Chiropractic??

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doclm

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Hello All,

I have a friend who is seriously considering going into a Chiropractic program, so I would like some input from someone with some good knowledge.

Where do you think Chiropractic is going in the future?? I understand that there is a push for research based medicine with chiropractic. National University recently had a large grant from the NIH for doing 4 years of evidence based chiropractic research. Also, I have heard that more people are turning to forms of alternative medicine.

If you are ignorant and want to just bash the profession, please do not respond to this thread. I am looking for some open minded advice from someone who actually knows something about Chiropractic Medicine and its stability as a future profession.

Thanks. :thumbup:

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I have nothing against chiros as long as they stick to the musculoskeletal issues. I have a good friend at Parker in Dallas. I'm not sure where the profession is heading but as osteopathic medicine is gaining more recognition, I can't see that being a good thing for chiros (as far as OMM is concerned). I would feel much more comfortable sending a family member to a DO because if it were needed, a DO could treat them medically, as to where a chiro couldn't. My two cents.
 
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I was also considering chiropractic as a career up until last october. Actually, I was set on going to chiropractic college, so I guess there wasn't must "consideration" going on. I was raised in a family that believes in chiropractic. My grandfather, uncle, and many of my dad's cousins are chiropractors. My great-uncle is on the board of the WCA(world chiro alliance). My grandfather's numerous lawsuits against the AMA were used as evidence in the 1987 federal court case that put a stop to the AMA's official criticism of chiropractic. So, I know a little bit about the profession, belief system, etc.

If your friend has any intellectual talent, he shouldn't go into chiropractic. It is becoming a dead-end profession. Everywhere you go, there are chiro offices on every street corner. Supply and Demand are making it ever harder to make a living as a DC. Most graduates now days are relegated to associateships in established firms. These are demeaning positions where the "doctor" is required to spend all his freetime at walmart, grocery store, etc... doing spinal screenings, trying to convince people to come in and be his patient. Clinic in chiro college is the start of embarassment, where you are forced to recruit a certain number of patients to the student clinic. If your patient numbers aren't high enough, you fail the term and have to repeat it. Most medical colleges are associated with teaching hospitals, where patients are there because they need help, not because you convinced them to get help.

The list of problems like this goes on and on. I would suggest going to http://chirotalk.proboards3.com where you can hear all this from people who have attended/graduated from chiro college, and some who have been practicing for a few years. I was so glad I found this other source of information(as opposed to my familial contacts). I feel I would have ruined my future had I chosen to stay with chiropractic as my profession.
 
I would agree with the suggestion of DO school. There would be more opportunities and a greater sense of stability. But if set on Chiropractic, i know that Plamer in Davenport, IA is well known and respected.
 
I want to thank all of you for giving me some good info on this. Now that I see what everyone thinks, I am more weary of having my friend go down that path. She almost has a psyc degree from a state college and wants to transfer to National University of Health Sciences for their Biomedical Science program, which would give her the prereqs for any form of medical school. If she wanted to do Chiro, she could get grandfathered into the program after a year with a total of 125 credits. However, I am not sure if she should go do this?

I am thinking of having her go and get more prereqs/take the MCAT/ and go from there.

Do you think that regular medical schools MD/DO would have a problem if she got her prereqs and Biomedical Science degree from National University of Health Sciences? Since the classes are accelerated into trimesters and it is a private Chiro/ Naturopath/ Accupunture school. This would be a great opportunity for her to get all of the prereqs at once in a atmosphere that would mimick a mini medical school curriculm.

Also, I hear that National University has a fMRI for the chiro students to use on a daily basis. Does any of you believe that there will be any compelling data in favor of Chiro's coming out of the research in the next four years at National University?

Again thanks for your input :thumbup:
 
doclm said:
Do you think that regular medical schools MD/DO would have a problem if she got her prereqs and Biomedical Science degree from National University of Health Sciences?

No, most would accept the coursework. National is an accredited college. The AMCAS GPA calculation would include coursework done there, and this is, at base, what most adcoms use.

doclm said:
This would be a great opportunity for her to get all of the prereqs at once in a atmosphere that would mimick a mini medical school curriculm.

If she is doing this to "mimic" a "mini-medical school curriculum", I would suggest one of the medical school affiliated post-bacc/special master's programs for two reasons. First, I think she would have a "hard sell" convincing any adcom member that the coursework at National was, in fact, arduous and similar to medical school. I'm not arguing that it is or is not, but speaking as a former adcom interviewer, my colleagues and I would likely laugh out loud if this supposition were made during an interview. This is not only born of the animus which generally exists between allopathic medicine and chiropractic but also from the well published and well publicized fact that the entrance standards for chiropractic college are far less than those of medical school. Second, if the coursework is as difficult (again, I don't know if it is or is not), then she deserves the consideration for completing it she would get if she attended a medical school affiliated post bacc (most have some sort of admissions preference for those who excel during the program). It boils down to the eventual goal. If she is trying to go chiro, or natropath, then go to National. If she is trying to go MD/DO then the post bacc at Roselind or Loyola or a Master's from UIC will likely serve her better.

doclm said:
Does any of you believe that there will be any compelling data in favor of Chiro's coming out of the research in the next four years at National University?

Nope. Given that there has been none to date, I don't see an MRI making the difference. But that is only my opinion.

- H
 
I'm a DO student and I think chiropractic has an excellent future. Most DO's do not practice OMM. I think it's said that only 20% practice OMM? But I must add that the reason most DO's do not practice OMM is because it requires a lot of additional coursework and practice beyond DO school to truly become proficient at it. It's not that DO's are disatisfied with OMM or don't believe in it. That is a common misconception. Yes, many DO's don't believe in aspects of OMM but it's not as if they think the entire practice is bunk. Anyway, I'm aware that chiropracty and OMM don't have a lot of double blind published research to support it and thus many academics are skeptical of its benefits. However, the general public still swears by it and routinely seeks these treatments. And lets be honest, if you have a minor work, accident or sports-related injury, you are not going to see an orthopedic surgeon to schedule a surgery right away. The only types of people that can treat these dysfunctions are chiropractors, sports medicine FP docs, occupational therapists and physical therapists. And all of these fields are starting to use many of the same treatment modalities. For example, physical therapists, chiropractors, sports medicine and OMM all use muscle energy as a form of treatment. There will always be need for chiropractors IMHO.

