The 'chiropocalypse' continues. Hot on the heels of the McTimoney Chiropractic Association's urgent request that members remove their websites and medical claims; the United Chiropractic Associated have issued their own urgent call to members as the fall-out from the British Chiropractic Associates increasingly disastrous libel action continues. It includes new advice issued by the BCA to its members. (Hat tip to the anonymous commenter who alerted me to this.)
I've included the statements from the UCA and BCA below, but several things stand out. Firstly, this is advice that the BCA should have been giving out all along; one wonders why it has taken a mass complaint to the authorities to get them to crack down on the false claims that are endemic in the profession.
Secondly, the statements provide an acknowledgement that the criticism of chiropractic by scientists and skeptics has been pretty much spot on, from the use of the 'doctor' title, to the claims of treating childhood illnesses, to the need for people presenting themselves as public health workers to practise evidence-based care. Some of the phrases really stand out: "do not use unfamiliar words for common conditions", and "do not unjustly criticise other healthcare professionals." The advice of the BCA reads like a handy guide to chiropractic quackery.
The UCA talk about "a concerted campaign to discredit the profession", but the simple fact is that the chiropractic profession has discredited itself, by demonstrating that it is institutionally corrupted by quackery, that the majority of those in the profession are guilty of making unsubstantiated claims, and that regulatory bodies have completely failed to maintain any sort of control over the situation.
There are doubtless some decent chiropractors out there, and by all accounts they are appalled by the mess that the regulatory bodies have created for them. There are several problems they need to address as a matter of urgency.
The first is that the only evidence-based treatment they use - spinal manipulation - is a standard medical technique used by other professions, who are able to perform it with substantially less risk. The second is that this nonsense about cracking joints "boosting" the immune system or fighting diseases needs to stop unless specific, reliable, substantial evidence can be found to back it up. The third is that the profession is plagued with quackery, from the clinics right up to the top of the regulatory bodies. Until these three problems are sorted out, the profession will continue to be one mass complaint away from crisis.
Anyway, here is the UCA Statement in full:
The UCA Office has become aware of the ongoing media coverage of the libel case involving the BCA and Simon Singh. As a result chiropractors are being targeted as part of a concerted campaign to discredit the profession, particularly in relation to the publicity materials they are using. The Investigating Committed of the GCC have a statutory responsibility to look into every complaint they receive. This is an attack on the profession which all chiropractors should be aware of.
There is also evidence that complaints are being made to Trading Standards authorities, and several chiropractors have received enquiries from them. Before responding to any communications you might receive, please contact the UCA office in the first instance for help and advice.
The BCA have issued the following statement to their members. The UCA fully supports this statement and recommends members to adhere to the points raised.
The UCA included the following BCA Statement:
The BCA would remind members of their obligations under the Advertising Standards Authority (ASA) section 50 (relating to Health & Beauty Products and Therapies: see
Members are strongly encouraged to review their current marketing materials (whether they are paper- or web-based to ensure that they are compliant with both ASA and GCC requirements. Note that the ASA has no jurisdiction over editorial materials placed on members own websites.
When reviewing your materials it may be helpful to consider the following:
1. Are there any claims made that cannot be justified by reference to evidence? Remember, the GCC requires chiropractors to practice evidence based care, which is defined as "clinical practice that incorporates the best available evidence from research, the preferences of the patient and the expertise of practitioners (which includes the individual chiropractor himself).
2. Be mindful of making promises that you cannot be sure of delivering on;
3. Be wary of listing conditions that are controversial and away from mainstream chiropractic care e.g. dyslexia/dyspraxia unless you have research to back this up. If you have made references to prolonged crying, sleep and feeding problems, breathing difficulties and frequent infections, as these are symptoms rather than condition specific, we suggest you remove these references.
4. Do not refer to yourself as a specialist in any particular form of chiropractic;
5. Do not use unfamiliar words for common conditions;
6. Do not unjustly criticise other healthcare professionals;
7. If you refer to subluxations, provide information to explain what they are.
8. Take care in the use of the Doctor title. Ensure that there is no way there can be any doubt that you are a chiropractor, and not a registered medical practitioner. Do not use the doctor title in paper advertising without explicitly stating that you are a chiropractor.
http://layscience.net/trackback/594
Hmmm, maybe I'm reading him wrong but I don't think Richard Lanigan (who also has an anti-vax site) is a supporter of the sceptics - it appears he's just using the sudden success of the campaign as another "I told you so".
When he says "...this will be the GCCs doing not Simon Singh or the sceptics." I'm not reading that as a statement supporting the campaign, except to the extent that it embarrasses the hierarchy.
But, I could be misreading him.
Well no, but then I haven't said he supports the campaign, just that he's pissed off about the BCA :)
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Amazing what a simple letter can do! However, it remains to be seen if the GCC do actually clean up their act and get the chiros in line.
A tiny storm in a teacup..sparked off by a non clinical layperson spouting uninformed garbage.........frankly who cares what Singh THINKS OTHER THAN his disciples drawn from FRUSTRATED BASEMENT BOUND SCREAMING SKULL ANORAK WEARING
WHINE MERCHANT BRIGADE....Gentlemen and lady, chiropractic doctors comprise of MD's,ex-vets,multiple Phd's,professors along with the other rank and file doctors of chiropractic et al.Can all these well trained professional be quacks, as the limp wristed great unwashed would have us believe......No, even the case judge who found Singh guilty of having a big mouth could see that he was a man with an unusual agenda...Oh I recall....yes,to make money.
Have a nice one.
Dr. Mike, what is this "uninformed garbage" of which you speak? No, that's not a rhetorical question; I'd really like to see if you can back up your accusation or whether you just have a "big mouth". Also, what is your doctorate in?
Hi Dr Mike,
May I ask what you're a doctor of?
You'all have a good weekend too y'hear?
I am not here to talk about me....I am here to enlighten the great unwashed about the inane ramblings of a court rejected outright chancer and his following of babbling quislings none of whom have the slightest idea what doctors of chiropractic do or do not do in the clinical domain.
Frankly,it matters not to the profession that the train spotter following,err uhmm "groupies" of Mr Singh wish to vent their spleens on pathetic unerworld blogg sites as the law of the land has found him guilty of big mouth'ism and like all who fall foul of the courts he will have to drop his trousers and take his punishment like a man.
His followers all ten of them...will simply have to console themselves with a period of mourning...do the ashes in the hair thing and then get over themselves....heck its something to regurgitate and hopefully enliven those meetings down at the train spotters club.....
Hope this helps.
Have a nice one.
Dr Mike,
You are wrong. My anorak has an Atari logo on it.
LOL..nice DT
Here is a rationl perspective..In defense of chiropractic
13 June 2009 by Richard Brown
Magazine issue 2712. Subscribe and get 4 free issues.
For similar stories, visit the Comment and Analysis Topic Guide
SINCE the British Chiropractic Association (BCA) decided to sue science writer Simon Singh for libel, scientists and journalists have unleashed a torrent of criticism against chiropractic. Much of this is misinformed and needs to be corrected.
Many critics - including Edzard Ernst (New Scientist, 30 May, p 22) - hark back to the origins of chiropractic. This has the clear intention of suggesting that modern chiropractors cling to the 19th century idea that spinal misalignments are responsible for the majority of diseases. While a tiny minority retain this view, most are aware that such claims have long since been debunked.
Claims that chiropractic is dangerous overlook two recent pieces of research. One found no causative association between chiropractic manipulation and stroke. The other concluded that the incidence of stroke after chiropractic was no greater than after a consultation with a general practitioner (Spine, vol 32, p 2375, and vol 33, p S176).
Our critics also make the mistake of equating chiropractic with spinal manipulation, especially with regard to treating non-spinal conditions such as asthma. This demonstrates a lack of understanding of the fact that chiropractors utilise a range of treatments, including postural advice, reassurance and exercise.
Ernst and others claim that chiropractic lacks evidence, pointing to a paucity of randomised controlled trials. This overlooks the fact that many accepted medical interventions have little or no research evidence to support them.
Finally, the case against Singh has been recast by his supporters as a freedom of speech issue. It is not. Libel law is about the proper censuring of individuals' ability to publish false and defamatory material that causes damage to reputation. To stifle scientific debate would clearly be wrong.
The case against Simon Singh has been recast as a freedom of speech issue. It is not
Each year tens of thousands of patients benefit from chiropractic. Its safety record is equal or superior to that of other regulated health professions and there have been no known deaths from chiropractic in the UK. Patient satisfaction is consistently high and we are committed to delivering ever enhanced standards of care.
Richard Brown is a chiropractor and vice-president of the BCA
I could say I told you so.....but that would be impolite.
Have an even nicer one.
Do you actually know what chiropractic is, Dr Mike?
Thank you Mr Neuro.............no, I just like to comment on matters I know nothing about.
To borrow a well known phrase..."you can not be serious"
However thank you for the effort.
Have a nice day.
Dr. Mike, was Simon Singh "spouting uninformed garbage", as you stated, when he said, "The British Chiropractic Association claims that their members can help treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying, even though there is not a jot of evidence."
If you believe he was, please back up your statement with evidence or at a minimum, a reasoned argument. Or is that too much to expect of you?
By the way, what kind of a person would call himself a doctor, then refuse two polite requests to reveal just what he is a doctor of? Are you ashamed of your degree?
Well, it's just that what with being an obviously intelligent man, having a doctorate as you do and knowing long words like "quisling", you couldn't possibly be defending chiro if you knew what it was.
I assumed you didn't speak English very well and had mistaken chiropractic for an actual medical speciality.
Another tip, "Ernst and others claim that chiropractic lacks evidence, pointing to a paucity of randomised controlled trials. This overlooks the fact that many accepted medical interventions have little or no research evidence to support them." is not a "rational perspective", it's a "completely fallacious argument".
Keep up with the English classes Dr Mike and you'll get there in the end!
Dr Mike, you quote some random magazine article:
"Ernst and others claim that chiropractic lacks evidence, pointing to a paucity of randomised controlled trials. This overlooks the fact that many accepted medical interventions have little or no research evidence to support them."
care to name a few of these "accepted medical interventions"...?
Look Anti-boy......I could hold your hand and lead you through a torrent of research showing mountains of questionable medical practices that are offered to the great unwashed on a daily basis, in the clinical domain.......Anti-Boy,why should I.You are capable of readinhg the research yourself...at very least read the conclusion section of the reseach documents or a mini summary...go fill your boots.
Ok...I am a nice guy here is a kick start...look up facet joint injections.........ok, don't like that then try
steroid joint infiltration......OK OK go for the big picture...how about failed back surgery....
Now Anti-boy...that will keep you busy for a month or two.
In the meantime.....lets not forget about the issue of the big mouth layperson Mr Singh.......he has received public
delivery of corporal punishment for what any reasonable observer would call journalistic stupidity...He can whine moan and obfuscate but .....bottom line is you talk about something you know nothing about and you criticise publically a noble profession especially one with virtually unlimited resources what are you going to get....Yes Anti-Boy.....a humiliating public defeat and a lesson in learning how to shut up.
Sorry Anti-boy,this is not what you are hoping to hear...but welcome to the real word.
So I guess my last word to you is...study the research and suck up the Singh humiliating defeat.
Have a nice one....chow.
Obvious troll is obvious.
Here is a little information nugget for Mr Andrew........
The average medical trainee receives (excluding radiologist interns)35 hours of radiology training...a doctor of chiropractic intern receives 300 plus hours of radiology training...now Andrew....who do you want to read your x-ray....Hmmmmm perplexing.
Yes Andrew,I hear you say darn,this is difficult to argue against. And the layperson journalist Mr Singh will not even know this fact as he shoots his mouth off in public making stupid utterances about areas of chiropractic which he knows nothing about. He has probably never even bothered to read the preponderance of research supporting chiropractic treatment in the viscero-somatic treatment domain.......yet he has the ordacity to criticise it.........That is the level of layperson chiropractic is squashing.
Frankly the whole stupid business of dealing with the whinings of laypeople err uhmm the rantings of the great unwashed in the UK is positively a big fat time waste.
Just as a wee side note...this issue is more important to the Singh clacks and luddites than it is to the local or international arms of the chiropractic profession....a mere diversion.
Sorry to say.........but true.
Have a very nice day.
When I recenty enquired of the Sainted Richard Lannigan:
You cunningly obliquely imply on your practice website that, say, infant colic, (amongst other implausible maladies) is on your list of indicated conditions.
Is this simply a hypocritical ruse to avoid legal scrutiny?
If not, why is it mentioned AT ALL???
He responded:
Which part of "There is no suggestion that spinal care can cure any of these conditions however for a variety of reasons we find improving spinal joint function does improve the quality of life of the vast majority of our clients. If you click the links there is plausable anecdotal evidence of people being helped". do you not understand?
If you look at the evidence there is more evidence to support chiropractic as an intervention for colic than anything else. Therfore that would be described as best evidence. Presumably you know who David Sackett is.
And then disabled my ability to respond!!!
In other words:
1) Don't answer any questions directly.
2) Respond by showing the fine print, (and include vast quantities of unconfirmable suspect anecdotal sewage), indicating that it WAS in fact a hypocritical ruse.
3) An outright lie about evidence.
4) More anecdotes, as though somehow impressed me.
5) An appeal to authority, combined with an implied insult against my erudition.
6) More anecdotes.
7) No evidence whatsoever.
8) More anecdotes.
