Overcoming Technique Bias

There is a great deal of diversity in our profession. Diversity is a good thing. It gives rise to different ways of thinking and unique perspectives that could result in much-needed change in certain areas of our profession.

There is a great deal of diversity in our profession. Diversity is a good thing. It gives rise to different ways of thinking and unique perspectives that could result in much-needed change in certain areas of our profession.

Dr. Minardi utilizes an MPI side posture manual adjustment to correct for an ilium subluxation. Advertisement

However, as a product of this diversity, like-minded groups begin to develop. Within these groups, camaraderie builds, and with it, an accepted wisdom. This creates an environment where certain biases begin to manifest. In this situation, an alternative thought process may not be a welcomed friend, and is often shunned altogether. Unfortunately, this unhealthy bias among groups, and their viewpoints, has long existed in our profession, and, in particular, prevails in the technique area of chiropractic. Equally unfortunate is that this bias is usually engrained in a student’s development, initiating the cycle of bias early on.

I was recently contacted by a student who had a question regarding a technique article that I had written. This is a common occurrence, and I am always happy to assist fellow chiropractors and chiropractic students who display a passion for chiropractic technique. In my humble opinion, chiropractic technique is the backbone of our profession (no pun intended). Quite simply, the more proficient we become at technique – which to use in a given situation and how to use it in the safest way and to the greatest advantage – the more we will be able to improve a person’s health and well-being. This, I feel, will result in chiropractic making a greater impact in this world.

This particular e-mail, however, struck a chord of sadness with me. The student began his e-mail by stating that he loved the study of technique, which I am always pleased to hear. He then proceeded to state that he was not a proponent of many non-diversified patient assessments, but could appreciate their existence. I found this disheartening. How could a student, who is filled with enthusiasm, not be a proponent of other techniques, and merely “appreciate the existence” of adjustment protocols that our pioneers literally went to jail for?

This e-mail disappointed me because this particular student, like many students, had most likely been taught this way of thinking. He certainly didn’t walk into chiropractic college with the idea that one particular assessment protocol was any better than another. (He probably had no idea that different protocols existed in the first place.) He learned this biased thought process from an individual(s), who believed this to be true, and passed it on to the student. However, whether inadvertently or not, this teaching style also encourages the negative connotation that one particular assessment protocol is “good,” or valid, and others are necessarily “bad,” or invalid.

I remember very clearly that these same biases existed when I was a student. I remember listening to a variety of chiropractors state that certain assessment protocols were a “leap of faith,” and to stay away from them altogether. These individuals were presenting themselves as authorities in technique, and therefore, used their authority to influence others. Furthermore, these individuals were planting seeds of bias in students’ minds. These seeds would often grow as the student became a practising chiropractor, encouraging further division within the profession. Although it is not my intention to discredit anyone’s teaching methods or the technique systems they were trying to instil – or used in practice – it is my goal, instead, to encourage unity, in our profession, by opening our collective mindset to the habit of at least hearing each other out, rather than shutting each other out for the wrong reasons. What do I mean by this? Read on and you’ll find out.

WHAT DRIVES THIS BIAS?
What always amazed me was that this biased mindset was often a result of ignorance. I remember when I questioned these individuals further about the very technique they were so comfortable discrediting, it was revealed that these same persons knew very little of said technique. I remember one specific incident, when a friend of mine asked a chiropractor what the difference was between a NUCCA adjustment and an HIO adjustment. The chiropractor, who was regarded as the technique expert, confidently stated that they were the same thing – but that the NUCCA adjustment had a faster recoil – and that it was a leap of faith to use either. First, this was an entirely incorrect answer, demonstrating that this person was ignorant of the particulars of one or both techniques. “Second, the response was filled with bias and, furthermore, was not based on fact or evidence.

Often, individuals who are proponents of a certain protocol or technique have chosen to read very little, if anything, about other techniques. When asked to comment, then, rather than encourage investigation into them, they simply proceed to discredit these other techniques, but without being able to back up their statements. In my experience, the vast majority of these persons have not attended a thorough seminar on the technique that they are biased against, nor have they gathered research to substantiate their claims. Unfortunately, the bias often continues with insinuations that only those techniques and assessment protocols used by particular individuals are valid, and that all others are suspect at best.

Does this way of thinking make sense to anyone? Hopefully, the answer that you are speaking out loud at this moment is a resounding “no.” However, this careless thinking process is exploited by many individuals in our profession – and not just instructors in college, but DCs everywhere. For years, I have heard how Gonstead practitioners disliked Thompson practitioners, who in turn detested Applied Kinesiology, who in turn hated Diversified, who in turn ostracized everyone else. I am exaggerating blanket statements concerning the aforementioned techniques to display a point. Certain practitioners believe that the technique that they are implementing is more valid than another, and will often unjustly demean or discredit other techniques.

ACHIEVING UNITY THROUGH DIVERSITY?
The truth of the matter is that each and every technique has its own strengths and limitations. We have to embrace this truth, and be open to learn from each technique. Once we welcome this truth, we can improve upon the techniques’ weaknesses and capitalize on their strengths, for the greater good of our patients and the profession.

For the past two years, I have written a regular column for Canadian Chiropractor magazine entitled Technique Toolbox. As some of you may be aware, each of these columns explains a different technique or protocol. Some of you may also be aware that I specialize in the Thompson Technique, and have spent countless hours researching and updating that very information. Because of this, there are those who have questioned why I spend so much time explaining other techniques in my columns, considering that I have “nothing to gain” by promoting these other techniques.

