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At Your Own Risk:
The Case Against Chiropractic

Chapter 4: The Supersalesmen
© 1969, Ralph Lee Smith

James W. Parker is one of the most successful chiropractors in the United States -- a shrewd, earthy man, a born storyteller, and a person of tireless energy. He has the revivalist preacher's gift for holding an audience for hours, permitting his voice to gain in speed and rise in Pitch and dramatic intensity, then suddenly lowering it to make a point, start another subject, or tell an unexpected deadpan joke.

Parker has the King Midas touch. The creator of a chain of eighteen thriving chiropractic clinics in Texas, he has grossed millions of dollars while spending over half a million on advertising and public relations. After making one fortune from treating ill persons he is making another from his fellow chiropractors. His project seems to be nothing less than turning the entire chiropractic Profession into an army of smooth-talking, wheeling-and dealing supersalesman.

Parker has set up an operation called the Parker School of Professional Success. This, in turn, is a division of another Parker creation, the Parker Chiropractic Research Foundation. The name of this latter organization appears on diplomas issued by the school.

Finally, there is a third organization, Share International, which uses the offices and personnel of the other two. Share International is the sales arm of the operation, providing chiropractors with materials for putting the Parker system into operation in their own practice. It issues a mail-order catalog, and also sets up shop and sells its wares during the three-day seminars in "practice building" that Parker holds six times a year, usually at the headquarters of the three enterprises in the Hotel Texas in Fort Worth. Six thousand chiropractors and their assistants have attended one or more of the seminars, and more flock to Fort Worth as each new one is head.

The fee for attending the three-day course is $250. I sent it in, calling myself "Dr. Lee Smith, Chiropractor." There are directories of licensed chiropractors, and I am not listed in them since I am not a chiropractor. But my registration was accepted without question.

When I checked in at the seminar registration desk in the Hotel Texas an attractive girl smiled and handed me a handsome split cowhide briefcase with "Dr. Lee Smith" stamped on the side in gold. Inside was a sample packet of materials available from Share International, and a 336-page multigraphed soft-cover book called Textbook of Office Procedure and Practice Building for the Chiropractic Profession. The seminar, I soon learned is built around this remarkable book.

Over 200 chiropractors and their assistants were in attendance when Parker, a man of medium height with black hair, a burr haircut, black horn-rimmed glasses, and a neat small mustache, wearing a badge that said simply "Dr. Jim," stepped to the rostrum to begin the first session at 1 P.m. "At these sessions," he said, "I intend to teach you all the gimmicks, gadgets, and gizmos that can be used to get new patients. . . . Thinking, feeling, acting determine the amount of money you will take to the bank. . . . Remember, enthusiasm is the yeast that raises the dough."

The afternoon and evening sessions were devoted to "Success Philosophy." It turned out that, when it comes to love, the hippies have nothing on Jim Parker. In order to succeed, the Textbook says, the chiropractor must "LLL: Lather Love Lavishly!!" "When you meet a new patient," Parker explained, "you can push a button. You can push the LLL button, the love button. It's like a fight bulb that you switch on. When you meet a new patient, LLL him in. When you do this, you disarm a patient who has developed sales resistance." However, like the hippies, Parker finds some people more lovable than others. An unlovable type from the chiropractor's point of view is a person with an acute illness. The course, says the Textbook, "is designed to make you a 'D.C.' -- 'Doctor of Chronics' rather than a Doctor of Acutes.' "You'll make a lot more money," Parker explained.

But what if the patient comes in with acute, rather than chronic, symptoms? The chiropractor's task, Parker said, is to try to discover that the symptoms are "an acute flareup of a chronic condition," and to convince the patient that this is so.

During this and succeeding sessions many subjects were covered, including: how to advertise for patients (chiropractors can buy mats for whole series of newspaper ads from Share International); how to get patients to refer other Patients; how to answer the questions of people who doubt the validity of chiropractic treatment (a dual technique is used-frightening people away from scientific medical treatment by alleging that its methods are "deadly," and claiming that such treatment, with all its dangers, deals only with "the symptoms" of disease while chiropractic attacks and eliminates the "true cause"); when to give presents to patients and their children and what to give; how to arrange the office suite ("Place Bible in reception room"); how to maintain a mailing list and what literature to send.

Perhaps the most important topic, however, was the basic Procedure for getting the patient into treatment. As the Textbook neatly summarized it: "From the time the telephone rings until the time you start the examination, you are working toward one goal: 'Mr. Jones, there is most definitely something wrong with your spine that could absolutely be causing almost all, if not every bit, of your trouble.'"

The Textbook kicks off the subject with a detailed discussion of telephone technique, including many sample conversations. "If possible," it says, "the assistant should handle calls since she can refuse requests for prices and can praise the doctor and chiropractic with an emphasis not possible for the doctor himself."

