Ethics: an analysis and a theory

Article Abstract:

Many people are analyzing their own moral conduct and that of their businesses, perhaps because of an increased awareness of the consequences of living in a society whose main emphasis is on material, rather than human, relationships. The mass media have influenced America's idea of right and wrong, and good and bad. The author, president of a public relations firm, participates together with the McDonnell Douglas Aircraft Corporation in a pilot ethics project for graduating high school students. To determine the ethics of the students, they were asked a number of questions on whether they would resort to lying and cheating in various circumstances in order to benefit financially. The surveyors expected the high school students to be ethically idealistic, but the students were found to have much lower ethical values than the businessmen surveyed. For example, 68 percent of the students and 5 percent of businessmen said they would lie to achieve a business objective. Only 5 percent of the businessmen would risk going to jail for six months to make a million dollars, whereas 66 percent of the students would take the same risk. People in influential positions help breed these attitudes with such lessons as can be found in the Harvard Business Review, where Theodore Levitt wrote ''Business must fight as if it were at war. And, like a good war, it should be fought gallantly, daringly, and above all, not morally.'' Still, in the face of such an influence, many people are becoming aware that they, and their businesses, cannot exist compatibly in society without strong ethics. Beyond having a reputable trade, which chiropractic is, each individual chiropractor is responsible for the perceptions he creates among the people he employs, serves, and comes in contact with in every way. The author feels that the ethical problems that face chiropractic today come from an isolation which results from building barriers against attack. Also, many chiropractors, not having the experience of working in hospital-like settings, are physically isolated in very small practices. This autonomy often leads to feeling totally self-dependent, and perhaps insecure. These chiropractors often become susceptible to the business entrepreneurs, or practice managers, who play on these insecurities to help sell their ''practice improvements''. The threat is planted when standards of care are set aside and monetary success and practice building goals take top priority. One solution is to break out of isolation by participating in the national and state associations, and the community at large. Although there are many theories on ethics, it is generally agreed upon that ethical problems do not necessarily come from immoral people, but rather

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Chiropractic practice builders: can we afford them?

Article Abstract:

It has been stated that in 1989, 4 million unnecessary operations were performed, leading to 48,000 unnecessary deaths. Shopping around for services, ranging from dental care to car repair, will reveal unnecessary charges for unnecessary services as a part of life. This could be the reason why more and more businesses are being questioned by their patrons. Chiropractors who use certain practice building techniques recommended by some practice builders need to be cautious consumers. One technique, called collecting fees on a 'case basis', which entails prescribing a predetermined number of visits in the beginning and collecting the money in advance, leaves many people skeptical. One of the most famous practice builders explained during a seminar that each patient should be prescribed 20 visits, which should be carried out regardless of the patient's response to treatment, and then went on to justify this practice with a questionable explanation. The patient was to be informed of this treatment and given a preplanned rationalization of its necessity and its cost-effectiveness. Doctors are taught to maximize, not minimize, the patient's problem. Practice builders seem to have the ability to exaggerate even simple concepts. Practice building schemes can certainly fill up the appointment slots in a matter of weeks. But these schemes can ruin a physician's reputation when the local patients begin to catch on. Even though there are good principles that can be learned from professional success experts, it is dangerous to follow advice based on greed and dishonesty. Doctors who overtreat, and consequently overutilize insurance, are partially responsible for the skepticism of patients and insurance companies. Treatment of a patient should conclude when the signs and symptoms of disease are gone. Because of the oppression and resistance that chiropractors feel in the medical arena, and the fact that they are solely responsible for attracting a patient load, beginners may find some relief in the advice of practice builders. But the damage caused to the profession by unethical business practices is too severe to justify the means, and it is the responsibility of the profession to set and monitor ethical standards. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Practice, Medical ethics, editorial

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Chiropractic specialists: a referral resource

Article Abstract:

As in other fields of medicine, there are general practicing chiropractors and chiropractic specialists. Chiropractic specialists provide services to the general chiropractic practitioner. After graduation from chiropractic college, these doctors continue to focus on excelling in one field of choice, such as radiology, sports medicine, nutrition, or neurology. Sometimes there is a need for chiropractors to refer to a specialist, as in the case of a patient who needed an orthopedic evaluation to be able to further receive his workman's compensation reimbursements. He was referred to a chiropractic orthopedist, who could more accurately diagnose his lower back injury. Chiropractic specialists are not only useful for second opinion back-up in difficult cases, but can also be useful as consultants in legal cases. Chiropractic radiologists are regularly used throughout the profession for their expertise, but few other specialists are considered when they should be. Recommendations on how to best facilitate the use of chiropractic specialists within the profession include publishing a yearly directory of available specialists, which would then be made available to the whole profession. The listed specialists are urged to publish information as to how they can be of help to the general practitioner, such as using the specialist to help justify a much needed long-term treatment plan. General practitioners should not worry about referring to a specialist to treat specific conditions in fear of the patient not coming back to them. The specialist only wants to treat special conditions within his expertise, and when his job is done wants to refer the patient back to the original doctor. The chiropractic specialist also helps to upgrade the profession by providing these services and improving the quality of care to the health care consumer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Management, Medicine, Medical specialties

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