Welcome to the blog

Before I say anything else, I want to express my appreciation to the two individuals who unknowingly prompted me to begin this blog.  The first individual is Daniel Bronstein, current intern at the World Health Organization and soon-to-be Doctor of Chiropractic, who has already created a blog to share his experiences forging the way for the profession into the global public health arena.  The other individual is Dr M. Navarro of Minnesota, a private practice clinician for whom I have a great deal of respect.   In speaking to Dan about his blog, Dr Navarro asked if I had one, too, thus allowing more individuals to learn about the experiences I have had and the opportunities which exist within WHO.

When I heard about this, I realized that this was a lapse on my part.  I have spent my time here sharing my experiences with a fairly select group of individuals who have expressed interest in being “in the know”, but direct e-mail is far too inefficient for mass communication, even when supplemented with a number of personal phone calls as necessary.    Thus, I have taken the plunge and joined in.  I will attempt to keep up with things as they happen, while also providing some historical perspective, as time permits

As long as I am here, I may as well begin!

I was initially accepted into the WHO Internship Program last year while attending Northwestern Health Sciences University in Bloomington, Minnesota.  Approximately 12 weeks after submitting my application, I heard back that I had been accepted.  Fifteen weeks later, I left for Geneva, Switzerland, making me the first ever Doctor of Chiropractic Student to be accepted to the World Health Organization in their entire 60 year history.  It was amazing, and something which would not have been possible without the support of many organizations and individuals.

The internship learning curve was steep, and I am exceedingly grateful to my prior education which provided me with a strong foundation in both basic and clinical sciences on which I could build.  I learned an exceptional amount in a very short time, and was able to integrate into the Organization as well as learning the fundamentals required to operate within a world of “WHO speak”.

In an interview I gave just before leaving for Geneva in early 2008, I was asked what my primary objective was for my time at WHO as related to the chiropractic profession.  Forced to only choose one, I said “If I can make it so that when I am done, they say ‘Wow, if all chiropractors are like Molly Meri, we need to bring more of them over,’ then I’ll be satisfied.”

Well, I don’t know if I can comment on that, but I have been very fortunate, and following my internship in Traditional Medicine and graduation as a Doctor of Chiropractic, I was invited to return on a one-year contract as a Technical Officer in the same area.  I began back here at the start of the year, but this is a marathon compared to last year’s sprint.  Additionally, there have been other Doctor of Chiropractic Students who have correctly and successfully negotiated the rigorous Internship Program application process and also come to WHO.  Earlier this year, Dr Jennifer Nash, of the Canadian Memorial Chiropractic College, spent three months in Geneva.  As previously mentioned, future Dr Daniel Bronstein, of Southern California University of Health Sciences, joined WHO at the start of last week.   As a graduated doctor and WHO staff member, I have done what I can to assist these new interns with the necessary preparations and the complex internship period, as one of the hardest things I had dealt with was having no guidance within the Organization.

If forced again to choose one primary objective, I would have to say my goal this year is to help bring a genuine public health perspective to chiropractic, and to bring chiropractic into public health.

This is more complicated then it initially may appear. 

First, even the colleges and universities with the strongest academic programs are aware that the vast majority of graduates will be practicing clinicians, and therefore the curricula are designed to support this objective.  Public Health is included in the coursework to varying degrees, of course, but I do not believe that all students, everywhere in the world are truly qualified upon graduation to integrate public health concepts into the treatment of their patients and to support the advancement of public health objectives.  Many Doctors of Chiropractic focus on the individual patients, as well they should, but sometimes may fail to consider community health at the population level.

Second, chiropractic students do not always learn to work together with other health care professionals, whether within the realm of TM/CAM or without.  The fundamentals of this involve finding and focusing on common ground, and speaking a common language.  We are not exactly like any other health care provider, but neither are we all exactly like each other.  All of us, however, have the best interests of the patients at heart.  Let us respect our individualities but still focus on the points of convergence in our efforts to work together for the benefit of the patients we serve. Let us also not let historical or traditional language prevent us from moving forward.  To put it into perspective, I do not wander around Geneva demanding that everyone understand my English.  I may not speak French well, but in an attempt to get along, I am learning, and I make the effort.  We have a common meaning; let us work in common terminology.  After all, anyone can talk a good game, but it is through our actions that we will be defined.

The road we must follow is simple enough to explain, even if difficult to navigate, and it centers on the three pillars of safety, efficacy, and quality.  These concepts are absolutely necessary in any health care system, and although equally important, they must be addressed in order.

First, we must be able to prove that the practice of chiropractic is safe.  This seems like an obvious statement to those of us who have had a considerable amount of experience and training in the field, but anecdotal evidence and clinical experience, no matter how voluminous, is not sufficient.  We must prove this to a commonly accepted standard, as it does not matter if we are effective if we cannot legitimately and accurately judge the risks and the benefits.  The fortunate thing is that much of this evidence already exists, we need only to start to collect it, organize it, identify what we have and where the holes may be, and format the findings.

After we handle the issue of safety, we can begin on the issue of effectiveness, and lastly, issues of quality control in training, interventions, etc.

This is not a quick project, and it is not something any one of us can do alone.  It is a feasible project, however, and a necessary one.

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