(And why do we even care? A commentary on the transformative power of the chiropractic lexicon)
Urban Legend has it that the Sami people of Norway and Sweden have around one hundred and fifty different words for ice, and about three hundred for snow, compared to the mere fifty-five we have in English. From my desk here on the Sunshine Coast I find it incomprehensible and yes, even distasteful to think of any more than five. I have deliberately placed myself in a location that knows nothing of the nuances of frozen things (unless we are talking about the chinking of ice cubes against the side of a glass). It seems our environment, and the experiences we have on a daily basis, shape the language we use.
We see this in most niche areas of expertise and interest. From my window I can see the beach, and today the surf is what I would call, “ A bit flat” and yet I know if I popped my head into the window of any of the utes and 4WDs parked over in the wave viewing area, they would give me a much richer description of what is happening out at the break today. In embracing the distinctions and the delicate detail of the lingo of the surfers I would be able to see, and even experience things that my land-loving eyes just don’t notice.
Paradoxically, the reverse is also true. It turns out, that just as creating and communicating words expands our ability to think more broadly, taking them away contracts our minds. This is well known to historians and academics who study growth and destruction of civilisations. In Australia, up until as recently as the 1950s it was illegal for the Aboriginal people to speak their native language, in a concerted political effort to ‘assimilate’ and effectively erode their culture. It was known and acknowledged that this removal of language would decimate their race.
Much has been spoken about the Chiropractic Lexicon over the years, and it seems that in Australia right now, we are faced with a situation much like the original Australians – do we defend our right to use the words of our profession, or do we meekly surrender them to the annals of history and move forward without the words that specifically and precisely define Chiropractic?
A Critical Crossroad for Chiropractic
Right now, more than ever before, we have an opportunity to make that choice. We have ample opportunity to engage in vigorous and intelligent discussion, easy access to resources and an ability to disseminate our ideas and definitions quickly and efficiently.
It is often said that Chiropractic is a science, art and philosophy. We are taught this in our universities from our very first year. When I was at college in what my kids call ‘olden days’ of the early 90s, it was one of the first ideas we tackled in a subject called ‘Chiropractic Principles’. I remember being excited but the use of the word ‘is’. Not chiropractic has a philosophy, but chiropractic is a philosophy.
That distinction is important. If we accept that chiropractic is a philosophy, then it’s imperative we have words and definitions that support that. It is not sufficient for us to adopt the language of other professions without carefully considering the implications of doing such a thing.
We can all use a dictionary, so you don’t need me to go through a long list of definitions for words you use in your offices, but we do need to have a little chat about something that is dear to most chiropractors: the relationship between structure and function. We talk about this relationship a lot in practice, and it could be argued that this is the very foundation upon which our profession is based. So it is interesting to take a look at the relationship between the structure of our language and the functions that are created.
The Power of Words to Create Congruency
Writer Jen Sincero, suggests that words are so important in creating the reality/life/situation that we want, that we should spend time meticulously noticing the words we use, and checking back to ensure that the internal dialogue is congruent with what we aspire to. She says, “When you don’t investigate what is going on with your words, thoughts and beliefs, you risk stumbling through your life on autopilot.”
She suggests that the structure, the precise wording, will affect our ability to function. Our wording will affect our function.
So just for fun, you might like to look up the definitions of a few of the words that have become part of the conversations in your office. Here’s a few ideas to start with: patient, doctor, clinic, treatment, therapy. Do these definitions accurately describe your place of business? Are these words reflective of what you intend to do?
Last weekend, I overheard a conversation between two bar staff at a local venue. One was bemoaning his ‘pet hates’ in dealing with people. His top two were: incorrect pronunciation and incorrect choice of words. He went on to list all of the things that customers say wrong, and all the words they use in the wrong context. Some of them were specific to bar work (like saying Champagne when they really wanted a glass of Sparkling from Australia). Others covered acronyms. (ATM machine, which would mean Automatic Teller Machine machine). Some words were just wrong, like asking for a rum and Coke in a bar that only served Pepsi. On the surface he may have seemed to be a little pedantic, but if you’ve ever worked in a bar, you know all about the ramifications of serving the wrong kind of black sugar syrup.
