Exploring Diverse Career Paths and Recommendations for Celebrating Chiropractic Day 2021: A Narrative Inquiry

Abstract

Objective

The purpose of this report was to explore the views of chiropractors about their career paths and recommendations for Chiropractic Day.

Methods

For this narrative inquiry, selected individuals from diverse backgrounds were invited to share their experiences about becoming chiropractors and their recommendations for Chiropractic Day. Each doctor of chiropractic was asked to provide a response to a set of structured questions. The responses were collated into a descriptive narrative, and themes were identified from these narratives.

Results

Five chiropractors from diverse backgrounds, who graduated from chiropractic programs in the United States, participated in this project. Each reported a different path to becoming a chiropractor. From these different career paths, common themes emerged, which included (1) a drive to serve others, (2) a personal experience or quest, (3) and a propensity to be problem solvers and inquisitive learners. Their recommendations for celebrating Chiropractic Day paralleled their individual qualities and values, which included providing educational seminars to patients and other health care providers, mentoring students, reading scientific papers about health issues related to diversity, providing chiropractic services to underserved populations, appreciating our predecessors and mentors, and performing community outreach.

Conclusion

This narrative provides insight into the thoughts of people from diverse backgrounds about why they may choose chiropractic as a profession and their paths to a career in chiropractic. This article demonstrates that chiropractors come to the profession for a variety of reasons but may have similar themes such as that the choice may generate from a personal experience, a quest for knowledge, an interest in helping others, and a joy for service. This narrative provides unique insights about the authors’ values for chiropractic, which were congruent with their recommendations for celebrating Chiropractic Day.

Introduction

Choosing to become a health care professional may be a personal matter that can be affected by many factors, including psychological, socioeconomic, racial, cultural, religious, sex/gender, historical, and other influences.1, 2, 3, 4 Thus, what may be a set of determinants to seek out a career for one person might not be the same for another. Understanding the reasons why a career is chosen reflects on the values and interests of the individual making the selection but can also give insight into the perceptions of a profession. Drivers for career selection may have ramifications for chiropractic programs as they prepare for the changes in the future needs of an increasingly diverse population.5, 6, 7 Patients may select their health care provider based on many factors,8, 9, 10, 11 and these relationships and associations have not yet been fully explored for chiropractic patients.

Books have been published about the path to a chiropractic career^12,13; however, studies about why people choose to become chiropractors are sparse.14, 15, 16 Additional qualitative investigations into why people chose to become chiropractors may help to expand the knowledge in this area. Therefore, the purpose of this article is to provide an exploration of experiences of people from diverse backgrounds about why they chose to become members of the chiropractic profession.

Methods

Selected chiropractors practicing full time in the United States were invited to participate in this project. Each practitioner was asked to share their story and were given a series of open-ended questions to complete from March 2021 to April 2021 (See appendix for the questionnaire.)

Chiropractic Day has been celebrated for decades and recognizes the beginnings of this profession.¹⁷ September 18, 1895, was the day that Daniel David Palmer attributed to giving the first chiropractic adjustment to the person that he considered to be the first chiropractic patient, Harvey Lillard. Harvey Lillard, an African American man who lived in Davenport, Iowa, reported that his hearing was greatly improved after the treatment he received from D.D. Palmer. This empirical observation resulted in D.D. Palmer exploring this hypothesis and eventually developing his practices into what we know today to be chiropractic.^7,18, 19, 20

Because Chiropractic Day is familiar to most chiropractors, regardless of which program someone graduated from, it provided a common focal point for us to gather reflections. Thus, through triangulation (ie, use of multiple data sources to develop a comprehensive understanding of phenomena) this helped us to test face validity by considering information from different sources.²¹ Each author was asked to provide recommendations for how to celebrate Chiropractic Day.¹⁷

For any section of a story that was unclear, further inquiry was made to the author and clarification was requested. Once all stories were collected, common themes among the narratives and Chiropractic Day recommendations were identified. All participants consented and were invited to be coauthors of this paper.

Results

The following are the resulting narratives that were contributed by each author. Each story is presented in alphabetical order by author's last name and includes the author's recommendation for how they recommend that chiropractors could celebrate Chiropractic Day.

Shery Assal

I was born and raised in Alexandria, Egypt. My family was considered middle-class. Both my parents had college degrees and vowed to starve, if needed, to get their 3 daughters to the highest possible education level. My father was our personal tutor. He was very tough and would accept no excuse when it came to our schoolwork. He taught us to aim high, dig deep, and apply everything we learned (Fig 1).

Fig 1.

Shery Assal, DC, Whole Health, TN Valley VA Healthcare System, Murfreesboro, Tennessee.

While growing up, I always dreamt of becoming a doctor. The respect that my parents bestowed on doctors and their ability to ease suffering sparked a desire to someday become one myself. I wanted to be available for anyone in need. I still remember them saying that they dreamed one day of “having 3 doctor daughters.” Eighteen years ago, we moved from Egypt to the United States to escape from religious persecution. Christians are a small minority in Egypt and young girls are at the risk of being kidnapped or becoming victims of child trafficking to force religious conversion. As a family that had 3 daughters, my parents decided that fleeing to the United States would ensure an equal opportunity, safe environment, and religious freedom for their young girls.

