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As a PT I have learned that massage is an ABSOLUTE contraindication to patients with CA. Want to find out who really has trouble with chiropractors? talk to some PTs. I know of plenty of chiropractors who claim to employ PTs or perform PT when in fact they have not been licensed and it is illegal in just about all states to say you are performing "physical therapy" or that you are a "physical therapist" without proper education and licensing requirements.
I don't think MD/DOs have as much trouble with chiros and I do believe they have their place but it bothers me to see the ones who are shady.
Sorry for the rant but that sums up my perspective.
-J
I don't think MD/DOs have as much trouble with chiros and I do believe they have their place but it bothers me to see the ones who are shady.
Sorry for the rant but that sums up my perspective.
-J
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There are very, very few chiropractors in hospitals and if so, usually in an outpatient setting. As a chiropractor myself, I have this to offer. The problem with chiropractic is the variation within the profession. You have chiropractors who are very scientific and evidence-based. Then you also have those who are very alternative and seem to have forgetten all the basic sciences they ever learned in chiro school. When I was practicing, there were physicians/surgeons who were willing to work with me (and referred patients to me) and probably a few that just thought I was a quack. I think what it largely comes down to is personal experience with chiropractors.
I've been seeing a chiropractor since I was born. While I think there are a lot of them who promote their practices in misleading ways, I really enjoy going to mine. I can tell when I need to go, and over the years he's saved my butt in some of those "oh no I slept wrong and can't turn my head to the right" situations. He loves to give me a hard time for getting an MD, but recognizes that not everyone shares his theory on the best way to practice healing. He does no massage and never claims to practice PT. He refused to treat my grandmother after she was diagnosed with cancer because of the risk of fractures. A friend of mine with uncontrolled asthma went and, although skeptical of benefit he might have with regards to breathing, found himself using his inhaler MUCH less often following his adjustment. I think when used responsibly and honestly, chiro can be a good thing, and shouldn't automatically be poo-pooed.
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Totally agree with awdc.
I have a good friend who is nearing the end of her chiro program, and one of the major things she complained about was the variation within the profession, and the competing schools of thought in terms of treating patients.
I would not go as far to say that chiro is a bunch of BS, esp. when looking at the extensive courseload and heavy science basis that students of chiropractic endure. It is by no means medical school, but its significance and breadth cannot be understated. If anything, chiropractic definitely helps in terms of maintenance of chronic conditions. I've had several friends and family members go to chiropractors, and it has definitely improved their quality of life - not placebo effect.
I think that people may also look toward the profession as quackery b/c of the limited requirements for entrance into schools of chiropractic (just recently 90 undergraduate credits were required for entrance, previously 60) in addition to a lack of prescriptive power in healing and the example set by a bad seed (i.e., see loss of accreditation at one southern chiro school). Chiropractic seems to be going through motions similar to what the osteopathic medical profession endured (and still endures in the eyes of some folks). The bottom line is indeed that one's interaction with chiropractors determines value in the profession, as well as the appreciation (or lack thereof) for holistic methods of healing.
Just my two pennies...
H&T
I have a good friend who is nearing the end of her chiro program, and one of the major things she complained about was the variation within the profession, and the competing schools of thought in terms of treating patients.
I would not go as far to say that chiro is a bunch of BS, esp. when looking at the extensive courseload and heavy science basis that students of chiropractic endure. It is by no means medical school, but its significance and breadth cannot be understated. If anything, chiropractic definitely helps in terms of maintenance of chronic conditions. I've had several friends and family members go to chiropractors, and it has definitely improved their quality of life - not placebo effect.
I think that people may also look toward the profession as quackery b/c of the limited requirements for entrance into schools of chiropractic (just recently 90 undergraduate credits were required for entrance, previously 60) in addition to a lack of prescriptive power in healing and the example set by a bad seed (i.e., see loss of accreditation at one southern chiro school). Chiropractic seems to be going through motions similar to what the osteopathic medical profession endured (and still endures in the eyes of some folks). The bottom line is indeed that one's interaction with chiropractors determines value in the profession, as well as the appreciation (or lack thereof) for holistic methods of healing.
Just my two pennies...
H&T
Cervical manipulations can be extremely dangerous (as demonstrated by a recent court ruling here in Canada where a 40ish year old lady suffered a massive stroke and died following treatment by a chiro). IMO, evidence based practices should be universal; no matter what "branch" of health care. This isn't the case for chiropractors. If memory serves me right (and please correct me if I'm wrong), the chiropractic profession originates from a boy who worked in a fruit store in the 18th or 19th century who decided to manipulate his brothers neck following an injury. The injury resovled and the first chiropractor was born.
Y
Spinal manipulation for the treatment of acute low back pain is well-established (do a Medline search) and is as effective as other forms of "standard" therapy such as exercise, physical therapy, and medicine. There was a recent RAND study and AIM article on this. Most of the evidence-based chiropractors limit themselves to the neuromusculoskeletal system and what they do is very similar to physical therapy and rehabilitation. Where some DC's get wild ideas stems from the traditional chiropractic philosophy espoused by the founder's son, BJ Palmer in the early 1900's. Unfortunately, depending on the chiro school and a few professors, the traditional chiropractic philosophy can be heavily emphasized. Chiro students also get wild ideas at various seminars and other DC's in practice that they try to emulate. I have yet to figure out why some students are prone to subscribing to questionable theories and practices, though.