9) No references to the 'evidence' that he claims abounds.
10) Made NO attempt to answer my actual questions.
11) Closed off my chance to respond!
It is my personal judgement that Lanigan wants his superstitious cake, and to eat it too.
And it is my judgment that he is as much a quacksalver as any "alternative to medicine" practitioner.
As a resource for honesty, I have written him off entirely, and ditch him squarely in the same garbage bin as the rest of the self-deluded bogosities.
You're hearing things.
I apologise for the troll comment, thugh, as you seem sincere, and not just trying to get a bite by peppering your comments with ill-aimed insults, as your first comment seemed to do.
Thank you Andrew...no I am not a troll. I am happy to engage meaningfully.
Somebody was asking for viscer-somatic type research.....would that sombody get working on these. Lets forget big mouth Singh
that all knowing layperson who can not be bothered to research the facts ...lets get down and dirty GO.
Sixteen Infants with Acid Reflux or Colic Undergoing Upper Cervical Chiropractic Care to Correct Vertebral Subluxation: A Retrospective Analysis of Outcome
J Pediatric, Maternal & Family Health - Chiropractic May 2009: 1–7
Comparison of the Short-term Effects of Chiropractic Spinal Manipulation and Occipito-sacral Decompression in the Treatment of Infant Colic: A Single-blinded, Randomised, Comparison Trial
Clinical Chiropractic 2008 (Sep); 11 (3): 122–129
Chiropractic Management of Infantile Colic Clinical Chiropractic 2004 (Dec); 7 (4): 180–186
Vertebral Subluxation Correlated with Somatic,Visceral and Immune Complaints: An Analysis of 650 Children Under Chiropractic Care
Journal of Vertebral Subluxation Research 2004 (Oct 1: 1–23
Differential Compliance Instrument in the Treatment of Infantile Colic: A Report of Two Cases J Manipulative Physiol Ther 2002; 25 (1) Jan: 58–62
Chiropractic Management of an Infant Experiencing Breastfeeding Difficulties and Colic: A Case Study
J Clinical Chiropractic Pediatrics 2000; 4 (1): 245-247
The Short-term Effect of Spinal Manipulation in the Treatment of Infantile Colic: A Randomized Controlled Clinical Trial with a Blinded Observer
J Manipulative Physiol Ther 1999; 22 ( Oct: 517–522
Chiropractic Care of Infantile Colic: A Case Study J Clinical Chiropractic Pediatrics 1999; 3 (1): 203-206
Infantile Colic Treated by Chiropractors: A Prospective Study of 316 Cases J Manipulative Physiol Ther 1989; 12 (4) Aug: 281–288
Have another nice one.
Further simple investigation of Saint Richard reveals that he has listed as his HOMEPAGE, a profoundly infant slaughter advocating site as
http://www.vaccination.co.uk/
Just look at this obscene FUCKING site!!
(With the date at the top right of: Sunday, June 14, 2009)
Let there be no doubt about its author:
This site is presented by Richard Lanigan DC. BSc Chiropractic. MSc Health Promotion and Public Health. Richard has four children and is in private practice with a special interest in paediatrics.
(Apart from the fact he now claims possession of a BSc., which I doubt arose from anywhere bar a box of cornflakes.)
HEALTHY AND NO VACCINATIONS: Molly and Isabelle's first Trip to Ireland in 2004 to visit their late great great aunt Daicy who was 94 at the time. There are four generations in this picture and none of them had been vaccinated against Measles, Mumps, Whooping Cough, Chicken pox, normal childhood illness when aunt Daicy was young "children were happy to have a week off school".
No one disputes that there can be complications from infectious diseases, the most likely reason being compromised immune systems due to poor social conditions. In fact in January 1959 during on of the worst measles epidemics on record; The British Medical Journal reported that "measles was the commonest infection in the world and that complications were extremely rare thanks to improved living conditions". Almost fifty years later despite continued improvement in living standards, parents are being told measles is a killer disease, because the government wants everybody vaccinated. In April 2006 it was reported that for the first time in fourteen years someone, a 13 year old boy had died from complications after contracting measles. Was it the measles that killed this boy or the fact he was a traveler, with a lung disease that required immunosupressive medication. The government wants me and other parents to vaccinate our children with the risks involved so this unfortunate child is protected by heard immunity? I believe the answer is in better social conditions, vaccination helps cover up health problems in the poorest part of our society where child poverty in the UK is one of the highest in the EU.
The fact is, it is cheaper to vaccinate than deal with the social conditions that predispose many children to complications from infectious diseases. Are vaccinated children healthier than unvaccinated? No one knows, and is anybody looking? In fact there is much scientific evidence that demonstrates a link between vaccination and autoimmune disorders (i.e. asthma , eczema), which are now considered the normal childhood illnesses. There is also much evidence that infection strengthens the immune system of children. I will share my experience on this website, of bringing up our children with the emphasis of optimising their immune systems with active lifestyles and good nutrition.
The little boys in the picture are Sean and Dan who were five and six, they are Molly Isabelle and Eloise's first cousins. None of these children has ever had medicine of any kind to treat illness including Calpol. They were all breast fed for twelve months. They eat mostly home cooked organic food, and get lots of fresh air and exercise.
The girls are in nursery in London the boys go to school in Dublin. In the coming years I will keep a journal about the childrens health and how they cope with illness, this may be useful to other parents trying to promote family health. All the children have contracted Chicken pox, Rubella, and most recently Whooping cough which was also contracted by Elosie when she was only two weeks old with no ill effects, beyond many sleepless nights for mommy and daddy.
This guy is not only somewhat careless with the truth to me, but is also a proud anti-vax KOOK!!!
That means that he is consciously placing both his offspring, and the community at grave risk of death and/or serious disability!
The guy is an admitted dangerous loon!
Don't take my word for it: Look at the website, before he takes it down.
(If this site proves to be a hangover from his previous lack of sanity, and he has since recovered, then why has it not been edited? Were it I, my complete efforts would have been exerted in removing traces of what I then knew to be outright lies, and unconscionable fraud)
First things first: What's up about this claimed BSc.?
As I am prevented from asking him directly, can someone else please enquire on my behalf?
It just gets worse and worse.**
If only Lanigan were to come clean he might avoid the predictable long-term consequences of avoiding reality.
He only need look at the BCA to realise what a PR disaster is brewing.
______________
** And worse and worse and worse.
Perhaps I should establish my own
"Reveal the truth about Richard Blarney Lanigan" blog?
It surely will not be this blog supplier, who cannot even display "blockquotes"...
Yes,no counter argument from me on that one,Michael.
Other than he is clearly a man who follows his personal belief system /convictions with astonishing vigour.Hmmmmm
Lets shift the focus away from silly mr singh and his unresearched vacuous utterances and focus on the real issues of quack/bogus medicine....here let me help
Hudson spinal surgeon faces scrutiny again with latest malpractice suit
By Lisa Buie, Times Staff Writer
In Print: Sunday, June 14, 2009
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Stage fright
HUDSON — A spinal surgeon who draws patients from around the world and who has been sued numerous times for malpractice is being sued again, this time by a Michigan woman who says he performed 13 surgeries on her in seven months and kept her at a private condominium for six weeks after a botched operation.
Like many other patients from out of state, Stacy Mahan, a 41-year-old registered nurse, found Dr. Alfred O. Bonati on the Internet, said Susan Ramsey, an attorney at the firm of Gary Roberts, the West Palm Beach attorney who filed the complaint in U.S. District Court in Tampa last month.
The 45-page lawsuit names Bonati, his practice and subsidiaries, three anesthesiologists, two nurse practitioners and two nurses, as well as Maxim Healthcare Services and its home health care division, along with 15 of its nurses. The case cites the federal Racketeering Influenced Corrupt Organizations Act, which entitles plaintiffs to triple damages if they receive a monetary verdict.
Bonati is the founder of the Bonati Institute, a practice that specializes in minimally invasive back surgery. Bonati's Web site says he uses patented tools and techniques for outpatient operations that require local anesthesia.
Ramsey declined to talk about specifics of the case, citing pending litigation, but she agreed to talk generally about what plaintiffs report happens at the Bonati Institute. She described their initial encounters as "a seduction."
"They have gone through more conventional treatments and still have pain. They're told, 'Dr. Bonati is God, and he will fix you.' If you're the person who's been through hell, this is exactly what you want to hear."
Bonati's lawyer said last week that she had not seen a copy of the complaint and could not comment on it. Maxim Health Resources did not return calls for comment.
Several surgeries
The lawsuit says Mahan was suffering from moderate lower spinal and back, hip, and left leg pain when she first visited the glass-walled Bonati Institute at 7315 Hudson Ave. on Nov. 6, 2006.
A nurse practitioner diagnosed her with lower spine pain, with symptoms of weakness and numbness. The nurse ordered X-rays and tests.
A series of surgeries followed. During the fourth operation on Dec. 18, 2006, the lawsuit alleges, Bonati "caused or produced" an injury to the covering of Mahan's spine, causing her spinal fluid to leak. A drain was put in place and removed the next day.
Two days later, Mahan called to report a large amount of light red drainage from her incision and developed "intractable pain."
After another surgery on Feb. 20, 2007, the lawsuit said, Mahan reported more drainage.
A leak in the covering of the spine was identified and immediately repaired.
By then, Mahan was in so much pain she needed a strong narcotic patch to control it, according to the complaint.
"The number of operations carried out on Mahan is in keeping with a pattern of practice including multiple operations on virtually each patient seen and treated at the Bonati Institute and Gulf Coast Orthopedic Center over many years," the lawsuit said.
"Regardless of whether or not such practice is or is not appropriate conduct and practice for a spine surgeon (even a 'minimally invasive one')," the lawsuit continues, "none of the operations done after 2/20/07 by Bonati could have been reasonably expected to address the problems both created by and identified by previous operations carried out by Bonati on Mahan."
The complaint accuses Bonati and his agents of negligently concluding and advising Mahan that she did not have an active spinal leak. The lawsuit also says Bonati and his staff never addressed the problem during later surgeries.
Starting April 5, 2007, the lawsuit alleges, Mahan was put in a private condo at 707 W Gulf Beach Island and Tennis Club in Hudson and received care from nurses employed by Maxim Health Services.
"Her severity of illness was far beyond the ability to care for her medically and/or surgically in a hotel/motel/condominium location," the lawsuit said.
It also questioned whether Bonati was operating what amounted to a health care facility in the condo, in violation of local and state laws.
The complaint accused Bonati, who does not have hospital admitting privileges, of "trying to hide his mistakes" by putting Mahan in the "off-site private, unsanitary condominium."
Pasco County Zoning Administrator Debra Zampetti said such use of a condo does not appear to violate any zoning laws.
"It would be the same as an elderly person who didn't want to move to an assisted living facility hiring nurses," she said.
In addition to the malpractice claims, the lawsuit also makes allegations about Bonati's background.
Among them:
• That he fraudulently entered the United States from Chile, failed the American Board of Orthopedic Surgery exam twice, then created his own board and certified himself;
• That to be accepted in Cook County Hospital's training program, he falsely represented in writing that he attended Catholic University in Rome, later admitting that the university was bogus; and that he later claimed to have attended the University of Naples in Italy, which in litigation he admitted was bogus and that he doesn't even know if it exists;
• That he falsified recommendation letters to get into medical school at Wake Forest University. The lawsuit says two doctors whom Bonati claimed to have drafted and signed the letters denied doing so in court depositions.
• That he was placed on academic probation at Wake Forest, and while there submitted false information to obtain medical licenses in North Carolina and Florida, which "he still holds by renewal."
Prior battles
Attorney Roberts and Bonati have a long history of court battles.
In 1996, Roberts won a $3.5 million judgment against Bonati, his fellow doctors and his Hudson medical practices.
A Hernando County woman told the jury that Bonati and his clinics performed unnecessary and risky surgeries in a scheme to collect insurance money.
The jury found against Bonati, but the doctor declared bankruptcy during the trial. The jury's $3.5 million verdict was later overtured by a U.S. magistrate who said it was "grossly excessive and without support in the evidence."
The Hernando woman's complaint and a number of other malpractice claims against Bonati ended in 2001. They shared in an $8 million court settlement that allowed Bonati and his practices to emerge from bankruptcy. The doctor admitted no liability and his disgruntled ex-patients dropped their complaints.
In the meantime, the Florida Board of Medicine investigated numerous complaints against Bonati. He reached a deal with the board in 2002 that let him continue to practice under the supervision of another surgeon.
That ended in 2005, and the Florida Department of Health said the doctor has fulfilled all his obligations to the state.
A check of any pending complaints shows Bonati's record is clear and his license is active.
Despite the lawsuits against the Hudson surgeon, the Bonati Institute for Advanced Arthroscopic Surgery's Web site is filled with testimonials praising his medical care.
Perhaps this is an area for the layperson err uhmmm scientist to vent their spleens....Oh' there is more lots more...but I will not burden you with detail.
Have yet another nice day.
Sorry about the additional local preamble...my bad.
Try for another nice day.
A note to Michael Kingsford Gray,
Reading Richard Lanigan's site, it is fair to say he does not fall into the sceptic camp; even if you have only read "more power to the skeptics elbow", his orientation should be fairly plain: To wit, he is a traditional, Straight, subluxation based chiropractor - although because of the way the law is written he cannot use that title because he has refused to maintain registration with the GCC. (Straight chiropractic is the belief that chiropractors don't treat or diagnose any medical disease, they find and remove "subluxations" and this is expected to help the bodies' own "innate intelligence" heal itself).
