Never Have, Never Will
Join Drs. Jason Deitch and Tom Klapp as they lay out the rationale for remaining one of the few drug-free options for improving health and wellbeing.
Dr. Klapp says there are three drivers for chiropractors who are trying to bring drugs into the profession…all based on false premises:
- Schools teaching a medical/allopathic approach instead of the chiropractic approach
- Unsuccessful chiropractors who believe drugs would make them more money
- “Pied pipers” who claim prescribing drugs would make chiropractic more “advanced”
Bottom line: Americans’ declining health is NOT because we are suffering from a deficiency of drugs.
Jason Deitch: Hello, everyone. Dr. Jason Deitch here, and today I’m excited to be having a great conversation with my great friend Dr. Tom Klapp. Dr. Tom, thanks so much for making some time in your busy schedule to talk about, what I believe, might just be one of, if not the most important conversation in the chiropractic profession, which is asking the question, “Why is the chiropractic profession better off a drug-free profession?” Now before we get into that, a lot of people know you, you’re on the board of Life University, you’ve been very involved in the politics in the state of Michigan, but for those that may not be aware of who you are, recent graduates and so on, before we get into the message, let’s talk about the messenger. Share with us some of your background and why you have really become one of, I’ll say the world’s, most vocal proponents about keeping chiropractic as a drug-free profession.
Tom Klapp: Well first of all, I’ve been in practice for, it’ll be 37 years next month, and I have a lot of experience in politics, as you mentioned. I’m the past president of the Michigan Chiropractic Association. I’m the past chairman of the Michigan Association of Chiropractors, which was the newly merged association in Michigan that came together 10 years ago now, believe it or not. I am, as you mentioned, on the board of Life University, and I have a long list of low paying jobs in this profession, so for whatever that’s worth, I know my way around the profession. Let’s put it that way.
Jason Deitch: Right. You’re being facetious about low-paying jobs, but what you’ve done is you’ve volunteered and participated on a lot of levels around the world in this conversation or really about how to elevate our profession, I’ll say, to the stature that it really deserves to be. You were instrumental, I know, in the mergers of the two state associations. You’re being humble and so on, and that’s all well and good. Let’s get into it. For those chiropractors watching, you may have some chiropractors that have been around for decades, others who are in school, let’s have the conversation. There are those within our profession that actively believe that we will be a better profession with drugs. Why is that not true?
Tom Klapp: Well, the first reason it’s not true is because there are plenty of professions already out there that are willing, ready and able, and in fact eager, to write as many prescriptions as humanly possible. Currently in the United States, the average American, get this, it’s 13 prescriptions written for him or her annually, and 75% of Americans are taking at least one prescription drug.
The first question I would ask a chiropractor thinking this way is what benefit do you bring to a patient above and beyond what all these other providers and physicians that are writing prescriptions for drugs like crazy, what benefit do you bring that they’re not already getting?
That’s the first question. Then on the other side of the coin, what destruction are you doing, are you wreaking, on the world’s only drug-free [healthcare] profession?If you look around the landscape, there’s all kinds of providers, and I would even argue people like homeopaths and naturopaths, in their own way, have a form of prescribing what could be considered drugs. Yet here we are, we are a holdout.
The number one thing that the public likes and appreciates about the chiropractic profession is that we are drug free. The public loves knowing that there is a doctor out there that they can go to that isn’t standing ready as they walk in the door to write a prescription. We have other ways, magnificent, effective, sometimes even unbelievably effective, ways of healing without the necessity, without the bastardization of bringing drugs into our beautiful profession.
Jason Deitch: What are some of the claims? Those that do believe this. Maybe just share for those that are new to the conversation, why do they think that it’s a better profession with drugs?
Tom Klapp: I have looked this over, and I’ve kind of come down to three reasons why the profession wants to go down this path. Let’s call them drivers, if you will.
