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
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.