I also agree with what others have said on this thread. There are a lot of chiropractors in existence. And there are a lot of chiropractic chains so the competition has gotten intense. As a result of this competition, I think the income potential in chiropracty has fallen somewhat. Those who are earning a lot of money in chiropracty have segued into sports medicine and are operating inside a gym and have marketed themselves that way. So yes, I think there is a demand for chiropractors but at the same time, I don't think it's a field in which you have the same income potential as medicine, dentistry or podiatry. Overall, I still think it's an excellent option.
 
I agree w/ most of that last post.... and I don't want to hijack the OP's thread and turn it into a debate about the above....just a few quick things....

OMM is a big "use it or lose it" type of thing w/ DO's who go into non-primary care fields..and DO's who do Allo Primary residencies....not much chance to practice it in those situations outside of med school. In addition, regarding the research.... there is a ton in the works at DO schools, off the top of my head...TCOM and PCOM...I'm sure there are others....(in addition to the few major studies that are out there already). The current state of OMM research is like the many drugs out here there where modern science hasn't been able to find a clear scientific mechanism. (We can all think of tons of drugs that are like that....with theories for mechanisms...but he drugs definitely work). It is the same way w/ OMM....we know how to do it and how the results will be on patients...but the in between details are now being figured out (and rightly so in a world of EBM). Hopefully within a few years some detailed scientific mechanism papers will come out on OMM so the rest of the medical community can learn about and accept what DO's and our patients have known for a long time.

Hope you enjoyed my rambling..
 
I think it's also important to distinguish OMM from chiropracty. Chiropracty and OMM share treatments in common like HVLA techniques but OMM also involves others techniques like counterstrain and myofascial release. In layman's terms, the bone popping is called HVLA. But contrary to popular belief, DO's don't universally apply HVLA to every patient they see . HVLA is contraindicated in many cases such as small children, the elderly, people with traumatic cases, thus DO's use a lot of other techniques besides HVLA. A lot of patients sufferring from intense acute pain will not be administered HVLA for obvious reasons. Likewise, I'm certain chiropracty offer techniques that are not included in OMM. The two fields are similar but they are not identical. This is another misconception. Don't worry though because I thought the two were nearly identical as well prior to starting DO school. :)
 
I attended and finished chiro school before going on to med school. I think it's a wonderful profession, but it has it's issues. i don't think there is a perfect profession, so if you can deal with it, go for it. The one thing that I hated the most about chiro school was having to recruit my own patients at the end. Yes, I realize that is what must happen in the real world to succeed, but it still sucks. I think it helped me get into medical school, they were impressed by the course load and all that.
 
Does anyone want to dilute and dishonor the title of "Dr."???? Become a chiropractor!!
 
How can DOs not believe in OMM? Isn't it a major part of their training?
 
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How can DOs not believe in OMM? Isn't it a major part of their training?

Somewhere between half and 90% of the DO's I've met don't believe in it. My n is small, but what I get is DO school is a means to an end, and, even for the people who like it, if they never do it ever again in practice, they won't weep for it. "Major part" is open to interpretation.

That's why I never applied DO - I didn't believe, and, perhaps naïvely or nobly, didn't want to possibly take a spot from someone who did.
 
How can DOs not believe in OMM? Isn't it a major part of their training?

I don't believe most of what was taught to me in medical school about OMM. Once you integrate "Somato-Emotional Release" into the curriculum, you've lost all credibility with me. A major part of DO training is devoted to primary care, and that is the part of osteopathic medicine that I am proud of.

But there is a tremendous paradox in osteopathic medical training. On one hand you have all this emphasis put on critical thinking and the scientific method as with any other medical school, then on the other hand you have this seperate coursework that emphasizes this sort of vague mysticism that eschews the whole scientific process. At least this was the case at my medical school, where many of the OMM instructors were particularly flighty.
 
The big thing with OMM that people don't buy into is cranial, one of the big things that pops into my head, but of course we all know there are a few other things that pretty much is "emotional energy". That is a given, but the rest of the stuff that you are taught is the "use it or lose it" philosophy. In the volumes of information, OMM is slowly lost along the way in med school. Hence why the AOA president is calling to "go back to the roots" to focus on osteopathy, specifically OMM. I think OMM is an extremely useful tool in certain circumstances. I know many students who have used it on rotations alot, but then on the other hand, most of the time you probably won't need to use OMM or you won't get a chance to use it. I know people that have use OMM in the NICU, PICU, Surgery, and of course general practice. I consider it another tool in the toolbelt but the sad part is I think that the number who actually practice OMM is more like less than 5%, I remember reading an AOA article citing that number (for daily basis use on patients). Depends on how you use the tools you've been given ... but with out the stats to back it up ... alot of people have their doubts and who wouldn't? Not all of the techniques work in every situation and how can to measure it statistically?





But if this is going to turn into a thread about OMM, I would suggest another thread be started as the OP has the answer to their question. If you would like another thread I can pull the posts concern OMM into another thread.

Thanks.
 
I don't believe most of what was taught to me in medical school about OMM. Once you integrate "Somato-Emotional Release" into the curriculum, you've lost all credibility with me. A major part of DO training is devoted to primary care, and that is the part of osteopathic medicine that I am proud of.

But there is a tremendous paradox in osteopathic medical training. On one hand you have all this emphasis put on critical thinking and the scientific method as with any other medical school, then on the other hand you have this seperate coursework that emphasizes this sort of vague mysticism that eschews the whole scientific process. At least this was the case at my medical school, where many of the OMM instructors were particularly flighty.
If one does not subscribe to the beliefs of osteopathy, then why go to osteopathic school, why not go to allopathic medical school?
 
