The case of the APCDF
In Asia, the chiropractic profession is in its early stages of development since it began in America 120 years ago in 1895. Today there are about 100,000 Doctors of Chiropractic (DC) throughout the world where in some regions there are barely a handful in practice while in other regions the development of the profession allows each community in their country to access one DC for every 5,000 inhabitants; in stark contrast to the ratio of 1:4,000,000 in the Philippines.
Similarly, the formation of professional associations in each country has its own personal story of survival, struggles and eventually greater success in serving the needs of their communities and individual professionals.
In Europe, as in Asia, when each country has fewer than 100 DCs, the task of formalizing the profession within their country was daunting, so out of necessity the European Chiropractic Union (ECU) emerged and demonstrated the valuable role of collective regional representation.
In those days there was no World Federation of Chiropractors (WFC) so the ECU case was not difficult to accept. The next regional group to form in the shadow of the ECU was the Eastern Mediterranean Chiropractic Association which later expanded to include nearly all Arabic-speaking countries, renamed the Eastern Mediterranean and Middle East Chiropractic Federation. Latin America and Southeast Asia were next, but only the Latin American Federation of Chiropractic (FLAQ) was successful, mainly due to their common culture and languages, Spanish and English. In Asia, the only common language is English, a second language for most, but more significant are the great cultural differences that make success difficult. The Southeast Asia Association collapsed in the late 1990s and was reorganized, restructured encompassing the entire region to include “down” and the Pacific islands, called Asian Pacific Physician Chiropractic Federation (APCDF). The last Federation that was formed in 2013 is for Africa.
As in Europe and Latin America, the perseverance for the development of the APCDF generally falls to a small group of people who remain stable for decades in their active and support roles within their country and, to a lesser extent, in support of APCDF. Many of them are worth mentioning here:
Dennis Richards, DCAustralia | Laurence Tassel, DC Australia
Patrick Montserrat, DC Bali | Henry Chan, D.C. Hong Kong
Bruce Vaughn, MSCh Hong Kong | Amit Nanda, D.C. India
Tony Dawson, D.C. Indonesia | Kei Takeyachi, D.C. Japan
Graham Hunt, MSCh Malaysia | Thomas Ong, D.C. Malaysia
Martin Camara, DC Philippines | Michel Tetrault, DC Philippines
Janet Sosna, DC Singapore | Terrence Yap, D.C. Singapore
Taeg Su Choi, DC South Korea | David Chen, D.C. Taiwan
(Apologies for missing a few we may have missed)
Since the formation of the WFC, now 25 years old, holding the international position of representing its members, the National Chiropractic Associations (CNAs) of the world, there is a small splinter group of DCs in Asia who feel that the WFC is enough to meet their support needs and that the APCDF is redundant. As an active associate member of the WFC for over 15 years, it is clear that the WFC’s mandate and capacity to assist CNAs locally in Asia is extremely limited in both financial and manpower support.
The international role of the WFC is undeniably important, but in most situations it cannot be very effective on critical local issues. Its policy of “national self-governance” has resulted in dedicating available resources to focus on Education, Research and representation in the World Health Organization (WHO), areas of true international impact.
The countries with more than 50 years of professional development in the APCDF region are Australia and New Zealand, with the largest number of chiropractic schools and development centers and sharing similar cultures and languages with other advanced countries in the world. Asia and the Pacific Islands cannot claim much progress with most countries having fewer than 100 chiropractors. Survival is the most accurate description of your CNA if it exists and each country faces similarly limited human and financial resources that severely limit your professional development within its borders.
At the same time, the APCDF is also in its infancy, so it relies on a few key people who volunteer their time and finances to help build the organization to be more effective in supporting CNAs in their region. of the Federation. It is still useful to look at the ECU model to guide the organizational development of the APCDF. A small but significant contributing factor in ECU’s advancement came from personal wealth and time given away by only a few dedicated people of social standing; and thus, today, the ECU can boast an annual budget of more than one million euros that allows significant support to its member associations.
