A chiropractic presence at the World Health Organization has been a landfall victory for our profession. I am proud to report that on a public level, we seem to have outgrown our historically fueled inferiority complex and have finally begun to participate in the realization of a vision greater than our own. Chiropractors are powerful players in the realm of global health care policy. We are as knowledgeable in basic science as any other group of primary care providers and have significantly more experience in the treatment and toll of musculoskeletal and degenerative diseases. We are slowly outgrowing our forced identity as complementary or alternative medicine providers and adopting a more integrated role. In my short time at WHO, I was able to complete the draft of what I feel will be a landmark systematic review which compellingly argues that chiropractic care, in the hands of duly licensed, diligent and qualified chiropractors is extremely safe. This stands in contrast to previous reviews which have failed to clearly identify and distinguish highly-trained chiropractors from other manipulators and while this may seem like a small step, it will be necessary in order for governments to create policies protecting chiropractors and patients in countries where it is poorly regulated; by some accounts, this even includes countries like the United States and United Kingdom, where research continues to misclassify all forms of spinal manipulation as chiropractic care. This work will benefit every licensed chiropractor in the world, regardless of scope or philosophy. In this way, we have created opportunities that are too powerful to ignore and cannot be allowed to slip away.
Despite these advances, our collaboration with WHO has not been without controversy. There are some in the chiropractic profession who have criticized our participation in the organization. Some feel that we are not doing enough chiropractic-centric work. Others feel that are we not doing enough to promote the chiropractic philosophy of healing internally and while it may seem from the outside that the bureaucracy of such a large organization may dilute our contributions, I believe such opinions are a matter of perspective. Work at WHO is a thankless job. The hours are long and recognition is rare. It takes a minimum of 18 months and as long as 5 years for most documents to be published which means that technical officers often find themselves caught in the cogs of the Marxist machine. Grassroots work is dirty and dangerous and most WHO doctors rarely connect to the patients whose lives they dreamed of impacting when they were in school. Suffice it to say, policy-writing can be tedious and the final product could outlive the work of any one individual. With this in mind, detractors must be aware that public service within the construct of the social norm is the necessary price we must pay for progress. Chiropractors are too frequently encouraged to abandon institution and seek personal and professional success after graduation at the expense of a larger vision. Misnomers such as “chiropractic principle” and “chiropractic philosophy” are the rallying cries of an embattled minority which have frequently muddied the waters of professional identity. We have shown in our short time at WHO that we have much to contribute, but re-writing the book on healthcare delivery is neither necessary nor justified. As Dr. Gerald Clum said at the 29th World Congress of Chiropractic Students in Mexico City, “the right over the adjusting table comes from time spent at the conference table.” We finally have a seat at the largest table in the world. Let us not abuse it.
It goes without saying that global health care delivery systems need us. We are poised, confident and knowledgeable. We bring a fresh perspective to an often tired debate and create new opportunities for the realization of sustainable health among populations with no access to essential medicines, quality sanitation and nutritious food, but we have work to do in order to be maximally effective. Of primary importance is the need for the most vocal of us, as I’ve argued before, to “get smart and get humble.” Too often do we allow our educational system to become polluted with the perpetuation of religious pseudoscience touted as fact. By all means, we must continue to think outside the box and push the boundaries of science, but critical rationalism must replace a desperate reliance on practice management for the sake of patient safety. We must acknowledge our weaknesses just as we tout our strengths and work alongside scientists outside of the profession to maximize our effect. We owe it to ourselves to develop a culture of perpetual learning. As Albert Einstein is frequently quoted as saying, “we cannot solve our problems with the same thinking we used when we created them.” Relying on the philosophical mantras of a few dead charismatic figures will not help us progress. There is still much for us to learn and we must espouse a rigorous culture of scientific discovery in order to realize this. Additionally, we must not be afraid to branch out. Few will argue that participation in entities like the American Public Health Association and the National Institutes of Health has helped to open the floodgates of acceptance in the US. We have cultivated political alliances with figures such as Representative Tom Harkin who has adopted our cause and rallied it in the United States Congress. Our presence at WHO is no different, save the magnitude of our potential impact. I believe that it is only a matter of time until a chiropractor chairs one of WHO’s higher projects, committees, units or clusters and with this responsibility will come huge promise. I have learned that we can continue to focus on ourselves and perish or show the world how vital we are and flourish. This is our generation’s calling and our legacy; the foundation is already laid. All that is required is additional momentum in the form of institutional support and unified collaboration. The only remaining question is, as I asked in a previous post, “who will carry the torch?”
The answer must necessarily be each and every one of us. Join the cause, support your national and international associations that pour resources into the realization of this vision and leave a lasting legacy for the next generation to follow.
For information about internship opportunities at WHO, please visit: http://www.who.int/employment/internship/en/.
This is such wonderful news for our profession. Keep up the great work Dan!