The first driver is that there’s a lot of colleges out there, chiropractic colleges, that are training their doctors in, what I would call, allopathic practice. They teach them how to diagnose; they teach them how to refer to medical doctors; they teach them how to practice, think, and act like a medical doctor. Then what happens to these graduates is when they graduate and they get their chiropractic license, they realize chiropractic is not allopathic, that all the things that they may have been taught in these allopathic-leaning schools, they can’t do. What that leads to is a lot of frustration, anger, maybe they feel … like they were baited and switched, but in any case, they feel like they’ve been, maybe even defrauded. In my mind, maybe they were defrauded.
So we have a lot of dissatisfied graduates when they get out of school thinking, “Well, when I get out of school, I’m going to be a doctor.” They’re a doctor, but not an allopathic doctor. So it leads to “Maybe we should change the profession to reflect what I was taught.” Okay. I’m deeply opposed to anyone who graduates from a college thinking I’m going to change the profession instead of adapting my practice to the laws that govern chiropractic. Because that’s what this amounts to. We have laws that govern what we do, and the schools should be teaching what those laws allow and not all this other stuff. Okay? That’s one major driver.
I think another driver is, simply, lack of success, that a lot of doctors aren’t as successful as they feel like they want to be or they feel like they should be. They look at the medical profession, they see that they get paid when they send a bill to the insurance company, and they think, “Well, if I could only do what they do, maybe I could get paid like they get paid.” Well, that’s very wrong thinking because you’re still a doctor of chiropractic, and there’s no indication that if you were to, all of a sudden, be able to write a prescription, that somehow you’d get paid more. In fact, I’m going to throw a factoid out there that a lot of people may not have even thought of and it’s this: there’s no CPT code for writing a prescription. It’s part of the E and M code, the evaluation and management code. You can already do that. So where’s the advantage? I’d like to see them pay us now for the E and M that we can already do, instead of trying to add prescriptive rights to something and then try to send that in for payment. There’s no indication we’re going to get paid more.
Jason Deitch: Right.
Tom Klapp: It’s a pipe dream. The other drivers are there’s the pied pipers in the profession. There’s a group out of Florida that makes a lot of noise about how much more advanced we could be if we could just write prescriptions. Well, I would argue the opposite. We would be devolving as a profession if all of a sudden we [started] acting like every other profession. What makes us powerful, what makes us different, and especially in the mind of the public, is that we are drug free.
Jason Deitch: Right.
Tom Klapp: I’d like to see the pied pipers tone down their rhetoric because in addition to all the other bad ideas out there, to make this happen, politically, would be a nightmare for our profession.
Jason Deitch: There are some that argue that they want the rights in order to be able to take people off of drugs. Do you believe that as a rational argument? It sounds logical. What do you say to those that say, “That’s why I want these rights”?Tom Klapp: If you believe that argument, there’s a bridge in Brooklyn that I’d love to sell you because it’s just about as ridiculous. I don’t believe a word that these people are saying when they say, “Well, I want to take my patients off drugs.” Here’s what I do, I ask every patient that I see who is on a lot of medications, and believe me, we all see it, I sit down with the patient and I suggest to them that they go see their medical doctor and ask him or her which of the drugs that they’re taking can they live without. Let the medical doctor do his job. His job is to take people off drugs and put them on drugs and all that. My job is to educate my patients that there’s a better way than just dousing your body in harmful chemicals and toxins in the form of prescription medication.
Jason Deitch: Okay, so is that-
Tom Klapp: That’s a false argument.
Jason Deitch: So it’s an argument that on the surface seems logical but that may have some underlying ulterior motives behind it.
Tom Klapp: Right.
Jason Deitch: What about those in the profession that say, “Hey listen. I don’t want to prescribe drugs. Tom, I agree with you. I think you’re right. It’s our tradition, it’s our history, it’s our unique selling factor. But what’s the harm if some people in our profession would like to do it? I don’t want to do it.” What impact does sort of opening this door or going off that cliff, what impact will it have for those that think that we can sort of live and let live? Let those that want to do it, do it. I don’t choose to do it. I’m just making a living helping people in my community.