Getting some terminology a little off the mark isn’t going to bring the food and beverage industry to a complete standstill, but being specific and correct really does make things smoother for everyone.
Whilst we are thinking of Champagne, I like to think that our chiropractic offices are like a glass of something fancy. We all put much love, science and attention to excellence into what we do every day. We deliver a product that is premium; something to be celebrated. I also like to think that despite the similarities that bind us together, and perhaps because of the differences that threaten to tear chiropractic apart, we are most assuredly distinct and different to any other profession. For this reason I believe it’s time for us to reassess the words we use in our daily practice, to create further contrast and clarification. Purely by using different terminology, we will create the structural framework of the uniqueness of what we do. These distinct and specific words will then help us to easily flow into the function that is chiropractic. We have a choice to either adopt the terminology and the ways of other professions, or to create a reality of our own.
Some words we might like to consider looking at could be things such as: ‘waiting room’ as compared to ‘reception’. ‘Receptionist’ as compared to ‘Chiropractic assistant’. ‘Chiropractic table’ as compared to ‘beds’. Once you get going, I’m sure you’ll think of many more, and it will be interesting to see how each of the words you choose to modify are able change their function when you change them up. Imagine if we took things even further, and called our reception a “transformation zone” or our adjusting area the “reconnection space.”
Let’s have a look at two different chiropractic offices, with two different structures, and have a spy at what happens when we bring this structure and function idea together. Imagine visiting these two very different chiropractic offices and how they might look and feel to you. Consider which one you think best serves the people who come to see you.
First Stop: Dr Harris
When you call the office of Dr.Harris (who’s name you found on Health Engine) you are immediately greeted by Linda, “Good morning, Harris Chiropractic Clinic, Linda speaking. How may I help you?” Linda is nice, and sounds friendly enough, if a little rushed. You can hear relaxing music in the background and she has to put you on hold twice to attend to other calls before she makes an appointment for you later that day. She apologises for the interruptions, and says, “The phone always runs off the hook on Monday morning.”
She asks you to come a few minutes before the appointed time to fill out your ‘patient information’ form. When you ask how much your visit will be, she says it will be one hundred and twenty dollars, but they have a Hicaps machine so you will be able to get an immediate refund from your private health fund. She assumes you have one.
When you arrive at Harris Chiropractic Clinic you notice it looks a bit like your doctor’s surgery, with all the usual accoutrements: large front desk with Linda sitting behind a massive computer screen, chairs lining the perimeter of the waiting area, and a TV showing the midday movie with the sound down. A few of the gossip magazines and a copy of National Geographic are on a coffee table next to a little space for children. (There are no children to be seen, which is just as well, because the toys don’t look particularly inviting.)
Linda looks up from behind her screen, smiles and hands you a clipboard with a form entitled “Patient Information”. She asks to you take a seat and fill it out, as she takes a phone call from someone who sounds like they are in pain. She tells them she can fit them in at 2pm in the space Dr.Harris has reserved for emergencies.
You fill out the brief standard-type form and hand it back to Linda, who thanks you and says, “Dr.Harris won’t be too long. She’s running a little late as there has been a few emergencies today, but she will be with you soon.”
You take a seat in the waiting room, and wait. You have a quick look at all of the closed doors down the hallway and wonder if you’ll be going into Treatment Room 1, 2 or 3.
Things seem just like you would expect them to be. Just like when you go to the medial doctor or the physio or the osteo. You wonder if you are in the right place, seeing as all of those others have already had a go at treating your headaches and nothing much has changed. You hope you aren’t wasting even more money on yet another failed treatment.
Second Stop: a chiropractor we shall call Alice…
It was a bit of a hassle to get onto Alice because she only had a mobile number and she didn’t answer the phone immediately, you had to leave a message. When you get a return call, it’s from Alice herself. After a quick greeting and exchange of niceties she asks you who referred you to her. At first you think she means which medical person, but she laughs, and says, “No, which one of your friends told you about me?”