In the beginning, I did not know what to expect from my new American homeland. The transition to the opposite side of the world involved me facing several challenges: financially, emotionally, and socially. Initially, I struggled to communicate, to work, and to continue my education and was uncertain about the appropriate pathway to achieve my dream. I worked 2 jobs while going to undergraduate college full time, so sleep was a treat on the weekends. I look back at those days and think of it as a “doctor in the making.”

While taking premed courses at college, I was injured in a motor vehicle accident. I sustained a concussion and focal disc herniation in my neck. After multiple courses of medical care with physical therapy and medications, nothing seemed to help. After suffering for several months, I was introduced to chiropractic. I responded very quickly to chiropractic care and was relieved of my neck pain. The chiropractor opened my eyes to a pathway to achieve my dream to help others. Thus, my road to chiropractic was paved with my own pains and aches, which dissipated owing to the healing hands of a loving and caring chiropractor.

When I decided to go to chiropractic college, Southern California University of Health Sciences was my school of choice owing to proximity to my home. My class had 96 students with approximately 48% female students, but I was the only Egyptian in my class. Despite that I had only been in the United States for several years before entering chiropractic school, I noticed that the small class and close communications brought up the culture differences. I did not understand every joke made in class or every comment said and occasionally felt left out. However, I was not embarrassed to ask for clarification to better understand the culture, not only the language.

After 2 semesters, I was succeeding in my studies. My professors asked me to assist in instructing several classes, which included anatomy, biochemistry, and histology. By the second year in the program, I was a teacher's aide for courses throughout the curriculum, which allowed me to tutor, reenforce the material, and broaden my readings. By the time I graduated, 3 more female Egyptian acquaintances enrolled in the chiropractic program. All 3 are currently practicing in private offices in California.

After graduating with my doctor of chiropractic degree, I was accepted into chiropractic residency at 1 of the Veterans Health Administration locations. I worked with a variety of patients from a range of economic, social, and cultural backgrounds and who had a wide range of comorbidities. This opportunity enabled me to work with complex cases and to hone my skills. But most importantly, I learned the importance of taking into consideration the psychosocial aspects of pain. I learned how to listen to my patients and give them the time they needed to address their concerns. During the residency, I learn something new from every patient. I found personal satisfaction taking care of veterans and helping them achieve a better quality of life.

After completing my residency, I accepted a position as a chiropractor at Tennessee Valley Healthcare System, working side by side with a physical therapist and an acupuncturist. As a team, we perform multidisciplinary evaluations with the patients and develop a comprehensive plan of care. Our team begins with the veteran as an individual and what matters most to his or her life. We help them transition from a focus on pain management alone to a focus on functional improvement. Then, as a team of providers and the veteran, we establish functional goals during the initial assessment and determine the best care modalities and whole health offerings needed to assist the veteran in achieving their functional goals. In addition, my training as a health and wellness coach has helped my interactions with these patients. Health coaching is an important link to helping patients achieve their strategic goals and objectives. My additional training as a therapeutic pain specialist, tai chi instructor, and yoga instructor also add to the richness of the patient care they receive.

What I love most is hearing my patients’ feedback about how chiropractic has enhanced their lives. For example, a patient wrote a note to his primary care medical provider stating, “Tell Dr Assal that she has changed my life, I now can be a better grandfather to my grandchildren.” I enjoy working with veterans and making positive changes in their day-to-day life. I enjoy incorporating my training to optimize the care provided. When the COVID-19 pandemic required that we could no longer have face-to-face classes, the clinic developed a program called “Healthier in Place.” This program encouraged veterans to stay active while at home by providing video conferencing classes including yoga, tai chi, and nutrition in a fun atmosphere to encourage participation. This inspired me to offer a belly dance–inspired exercise class for low back complaints. This class has gained popularity among both male and female veterans.

As chiropractors, we must serve our patients by being an educator, a health coach, a health care provider, and a confidant. As an educator, we must take the time to explain findings to our patients. As a health coach, we must walk along their side toward a healthier lifestyle. As a health care provider, we must deliver individualized care to each patient. As a confidant, we must earn their trust and address their conditions but also their personal needs.

Dr Assal's Chiropractic Day Recommendations

Chiropractic Day provides an opportunity for chiropractors to reflect on how far the profession has come and how we continue to serve our patients and communities. It is an opportunity for me personally to connect on this special day with other medical professionals and educate them about chiropractic and our role in multidisciplinary settings. This year, I plan to offer a group exercise class to include spinal stabilization for low back pain. Chiropractors can celebrate in so many ways. I recommend including educational seminars or lunch-and-learn opportunities with medical providers in community. One might consider offering virtual resources for patients for spinal self-care including stretching, mobilization, and strength training. Also consider opportunities to share your knowledge by connecting with current chiropractic students, to share your stories and offer your mentorship.

Valerie Johnson

My chiropractic story begins with my family history. The severe lack of accessible health care in Black communities and disease prevention in health care had greatly impacted the longevity of both my maternal and paternal grandparents. One grandmother died in her late 20s for lack of access to antibiotics after childbirth and a grandfather died in his early 40s from myocardial infarction. This was perplexing because my great grandparents, both children of ex-slaves and farmers, lived into their 90s. My family lived in segregated states like Louisiana and Oklahoma, which, until Civil Rights Act passed in 1964, did not allow Black people into hospitals or access to basic health care. It was not until the passage of Medicare and Medicaid in 1965 that changes began to ease some of the great disparity in traditional health care. This environment shaped my view of health care and the possibilities for a career (Fig 2).