Well, the reason for this is quite simple. It is because exposure to these techniques is needed in our profession. Exposure to different ways of thinking, various assessment protocols, diverse adjusting procedures, and assorted tools to utilize for subluxation correction is not only needed, but should be encouraged. Even though I specialize in one technique, this does not mean that I use that technique solely. In fact, I have spent many hours in continuing education courses to learn a variety of techniques, and strongly support the incorporation of several techniques into practice, with the intent of helping our patients.

As independent minds within a profession, each and every one of us may have different philosophies or diverse practice methods. However, we collectively have one overwhelmingly important trait in common. We all adjust our patients in an effort to enhance their health and well-being. So, if this is the case, why limit the very tools available to support that process? It is my vision to open the minds of all chiropractors, rid us of the negative biases that exist and unify us through our techniques. This will benefit our profession and, more importantly, our patients.

Unfortunately, some of our colleagues do not believe in this brand of unity, and would rather disregard or discredit techniques that they are not familiar with. This thinking pattern breeds an unhealthy attitude, and is the exact reason that I am writing this article. We all must do our part to overcome the bias that is present in chiropractic technique.

OVERCOMING THE PROBLEM
What can we do to overcome this technique bias in an effort to unify?

1. Attend a seminar for a technique that you are not familiar with.
When was the last time you attended a technique seminar? Many individuals attend practice management seminars, philosophy seminars and even research symposiums. But too few attend seminars to expand and perfect the very thing that we do each and every day with each and every patient. Sadly, there are many other professions now adding “manipulative techniques” and “manual medicine” to their treatment regime. We have to show the world that we are the very best at adjusting, bar none. Go to a technique seminar, any technique seminar – you will benefit greatly.

2. Keep an open mind.
When you attend a technique seminar, or are speaking with a colleague who utilizes a technique that you are not familiar with, please have an open mind.

• Listen to the individual.
• Discuss particular aspects of the technique with the individual that may be confusing you.
• Ask to work with the individual further.
• Ask for any literature, or accessible teaching materials, that the individual can suggest.
• If there are things you are collectively unclear about, agree to do further research together in the near future. Compared with portraying negativity and doubt, working together with an open mind will always achieve greater results.

3. Ask questions.
Please do not assume that I am promoting blind faith in each and every technique. Quite frankly, it is good to think critically, and ask questions about techniques. It is noble to question the validity and reliability of technique protocols. However, these questions should be asked respectfully and with the intent to learn, not with the intent to attack. If questions arise that cannot be answered, begin your own research to uncover the answers. The answers are always there – we just need to discover them.

4. Create opportunity by calling out naysayers.
If you encounter a colleague bashing a technique in a way that reflects ignorance or personal bias, politely confront them. Ask them what they have read on that technique, which seminars they have attended or what research they have compiled to develop such negative views. As stated earlier, it is often the case that these individuals do not actually know much about the technique. This raises the opportunity for you to begin to educate them. But, always remember to stay positive with your comments. Battling negativity with more negativity results in disaster. I recommend “killing them with kindness.” You will be surprised how many people’s minds you can begin to open.

I perform the SOT technique Arm Fossa Test to distinguish which axis of rotation the ilium has subluxated on.

Over the years, I have been fortunate to have been invited as a guest lecturer at various events. With great humility I convey that, on occasion, I have been referred to as a technique expert. I would not label myself as an expert in technique, but rather would consider myself a student of technique. I encourage all of us to adopt the concept of being students of technique. As students, we should constantly strive to learn as much as possible, by educating ourselves on a multitude of techniques, in an effort to better serve our patients.

Always remember, expanding your toolbox means much more than adding a “manipulation” to things you already do. It means taking the time to understand the technique, knowing why it was initially developed, understanding the basic science behind why it works and incorporating all these aspects into your practice to better serve the patient in front of you.

Fortunately, thought processes can change if we offer our assistance and, in exchange, be open to the questions and comments of those who seek to learn. Thankfully, further correspondence with the student that I mentioned earlier resulted in the student’s interest being piqued through our communication. I pointed the individual in the direction of some material to read, and hopefully, this bright young man will begin to incorporate more and more technique protocols into his toolbox.

Technique bias may have existed for years, but it does not have to remain the accepted course of action in our profession – there is a difference between thinking critically and thinking with bias. Let us work together to expand our technique toolbox and get rid of this unwelcome bias. By working collectively, we can reinforce that chiropractors are the most skilled adjusters in the world. Let’s lead by example with an open mind. Through this positive change we can override all naysayers.

Let’s lead the charge for unification and become the strongest profession on the planet. It can happen, but it is up to us.

Lead by example . . . open your minds. . . expand your thinking.

See you at the toolbox. •

Dr. John Minardi is a 2001 graduate of Canadian Memorial Chiropractic College. A Thompson-certified practitioner and instructor, he is the creator of the Thompson Technique Seminar Series and author of The Complete Thompson Textbook – Minardi Integrated Systems. In addition to his busy lecture schedule, Dr. Minardi operates a successful private practice in Oakville, Ontario. E-mail: johnminardi@hotmail.com, or visit www.ThompsonChiropracticTechnique.com.