You then have a brief chat about your friend Sue, who was the one who put you on to her, and although she doesn’t say anything much about Sue, she seems to know her quite well. Alice then asks you why you want to come and see her. You tell her a little about the headaches you’ve been having and she just lets you talk. She then asks if Sue has told you much about the way she works and you admit that Sue did say to expect things to be ‘a little different’. She laughs and says, “That sounds about right.”
She then says, “Now my next available appointment is two weeks away, are you okay to wait? Because if you want to see someone before then, I can give you the details of some of the other great chiros in our area. If you want to wait for me, I can book you in now.” (Which you do). When you ask if you can claim back on private health cover, she says you can if you have the appropriate cover- she will give you a receipt and you can claim it yourself.
When you arrive at Sunnyside Family Chiropractic you immediately notice that it doesn’t look much like the physio you had a few visits with last year. There is a cubby house with two children playing inside, and fragrant herbs are growing along the pathway on the way in.
You are greeted by a smiling young women who is standing behind a small desk (that looks more like a podium) with a laptop on top. She steps out, shakes your hand with a grin and introduces herself as Kristin, the chiropractic assistant.
She asks you if you’d like a drink of water or a herbal tea, and gestures for you to get comfy on the couch. You notice a bookcase with some interesting, slightly quirky books and a sign saying ‘Help Yourself’. There are some posters of smiling children, and a large canvas with Sunnyside’s tag line, “Chiro: for everyone you love”. The music is a funky Cafe del Mar type vibe, and you can smell some kind of orangey-citrus blend coming from the diffuser. The overall feeling is that things here are fresh and new.
Kristin brings you an iPad and sits next to you on the couch. She checks that you are familiar with the workings of iPads, and then asks you to fill out the ‘Practice Member Health Journey’ form. She tells you it’s quite extensive because, “Alice will want to find out about what your life has been like up until now, so you can figure out together where to go from here.”
You click through the form, thinking back over your life, as you hear laughter of little kids and their parents coming from the open area on the other side of reception. You can see a small chiro table shaped like an owl and a few other tables lined up behind them. You can’t see who is lying on them, but you can hear the lilt of their voices as they are being adjusted. Kristin sees you looking and says, “I’ll take you into the adjusting area as soon as you’ve had a chance to sip your water and get relaxed, and Alice will be right with you.”
Things seem a little different here and you feel like you’re in the right place, because you’ve been thinking for a while it’s probably time to try a different approach. You feel a sense of hope, as well as something else- maybe this is the place that can get you reconnected to the life you wish you could be living.
Clearly, both of these offices could exist in Australia today, and probably do. Both of them have the right to exist, and both can be successful in their own right, and many offices would be some combination of both of these.
The Questions That Need Asking
The questions I have for you are threefold: which one serves our practice members the best? Which one serves us as individual chiropractors best, and which one serves the profession as a whole the best?
The way you answer these questions will depend on your own interpretation of our philosophy, which will determine the way you choose to perform the art of chiropractic, and whether or not you would like to examine all of the components of your office for integrity with your intended outcomes (or functions).
In my opinion the future of our profession depends upon us scrupulously examining our offices, and being both vulnerable and brave enough to look them with a drone’s-eye view, acknowledging any areas of incongruence we have created, and making the necessary changes. This is often a difficult task. According to Einstein, ”We cannot solve our problems with the same thinking we used when we created them.” This is why inspection from above is necessary to really shift ourselves up to the next level, and why help from a sympathetic third party can be invaluable to making meaningful adaptations. The great thing, is not only do we not have to do it alone, it’s preferable not to. We can support (and challenge) each other.
Andy Warhol once said, “They always say times changes things, but you actually have to change them yourself.”
It is time for us to define what we want for our people and our practices.
It is time to make active choices in what we want for our profession. And it is time for us to define what we want our work here to be about. We are the only ones who can do it.
Written by Dr Alison Asher