His problem, so far as I can gather, is that he accuses the GCC of having a hidden agenda of introducing a "medipractic" scope of practice by the back door. This is a derogotary term used by straights to describe a chiropractor who attempts to make a list of differential diagnoses of the patients' problem, use standard medical techniques to reacha working diagnosis, and use a broadly "biomedical" basis for determining appropriate treatment for the problem diagnosed, this type of chiropractor may self identify as "evidence based", "pain based" or "reform".
If you read the GCC code, straight, or "objective straight" practice would not strictly be possible, as the chiropractor must make a diagnosis and use an "evidence based" treatment plan to treat that disease. In that sense then he's right and this does leave any straight open to censure from the GCC, even though they are practicing what BJ Palmer would have recognised.
It is ironic then that his antagonism to the "reform" agenda of the GCC makes him an unlikely bedfellow with the skeptic movement, he would like the GCC bought down so that straights can practice as they see fit in peace without interference and skeptics are opposed to the attempts at mainstream respectibility of the "reform" chiros. I don't think this is without precident either, I seem to remember some of the posters on "chirotalk" discussing the role of straight organisations in America in bringing down the plans for a very "reform" oriented chiropractic school in Florida, it is quite possible that this type of allegience has kept chiropractic effectively ghettoised for most of its history.
His site is a very straightforward and honest one, being more a forum for his deeply held beliefs than a marketing tool, as he has put himself in the risky positon of being an unregistered practitioner for these beliefs, he is unlikely to remove it for this current escapade, and of course he is not under the authority of the GCC!
Incidentally, when he graduated from the AECC the 'BSc Chiropractic' was the primary qualification of a British chiropractor, it is the DC that is problematical; British chiropractors now hold either a 'BSc Chiropractic' or an 'MChiro', this is the reason Zeno has included the use of the title 'doctor' on his complaint to the GCC, the American 'Doctor of Chiropractc' is not awarded here.
Note, my last paragraph concerning the BSc was aimed at your question MKG, the rest got jumbled in the edit and are intended as a discussion of your points about this guy.
"The 'chiropocalypse' continues. Hot on the heels of the McTimoney Chiropractic Association's urgent request that members remove their websites and medical claims; the United Chiropractic Associated have issued their own urgent call to members as the fall-out from the British Chiropractic Associates increasingly disastrous libel action continues. It includes new advice issued by the BCA to its members. (Hat tip to the anonymous commenter who alerted me to this.)"
Thank you, kind sir!
With regard to the Doctorate of Chiropractic claimed by many chiropractors world wide, this appears to be a postgrduate post nominal 'awarded' by organisations such as the European Chiropracic Union for
1) managing to graduate from a ECCE 'accredited' college of chiropractic
http://www.cce-europe.com/docs/ecce_standards_version_2.pdf
and then 2) completing a post graduate training programme
It is NOT an award made by a University.
Some chiropractic colleges are excluded (Sweden, McTimoney).
And whats the point of your post Mr Dizzyblond...is it purely an information broadsheet.....or are you actually trying to suggest that doctors of chiropractic should by some method, have the professional doctorate withdrawn from them......
It may frustrate you to know that the chiropractic doctorate is protected by a government statutory instrument(go look it up)and is probably the only major primary health profession that does have that protection....from the great unwashed.
Now to follow on...lets go a bit further...as medicine has no legal right to the title doctor like chiropractic it is a professional doctorate...would you also like to remove that title from the medics...it would be certainly a lot easier to remove than the chiropractic doctor....
In summary...errr uhmmmm whats your point.
Use of the doctor title is, at best, a peripheral issue, although it is one of the criteria used in zeno's omnibus complaint to the GCC; since the GCC code allows the use of the title so long as it is clear that one is not a medical practitioner, and the complaints are in regard to chiropractic websites, I'm not sure there is any breach of the rules occuring there.
I am a little confused, however, by your last post Dr Mike; when you refer to professional doctorates are you referring to the American tradition, or to the honorary certificates handed out by professional organisations after one years practice? Also what statutory instrument are you referring to, so far as I know there is only the 1994 Chiropractors act?
Incidentally there is a professional doctorate awarded by the AECC in cpartnership with the university of Southampton (DChiro), this is a postgraduate degree based on further study of research methodology and is not a primary chiropractic qualification; that is either BSc or MChiro.
Professional doctorates awarded by the European Academy of Chiropractic following One year further training after graduating MSc.Chiro.
The American system awards direct on graduation DC(doctor of chiropractic)
DO(doctor of osteopathy) MD(medical doctor) etc etc......
There is nothing controversial about either the UK or American systems...........
And there is no confusion.....there is inter-national reciprocation of doctorates.
Simple as that.
Yes look under chiropractors act......find chiropractic physician.
32.—(1) A person who (whether expressly or by implication) describes
himself as a chiropractor, chiropractic practitioner, chiropractitioner,
chiropractic physician, or any other kind of chiropractor, is guilty of an
offence unless he is a registered chiropractor.
THis seems to be the only reference to chiropractic physician in the 1994 chiropractors act.
Why do you mention it?
Simply this is a protected title...chiropractic physician or if you like doctor of chiropractic or indeed any of the other protected titles relating to chiropractic doctors....I mention it as a contribution to the debate that has gone before...
Thats it.
Aha. I see you have a dose of the Dr Mikes over here too. Martin. S/he has also been giving us the benefit of his/her opinion over on this thread at Science Punk:
http://scienceblogs.com/sciencepunk/2009/06/panicking_chiropractors_orde...
Good lord Aust...are you stalking me.........I thought we had settled the business of a certain small things physicist soiling himself in the public domain..........And there you go again firing on all two cylinders.
What am involved in here the secret society of the UK doppelgangers....
Your stalked friend clinical advisor and reluctant mentor, Dr Mike.
Hi Dr Mike,
My point is that the ECU is an old boys club that gives out pieces of paper pretending to be doctorates for nothing more than passing the final exams at college and doing a few hours cpd once out in practice.
The ECU, ECCE, CCE are cartels operating to standards they set themselves without licence from any government or recognised educational institution.
Regards, Dizzyblonde (absolutely NOT a Dr of any kind at all)
PS, your style reminds me of someone .... I wonder WHO?
Oh'Come on Dizz...................love your speculation.
Do the research.....professional doctorates to chiropractors are conferred after minimum of 4 years or 5 if you include the pre-chiropractic prep year and 6 if you include post grad associate learning requirements.....
Nothing is free its is all given through academic rigour...
Sorry to bust your bubble Dizz...
Your new friend Dr Mike
awarded by whom?
European Academy of Chiropractic
and they are a University or what?
Thank you Dizz...as a member of McT I understand why you feel angst against the international chiropractic community...outright rejection due to questioable credentials is difficult to reconcile I'm sure.
Now instead of me continuing to spoon feed you regarding doctors of chiropractic and their educational bodies why not perform your own research and satisfy yourself regarding the educational system...which I might add easily equates with medicine and in specific areas outstrips medicine in hours of clinical training....Let me help you...take radiology..med students are given 35 plus minus hours of rad training a chiropractic intern receives 300 plus minus hours of training...in the area of orthopaedics similar disparity of training hours may be found.
You may find this shocking.........but true.
Now I am here to talk about a slippery small bits physicist
and not to offer a short course on the qualities of the doctor of chiropractic and the ill informed notions of the chiroskeptic fraternity.
Hope you find that helpful...
Regarding hours of training in this and that, and who might emerge as the more competent and reliable practitioner, my view is that quality trumps quantity any day.
No, I wouldn't be happy to have my x-rays read by someone who had received 300 hours of false information showing him how to misinterpret aligning artefact on over-large films as "subluxations". I'd go for the professional with 35 hours of quality training by radiologists who actually know what they're looking at. Every time.
Hours of training means nothing unless you know that the information being imparted during that time is rational.
Yes if thats your belief system......ok.
It matters not.
Here this may help open a closed mind
Chiropractic Radiologists
Chiropractic Radiology is a specialty that provides radiology services to the chiropractic profession. Chiropractic radiologists are Doctors of Chiropractic who have completed an additional three year radiology program. Chiropractic radiology training includes training in conventional radiography, fluoroscopy, tomography, radioisotope imaging, computed tomography, and magnetic resonance imaging. The training may also include participation in educational programs within teaching hospitals and imaging facilities.
The certification of a chiropractic radiologist is granted upon successful completion of a residency program and a series of examinations administered by the American Chiropractic Board of Radiology. The certification is a Diplomate of the American Chiropractic Board of Radiology (D.A.C.B.R.)
Radiology Residency
The Palmer College of Chiropractic Radiology Residency is a three-year program. This in-house program provides the additional education, training and experience in chiropractic radiology and specialized imaging. The resident is then eligible to sit for the board examination administered by the American Chiropractic Board of Radiology. The radiology residency is based in the Clinic Radiology Department. One new resident is accepted each year. Student education has been significantly enhanced by the residency. After completing the program, the residents training requires intensive study and review of current literature, which is imparted in the classroom. Further, the residency is continuing to improve presentation techniques of slides and radiographs.
That's hilarious. So the alignment-artefact-is-subluxation gang have CPD and "higher" qualifications in misinterpreting diagnostic images.
No matter how long you spend studying misinformation and having the higher forms of misinformation imparted to you, it is still misinformation.
This is about as relevant as claiming that studying astrology and advanced astrology in "residency programmes" validates the notion that the position of the constellations affects our lives.
That is a ridiculous comment........Mr Rolf you sound like a rabid troll..Here let me try to help
Much of the content of this article closely paralles the presentation of survey data previously published in the Mosby Year Book's Journal of Manipulative and Physiological Therapeutics (JMPT) in "Chiropratic Radiologists: A survey of demographics, abilities, education attitudes and practice trends." 1998;21(6);592-598. With permission.
History of Chiropractic and Radiology
Both the profession of chiropractic and the discipline of radiology trace their beginnings to 1895. It is believed that in 1910, B.J. Palmer purchased the first radiographic unit from Scheidel-Western X-Ray Coil Company of Chicago.2 B.J. installed the machine in a building owned by the Palmer School of Chiropractic and thereby began the connection between chiropractic and radiology. Soon, radiology departments were established at the National School of Chiropractic in Chicago, Pacific Chiropractic College of Portland, Cleveland Chiropractic College of Kansas City, Los Angeles College of Chiropractic, Missouri Chiropractic College of St. Louis, and others.2
Today, the chiropractic profession has grown to more than 50,000 practitioners and 32 training institutions throughout the world.3 Radiology has become an integral and popular component of chiropractic. Currently more than 82 percent of chiropractors have the equipment necessary to produce plain-film radiographs in their offices.' Radiographic data is often crucial to appropriate patient management. This is especially true for evaluating possible fractures, dislocations, or aggressive bone pathology. Its popularity in clinical practice explains why radiology is a dominant topic in chiropractic education, with sections devoted to it on most national and state board examinations.
The Evolution of the Chiropractic Radiologist
Immediately following the development of radiography, physicists, photographers, and electricians took center stage as experts with the new technology. But as the units became capable of imaging deeper body tissues, the clinical applications of this new technology were recognized. Radiology was rapidly evolving into its own discipline, but there were unanswered questions. Who were the experts in the field? Who would instruct existing practitioners and students in radiographic methods and image interpretation? With the growing clinical utility of the subject to the health sciences, and the explosion of information offered by improving methods, both the medical and chiropractic professions realized specialty training was needed.
The first medical residency training program in radiology was established in 1915 at Massachusetts General Hospital.8 In 1934, the American Board of Radiology (ABR) was formed and held its first examination.2 Similarly, chiropractic organizations formed and began to regularly meet and exchange case material and ideas. The largest and most formalized was probably the first annual symposium of the National Council of Chiropractic Roentgenologists (NCCR), held on June 7, 1946.2 Formal certification procedures and examinations were adopted and the first certification as Diplomate of the American Board of Chiropractic Roentgenology (DABCR) was granted in 1958.' In 1968, the certified chiropractic radiologists formed the American Chiropractic College of Radiologists (and the designation for a diplomate was changed to DACBR).' They continue to hold annual workshops and improve upon their standards of examination and certification for diplomate status (Fig. 1).
The Chiropractic of Today
Currently, a best estimate indicates there are 175 active DACBRs worldwide. The density of diplomates includes: 16 percent in California, 10 percent in Canada, 7 percent in Illinois, 7 percent in Ohio, 6 percent in Colorado, 5 percent in Oregon, 5 percent in Texas, and the remaining 44 percent percent divided between other states and countries. Consistent with the demographics of non-radiologist chiropractors, DACBRs are typically middle-aged white men; although still in the minority, the percentage of women DACBRs (19%) is larger than that for non-radiologist chiropractors (13%) and medical radiologists (14%).6
Chiropractic radiologists are first of all doctors of chiropractic. Most DACBRs received their DC degrees from either Palmer College of Chiropractic (20%) or National College of Chiropractic (20%) .6 They are familiar with the clinical practice setting. Sixty-three percent of them were in clinical practice an average of 5.3 years (standard deviation 8 years) before pursuing their radiology training.6 Eighty-four percent of DACBRs currently have a radiology practice. About 32 percent of all DACBRs currently have clinical practices in addition to their radiology practices.