And to correct a previous post, chiropractic was founded by DD Palmer in 1895 in Davenport, Iowa. He labeled himself a magnetic healer (don't quite remember what that meant or his history/qualifications, though) and "stumbled" upon chiropractic when he adjusted the neck of a deaf janitor who suddenly regained his hearing.
And yes, manipulation can be dangerous but far less so than most people think. The risk of an adverse event with cervical manipulation is estimated at 1 in 1 million to 1 in 3 million depending on the literature. I believe this is far less than NSAIDS (correct me if I'm wrong). There are also certain risk factors that make certain people prone to an adverse event from cervical spine manipulation and the wise DC should take heed.
And geez, never take a lay public program on health related issues as the last word. They always have a way of distorting the facts and have a habit of leaving out important data and conclusions.
And to correct a previous post, chiropractic was founded by DD Palmer in 1895 in Davenport, Iowa. He labeled himself a magnetic healer (don't quite remember what that meant or his history/qualifications, though) and "stumbled" upon chiropractic when he adjusted the neck of a deaf janitor who suddenly regained his hearing.
And yes, manipulation can be dangerous but far less so than most people think. The risk of an adverse event with cervical manipulation is estimated at 1 in 1 million to 1 in 3 million depending on the literature. I believe this is far less than NSAIDS (correct me if I'm wrong). There are also certain risk factors that make certain people prone to an adverse event from cervical spine manipulation and the wise DC should take heed.
And geez, never take a lay public program on health related issues as the last word. They always have a way of distorting the facts and have a habit of leaving out important data and conclusions.
There was actually a proposal to start employing chiropractors in VA hospitals a few years ago. I don't know whatever became of that. I'm all for whatever works for patients, whether it's placebo or not. The only danger with chiropractors is that sometimes their manipulations can be dangerous to patients with things like osteoporosis, and sometimes they miss real pathology that could be medically or surgically corrected if caught on time. I met one patient in the ER who was telling me how he had been seeing a chiropractor for the past 5 months for his case of what we diagnosed to be spinal stenosis. He finally came to the ER when his legs began to get so weak that he wasn't able to stand on his own anymore and his legs were both numb. This is a condition that may have been able to be fixed with neurosurgery, but because of the long delay in therapy, there's a good chance that he will never walk without assistance again. I don't know what they train chiropractors, but they definitely do need to focus more on training the neurosurgical emergency signs to help them diagnose it.
Everything you suggested above is emphasized in chiropractic education and training. The problem I find is that there are those few chiropractors who for some reason or another, aren't too bright or vigilant about such things. Or they're convinced that the adjustments will eventually work despite worsening symptoms. Either way, it's sad...
Chiropractic school is not easy. Yes the entrance requirements may be low but the norm for entering students is not. I would say at least 90 percent of entering students have an undergraduate degree and 3.0 plus GPA. Not all medicals schools require an undergraduate degree and some do have low entrance requirements. This doesn't mean that everyone who enters has a real low GPA or doesn't have an undergraduate degree.
A lot of the quackery you see practiced by chiropractors is learned on their own. Chiropractic school does not teach you that chiropractic can cure infections or even cancer. Where these quacks learn this stuff is beyond me. Even the worst chiropractic school, which recently lost it accreditation doesn't go that far.
As far as the risk of chiropractic manipulation and stroke goes it is very low as stated by awdc.
Some PT's have problems with chiropractors but it is for political reasons. Chiropractors are licensed to perform physical therapy in most all states. The only one I'm unsure about is Michigan (which until recently had the lowest requirements to get a license). It is illegal for a chiropractor or anyone else, in most states, to advertise they perform physical therapy. The term "physical therapy" is protected by most physical therapy practice acts like the term "chiropractic" is. Chiropractors can employ physical therapists and also can delegate physical therapy services. There is nothing illegal about it. We are fully trained in physical therapy and its practice is within our scope.
It is true that many hospitals do not employ chiropractors. This has changed quite a bit over time. There are now hospitals that grant chiropractors privileges in many areas and some even have co-admitting privileges. A chiropractor really couldn't have admitting privileges on his/her own as they really can't write orders without some sort of prescription rights. This is why they have "co-admitting privileges".
There was actually a proposal to start employing chiropractors in VA hospitals a few years ago. I don't know whatever became of that. I'm all for whatever works for patients, whether it's placebo or not. The only danger with chiropractors is that sometimes their manipulations can be dangerous to patients with things like osteoporosis, and sometimes they miss real pathology that could be medically or surgically corrected if caught on time. I met one patient in the ER who was telling me how he had been seeing a chiropractor for the past 5 months for his case of what we diagnosed to be spinal stenosis. He finally came to the ER when his legs began to get so weak that he wasn't able to stand on his own anymore and his legs were both numb. This is a condition that may have been able to be fixed with neurosurgery, but because of the long delay in therapy, there's a good chance that he will never walk without assistance again. I don't know what they train chiropractors, but they definitely do need to focus more on training the neurosurgical emergency signs to help them diagnose it.