Fig 2.

Valerie Johnson, DC, Physical Medicine and Rehabilitative Services/Chiropractic, VA Greater Los Angeles Healthcare System, Los Angeles California.

My first exposure to chiropractic occurred in elementary school when my parents took me to one of the few health care providers in our community, a chiropractor, for a knee sprain. I recalled the clinic and staff were welcoming and the care was affordable and effective. The chiropractor and his staff were professional and kind. His treatments helped me to return quickly back to my school activities that included track-and-field competitions, such as running and representing my school in standing long jump competitions. Throughout the years, various family members would seek chiropractic care for all sorts of health issues. Care included manipulation, nutritional supplements, and in-office health education. Chiropractic was effective and affordable for my self-employed family to manage their health care needs.

My mother was dedicated to make sure that our family lived as healthy of a lifestyle as possible to avoid the fate of my grandparents. She embraced chiropractic, as chiropractic embraced preventive health care. She thought that preventive health care could be a solution to restoring longevity for our family. This is partly why I chose to become a chiropractor. I was looking for any profession that included a thorough education on human anatomy, physiology, and biology in addition to providing a nonpharmaceutical approach to whole body disease prevention.

I grew up in Southern California, in the Compton Unified School District, around the time when the street gangs were beginning to establish themselves and their territories. It seemed that being a good student and coming from a stable family made me a target for gang members. After several concerning threats, I decided to check myself out of public school and finish the remainder of 12th grade in home school. It was the hardest grade I had to complete and the first time I had to finish every assignment in every textbook to graduate.

My path to chiropractic was an indirect route. Because I did not have the finances to pay for a university education, I decided to take a few business courses at a community college while continuing doing bookkeeping for my family's business. In addition, I began taking on some part-time jobs with an accounting firm. This led to a well-paid full-time position and later an offer to become their new West Coast representative. However, at that time, members of the company's Los Angeles branch and I were unaware of the blatant racism that permeated the parent corporation, which was located in North Carolina.

I recall when the corporation flew their vice president to Los Angeles with all intention that he would work with me for a day so he could claim me incompetent and then fire me on the spot. Instead, at the end of the day, the vice president apologized to me and advised the California firm that I qualified for the position and salary with one caveat. He said that I could remain in my job but we should never make it public that I was Black. I was told that I was never to have my picture in a national trade paper because I would have been the first African American to hold this position nationwide in that manufacturing industry. This request did not sit well with the partners in my firm who were both Jewish. They firmly stood by me and against discrimination. They gave me the position and announced it with a picture of me in a national magazine, local newspapers, and a few trade papers. Although I appreciated my firm's support, I decided that this was jeopardizing the firm's relationship with the parent company. It was then that I decided it would be a good time to pursue what I really wanted to do and try again to go back to a college full time.

I had saved enough money to start at the local city college and then attend an affordable state university. I finally entered the Los Angeles College of Chiropractic (now called the Southern California University of Health Sciences). However, no one in my family had a career in health care and because of the lack of access to health care that had existed while I was growing up, we all had little experience in orthodox medicine. Therefore, I figured the best way to learn about health care was get a job in it. I became a volunteer Spanish translator in a free clinic in Pasadena. During my third term at chiropractic college, I decided to get a job as a lab clerk at Huntington Memorial Hospital. I worked the graveyard shift 3 nights a week from midnight until 7 in the morning then would head off to chiropractic classes. It was exhausting but exhilarating at the same time. Delivering lab results to every department nightly gave me the opportunity to have an inside view on the culture of a hospital and engage in numerous conversations with physicians, residents, and hospital staff.

The knowledge I learned in chiropractic school contributed to what I was learning about the health care system. This helped me to appreciate my chiropractic courses and why I needed to learn them to be able to fully contribute as a health care provider. These experiences led to my journey into integrative health care and a health care profession that had a nonpharmaceutical approach to managing everyday health for all systems of the body.

I later worked with a medical family physician in Beverly Hills who had the contract for providing health care services for the City of Beverly Hills. I provided chiropractic care that included an active care program for nonsurgical patients or a rehab program for postsurgical patients. I worked with a large multidiscipline staff that included surgeons, a physiatrist, a physical therapist, and an acupuncturist. There were no formal chiropractic rehabilitation diplomate programs available at that time, so I worked alongside the other health care providers who were very good about sharing their techniques. The patients included many well-known people in the entertainment industry, politicians, and their family members. Because the staff and patient populations were at the top of their game, I knew that I had to improve my skills to provide the best possible services required. I loved working there and learned so much from the daily interactions with the staff. When that surgeon closed his rehabilitation department, I applied for the newly posted inaugural chiropractic position in the Veterans Healthcare system at Veterans Administration in Greater Los Angeles (VAGLAHS). My history of working at Huntington Memorial, and the various medical groups, and good references from known sources, gave the VAGLAHS the confidence to choose me for that new position.

I came on board in 2005 as the VAGLAHS's lead chiropractor. I did not think working in health care could get any better until I came on board working as a federal health care provider at the Veterans Administration. The learning resources that the federal government provides and the demands of providing health care to veterans with multiple complex comorbidities took my skills to an entirely new level. Because my father and others in my family were drafted into the military and are now veterans, I knew how participating in war affected one's life and health.