If one does not subscribe to the beliefs of osteopathy, then why go to osteopathic school, why not go to allopathic medical school?

There are lots of reasons, and I'd be happy to delve into them, however not in this thread since, as pointed out, we strayed from the original topic.
 
I have nothing against chiros as long as they stick to the musculoskeletal issues. I have a good friend at Parker in Dallas. I'm not sure where the profession is heading but as osteopathic medicine is gaining more recognition, I can't see that being a good thing for chiros (as far as OMM is concerned). I would feel much more comfortable sending a family member to a DO because if it were needed, a DO could treat them medically, as to where a chiro couldn't. My two cents.

So your ok if a chiroprater treats someones dislocated shoulder or sets a broken arm or writes for Lortab for back pain?

That is all musculoskeletal. What about joint injections?
 
Ahhh....the debate about good 'ole quack-o-practors. I guess it all depends on your perspective. Voodoo is still considered good medicine in some parts of the world.
 
Chiropractic may be a good choice if you are strictly interested in running a successful self-made business. Depends where you want to set up shop. But if you have any passion at all for science, then you probably won't be happy in a chiropractic career.
 
<snip>

Also, I hear that National University has a fMRI for the chiro students to use on a daily basis.
It is highly improbable that their MRI is "for the chiro students to use on a daily basis" The only students that would "use" it would be interns that would order it for a patient for whom an MRI is considered diagnostically efficacious.

Of interest to note on National's MRI unit: it is the only open gantry unit in that area of Chicago and that the largest users of their MRI are local MDs.

National also uses it for research. eg. SEE:
Cramer GD, Gregerson DM, Knudsen JT, Hubbard BB, Ustas LM, Cantu JA.
The effects of side-posture positioning and spinal adjusting on the lumbar Z
joints: a randomized controlled trial with sixty-four subjects. Spine. 2002
Nov 15;27(22):2459-66.


Does any of you believe that there will be any compelling data in favor of Chiro's coming out of the research in the next four years at National University?

Again thanks for your input :thumbup:




Although there is much research being conducted at the various chiropractic schools, these are National Specific research projects:

http://www.nuhs.edu/show.asp?durki=170


This is National's indexed, peer-reviewed journal:
http://journals.elsevierhealth.com/periodicals/ymmt


Here is a site of research sponsored by the Consortial Center for Chiropractic Research:
http://www.c3r.org/publications.htm

Here is a very small sample of some other recent chiropractic research awards and projects:

HRSA awards grant to Logan College

Health Resources and Services Administration (HRSA) awarded a $234,000 grant to Logan College of Chiropractic to fund its Musculoskeletal and Obstetric Management Study (MOMS).

Since 1998, internal funding from Logan College has been supporting this project, resulting in a successful and ongoing collaboration between Logan College of Chiropractic and Washington University School of Medicine's clinics at Barnes-Jewish and Missouri Baptist hospitals. MOMS has developed solid interdisciplinary relationships among chiropractic physicians, medical physicians, and nurses in hospital-based clinic settings serving the healthcare needs of pregnant women in the St. Louis community. .........
.......identify and provide solutions for musculoskeletal problems in pregnant women. We believe the MOMS project is a step in this direction, a step in which an interdisciplinary team (including chiropractic and medical physicians) works together to treat and prevent pregnancy-related musculoskeletal pain."

-------------------
Western States Chiropractic College (WSCC) was awarded a $2.8 million federal grant to study treatment of lower back pain by the National Center for Complementary and Alternative Medicine of the National Institute of Health.

The grant &#8212; one of the largest grants given to a single-study project &#8212; is aimed at giving chiropractors more specific treatment plans, patients a firmer idea of how long it will take before they feel better, and insurance companies guidelines on how many visits to cover.

Four hundred volunteers from the Portland area who suffer from lower back pain will be recruited, beginning after the first of the year.
------------------

The Wolfe-Harris Center for Clinical Studies (WHCCS) at Northwestern Health Sciences University received a $1.2 million grant from the U.S. Department of Health and Human Services, Health Resources, and Services Administration (HRSA).
The grant is for a three-year randomized clinical trial comparing two approaches for the treatment of low back pain.

A sampling of a few other research projects at Northwestern:
-Chiropractic, Medication, and Self-Care for Neck Pain
Funding: The National Institutes of Health (NIH)
$1,530,150

-Manipulation, Exercise, and Self-care for Low Back Pain
Funding: Health Resources and Services Administration (HRSA)
$1,070,103

-Chiropractic and Exercise for Seniors with Low Back Pain
Funding: Health Resources and Services Administration (HRSA)
$1,237,218



$2.4 million awarded for joint research effort

The United States Health Resources and Services Administration (HRSA) granted $2.4 million for a study on back-related leg pain, to be conducted by The Wolfe-Harris Center for Clinical Studies (WHCCS) at Northwestern Health Sciences and the Palmer Center for Chiropractic Research (PCCR) at Palmer College of Chiropractic, Davenport campus.
---------------------------

Although what I have supplied above is by no means an exhaustive list of chiropractic research, hopefully, it helps answer your question, and gives you sites and links to further explore.
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As to the assertion of "McDoctor"
Chiropractic may be a good choice if you are strictly interested in running a successful self-made business. Depends where you want to set up shop. But if you have any passion at all for science, then you probably won't be happy in a chiropractic career.

Well, I addressed/debunked his "science" assertion above.

Although private practice or associating with an established DC, have traditionally/historically been the primary types of DC practice, that is also steadily changing and expanding.

A short list of a few examples are:
Depending upon the DCs areas of interest,
-there are many and various research options(touched on above),

-The Veterans Administration now offers chiropractic at more that 26 sites, and working for the VA is now another option.

-There are many very large and prestious multidisciplinary clinics, such as Texas Back institute that employs DCs(http://www.texasback.com/doctors.htm)

-There is also CAM research fellowship available for DCs. Chiropractors who are interested in researching complementary and alternative medicine (CAM) are invited to apply for a research fellowship from the National Center for Complementary and Alternative Medicine (NCCAM), a component of the National Institutes of Health.
------------------------

I recommend a visit to the National Campus for both you and your friend.
 
