeping records or not providing expert care, that hurts all of us. And then people can only talk about those bad experiences they’ve heard about. I’m out there doing what I think is right for every patient and there are docs who are out there for other purposes than helping their patients get well. They make me mad because it affects our profession.”

Blurred Lines

Chris Walker, D.C., a LIFE alumnus, echoes Kreuger’s anger over colleague-created image problems for the profession. Walker is proud of his alma mater’s foundation on Lasting Purpose—“To Give, To Do, To Love, To Serve Out of a Sense of Abundance”—and has based his own practice on that set of values. His feeling, though, is that the chiropractors’ image is “a mixed bag and it’s our own profession’s fault. We, as a profession, confuse what Chiropractic is and keep blurring the line. Fifty years ago, there was no question what we do—we moved the bone to correct subluxation. Now, people aren’t sure they’re even being adjusted, and Chiropractic may not even be the primary concentration of what they’re being offered as patients. It might be some modality or nutrition. They’re not getting the message that it’s Chiropractic opening the channel between the brain and the body by removing subluxations. Some patients don’t even know what subluxation is. Basically, the professional ‘image problem’ many chiropractors have is they don’t have a clear image.”

Since being overweight is a health concern for so many Americans, we asked Walker what personal image challenges an overweight chiropractor might face. “Some of the best DCs I know are a little hefty,” he replies. “I’ve gained 20 pounds myself over the last two years. I’m working on losing the extra pounds because [motivational speaker] Larry Winget said it best: he asked, ‘How can a doctor expect a patient to be healthy if he or she is smoking or is overweight? It’s hypocritical.’ And that made me think. I need to make the same sort of good choices I’m telling my patients to make when I preach health. But, having gained a few extra pounds, it makes me able to communicate that I know it’s a struggle; I struggle, too.”