The proposal pasted back in 2000. http://www.amerchiro.org/government/dod/101700.shtml
There is danger with just about any treatment. Chiropractors spend more time learning when NOT to adjust or perform manipulation than we do learning when to adjust or manipulate. The danger lies in those not properly trained in manipulation and those not trained to recognize when and when not to use it. Spinal stenosis is something we see all the time. It is something we diagnose all the time. Many of these patients get tremendous relief from chiropractic care. We are trained in "emergency signs" such as TRUE Cauda Equina Syndrome. There are many scenarios we could unravel if we new the actual interaction the chiropractor and patient had. Maybe the guy went for five months, quit going, and then showed up in the ER a year later...
A lot of the quackery you see practiced by chiropractors is learned on their own. Chiropractic school does not teach you that chiropractic can cure infections or even cancer. Where these quacks learn this stuff is beyond me. Even the worst chiropractic school, which recently lost it accreditation doesn't go that far.
As far as the risk of chiropractic manipulation and stroke goes it is very low as stated by awdc.
Some PT's have problems with chiropractors but it is for political reasons. Chiropractors are licensed to perform physical therapy in most all states. The only one I'm unsure about is Michigan (which until recently had the lowest requirements to get a license). It is illegal for a chiropractor or anyone else, in most states, to advertise they perform physical therapy. The term "physical therapy" is protected by most physical therapy practice acts like the term "chiropractic" is. Chiropractors can employ physical therapists and also can delegate physical therapy services. There is nothing illegal about it. We are fully trained in physical therapy and its practice is within our scope.
It is true that many hospitals do not employ chiropractors. This has changed quite a bit over time. There are now hospitals that grant chiropractors privileges in many areas and some even have co-admitting privileges. A chiropractor really couldn't have admitting privileges on his/her own as they really can't write orders without some sort of prescription rights. This is why they have "co-admitting privileges".
There was actually a proposal to start employing chiropractors in VA hospitals a few years ago. I don't know whatever became of that. I'm all for whatever works for patients, whether it's placebo or not. The only danger with chiropractors is that sometimes their manipulations can be dangerous to patients with things like osteoporosis, and sometimes they miss real pathology that could be medically or surgically corrected if caught on time. I met one patient in the ER who was telling me how he had been seeing a chiropractor for the past 5 months for his case of what we diagnosed to be spinal stenosis. He finally came to the ER when his legs began to get so weak that he wasn't able to stand on his own anymore and his legs were both numb. This is a condition that may have been able to be fixed with neurosurgery, but because of the long delay in therapy, there's a good chance that he will never walk without assistance again. I don't know what they train chiropractors, but they definitely do need to focus more on training the neurosurgical emergency signs to help them diagnose it.
The proposal pasted back in 2000. http://www.amerchiro.org/government/dod/101700.shtml
There is danger with just about any treatment. Chiropractors spend more time learning when NOT to adjust or perform manipulation than we do learning when to adjust or manipulate. The danger lies in those not properly trained in manipulation and those not trained to recognize when and when not to use it. Spinal stenosis is something we see all the time. It is something we diagnose all the time. Many of these patients get tremendous relief from chiropractic care. We are trained in "emergency signs" such as TRUE Cauda Equina Syndrome. There are many scenarios we could unravel if we new the actual interaction the chiropractor and patient had. Maybe the guy went for five months, quit going, and then showed up in the ER a year later...
Do you have a source that supports these numbers?
according to
J Manipulative Physiol Ther. 1997 Feb; 20(2): 86-91. Comparison of entrance requirements for health care professions.
Type and Number
of Schools
% with
Bachelor's Degree
Avg. Minimum
GPA Required
Avg. GPA of Enrollees
Medical (17)
99.35%
3.16
3.56
Optometry (16)
76.88%
2.55
3.30
Osteopathic (16)
97.00%
2.68
3.26
Dental (15)
66.87%
2.79
3.13
Podiatry (7)
89.40%
2.76
3.06
Chiropractic (16)
42.25%
2.38
2.90
number in parenthesis are sample size
first number is percent w/undergraduate degree
second number is minimum gpa
third number is mean gpa of attending
Chiropractic is the lowest by far. And less than half even graduated college. on the other hand, over 99% allopathic students have an undergraduate degree with a mean GPA over 3.5.
this study was from faculty at Los Angeles College of Chiropractic, Whittier, California
i'm not trying to say that all chiropractics perform quackery, but i don't agree with some of the comparisons you are making between the entrance requirements between the two disciplines.
goo
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nuclearrabbit77, I wasn't denying that entrance REQUIREMENTS were low or lowest with regard to chiropractic school. I was saying that not every student that enters chiropractic school enters with the minimal requirements. I agree I threw some numbers out there before looking at the whole picture.
Unfortunately with chiropractic school there are good and bad schools. The bad schools outweigh the good ones. I was basing my opinion on the school I attended and the class I was in. I wouldn't draw my conclusions from one study.
Unfortunately with chiropractic school there are good and bad schools. The bad schools outweigh the good ones. I was basing my opinion on the school I attended and the class I was in. I wouldn't draw my conclusions from one study.
True, however that data is nearly 10 years old. Although the data probably still follows similar trends, that validity of that quoted data may be questioned.
Also, those sample sizes are completely absurd.
I don't really understand how the sample sizes are completely absurd. Please enlighten me.
Have a look at http://www.cbc.ca/consumers/market/files/health/vaccines/pg_one.html
You can watch the video from this episode as well.
I realise that this group may not represent most Chiropractors, but they are very vocal and they tarnish the entire profession.
