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Chiropractic Journal of Australia : CJA March 2012
1 Chiropractic Journal of Australia Volume 42 Number 1 March 2012 Imagine you are standing in a multi-purpose room in a Senior High School, circled by 32 students, both men and women, aged 16, 17 or 18. All are ft, healthy track and feld athletes and some are in the nation’s top fve or six for performance in their age group. An invitation has been extended to you to talk about health, wellness and chiropractic, and for two and a half hours you are expected to answer questions, offer advice and make relevant conversation. The students’ English is somewhat better than your Japanese but you are on your own, without a translator. There comes a point at which you realise you are all in this together and regardless of the frameworks we construct to express ourselves in conversation and life’s activity, there turns out to be connectedness and commonality. The same can be said about chiropractic itself, a global discipline now practised in some 90 countries. We have a remarkable connectedness and commonality regardless of the language we speak or the society in which we practise. In many communities chiropractic continues to experience strong growth, especially in Australia where even chiropractic education is expanding beyond the capital cities and into regions of active economic development. Yet this growth and the opportunities it brings may not suffce for some. There are still minority, fringe elements within chiropractic that eschew commonality and instead argue in favour of an elitist scope of practice that includes the use of drugs where indicated within the terms of a Western medical model. Often this view goes along with a call to limit chiropractic to the treatment of spine pain and to cease caring for children; a call to essentially rewrite the core premise of chiropractic. However the solution is simple, rather than medicalise a drug-free discipline that one studied in the full knowledge of what it stood for, change horses! There are options for further study such as osteopathic medicine and Western medicine, indeed this writer knows of a number of chiropractors who have completed such additional qualifications with the outcomes including the retention of personal integrity and an even greater connectedness. It is heartening to note most who make the effort to achieve dual qualifcation also make the commitment to give back to the chiropractic discipline and its students. So rather than changing chiropractic they accept the responsibility to change themselves and then connect back to enrich the greater health care community. On a day to day basis most chiropractors see clinical results directly related to their adjustment of spinal subluxation, regardless of what they call it or the age of the patient in which it is identifed. And we are now seeing the evidence, albeit it largely from other disciplines, that is building and contributing to our jigsaw of understanding. Yet sceptics maintain their rage and demand that evidence to only be seen through their lens. Sadly, the two or three Australian Just Another Saturday Afternoon. chiropractors who feed them take the self-righteous position that the discipline must change so it can be focussed by that lens, regardless of its distortions. Perhaps the real question is about the paradigm we use to see and interpret the evidence, which is a little like this writer’s time with the Japanese students. That paradigm was one of a shared human experience as opposed to a Westerner teaching English Conversation. Together we learned it is always good to start a conversation with “hello.” A simple word that establishes contact and buys time to think. A little like the word “dysafferentation.” When asked about how chiropractic works, dysafferentation is a great word to use while we search for phrases that describe how mechanical changes in the spine have been shown to create neurological change which in turn allows changes in body function, and how correction of that change can result in improved health and wellbeing. Simple, perhaps too much so to be grasped by those who use a distorted lens which can only see randomised, controlled clinical trials. It is about now that the connection emerges between the opening par of this Editorial and its theme; whilst we as humans have common ideas about the value of health and wellbeing, we have different language systems which we use to position ourselves on that spectrum, in much the same way as we have different paradigms about health and wellness to position ourselves in the clinical science community. And there will always be the rogue outliers which, in statistical terms, are best dealt with by exclusion from the main data set. We can bridge the gap by the gentle use of sound pedagogical techniques within a bidirectionally acceptable paradigm, as evidenced in this writer’s meeting with students, and we can make diligent use of communication skills to re-educate those few among us who demean the discipline through ill-informed behaviour. To achieve unity there must be a priority among chiropractors to stop cannibalising themselves and instead focus on a new sense of service for the greater good. When all things are considered one must certainly rate that particular Saturday afternoon in Kanazawa as one of the most rewarding and endearing Saturday afternoons this writer can remember. Given that the original and core premise of chiropractic is, on a regular basis, becoming more evidence-based, it should be relatively straight forward for every day spent with our patients to be as equally rewarding and endearing. And for Saturday afternoons to be special, family time. Professor Phillip Ebrall BAppSc(Chiropractic), Grad Cert Tert Learning & Teaching, PhD, FICC, FACC Assistant Editor Professor of Chiropractic, Central Queensland University Adjunct Professor, International Medical University
CJA June 2012