Three DCs share their rewarding experiences while practicing abroad.
By Mark Farmer
While it’s true that America createdchiropractic and the profession is
still largely American, subluxations of course know no border. And each year
a number of enterprising doctors decide to take their skills abroad, in the
process finding challenges and rewards that stateside doctors may never see.
Dr. Scott Kircher, a 1998 graduate of National College, has spent the past eight
years meeting the chiropractic needs on the Island of Cozumel, off the Yucatan
peninsula of Mexico. Cozumel has long been known for its excellent diving sites
along the barrier reefs on the western coastline and in recent years has become
a popular cruise ship destination.
Motivated by a desire to travel and experience diverse cultures, Kircher took
over an existing practice located in a storefront a block from the waterfront.
“When I first got there I didn’t speak Spanish. I didn’t understand
the culture,” says Kircher. “One of the first things you learn here
is that being on time is a relative thing. If a patient makes an appointment
for 9 o’clock, as long as they show up by 10, they’re on time.”
Kircher’s patients are primarily local residents, with about 25 percent
coming from cruise ship employees and tourists. He said the greatest rewards
of practicing there have been “the way people have accepted me, bring
their families in for care and especially the opportunity to work on last resort
patients and see them get well.”
Dr. Shawn Henry Dill, a 1995 Logan graduate now on staff at Life West, spent
eight years in practice in Costa Rica. He is blunt in his praise, as well as
his warnings, about practicing in another country. “You cannot dream up
any better practice environment than what I had in Costa Rica,” he says.
“No paperwork, no malpractice. It’s not even an issue.”
“In the United States, everybody has had some experience with chiropractic
that could range from crystals and auras to straight chiropractic. Outside of
the United States, you get to make chiropractic what it is. I always tell people
the professional atmosphere in Costa Rica was second to none. But you also have
to be prepared to cope with the living conditions.”
| On
A Mission |
In fact, the separation from the familiar and the convenient in the United States
can be tough for anyone relocating abroad. But at least the doctors have work
to occupy them. Their families could be another matter.
“The separation was smooth for me, but when I went there I was single,”
Dill explains. “I’ve had a whole host of associates come and work
for me, and I can also say that when someone brings along their significant
other, it is tremendously difficult for them. At home by themselves in a foreign
country, those people almost always end up going back.” Later married,
Dill himself elected to return to America when his two daughters came of school
age.
Many of Dill’s sentiments are echoed by Dr. Douglas Inkol, a 1981 Life
College graduate from Canada and now a resident of the Mediterranean island
nation of Malta. “Living and working in a foreign country in my opinion,
is one of the most exciting and fulfilling career paths a doctor of chiropractic
can choose,” he said via email. “An average day will require you
to go where no others have gone before, where challenges as basic as getting
your dry cleaning done or finding fresh vegetables are as difficult as teaching
a culture how to pronounce the word “chiropractic” and even more,
getting them to understand what the word means.
“But over time, as you watch your profession go from being almost non-existent
to eventually helping hundreds of men, women and children regain their health,
the joy and hope you bring to a culture that’s been without this kind
of care may be one of the single most gratifying experiences of your life.”
However, Inkol also notes the hurdles, “Moving to and working in a foreign
country is not easy. Each country has its own very different laws and rules
(or lack thereof) concerning a foreigner’s right and ability to work within
their country. A great deal of due diligence is required, with considerable
money and time being spent up front for an end result that is not always predictable.
The bottom line is that if you want to live and work abroad, you must be 100
percent committed and have a solid ‘no turning back’ attitude.”
Doctors find their way to other countries by a variety of routes and draw on
a number of sources. Sometimes they use personal contacts, alumni networks,
or professional organizations. The Inter-national Chiropractors Association,
for instance, maintains a list of foreign doctors who can be reached to get
further information. Some DCs sample the waters by going on shorter mission
trips first. (See sidebar).
Inkol bought his Malta practice through an online classified ad. “Surprisingly,
we found several small practices for sale in various parts of the world and
continually see interesting opportunities listed on different websites for places
such as Italy, France, Norway, Spain, Croatia, Ireland, England and even South
Africa,” Inkol said.
Dill originally looked at Nicaragua, but that country’s political and
economic climate proved too imposing. When his Nicaraguan contacts suggested
Costa Rica, he got help along the way from, among others, the World Federation
of Chiropractic (WFC). “The WFC supplied us with a mountain of literature
[to pass on to the Costa Rican government] pertaining to the regulation of chiropractic
in other countries including the United States and relating to chiropractic
education,” he says, “Logan College also hosted four legislators
so they could see the quality of chiropractic education.”
While there is no one-stop shop for support in setting up practice outside the
United States, the closest thing may be the Chiropractic Diplomatic Corps. The
organization’s founder, Dr. Michel Tetrault, describes it as “a
group of semi-retired volunteers,” who have set a goal of full access
to chiropractic for the world’s population by the profession’s bicentennial
year, 2095.
“People are staying longer [in other countries] because of our information,”
Tetrault maintains. “We’ve raised the bar because we say, you have
to think about those patients first off. If you’re going to be there,
you better have stayed there long enough to have a practice that someone else
can come and take over. You’ve got to have a little bit of responsibility
to the people who are there.”
His website (www.chiropracticdiplomatic.com) offers a wealth of information,
a good portion of which is gleaned from a recent survey of pioneer doctors themselves.
Some of the topics addressed on the site include selecting the right country,
establishing initial contacts, legal practice requirements, and promoting a
foreign practice. He also posts a self-assessment test to help doctors determine
their compatibility with working abroad.
Dill also strongly believes the preliminary work is vital. “Do your homework
before you go,” he says. “A lot of people show up and try to wing
it once they get there.” He suggests contacting the U.S. Embassy about
chiropractic and just working in the country of your choice. He urges doctors
to learn about health permits and college degree recognition, as well. Dill
says his best advice is, “Speak the language. It’s almost disrespectful
not to speak the language.”
What are the top motivators for doctors to go and stay abroad? Tetrault thinks
he has the answer. “Blood and belief,” he says. “Those are
the predominant attributes that determine longevity. If there is marriage or
ancestry or a place where they can practice their religion more comfortably,
these form a really solid anchor for them. They are less likely to uproot.”
Provide your feedback on this
article.
© Copyright 2004 Today's Chiropractic