Backtalk: I'd like to know what you think about the guys on the link that I provided. We've interacted on this site before and you've always come across as very rational and reasonable. Have you heard of Tedd Koren? This guy strikes me as a complete idiot (albeit wealthy). This bastard shoots his mouth off about all sorts conspiracies which would apparently make the conspirators very rich, all the while getting rich by getting people to pay to watch him shoot his mouth off!! What a hypocrite 😡
I particularly liked his response when they asked him how he knew that various and sundry conditions are 2ary to vaccinations, "The child is normal and then develops autism right after the vaccination". Way to ignore the large body of evidence against you Tedd, all the while using reasoning which could kindly be described as specious.
Dr. Collins, the other Chiropractor they interviewed, said nothing intelligent and was clearly stumped when the interviewer suggested that her advice, if followed by many, could be a catastrophe.
You can watch the video from this episode as well.
I realise that this group may not represent most Chiropractors, but they are very vocal and they tarnish the entire profession.
Backtalk: I'd like to know what you think about the guys on the link that I provided. We've interacted on this site before and you've always come across as very rational and reasonable. Have you heard of Tedd Koren? This guy strikes me as a complete idiot (albeit wealthy). This bastard shoots his mouth off about all sorts conspiracies which would apparently make the conspirators very rich, all the while getting rich by getting people to pay to watch him shoot his mouth off!! What a hypocrite 😡
I particularly liked his response when they asked him how he knew that various and sundry conditions are 2ary to vaccinations, "The child is normal and then develops autism right after the vaccination". Way to ignore the large body of evidence against you Tedd, all the while using reasoning which could kindly be described as specious.
Dr. Collins, the other Chiropractor they interviewed, said nothing intelligent and was clearly stumped when the interviewer suggested that her advice, if followed by many, could be a catastrophe.
thanks for the link. it's quite good.
No problem.
When I watch reports on medical topics, I often find that the reporters give equal credence to all opinions (even if some of the opinions are very uninformed, as in this case) in the name of objectivity. However, in this particular argument , one side has almost all of the evidence in their favour and the journalist seems to recognise that.
My sister-in-law is a Certified Chiropractic Assistant and although she doesn't currently work for a Chiropractor she has done so in the past. Since I am in medical school I manage to piss her off from time to time with my opinions on Chiropractic.
One story she loves to tell is about how the chiropractor she worked for "diagnosed" a brain tumor. Of course when pressed the whole story went something like this. A guy comes in complaining of severe headaches and continues to receive chiropractic treatment for a period of time without it helping his headaches. Finally the chiropractor, realizing that he can't do anything, sends him to an M.D. who orders the proper tests and finds a brain tumor. So the chiropractor likes to take credit for being involved in the diagnosis of the brain tumor when in fact he was just delaying proper diagnosis and treatment of the tumor which eventually killed the patient.
I actually looked into chiropractic as a career before deciding that medical school was a MUCH better option. I'm glad I didn't make that mistake. In large part it's because of what I read on the quackwatch.com website and their special section devoted to chiropractic.
One story she loves to tell is about how the chiropractor she worked for "diagnosed" a brain tumor. Of course when pressed the whole story went something like this. A guy comes in complaining of severe headaches and continues to receive chiropractic treatment for a period of time without it helping his headaches. Finally the chiropractor, realizing that he can't do anything, sends him to an M.D. who orders the proper tests and finds a brain tumor. So the chiropractor likes to take credit for being involved in the diagnosis of the brain tumor when in fact he was just delaying proper diagnosis and treatment of the tumor which eventually killed the patient.
I actually looked into chiropractic as a career before deciding that medical school was a MUCH better option. I'm glad I didn't make that mistake. In large part it's because of what I read on the quackwatch.com website and their special section devoted to chiropractic.
Yes I've heard of Tedd Koren. In my opinion he is a quack job and bad for our profession. My opinion of vaccination is that it does more good than harm. Both my kids are vaccinated and doing fine. Of course there is risk with vaccination and I would hope all physicians at least realize that.
As far as the brain tumor goes it is the RADIOLOGIST who actually diagnosed it. As I've said before they are the most relied upon doctor in my opinion. The chiropractor your sister worked for should be commended as he actually did the right thing. Since his patient was not responding to care he appropriately referred the patient. As far as taking credit, well that's debatable.
I had a patient come in about three months ago with lower back pain. Sent for x-rays and they were negative for anything other than arthritis. Treated him for two weeks and he was not getting better. I send him for a MRI and he has renal carcinoma. So does that mean I'm a quack too? Who made the diagnosis? Was it me because I ordered the proper test? Or was it the radiologist who read the films? I sent this guy off to a specialist and his life was saved. I guess I could say I saved his life couldn't I.
Sometimes there is a delay in diagnosis. The guy I told you about saw his MD for 2 months complaining his back hurt. He was prescribed pain medication and muscle relaxants and told to return in a month if pain persisted. Month goes by and he is still hurting but pain medication is giving him temporary relief. The MD adds Celebrex to the mix and sends the patient to physical therapy. After that fails (3X week for 4 weeks) he ends up coming to me for his back pain. You see the delay in diagnosis here?
As far as the brain tumor goes it is the RADIOLOGIST who actually diagnosed it. As I've said before they are the most relied upon doctor in my opinion. The chiropractor your sister worked for should be commended as he actually did the right thing. Since his patient was not responding to care he appropriately referred the patient. As far as taking credit, well that's debatable.