As to the assertion of "McDoctor"


Well, I addressed/debunked his "science" assertion above.

Although private practice or associating with an established DC, have traditionally/historically been the primary types of DC practice, that is also steadily changing and expanding.

A short list of a few examples are:
Depending upon the DCs areas of interest,
-there are many and various research options(touched on above),

-The Veterans Administration now offers chiropractic at more that 26 sites, and working for the VA is now another option.

-There are many very large and prestious multidisciplinary clinics, such as Texas Back institute that employs DCs(http://www.texasback.com/doctors.htm)

-There is also CAM research fellowship available for DCs. Chiropractors who are interested in researching complementary and alternative medicine (CAM) are invited to apply for a research fellowship from the National Center for Complementary and Alternative Medicine (NCCAM), a component of the National Institutes of Health.
------------------------

I recommend a visit to the National Campus for both you and your friend.

I'm not saying that going into Chiropractic medicine actually requires an outright rejection of all things scientific. You could strictly adhere to scientific reasoning and evidence based treatments, but you would be in the minority among the profession.

As far as the NCCAM at the NIH, the formation of this branch was primarily politically motivated and its existence remains controversial at best. Just because the government is willing to pour money into something doesn't automatically make it a worthwile endeavor. (There are too many examples of this to even begin to list.)
 
I'm not saying that going into Chiropractic medicine actually requires an outright rejection of all things scientific. You could strictly adhere to scientific reasoning and evidence based treatments, but you would be in the minority among the profession.

Can you please supply some documentation to support this assertion.

As far as the NCCAM at the NIH, the formation of this branch was primarily politically motivated and its existence remains controversial at best. Just because the government is willing to pour money into something doesn't automatically make it a worthwile endeavor. (There are too many examples of this to even begin to list.)

WHAT in healthcare is not "politically motivated"? :laugh:

However when 62%(when considering for prayer) of americans are using some sort of CAM- the need for NCCAM is more than obvious.
 
Can you please supply some documentation to support this assertion.



WHAT in healthcare is not "politically motivated"? :laugh:

However when 62%(when considering for prayer) of americans are using some sort of CAM- the need for NCCAM is more than obvious.

I'll concede that I probably can't produce any reliable statistics on the beliefs and practices of chiropractors today. I could provide links to various skeptical websites (Quackwatch, Chirobase, New England Skeptical Society, etc...) but they have their flaws, too, and this has been debated ad nauseum on these forums. My assertion is based on what I encounter in patients who frequent chiropractors and the reckless care that these chiropractors seem to provide.

I've already mentioned that as a DO, I get frustrated when I see some of these flighty osteopaths who reject all mainstream care and promote manipulations for every ailment and bilk patients for bi-monthly visits for "routine OMM". However, these clowns are in the minority for practicing DO's (though sometimes I think they run the AOA as well). What I see for chiropractors, though, is alot more of the homeopathy and "mineral therapy" and mega-vitamin therapy and "routine back maintenance" and "subluxations" and very little mainstream science.

I'm only suggesting that someone with a real passion for science would be unhappy in chiropractic school. The same person may be unhappy in osteopathic medical school, as well.
 
I'll concede that I probably can't produce any reliable statistics on the beliefs and practices of chiropractors today. I could provide links to various skeptical websites (Quackwatch, Chirobase, New England Skeptical Society, etc...) but they have their flaws, too, and this has been debated ad nauseum on these forums.

Perhaps- I don't know. However, you DO need to be aware of, and critically assess the sites you mention. They are not accurate, reliable or credible, and extremely biased and deceptive and oft quoted by the "agenda oriented".

Below are some excerpts, links, and highlights that support my assertion. I know, if you spend time to read/explore the links, you will no longer accept any of these sources with a blind eye as being even remotely credible. and will consider their diatribes for the deceptive and dishonest rantings they truly are.

There is SOOOO much to post on this, and my "below" may be not in "perfect" form/order, but if you follow the links, click on the links, you will get most of the important information.
-----------------------------------
Why the so-called "skeptics"(you referred to) are not "skeptics" at all-
Scooped! Sciency debunkery and other pseudoskeptical topics

http://www.randomjohn.info/wordpres...y-debunkery-and-other-pseudoskeptical-topics/
-----------------------


Some notes on Skepticism
http://www.suppressedscience.net/skepticism.html

Many who loudly advertise themselves as skeptics are actually disbelievers. Properly, a skeptic is a nonbeliever, a person who refuses to jump to conclusions based on inconclusive evidence. A disbeliever, on the other hand, is characterized by an a priori belief that a certain idea is wrong and will not be swayed by any amount of empirical evidence to the contrary. Since disbelievers usually fancy themselves skeptics, I will follow Truzzi and call them pseudoskeptics, and their opinions pseudoskepticism.


The remainder of this text is devoted to a detailed discussion of pseudoskeptical arguments and their pseudohonest debating tactics.
-------------------------
-If it was true, there is no way that science could have missed it!
This is a variation of the end of science argument

-Confusing Assumptions with Findings
Pseudoskeptics like to claim that the assumptions underlying modern science are empirical facts that science has proved
------------------------

-"Debate Closed" Mentality
Since Pseudoskeptics have by their nature made up their minds on any question long before the evidence is in, they are not interested in participating in what could become an involved, drawn-out debate. On the contrary, their concern is with preserving their own understanding of how nature works, so discordant evidence has to be disposed of as quickly as possible. When sound evidence to that end is unavailable, anything that sufficiently resembles it will suffice. Pseudoskeptics like to jump to conclusions quickly - when the conclusion is their own, preconceived one.
--------------------

-Overreaching and Armchair Quarterbacking
Faced with contradictory or inconclusive evidence, the skeptic will only say that the claim has not been proved at this time, and give the claimant the benefit of the doubt. The pseudoskeptic will make the (incorrect) counter-claim that the original claim has been disproved by the evidence (and usually follow up with generous amounts of name-calling and other extra-scientific arguments discussed below).
---------------------------

