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Looking in the mirror: a clear identity for Palmer doctors of chiropractic

graduate in garb, looking at self in mirror

From the time of D.D. Palmer’s earliest efforts, the chiropractic profession has been in perpetual motion. Growing. Retracting. Uniting. Dividing.

Despite those ups and downs, the common focus among doctors of chiropractic has been centered on applying the philosophy, art and science of the profession for the benefit of the patient. Over the years, numerous studies and reports have shown that the patients we serve consistently recognize chiropractors for effective care, strong doctor-patient communication, and an affordability that defies the epidemic inflationary health care expenses overwhelming our country today.

From these patient views, doctors of chiropractic ultimately may receive what might be the most sought after outcome of all: patient satisfaction.

With a reputation such as this, it is easy to imagine that patients would be lining up outside the neighborhood chiropractor’s door. Unfortunately, that’s not always the case. Annual utilization of chiropractic care among the U.S. population has remained relatively unchanged for years at about eight percent. Furthermore, studies indicate that approximately 20 percent of Americans will visit a chiropractor in their lifetime.

So why does the chiropractic profession continue to struggle in its efforts to reach a greater segment of the general population? In part, it is about the absence of a clear and consistent identity for the Doctor of Chiropractic.

“One of the primary obstacles to broader use of chiropractic by the general public is a basic lack of understanding,” says Palmer Chancellor Dennis Marchiori, D.C., Ph.D. “A number of survey efforts, most notably the WFC’s 2004 Identity Project, indicate obvious interest within the profession for establishing cultural authority and really bringing the chiropractic identity out to the masses. The irony of this is, while everyone agrees that a clear identity and description is important, a true identity for the profession and its practitioners does not exist.”

And from Palmer College’s perspective, it is time for that to change …

Catalyst for change

As reported in past issues of Insights and Highlights, Palmer College has been engaged in a three-year process of reviewing and updating its internally and externally directed guiding documents. the project benefited from the leadership of Board of Trustees Chairman Trevor Ireland, D.C. (Davenport ’70), and his appointment of Vickie Palmer to lead the ad hoc committee to develop a relevant and marketable identity that explains the role of the Palmer Doctor of Chiropractic, specifically, and all chiropractors, ultimately.

The development process included several rounds of surveys, focus group discussions and committee refinement before taking the penultimate drafts of the language out to a wide-scale audience as a final test.

“We reached out to nearly 90,000 people in our target audiences including our faculty and staff, students, alumni, patients and the general public,” says Dr. Ireland. “In the end, more than 3,500 individuals provided feedback on our language proposals. So we feel that we have a good sense of what people think about chiropractic, what we think about it and how we can merge the two.”

“I’m very proud of our outcomes and that this effort truly was a team project,” says Ms. Palmer. “Each audience was engaged and contributed a great deal.”

Adds Dr. Marchiori: “What stands out to me, though, is our faculty. They shared valuable feedback and provided the early voice of the seven documents that were ultimately approved by the Board of Trustees. In particular, the work of Dr. Victor Strang was invaluable.”

That approval came in unanimous fashion at the Board’s June 8, 2012, meeting. The final documents included the Identity Statement, Chiropractic Pillars, the Mission, the Vision, the Values, the Philosophy Statement and the Practice Paradigm. (See descriptions on pages 14-17 or visit Our Identity.)

In talking with Dr. Ireland, it is easy to see his enthusiasm for the outcomes of this project as they relate to the philosophy, art and science of chiropractic. “I feel very strongly that we have the catalyst now in place to bring about unity to our profession with our core identity still intact,” he says. “We appeal to the mainstream, which also includes the scientific and the academic communities. We can give these messages to a medical doctor, a legislator, an attorney, a teacher or anyone else and they can get true understanding of what we’re about.”

With chiropractic firmly established as the third-largest form of health care in the U.S., behind medical doctors and dentists, Palmer’s identity efforts are intended to preserve that core identity while building greater collaboration within the national health care system. The language approved by the Board reinforces that direction by providing not only an identity, but a description of what chiropractors do.

Dr. Marchiori adds, “I don’t want this important work on identity to be misconstrued. Palmer knows who it is and we know what we’re about. This identity project is really a project to explain, to communicate to those outside the Palmer community the unique experience and benefit of chiropractic and specifically Palmer.”