I had a patient come in about three months ago with lower back pain. Sent for x-rays and they were negative for anything other than arthritis. Treated him for two weeks and he was not getting better. I send him for a MRI and he has renal carcinoma. So does that mean I'm a quack too? Who made the diagnosis? Was it me because I ordered the proper test? Or was it the radiologist who read the films? I sent this guy off to a specialist and his life was saved. I guess I could say I saved his life couldn't I.
Sometimes there is a delay in diagnosis. The guy I told you about saw his MD for 2 months complaining his back hurt. He was prescribed pain medication and muscle relaxants and told to return in a month if pain persisted. Month goes by and he is still hurting but pain medication is giving him temporary relief. The MD adds Celebrex to the mix and sends the patient to physical therapy. After that fails (3X week for 4 weeks) he ends up coming to me for his back pain. You see the delay in diagnosis here?
No doubt about it, we chiros have our share of lunatics, just like any other profession, maybe more than most. But it's my experience in 20 years of practice that most MDs are intelligent enough to judge DCs individually, not as a profession.
I realize that forums allow a certain anonymity, and thus more vitriolic attitudes than would probably be the case in personal communications.
Yes, I've met my share of MDs that I wouldn't let treat my dog, but I certainly don't conclude that therefore all MDs are buffoons. That would be childish and foolish.
An earlier poster acknowledged that the vocal minority get the press, and I couldn't agree more.
It's reasonable to conclude that chiropractic is a relatively new profession, and will undoubtedly greatly improve in all respects with time. One of our greatest shortcomings is a paucity of DB RCTs, but it's difficult logistically to perform sham versus legitimate manipulation for research purposes.
My best,
ChiroOrtho
I realize that forums allow a certain anonymity, and thus more vitriolic attitudes than would probably be the case in personal communications.
Yes, I've met my share of MDs that I wouldn't let treat my dog, but I certainly don't conclude that therefore all MDs are buffoons. That would be childish and foolish.
An earlier poster acknowledged that the vocal minority get the press, and I couldn't agree more.
It's reasonable to conclude that chiropractic is a relatively new profession, and will undoubtedly greatly improve in all respects with time. One of our greatest shortcomings is a paucity of DB RCTs, but it's difficult logistically to perform sham versus legitimate manipulation for research purposes.
My best,
ChiroOrtho
DB RCT?
All I come up with when I see those acronyms are "distobuccal" and "root canal therapy." Translate the jargon?
All I come up with when I see those acronyms are "distobuccal" and "root canal therapy." Translate the jargon?
Hi again Bill,
DB: double-blind
RCT: randomized controlled trials
Your favorite DC,
ChiroOrtho
By the way, your earlier post about your friend the gastroenterologist getting the worst end of the alimentary tract was great.
By the way, just to show I have a sense of humor:
Q: How many chiropractors does it take to change a light bulb?
A: Only one, but it takes 20 visits (for my intense DC colleagues, please don't flame me--a little humor is a good thing)
This gets to the heart of the matter. The foundation of science relies on hypothesis testing.
I agree completely. Hopefully the logistical limitations will be overcome in time relative to manipulative therapy. I'm as interested as you may be in testing the hypothesis that manipulation is better than other interventions (or no interventions at all) for given musculoskeletal conditions.
I focus on musculoskeletal disorders in my practice, vis a vis my colleagues that make various claims to treat this or that disease, and empirically we know that chiropractic treatment helps a subset of patients with mechanical neck/back pain. But the science is insufficient as to exactly why, and this troubles me.
I welcome rigorous evaluation by research, and let the chips fall where they may. This is not an emotional issue to me. If it's placebo, fine. If it's an as-yet understood mechanism, fine. I'll synthesize good science and deal with it.
But again, RCTs/DB studies are difficult in this area, and I hope that someday this obstacle is overcome.
ChiroOrtho
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Here's part of the problem as I see it:
In medicine, I think that we try to rein in the fringe elements. Often , those on the fringe will complain that they're being disciplined for 'not toeing the line', but that's not really the case. They get themselves in trouble by making ridiculous claims or using bogus modalities (I can think of one such case in my area a few years ago).
In Chiropractic, there seem to be a lot of apologists for the nutbars. The response is , 'most of us don't practice that way', but the fringe is allowed to continue making improbable claims without fear of being sanctionned.
I also agree with you that the fringe element in Chiropractic is larger than would be desirable. The WCA apparently claims 5000 members---that's almost 10% of the profession. I've read through their website ( http://www.worldchiropracticalliance.org/ ) and I'm prety sure that these folks live in a parallel universe to us.
I am also well aware that there a plenty of competent Chiros who do a good job with NMS problems and don't claim to treat hypertension/diabetes/Kluver-Bucy syndrome/etc. with SMT.
True
It's true that there is room for improvement as long as the desire is there. Sham SMT may be tricky, but it's an obstacle that can be overcome. One thought would be to recruit patients who've never had SMT to participate in studies. They would be easier to fool. There are other manual techniques used by Chiros which could be subjected to DB RCT. ART comes to mind. I've had ART quite a few times, but I think that I could still be fooled by a sham procedure. I'd also like to see how ell ART does in large scale trials. There are lots of impressive testimonials (my own experience has ben that it may have provided a modest benefit), but I can't find much hard data.