DACBRs are trained in all aspects of radiology and advanced imaging but have special emphasis in neuromusculoskeletal topics and biomechanical changes, which may impact chiropractic management. Eighty-six percent of DACBRs feel extremely confident to interpret plainfilm studies of the skull and spine.6 Nearly 40 percent of DACBRs have obtained advanced certification in computed tomography and magnetic resonance imaging studies.6 These confidence levels reflect their function in radiology practice, which entails reading more plain-film studies of the musculoskeletal system than specialized imaging studies of the brain, chest, or abdomen.
Reference:
1 American Chiropractic College of Radiology Web site; http://www.accr.org
2. Canterbury R. Radiology and chiropractic spinography. In: Chiropractic: An Illustrated History. St. Louis, MO, Mosby-Year Book, Inc. 1995
3. College directory at Chiroweb Web site; http://www.chiroweb.com/college
4. Harger BL. Taylor JAM, Haas M, Nyiendo. J. Chiropractic radiologists:
a survey of chiropractors' attitudes and patterns of use. J Manipulative Physiol Ther 1997; 20(5):311-314
5. Goertz C. Summary of the 1997 ACA statistical survey on chiropractic practice. JACA 1998; November: 30-34
6 Marhiori DM, Hawk C, Howe J. Chiropractiv radiologists: a survey of demographics, abilities, educational attitudes, and practice trends. J Manipulative Physiol Ther 1998; 21(6);392-398
7 Taylor JAM, Clopton P, Bosch E, Miller KA, Marcelis S. Abnormal lumbosacral spine radiographs: A test comparing the interpretations of students, clinicians, radiology residents, and radiologiest in medicine and chiropractic. Spine. 1994;20;1147-1154
8 Wyman SM Department of Radiology, Massachusetts General Hospital: a brief history AJR 1993;160;1141-1144.
BY DENNIS M. MARCHIORI, DC, MS, DACBR, INTERIM CHAIR, DEPARTMENT OF ACADEMIC RADIOLOGY, PALMER COLLEGE OF CHIROPRACTIC, DAVENPORT, IOWA
Lets try even harder Mr Rolf ...lets compare and contrast. As a McT weekender this may all be new to you and thus explains your lack of intimacy with the profession.
Today's Doctor's of Chiropractic Have Six or More Years of College
Have you ever wondered just how much education your doctors of chiropractic has? The facts will surprise you.
Six years of highly specialized college training are required to graduate and earn license, and chiropractic has gained recognition as a compressive, scientifically sound force among the healing arts. Only chiropractic concerns itself with the interrelationship of structure and body functions, and only chiropractic effectively utilizes natural, drugless methods of treatment - primary spinal adjustments.
The doctors of chiropractic readily acknowledges that the early formative years of chiropractic education - like those in medicine left much to be desired.
Doctors of chiropractic must meet stringent educational requirements, including approximately 600 hours of externship, which qualifies them for licensure in all states and Canadian provinces. In many states they must pass a basic science examination - the very same examination that is given to all medical students. Doctors of chiropractic must also pass a rigid chiropractic board examination. All states require continuing educational seminars for annual licensure renewal.
Chiropractic Education
vs.
Medical Education
Class Hours
Subject
Class Hours
520
Anatomy
508
420
Physiology
326
271
Pathology
335
300
Chemistry
325
114
Bacteriology
130
370
Diagnosis
374
320
Neurology
112
217
X-Ray
148
65
Psychiatry
144
65
Obstetrics & Gynecology
198
225
Orthopedics
156
2,887
TOTAL HOURS
2,756
Other required subject for doctors of chiropractic
Adjusting, Manipulation, Kinesiology, and other similar basis subjects related to their specialty.
Other required subjects for doctors of medicine
Pharmacology, Immunology, general surgery, and other similar basic subjects related to their specialty.
GRAND TOTAL CLASS HOURS
CHIROPRACTIC4,485
MEDICAL 4,248
Chiropractic is safe....regardless of the ludditeism it faces.
Controversy. The Media feeds on it.
Millions of patients love their chiropractor and appreciate our unique and safe approach to recovery from pain. Significant research suggests that chiropractic is the safest approach available for relief from neck pain, back pain, headaches and other “musculo–skeletal” complaints. Lets review that research, and discuss how modern medicine has contributed to the Myth that chiropractic care is dangerous.
First, a short review of history
In the early 1960's, the American Medical Association (AMA) decided to try to contain and eliminate Chiropractic as a profession. [ 1 ] The AMA's purpose was to prevent medical physicians from referring patients to Chiropractors, as well as preventing them from accepting referrals from Chiropractors; to prevent Chiropractors from obtaining access to hospital diagnostic and radiology services; to prevent medical physicians from teaching at chiropractic colleges, or engaging in any joint research; and, to stifle any other form of cooperation between the two professions. The AMA also told its membership, medical students, insurance companies, and the general public that Chiropractic was an “unscientific cult”.
In 1976, five Chiropractors filed a lawsuit against the AMA (and other named entities) for violation of the Sherman Anti-trust Laws. After 15 years of litigation, the U.S. Court of Appeals stated that the AMA intended to “destroy a competitor,” and that there was evidence “showing that the AMA was motivated by economic concerns”. The court found that the AMA had concealed evidence showing it's guilt, and was caught “doctoring” documents. The AMA was also “guilty of systematic, long term wrong doing and has not acknowledged its lawlessness”. [ 1 ]
Following the Court enforced reversal of AMA's policy, tiny splinter groups formed, with the intention of labeling chiropractic as a quackish cult. Their methods mimicked the earlier AMA suppression tactics: Create doubt about the quality of chiropractic education, and mislead the public into believing that chiropractic claims ALL disease is caused by subluxations. Although these groups hide behind the noble claim that they wish to protect the public from unscientific practices, their true motives are transparent. Their sole intention is to suggest that only allopathic medicine is well supported by scientific research. However, that is just not true!
In an editorial in the highly esteemed British Medical Journal, titled Where is the Wisdom? The Poverty of Medical Evidence, BMJ's editor Dr. Richard Smith recounts a lecture he attended with renowned health policy consultant Dr. David Eddy. Eddy found, after doing significant research, that only about 13% of medical interventions are supported by, solid scientific evidence and that only 1% of the articles in medical journals are scientifically sound. Why is that? Because most of those articles quote from other articles which make unsupported and unfounded claims.
The Increasing Popularity of Alternative Medicine
After publication of David M. Eisenberg's 1993 New England Journal of Medicine article (Unconventional Medicine in the United States), various factions of modern medicine became increasingly anxious and aggressive in their accusations that alternative approaches to medical healthcare were not supported by research. [ 2 ] This same group was NOT forthcoming in mentioning the small fraction of established medical practices that have ever met these same stringent requirements. They certainly never mention the low level of success which medicine delivers for the same health complaints that chiropractic is so famous for.
The High Risks of the Medical Approach
Dr. Lucian Leape, researcher at the Harvard Medical School of Public Health, also states that only 13% of medical procedures have ever been tested for appropriateness by randomized trials. He noted that adverse events occurred in 3.7 percent of all hospitalizations. Worse yet, 13.6 percent of those adverse events led to death! [ 3 ]. He is quoted as saying, “Medicine is now a high risk industry, like aviation. But, the chance of dying in an aviation accident is one in 2 million, while the risk of dying from a medical accident is one in 200!” [ 4 ]
The most comprehensive review of “adverse events” (also referred to as “Iatrogenic Injury”) caused by modern medicine is the article Death by Medicine, written by Gary Null, Ph.D.; Carolyn Dean MD, ND; Martin Feldman, MD; Debora Rasio, MD; and Dorothy Smith, PhD. [ 5 ].
This fully referenced report reveals that:
2.2 million people experience in-hospital, adverse reactions to prescribed drugs per year.
20 million unnecessary antibiotics are prescribed annually for viral infections
7.5 million unnecessary medical and surgical procedures are performed annually, and
8.9 million people are exposed to unnecessary hospitalization every year!
The most stunning statistic, however, is that the total number of deaths caused by conventional medicine is an astounding 783,936 per year!
That is a mind-boggling 2147 people killed daily!
That's 7 jumbo jet plane crashes, each and every day.
That's a 9-11 incident occurring every other day...FOREVER. God help us all.
Now, Lets Discuss the Safety of Chiropractic
Canada has a government-run national health care system. As occurred with Medicare in this country, there had been such pressure on the Canadian government to include chiropractic as a covered benefit, that the Ontario Ministry of Health hired a renowned heath care economist to make a recommendation. The first “Manga Report” [ 6 ] was published in 1993.
This comprehensive study reviewed all the published literature on low back pain and made some astounding suggestions. In a nutshell, it concluded that: chiropractic should be the treatment of choice for low back pain – excluding traditional medical care altogether!
The specific Findings of the report were:
There is an overwhelming body of evidence indicating that chiropractic management of low-back pain is more cost-effective than medical management
Many medical therapies are of questionable validity or are clearly inadequate
There is no clinical or case-control study that demonstrates or even implies that chiropractic spinal manipulation is unsafe in the treatment of low-back pain. Some medical treatments are equally safe, but others are unsafe and generate iatrogenic complications for LBP patients.
Chiropractic is more cost-effective. There would be highly significant cost savings if more management of LBP was transferred from medical physicians to chiropractors.
There is good empirical evidence that patients are very satisfied with chiropractic management of LBP and considerably less satisfied with physician management
The specific Recommendations were:
Chiropractic services should be fully insured under the Ontario Health Insurance Plan
Chiropractic services should be fully integrated into the health care system. Because of the high incidence and cost of LBP, hospitals, managed health care groups, community health centers, comprehensive health organizations, and health service organizations and long-term care facilities should employ chiropractors on a full-time and/or part-time basis
A good case could be made for placing chiropractic as the gatekeepers for all musculoskeletal complaints that presented to hospitals.
More Bad News For Medical Patients
A series of articles reporting on the lack of medical training in musculoskeletal disorders was published between 1998 and 2002 by Kevin B. Freedman, MD [ 7 ], [ 8 ]. It seems that the department chairs of several hospital-based orthopedic residency programs designed a basic examination on musculoskeletal competency and gave it to their residents. 82 per cent of medical school graduates failed the examination. Four years later the test was simplified and, once again, 78% of the examinees failed to demonstrate basic competency in musculoskeletal medicine. When this test was given to final quarter chiropractic students 70% of them passed the exact same exam! [ 9 ]
The differences between these 2 student groups should be noted. The medical students had already graduated from medical school (as MDs) and had currently been deployed in rotation through various hospital departments. They had also been accepted into an orthopedic residency program...as the pinnacle of medical musculoskeletal specialists. The chiropractic students however were still just students. 80% medical failure versus 70% chiropractic success. Quite astonishing!
Review of Specific Safety Studies
A. The Safety of Cervical Adjusting
No one pays closer attention to injury statistics than Malpractice Insurance carriers.
Scott Haldeman, MD, DC reviewed malpractice claims records for a 10-year period between 1988 and 1997. In reviewing the outcomes following the application of 134.5 million cervical manipulations (commonly referred to as the chiropractic adjustment), the records indicated that there were 23 reported cases of stroke or vertebral artery dissection (VAD). [ 10 ] Of this group, 10 of the patients had the complicating factors of high blood pressure, use of oral contraceptives, or a history of smoking, all of which are associated with vascular disease. The actual incidence of stroke or VAD following cervical manipulation was found to be one per 5.85 million cervical adjustments. That means that the average chiropractor could work for 1430 years (or practice 48 full chiropractic careers!) before they might be involved with this type of litigation.
Other reports listing a higher frequency of adverse events have been compromised by the tendency of those authors to inappropriately list the pracitioner as a chiropractor, even when it turned out that the injury was caused by a medical doctor, a physical therapist or a hairdresser! [ 11 ], [ 12 ]
Rather than raising concerns about the safety of chiropractic, these statistics emphasize that spinal manipulation, in the hands of unskilled practitioners, is dangerous, and the practice must be closely regulated. [ 13 ]
The World Health Organization recently released a comprehensive set of guidelines that clearly states that chiropractic is a separate profession, rather than a set of techniques that can be learned in short courses by other health professionals. They also make it clear that medical doctors and other health professionals, in countries where the practice of chiropractic is not regulated by law, should undergo extensive training to re-qualify as chiropractors before claiming to offer chiropractic services. In some countries there have been recent efforts by medical groups to provide short courses of approximately 200 hours in chiropractic technique. WHO’s guidelines indicate that a medical graduate should a require an additional minimum of 1800 class hours, including 1000 hours of supervised clinical training, before claiming to offer chiropractic services. [ 14 ]
B. The Safety of Low Back Adjusting
Lower back injury alleged to have occurred following spinal manipulative therapy has been reported in patients with pre-existing disc herniation or prolapse. While it is suggested that the forces required to cause a disruption of the annular fibers of the healthy intervertebral disc well exceed that of a rotational manipulative thrust, some disc herniation/protrusion may certainly be aggravated by an inappropriately applied manipulative maneuver, as it may be by other simple activities of daily living such as bending, sneezing, or lifting. The most frequently described severe complication is compression of the cauda equina by massive midline nuclear herniation at the level of the 3rd, 4th or 5th intervertebral disc.
