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Guest Essay

The Future of Chiropractic is Now
Growing beyond our differences to better our profession

By William F. O’Brien, Ph. D.

As a strategist for a number of companies in high technology and in healthcare, I am responsible for predicting changes in marketplace conditions and for preparing management teams to position themselves and align their organizations accordingly. In that context, I am often asked by chiropractors for my “outside” opinion regarding the future of their profession. The question typically comes after I have listened to the usual discourse from doctors bemoaning the problems that plague chiropractic. I answer with the following story.

Jason was prepared. He was applying for a job with a world renowned company, soon to be acquired by Microsoft, “the greatest of all software companies.” He had already done his preliminary interviews. Now he was spending a day with me at corporate headquarters. He was proficient in his computer skills. He was brilliant, an expert in his specialty: design, graphics and programming for ‘knowledge management platforms.’ He was ready for the interview and his answer to my first question was a home run:

How would you design the remote control system for a DVD?

He responded with confidence: vary the technologies, color schemes and options for input functionality according to the age range and other demographics of each target population.

He was not ready for the questions that followed:

Why is the learning experience so emotional?

The questions became more remote from his frame of reference:

Why do some professionals get defensive when receiving feedback from peers and subordinates?

In fact, some of the questions seemed downright weird to Jason:

Draw a picture that represents your last client’s frame of reference.

How would you characterize the contextual value of words?

Draw a three dimensional image of this company’s mission.

It was only after the interview that Jason realized he had not been asked to demonstrate his technical competencies. He reflected on that for a while, wondering what the point of the interview had been. Then it hit him like a flash of lightning: I wasn’t interested in what he’d learned. I was interested in his thoughts on applying it. My interview revolved around his ability to reason, to think. And not just to think logically—to establish a logical progression of ideas—but to think creatively! To solve vital, “live” problems that the executives he’d be working for were wrestling with! I wanted him to produce new images of information which were not yet available to us. Jason realized that he was attractive as a job applicant only to the degree to which he could generate new ideas. Eventually the executives told him that his answers were no better than theirs.

Jason was unprepared for living in the future, but the future is now!

In my opinion, the future of chiropractic is up for grabs. We can blame the usual suspects (MDs, pharmaceuticals, insurance, the media, etc). However, I believe that those answers allow chiropractors to avoid introspection rather than demand it. Let’s face it. The problem in chiropractic is internal as well. Chiropractic is crippled by a disperate set of independent constituencies who believe that the profession would be just fine if everyone else would simply conform to their own view of how the profession ought to be governed. Some of these constituencies have significantly opposing views. More importantly, they do not relate well with each other. The chiropractic culture is conditioned by a poor approach to socializing differences of opinion.

Let’s get back to basics. Chiropractic, no matter what your flavor, espouses the importance of natural interventions. Chiropractors are nature’s catalysts who can create the conditions that allow nature to do what it does best, act naturally. The results include pain relief, healing, health and optimal functioning. No matter what tribe you identify with, there is general agreement regarding this principle and a consensus that it can be supported by science.

Indeed, it is imperative that we employ science to study the effects of natural healing. What an elegant irony. Simply stated, science is exactly that; the study of nature. Science is the study of the nature of nature. Scientists are nature’s biographers. And what do scientists consistently discover? They discover that the nature of nature is social. Nature relates dynamically and asymmetrically to produce continuous change. In nature, all phenomena relate interdependently in order to avoid stasis. It exists; indeed it thrives, in a constant state of imbalance. Nothing relates independently or it dies!

Is our scientific observation simply a metaphor or is it, indeed, the answer to what plagues the profession; hiding in plain site? Imagine, ego free processing among chiropractic’s leaders, relating interdependently. Imagine leaders relating, representing and reasoning with all perspectives in mind. Imagine people with opposing views engaged in a dynamic process as high functioning as nature itself; get, give, merge, grow and go! Imagine creating solutions that didn’t exist moments before under previously unnatural and limiting conditions. Imagine the impact upon the profession’s future?

So how do we do this? Let’s begin by examining the cognitive processes that make up this dialogue to honestly assess what’s really happening.

At the lowest level, we find basic S–R conditioning systems in which there is no processing between the stimulus (S) and the response (R). In reality, in both human and mechanical processing, there is a phenomenon of anticipatory S–R responses that link the S and R. We label these S–R systems “conditioned responding systems” because the organism can be conditioned to make these “knee-jerk-like” responses:

Chiropractic good, medicine bad; Cash good, insurance bad. My association good, your association bad. My approach to chiropractic is principled, your approach lacks integrity. My technique is sophisticated, yours is primitive.

Under S—R conditions, the answers are already known; we simply wait for the questions to be asked. Consciously or unconsciously, these folks are well scripted.

At the next highest level, we find S–O–R processing systems in which the organism (O) intervenes between the stimuli (S) and responses (R). It’s a bit like a computer that is capable of generating various pre-programmed responses based upon the question being asked. In fact, the organism is no more, nor less than a repository of S–R conditioned responses. Enabled by a range of responses, the organism (1) discriminates the stimuli, (2) searches the preordained list for the appropriate responses, and (3) emits the appropriate response. Their script is more sophisticated:

The following associations are all good, the others are all bad. These types of practices vary in procedure but are all good; these others are all bad. All corrective cases, no matter what the technique, are good, however all pain oriented practices are bad. The way to fix our profession is to get in line behind movement X and to make sure that movement Y never takes hold.

At the next highest level, we find S–P–R processing systems in which processors (P) intervene between the stimuli (S) and responses (R). This is the role of human brainpower. In S–P–R processing, we relate, represent, and reason with all frames of reference to generate entirely new and more productive responses. We label these S–P–R processing systems “generative processing systems” because they generate responses that the stimuli were not intended to elicit. S–P–R begins with the belief that the answer does not yet exist. These answers are prescriptive not pre-scripted.

Under S–R and S–O–R conditions the answers are always the same. They vary only by your particular orientation. If you commit the answers to memory and have a penchant for passion, you can become an expert. If your rhetoric is riddled with criticism toward those who have differing perspectives in chiropractic, you can become an arrogant expert and create a large following.

However, under S-P-R conditions the answers aren’t known. Not yet anyway. It doesn’t require brilliant oration. It requires humility. It requires the commitment to avoid defending your dogma. It asks that you accurately reflect a comprehensive understanding of different orientations before you judge them. Like nature itself, it is inclusive. It requires wisdom.

These are the “live” problems that must be solved in chiropractic. Future leaders in chiropractic, in my opinion, are attractive only to the extent that they can generate new ideas to solve old problems. Chiropractic’s leaders can not avoid the responsibility to be thinking in the future. The future is now!

The next day I received a phone call from Jason. “I woke up in the middle of the night,” he said, “thinking about something that never occurred to me before.” He continued, “Learning and changing are very emotional experiences. I think it’s because some people feel their ego is on the line. It’s even worse if their self assessment is over inflated and they already consider themselves to be experts. For those people, training is about moving them from where they are, all the way up to where they think they are.”
“Congratulations,” I said, “you’re hired.”
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