Personally, I like having the option of manual therapy. I don't want to pop 10 Advils a day every time I get injured. But the onus of proof is on the claimant, and it's important for Chiro researchers to produce the evidence (and not that garbage in JVSR that the straights like to quote) for their treatment modalities.
Originally posted by russellb
Here's part of the problem as I see it:
In medicine, I think that we try to rein in the fringe elements.
-I agree. But medical associations are not only much larger, but have funds to pursue the fringe doctors. Apart from that, with the current paucity of objective research, chiro boards worry that they'll be sued for restraint of trade. Trust me, at least in Florida our board is as proactive as any. See www.doh.state.fl.us/mqa/chiro/chiro_minutes.html (I hope the link works) and check out the minutes of recent board meetings.
In Chiropractic, there seem to be a lot of apologists for the nutbars. The response is , 'most of us don't practice that way', but the fringe is allowed to continue making improbable claims without fear of being sanctionned.
-The fact is, most of us don't practice that way.
I also agree with you that the fringe element in Chiropractic is larger than would be desirable. The WCA apparently claims 5000 members---that's almost 10% of the profession. I've read through their website http://www.worldchiropracticalliance.org/ and I'm prety sure that these folks live in a parallel universe to us.
-Don't believe most of what you see regarding membership numbers. These straight organizations are not what they appear to be. Ask the WCA to document their membership numbers (actual paying members).
I am also well aware that there a plenty of competent Chiros who do a good job with NMS problems and don't claim to treat hypertension/diabetes/Kluver-Bucy syndrome/etc. with SMT.
-My take on this is if I take care of all the NMS problems in my town, there won't be any time for the other stuff. It's a no-brainer to me, but the vocal few will still deny the value of vaccinations, etc.
[B}It's true that there is room for improvement as long as the desire is there. Sham SMT may be tricky, but it's an obstacle that can be overcome. One thought would be to recruit patients who've never had SMT to participate in studies. They would be easier to fool. There are other manual techniques used by Chiros which could be subjected to DB RCT. ART comes to mind. I've had ART quite a few times, but I think that I could still be fooled by a sham procedure. I'd also like to see how ell ART does in large scale trials. There are lots of impressive testimonials (my own experience has ben that it may have provided a modest benefit), but I can't find much hard data.
-Can't comment about ART...I have no idea what it is. Maybe you're right.
But the onus of proof is on the claimant, and it's important for Chiro researchers to produce the evidence (and not that garbage in JVSR that the straights like to quote) for their treatment
modalities.
-Agreed.
ChiroOrtho
Here's part of the problem as I see it:
In medicine, I think that we try to rein in the fringe elements.
-I agree. But medical associations are not only much larger, but have funds to pursue the fringe doctors. Apart from that, with the current paucity of objective research, chiro boards worry that they'll be sued for restraint of trade. Trust me, at least in Florida our board is as proactive as any. See www.doh.state.fl.us/mqa/chiro/chiro_minutes.html (I hope the link works) and check out the minutes of recent board meetings.
In Chiropractic, there seem to be a lot of apologists for the nutbars. The response is , 'most of us don't practice that way', but the fringe is allowed to continue making improbable claims without fear of being sanctionned.
-The fact is, most of us don't practice that way.
I also agree with you that the fringe element in Chiropractic is larger than would be desirable. The WCA apparently claims 5000 members---that's almost 10% of the profession. I've read through their website http://www.worldchiropracticalliance.org/ and I'm prety sure that these folks live in a parallel universe to us.
-Don't believe most of what you see regarding membership numbers. These straight organizations are not what they appear to be. Ask the WCA to document their membership numbers (actual paying members).
I am also well aware that there a plenty of competent Chiros who do a good job with NMS problems and don't claim to treat hypertension/diabetes/Kluver-Bucy syndrome/etc. with SMT.
-My take on this is if I take care of all the NMS problems in my town, there won't be any time for the other stuff. It's a no-brainer to me, but the vocal few will still deny the value of vaccinations, etc.
[B}It's true that there is room for improvement as long as the desire is there. Sham SMT may be tricky, but it's an obstacle that can be overcome. One thought would be to recruit patients who've never had SMT to participate in studies. They would be easier to fool. There are other manual techniques used by Chiros which could be subjected to DB RCT. ART comes to mind. I've had ART quite a few times, but I think that I could still be fooled by a sham procedure. I'd also like to see how ell ART does in large scale trials. There are lots of impressive testimonials (my own experience has ben that it may have provided a modest benefit), but I can't find much hard data.
-Can't comment about ART...I have no idea what it is. Maybe you're right.
But the onus of proof is on the claimant, and it's important for Chiro researchers to produce the evidence (and not that garbage in JVSR that the straights like to quote) for their treatment
modalities.
-Agreed.
ChiroOrtho
Interesting perspective.
I'll have to take your word for it.
Hmmm....I'll e-mail them and see if I get a response. You may well have a point, though. Their philosophy is not based on facts, so their quoted membership numbers may not be factual either.
That's a rational approach and that's probably how things should be. As we've discussed, it's the vocal few who ruin it for the group because they paint a very negative image of the profession to other health professionals---- it's what we see and hear.
Re: vaccinations ---that's a bit of a sticky issue. The % of anti-vax Chiropractors is surprisingly high. What's interesting is how their views seem to evolve during Chiropractic school:
http://www.cmaj.ca/cgi/content/full/166/12/1531
The lead author of this article is a DC from CMCC.