Of the 30 cauda equina complications associated with manipulation reported in the French, German and English literature over an 80 year period, only 8 were allegedly related to chiropractic treatment. [ 15 ]
The Risks of Medical Procedures Aimed at Relief of Similar Symptoms
A. Non Steriodal Anti-Inflammatories (NSAIDs)
One group of patients who rely on NSAIDs for pain relief are those suffering from rheumatoid arthritis. In 1998, Dr. Singh of the Stanford University of Medicine reviewed the records of 11,000 arthritis patients at 8 participating institutions. He extrapolated that approximately 107,000 patients are hospitalized annually for nonsteroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) complications (internal bleeding) and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone. The figures for all NSAID users would be overwhelming, yet the scope of this problem is generally under-reported. [ 16 ]
Another article titled “36 Percent of Acute Liver Failures Are Linked to Acetaminophen” suggests that other organ systems are also compromised by the use of over-the-counter pain medications. [ 17 ]
Lauretti's review of the literature found that The best evidence indicates that cervical manipulation for neck pain is much safer than the use of NSAIDs, by as much as a factor of several hundred times. [ 27 ]
B. Spinal Surgery
First, let's review some history. In 1974, the Congressional Committee on Interstate and Foreign Commerce held hearings on unnecessary surgery. Their findings from the First Surgical Second Opinion Program found that 17.6% of recommendations for surgery were not confirmed. The House Subcommittee on Oversight and Investigations extrapolated these figures to estimate that, on a nationwide basis, there were 2.4 million unnecessary surgeries performed annually resulting in 11,900 deaths at an annual cost of $3.9 billion. [ 18 ]
With the total number of lower back surgeries having been estimated in 1995 to exceed 250,000 in the U.S. at a hospital cost of $11,000 per patient. [ 19 ] This would mean that the total number of unnecessary back surgeries each year in the U.S. could approach 44,000, costing as much as $484 million. [ 20 ]
So, the biggest risk of spinal surgery is that it may not be necessary.
The next set of risks include:
a 2.1% chance of a serious adverse drug reaction. [ 21 ]
a 5-6% chance of acquiring a nosocomial infection [ 22 ]
a 4-36% chance of having an iatrogenic injury (medical error or adverse drug reactions). [ 23 ]
a 17% chance of a procedure error. [ 24 ]
As few as 3%, and no more than 20% of iatrogenic injuries are ever reported! Yipes! [ 5 ]
That takes all the fun out of being a statistic, doesn't it?
This September 2006 article from the Journal of the American Academy of Orthopedic Surgeons says it all:
“Failed back surgery syndrome is a common problem with enormous costs to patients, insurers, and society. The etiology of failed back surgery can be poor patient selection, incorrect diagnosis, suboptimal selection of surgery, poor technique, failure to achieve surgical goals, and/or recurrent pathology.” [ 25 ]
That my friends is right from the horse's mouth.
The most recent controversy is from the New York Times:
“Spinal-fusion surgery is one of the most lucrative areas of medicine. An estimated half-million Americans had the operation this year, generating billions of dollars for hospitals and doctors.
But there have been serious questions about how much the surgery actually helps patients with back pain and whether surgeons’ generous fees might motivate them to overuse the procedure. Those concerns are now heightened by a growing trend among some surgeons to profit in yet another way — by investing in companies that make screws and other hardware they install.” [ 26 ]
Now, added to concerns about medicine's poor musculoskeletal training and dangerous statistics, we have to wonder if the orthopedist might be motivated to install 6 of those $1000 screws in your spine because they are a stockholder in a lucrative medical device manufacturer.
The sanest and safest approach is to use conservative approaches like chiropractic care first. You can always resort to drugs or surgical approaches as a last-ditch resort, but the statistics suggest that most low-back and neck pain can be successfully managed with lower costs and higher patient satisfaction by chiropractors.
You may want to explore research supporting chiropractic care for a wide variety of conditions in our Research section. There is also a significant body of work demonstrating the vastly superior Cost-Effectiveness of Chiropractic, as well as contrasting Patient Satisfaction With Chiropractic with standard Medical Care for the same conditions.
REFERENCES:
[1] The Chiropractic Antitrust Suit ~ Wilk, et al vs. the AMA, et al
The Chiropractic Resource Archives
http://www.chiro.org/Wilk/
[2] Unconventional Medicine in the United States: Prevalence, Costs, and Patterns of Use
New England Journal of Medicine 1993 (Jan 28); 328 (4): 246–252
http://www.chiro.org/alt_med_abstracts/
ABSTRACTS/Unconventional_Medicine.shtml
[3] Incidence of Adverse Events and Negligence in Hospitalized Patients
Results of the Harvard Medical Practice Study I
New England Journal of Medicine 1991 (Feb 7); 324 (6): 370–376
[4] The Iatrogenic Injury Page
http://www.chiro.org/LINKS/Iatrogenic_Page.shtml
[5] Death by Medicine
Life Extension Foundation
http://www.chiro.org/LINKS/FULL/Death_By_Medicine.html
[6] A Study to Examine the Effectiveness and Cost-Effectiveness of Chiropractic
Management of Low-Back Pain
Ministry of Health, Government of Ontario Canada 1993
http://www.chiro.org/LINKS/GUIDELINES/Manga_93.shtml
[7] The Adequacy of Medical School Education in Musculoskeletal Medicine
Journal of Bone and Joint Surgery 1998 (Oct); 80-A (10): 1421–1427
http://www.chiro.org/ChiroZine/ABSTRACTS/Adequacy.shtml
[8] Educational Deficiencies in Musculoskeletal Medicine
Journal of Bone and Joint Surgery 2002 (Apr); 84–A (4): 604–608
http://www.chiro.org/ChiroZine/ABSTRACTS/Educational_Deficiencies.shtml
[9] A Comparison of Chiropractic Student Knowledge Versus Medical Residents
Proceedings of the World Federation of Chiropractic Congress 2001 Pgs. 255
http://www.chiro.org/ChiroZine/ABSTRACTS/
A_Comparison_of_Chiropractic_Student_Knowledge.shtml
[10] Arterial Dissections Following Cervical Manipulation: The Chiropractic Experience
Canadian Medical Association Journal 2001 ( Oct 2); 165 (7): 905–906
http://www.cmaj.ca/cgi/content/full/165/7/905
[11] Misuse of the Literature by Medical Authors in Discussing Spinal Manipulative Therapy Injury
J Manipulative Physiol Ther 1995 (May); 18 (4): 203–210
http://www.chiro.org/LINKS/ABSTRACTS/Misuse_of_literature.shtml
[12] Inappropriate Use of the Title Chiropractor and Term Chiropractic Manipulation in the
Peer-reviewed Biomedical Literature
J Manipulative Physiol Ther 1995 (May); 18 (4): 203-210
http://www.chiro.org/ChiroZine/ABSTRACTS/
Inappropriate_Use_of_the_title.shtml
[13] Are German Orthopedic Surgeons Killing People With Chiropractic?
ChiroZine ~ 3-26-2005 ~ Editorial Commentary
http://www.chiro.org/Professional_Regulation/
[14] Guidelines on Basic Training and Safety in Chiropractic
World Health Orgainization ~ November 2005
http://www.chiro.org/LINKS/FULL/
Basic_Training_and_Safety_in_Chiropractic.pdf
[15] Guidelines for Chiropractic Quality Assurance and Practice Parameters
Preceedings of the Mercy Center Consensus Conference; Page 171
Aspen Publications 1993
[16] Recent Considerations in Nonsteroidal Anti-inflammatory Drug Gastropathy
American Journal of Medicine 1998 (Jul 27); 105 (1B): 31S–38S
http://www.chiro.org/LINKS/ABSTRACTS/Recent_Considerations.shtml
[17] 36 Percent of Acute Liver Failures Are Linked to Acetaminophen
U.S. News & World Report July 2, 2001
http://www.chiro.org/LINKS/ABSTRACTS/
Liver_Failures_Are_Linked_to_Acetaminophen.shtml
[18] US Congressional House Subcommittee Oversight Investigation.
Cost and Quality of Health Care: Unnecessary Surgery.
Washington, DC: Government Printing Office, 1976
[19] Herman R. Back Surgery. Washington Post [Health Section], April 18, 1995
[20] Testimony to the Department of Veterans Affairs' Chiropractic Advisory Committee
George B. McClelland, D.C., Foundation for Chiropractic Education and Research March 25, 2003
http://www.chiro.org/LINKS/ABSTRACTS/
Testimony_to_the_Department_of_Veterans_Affairs.shtml
[21] Incidence of Adverse Drug Reactions in Hospitalized Patients:
A Meta-analysis of Prospective Studies.
JAMA 1998 (Apr 15); 279 (15): 1200-1205
[22] Nosocomial Infection Update
Emerg Infect Dis 1998 (Jul); 4 (3): 416-420
[23] Error in Medicine
JAMA 1994 (Dec 21); 272 (23): 1851-1857
[24] Medication errors in hospitalized cardiovascular patients
Arch Intern Med 2003 (Jun 23); 163 (12): 1461-1466
[25] Failed Back Surgery Syndrome: Diagnostic Evaluation
Journal of the American Academy of Orthopaedic Surgeons 2006 (Sep); 14 (9): 534-543
http://tinyurl.com/24nn6m
[26] The Spine as Profit Center
New York Times December 30, 2006
http://tinyurl.com/y9qohn
[27] A Risk Assessment of Cervical Manipulation
vs. NSAIDs for the Treatment of Neck Pain
J Manipulative Physiol Ther 1995 (Oct); 18 (8): 530–536
http://www.chiro.org/LINKS/ABSTRACTS/
Risk_Assessment_of_Cervical_Manipulation.shtml
Now that we have put credentialling issues to bed and demonstrated chiropractic expert radiology at centres of excellence....lets turn our attention to somato-visceral clinical matters which the layman Mr Singh might have bothered to turn his attention to prior to talking tosh...GO
Self-reported Nonmusculoskeletal Responses to Chiropractic Intervention:
A Multination Survey
J Manipulative Physiol Ther 2005 (Jun); 28 (5): 294–302
Positive reactions were reported by 2% to 10% of all patients and by 3% to 27% of those who reported to have such problems. Most common were improved breathing (27%), digestion (26%), and circulation (21%).
Chiropractic Co-management of Medically Treated Asthma
Clinical Chiropractic 2005 (Sep); 8 (3): 140–144
This article presents three cases where patients, being treated by conventional pharmacological means, had chiropractic manipulation administered to the upper thoracic spine twice a week for a period of 6 weeks. Objective measurements were collected using a peak flow meter and subjective data using an asthma specific questionnaire. All three cases resulted in increased subjective and objective parameters and suggest the need for larger studies with appropriate methodology.
Spinal Manipulation May Benefit Asthma Patients
Foundation for Chiropractic Education and Research (FCER)
Patients afflicted with asthma may benefit from spinal manipulation in terms of symptoms, immunological capacity, and endocrine effects, an audience was told on October 5 at the 9th International Conference on Spinal Manipulation in Toronto. The investigative team, headed by Ray Hayek, Ph.D., has been conducting a trial at 16 treatment centers in Australia involving 420 patients with an average age of 46 in an effort to find out what effects spinal manipulation has on symptoms, depression and anxiety, general health status, and the levels of immunity as reflected by the concentrations of both an immunoglobulin (IgA) and an immunosuppressant (cortisol).
Join Us in Documenting the Effects of Spinal Manipulative Therapy
(SMT) on Asthma
Anthony L. Rosner, Ph.D., Director of Research and Education for FCER
This project, conducted by researchers at Macquarie University in Sydney with 420 subjects, follows on the heels of preliminary observations which suggest that chiropractic management of spinal dysfunction in asthmatic subjects reduces symptoms, anxiety and cortisol levels.
Asthma Trial Update: Preliminary Data Encouraging ~ Your Help Needed to Put Funding “Over the Top”
Vincent P. Lucido, D.C., President of FCER
This trial is of paramount importance in addressing the major flaws in a previous and unfortunately highly visible clinical trial published in The New England Journal of Medicine. [1] It also represents one of the few investigations that taps into the field of endocrinology—an area that must be addressed if one is to gain further insight into the systemic effects of spinal dysfunctions and their management by chiropractic care. This research represents only a handful of investigations that have addressed the consequences of manipulation involving chemical (as opposed to electrical) messengers within the body.
Response to the “Manual Therapy for Asthma” Cochrane Review
Anthony Rosner, PhD, FCER Director of Research
Hondras' recently published systematic review of randomized clinical trials 1 addressed to manual therapy represents a sincere effort to summarize those investigations in what is commonly regarded as the gold standard of clinical research. That said, however, one has to remain particularly vigilant against accepting randomized clinical trials at face value, particularly in those instances involving physical interventions, in which the complete blinding of practitioners [and most likely patients as well] in the traditional RCT design is all but impossible.
Effect of Chiropractic Treatment on the Endocrine and Immune System in Asthmatic Patients
Proceedings of the 2002 International Conference on Spinal Manipulation. 2002 (Oct)
The broad aims of this FCER funded study is to determine whether stress is a factor in the pathophysiology of asthma and to determine if chiropractic management of asthmatics can alleviate stress induced asthma. More specifically for this meeting, our study aims to determine whether chiropractic treatment has beneficial effects on the endocrine system through measurement of salivary cortisol and on the immune system via salivary IgA determination.
Chronic Pediatric Asthma and Chiropractic Spinal Manipulation: A Prospective Clinical Series and Randomized Clinical Pilot Study
J Manipulative Physiol Ther 2001; 24 (6) July: 369–377
After 3 months of combining chiropractic SMT with optimal medical management for pediatric asthma, the children rated their quality of life substantially higher and their asthma severity substantially lower. These improvements were maintained at the 1-year follow-up assessment. You may also be interested in this follow-up letter to the authors which notes the continuing problems with the design of placebos in manual spinal trials.