In 2006, the chief of Physical Medicine and Rehabilitation at the VA, the president of the Southern California University of Health Sciences, and I arranged for chiropractic students from the Los Angeles College of Chiropractic to do a clerkship at VAGLAHS. In 2014, after having a proposal accepted by VA Central Office, we received funding for our VA Integrative Chiropractic residency program. Later we received the first accreditation of a residency program with the Council on Chiropractic Education and the US Department of Education.

One of my greatest joys is working at the VA. It allows me to practice the way I was taught with a single goal in mind: do what is best for the veteran. It is a joy to teach and empower patients with knowledge to help improve their health. They appreciate when we take the mystery and complexity out of the health care process so they can learn simple, achievable steps to get healthier. Another joy for me is teaching students and residents. Having a background in working at a hospital lab and diplomate as a chiropractic internist has helped make it easier to teach students and residents how to read and decode lab reports. My patients who are veterans get very excited when they can understand what the lab results mean and how to correlate what action steps they need to take to improve their health and then actually see them improve over time.

Looking in the rearview mirror, I can see how the lab position at Huntington and other positions in orthodox medical health care led to my current position as a chiropractor at the Veterans Administration hospital. Being able to observe firsthand the strengths and weaknesses in basic health care, I understood the role that chiropractic could have in disease prevention and health education. I also believe that the combination of knowledge that I learned in orthodox medical settings and my chiropractic education have contributed to the longevity of my parents, who both outlived their parents by 40 to 60 years. It was an honor to be their caregiver in our multi-generation home. My mother was 82 and my father was almost 89 years old. As they had provided for me when I was younger, being able to deliver preventive health care to them has been my biggest success.

I knew that deciding to become a health care provider and choosing chiropractic was going to be an exciting journey into the deep unknown, but the real-life journey exceeded my wildest dreams. The current health care system needs deep repair and faces urgent and complex challenges. However, new tools in technology, exploding knowledge in evidence-based care, and the trends in integrative health care and patient-centered whole health are promising.

My recommendation for chiropractors starting into practice is to be courageous and to step into the unknown. Know that your unique diverse background and experiences could be what is needed to contribute to the health care system and improve someone's quality of life.

New graduates are entering into the health care system that has unlimited problems and yet at the same time has unlimited potential solutions. The health care industry is continuously evolving to solve problems as we know it. Even though someone might be early in their career, they can offer solutions that meets the individual needs of their patients. As chiropractors, we can reduce problems in health care. We can reduce them by single daily acts that we can deliver with our team of providers, possibly in an integrative setting or even with a team made up of just the chiropractor and the patient.

Some of the challenges in an integrative setting includes learning how to be effective at working together with others and how to harness everyone's capabilities together to make the right care happen. This is not always easy because people do not always agree. Understandably, there will be disappointments and at times there will need to be difficult conversations. But what a beautiful thing it is when a group of people become clear about the priorities that they aim to solve for a person, and then, pull together in the same direction. That is the joy of health care, being effective at what matters most for people. My wish is that all use their education to contribute to a healthier future for all.

Dr Johnson's Chiropractic Day Recommendations

My recommendation for Chiropractic Day is to read at least 1 scientific paper relevant to delivering preventive health care to patients who are from a different race, gender, age, religion, or culture, who are present in your current practice. Then look for an opportunity on Chiropractic Day to apply that information in your patient population. Most of us can be more knowledgeable or effective at communicating, educating, and motivating patients of diverse backgrounds to take the necessary action steps to improve their health. My question to you is: What new tool can you add to your educational toolbox every year on Chiropractic Day?

Kim Khauv

I was born in Cambodia. When I was 2 years old, the Khmer Rouge came into power. For the next 5 years, it was hell on Earth, which made famous by the movie The Killing Fields. Two million Cambodians, people from my nation, died from starvation or murder. My family and I were a few of the lucky ones to have survived. We were sponsored out of the refugee camps in Thailand to Southern California when I was 8 years old (Fig 3).

Fig 3.

Kim Khauv, DC, MPH, Private Practice, Metro Manila, Philippines.

Living in Orange County, California as refugees, we were a poor family. My father worked nights baking donuts 7 nights a week with no time off. My mother worked days selling donuts at another donut shop. I started public school in second grade without knowing a word of English. I struggled learning a new language in a foreign land, but I knew it was much better than the refugee camps that we came from in Thailand.

I brought with me 2 things from my life and experiences in Cambodia. First, I carried with me survivor's guilt. Growing up in grade school, to high school, even in college, I always wondered “Why was I spared, yet 2 million people died? What was my purpose in life?” The second thing I brought with me was an illness. In my childhood, I developed a persistent sinus condition and was later diagnosed with chronic sinusitis.

My sinuses were infected due to chronic allergies. I was allergic to the weeds, grass, and tree pollens in Southern California. I looked like I was suffering from a cold for 10 years straight. My eyes were always teary, I had a constant running nose, and tissue papers were everywhere. I was unable to breathe through my nose, or smell, or taste food. My social life suffered. I did not want to go out with friends because I was embarrassed. I was dependent on the nasal sprays and my allergy drugs. I felt powerless, hopeless, and afraid for my future.