ART= Active Release Techniques. It's popular among athletes and weekend warriors:
http://www.activerelease.com/
It may be a promising technique, but there's not much data behind it.
My interactions with Chiropractors on this site as well as in real life (my gym is right near CMCC and there are quite a few members who are students or staff Chiros there) have been largely positive. Some of my initial concerns have been put to rest.
My impression is that there are certain schools in the US which are anti-vax (Palmer, Life, Sherman).
CMCC is a good school and the admission standards are reasonably high ( I think that the average GPA is about 3.3). They are also officially pro-vax, which makes the rate of anti-vax sentiment there quite surprising. If you have a few moments, watch the video from http://www.cbc.ca/consumers/market/...nes/pg_one.html
Dr. Busse's comments are insightful.
On the other hand, Dr Koren and Dr Collins' comments are embarrassing .
Thanks. It's good that there are a few Chiropractors who join in these discussions. You guys can help us develop a balanced perspective of your profession 😎
No, I read it to be the number of schools. But how many medical schools are there (MD)? 120+? They only sampled 17 of those. Does that really give a valued representation of averages?
No. I graduated from Dalhousie Med (Halifax, Nova Scotia). I did my residency (Radiology) in Ottawa,Ontario (U. of Ottawa) , and my fellowship in Baltimore at Johns Hopkins.
You're right. They're free to think whatever they want. The key is making sure that they don't have a noticeable effect on public health.
I gather that this isn't the first time Koren's made controversial statements.
17 is almost 15% of the total # of med schools. As long as they sampled a mix of private and public schools from various states, the results should be represebntative (not sure if they did this). Judging from the published average med school GPAs (these can be found in the US News and World Report Guide to Grad Schools), 3.56 sounds pretty close (the range was about 3.4 to 3.85, so 3.56 might be a bit low).
Originally posted by russellb
You're right. They're free to think whatever they want. The key is making sure that they don't have a noticeable effect on public health
--Sadly, disinformation is all-too-readily given airtime, and you're absolutely correct...the results are at times tragic.
I gather that this isn't the first time Koren's made controversial statements.
--You gathered correctly. If I were inclined, I could send you some of the positions that Dr. Koren has held, but neither of us needs to take time to review it. Suffice it to say that videos such as you referred to previously speak eloquently for themselves.
My best,
ChiroOrtho
You're right. They're free to think whatever they want. The key is making sure that they don't have a noticeable effect on public health
--Sadly, disinformation is all-too-readily given airtime, and you're absolutely correct...the results are at times tragic.
I gather that this isn't the first time Koren's made controversial statements.
--You gathered correctly. If I were inclined, I could send you some of the positions that Dr. Koren has held, but neither of us needs to take time to review it. Suffice it to say that videos such as you referred to previously speak eloquently for themselves.
My best,
ChiroOrtho
there can be problems with the methodology of the experimental design, but saying that the validity of the experiment is completely absurd intrinsically due to the previously mentioned sample size needs support.
Lets say there was a clinical trial testing vitamin X for preventing breast cancer, with 20,000 participants at 22 hospitals. Is the validity of the sample size completely absurd due to your proportional reasoning (17/120) vs. (20,000 women/100,000,000+women in USA) or (22 hospitals/1000++ hospitals)
There is a way to test whether the sample size is good enough, and it will be addressed in the statistics part of your curriculum. (if they have it at your institution)
Canuck MD,
Your post is very misleading, and it is obvious that you simply heard of this case on the 11 o'clock news and are unaware that the case was thrown out, as Ms. Lana Lewis' stroke was not caused as a result of a chiropractic adjustment. In fact it was determined that advanced atherosclerosis was the cause of this lady's stroke:
Advanced Atherosclerosis Caused Stroke, Noted Neuropathologist Tells Lana Lewis Inquest
Toronto, December 9, 2002 - Dr. Harker Rhodes, a noted Harvard, Cornell and Rockefeller University educated neuropathologist today told the jury in the Lana Lewis inquest that Ms. Lewis "died as a result of a clot that formed in her vertebral artery caused by her atherosclerosis."
Dr. Rhodes stated that "it was simply a coincidence" that Ms. Lewis had received a neck adjustment more than a week prior to her stroke. Dr. Rhodes projected slides of the tissue samples from Ms. Lewis' autopsy and showed the jury the extent to which atherosclerosis had seriously damaged Ms. Lewis' left and right vertebral arteries. The slides illustrated that Mr. Lewis' left vertebral artery was, in Dr. Rhodes words, "virtually, completely destroyed" by atherosclerotic disease. Dr. Rhodes also noted the presence of severe atherosclerosis in Ms. Lewis' right vertebral artery which was 70 per cent blocked by the disease.
Dr. Rhodes based his testimony on an independent examination of the tissue samples prepared by the Coroner's office. Dr. Rhodes stated that his assessment of the evidence agreed with Dr. Pollanen's assessment that Ms. Lewis suffered from severe end-stage atherosclerosis which led to clotting and stroke.
Dr. Rhodes stated that there was "no evidence of dissection" which would be expected if there had been externally-caused injury to the artery. He testified that the clot present in Ms. Lewis' left vertebral artery exhibited, "the classic appearance we expect to see in a thrombus built-up through atherosclerosis."