Chiropractic Management of 47 Asthma Cases
Todays Chiropractic 2000 (Nov) ~ FULL TEXT
Over a seven-year period, 47 cases of asthma were managed in an outpatient setting. Every case was followed for a minimum of two years to observe effectiveness of care. The study group comprised 28 males and 19 females, ranging from 7 to 42 years of age. Of the 47 cases, 32 patients ranged in age from 7 to 19 years.
An Example of Flawed Asthma Research
Comparison of Active and Simulated Chiropractic Manipulation as Adjunctive Treatment for Childhood Asthma
New England Journal of Medicine 1998 (Oct 8); 339 (15): 1013–1020
This article raises an interesting question. Was the “Simulated Chiropractic Manipulation” sham treatment a confounder? How else to explain their findings that “Symptoms of asthma and use of -agonists decreased and the quality of life increased in both groups, with no significant differences between the groups.” You may want to review the Problems with Placebos/Shams Page for a more in-depth discussion of this topic.
Anthony Rosner, Ph.D.'s response to the NEJM Asthma Study
At a time when public interest in the application of alternative medicine is rising, it is regrettable that a study with such deep flaws should have found its way to the lead position in such a prominent journal. Major deficiencies of the study are summarized as follows. Thanks to FCER for permission to reproduce this article. Dr. Rosner is the FCER Director of Research.
Other Responses to This Article by the Chiropractic Academic
and Research Community
Here are comments from researcher Bill Meeker, D.C., Daniel Redwood, D.C., the Meridian Institute, Daniel Becker, D.C., DABCN, James Provoost, D.C., and the Pennsylvania Chiropractic Association.
End of Flawed Asthma Research Articles
Manual Medicine Diversity:
Research Pitfalls and the Emerging Medical Paradigm
J Am Osteopath Assoc 2001; 101 (8) Aug: 441-444 ~ FULL TEXT
Recent studies published in leading medical journals have concluded that chiropractic treatment is not particularly helpful for relieving asthma and migraine symptoms because even though study participants showed notable improvement in symptoms, those subjects who received sham manual medicine treatments also showed improvement. Yet the sham treatment received by control groups in these studies is reminiscent in many ways of traditional osteopathic manipulation. This seems to represent not only a failure to recognize the value of many manual medicine techniques but also an ignorance of the broad spectrum of manual medicine techniques used by various practitioners, from osteopathic physicians to chiropractors to physical therapists.
An Impairment Rating Analysis Of Asthmatic Children
Under Chiropractic Care
Journal of Vertebral Subluxation Research 1997; 1 (4) Jul: 1–8
A self-reported asthma-related impairment study was conducted on 81 children under chiropractic care. The intent of this study was to quantify self-reported changes in impairment experienced by the pediatric asthmatic subjects, before and after a two month period under chiropractic care. Significantly lower impairment rating scores (improvement) were reported for 90.1% of subjects 60 days after chiropractic care when compared to the pre-chiropractic scores (p
Osteopathic Manipulative Treatment Applications
for the Emergency Department Patient
J Am Osteopath Assoc 1996; 96 (7) Jul: 403–409
The emergency department (ED) setting offers osteopathic physicians multiple opportunities to provide osteopathic manipulative treatment (OMT) as either the primary therapy or as an adjunct to the intervention. In doing so, osteopathic physicians can decrease or eliminate the morbidity and symptoms associated with protracted dysfunction. Low back pain, chest pain, torticollis, asthma, and sinusitis are some of the illnesses in which OMT should be implemented as part of the management plan
Management of Pediatric Asthma & Enuresis
with Probable Traumatic Etiology
ICA Internat Rev Chiro 1995 (Jan): 37–40
On May 20, 1988 the child was seen for chiropractic examination and evaluation, and from that date to August 3, 1991 the child received 28 chiropractic adjustive/manipulative treatments. Dramatic improvement of asthma and enuresis followed chiropractic management.
A Wholistic Approach to the Treatment of Bronchial Asthma
in a Chiropractic Practice
Chiro J Aust 1993; 23 (1): 4–8
Three case studies involving two children and a mature adult with established diagnoses of bronchial asthma are presented. Management in each case involve chiropractic adjustments combined with a "clinical ecology" approach which has been found useful in identifying food and environmental allergens that may act as triggering factors for asthma attacks. This paper suggests that such a broad-based management approach may lead to higher rates of response to chiropractic treatment of asthma, as well as providing greater long-term relief for its victims.
Manipulative Therapy an Alternative Treatment for Asthma:
A Literature Review
Chiro: The J Chiro Res and Clin Invest 1992; 8(2): 40–42
This is a literature review of the effects of manipulative therapy as alternative treatment for asthma. Subjective studies show that manipulation of the spine relieves the patients' symptoms. However, objective findings have yet to be compiled using respiratory indices. We recommend an extensive study be performed to determine the effects of manipulation on bronchial asthma.
Review More Abstracts on Chiropractic and Asthma
Review abstracts about chiropractic and a variety of organic and visceral disorders at the wonderful International Chiropractic Pediatric Association (ICPA) website
Other Management Approaches for Asthma
The Etiologies, Pathophysiology, and Alternative/Complementary
Treatment of Asthma
Alternative Medicine Review 2001; 6 (1): 20–47 ~ FULL TEXT
Antioxidant nutrients, especially vitamins C and E, selenium, and zinc appear to be necessary in asthma treatment. Vitamins B6 and B12 also may be helpful. Omega-3 fatty acids from fish, the flavonoid quercetin, and botanicals Tylophora asthmatica, Boswellia serrata and Petasites hybridus address the inflammatory component. Physical modalities, including yoga, massage, biofeedback, acupuncture, and chiropractic can also be of help.
Research Perspectives in Asthma: A Rationale for the Therapeutic Application of Magnesium, Pyridoxine, Coleus forskholii and Ginkgo biloba in the Treatment of Adult and Pediatric Asthma
The Internist 1998; 5 (3) Sept: 14–16 ~ FULL TEXT
Thanks to the American Chiropratic Association's Council On Family Practice for their permission to reprint this article exclusively at Chiro.Org!
Natural Asthma Relief
Asthma is best described as a chronic inflammatory condition rather than a respiratory disease. In fact, asthma's origins have more in common with arthritis than they do with emphysema or tuberculosis. Asthma is simply a chronic inflammation of the airway rather than the joints. People with asthma have inflamed, hyperreactive airways that produce excessive bronchial mucus. After repeated asthma attacks, the airway lining becomes scarred, and immune cells, which cause or exacerbate inflammation, proliferate there.2 Asthma eventually damages the airway permanently, making it more prone to inflammation and less functional overall.
WHAT MORE NEEDS TO BE SAID.
HAVE A NICE ONE.
Hey Dr. Mike:
GP's have spent less time learning to read x-rays than chiropracters, because:
1. they have REAL medicine to learn;
2. they have REAL experts they can defer to -- radiologists
3. it takes longer to train chiropractors to see what isn't there: subluxations.
Thank you..A Real Dr. Mike
As you state the medics lack of training and expertise in this area, radiology ,compared to the accepted level of expertise of chiropractors is probably not a great burden to the medics,although not ideal,they do have radiologists to fall back on when they come up short and as you must already know chiropractors also have chiropractic radiologists who train intensively within the specialty.....although most field chiro doctors read their own MRI's and radiographs.
Thank you for the frank and candid admission of the regarding the higher level of professional clinical training of chiropractors over medics.....Now we are getting somewhere.
Well done.
Your new friend Dr Mike.
Gee, I thought I'd pop back and see if this discussion had advanced any, and what do I find? Much expenditure of electrons by "Dr Mike" in expounding in even greater detail just how many hours quacks spend explaining their delusions to other quacks and wannabe quacks.
No matter how many hours, days, weeks, months and years astrologists spend explaining to other astrologists and wannabe astrologists how to read star charts, this does not validate the delusion that the stars and planets influence our daily lives in the slightest. Homoeopaths also have impressive-sounding degrees and mindnumbing hours of study in exactly which flavour of magic shaken-up suger pills is indicated if the patient expresses a dislike of green wallpaper, for example, but that doesn't mean that shaken-up sugar pills have any physiological effect on the body.
And no matter how many sciency-sounding articles and journals and reviews and so on are written by astrologists, or homoeopaths (and by golly the latter group are at least as good as the chiropractors on that one), none of that will ever show that a horoscope is anything but minor entertainment for a coffee break, or that sugar pills do anything but produce an infinitesimal and unmeasurable increase in blood glucose.
What is required is actual evidence. You know, the stuff you get when you conduct properly blinded, controlled trials with pre-determined endpoints and no data-dredging. Got any?
That's Dr. Rolfe to you, please note the spelling.
And don't tell me what kind of a day to have.
Oh, and while I'm at it, I don't require that my GP be an expert radiologist. That's not her job. I require her to be an expert in history-taking and clinical examination. If I require any diagnostic imaging I require her to refer me to a specialist in that discipline.
That would be someone who actually knows how to read an x-ray (and ultrasound and MRI scan and so on), and has not been "educated" in the delusions of the non-existent "spinal subluxation" for countless hours that would have been better spent learning a useful trade such as plumbing.
Thank you Rolf buddy......like your points.
Love the axe you have to grind......
You are certainly a legend in your own lunch break...with views like those.
Keep up the good work.
Your new friend Dr Mike.
Have a nice one.
No, thank you Dr. Mike, for claiming that I said the opposite of what I said.
Your claim that more time spent training means greater knowledge is a fallacy because medical doctors spend their time learning to see what X-rays really show. Chiropractors, including chiropractic radiologists, don't.
Now let me see Real Dr Mike.....what have we here....
You confide that medics spend less time radiology training than chiropractors your inference is thus...chiropractors are better radiologists than the average joe medic....glad you support me in this..thank you.
But then Real Mike, you do a spin and tip cold custard on your head...my sympathies with your plight.
Are you truly seriously genuinely mumbling to the assembled great unwashed that more time spent training does not equal greater knowledge and that the medics 30 plus/minus hours of training is more valuable than 300 plus hours of chiropractic radiology......Real Mike.....whata guy,you remind me of me except I have the edge.
Real Dr Mike...thank you for the laugh.
Keep em cummin buddy.
Definately your new friend and clinical mentor and psychosocial councellor...if you ask.
You infer. I did not imply. I indicated that chiropractic radiologists additional hours of training over chiropractors did not mean anything, because they're looking for something that doesn't exist.
With real doctors and radiologists it's different.
I did not mumble: I typed, and spelled correctly, I might add.
If you had actual evidence to support your position, please provide it.
I'm just making the same points Rolfe did, and I see you replied equally intelligently to him. Rather than address his points, you insulted him personally.
Yes Real Dr Mike....you know what you said.
Thank you for reversing the laws of logic.....more learning/training = less knowledge.
Thats a monumental howler...........and I think,sums up the debate.
Now I must away to one of my beachside condos for some RR...
Let me leave you with a common clinical abomination from practical practice......81 year old 14 week Hx of leg and Low back pain attends my office.
14 weeks of GP management...with a diagnosis of sciatica and bursitis. GP gives mid range analgesia and lots of it. The patient turns to me in desparation as she is now in agony and suffering from drug side affects.
Yes, guess what...I x-ray her and find a fractured pelvis.
Point...because of the GP's incompetence and lack of radiological training he failed to take the appropriate clinical investigative steps...30 radiology hours does not
equip anybody for primary practice..........just not enough exposure.
This is not an isolated shameful event.
Hurts Real Doctor, reality hurts.As for Rolf..his comments were irrelevant.
Have a nice one again
Dr Mike...friend to the uninformed.
Hey "Dr" Mike,
Having made this amazing almost House-like diagnosis, did you then refer her to an orthopaedic surgeon?
Have a nice one.
I honestly cannot see Dr Mike as anything other than an incredibly rude reductio ad absurdum. If he really wished Chiropractic to be taken seriously I would suggest he stop posting immediately. Hopefully, however, he'll ignore the advice...
Ah ha....another pair of anti-chiropractic layman hopefuls line up for the Dr Mike treatment...Thank you Phil and Spk.....keep yourselves warm, I will be attending to you both in due course...While I am away engaged in other matters please do your homework,read the chiropractic literature,so that you both have an inkling of what you complain about.
Thank you in advance...now GO.
Errr Uhhmm Gentlemn...A word to the wise. I will know if you have not done what I have just advised you to do.
Have another nice one
Your new friend Dr Mike
Dr. Mike
Good for you.
That said, the fact that a doctor made a mistake is not proof that chiropractic works.
How did you treat the patient? I hope by referring her to a real doctor.
As you know, the reason this topic is in the blogosphere is because Simon Singh is being sued for libel because he said:
"The British Chiropractic Association claims that their members can help treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying, even though there is not a jot of evidence. This organisation is the respectable face of the chiropractic profession and yet it happily promotes bogus treatments."
I believe he was referring to the "Happy Families" brochure on the BCA's website, which said:
"There is evidence to show that chiropractic care has helped children with the following symptoms: Asthma [,] Colic, Prolonged crying[,] Sleep and feeding problems[,] Breathing difficulties[,] Hyperactivity[,] Bedwetting[,] Frequent infections, especially in the ears."
