By Dr. Matthew McCoy, Editor – Journal of Vertebral Subluxation Research
(snip)
Our profession spent its infancy battling to establish itself, then we struggled to stay out of jail and gain licensure, then came the battle for insurance equality which was quickly followed by the Mercedes 80’s. Sure, bring the whole family in 3 times a week for 6 months – you’ve got the Blues!
Got no insurance – no worries I’ll treat you and the family for $10 a visit and make it up from PI, Work Comp and those who have the Blues. After all I’m a selfless server.
While our leadership got drunk off the 80’s insurance trough no one noticed that the age of accountability in health care was already under way. And while we were getting stung badly during the managed care era - leadership was too busy trying to figure out how to relive the 80’s than figure out how to plan for the future – which is where we find ourselves right now.
Dazed, confused and hung over – we sit and wonder why our market share has dipped from 7% to 5%. We wonder why chiropractic college enrollments are down 40%. We wonder how the chiropractic managed care groups took control and are now really the ones who are directing the future of our profession. They must sit and laugh as the ACA and ICA bicker over whether or not they should merge – as if that is going to stop the downward spiral or loosen the MCO’s grip on power.
We wonder: why, in the face of increasing utilization of complementary and alternative care and the prospect of an impending $1 trillion ‘wellness’ industry, isn’t the public beating a path to our door?
The answer is: Negative Brand Equity.
Most people are not neutral when it comes to chiropractic – they already have an opinion – and it ain’t a good one.
According to Gallup, we rank just a couple notches above used car salesmen when it comes to the public’s perception of our level of honesty and integrity. And even when a particular John Q. Public does have a favorable view of us – chances are it’s for fixin’ bad backs. (NOT FOR ‘WELLNESS’! The public wants SOLUTIONS to their PROBLEMS. Not PREVENTION of their problems. You can’t sell chiropractic as prevention to anything!)
So I wonder…
What will the leadership of the profession do now that the future is here - a future dependent on outcomes. Who can help a patient get better faster and cheaper while providing high quality care that the patient is satisfied with? Who has solutions for the new public health issues that are now taking the place of those from the early part of the century? Who has solutions for the chronic debilitating diseases that nearly 100 million people are going to be showing up at the doctor for? Who has solutions for these nearly 100% lifestyle and functionally based diseases?
Oh, I see you jumpin’ up and down shouting: “we do, we do!” Not so fast Lash LaRue. Stop your spurs from jingling and jangling for a second. Maybe, just maybe, we should stop and be thoughtful about how we try and catch up with the future. God knows our previous approaches haven’t worked.
First, I suggest we admit to ourselves that 75% of the chiropractic lifestyledoesn’t belong solely to us. You can get diet, exercise, and positive mental attitude training from the personal trainer at your local gym. Paul Zane Pilsner points out that much of the $1 trillion in ’wellness’ services that will be provided will be provided by individual entrepreneurs – most of whom will not be health care providers.
Secondly, I don’t know any other provider that is offering the final quarter of the chiropractic lifestyle – analysis and correction of vertebral subluxation.
So, am I saying we should drop everything and everyone should become a straight chiropractor – no. Although, I don’t see that as a bad thing. What I am saying is that whichever of the two we choose – we better have proof that our outcomes matter. Because no matter what happens in health care it is guaranteed that the future is strict accountability - regardless of the payor. One thing that everyone agrees on is that health care cannot continue to consume 16% of the gross domestic product – we are headed for a meltdown and no one denies this. If you can see beyond the short term plans to put band aids on it so somebody can get elected you’ll see that the only real long term solution being discussed is looking at and paying based on outcomes.
So, if chiropractors can show that when it comes to the chronic, debilitating lifestyle diseases that make up the epidemics of our time that we improve outcomes more effectively, cheaper, and with greater patient satisfaction – then we have a viable future. If we don’t demonstrate this I can guarantee that someone else will.
