Dynamic Chiropractic – March 13, 1992, Vol. 10, Issue 06

The Mercy Center and You

By Richard A. Flaherty, President/CEO, Leander Health Technologies Corporation
The sun was shining as I stepped outside the terminal at San Francisco International Airport. I was told to wait outside the baggage claim area: a passenger van would be commuting participants of the Mercy Center Conference to Burlingame throughout the day.
As I stood waiting on this warm, beautiful Saturday afternoon, I couldn't help but feel that I was about to witness a very special occurrence in the history of chiropractic.

Within several minutes a young man approached carrying a "Mercy Center" sign and asked politely, "Are you with the conference?" I replied "Yes," and he indicated to follow him. We walked to a waiting seven-passenger van and were greeted by a young lady from Life Chiropractic College-West who was to shuttle us to the Mercy Center. We picked up several more participants and made our way out of the airport and on to Burlingame.

The Mercy Center is a 40-acre Catholic convent and retreat located just minutes from the airport. It is surrounded by a chain-link fence topped with barbed wire. As we passed through the gate I wondered aloud to the other passengers, "What's Petersen got us into now?" Everyone laughed. I continued, "If there is ever to be a miracle, where 35 chiropractors could come together in one place and have a consensus view on so many issues, this is surely the place for it to happen." I thought to myself -- the heavens will surely be rumbling for the next five days.

Our sleeping quarters were sparse at best. An 8' x 10' room with a single bed, small wash basin, medicine cabinet with mirrored sliding doors, 2' wide closet, and a small wooden desk, chair, and rocker. Above the head of the bed was a small night lamp, and hanging next to the bed was a religious picture. One couldn't but wonder if within this divine province something great was about to happen.

As I left my "dorm" room and headed down the hall toward the elevator I stopped to check out the community shower/bathroom. As I stood inside and viewed the enclosed showers and toilets I thought to myself, "Everyone here is being placed on the same level -- some of the legends of chiropractic, some of the very best minds in the profession, and many, until now, unknown practitioners will be living, eating, sleeping, and showering within the confines of several thousand square feet on four floors of this convent." "Wow," I thought further, "If there are fireworks between any of the commission members, this place could get a little too cozy." I quickly exited the shower/bathroom and headed for the elevator; I definitely needed a breath of fresh air.

As I made my way down the hall to the chapel area where the exit was, I saw many faces I recognized from articles I had read, and others I've known from my seven years in the profession. Everyone was joking and laughing freely about the "posh resort."

After exchanging pleasantries with those I knew and meeting several others, I continued on my way to view the spacious surroundings of the Mercy Center. Scattered throughout the grounds are towering pines and 500-year-old oak trees. A stream borders several acres of the property in an almost forest-like setting. Paths wind along the stream and through the forest of trees. The serenity and peacefulness would prove to be a definite asset in the difficult days to follow.

At 6 p.m., Saturday, January 15, 1992, the Mercy Center Conference officially began with dinner in the basement cafeteria of the convent. The three buffet style meals daily (bus your own dishes) took me back almost 20 years to my high school and college days. The highlight of this scenario was the ability for 10-12 different individuals to sit together at a different table each meal and discuss the myriad of issues that would be presented over the next four days. The camaraderie that developed during these daily get-togethers, I'm sure, will be talked about for years to come.

The wake-up call, courtesy of Don Petersen's key rap on your door, was at 5:30 a.m. each day. (Frankly, I'm not sure Don ever slept a wink the entire five days -- except one, now that I think of it -- but we'll save that story for another time.) By Wednesday, January 29th, at 2:00 p.m., the commission had reached a consensus on nearly every issue and National Practice Guidelines were finally established for the chiropractic profession.

These new practice guidelines will have a major impact on your practice. In the days, weeks, and months ahead, virtually every chiropractic newspaper, magazine, and scientific or refereed journal will have the opportunity to publish excerpts, reprints of whole chapters, and summaries debating the major decision regarding this historic document.

An independent Advisory Board of nine members was elected just prior to the closing and dissolving of the commission. This board will be asked to manage those funds remaining from the Mercy Center Commission and any funds that may be derived from the distribution of the final bound document.

This Advisory Board will also be responsible for assisting any future commission to review, upgrade, and make appropriate changes in the practice guidelines as established by this historic first meeting at the Mercy Center.

Dr. Herve Guillain spoke at the Mercy Conference. He oversees various panels for the Agency for Health Care Policy and Research within the Department of Health and Human Services. His address began: "I'm here to tell you what you are here for!"

Dr. Guillain pointed out that the foundation for practice guidelines must be on science, explicit yet flexible, developed by practitioners, and subject to revision. I can tell you candidly and firsthand that each of these requirements were met.

The often passionate discussion that led to unbiased and cooperative participation and compromise from all 35 members of the commission reflected the mood for definitive change to bring about accepted guidelines for practice within the chiropractic profession.

The commission members attacked its important mission with unparalleled zeal. The adrenaline level was at its peak. The air was filled with tension; emotions were running high. The give-and-take between the general practitioner, academician, scientist, and researcher will have far-reaching influence for years to come.

Prior to the opening of the Mercy Center event, many had drawn "lines in the sand." I can't describe to you in words the incredible cooperation, compromise, diplomacy, and professionalism that was displayed by each and every member of the commission to effect a consensus viewpoint on the practice guidelines for the good of all practitioners within the profession.

As Paul Shekelle, M.D., MPH, the primary investigator of the RAND project studying the effectiveness of chiropractic said, "The payer (insurance companies as you know them) will be looking over the shoulder of the health care provider -- no marginal care without procedures, guidelines, research, and scientific studies."

In other words, doctors, chiropractic must have a consensus so that a "standard" in clinical approaches is reached. No guidelines, no reimbursement.

The commission for the establishment of Guidelines for Chiropractic Quality Assurance and Standards of Practice, as it is known, did establish these much needed guidelines. The consensus document will at last afford the opportunity to bring chiropractic to the forefront of health care providers.

I want each and every reader to know just how lucky you are to have been represented by the 35 members of the commission. They represented the profession with candor and immediacy of purpose. Their accomplishment will herald in a new era of growth, acceptance, and cooperation with the legal profession and insurance industry.

I am honored to have been chosen as an observer and to have participated in and contributed to this historic event. The vision of Donald M. Petersen Jr., the commission secretary; David Chapman-Smith, commission counsel; and Dr. Scott Haldeman, commission chairman, deserve profession-wide as well as international recognition for their efforts.

The 35 members of the commission would surely concur with my closing remarks: "It took courage, understanding, and an unwavering commitment to the chiropractic profession for each of the members to prevail in their individual beliefs, yet so often as it was, to step back, listen to another opinion, and yield to another point of view, without compromising ethics, morals, standards or beliefs, and settling on the establishment of guidelines that all within the profession could live with. In the end, it was their love for the profession and a personal caring and love for each other that prevailed.

I wish I could answer the many questions you will surely have; however, I am not a practitioner. I cannot do justice to the many writings within the 14 chapters that make up the final document. However, I can tell you that my love for your profession has grown over the past seven years of involvement, and that is why I bring this final message, as the 35 members did so eloquently for four straight days, and in most cases 20 hours each day, they gave it a chance. You too, need to give it a chance, to review this historic undertaking and to speak forcefully and persuasively in your conviction of your profession.

This was a powerful achievement and a moving experience. Now every practitioner can be part of the commission's success. Congratulations to those dedicated few who gave of their valuable time. You are all true leaders of your profession.

Richard A. Flaherty
Leander Health Technologies Corporation


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