Throughout this, I continued to work hard at my studies. Eventually, I excelled in school and was the first in my family to graduate high school and go to college. It was during my senior year in college that I discovered chiropractic care, which changed my life forever. When I was 21 years old, I was sick and tired of being sick and tired. I did not survive the Khmer Rouge and the killing fields to be sick the rest of my life in this beautiful country that took us in. I felt that there must have been another purpose for my life.

In college, I went to see an allergist for my allergies. He performed a skin prick test on my back and put allergens on my skin. As expected, my skin flared up all over my back, confirming my allergies to pollens from Southern California. His answer to me was to move to the desert. Or have allergy shots 3 times per week for 6 months. Neither of those options were acceptable to me. So I asked for a second opinion from an ear, nose, and throat specialist. The specialist ordered a computed tomography scan of my head, which revealed I had an infected sinus. His answer for me was to have surgery and drill a hole to drain the sinus. He explained a complication of the procedure could be facial paralysis. I remember joking with him, “Hey doc, I already look sick, a droopy face is not going to help my situation.” I did not feel that surgery was an option for me either. At this time, I was in despair and worried about what my life would be like.

Do you believe in higher beings who look after you throughout your life or when you are making a tough decision? I believe some being was looking after my family and me while we were in Cambodia to keep us safe. We could have made a right turn instead of a left and stepped on a landmine, but we survived. I also believe that I was being watched over during this time when I was debating between surgery or allergy shots. At that moment, I saw an event flyer on a wall. It said “free food.” I must be honest. I did what any college student would do, I went for the free food.

The event was a health talk given by a local chiropractor. He talked about how the body can heal itself and how the brain controls everything in the body. I raised my hand and asked if he had any success with allergies. He asked me if I was able to remember a time when I was at a park with someone. I shared I was with my younger brother; he barely survived the Khmer Rouge. I was sneezing my head off, my eyes were watery and itchy, I was a mess. But my brother was not affected. The chiropractor then asked, “What is the difference between the two of you?” I thought about it, we both had the traumatic childhood, so it could not be that. What do you think was the difference? It was our nervous systems. My body was overreactive to pollen and my brother's system was not. He explained that it was our body's reactions and nervous systems that were the difference. We had similar DNA, experienced the same traumatic childhoods, both malnourished, yet different reactions to our environments.

After that, I decided to receive chiropractic care. I went each week for the next 3 months and in the third month, my sinuses started draining. Three months after that, 6 months into care, I was able to breathe through my nose and taste food for the first time. Right then, I finally learned what all the hype was for In-N-Out burgers and finally discovered how those burgers were supposed to taste. Three months after that, 9 months into care, I no longer had allergic reactions. I was still living in Southern California, but no longer reacted to the grasses, trees, and pollens. And, I did not have to move to the desert, have allergy shots, or have surgery. It was because of this experience that I knew my purpose in life and why I survived the Khmer Rouge. My purpose was to become a chiropractor.

I decided to attend the Life West chiropractic program in the California Bay Area. I was able to attend chiropractic college by paying the tuition with student loans. I enjoyed the program; however, there were few students of color in the college at that time. One of my most memorable experiences was passing the clinic entrance exam. I was excited to wear my white coat and to finally start taking care of patients. I felt that my hard work, with long hours of studying, was finally paying off. I looked forward to helping people with chiropractic care and to start paying it forward.

After I graduated, I practiced in different locations in California. When I was in San Diego, I worked for the United States Navy offering chiropractic care to active-duty military. It was an honor helping military service members for 5.5 years. Most recently, my family and I moved to the Philippines so that I could provide chiropractic care to underserved populations in Metro Manila. There are less than 50 registered chiropractors in this country with a population of over 110 million. Not many people here have heard about chiropractic, therefore I felt that it was important to educate the public about chiropractic care and its benefits.

Because I wanted to pay forward this gift that was given to me, I founded a nonprofit organization called Well-Balanced World, which was created for 2 purposes. I wanted to help as many people as I could with affordable chiropractic care. As well, I wanted to bring the gift of chiropractic back to the people of Cambodia. We have provided mission trips to Cambodia to offer chiropractic care. We have since added the Philippines for our mission trips and will be alternating mission trips to Cambodia and the Philippines in the future. My mission is to help as many people as I can with chiropractic care.

My greatest joy in practice is hearing from my patients how well they are doing after starting chiropractic care. I hear a sense of hope in their voices and hope in their future, that they do not have to suffer anymore. That is what brings the most joy to me in my chiropractic practice.

Dr Khauv's Chiropractic Day Recommendations

My recommendation is for chiropractors to look for underserved people in their area or an area of the world that is dear to you. Look for ways to provide chiropractic services or support other health care services that improve the health of people in that area. For Chiropractic Day this year, I am planning to do chiropractic outreach in the Philippines and provide charitable chiropractic services to underserved people who cannot afford chiropractic care at my practice. Chiropractic is a great gift that I have chosen to pay forward. My hope is that other chiropractors will join me in doing the same.