The APCDF will be well served by fostering the commitment of its own grantees to the development of chiropractic in the Asia Pacific region. If your heart and personal integrity are drawn to being one of these few dedicated followers, you can follow that interest and go to their website to introduce yourself.
There are unique problems that exist in the Asia Pacific region that WFC cannot solve, beyond strategic support. It really falls to the leadership of each CNA to meet the challenges within their borders. Going it alone is frustrating, with little internal involvement from DCs in their own country who only focus on their practices, family, and economic survival. Gathering with like-minded colleagues through APCDF activities provides much-needed moral support, leadership training, and “out-of-the-box” insight into problem-solving capabilities that spring from a collective mind.
Over time, the APCDF Annual Assembly will reflect the successes of the ECU and the recent regional activities of EMMEF and FLAQ, not to be outdone. It cannot be stressed enough how challenging it will be for a region so rich in cultural diversity to function within a common organization and effectively meet common needs.
The state of chiropractic in the Asia Pacific region currently looks like this:
2 countries are fully developed with 1 DC per 5,000 population in Australia and 1 DC per 10,000 population in New Zealand. 3 other countries have over 100 DCs with their own CNA training and maintenance war stories; namely Hong Kong, Japan and Singapore. The three suffer internal dissidence and multiple associations or groups of interests or common ideals. Countries with less than 50 developing countries may or may not have a functioning CNA. These are India, Sri Lanka, South Korea, China, Taiwan, Thailand, Vietnam, and Malaysia; Philippines, Indonesia, Papa New Guinea, and a handful of Pacific islands such as Cook Island, Guam, Mariana Island, New Caledonia, Samoa, and Tahiti. The remaining countries have yet to attract a single known permanent chiropractor.
Perhaps if we were to take a reverse view to gain perspective… what would the Asia Pacific region look like in 50 years without the APCDF? That raises a lot of questions:
Will South Korea overcome its illegal status that allows chiropractors to avoid incarceration for choosing to practice their profession? Will Japan consolidate its many associations and overcome the complex conditions that prevail due to unqualified chiropractic courses? Will chiropractic schools meet CCE standards or will we see a plethora of hybrid schools like we see today in Indonesia, Japan and China? What will that look like with many schools screwing up chiropractic education and creating an underclass of chiropractors that creates a lot of public confusion and professional development issues in these affected countries that could spill over into neighboring countries, like the Japanese intrusion of fake chiropractors in the Philippines? ?
Will China and Vietnam allow free meetings with professional organizations? Will India finally interest its expat chiropractors to come back home and set up chiropractic schools to raise DCs in serious numbers? How long will it take for Hong Kong, Japan and Singapore to match the progress of Australia and New Zealand? Will the CNAs be run by good will and integrity or by the social class and vain interests of their leaders?
What challenges will be faced due to the strong presence of alternative traditional professions in Asia? Will CNAs continue to regulate their members or will they force local governments and medical societies to get involved in regulating DCs? What challenges will be experienced when organized medicine decides to view the profession as a competitor in Asia? Will there ever be CDs in the poorest countries?
ECU now has a fully institutionalized organization that can support the entry of former USSR countries into chiropractic, relying on the strength of its European member countries in progress. The WFC is equally institutionalized in Public Health, Education, Research and representation in the WHO. The Biennial Assembly offers countries some logistics and an exchange to bring their concerns and pleas for assistance within their borders.
The APCDF has a long way to go to be as effective as these regional organizations; however, the long-term needs of the Asia Pacific region will be met sooner and inter-regional harmonization of the profession will be achieved by providing the APCDF with the fullest support and broadest participation of its full and active CNA members. The idea that the chiropractic profession in the Asia Pacific region can get by without the leadership role of the APCDF sounds pretty absurd. What do you think?