Strengthening the future of the profession

“Relative to the profession and cultural authority, I see a direct relationship between what we’ve done and an increased utilization in chiropractic,” says Dr. Ireland. “I hope to move that number in a very significant manner and I think this is a first step in advancing utilization and patient care.”

“Right now, we’re claiming this identity for Palmer,” says Dr. Marchiori. “But clearly, in the backs of our minds, our hope is that it generates a larger effort for all chiropractors in the profession to embrace their role as the primary care professional for spinal health and well-being.”

West Campus President Bill Meeker, D.C., M.P.H. (West ’82), recognizes that agreement within the profession is not a foregone conclusion. “It is natural that all 25,000 Palmer alumni won’t always agree on every topic about chiropractic,” he says. “However, the healthy level of diverse thought that came through their feedback helped drive this identity process forward. That’s where innovation comes from.”

According to the U.S. Department of Labor and Statistic’s most recent Occupational Outlook Handbook, employment of chiropractors is expected to increase 28 percent between 2010 and 2020, much faster than the average for all occupations.

Faced with such a positive forecast for the profession, college administrators, faculty, alumni and students agree that introducing these identity documents will have an even greater impact on the recruitment of students.

“Palmer is clearly committed to a balance of the philosophy, art and science, which then translates into attracting the highest-quality students who are passionate about chiropractic,” says Dr. Ireland. “That’s what Palmer is about.”

“I tell all of the prospective students I refer that Palmer has always been the trusted leader for me,” says Jodi Judge, D.C. (West ’92), a third generation chiropractor. “Introducing this set of documents on behalf of its graduates and other doctors of chiropractic is a huge step for Palmer and reinforces its importance to the future of our profession.”

Current Palmer students recognize the value of this identity project and what it means for the future.

“I feel that students at all chiropractic colleges are similarly frustrated that there’s not one thing that truly identifies us,” says Cristin Fitzpatrick, a 9th trimester student on the Davenport Campus. “The various professional groups and organizations all seem to be going their separate ways. The important thing about this set of documents is that it is, once again, Palmer leading by example. They continue to provide us with more focus as students and help us get to where we want to go.”

“Sometimes as students, we get so caught up with our philosophy and what we believe that we assume everyone around us knows what we are talking about,” says Devan Lysen, an 8th trimester Davenport Campus student. “Palmer’s efforts in developing this identity provide an understanding that prospective students and patients, and anyone outside of chiropractic can understand. I’m thrilled about that.”

Dr. Marchiori shares that enthusiasm. “We have something special here at Palmer and we’re excited to clearly communicate it to the world.”

Palmer’s chiropractic identity documents: What they mean

student clinician showing spine model

Each document created as part of this project has a carefully crafted purpose. The Identity Statement and the Chiropractic Pillars explain what chiropractors are in Palmer’s terms. The Mission, Vision and Values put Palmer’s beliefs and goals into words. The Philosophy Statement provides a contemporary view of Palmer’s philosophical foundation, while the Practice Paradigm defines the scope of care for Palmer chiropractors.

Identity Statement

Palmer’s Identity Statement is a clear and concise view of what a chiropractor is: The primary care professional for spinal health and well-being. 

Chiropractic Pillars

The Identity Statement is supported by the Chiropractic Pillars, which are more detailed statements about what a Palmer Doctor of Chiropractic is and does.

  • Integrate evidence, clinical experience, and patient values and preferences
  • Deliver expert chiropractic adjustments, manipulation and other manual treatment
  • Embody a tradition of caring, effectiveness and patient satisfaction
  • Collaborate and coordinate with other health professionals
  • Enhance patient quality of life and performance
  • Promote vitality, wellness and patient empowerment
  • Enable patients to avoid unnecessary drugs and surgery
  • Offer readily accessible care
Mission

During his inauguration speech in March 2010, Dr. Marchiori said: “As the trusted leader in chiropractic education, Palmer College is committed to student learning, patient health and the advancement of both through research activities.” When work began three years ago on the Palmer Chiropractic Identity project, it was determined that the Palmer Mission Statement was too long and complex. Using Dr. Marchiori’s brief, focused statement as the starting point, a new Mission was created: The mission of Palmer College of Chiropractic is to promote learning, deliver health care, engage our communities and advance knowledge through research.

Vision

Simply stated, Palmer College of Chiropractic strives to be The Trusted Leader in Chiropractic Education. This new Vision is a direct reflection of the College’s commitment to living up to its brand, which was introduced in 2010.