Dr. Rhodes told the jury that thrombus or blood clotting is "a deadly complication of atherosclerosis" and that all of the physical evidence in Ms. Lewis' case was completely consistent with that diagnosis.
When asked by counsel if that diagnosis is a difficult conclusion to reach in this case, Dr. Rhodes testified, "No. It is not."
Dr. Rhodes is the fifth medical expert at the inquest to testify that Ms. Lewis died of natural causes arising from complications of advanced atherosclerosis. The inquest continues tomorrow.
Your post is very misleading, and it is obvious that you simply heard of this case on the 11 o'clock news and are unaware that the case was thrown out, as Ms. Lana Lewis' stroke was not caused as a result of a chiropractic adjustment. In fact it was determined that advanced atherosclerosis was the cause of this lady's stroke:
Advanced Atherosclerosis Caused Stroke, Noted Neuropathologist Tells Lana Lewis Inquest
Toronto, December 9, 2002 - Dr. Harker Rhodes, a noted Harvard, Cornell and Rockefeller University educated neuropathologist today told the jury in the Lana Lewis inquest that Ms. Lewis "died as a result of a clot that formed in her vertebral artery caused by her atherosclerosis."
Dr. Rhodes stated that "it was simply a coincidence" that Ms. Lewis had received a neck adjustment more than a week prior to her stroke. Dr. Rhodes projected slides of the tissue samples from Ms. Lewis' autopsy and showed the jury the extent to which atherosclerosis had seriously damaged Ms. Lewis' left and right vertebral arteries. The slides illustrated that Mr. Lewis' left vertebral artery was, in Dr. Rhodes words, "virtually, completely destroyed" by atherosclerotic disease. Dr. Rhodes also noted the presence of severe atherosclerosis in Ms. Lewis' right vertebral artery which was 70 per cent blocked by the disease.
Dr. Rhodes based his testimony on an independent examination of the tissue samples prepared by the Coroner's office. Dr. Rhodes stated that his assessment of the evidence agreed with Dr. Pollanen's assessment that Ms. Lewis suffered from severe end-stage atherosclerosis which led to clotting and stroke.
Dr. Rhodes stated that there was "no evidence of dissection" which would be expected if there had been externally-caused injury to the artery. He testified that the clot present in Ms. Lewis' left vertebral artery exhibited, "the classic appearance we expect to see in a thrombus built-up through atherosclerosis."
Dr. Rhodes told the jury that thrombus or blood clotting is "a deadly complication of atherosclerosis" and that all of the physical evidence in Ms. Lewis' case was completely consistent with that diagnosis.
When asked by counsel if that diagnosis is a difficult conclusion to reach in this case, Dr. Rhodes testified, "No. It is not."
Dr. Rhodes is the fifth medical expert at the inquest to testify that Ms. Lewis died of natural causes arising from complications of advanced atherosclerosis. The inquest continues tomorrow.
Never mind.... found what I was looking for.
Hey wabbit - you think the person you're replying to is still looking at this thread almost 3 years later?
The general consensus from docs in my town was as long as they know what they are realistically good at...it doesn't bother them. The chiropractors that bother, at least my parents, are the ones that take xrays for no real reason and talk about how going there will solve all of their problems.
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D
Dr_Feelgood
One thing that validates DC medical education is DO programs. OMM is similar to the theories taught in chiropractic school. One thing that I've always been puzzled is why DC patients don't go to DOs. Many times DC services are not covered (I know it is not covered by Medicare) but OMM from a DO is covered.
My guess is b/c most DOs don't practice OMM after they leave med school. This is what also hurts DC. Most of the physicians who are trained in OMM abandon the practice.
My guess is b/c most DOs don't practice OMM after they leave med school. This is what also hurts DC. Most of the physicians who are trained in OMM abandon the practice.
D
Dr_Feelgood
I'm sure there has to be something more recent, this article is almost 10 years old.
Why do most people go to a chiropractor rather than a osteopath for manipulation? I think it is like you said, many do not practice OMM. Also, most people don't know what a DO is and when it comes to manipulation, most people know a chiroipractor is the one to see. Chiropractic care is covered by most all insurance plans and it is covered under Medicare. I see quite a few Medicare patients.
D
Dr_Feelgood
This is news to me. I'm not a chiropractor but we just talked about Medicare laws and the university lawyer told us that it was not covered.
D
Dr_Feelgood
Sorry of the misinformation. I should have gone on line instead of listening to the lawyer (I've got to remember never trust a lawyer 
)
From what I've read you must X-Ray Medicare patients to prove the necessity of acute care. Is this true?
Also, since we are on the subject. Please don't ever tell a patient that they have heel spurs. Nothing bugs me more than that. FP and DC are notorious for doing this. It is plantar fascia not the bone. Also, if they have heel pain refer them don't X-ray them b/c I haven't seen a good foot or ankle x-ray from a DC yet. 🙂
)From what I've read you must X-Ray Medicare patients to prove the necessity of acute care. Is this true?
Also, since we are on the subject. Please don't ever tell a patient that they have heel spurs. Nothing bugs me more than that. FP and DC are notorious for doing this. It is plantar fascia not the bone. Also, if they have heel pain refer them don't X-ray them b/c I haven't seen a good foot or ankle x-ray from a DC yet. 🙂
