Chapter 10, Part 2 – 1992
Campus-wide confusion and consternation about chiropractic identity carried over into 1992 as the college found itself unable to produce a clearly defined, unambiguous and universally acceptable mission statement. Students were frustrated at not having their questions answered and they became increasingly boisterous and outspoken on the issue of identity. The students were not dissatisfied with the education and clinical training they received; their discontent stemmed from a lack of understanding of their role or place in the health care delivery system. Students lacked a firm grasp and understanding of who they were, what they did, and why they did it. They were weary of listening to fellow students, faculty, administration, alumni, and trustees theorizing on their unique perspectives. Students wanted answers; in particular, they wanted an answer to what their professional life was supposed look like. They insisted the college provide them with a clearly articulated response that was unifying and clarifying.
Throughout 1992, meetings, forums, assemblies and discussions were held on campus. During each encounter, participants were challenged to respond succinctly to three questions:
- What is the role of a chiropractor today and for the future?
- What constitutes that practice of chiropractic?
- What can students expect by enrolling at WSCC?
From the very beginning of discussions, it became apparent that during a student’s migration from the classroom to clinical training, a serious disconnect was occurring. From the students’ perspective, the “disconnect” was the result of there being three different political/philosophical camps, each vying for dominance. One camp advocated a traditional approach to chiropractic, emphasizing the detection of vertebral subluxations and the adjustment as the primary and only means of care. Another camp advocated a more progressive approach to chiropractic, emphasizing primary care and the use of all natural, conservative, non-invasive, and scientifically-supportable diagnostic and therapeutic interventions. A third camp advocated a limited approach to chiropractic, emphasizing the management of only neuromusculoskeletal conditions as specialists in physical medicine and the manipulative arts.
In short order, the college was awash in even more unanswered questions and further entrenchment of advocacy for the various positions. New questions generated by the encounters were added to the growing list of those still unanswered:
- What is “primary care” and what definition will WSCC use? Is there a difference between a primary-care physician and a first-contact physician?
- What roles do obstetrics, gynecology, proctology or minor surgery play in chiropractic practice? Are WSCC students expected to demonstrate mastery, competence or proficiency of these sub-disciplines?
- Are WSCC graduates supposed to be physical medicine specialists that focus on a limited number of musculoskeletal conditions? Or, are WSCC graduates broad-scope generalists managing acute and chronic conditions that aren’t emergencies or require referral? Or, are WSCC graduates non-physician types who identify subluxations and adjust accordingly?
- What is the college’s research agenda? Is the focus on validation of the adjustment or measuring outcomes of chiropractic care in general?
More questions generated more discussion, more debate, and more disagreement. This process would continue for a number of years before the underlying issues could be fully aired and the perplexing questions answered. Eventually, something akin to an identity materialized. However, it did not occur suddenly, like a lightning strike, or with the finality that comes at the end to a long journey. The identity of WSCC would evolve incrementally, by consensus, over time, occasionally taking large, quick leaps and at other times, slowing to the point of stagnation.
It is important to note that the health and vibrancy of an institution’s identity depends it its ability to remain fluid and adaptive. A meaningful chiropractic identity would allow for change influenced by new information, politics, economics and the expression of clinical practice.
By mid-1992, it became apparent to the administration the college could not sustain itself with only a single, fall enrollment period. WSCC was losing students to chiropractic colleges offering multiple enrollment periods; too many students were unwilling to wait an entire year before entering a chiropractic program. Projected WSCC enrollment for the fall 1992 entering class was 112-115. If WSCC did not take immediate action, it would once again face destabilizing financial pressures. Having little other choice, the college moved to a twice-per-year admission cycle, enrolling a large class in the fall and a smaller class in winter. The year ended with a smaller than desirable fall entering class, but with optimism about a newly-created winter class.