This means that the profession has to vigorously shake off its cultural aversion to research. The days are over when the profession can rely on 70 poorly compensated researchers and a handful of research journals that no one subscribes to. The colleges are going to have to face the reality that their own future depends on producing the evidence of chiropractic’s effectiveness otherwise there won’t be any butts in their seats. Why get $200,000.00 in debt when you can do ‘wellness’ on less or in a profession without negative brand equity?
And finally, our practitioners are going to have to undergo some personality changes and work on not being so isolated. You are going to have to lift up your head from the adjusting table, get involved and force these needed changes. Because the entrenched powers in the profession are not going to do it otherwise.
If you take away all the student members of the national chiropractic associations we’ve got maybe 15,000 dues paying members combined. That should be a sign to every organization that the average practitioner does not see your value as an organization. Accept that and figure out how to better serve the practicing chiropractor.
As always I look forward to your feedback, comments and questions.
Re: Negative Brand Equity - Oh Mama! « Reply #1 on Feb 29, 2008, 11:11am »
IP, if I understand McCoy's letter, this editor of the leading chiropractic research journal is basically admitting.... there is NO research to substantiate chiropractic claims.
May I say to the chiropractic field...."I told you so".
Joined: Mar 2004 Gender: Male Posts: 5,939 Location: USA
Re: Negative Brand Equity - Oh Mama! « Reply #3 on Mar 1, 2008, 4:13pm »
Usually when someone uses fear it's to motivate somone to action. Regardless, good to see the mainstream coming around to what we've been saying for a few years now. However, research isn't going to save the profession since the mechanisms of action aren't plausible and scope is too narrow. This bird is cooked. Students avoid it like the plague.
"In God we trust, all others bring data" -W. Edwards Deming
rulerboyz Guest
Re: Negative Brand Equity - Oh Mama! « Reply #4 on Mar 1, 2008, 5:29pm »
Dr Matthew McCoy has used this sort of "sky is falling" approach in his writings for years now, even back when I was listening to his manditory research lecture that was added to 12th quarter practicum at Life. He's hitched his wagon to the chiropractic professsion, therefore he has no choice but to see this through. Yet prospective students should look at the big picture being suggested here, and realize that this is not a cause that they need to become involved with. It's good to see that he's applying some critical thinking and common sense to what it means to be a chiropractor in 2008 and beyond. Taking it to the next step, and admitting that the bird is cooked wouldn't be such a bad idea. However for those who have taken on this lifelong previous investment trap, this might be as close as they can come to admitting it's all crap, 24/7.
Joined: Mar 2004 Gender: Male Posts: 5,939 Location: USA
Re: Negative Brand Equity - Oh Mama! « Reply #5 on Mar 2, 2008, 12:16pm »
I'd like to hear what people think are the reason for the negative brand equity. A few that come to mind for me are:
Unreliable source for advice (don't vaccinate kids, AK quack testing of supplements, manipulation as a treatment to prevent degenerative joint disease, fail to give informed consent for treatments).
Only care about money (push cervical manipulation regardless of stroke risk, rip off insurers)
"In God we trust, all others bring data" -W. Edwards Deming
doctorsj Guest
Re: Negative Brand Equity - Oh Mama! « Reply #6 on Mar 2, 2008, 1:03pm »
Quote:
I'd like to hear what people think are the reason for the negative brand equity. A few that come to mind for me are:
Unreliable source for advice (don't vaccinate kids, AK quack testing of supplements, manipulation as a treatment to prevent degenerative joint disease, fail to give informed consent for treatments).
Only care about money (push cervical manipulation regardless of stroke risk, rip off insurers)
Unprofessional marketing (Trying to approach people at shopping malls, flea markets, Walmart, etc., to get them to sign up for treatment)
High pressure scare tactics and pushing expensive pre-paid plans (The old "You must keep coming back for the rest of your life")
Sid Williams and Life College's cheesy TV commercials (they used to run non-stop on TV in Georgia)
Admission to chiropractic college of anyone with a pulse (the public is aware that almost anyone can become a chiro, so it does not have the same status that other health professions do)
Highest student loan default rate of any health care profession
Increased public interest in skepticism of alternative medicine (and chiropractic is "The flagship of the alt-med fleet" to quote Dr. Novella)
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