Can Specialists Practice Holism?

Professions (including chiropractic) that require us to study large quantities of scientific information and then apply a finely-honed focus to specialized physical treatment methods, pose challenges to developing a holistic practice. To frame the key question precisely: Is it possible to be an accomplished specialist (e.g., in neuromusculoskeletal diagnosis and manual adjustment/manipulation) while also maintaining a holistic worldview and applying it consistently in interactions with patients?

Chiropractors are by no means alone in confronting this issue, but our current position at the intersection of conventional and CAM healthcare puts boldface type on the question. Like all challenges that arise from a clash of opposites at a time of changing paradigms, grappling with this question presents us a choice between reaching for a higher synthesis and retreating into old familiar patterns.

What would a higher synthesis look like? Conceptually, it would include: (1) high-level expertise in our hands-on, physically-focused, musculoskeletally-oriented specialty; (2) awareness that musculoskeletal patterns and symptoms comprise part, not all, of a patient’s physical health status; (3) recognition that nonphysical factors play a key role in the causation of illness and that mind-body interactions are present in all of us at all times; and (4) emphasis on prevention and health promotion throughout the course of treatment, with lifestyle changes monitored by the practitioner.

The Value and Limits of Specialization

In our quest for holism, we must acknowledge at the outset that we cannot be all things to all people. Cramming more and more jewels onto a crown does not enhance its beauty. Instead, choosing a smaller number with care, and attention to the ways they complement one another, is the mark of the artist. We would do well to see ourselves as healing artists with a vision steeped in holism.

It is no sign of failure for us, as individuals or as a profession, to admit that no one can attain specialist-level expertise in many areas simultaneously. All chiropractors are trained to specialist-level knowledge in neuromusculoskeletal diagnosis and manual adjusting methods, and some also attain wide-ranging expertise through postgraduate training in radiology, sports medicine, acupuncture, rehabilitation and other areas. Whichever areas of specialization we do or do not pursue, we need to also nurture within ourselves a generalist’s holistic perspective that incorporates awareness of a broad range of healthcare approaches, both inside and outside the chiropractic scope of practice. Then we need to share it with our patients whenever it is relevant to their healing.

We chiropractors have a responsibility to educate ourselves about other healing methods and traditions—both conventional and alternative—in order to deepen our understanding of other health practices and paradigms, to know when to refer patients to practitioners of these healing arts, and in some cases to incorporate into our own practices aspects of this knowledge compatible with our role as chiropractors. Calling on other qualified practitioners for assistance is sometimes precisely what the best interest of the patient requires. Developing a network of practitioners in your community, who bring a variety of skills to the table, is essential.

Every one of us can choose to think and practice more holistically. Let us all view health in wide-ranging terms that include but are not limited to the physical and the visible, apply our specialized skills to the best of our ability, and seek out collaborative relationships with others who share our desire to help our patients achieve optimum health.

Daniel Redwood, DC, is Associate Professor at Cleveland Chiropractic College–Kansas City and Editor-in-Chief of Health Insights Today and
The Daily HIT.