-Assuming False Scientific Authority
Many high-profile pseudoskeptics pass judgement based on scientific expertise they don't have. James Randi, for example, shares the following tirade in a July 13, 2001 commentary on his web site:
---------------------------

-Double Standards of Acceptable Proof and Ad-Hoc Hypotheses(this is a BIG one and needs to be read thoroughly)

The true skeptic will apply her skepticism equally to conventional and unconventional claims, and even to skepticism itself. In particular, the true skeptic recognizes an ad-hoc hypothesis regardless of the source. The pseudoskeptic, on the other hand, reserves her critical facilities for unconventional claims only.
-------------------------------

-Responding to Claims that were not made aka Demolishing Straw Men.
Benveniste (who showed that ultradilutions, i.e. homeopathic preparations not containing a single molecule of the original substance can still have a biological effect) was attacked by Nature editor John Maddox with the argument that dilutions of the kind used by Benveniste can simply not exist because they would require "1074 world oceans" (that is more water than contained in the entire universe) to manufacture. That is correct, if the definition of "dilution" requires that at least one molecule remain, but Benveniste (and generations of homeopaths) have readily conceded that very point! Everyone agrees that high homeopathic dilutions do not contain a single active molecule, so Maddox's argument is nothing but the ritual dissection of a straw man. He is not alone - "skeptical" discussions of homeopathy invariably spend a lot of time making this completely uncontested point.
--------------------------

-Technically Correct Pseudo-Refutation (credit for the term goes to Daniel Drasin):
Pseudoskeptics are fond of arguing that hundreds of respectable scientists believe that a certain idea is bunk, and therefore, it must be. When one points out to them that many scientific breakthroughs were ridiculed and dismissed by the scientific establishment of the time, they retort that not every idea that has been ridiculed or dismissed turned out to be correct. Correct, but completely irrelevant, because it responds to an argument that was not made. The argument was not that ridicule or dismissal by scientific experts is sufficient grounds for accepting an unorthodox claim, simply that it is insufficient grounds for rejecting it.
--------------------------

-Making criticisms that apply equally to conventional and unconventional research.
It should be obvious that a criticism is invalid if it applies just as well to established science as it applies to an unconventional claim (such a criticism is called uncontrolled). But pseudoskeptics get away with using this technique anyway. What follows are some common examples of uncontrolled and therefore invalid criticisms.
--Demanding an Unreasonable Degree of Reproducibility:......
--Profit Motive........
--Statistics can prove Anything!.........
--Fraud cannot be ruled out!........
--In Medicine: It's Unsafe!.......
--Accusations of Selective Reporting (the "File Drawer Effect").......
--Trying to End the Race when Their Side is Ahead:.........As an example, consider Randi's never-ending tirades against homeopathy. If you study his website, you will see that all he ever quotes is disconfirming medical studies, while the ones that confirm homeopathy are conveniently ignored.........
--Theory overrides Evidence:
--Misapplying Occam's Razor:...... in science, the simplest explanation tends to be the best. Pseudoskeptics usually insist that this heuristic rule of thumb is an immutable law of nature! In addition, they usually confuse simplicity with familiarity, and explanation with rationalization.
--Dislike of the consequences:
--Refusal to see the totality of the evidence:
--Setting Arbitrary Standards of Proof and Moving the goalposts: (changing previously agreed upon standards of evidence when those standards have been met.)
--Debunkery by association: If paranormal phenomena are real, then we might just as well believe in werewolves, fairies and unicorns! (one of my personal faves!!)
-------------------------------

--Dismissing claims because of their philosophical pedigree
Where debunkery by association seeks to discredit claims by linking them with similar, but unrelated, claims, this technique seeks to discredit ideas by discounting their empirical merits in favor of their philosophical origins. The Skeptic's Dictionary gives us once again a prime example. Under the heading "alternative health practices", we find the following definition:

Health or medical practices are called "alternative" if they are based on untested, untraditional or unscientific principles, methods, treatments or knowledge. "Alternative" medicine is often based upon metaphysical beliefs and is frequently anti-scientific.

But doctors of alternative medicine are frequently more scientific than their conventional colleagues. While the former employ modalities whose safety and efficacy has been demonstrated by decades (nutrition), centuries (homeopathy) or millennia (acupuncture) of clinical practice, the latter frequently derive their "scientific" knowledge from biased information and rigged drug studies communicated by pharma lobbyists. Death from alternative medicine is unheard of, but side-effects of conventional treatments are estimated to kill 100,000 people in the United States every year. It is therefore hard to dismiss alternative medicine on empirical grounds.

Yet for the pseudoskeptics, alternative medicine remains "unscientific", even "anti-scientific", because much of it is inspired by ancient beliefs and metaphysical ideas, such as the notion of a vital energy that animates the body, or the idea that thoughts create physical reality, not the other way. Pseudoskeptics find the notion that ancient civilizations could have known things that are still beyond the understanding of our current civilization deeply offensive. As rationalists, they believe that our ancestors were without exception superstitious, ignorant savages, and that our current understanding of nature represents the highest level of scientific knowledge that has ever existed on this planet. They are therefore categorically unwilling to entertain the notion that there could be any truth or validity to medical practices that were not developed by mechanistic, reductionist Western medicine. Whether or not alternative medicine has any merit is not at all a scientific question for them- it's personal.
-------------------------

--Slurs and Ridicule:......the true skeptic refrains from ad hominem attacks and name calling while the pseudoskeptic elevates them to an art form. Examples abound in pseudoskeptical books and periodicals. .......
------------------------------------


Dr. Stephen Barrett of Quackwatch Exposed In Court Cases
At trial, under a heated cross-examination by Negrete, Barrett conceded that he was not a Medical Board Certified psychiatrist because he had failed the certification exam.

This was a major revelation since Barrett had provided supposed expert testimony as a psychiatrist and had testified in numerous court cases. Barrett also had said that he was a legal expert even though he had no formal legal training.