Deepak Moosad

I was born in Mumbai, India, and I came to America when I was 11 years old. I was raised as an only child and both of my parents worked 2 jobs while they attended night school. Without siblings to keep me busy, I spent a lot of time alone. Therefore, I taught myself to do many things I now still love to do. I was mechanically inclined at a young age, so I would take things apart just to put them back together and to better understand their inner workings. I taught myself to woodwork by watching programs on the television, trying to replicate what I saw with what we had laying around the house. I taught myself to work on cars in my free time. Although my parents were not around all the time, they still wanted me to see me excel with my education. My parents enrolled me in schools where I could concentrate on my studies (Fig 4).

Fig 4.

Deepak Moosad, DC, VA Long Beach Healthcare System, Long Beach, California.

I am a firm believer that the chiropractic profession chooses you, you do not choose it. I like to think that I became a chiropractor by overcoming my failings. During college, I realized that I had a learning disability. For some people, this might have been a barrier to education, but for me, figuring out what my learning disability was and how I could fix it was a big part of what lead me to where I am now. When I realized I had a learning disability, I dropped out of college and joined the military, the U.S Airforce to be specific. I had a supervisor, Joe, who asked me why I never went to college. I told him that I had dropped out because I was failing. After that conversation, I decided to get assessed for learning disabilities and found out that I was reading at an 8th-grade level. The test also showed that I was a kinesthetic learner. With this newfound knowledge, I returned to college and excelled. In 2006, I graduated from Embry Riddle Aeronautical University with my bachelor's degree in aeronautics.

While in the military, I served in the honor guard, in which I was ceremoniously a guardsman for funerals. One time while lifting a casket, I injured my back. I was in excruciating pain but did not drop the casket during the ceremony in respect for the family and the flag. After the ceremony, I was immediately taken to the hospital. I was referred to a medical orthopedic physician and a physical therapist for rehabilitation. After a month into my recovery, I still had pain and therefore I decided to seek care from a chiropractor. After 2 chiropractic visits, my pain was completely gone. Fascinated with the quick recovery, I began asking myself why I was not given the option to have chiropractic care through the military health service at my location. It was clear that chiropractic would be an asset to other airmen and soldiers. I knew as a child that I always wanted to be a doctor, but I just did not know what path to take to achieve this. After my experiences with the military and air force, it all made sense to me: structure fits function. As a child, it made no sense, but as an engineer, the chiropractic approach made perfect sense.

I went into the chiropractic field hoping to provide chiropractic care to the military. In my 9th term in chiropractic school, I visited Walter Reed National Military Medical Center, where I wanted to do my externship program. Unfortunately, the timing was not right, and I was unable to enter the program there. Following this, I worked with a chiropractor at the VA. I worked in a familiar setting with other vets and that was a fulfilling experience. The experience went beyond joy, I finally felt like I was serving a purpose. I carried a lot of what I learned there into my practice today. Currently, I work alongside my family in my chiropractic practice; my mother and father are both licensed acupuncturists.

What I love most about being a chiropractor is having the integrity to ask questions and not being willing to accept mediocracy. After becoming a doctor of chiropractic, I earned my degree in acupuncture and functional medicine. I learned that we must ask our body how we can help ourselves. In helping to heal, we look at all aspects, whether it be through medical science, nutritional science, or the science of oneself. Most of all, I enjoy connecting with my patients. I love to help them and teach them that they are their own best doctors.

With the healing that happens when we touch our patients, chiropractors realize the power of our hands. When given the permission to touch another person, we must respect the fact that we are more than doctors, we are healers—we heal with our hands, and we should embrace this. And, as chiropractors we may never realize how powerful our profession is until we have had the pleasure of hearing a patient say that we have saved their life. We understand that we could save a patient's life through our care or just by simply listening to them.

Dr Moosad's Chiropractic Day Recommendations

My recommendation for Chiropractic Day is to say “Namaste.” But first, it is important to explain the full meaning of this term. This word originates from the Indian culture and is understood as a greeting, but the term means much more than that. Its true significance means “I see and respect the divine within you.” One principle of chiropractic is that we use our hands to help the innate power within our patients. When we speak of the divine, we speak of the innate. We speak of the changes that have taken place for our bodies to exist in this world today. Whether the change is happening in our environment that may cause changes to our body's functions or the changes that are happening in our profession, by people sacrificing everything to stand for something that they believe, we must take a moment and put our hands together and say thank you and recognize others. As I put my hands together and say “namaste,” I value the power that I hold in my hands to heal my patients. As I say “namaste,” I reflect and respect the sacrifices that our predecessors have done for our profession. As I say “namaste,” I thank all my chiropractic colleagues and mentors who are opening doors for others and standing for what they believe in. As I say “namaste,” I recognize that the integrity in what I do as a chiropractor is an important task and I ask the divine/innate to bless my hands as it has the power of touch and the power to heal. Namaste!

Brenda Morales

I was born in Mexico City, Mexico where my mother is from. My father was born in Tijuana, Mexico, but was raised in San Diego, California and thus mainly spoke English. After graduating from high school, he wanted to improve his Spanish, so he decided to attend college in Mexico City and the Universidad Nacional Autónoma de México. It is there where he met my mother. They married and had 3 girls (I am the second of the 3). My father spoke to us in English from the start. My mother spoke to us in Spanish. We lived in Mexico City until I was 8. We moved to San Diego, at my mom's request, so that we could better learn the language and have more opportunities for our future (Fig 5).

Fig 5.