Tom Klapp: I have two historical pieces of evidence that will defeat that argument specifically. The first one is the osteopathic profession, who began very much as the chiropractic profession, as a vitalistic manipulation-oriented profession. That’s what they did. They were vitalistic and they manipulated the joints of the body to increase blood flow, blah blah blah blah. In 1958, they had a movement similar to what we have today in chiropractic that said, “Hey, let’s start prescribing drugs. You folks over here, you just keep doing what you’re doing. We’re going to do this.” And that’s exactly what happened. Today, the people that were left to do manipulation are virtually gone, and I would love for you to find me an osteopath today who even remotely looks like one of those osteopaths from 1958. My point is this, that the minute that one chiropractor gets the right to prescribe, it won’t be long before the rest of us will probably be required to prescribe.
Then my second example from history is simply this, that in the various states where the arguments have been made, the liberal chiropractor would say to the conservative, “Let me do what I want to do, and I’m going to let you keep doing what you’re going to keep doing.” Okay? This has gone on … We have 50 states like this, and in all 50 states, when the final bell was rung and the whistle blew and the gun went off, the conservative chiropractor ended up having to be qualified in the exact same manner, take the exact same courses, get the exact same license as the broader-scope chiropractor. So that argument fails because we know what happens.
Jason Deitch: What I’m hearing you say is that it’s not a live-and-let-live approach. That may seem like that at the moment, however the implications are that in order to prescribe drugs, there’s more education. If there’s more education, there’s more testing. If there’s more testing, higher requirements for licensing, increased malpractice insurance costs because that has to be spread out over everybody basically,-
Tom Klapp: A big [crosstalk 00:13:58]
Jason Deitch: -that it sounds good but may not necessarily be the reality when it’s all said and done, [crosstalk 00:14:07]
Tom Klapp: It sounds good, but it never, ever turns out that way.
Jason Deitch: Okay. I’m not even sure it sounds good, but it sounds good to some.
Tom Klapp: Right.
Jason Deitch: The arguments are that this is a positive step or an advancement of our profession. Others say, “This is who we’ve always been. This is who we should continue to be. It’s what the market is asking for. People are appreciating drug free.” How does this proceed from here? What do people watching, what should they get from it and what should they do? How do they get involved? Do they just watch the potential train wreck happen or is there something they can do to participate, get involved, share their voice, perhaps even inspire others to see it a little bit more clearly, and so on?
Tom Klapp: Well, that’s a great question because there are a lot of chiropractors sitting on the sidelines of this debate. They’re kind of wondering what’s really wrong with it? Why wouldn’t we do drugs? Then there’s some who know intuitively that they’re against it, and yet they really don’t want to take a stand because taking a stand sometimes can be a problem, can be difficult.
The first recommendation I would make is if you believe that this is a bad idea, going into the path of drugs, if you believe as I do, take a stand. You need to decide within yourself no, this is not what I want to do. When you went to college, Jason, and every other doctor watching this, you didn’t get in it to prescribe drugs. It was never even a discussion. Nobody thought of it. Nobody wanted it. Now all of a sudden it’s a thing. You got into a drug-free profession. From the very get-go, that’s how it was when you got in, and that’s how we should keep it for so many reasons that … We don’t really have all day to enumerate them all but-
Jason Deitch: That was the deal. We signed up for that deal.
Tom Klapp: We signed up for it’s drug free.
Jason Deitch: Right.
Tom Klapp: Now go with it. The public is getting wise to the drugs. Okay, so what can you do? Stand up, be counted, take a stand against this whole movement, and support the people who are doing the same thing. For example, you and I are involved in a new organization, or a coalition, we call One Chiropractic. We want to unify the profession around one sentence: subluxation-centered, drug-free chiropractic. There you go. How many of us just think it’s that right there? We can create a big, big movement with just that, and there are other organizations out there. My own state of Michigan, the Michigan Association of Chiropractors, to my knowledge, is one of the very few state associations who have passed a resolution that we are drug free, we intend to remain drug free, and it’s not an issue for us.
But if your state association hasn’t done that, get involved. Ask them to take that same position. There are national associations. There are definitely colleges. We know Life University (Life Vision, Today’s Chiropractic Leadership), Life West, there are other colleges that have taken this same position. Those are the folks who need your support. On the other hand, there are colleges, there are individuals, there are associations out there who think that chiropractors should give up their history, give up their philosophy, give up who they are and become allopaths. Well, if you’re supporting them, take your support away. That’s how you can vote with your feet, as they say.
