What Evidence Based Chiropractic Gets Wrong

Hey guys, it's Chris from Patient Centered Training and today's video. It's a little different to usual. Rather than give you a quick bit of advice or a tip or something to improve your communication, I want to zoom out a little bit here and talk about something that's been on my mind. It's been bugging me for a while. I've been having sort of informal conversations with colleagues and friends about this and I think it's something I really want to just try and generate a wider discussion about it. And this is a problem that I think we have on the evidence based side. And it's quite a deep problem and it's been there for quite a while. And I'm seeing the symptoms of this more and more. And a large part of this is that we often from the evidence based perspective is we look at the other, the more traditional or the more vitalistic sides of the profession. We say, well, we don't want to do that, we don't like that. That's not ethical, that's not the kind of chiropractor I want to be, that's not backed up in the evidence, whatever it might be. And we've used that to kind of create an identity as evidence based chiropractors and to separate ourselves from the more traditional old school styles of practice. And that's great. And that's really led to a lot of advances. It's led to us looking at other approaches, other ways of treating, communicating, building practices. By and large, I think that's a really good thing. And certainly the way I practice is very different to how the majority of chiropractors practiced 20, 30, 40 years ago. But I think something gets a little bit lost there. And I think we can sometimes throw the baby out of the bathwater. And the real issue here seems to be that the evidence based side of the profession really tends to define itself by what it's not. We go, well, we're not like those other chiropractors. We're not all about the money and we're not high volume and we're not sublux base. And you know, and we talk all about how what we're not. We don't really talk about what we are. And it's put us in quite a reactive position. And the problem with that is you define yourself by the other side. It's, it's almost. And I can see why some people look at that as somewhat of a negative thing. I don't think the evidence based side of the profession is negative. I think We're a very positive force. But this reaction and this tendency to say, well, it's, it's about not being one of those chiropractors. It could be a little bit like, you know, I think of it a bit like a teenage atheist who like, you know, and I went through this phase myself, they start getting really like, oh, religion's a load of rubbish and there is no God. And you know, they really define themselves by what they're not. They're proudly not religious. And whilst it's a phase many people go through, that's no bearing on your faith or your spirituality. I think it's a, it's a phase that I grew out of and I don't think it's a particularly useful phase. And I think we're in that phase in the evidence based side. And what it means is that we often just run away from anything the vitalistic side of the profession does without really considering where we're going or if that's something that we need to completely run away from. Now there are some things that you see on the other side that I absolutely don't condone. Two minute treatments on a conveyor belt, walk in, crack, walk out, treatment plans that are a year long with 80, 90 visits, you know, trying to convince people to give up several thousands in a high pressure sales environment. I'm never going to be okay with that and I'm absolutely not going to defend that. However, I do see quite a few Cairos on the evidence based side looking at that and going, well, treatment plans are bad, or prepaid options are bad, or maintenance care is bad, selling supplements is bad. And that's all coming from looking at the other side of the profession going, therefore they do it, therefore it's bad, therefore I won't do it. And these are all things that I offer in my clinic and I really do believe you can do them in an ethical way that is for the patient that benefits both you and them together. But a lot of us, we react and we just go, well, if they do it, it's bad. I think we're really holding ourselves back and we're really avoiding making more progress with the profession than we could. And really I'm sharing this because I want to ask, okay, we talked about what we're not, we're all pretty clear on what we're not, what we don't like, but what are we like as the evidence based side of the profession? What are we for? What do we stand for? Because I ask people this and the response I generally get is, oh, we're patient centered, we're evidence based and we're patient centered. And I gotta be honest, I don't think that's a good enough answer. The majority of practitioners I see who say that don't really understand what patient centered is. There's a lot of evidence based chiropractors who don't practice in a patient centered way. By the way, there's quite a few of the more vitalistic chiropractors who do. We don't own that ground as much as we might like to think it, but we tend to pay lip service to it. We say, oh, well, it's all about the patient, but we can't really offer anything beyond that. Now, I don't have the perfect answer here. I'm not putting this out to tell you this is what I think this is what we should be for. I think that's the conversation that we need to have as a group and as a community. But I'm really just putting this video out there to open up and suggest that, because I don't see it happening. You know, I see some groups starting to talk about how we're not going to deal with the other side so much. We're going to go off and do our own thing, and that's great. But most of their members are still talking about the other side, defining themselves by what they're not. And in order for us to grow and become a more powerful voice in the chiropractic profession, I think it's really important that we have this conversation. So I'm really just putting this out there because I would love to hear your thoughts. You know, I'd love to know what you guys think because I've got my own impression and I know what I think we should be. But I don't claim to know everything about this profession. I haven't been working in the trenches for 30, 40 years like some of you have, and I really think we should be bringing all our voices together for this. So let me know what you think. Pop a comment below, shoot me an email, whatever works for you. But I really do want to hear what people think about this and if we can come together as a community, start really getting clear on what we're for. Not just a few buzzwords, not patient centered like we threw that around, but actually saying what it's about, what are our principles, what do we stand for? And I think that's really going to help us out. So like I said, let me know what you think. I don't have a clear answer. I'm just curious, and it'd be great to hear from you guys.