When the doctor does get on the line, his job is to get the prospect in. The bait on the hook is a "free consultation":

Q: "How much do you charge?"

A: "There is no charge . . . [pause] . . . for the consultation of the first visit. This is to determine the cause of your trouble and what should be done about it.' 'Tact and diplomacy are necessary," the Textbook notes. "Such sentences as the following OPEN THE TRAPDOOR:

" . . . I certainly understand what you mean when you say you spent so much money without getting results, we will try hard not to let that happen when you come here."

". . . Your (nice/cultured) voice tells me you are an intelligent (woman/man) and I am sure once you have made up your mind to try something you will follow through."

Actually, the Textbook explains, the patient will not learn "the cause of your trouble and what should be done about it in the free consultation. Its purpose is to get the caller into the doctor's office so he can make a complete selling pitch in person. "The consultation is without cost," says the book, "but the examination cost them money."

When the patient comes in, the chiropractors assistant first secures basic information including name and address. The doctor should "check the patients address for income status" (later on the doctor is also to "learn family occupation by developing interest in the family. This should be done subtly"). The patient is then ushered into the august presence, where the doctor deals with him in a thirteen-step procedure that leaves nothing to chance.

As the unsuspecting patient enters, the doctor pushes the love button and lathers him lavishly. While the lather flows the doctor seeks to establish common bond" through such links as "fraternal jewelry, children, similar religious affiliations."

"What would you like me to do for you?" he then asks. His moves now, according to the Textbook, are:

(1) Eye contact.
(2) Lean forward.
(3) Hands on desk, or one band on edge of desk and other at side.
(4) When patient begins to answer, you can lean back in chair and listen attentively with arms and legs uncrossed.

Now come the most important steps. First, the "Yet Disease." "If the patient has a pain in his left shoulder Dr. Parker said, "ask, "Has the pain started in your right shoulder yet?" "Use it when you must instill a sufficient amount of fear to get the patient to take chiropractic." The next step is to "dig for chronicity." The doctor puts an elaborate series of questions to the patient that suggest or imply that the condition is chronic. "How long has it been since you really felt good?" the doctor murmurs gently. ("I make $10,000 a year on that one, easy," a chiropractor sitting next to me whispered in my ear.)

With the verbal digging completed and chronicity unearthed, the chiropractor moves on to "Connect up affected parts (pain) with the area of treatment (spine)"that is, to tell the patient that his condition stems from spinal subluxations. Having done this, the chiropractor is then to "restate information (or acquire additional information) which may prove useful later on to explain limited results, or to excuse you from getting results expected." As a final step he releases some more lather to "establish LLL principle in patient's mind." At this point says the Textbook, "most patients are ready to proceed,"

With the fish on the line, the doctor is told to "lean back," make "eye contact," and reel him in with a speech that Parker calls "the assumptive close." It goes like this:

"Mr. Jones, at this point we can be sure of on thing-if you are not a chiropractic case, chiropractic will never help you. If you are a chiropractic case, nothing else will ever help you, so our first job is to determine whether or not you are a chiropractic case. We have had a number of similar cases in the past, and have found that the first thing to do is conduct a thorough (chiropractic) examination, including X-rays, laboratory tests, a physical examination, orthopedic and neurological tests, and whatever else might be indicated, depending upon what we find. If you are ready, we can begin your examination right now" OR "When would you like to start this examination?" OR "Come with me."

If the fish wriggles, the chiropractor plays him carefully. The Textbook provides answers the chiropractor can give to every imaginable patient objection or reservation.

If the patient is still balky, the chiropractor offers a preliminary examination." Beginning where the patient feels pain, he touches the afflicted parts, then says something like, "There doesn't seem to be anything wrong with the arm itself ... let's trace the nerves back to the spine and check there." When this has been done, Parker suggested that the chiropractor can say, "Oh here it is. Why didn't we look here first? I'm glad we found the trouble here, because this is my specialty. During the process, said Dr. Parker, the chiropractor can "ask leading questions" and "use little comments, innuendoes, such as "Hmm. I don't like that."

Now the chiropractor pulls out all the stops. "Build fear of more serious trouble, if necessary," the book says. ". . . Proceed to make a serious statement followed by a hopeful statement, which would cover the full scale of patient feeling and emotion, as follows: "Mrs. Brown, it's possible this could be the beginning of something serious. Let's see if chiropractic can help. It wouldn't make you mad if we stopped this pain/made a new back for you, would it?"

If Mrs. Brown still doesn't see what is good for her, she gets both barrels between the eyes. "Do you feel there could be a tumor or perhaps cancer causing these nerves to act up?" the chiropractor asks. Having raised such specters, the chiropractor sits back and lets Mrs. Brown's fears do the rest. "Put the problem of making these decisions on the patient's shoulders," the book says.