Jason Deitch: That’s exactly. That’s exactly. It’s a big topic. It’s a big issue. We’ve been close, I think, in New Mexico years ago. It was only by certain individuals, Drs. Guy Riekeman, Gerry Clum, and several others, that we sort of saved it from going over the edge. Is that true? Do you want to give any predictions as to how you think this might play out so that people can sort of be aware of what’s really happening, you know, in today, tomorrow’s time so they can get a sense of the urgency? Is this some theoretical potential problem or how serious is it?
Tom Klapp: Well, what’s happening even as we’re having this conversation, there are chiropractors, chiropractic associations, who are planning on introducing legislation that would allow chiropractors to prescribe drugs. Now, there are so many problems in passing this kind of legislation. The biggest problem is that other chiropractors don’t agree with it. Okay? We have one state, Wisconsin, where one association decided they were going to go into drugs, and they spawned a completely new association whose intent was it to make sure drugs never came to Wisconsin. What that means in Wisconsin is now you have a divided state. They’re never going to pass a law for drugs there because the legislators look at a divided profession, they’ll never pass it. Yet, the doctors in Wisconsin are being cheated out of a single, powerful, unified association that could be getting good things done.
How about instead of going for drugs, how about we start going for access to chiropractic care? That’s the holy grail. If we could just get what we do paid for on a par that the system pays for allopathy, my god, what an amazing win that would be for our profession. There’s always going to be … As long as this movement stays alive, somebody’s going to be out there trying to pass the law, but I’m telling you right here and right now, we are watching. I’m not even going to tell you who we are, but if somebody so much as introduces anything anywhere, we are going to know about it, we are going to oppose it, and we are going to kill it.
Now, there’s another kind of movement that’s sprung up that’s helping our cause, and that’s this whole idea of opioid addiction. Well, all of a sudden this has become a big thing, and the reason it’s a big thing is because MDs are prescribing opioid drugs, people are becoming addicted, then the MD takes them off the prescription, and now they have to go seek the same high with heroine. Now, you take a perfectly normal human being that had a job, had a family, had a life, and all of a sudden they become a street drug addict, and then they die. This is a serious problem. Why would we want to be involved in that?
See, now the chiropractic profession at the highest levels of leadership are all starting to get together and understand that this would be a disaster for chiropractors to even think about getting involved in any kind of prescriptive rights, especially if they involve opioid drugs. Let’s be smart. Let’s present ourselves as the solution to that problem and not simply buy in, sell our souls for a buck, so we can hand out drugs like Halloween candy, like the MDs do. It’s insane.
Jason Deitch: I’m hearing you say, on a lot of levels, just one, we’re not filling a need that’s not already being filled.
Tom Klapp: Exactly.
Jason Deitch: That’s a perfectly great argument. Two, drugs are dangerous. They have risks, and why would we want to increase any risk of somebody’s life and so on. What you cite is not the exception, it is become the rule. It is a problem epidemic that everybody agrees with at the highest levels. What do you see as the solution, Tom? There are some that say let’s, sort of, split the profession into two: those that want, those that don’t. Sort of create them into two professions or tier the profession, I think is the term that’s been used. That doesn’t seem to be a solution because that then, I guess, implies all these regulations that most of the profession doesn’t want to, and may have issues having to, address later on in their careers. There may be new testing for doctors that have been around for decades that all of a sudden are going to have to go back to school to perhaps take new tests and so on.
All of those things are possible, but what is the solution? For those ardent chiropractors that do feel duped, that do feel “Hey listen, maybe they did go to a school where that was part of the agenda from the get-go,” and as far as they’re concerned, they’re saying, “Wait a minute. The deal that they signed up for was that we were going to do what we can to serve patients, and in some cases some of the times, this is a good thing.” What do you tell those doctors? What’s their solution?
