our position on the hierarchy of con-sumer options is attracting support and referral from MDs. Here, chiropractic has failed to demonstrate a real competitive advantage. A February 2011 Cochrane Systematic Review article entitled, “Spi-nal manipulative therapy (SMT) for chronic low-back pain,” revealed that there is no clinically relevant difference between SMT and other interventions for reducing pain and improving function in patients with chronic low-back pain. If there is any consolation, chiroprac-tic is not alone in this dilemma. In a ma-jor body of work resulting in the book entitled, Redefining Health Care (Harvard Business School Press), a team of lead-ing and well-funded U.S. researchers – including the book’s authors Michael E. Porter and Elizabeth Olmsted Teisberg – conclude that the health care system is on a dangerous path, “with a toxic com-bination of high costs, uneven quality, frequent errors….” We propose that the disparate volume of evidence that exists among health-care professions in Canada leads to the same overwhelming conclu-sion – that the Canadian health system is tragically skewed in its approaches towards what constitutes health, that it is hopelessly unsustainable in its cur-rent form, and that the magnitude of the problem is staggering. Society’s rampant and growing depen-dence on, and perception of, value with respect to pharmaceuticals is an impor-tant element that has, we believe, led to further market decay and patient attri-tion. In addition to this, consumers have adopted a potentially catastrophic ac-ceptance of destructive values related to health and longevity – generally Western society equates being healthy to short-term disease control, not the absence of disease or long-term enhancement of health and vitality through constructive living habits. Chiropractic, collectively, has done little to correct these potentially di-sastrous misconceptions of and about health and the preservation and mainte-nance of well-being – but this is where we must evolve. We have to step up to a new role as thoughtful and passionate leaders in the drive for change. We need to be stronger regarding our own “mes-saging,” to create a shift in the perception of what being healthy or getting healthy really means.  s CANADIAN CHIROPRACTOR | JUNE 2013 HOW CAN WE DO THIS? Our belief is that for us just to survive, our leadership has to vigorously com-municate the importance of efficient mo-bility as a primary element in the control of many of the diseases associated with aging, enhancement of health and qual-ity of life. Establishing the chiropractor as the mobility specialist in health care is critical to all future growth. There are growing bodies of evidence and clinical experience to support this claim, espe-cially when applied to many of the de-velopmental conditions facing adult and aging populations. Since it is contended that evidenced-based health provision will ultimately be the only paradigm compensated by third-party providers within the next 10 years – and that pay-ment for everything outside of what evi-dence deems to be “standardized care” will be considered elective and the re-sponsibility of the consumer – it is para-mount to position the basis of our util-ity on research that supports a broader more realistic paradigm and then to build additional evidence, and hence value, for the benefits that our methods can offer to patients through the creation of a healthy society. It is clear, then, that the profession sits at a critical crossroads and faces fierce competition. In spite of rhetoric to the contrary, we are weak, which is blatantly evidenced by the facts presented. We suggest that as the number of practis-ing chiropractors grows, our profession actually weakens. If chiropractic fails to identify and adapt to new market trends and opportunities, the profession will ac-tually weaken. If research is not geared to provide new opportunities for practice growth, the profession actually weakens. Three strikes and you’re out! Logic points to the importance of pro-viding measurable and more consistent outcomes, aligning with evolving con-sumer values and delivering “utility” as the base platform from which to create a blueprint for future relevance and suc-cess. These have to be starting points as they are in step with where consumers and related economic realities are headed. One hundred plus years of history provide rich field data that we believe contains the solutions necessary to steer the profession away from its current downward spiral. The keys to our fu-ture relevance and competitiveness will be found with you the field practitio-ner – with how you position yourself as a health-care option and with how you identify and present your value to your community. We believe that the strate-gies for success are all here. We know that chiropractic works and is intellectu-ally a fit for the health-care needs of today and tomorrow. We also believe that with-out change, consensus with a progressive and tangible strategy, we risk redundan-cy. We believe that our leadership must step up to the challenge and continue with you, the chiropractor in your clinic, and your commitment to deliver relevant value and evidence-based utility to your patients. In summary, three things must happen for chiropractic to survive: manpower and market needs must align; we have to expand market opportunity to maintain relevance; and research must be extended to include the field practitioner and be directed to aggressively support an ex-«>`i`ÊvÌ«ÀÌÊvÀÊÌ iÊ«ÀviÃðÊU REFERENCES 1. Mior, SA and Laporte, A. Economic and Resource Status of the Chiro-practic Profession in Ontario, Canada: A Challenge or an Opportunity. 2. Galarneau D. Health care profes-sionals. Perspectives: Statistics Canada Catalogue no. 75-001 XIE. December 2003;14(12):14–27. 3. Waalen JK, Mior SA. Practice pat-terns of male and female Ontario chiropractors in 2000-01. J Can Chiropr Assoc. 2005;49:21–31. 4. Whitehall Management published an article in Dynamic Chiroprac-tic entitled “The Sustainability of Chiropractic.” 5. S. Mior and A Laporte conducted research published JMPT article, entitled “Economic and Resource Status of the Chiropractic Profession in Ontario Canada: A Challenge or an Opportunity?” 6. Flexner’s Medical Education in the United States and Canada: A Report to the Carnegie Foundation for the Advancement of Teaching, 1910. FO F OR MORE ON CHIROPRACTIC EDUCATION N , VI V IS SIT WWW.CANADIANCHIROPRACTOR.CO OM M www.canadianchiropractor.ca
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