No human extremity is out of bounds for the sales pitch. "In terminal cases," the book states, "mention "a miracle of nature has often occurred."

While tightening the screws the chiropractor simultaneously keeps a sharp eye peeled for "the green light." Sooner or later, the book says, it comes.

The netted fish is then examined and X-rayed. In talking to the prospect on the phone before he comes in the assistant is told, "Do not say the doctor is taking X rays or is in the darkroom. This may suggest that the caller will need X rays." If the patient puts the question to the doctor himself on the phone, the Textbook suggests various answers:

Q: Do I have to be X-rayed?

A: No, not necessarily. That depends upon what I find necessary after the consultation, for which there is no charge. What seems to be your trouble?

We require X rays in cases that may be serious. What seems to be your trouble?

Actually, in the Parker system it's a rare customer who escapes without at least one panoramic dose of radiation from the shoulders down to the area of the genitalia. X rays, Dr. Parker said, should be given to "most patients that come into the office," and they should be the big 14-by-36 glamour photos, "if for no other reason than psychological."

"If people hesitate about chiropractic X rays," Dr, Parker told the seminar, "compare them to dental X rays, and say that the spine is much more important." If the patient's spine has already been X-rayed in the course of established medical treatment and found to have no defects, he may wonder why it needs to be done again. The never-failing Textbook provides the chiropractor with his answer:

Q: My medical doctor has taken X rays and says there is nothing wrong with my spine.

A: He was looking for dislocation, luxations, fractures, ruptured discs, etc. We look for misalignments, curvatures, subluxations, thin cartilage, rotated or unbalanced hips and other conditions, any of which may be causing pressure on nerves, pain, distortions or other bodily abnormalities.

The Textbook also provides a note in parentheses: "Less patient resistance will be found if you say, 'Let's take some pictures' rather than 'Let's take X rays.'" If the patient is actively worried about radiation he should be soothed: "If you were to have X rays taken once a month for an entire year, your life might be shortened as little as two days. Your overweight condition and your smoking are shortening your life hundreds of times more than could the small amount of radiation involved in the few pictures I need of your spine."

The word "little" in that first sentence should win any contest for the Sleeper of the Year.

When the examination is completed, the doctor is told to collect for it on the spot. "That will be $27.50 for today," he is told to say, "Will that be cash or check?" "Begin writing receipt," the book continues. "Don't look up. "

The Textbook covers the matter of the financial transaction with characteristic thoroughness. Every conceivable patient objection to immediate payment is foreseen and forestalled:

Q: I would give you a check but I don't have my checkbook with me.

A: I understand (smiling). Why don't you use one of our counter checks? Which bank do you use? (Complete the check and hand it to the patient for signature.)

Q: Just bill me.

A: I'm sorry, Mrs. Brown. It is customary to take care of X rays, and examination at the time they are made.

Q: I didn't bring that much with me.

A: I understand. You may make a partial payment and take care of the rest tomorrow. Could you pay, say, $15 today? $10? $5? How much can you pay today?

Q: That certainly seems high.

A: Yes, it does doesn't it? Things certainly are high these days. (Then make an analogy to the cost of your equipment, dental work, etc.)

To take care of cases in which the chiropractor has unwisely extended credit, he can purchase from Share International a handsome wall certificate stating that be is a member of the "State Credit Association," and a bookful of collection forms of graduated degrees of severity and threat, all bearing the heading "State Credit Association." No address for this credit association is given on either the wall certificate or the forms, and the forms all say "MAKE YOUR PAYMENTS DIRECTLY TO THE CREDITOR." It is, of course, the chiropractor himself who mails them out.

On the patient's next visit the chiropractor hands the patient a document entitled Confidential Report of Chiropractic Examination and Recommendations, which consists of six sheets and a blue cover. Chiropractors purchase them from Share International. "Our examination has now been completed," it says. ". . . in your particular case, we have found definite misalignments in your SPINE resulting in a disturbed nervous system. Therefore, you are a case for chiropractic."

The Report explains the chiropractic theory of disease, and adds that "... the nervous system is the master system which controls all other systems of the entire body, including the glandular, reproductive, digestive, eliminative, respiratory, and circulatory." "They couldn't possibly have a condition not covered here," Dr. Parker observed.

The Report sets forth the chiropractor's "analysis" of the patients illness ("analysis" was a word frequently used in the seminar; some states do not permit chiropractors to "diagnose illness), together with a recommended number of visits for adjustments, a price for the series, and an offer of a discount if the patient pays the full sum in advance.

The Textbook adds some comments intended for the chiropractor's eyes only. "You might suggest only as many adjustments as the patient can pay for," it says. ". . . One adjustment for each year of age of the average chronic patient over twenty years of age is a rough thumbnail guide of what people will willingly accept and pay for." However, the book observes, there is no reason for the chiropractor to he unduly modest in his expectations: "Chiropractors should keep in mind that many truck drivers, carpenters, electricians, steel workers, and radio repairmen earn more than $12,000 annually."