The most damning testimony before the jury, under the intense cross-examination by Negrete, was that Barrett had filed similar defamation lawsuits against almost 40 people across the country within the past few years and had not won one single one at trial.

During the course of his examination, Barrett also had to concede his ties to the AMA, Federal Trade Commission (FTC) and Food & Drug Administration (FDA).
http://www.canlyme.com/quackwatch.html
----------------------

Some other very important reading here:

Data please: holding quackbusters to their own standards, Part I
http://www.randomjohn.info/wordpres...-holding-quackbusters-to-their-own-standards/

Data please: holding quackbusters to their own standards, Part II
http://www.randomjohn.info/wordpres...to-their-own-standards-part-ii-orac-you-know/
---------------------


Credibility of Barrett/Quackwatchers etc.
http://www.topix.net/forum/news/terri-schiavo/T9SDH0F0A1ONQK1L3
** Judge Fromholtz(not fooled by the fraudelent shift of "burden of proof" and in recognition of financial rewards-) ruled:
http://www.quackpotwatch.org/quackpots/california_superior_court_judge_.htm
***Furthermore, the Court finds that both Dr. Sampson and Dr. Barrett are biased heavily in favor of the Plaintiff and thus the weight to be accorded their testimony is slight in any event. Both are long-time board members of the Plaintiff; Dr. Barrett has served as its Chairman. Both participated in an application to the U.S. FDA during the early 1990s designed to restrict the sale of most homeopathic drugs. Dr. Sampson's university course presents what is effectively a one-sided, critical view of alternative medicine. Dr. Barrett's heavy activities in lecturing and writing about alternative medicine similarly are focused on the eradication of the practices about which he opines. Both witnesses' fees, as Dr. Barrett testified, are paid from a fund established by Plaintiff NCAHF from the proceeds of suits such as the case at bar. Based on this fact alone, the Court may infer that Dr. Barrett and Sampson are more likely to receive fees for testifying on behalf of NCAHF in future cases if the Plaintiff prevails in the instant action and thereby wins funds to enrich the litigation fund described by Dr. Barrett. It is apparent, therefore, that both men have a direct, personal financial interest in the outcome of this litigation. Based on all of these factors, Dr. Sampson and Dr. Barrett can be described as zealous advocates of the Plaintiff's position, and therefore not neutral or dispassionate witnesses or experts. In light of these affiliations and their orientation, it can fairly be said that Drs. Barrett and Sampson are themselves the client, and therefore their testimony should be accorded little, if any, credibility on that basis as well.
------------------------


*****Stephen Barrett, is the operator of 19 different Web sites, and to the uninformed, it would look like(which is exactly his intent) there is a large/huge following, when in essence, it only a handful of heavily networked/linked/computer savvy posters/contributors.-------------------
 
chiropractic is good money, people want alternative medicine
give people what they want and they'll be happy....
 
I don't think I gave any credence to Quackwatch in my post. I couldn't care less if the information on that site is accurate or not. I was just pointing out that a link to an anti-chiropractic website would just lead us to the same circular arguments we've all seen many times before on these forums regarding the credibility of these various demagogues and their websites. It looks like you felt the need to start the downward spiral, anyway.
 
My wife first started practicing acupuncture in a "wellness" clinic ran by chiropractor. At first, she really liked the place, but eventually [with my pleading, of course] she relocated and started working with another chiropractor. The new chiropractor is very good at what he does and stays within his scope. He also doesn't stroke the whole "wellness lifestyle" in order to rake in the money. This is quite different than the first chiropractor that was quoted in the KC small business journal as "hoping to put the hospitals out of business."

I hate that drivel. Anybody who has actually spent time in a hospital knows that all the chiropractic (or acupuncture, for that matter) in the world is going to do little to cut down on the number of patients that get admitted to the hospital. But this BS line does resonate well with many of the laypeople that latch onto these kinds of statements.

But to make masters worse, my wife spoke with one of her friends that still works at the old wellness center. Apparently the chiropractor, who calls herself the CEO BTW, is now trying to get all the staff to talk patients into getting their yearly lab work done at the center as opposed to with their PCP. She knows damn well that her patients' insurance will not reimburse them if they get their labs drawn there, but hey, more money in her pocket. Furthermore, she is expecting another chiropractor in her office to analyze the labs for the patients and act accordingly. She is knowingly telling her people to have the patients get their labs interpreted by a chiropractor as opposed to a doctor that actually learned how to do it in school, residency, and private practice.

Now off to my private acupuncture practice where I'm going to interpret my patients' ECGs.
 
If one does not subscribe to the beliefs of osteopathy, then why go to osteopathic school, why not go to allopathic medical school?



many people in osteopathic school could not get into allopathic school....sadly they do not believe in many of the tenets of osteopathy, but are simply looking to into "med school" ....this is sad but true
 
There is definitely a role for chiropractors..... their practices are actually very safe....you have a much higher risk of having an adverse reaction to a medication vs having an adverse event at your local chiropractor's office......the average chiropractor has more knowledge about spinal anatomy than the average internist....chiropractors who do not stray out of their scope of practice can be an asset to their patients...however, there are a few that cross the line.....it is interesting to me that some chiropractors approach schools about giving sports physicals...yet...the federal government (ie Medicare) will not reimburse chiropractors for an H&P (they only reimburse for manipulation).....personally, I would not take my child to a chiropractor for a sports physical....yet many schools to save a few bucks have decided to do this....good chiropractors know their strengths as well as limitations............I am a practicing interventional pain physician....I have seen many patients who were helped by chiropractors and I have seen many patients who thought that it was a big waste of time and money....In the end it is up to our patients to choose... we should provide them with good relevant information....there has been far too much fear and animosity between MD's and DC's....I encourage each of you to take some time out and visit one of your local chiropractors....you may be surprised at what you find.
 
many people in osteopathic school could not get into allopathic school....sadly they do not believe in many of the tenets of osteopathy, but are simply looking to into "med school" ....this is sad but true


I am in a combined MD/DO program. One of our hospitals is predominantly DO (to the point where MDs are pretty rare) and the other is about fifty-fifty. I think a lot of people don't realize that there are DO Orthopaedic Surgeons, Neurosurgeons, and every other specialty you can think of.