Brenda Morales, DC, Escalante Chiropractic and Sports Therapy, Escondido, California.

After my father finished college in Mexico City, we moved to the United States. I had excellent support at home to pursue education and anything that I was passionate about. My parents supported me and my sisters in our sports and the “you can do anything you put your mind to” attitude was a constant in our home. I have lived with my personal motto of “When there's a will, there's a way” since then. I believe this has allowed me to achieve so much, as well as push through the difficult challenges that have come my way over the years,

Swimming was my passion. I began swimming competitively when I was 7 years old and competed all the way through high school and the first 2 years in college. It was what I thought about, dreamt about, and talked about. It was who I was and what I did. As a 15-year-old freshman in high school, I decided to get more serious about my sport. I began training more often and harder, more hours, more repetitions, and more yards at the end of every week. This intense training began to take a toll on my body, shoulders, elbows, and knees. After a while, I developed tendonitis in my shoulders that was not remitting. At that time, I was training 6 days each week and putting in over 60,000 yards per week in the pool. Unfortunately, the intensity of the training regimen worsened my condition.

One day during swim practice, I was doing an important set that was necessary for me to compete at the national level. As the set progressed, so did the pain in my shoulder. I pushed through the pain to the point that tears filled my goggles. I kept going, but at one moment, the frustration of not being able to train and do what I loved, without pain, got to me. In the middle of the pool, I thought to myself, “I want to do something with my life where I can help people not go through what I am going through right now. This really stinks!” Right then and there, in a single thought, I feel that God gave me direction to become a health care provider. I never turned back from that desire. However, at that time I did not know that my life's purpose would eventually be realized through chiropractic.

Two years later, I saw a chiropractor for my shoulder injuries. He treated me at no charge because he was once a swimmer and wanted to give back to the sport. I was grateful for his generosity and service. However, it was not until the end of my freshman year in college that I decided that chiropractic would be the direction I should take. As one who has enjoyed using my hands in such things as drawing, painting, playing music, and tinkering with things that needed fixing, I knew that chiropractic was a place I could use these gifts, abilities, and my desire to help others get out of pain. In realizing this, I was convinced that a chiropractic career was the path for me.

When selecting chiropractic programs, I chose Palmer College of Chiropractic West. It was in the state of California and Palmer had an excellent reputation in chiropractic education. As a student, I became co-editor of the Palmer West student newspaper The Bartlett with my good friend, Sidney Bean, DC. It was a wonderful learning experience. The endless growing, making mistakes, and learning through the publications process made Dr Bean and I the professionals that we are today. This learning for me was priceless. I learned to pay attention to details while writing and editing, skills that I use in clinical practice. I learned to write letters and interview others in a professional manner. I learned to be more disciplined. I learned to work hard, to work as a team, and to work to get the job done. The memories of those days make my heart smile. All in all, the camaraderie between our classmates, students throughout the program, and the passion from our faculty and staff were incredible. I dearly enjoyed my educational experience at Palmer West.

After graduating, I moved back to San Diego. I eventually started my own practice in Escondido by renting a room from another chiropractor in town. Seven months later, an office building became available, and I jumped on the opportunity to start a practice on my own. I took out a loan, built out the space, and have been there ever since. Our grand opening included some very close friends, our families, and the blessing of our pastor. It has been an amazing blessing and I have enjoyed delivering chiropractic care at that location for 15 years.

During my chiropractic training, as well as from my private practice experience, I learned the importance of educating my patients and making sure they understood the “why” behind the treatment. This includes giving them a solid understanding of what caused their injury, what needs to be done to correct the problem, and to give their bodies enough time to heal. I have learned that communication with patients is essential for them to respond optimally to treatment, as well as promoting compliance and trust.

Throughout my years in practice, I have come to learn and understand that challenges come and go. However, our passion as chiropractors continues to make a difference in each patient's life and helps us persevere, and push through the bumps in the road. One of my greatest joys about practicing chiropractic is giving people hope. From the first day that they enter my office, patients want to know that we care, and that we will do everything in our power to bring them relief and help their bodies regain better movement and proper function. I have handed many patients tissues in the consultation room because they felt that they had lost hope. After consulting with them, those same patients walk out of the office the same day smiling, even though we have not yet started treatment. I believe that healing starts with hope. If we can give them that from day one, the rest is easy.

In addition, most of my community in Escondido is Latino. As a Latina myself, one who has lived in Mexico and understand the culture and speaks the language, I have the amazing opportunity to connect with my fellow Latinos in a way that few doctors here in Escondido can. Countless times I have had patients tell me “Doctora Morales, me da mucha tranquilidad que habla Español. Me siento mas agusto esplicandole mis dolores porque se que me entiende,” meaning “I am so glad you speak Spanish, Dr Morales. It makes me feel so much more comfortable knowing I can share my symptoms with you, and you understand me.” What a joy it is to be able to help patients feel at ease even before walking into the treatment room.

I enjoy trying to figure out why something does not work right. For my own athletic injuries, I had to figure these out firsthand, but these also motivated me to obtain my Certified Chiropractic Sports Practitioner certification. As a sports injury practitioner, a great pleasure is that I can ask the right questions and get answers that will help me help my patients. Performing the necessary diagnostic tests and coming up with different treatment options, modalities, and techniques help me to achieve optimal results. I enjoy working with each patient as a unique individual who has individual needs. I enjoy taking my time and treating every patient as a unique person; getting to know them, building a mutually trusting relationship, and listening to their needs and health goals. Every day is a different day that gives us opportunities as Doctors of Chiropractic to make a difference in our patients’ lives. This is the essence of what we do.