With the patient in treatment a new phase begins -- "Patient Management." The emphasis is on causing the patient to believe that he is getting better, and getting him to say so.

On the first visit, the chiropractor is instructed to say, "Your spine is certainly rigid, but that adjustment took well."

From then on, through the first ten visits, the doctor is to greet the patient with the words, "What's better?" followed by some appropriate comment. For instance, on the second adjustment, the Textbook says, "If patient states that nothing is better and restates his trouble, say, 'Yes, I know; that's on your patient record card, but the adjustment took so well yesterday some improvement should have been noticed. Think hard now ... isn't something better?' If patient tells of conditions that are better, say, 'Wonderful! Great! Good for you! I'm proud of you! I appreciate your getting well.'"

The recommended statements for adjustments three through ten are as follows:

Third adjustment: "What's better? Your eyes are brighter."

Fourth adjustment: "What's better? I hope you're feeling as good as you look."

Fifth adjustment: "What's better? You're getting a spring in your step."

Sixth adjustment: "What's better? You're getting in fightin' trim."

Seventh adjustment: "What's better? Your body and mind are getting more rest in each hour that you sleep than ever before."

Eighth adjustment: "What's better? Did you know you'll live longer as a result of these adjustments?"

Ninth adjustment: "What's better? Did you know you'll have fewer colds, sore throats, etc., as a result of these adjustments?"

Tenth adjustment: "What's better? Did you know you'll do better work during the time you are having these adjustments?"

As the treatment proceeds, the chiropractor moves on to the next step-he begins to pump the patient for names of possible prospects. "Repeat 'common bond' procedure," the book says, and subtly question patient about friends, neighbors, and relatives who may be in need of chiropractic." Names can even be gotten from patients who are not feeling improvement. "To get new names from non-responding patients," says the text, "say, 'if other illnesses in your family are worrying you, it will slow down your response. How is everyone in your family?'" Patients and others should be told to "Remind your friends that chiropractic is good for practically all diseases."

When the patient comes up with names, the chiropractor records them in a prospect list and goes after them. The procedure involves the mailing of special literature, personal letters (suggested wording supplied in the Textbook and even phone calls. If the prospect responds with interest he is offered a "free consultation and the cycle is repeated.

Throughout the procedure the chiropractor tries to wean the patient away from established medical treatment-permanently, if possible. "A true chiropractic patient," says the Textbook, " is one whose convictions with regard to health have been diverted from the muddy road of medicine to the superhighway of chiropractic by a series of correlated mental concepts, positively implanted in proper order."

As for the chiropractor, there is at least one concept of which he should never lose sight: the "Money Concept," It doesn't even hurt, the Textbook indicates, to let the world know that this concept interests you. "Carry $100 bill in billfold," it advises, and "write $$$$$ and big amounts."

After the three days of seminar sessions, members attended a farewell dinner. Dr. Parker gave each of us a handsome diploma from the Parker Chiropractic Research Foundation, stating that we had "completed the prescribed course of study at the Parker Chiropractic Research Seminar" (actually, no one was required to "complete" anything, since no attendance was taken at any of the sessions). Those wishing to do so could also join the Foundation for $10 a year and receive a second item -- an impressive black-and-silver membership plaque "similar to the plaque of the American Academy of Reconstructive Surgery (Plastic Surgeons), who are about the highest in prestige of any group of specialists anywhere."

I talked to many chiropractors during the three-day period. Their response to the seminar was overwhelmingly enthusiastic. Over half those in attendance wore blue badges showing that they had attended previous seminars and had come back for more. A chiropractor from Ohio told me that he had been attending the seminars since 1959; by applying Parker's methods he had built his practice from $25,000 to $100,000 a year. Another said that this was his eighteenth seminar. "After the first one my income went up from $2,000 to $4,000 a month," he said. He is also now near the $100,000 mark. A third didn't give figures but summarized his situation with graphic simplicity.

"We have gone," he said, "from rags to riches." While he learns to travel this upward path, his receptionist in his office back home -- if she is following the recommendations of the Textbook -- is telling patients and callers that "Dr. _______ is doing some graduate work in Fort Worth."

During intervals in the seminar sessions I browsed in the Share International display center in the room adjoining the seminar hall. Immense amounts of material were available and chiropractors were hauling it off by the shopping-basketful. One item was a small device called a "Thermeter," a meter with a needle, contained in a handheld circular metal housing from which two prongs protruded. It cost $79.95. Chiropractors who were standing around the display with me explained that the two prongs are applied to the spine, and the device is run up and down the backbone. Especially sharp deflections of the needle indicate the pattern of subluxations.

As we shall see in the next chapter, many chiropractors love gadgets.

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