The answer to ‘Do we dare mix?’ depends largely on the question, “What is the motive for the method?” It is my opinion that invariably, in pursuit of an answer, you will come to one issue that shapes every healthcare practitioner’s views on this subject. This issue that causes many chiropractors and medical doctors alike to put on special ‘tinted glasses’ is called insurance.
Allow me to illustrate this with an example from another equally respected profession: the automotive repair industry. The example I’m about to share is a true story that happened to me personally over 20 years ago. I took an ’89 Silverado to a garage for the first annual inspection since I purchased it used. The mechanics who inspected it attended the same church denomination as I so I assumed there would be no problems. Then I went to pick up the vehicle and pay the bill (which was a fair price for a brake job, had the brakes they installed been new from the auto parts store instead of the salvage yard). When I requested an itemized invoice, I discovered it costed me over a hundred dollars for them to change a wiper fuse. They admitted it did not take them the hour and a half they charged me to actually perform the work of changing a fuse, but the shop manual, used to price insurance jobs, ‘allowed’ them to do so, they asserted.
In healthcare, these ‘shop manuals’ are called ‘procedural codes.’ When you hire a healthcare practitioner that you want to bill your insurance, they will use these procedural codes to determine what charges are allowed. Depending on your insurance policy, some procedures or modalities may either be chosen to increase the bill, or, sadly, not be used, even if it would be in the patient’s best interest, because the particular insurance policy ‘limited’ what would be covered.
What is meant by Straight vs. Mixers
From the beginning of our 120 yr old profession, Chiropractic was known for its adjustment, which was done by the doctor’s hands. Over time many ‘new’ methods would rise, ranging from the addition of tools and table modifications to aid in adjusting patients, to the plethora of modalities used by physical therapists today. During the beginning years of Chiropractic, these new methods were dubbed ‘mixing’ by DD Palmer. Although insurance was non-existent at that time, DD admitted in the above quote, “If [Chiropractic] were mixed with all other methods offered, it would soon lose its identity.” It would have lost the identity the Palmers at that time controlled and with it the profits from teaching that went exclusively to the Palmers would have begun to be shared with others.
My Personal View of ‘Mixing’ Modalities
To best explain my view of ‘mixing’ modalities with chiropractic in the profession, it’s time to confess, I too, find myself reaching for a different pair of tinted glasses. They are called results. Out of my passion for relieving pain I will occasionally utilize various methods and modalities (even nutritional supplements) if I believe they will help a patient. I also confess without shame or apology, because I do not run an insurance practice, the dictates of what insurance will or will not allow has never affected my choice of method or of treatment, but whenever being a healer conflicts with being a businessman, I prefer to identify with the healer.