Dr Morales’ Chiropractic Day Recommendations

My recommendation for Chiropractic Day is to provide service by educating others. Maybe because I come from a family of educators, I feel that our profession has advanced because of the quality of our education. Our excellent chiropractic programs have provided this education to myself and my colleagues, but also, we must recognize through our education as Doctors of Chiropractic we can give to our patients and our communities. Without this education, our profession would not be where it is. I encourage chiropractors to create a monthlong chiropractic education campaign in our offices. This may include sharing daily fun facts about chiropractic, displaying famous chiropractic quotes, having patients answer a fun multiple-choice questionnaire while they wait, or putting up posters. Consider promoting your chiropractic event by including your local chamber of commerce, churches, and community centers. We must continue to educate the public about chiropractic and its benefits. Chiropractic Day is a great opportunity to do this.

Discussion

This is the first study of its kind to use narrative inquiry to explore individuals from diverse backgrounds about how they became chiropractors. Our findings for these practitioners are similar to Callender, who described common reasons that people to choose chiropractic as a profession, which included “(1) students are influenced by chiropractic role models who are frequently family members or friends, (2) students benefited from chiropractic care or family members did, and (3) chiropractic's natural drug-free philosophy is attractive.” ¹⁴ Although each of the authors of this study had a different recount of how they started their career path, we noticed that there were some common themes. These included associating their career choice with a personal experience, a quest for knowledge, an interest in helping others, and a joy for service.

Insights from Chiropractic Day Recommendations

Each of the contributors were asked to share their recommendations for celebrating Chiropractic Day. Asking participants for their recommendations to celebrate Chiropractic Day provided a common point of focus on which to view the participants’ narratives. The results provided us with additional insight into their views of the chiropractic profession and how they contribute to their practices or communities. The comments reveal the personal views of the chiropractic profession and how the authors might envision how chiropractors could interact with or contribute to their profession or communities.

• •Dr Assal's love for education is reflected in her recommendation provide educational seminars to patients or other health care providers and to engage in mentoring students.
• •Dr Johnson's continued thirst for new knowledge and value for diversity is clearly shown in her recommendation to read scientific papers about health issues related to diversity.
• •Dr Khauv's drive to provide care to the underserved is reflected in his recommendation to provide chiropractic services to those in need.
• •Dr Moosad's kinesthetic nature and value for the ability to heal through touch is reflected in his emphasis on the power of touch and respect for others.
• •Dr Morales’ love for teaching and the written word is reflected in her recommendation to educate others through various media and performing community outreach.

These narratives reveal the authors’ values and motivations and shows that the celebration of chiropractic through participation of Chiropractic Day can be a unique and personal experience. We reflect in how we express ourselves in what we value. Each author demonstrated their internal motivation and means of communicating as a health care professional. The recommendations for Chiropractic Day seemed to be congruent with the authors’ stories about their journey on their career paths.

Limitations

The method for this study was narrative inquiry, thus was not meant to replicate an experimental design or larger population study. We feel that the study method and objectives that we selected were properly matched but recognize that our findings are limited to the study design. The aim is primarily exploratory, not definitive; thus, our hope is that this paper may generate new ideas and directions for further investigations. This narrative inquiry included reflections from 5 people from diverse backgrounds, thus information from other people would likely vary. The authors are from the United States; thus, our findings may be limited to this region and may not necessarily be applicable to other world regions. Other similar studies should be done to explore other nations.

Future Studies

Very little is known about the motivations and beliefs of chiropractors before or after they have entered the chiropractic profession. We feel that this is fertile ground for further qualitative inquiry. Whereas quantitative studies show the current demographics, qualitative studies, such as the present study, investigate reasons behind the data. Narrative inquiry provides information that randomized controlled trials and surveys cannot. The addition of more qualitative studies to direct quantitative research can help us to better understand the environment and possibly help us to ask more meaningful research questions. Further investigation into why people choose to become chiropractors is needed. These efforts may assist helping the profession create a better balance and representation to serve the world's population.

Conclusion

This narrative provides insight into the thoughts of people from diverse backgrounds about why they may choose chiropractic as a profession and their paths to a career in chiropractic. This article demonstrates that chiropractors come to the profession for a variety of reasons but may have similar themes such as that the choice may generate from a personal experience, a quest for knowledge, an interest in helping others, and a joy for service. This narrative provides unique insights about the authors’ values for chiropractic, which were congruent with their recommendations for celebrating Chiropractic Day. Included for readers who wish to participate in Chiropractic Day are posters (see Fig 6) that can be freely printed and used to inform others about Chiropractic Day (see supplemental file for poster file).

Fig 6.

Chiropractic Day posters.

Practical Applications.

• •Chiropractors may choose chiropractic as a career for a variety of reasons.
• •They may have similar motivations such as having had a personal experience, a quest for knowledge, an interest in helping others, and a joy for service.
• •This narrative provides unique insights about the authors’ values for chiropractic, which were congruent with their recommendations for celebrating Chiropractic Day.

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