But I don't know a lot of DOs who do OMM.
 
There is definitely a role for chiropractors..... their practices are actually very safe....you have a much higher risk of having an adverse reaction to a medication vs having an adverse event at your local chiropractor's office......the average chiropractor has more knowledge about spinal anatomy than the average internist....chiropractors who do not stray out of their scope of practice can be an asset to their patients...however, there are a few that cross the line.....it is interesting to me that some chiropractors approach schools about giving sports physicals...yet...the federal government (ie Medicare) will not reimburse chiropractors for an H&P (they only reimburse for manipulation).....personally, I would not take my child to a chiropractor for a sports physical....yet many schools to save a few bucks have decided to do this....good chiropractors know their strengths as well as limitations............I am a practicing interventional pain physician....I have seen many patients who were helped by chiropractors and I have seen many patients who thought that it was a big waste of time and money....In the end it is up to our patients to choose... we should provide them with good relevant information....there has been far too much fear and animosity between MD's and DC's....I encourage each of you to take some time out and visit one of your local chiropractors....you may be surprised at what you find.

Chiropractors do have a role in spinal treatments. But the key words are "staying within their scope". If they start telling any of my patients that they are going to cure their gallbladder by adjusting their neck. I'm getting them out of there.

If they have acute back pain, I have sent them to a chiropractor. there is evidence that they can help for this.

I would never send a patient to a chiropractor for shoulder or arm pain. etc.
 
FWIW, there are several chiros at my medical school.

I wonder if there are any MD's at chiro school.
 
Chiropractors do have a role in spinal treatments. But the key words are "staying within their scope". If they start telling any of my patients that they are going to cure their gallbladder by adjusting their neck. I'm getting them out of there.

If they have acute back pain, I have sent them to a chiropractor. there is evidence that they can help for this.

I would never send a patient to a chiropractor for shoulder or arm pain. etc.



there are actually some chiros who do a good job at treating neck, shoulder, and arm pain (specifically cervical radiculopathy). Obviously patients with high grade stenosis or myelopathy are not good candidates for chiropractic treatment (they are actually contraindications).
 
there are actually some chiros who do a good job at treating neck, shoulder, and arm pain (specifically cervical radiculopathy). Obviously patients with high grade stenosis or myelopathy are not good candidates for chiropractic treatment (they are actually contraindications).

Where is the scientific evidence?

- H
 
Where is the scientific evidence?

- H


This is a good question. Even chiropractors themselves find very scant literature supporting what they do. Chiropractic manipulation is hard to look at in a traditional study model(how would you perform sham manipulation to make a randomized placebo control trial). However, in many procedure oriented disciplines evidence is lacking. Why do we do so much back surgery (evidence does not support this)? Why are there so many C-sections in this country? Why do cardiologists use antibiotic coated stents (very very expensive)? What about spinal injections for low back pain? There is little or no evidence supporting many of these practices.

However, as an interventional pain management specialist I see thousands of patients per year who have seen a chiropractor for treatment of low back or neck pain. I am yet to find anyone who is worse off or has had a major complication after chiropractic therapy. The vast majority of these patient have found some relief (albeit short term relief). Clinical experience does have some weight. In fact many studies are slanted one way or the other depending on who is conducting it (pharmaceutical companies promoting drugs, chiropractors promoting their professions, etc).


I dont know what specialty you practice. But if you ask your patients about treatment of their acute low back or neck pain, many will likely tell you that they found some relief with chiropractic therapy. I am afraid that this is the closest to a "study" that you will find.
 

Licensed in the US or Canada MD's? I could imagine that someone from the former Soviet Union or some other place that can't get licensed might go chiro, but someone able to practice? I know of one former MD/Ophtho from the Ukraine who went to optometry school because she didn't want to go to medical school and residency again in the US, to get licensed.

Why?

According to the chiros in my med school, they can get reimbursed about 10x for the same therapy as an MD than as a chiro.
 
This is a good question. Even chiropractors themselves find very scant literature supporting what they do. Chiropractic manipulation is hard to look at in a traditional study model(how would you perform sham manipulation to make a randomized placebo control trial). However, in many procedure oriented disciplines evidence is lacking. Why do we do so much back surgery (evidence does not support this)? Why are there so many C-sections in this country? Why do cardiologists use antibiotic coated stents (very very expensive)? What about spinal injections for low back pain? There is little or no evidence supporting many of these practices.

However, as an interventional pain management specialist I see thousands of patients per year who have seen a chiropractor for treatment of low back or neck pain. I am yet to find anyone who is worse off or has had a major complication after chiropractic therapy. The vast majority of these patient have found some relief (albeit short term relief). Clinical experience does have some weight. In fact many studies are slanted one way or the other depending on who is conducting it (pharmaceutical companies promoting drugs, chiropractors promoting their professions, etc).


I dont know what specialty you practice. But if you ask your patients about treatment of their acute low back or neck pain, many will likely tell you that they found some relief with chiropractic therapy. I am afraid that this is the closest to a "study" that you will find.

I practice emergency medicine. I have seen many patients worse off because of chiropractic. And while the literature is practically silent on the benefits of chiropractic, even the chiropractic literature is rife with descriptions of the risks. So no proven benefit versus mild documented risk. No brainer - no chiropractic.

- H
 

How many? Yes, we are all aware of the chiroweb article from a few years back, but do you honestly see an appreciable number of US/Canadian licensed MD/DOs going to chiropractic school? Look around SDN, there are a fair number of chiropractors in medical school (or contemplating doing so). I've never heard (outside of one propaganda article) of an MD/DO doing so. How many MDs in your class?

- H
 
The thing is, people want to believe that there is a miracle cure.

All the procedures done for backs only have limited success rates. Several studies over the years have shown that physical therapy works almost as well as surgery.