Rather than engage in a scientific debate on the facts, the BCA chose to sue Singh for libel. I note that the BCA declined an opportunity to respond in the same forum that Singh had published in.
The BCA sued for libel in the English courts, that through-Alice's-Looking-Glass world where the presumption is that the statement is false and the burden is on the defendant to prove otherwise.
The same legal system in which Oscar Wilde and Jeffrey Archer were confident enough to commence proceedings despite being guilty of the claims against them.
The BCA's recent press release, and PR campaign is a belated and blighted attempt to address the scientific issue on the merits.
The swift debunking of the evidence the BCA put forward to support its claims, and BCA's curious failure to cite Olafsdottir's study, corroborates the truth of Singh's impugned statement, and the BCA's awareness that the claims in their Happy Families brochure lacked merit. The BCA has put themselves in the unenviable position of saying, effectively, "we're not charlatans, we're idiots. We didn't knowingly promote bogus claims: we just couldn't understand that the clinical literature does not provide any good evidence to support our claims."
The facts speak for themselves. Reasonable people will be able to draw the correct conclusions from the evidence.
Your posts beg the question, and are irrelevant. While you may think you are scoring points here, you're not. Until you provide evidence and reasoned argument you won't persuade anyone of anything. Unless you do, you will be ignored.
Real Mike quotes
"believe he was referring to the "Happy Families" brochure on the BCA's website, which said:"
Please show this statement from the BCA...where is it.
You have cited it...love to review it....GO.
Dr Mike
This may help............Real Dr Mike
Reed WR, Beavers S, Reddy SK, Kern G. Chiropractic management of primary nocturnal enuresis. J Manip Phys Ther 1995 Mar-Apr;18(3):184-5
Kukurin G. Chronic pediatric asthma and chiropractic spinal manipulation; a prospective clinical series and clinical pilot study. J Manipulative Phys Ther 2002 Oct;25(8):540-1
Anrig C, Plaugher G (eds) Pediatric Chiropractic 1998 page 595, Williams & Wilkins (sleep disorders)
Anrig C, Plaugher G (eds) In Pediatric Chiropractic 1998 page 181, Williams & Wilkins (feeding problems)
Giesen JM, Center DB, Leach RA An evaluation of chiropractic manipulation as a treatment of hyperactivity in children. J Manipulative Physical Ter 1989 Oct;12(5):353-63
Krouse HJ, Krouse JH Complementary therapeutic practices in patients with chronic sinusitis Clin Excell Nurse Prat 1999 No.;3(6_:346-52
Eisenberg D Chiropractic treatment for chronic otitis medial with effusion
Current research at Division for Research and Education in Complementary and Integrative Medical Therapies, Harvard Osher Institute, Harvard Medical School, April 2001
Wiberg JM, Nordsteen J, Nilsson N The short-term effect of spinal manipulation in the treatment of infantile colic: a randomized controlled clinical trial with a blinded observer. J Manipulative Physiol Ther 2000 Jun:23(5):365
Budgell B A neurophysiological rationale for the chiropractic management of visceral disorders.
1998 Seminar Proceedings of the Internal College of Chiropractic, Friday Forum Series, February 6, Sydney, Australia (prolonged crying)
As all of you skeptics have now retreated to your damp basement headquarters to contemplate the lies about moon landings and the air is fresh again....just let me say, this was no contest. You start with a weak premise and you finish on a even weaker one........abject defeat.
As always in the British tradition we congratulate the losers so,nice try.
Have a nice one
Dr Mike
I'm very curious Dr Mike. Having looked at the nine papers you cite in your comment above, I'd like to know which ones you believe provide good evidence, and why?
I haven't had time to go through them properly yet, and I don't have the book that the Anrig papers are in, but just from skimming the abstracts:
(Reed, 1995) was unblinded and has a control group with only 15 people in it, with 11 patients dropping out. (Kukurin, 2002) appears to be simply a letter in response to a 2001 study by Bronfort that was one of the papers debunked in the BCA's recent statement. (Giesen, 1989), looks at just seven patients, and has a particularly weak trial design (and I'm curious why you haven't cited any follow up work from what was a preliminary study twenty years ago).(Wiberg, 2000) uses dimethicone as a control group, which is puzzling (and inappropriate) since there's no real evidence that dimethicone works either.
I can only assume that you haven't read (Krouse & Krouse), since it isn't a trial at all but simply a survey of how many patients use complementary therapies. Ditto (Eisenberg, 2001), which isn't a paper but (apparently) the name of a research project (I didn't find any related publications), and (Budgell, 1998), which isn't a study but a seminar!
I'm genuinely intrigued to know why you decided to post these particular papers in support of your views, given their obviously poor quality?
Martin is the editor of layscience.net.
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Thank you Martin....they are just useful information snippets.
Read some of the others they may be more gratifying.....
As for a papers autopsy........hmmmm maybe later.
Dr Mike
Martin here are some of my personal favourites...please dont ask me to deconstruct them one by one...thanks
1.
General Chiropractic Council. Code of Practice and Standard of Proficiency. 2005 http://www.gccuk.
org/files/link_file/COPSOP_Dec05_WEB(with_glossary)
The glossary defines evidence-based care as ‘clinical practice that incorporates the best available evidence from research, the preferences of patients and the expertise of practitioners (including the individual chiropractor him/herself)’.
07Jan09.pdf
2.
Klougart N, Nilsson N, Jacobsen J. Infantile colic treated by chiropractors: a prospective study of 316 cases. J Manipulative Physiol Ther 1989 Aug; 12(4): 281-8
A prospective uncontrolled study of 316 infants suffering from infantile colic and selected according to well defined criteria showed a satisfactory result after spinal manipulation in 94% of the cases.
3.
Mercer C, Nook B. The efficacy of chiropractic spinal adjustments as a treatment protocol in the management of infantile colic. In Haldeman S, Murphy B (eds) 5th Biennial Congress of the World Federation of Chiropractic: Auckland 1999: 170-1
Resolution of symptoms in 93% of infants treated with spinal manipulation. Study supports the suggestion of a beneficial effect of chiropractic.
4.
Wiberg J, Nordsteen J, Nilsson N. The short term effect of spinal manipulation in the treatment of infantile colic. A randomised controlled trial with a blinded observer. J Manipulative Physiol Ther 1999; 22: 517-522.
A randomised controlled trial comparing spinal manipulation with dimethicone. The study concluded that spinal manipulation is effective in relieving infantile colic.
5.
Bronfort G, Evans RL, Kubik P, Filkin P. Chronic paediatric asthma and chiropractic spinal manipulation: a prospective clinical series and randomised clinical pilot study. J Manipulative Physiol Ther 2001 Jul-Aug; 24(6): 369-77.
After 3 months of combining chiropractic spinal manipulation with optimal medical management for paediatric asthma, children rated their quality of life substantially higher and their asthma severity substantially lower. These improvements were maintained at the 1-year follow-up assessment. The observed improvements are unlikely as a result of the specific effects of chiropractic spinal manipulation alone, but other aspects of the
clinical encounter that should not be dismissed readily.
6.
Morley J, Rosner AL, Redwoord D. A Case Study of Misrepresentation of the Scientific Literature: Recent Reviews of Chiropractic. J Altern Complementary Med. 2001; Vol 7, No 1; 65-78
The article discusses inter alia the conduct of medical researchers. It deals with misrepresentation, calls for full debate and raises serious questions about the integrity of the peer-review process and the nature of academic misconduct.
7.
Kukurin GW. J Manipulative Physiol Ther 2002 Oct; 540
(Letters to editor) [The results] add to a curious trend reported in the literature, namely that patients report improvement in their asthma after a course of chiropractic manipulative therapy.
8.
Bockenhauer SE, Julliard KN, Lo KS, Huang E, Sheth AM. Quantifiable effects of osteopathic manipulative techniques on patients with chronic asthma. J Am Osteopathic Assoc 2002 Jul; 102(7): 371-5
Measurements of both upper thoracic and lower thoracic forced respiratory excursion statistically increased after osteopathic manipulative procedures compared with sham procedures.
9.
Mills MV, Henley CE, Barnes LL, Carreiro JE, Degenhardt BF. The use of osteopathic manipulative treatment in children with acute recurrent otitis media. Arch Paediatr Adolesc Med. 2003 Sep; 157(9): 861-6
The results of this study suggest a potential benefit of osteopathic manipulative treatment as adjuvant therapy in children with recurrent acute otitis media; it may prevent or decrease surgical intervention or antibiotic overuse
10.
Guiney PA, Chou R, Vianna A, Lovenheim J. Effects of osteopathic manipulative treatmenton paediatric patients with asthma: a randomised controlled trial. J Am Osteopathic Assoc 2005 Jan; 105(1): 7-12.
With a confidence level of 95%, results for the manipulation group showed a statistically significant improvement of 7 L per minute to 9 L per minute for peak expiratory flow rates. These results suggest that spinal manipulation has a therapeutic effect among this patient population
11.
Hawk C, Khorsan R, Lisi AJ, Ferrance RJ, Evans MW. Chiropractic care for non-musculoskeletal conditions: a systematic review with implications for whole systems research. J Altern Complement Med. 2007 Jun; 13(5) 47980
Evidence from controlled studies and usual practice supports chiropractic care (the entire clinical encounter) as providing benefit to patients with asthma, cervicogenic
vertigo, and infantile colic. Evidence was promising for potential benefit of manual procedures for children with otitis media
12.
Thiel HW, Bolton JE, Docherty S, Portlock JC. Safety of chiropractic manipulation of the cervical spine: a prospective national survey. Spine 2007 Oct; 32(21): 2375-8
Although minor side effects following cervical spine manipulation were relatively common, the risk of a serious adverse event, immediately or up to 7 days after treatment, was low to very low
13.
Cassidy JD, Boyle B, Cote P, He Y, Hogg-Johnson S, Silver FL, Bondy SJ. Risk of vertebro-basilar stroke and chiropractic care: results of a population based case control and case crossover study. Spine 2008 Feb 15; 33 (4 suppl): S176-83
The increased risks of VBA stroke associated with chiropractic and [GP] visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke. It was found that there was no evidence of excess risk of VBA stroke associated chiropractic care compared to primary care
14.
Bronfort G, Haas M, Moher D, Bouter L, van TulderM, Triano J, Assendelft WJ, Evans R, Dagenais S, Review conclusions by Ernst and Canter regarding spinal manipulation refuted. Chiropr Osteopat 2006 Aug; 14:14 .
Based on a critical appraisal of their review, the authors of this commentary seriously challenge the conclusions by Ernst and Canter who, they say, did not adhere to standard systematic review methodology, thus threatening the validity of their conclusions. There was no systematic assessment of the literature pertaining to the hazards of manipulation, including comparison to other therapies. Hence, their claim that the risks of manipulation outweigh the benefits, and thus spinal manipulation cannot be recommended as treatment for any condition, was not supported by the data analyzed. Their conclusions are misleading and not based on evidence that allow discrediting of a large body of professionals using spinal manipulation
15.
Froehle RM. Ear infection: a retrospective study examining
93% of all episodes improved. The study’s data indicates that
improvement from chiropractic care and analysing for influencing factors. J Manipulative Physiol Ther 1996 Mar; 19(3): 169-77
… the addition of chiropractic care may decrease the symptoms of ear infection in young children..
16.
Glazener CM, Evans JH, Cheuk DK. Complementary and miscellaneous interventions for nocturnal enuresis in children. Cochrane Database Syst Rev 2005 Apr 23; 2: CD005230
There was weak evidence to support the use of [chiropractic]
17.
Hayden C, Mullinger B. A preliminary assessment of the impact of cranial osteopathy for the relief of infant colic. Complementary Ther Clin Prac. 2006 May; 12(2): 83-90
The preliminary study suggested that cranial osteopathic treatment can benefit infants with colic.
18.
Hipperson AJ. Chiropractic management of infantile colic. Clinical Chiropractic 2004 Sep; 11(3): 122-129
The two case studies demonstrate chiropractic treatment successfully restoring correct spinal and cranial motion with an associated resolution of symptoms.
19.
Browning M, Miller J. Comparison of the short term effects of chiropractic spinal manipulation and occipitosacral decompression in the treatment of infant colic: a single blinded randomised controlled trial. Clinical Chiropractic 2008 Sep; 11(3): 122-129.
A single blinded randomised controlled trial. The study showed that both spinal manipulation and occipitosacral decompression offered significant benefits to infants including increased sleep and decreased crying.
20.
Leach RA. Differential compliance instrument in the treatment of infantile colic: a report of two cases. J Manipulative Physiol Ther 2002 Jan; 25(1):58-62
The mechanical adjusting device used was well tolerated and beneficial in two cases of infantile colic.
21.
Reed WR, Beavers S, Reddy SK, Kern GJ. Chiropractic management of primary nocturnal enuresis J Manipulative Physiol Ther 1994 Nov; 17(9):
Wet nights were significantly reduced after spinal manipulation. The study ‘strongly suggests’ the effectiveness of chiropractic treatment for primary nocturnal enuresis.
22.
Blomerth PR. Functional nocturnal enuresis. J Manipulative Physiol Ther 1994; 17: 335-338.
The patient’s enuresis resolved with the use of manipulation. This occurred in a way that could not be attributed to time or placebo.
23.
