No Sue - Sickness in Finland
By Dr Heli Kivimaa

“Speaking of overheads… What are chiropractors’ Professional Indemnity Insurance premiums like?” I asked Drs Krista and Jaakko Valli. “This year… 25 euro, I seem to remember…” was the almost absent-minded response. 40 dollars!

Visiting Finland, my country of birth, after more than a decade was a fantastic array of quaint old-fashioned values – chiropractic included – and the most amazing air of space-age acceleration where everyone is wired – thanks to Nokia, no doubt. Bizarre.

The country is tucked away in the far north of Europe, the language prohibitively difficult to learn and culturally… well, ‘unique’ will suffice. For chiropractic to have gained a foothold in this proud land at all is a miracle.

The first Finnish chiropractor graduated from Pacific (today ‘Western States’) Chiropractic College in the U.S. in 1927. A core group of five American-trained chiropractors – one of whom was my original mentor, and mum to Jaakko Valli, Dr Ragna Valli – founded the Finnish Chiropractors’ Association in November 1977. Since 1979, the vast majority of graduates have come from AECC.

The membership of the FCA now stands at 42. There are 50 trained chiropractors in Finland; this covers about 2/3 of a country the size of Victoria. The northern parts of Finland have no chiropractic services whatsoever. Many practitioners travel hundreds of kilometres between practices each week in order to provide at least some rudimentary coverage.

The need for chiropractors in Finland is extreme. My introduction to the state of affairs was graphic… I’d got as far as an outstretched hand and my Christian name when the President of the FCA, Dr Tuomo Ahola, queried if I’d be available to stay in Finland and work. I feared chiro-napping!

The difficulty, of course, is that there is no chiropractic education available in Finland – the closest is Bournemouth, U.K. Expensive, and a long way from home. As for imports – the language is devilish!

The need for chiropractic services is such that hundreds (an estimate only – no one really knows how many) of back-yarders are operating all over the country. I had stepped back in time!

In 1994 a law was passed to protect “trained chiropractors”. However, anyone can still call himself or herself a “chiropractor”. Confused? I’m sure the general public is. The FCA certainly have their work cut out for them for years to come.

In the main, the Finnish populace appears to maintain a blind faith in the medical establishment; “alternatives” have always been around but are more part of folklore than mainstream. This country of firm traditions is unlikely to change its values even as the world changes around it. Chiropractic in some ways is in a position not unlike that in Australia in the 70’s and 80’s.

On the flip side, the medical profession appears surprisingly willing to cooperate with chiropractors – a cynic would probably conclude that in the greater scheme of things, 50 practitioners don’t pose a threat. True enough. But having spoken with many mainstream medical professionals, including close personal friends I’m getting the feeling that there is a lot of respect and admiration for our level of training, and especially for the results we get, quickly and with such minimal invasiveness. The “trained chiropractor” in Finland is no longer a “quack” in the eyes of the medical profession.

Other ‘nuts and bolts’…

Chiropractors do not have legal access to radiology services, nor can they provide them – however, GPs tend to be very obliging with their referral pads and there does not appear to be a problem in this area.

Continuing education is not compulsory but certainly considered a practitioner’s duty. Chiropractors travel abroad a great deal to maintain standards.

Fees: anywhere from 80 to 120 dollars for a standard visit.

Ah yes, insurance. That certainly was a breath of fresh air. Whoever you speak with… chiros, medical people, the average Tom, Rick or Sally… “Anyone can make a mistake.” “They don’t set out to hurt you.” “Courts are for criminals, not someone who tries to help you.” Professional groups have trust funds for the unlikely event that attitudes change. Music to one’s ears.

Great eye-opener, but it’s good to be home.

In Memoriam
During the time I spent in Finland, Dr Risto Auvinen, one of the great pioneers of Finnish Chiropractic, and someone that I had had the privilege to spend many wonderful professional moments with, passed away. Too soon, at the age of 50, after a battle with cancer. I took it upon myself to pass condolences to his young family on behalf of Australian chiropractors. He was a great loss to us all.