Interventional medicine is good as well, but not 100%. Nothing even comes close to 100% for everyone.

There are patients that do get good results.

A big part of all of this is providers (regardless of specialty) need to tell the patients that there is not miracle cure and patients will see some symptoms resolution but not complete resolution.

When you combine most of these non-surgical modalities, patients seen to do well. It takes time and it take repeated treatments and since pain is chronic in many cases, they will have to come back for more repeated treatments.

Some may need surgery, but not as many as are being done to date.
 
The thing is, people want to believe that there is a miracle cure.

All the procedures done for backs only have limited success rates. Several studies over the years have shown that physical therapy works almost as well as surgery.

Interventional medicine is good as well, but not 100%. Nothing even comes close to 100% for everyone.

There are patients that do get good results.

A big part of all of this is providers (regardless of specialty) need to tell the patients that there is not miracle cure and patients will see some symptoms resolution but not complete resolution.

When you combine most of these non-surgical modalities, patients seen to do well. It takes time and it take repeated treatments and since pain is chronic in many cases, they will have to come back for more repeated treatments.

Some may need surgery, but not as many as are being done to date.

I fully agree with you. What is often missing in the non-surgical techniques, and in my experience especially so in the sCAM community, is a realistic discussion of the risks, benefits, and alternatives. I also have concerns regarding the information provided to patients about their provider's level of education / training.

- H
 
How many? Yes, we are all aware of the chiroweb article from a few years back, but do you honestly see an appreciable number of US/Canadian licensed MD/DOs going to chiropractic school? Look around SDN, there are a fair number of chiropractors in medical school (or contemplating doing so). I've never heard (outside of one propaganda article) of an MD/DO doing so. How many MDs in your class?

- H
The question was were there ANY. The answer was yes. Usually they are foreign MD's unable or unwilling to get licensed here.
 
I fully agree with you. What is often missing in the non-surgical techniques, and in my experience especially so in the sCAM community, is a realistic discussion of the risks, benefits, and alternatives.

Do you notice that you ask for evidence when talking to other people but use your experience when you are asked to provide some? You say the sCAM providers fail to give a realistic assessment of the risks, benefits, and alternatives for what they do - is this from your experience also? Do you have research to back it up? If a clinician's anedoctal evidence doesn't sway you, then why should your anecdotal evidence sway them?

Edit: seeing both sides of the education I readily admit that many of us sCAM providers are trained to the level to accurately give all the risks, benefits, and alternatives. Of course, that 's based on my experience...

I also have concerns regarding the information provided to patients about their provider's level of education / training.
- H

Couldn't agree more. In addition to sCAM providers being honest about the level of their schooling, conventional providers should say up front if they actually studied a sCAM modality or if they did a series of weekend courses to bring more money into their practice.
 
Do you notice that you ask for evidence when talking to other people but use your experience when you are asked to provide some? You say the sCAM providers fail to give a realistic assessment of the risks, benefits, and alternatives for what they do - is this from your experience also? Do you have research to back it up? If a clinician's anedoctal evidence doesn't sway you, then why should your anecdotal evidence sway them?

Actually, yes, I do discuss the risk, benefits, and alternatives to treatment with all of my patients. When there exists decent evidence, I explain that to them, if the treatment is anecdota, I explain that as well. The problem is that, for chiropractic, there exists no good evidence that the modality works for anything. It is unfair to compare one or two possibile treatments a cardiologist may offer to chiropractic. On the whole, cardiology works.

Edit: seeing both sides of the education I readily admit that many of us sCAM providers are trained to the level to accurately give all the risks, benefits, and alternatives. Of course, that 's based on my experience...

Risks, benefits and alternatives including traditional medicine?

Couldn't agree more. In addition to sCAM providers being honest about the level of their schooling, conventional providers should say up front if they actually studied a sCAM modality or if they did a series of weekend courses to bring more money into their practice.

Absolutely! In fact, I am somewhat against MD/DOs providing sCAM modalities. If they believe the therapy works, then set the patient up with a qualified provider...

- H
 
I also have concerns regarding the information provided to patients about their provider's level of education / training.

- H

I agree and share the same concerns. -----How many patients presenting to a GP with low back pain, or neck pain are "provided" this information @ "level of education/training" of the provider, relative to NMSK?

J Bone Joint Surg Am. 2005 Feb;87(2):310-4. Links
Adequacy of education in musculoskeletal medicine.Matzkin E, Smith EL, Freccero D, Richardson AB.
University of Hawaii and Tripler Army Medical Center, Honolulu 96859, USA. [email protected]

BACKGROUND: Basic musculoskeletal knowledge is essential to the practice of medicine. A validated musculoskeletal cognitive examination was given to medical students, residents, and staff physicians in multiple disciplines of medicine to assess the adequacy of their musculoskeletal medicine training. METHODS: The examination was given to 334 volunteers consisting of medical students, residents, and staff physicians. Analysis of the data collected and comparisons across disciplines were performed. RESULTS: The average cognitive examination score was 57%. Sixty-nine participants (21%) obtained a score of >/=73.1%, the recommended mean passing score. Of the sixty-nine with a passing score, forty (58%) were orthopaedic residents and staff physicians with an overall average score of 94%. Differences in the average scores for the orthopaedic residents compared with all other specialties were significant (p < 0.001). The average score was 69% for the 124 participants who stated that they had taken a required or an elective course in orthopaedics during their training compared with an average score of 50% for the 210 who had not taken an orthopaedic course (p < 0.001). When the scores of those in orthopaedics were excluded, the average score for the participants who had taken an orthopaedic course was 59%; this difference remained significant (p < 0.001). CONCLUSIONS: Seventy-nine percent of the participants failed the basic musculoskeletal cognitive examination. This suggests that training in musculoskeletal medicine is inadequate in both medical school and nonorthopaedic residency training programs. Among the nonorthopaedists, scores were significantly better if they had taken a medical school course or residency rotation in orthopaedics, suggesting that a rotation in orthopaedics would improve the general level of musculoskeletal knowledge.
 
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