Fallon JM. The role of the chiropractic adjustment in the
The results indicate that there is a strong correlation between
care and treatment of 332 children with otitis media. J Clin Chiropract Paediatrics 1997 Oct; 2(2): 167-183
the chiropractic adjustment and the resolution of otitis media for the children in this study.
24.
Miller J. Cry babies: a framework for chiropractic care. Clinical Chiropractic 2007 Sep; 10(3) 139-46
A rational framework is proposed for the care and management of excessive infant crying.
25.
Nilsson N. Infant colic and chiropractic. Eur J Chiropr 1985; 33(4): 264-265
Respondents to a questionnaire revealed that 91% of infants improved after 2-3 manipulations.
26.
Sackett DL, Rosenberg WH, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn’t.
Evidence based medicine is about integrating individual clinical expertise and the best external evidence.
27.
Blower AL, Brooks A, Fenn CG, Hill A, Pearce MY, Morant S, Bardhan KD. Emergency admissions for upper gastrointestinal disease and their relation to NSAID use. Aliment Pharmacol Ther 1997;11: 283-91.
There is a strong association between NSAID use and propensity for upper gastrointestinal emergency admission; NSAID use is associated with significant morbidity and mortality each year in the UK.
28.
Hawkey CJ, Cullen DJ, Greenwood DC , Wilson JV, Logan RF. Prescribing of nonsteroidal anti-inflammatory drugs in general practice: determinants and consequences. Aliment Pharmacol Ther 1997;11: 293-8.
The data are compatible with 1 hospital admission per 2823 NSAID prescriptions and they emphasise the need for strategies to reduce levels of NSAID prescribing.
29.
M MacDonald TM, Morant, Robinson GC, Shield MJ, McGilchrist MM, Murray FE, McDevitt DG. Association of upper gastrointestinal toxicity of non-steroidal anti-inflammatory drugs with continued exposure: cohort study. BMJ 1997 315: 1333-7.
The study provides evidence that NSAID toxicity persists with continuous exposure and that this toxicity persists after the end of prescribing. http://www.ministryoftruth.me.uk/wp-content/uploads/2009/06/BCA-Statemen...
What an absolutely pathetic response. You have simply copied and pasted the 29 citations from the BCA's recent statement, complete with their descriptive text. What makes this particularly sad is that
Dr Mike said: "Martin here are some of my personal favourites...please dont ask me to deconstruct them one by one...thanks"
Luckily for you Mike, I already have deconstructed them one-by-one, here: http://layscience.net/node/598, along with about a dozen other writers referenced from that post. Half of them aren't even about the effectiveness of chiropractic, suggesting you haven't actually read these.
Your move kid, but here's a tip: copy-pasting a bunch of citations you found on the internet that you apparently haven't even read is not particularly impressive, and is liable to leave you looking a bit silly.
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Dr Mike said: "Please show this statement from the BCA...where is it. You have cited it...love to review it....GO."
Curiously the BCA have decided to remove it from their website since, but you can still find a link to it from the Wikipedia article here: http://en.wikipedia.org/wiki/Simon_Singh . The bit cited comes from page 1, in the section on "Birth Trauma."
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Sorry you feel agrieved Martin...these papers are useful background reading and as the BCA submitted they associate nicely with the proposition that spinal manipulation can influence the viscero-somatic system and thus help with certain conditions...what more can you want........perhaps a pint of blood.....Do not forget that the chiropractic profession does not sit around all day brooding over visceral conditions as neuromusculoskeletal practice is the daily clinical diet. Side issues are for the lay public to have panic attacks over or journalists to shame themselves in public over.....
Hope I have made you happy again.
Dr Mike
Here Martin this is for your personal edification
Asthma
A study published in the November / December 2000 issue of Today's Chiropractic gives some insight into the use of chiropractic in combating asthma. Forty seven patients were observed for a two year period. They had been medically diagnosed with persistent asthma ranging from mild persistent in 11 cases, moderate persistent in 28 cases, to severe persistent in 8 cases. The care rendered consisted of specific chiropractic adjustments. The range of visits was from 14 to 44, with the average being 26 during the study period.
All 47 of the study patients showed "a marked improvement ranging from 87 to 100 percent." Their symptoms improved as well as a decrease in their usage of acute asthma attack medication. Even more impressive was the fact that all of the patients in the study reported maintaining their improvement after a two-year follow up.
Childhood Asthma and Chiropractic
Chiropractors suggest that there is a strong link between people who suffer from childhood asthma and nerve interference from subluxation. Subluxations are when bones in the spine pressure or irritate nerves causing abnormal nerve function.
An article published in the Journal of Vertebral Subluxation Research (Vol. 1 No. 4) showed positive effects of chiropractic care on 81 children with asthma. It concluded that "Based upon information currently available, chiropractic care represents a safe non-pharmacological health care approach, that may be associated with a decrease in asthma-related impairment, reduced respiratory effort, and a decrease incidence of asthma attacks. The correction of vertebral subluxation could reduce or eliminate the need for medication, and potentially ease the severity of the asthmatic condition."
This was verified in another study. In a study conducted in 1996 by the Michigan Chiropractic Council (MCC), a panel of doctors performed an out-come assessment study to test the qualitative and quantitative effectiveness of chiropractic care on children with asthma. There was an overwhelming interest in the study. More than 500 parents called the MCC seeking to get their child involved in the chiropractic study.
The study, which took place during May and June of 1996, examined the chiropractic effectiveness in correcting the cause of asthma in patients from birth to age 17. The average age of the participant was 10 years. After 30 days of chiropractic health care, patients averaged only one attack, whereas prior to the study they were experiencing more than four attacks. Medications were decreased by nearly 70 percent. Patient satisfaction was rated 8.5 on a scale of 10. More than 70 chiropractors from 62 cities in Michigan participated in the study involving more than 80 children suffering from asthma.
The International Chiropractic Pediatric Association cites several studies when coming to the following conclusion discussing the benefits of chiropractic for children with asthma:
76.5% of patients with bronchial asthma said they benefited from chiropractic treatment. Peak flow rate and vital capacity increased after the third treatment. Significantly lower quality of life impairment rating scores were reported for 90.1% of children after 60 days of chiropractic care. During this same time period the average number of asthma attacks decreased an average of 44.9%, and asthma medication usage was decreased an average of 66.5%. Among parents of asthmatic children who had received chiropractic treatment, 92% considered this treatment beneficial. Autonomic Nervous System and Chiropractic Adjustments
Researchers found that chiropractic adjustments have an effect on the Autonomic Nervous System. They measured the changes in "Edge Light Pupil Cycle Time" (ELPCT) which is one of the light reflexes of the eyes. This reflex is controlled by the Autonomic Nervous System. A decrease in the Edge Light Pupil Cycle Time was observed with chiropractic adjustment implying a direct link between a chiropractic adjustment and a response in the Autonomic Nervous System. The study was published in the September 2000 issue of the Journal of Manipulative and Physiologic Therapeutics.
If this is true, it will have implications well beyond vision problems. The Autonomic Nervous System is that part of the nervous system responsible for the control and function of internal body organs. Chiropractors believe that interference to the nervous system creates a situation whereby various parts of the body will not be functioning at their full potential. This research shows a link between chiropractic adjustments of the spine and the part of the nervous system responsible for the control of internal organs. Chiropractors suggest that this shows conclusively that chiropractic care can have a positive affect on organ system health problems
@Dr Mike:
You say "what more can you want." Well it's quite clear what scientists want - evidence from well-controlled clinical trials. It's not much to ask, it's the most basic of requirements in fact, and yet not one of the 38 citations you've dumped in these comments provide it. The burden of proof is on chiropractors to show that their treatments work - why are they apparently so bad at doing this? You don't seem to realise or accept that your profession has a responsibility to provide clinical evidence for the treatments practised. That suggests you don't have a lot of respect for the public.
You then copy-pasted an abstract. I've already told you (as I note have other commenters at SciencePunk), that there's little point posting studies if you're not able to discuss them, so I'll ask again: why do you believe that this abstract provides good evidence for the efficacy of chiropractic? Do you believe that a study covering just 47 patients that has no control group is good quality?
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Try performing research without the drug company sponsorship
Thats your answer in short....For what the profession has actually achieved in the research domain they should be congratulated...so Martin get real.
If the consumer of clinical treatment or the skeptics dont like that....well tough nuts.
The simple answer for them is to avoid chiropractics clinics and treatment at all cost.......I am sure the profession can live with that in fact I am certain off that..
As for going out to please the world and satisfy the naysayer....actually we are too busy to be encumbered...
So Martin moan complain gnash teeth and toss ashes in your hair
Come Monday morning chiropractic offices will be open for business as usual and..strange as it may seem to you VERY BUSY.
Thats just a fact of life in the real world.
@Dr Mike: "Try performing research without the drug company sponsorship Thats your answer in short....For what the profession has actually
achieved in the research domain they should be congratulated...so
Martin get real."
So having failed miserably to provide any evidence to back up your claims, you're now resorting to the poor excuse that a multi-billion dollar global industry doesn't have the resources or ability to do some really cheap and basic clinical trials with a control group.
"If the consumer of clinical treatment or the skeptics dont like that....well tough nuts."
Now you see Mike, I believe that people who make medical claims should be able to back them up with evidence. I think you'd agree that this is a standard that for example drugs companies should be held up to. It is beyond me why you're so hostile to the idea that chiropractic too should be evidence-based - after all, if your treatments really can treatments the likes of colic then what do you have to fear from some inexpensive clinical trials, particularly if they then allow you to answer the ASA and Trading Standanrds and advertise the fact?
Although I suspect I've answered my own question...
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"Try performing research without the drug company sponsorship"
Can I refer you to this story?
US Government Spends $2.5 billion on alternative remedies
Seems there's a lot of money available outwith of drug company sponsorship. The evidence also suggests there should be a lot less.
T
With chiropractics getting so much unfavorable scrutiny, there will probably start to be a higher demand for nurse practitioner jobs and careers in other medical fields as well.
Dear Dr Mike
I start this comment in the full knowledge that you won't give me a coherent response but will use condescension as a way of feeling better about yourself, but hay-ho...
Others here are demonstrating that the evidence for chiropractic is inadequate and your cut n' pasting is not intimidating just repetitiously unfounded. What I would like to take issue with is your seeming misunderstanding about the Simon Singh trial.
Firstly, Singh has not been 'found guilty' of anything, let alone 'having a big mouth'. There has been a preliminary hearing about the meaning of the article he wrote which the BCA considers libelous. That ruling meant that Singh would have to prove that the BCA had promoted specific treatments with "dishonesty and indeed [Singh] accuses them of thoroughly disreputable conduct."
Singh is now appealing this ruling of the preliminary hearing. He has not been "found guilty" because the trial proper has not yet started. He has therefore not been punished and with regret it is unlikely that the punishment would involve him having to "drop his trousers and take his punishment like a man". The mind boggles.
As you seem unfamiliar with the case, I suggest you follow it here: http://jackofkent.blogspot.com/2009/05/bca-v-singh-official-ruling.html
I think in a debate about the misrepresentation of facts and indeed libeling people, its probably not best to get those kind of facts wrong.
If you do not intend to respond substantially to my point and at anytime feel your fingers hover over the keyboard with the intention of typing "unwashed", "....", "keep yourself warm" or "Your new friend Dr Mike", then please don’t bother.
Chiropractic article featured in Toronto Star June 24, 2009
Source: Toronto Star, Judy Gerstel, www.thestar.com
Edited by Martin, explanation to follow...
Dr Mike
I have edited your previous comment, which was a copy-paste of a copyrighted article from yesterday's Toronto Star (I would have linked but couldn't find it, here is the lst of Judy's articles - http://www.thestar.com/comment/columnists/94605 ).
I very rarely censor comments, but I removed it for two reasons. Firstly, it was in breach of copyright, and secondly it was to all intents and purposes spam.
If you have an argument to make, make it. If you want to draw on evidence, then cite it. But copy-pasting endless reams of content from elsewhere that you often don't appear to have even read is not a useful or effective mode of argument.
So, perhaps you'd like to add a new comment citing the Toronto Star piece, and explaining what point of yours you feel it supports and why. You are free to write what you want here, but I won't continue to tolerate copy-paste spamming of copyrighted content from you.
And as an aside, it's fascinating to watch your continued devolution from peer-reviewed research back to tabloid op-eds as sources.
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Yes Thank you for that Martin...You are quite correct.
Sorry for the inconvenience.
Dr Mike
Happy Families, Dr. Mike:
Yes the BCA removed the "Happy Families" brochure from their website -- but it's been archived in many places on the internets. I found it in about 30 seconds using google.
You should be able to, as well. Otherwise I'd be happy to email you a copy as a pdf file.
The argument that clinical trials can't be done without drug company sponsorship is specious. Chiropractors and their institutions make money -- they can devote a fraction of that to conducting proper clinic trials. From the many citations you've copy-pasted, they're quite capable of doing research that is insufficient to establish the efficacy of chiropractic beyond placebo.
It would not surprise me if the NIH's National Center for Complementary and Alternative Medicine funds research into chiropractic therapy.
No, even the case judge who found Singh guilty of having a big mouth could see that he was a man with an unusual agenda...Oh I recall....yes,to make money.BE degree | Online degree programs
The simple answer for them is to avoid chiropractics clinics and treatment at all cost..Nursing degree.....I am sure the profession can live with that in fact I am certain off that..Animation degree
As for going out to please the world and satisfy the naysayer....actually we are too busy to be encumbered...Must University