Tom Klapp: That’s a great question. There are any number of professions out there for which a chiropractor is eminently qualified: nursing, physicians assisting. Go back to DO school, I bet they’d take a lot off your credits. If you want to prescribe, I’m in favor of you prescribing, but I’m not in favor of you prescribing with your DC license. I’d like to quote the late Nancy Reagan, “Just say no.” That’s what this profession … We just need to finalize the decision and make a decision once and for all, it’s too dangerous, it’s too divisive, its consequences are too long-lasting for us to consider doing this, and that all of us will be so much better off using our efforts and our resources to getting more patients, and getting access to more patients, as opposed to getting access to prescription rights.
Jason Deitch: Absolutely. There is a pathway for those that really want it, really believe in it, really in their gut, assuming there are some out there that actually think this is a great solution, for those individuals, they absolutely can get the appropriate degrees to have the ability to do what it is they want to do. The real issue is don’t change the drug-less profession for your individual preference. Get the degrees from those professions that have those rights as it is. That’s what I’m hearing you say, and that’s totally rational.
Tom Klapp: That’s right. There are drug-dealing professions all over the place.Jason Deitch: All right.Tom Klapp: Leave mine alone.
Jason Deitch: Let’s wrap things up. Let’s conclude in just a few moments. My closing comments, from what I’m hearing you say, Tom, is you’ve got to take a stand, and what that means is just sitting back and hoping a few leaders are going to handle this without supporting them, whether it’s financially, whether it’s showing up at events, participating in movements, organizations, new coalitions, and so on, shouldn’t be an option. That there is a very real and imminent threat, that this could go through because they’re vocal, they’re active, they raise money, who knows what other sources of money they’re getting, but they’re active and the drug-free movement tends not to be so active for a variety of reasons.
So what I’m hearing you say is it’s time to, basically, take a stand; make your opinion heard; support those groups, organizations, and schools; send students to those schools that are very clearly saying we stand for drug-free chiropractic; support those associations, state associations, coalitions that will protect your rights to stay drug-free, and to … I love what you said in terms of what you do in your practice to, in fact, enhance those that think that having this as an option, or that they’re lesser qualified doctors because they can’t, really need to shift that perspective to realize that … As you’ve told me, time and time again, one of the things your patients appreciate most is that you’re actually a doctor who’s looking out for their long-term interests, and almost as an advocate can say, “Go back to the guy who prescribed you the drugs and just ask for only the ones that are life-saving and really required.” That sounds like a phenomenal service that doesn’t happen within the medical profession, for the most part, as a system.
Let’s close this up with some final thoughts. Please get involved. I’ll just say join us at LIFE Vision Seminars. This is a movement of people just like us who are looking to focus on our unique advantages and bring them to the world as a new force, a new movement, a new group. Send your students to Life University, where it’s very clear that this is a school that stands for, promotes, not just for its own state or for its own protection, but for the entire profession, stands up for the rights to stay drug free. OneChiropractic.org is something to look into. It’s going to spread wildly, I think, once people are aware of what exactly it is and the potential it has. Our future’s only as good as your engagement, as our profession’s engagement. Tom, what am I missing? What other closing comments do you have?
Tom Klapp: Well, if we sit back and do nothing, if all of us who just assume that chiropractic is and always has been and always will be drug free, and if we sit back and just allow these people to do what they do … And here’s what they do, they very quietly, behind the scenes, do a lot of work. They lay a lot of political groundwork, they acquire political capital, and then they start to quietly move behind the scenes. I would even characterize it as they do it secretly because when people really understand what’s going on behind the scenes, by the time they find out, it’s too late. It’s a done deal. So don’t assume that it’s always going to be the way it’s been. Okay? Don’t get me wrong. We can improve our profession, but putting drugs and prescription rights in our profession is the exact wrong way to do that. In fact, ultimately, that would kill our profession.So be on the lookout. Be vigilant. Keep your eyes open for signs that this movement is gaining traction. Again, support those who support drug-free subluxation-centered chiropractic.
Jason Deitch: And withdraw your support for those that you think might threaten that.
Tom Klapp: Absolutely.
Jason Deitch: Tom, I appreciate your time. We’ll get back to work on all the things that we love, but thanks for joining me here today and really sharing your passion and your expertise with everyone today.
Tom Klapp: Thanks.