Values

While the Values are new to Palmer’s guiding documents, the College has always been recognized as living these values. They have been vital to our decisions of the past and will continue to drive our decisions of the future.

  • Academic excellence
  • Business acumen
  • Collaboration
  • Community health
  • Critical thinking
  • Diversity
  • Evidence-based chiropractic practice
  • Heritage and tradition
  • Justice, ethics and integrity
  • Life-long learning
  • Open and direct communication
  • The philosophy, science and art of chiropractic
Philosophy Statement

Updated from its original 2007 version, this new Philosophy Statement has been carefully crafted and expands upon Palmer’s foundational chiropractic philosophy to explain it in a broader health care context.

The statement reflects chiropractic’s philosophical foundation on the constructs of vitalism, holism, conservatism, naturalism and rationalism, and it reiterates that central to the philosophy of chiropractic is the principle that life is intelligent. It also refers to the progression of Palmer’s chiropractic philosophy from D.D. Palmer’s early writings to the present day, and how it will continue to evolve.

Chiropractic is a philosophy, science and art. The philosophy of chiropractic is built upon the constructs of vitalism, holism, conservatism, naturalism and rationalism. It provides context for the application of science and art.

Health is a state of optimal physical, emotional and social well-being. Central to the philosophy of chiropractic is the principle that life is intelligent. This innate intelligence strives to maintain a state of health through adaptation mechanisms. The nervous system is recognized as an avenue for these self-regulating processes. Interference with neurological function can impede these mechanisms, disrupt homeostatic balance and adversely impact health. Chiropractic posits that subluxation of the spinal column and other articulations can affect nervous system function and the expression of health, which may result in symptoms, infirmity and disease.

The understanding of the subluxation complex continues to progress from D.D. Palmer’s early writings about misalignment of vertebrae and other articulating structures to include additional anatomical, physiological, biomechanical, chemical and biopsychosocial factors.

Practice Paradigm

The Practice Paradigm is a new document that provides a full explanation of the chiropractic scope of care from Palmer’s point of view. It details what chiropractors do for their patients, from assessments of their health status through subluxation diagnosis, care coordination, providing adjustments, use of passive modalities, active exercise and rehabilitation along with nutritional and other counseling as well as overall health promotion activities.

The Practice Paradigm is not meant to be a direct replacement for the Palmer Tenets because the context of the Tenets also is reflected in other identity documents such as the Philosophy Statement, but it updates them and provides more details and clarity on the Palmer definition of chiropractic scope of care.

Chiropractic focuses on neurological and musculoskeletal integrity, and aims to favorably impact health and well-being, relieve pain and infirmity, enhance performance, and improve quality of life without drugs or surgery.

The Doctor of Chiropractic is a primary care provider for the prevention, diagnosis and conservative management of spine-related disorders and associated locomotor conditions. Serving the patient’s best interest in a professional and ethical manner, the Doctor of Chiropractic employs experience and the best available evidence to make clinical decisions, deliver care and manage identified health concerns and conditions. In addition, Doctors of Chiropractic comply with the laws and regulations governing chiropractic practice in the applicable jurisdiction, including documentation, coding and billing practices.

The practice of chiropractic includes clinically necessary:
  • Assessments of a patient’s health status, needs, concerns and conditions by obtaining a case-appropriate history and physical examination, and by acquiring necessary imaging, laboratory or diagnostic studies
  • Consideration of axial (spine) and appendicular (extremity) structure and function, including subluxation, and the status of contiguous muscular and neural systems by means of physical evaluation, imaging and/or special test procedures
  • Patient-centered management consistent with the obtained history, clinical information and diagnoses
  • Care coordination accomplished through goal-oriented management plans that include treatment recommendations intended to favorably influence outcomes, prognosis, risks, behaviors and lifestyle
  • Administration of manual therapeutic procedures – such as chiropractic adjustment, manipulation, mobilization or soft tissue techniques – as indicated by the history and clinical examination
  • Use of complementary measures, such as passive modalities, active exercise and rehabilitation, nutritional counseling and supplementation, bracing, strapping and orthoses, and other procedures allowed under respective chiropractic practice acts
  • Promotion of health, wellness and disease prevention by evaluating relevant indicators and risk factors, and by providing care directed at mitigating health risks and encouraging healthy lifestyles.
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