Jack Daniel
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Nemo said:
There is very little evidence to support ANY treatment modalities for most common types of musculoskeletal pain (i.e. Low Back Pain). I'm not aware of any evidence that supports the use of NSAID for longer than 3 weeks for instance.
I don't understand all the outrage. Patients are seeking out chiropractors, nobody is forcing patients to see them. If a chiropractor is suspect, it is up to the consumer to figure that out.
I constantly see people bashing alternative medicine because of lack of evidence, and I just want those people to acknowledge that alot of things done in allopathic medicine lack evidence as well. Most of the research done these days is funded by pharmaceutical companies, so there are disproportionately more studies to support use of medication vs alternative modalities in many cases.
But where is all the outrage over the overwhelming use of Neurontin for neuropathic pain without good evidence, or even FDA approval, to support this? What about doctors who heavily prescribe Statin's for primary prevention of heart disease even though the evidence to support this remains underwhelming. Is this quackery?
Personally, I'm not an advocate of alternative medicine but I don't feel threatened by it either.
BostonDO said:
I live in Illinois and hate huge cities. Chigago and Philly (been to both MANY times) are not my place. I hate NJ (no offense). UNECOM is one of my top choices, but I have been searching for chemist jobs in the area and have had trouble. Dh does not want to communte almost at all, if possible. We have 3 kids, and he doesn't want to only get to see them a couple hours a day with the commute. I used to commute over an hour and hated it.
PublicHealth said:
He attended the one near St.Louis (name?). So did his brother who I hear is also fabulous. I also have several classmates who were planning on going there. I can't remember the name of the school off the top of my head, though...
dnw826 said:
Logan
McDoctor said:
No one has suggested that there is (evidence to support ANY treatment of LBP). The best studies have shown that chiropractic and "traditional" medical therapy are roughly equal in efficacy but that chiropractic patients are generally "more satisfied" with their care (for LBP). However, both treatments are only slightly better than placebo in terms of outcome.
McDoctor said:
See this is where I disagree with you. Chiropractic is marketed to seemingly healthy people, often with dubious claims and tests (subluxation, thermal dynamics). Patients begin courses of "therapy" for these "problems". All well and good - caveat emptor. But then a "real" medical problem develops, and the patient's chiropractor, marketing themselves as a PCP, misses it. Now the patient, convinced they are being treated by a "doctor" recieves no follow-up. There are no practice managers, no nurses, no oversight at all to prevent or address lapses in care. Even the law is of little utility as chiropractors are held to the standards of chiropractic, a distinction patients may not comprehend.
McDoctor said:
But there are plenty of once "alternative" therapies that do work, have been validated by studies, and have become part of the science of medicine. It is not just the lack of validity that plauges chiropractic, it is the lack of definition of scope of practice, methodology, training, or general approach to care that endangers patients. I mean Hippocrates believed in the four humors but is still considered the father of modern medicine. Why? Because he brought a consistent, ordered, scientific approach we still use to this day.
McDoctor said:
The outrage is at the level of insurance providers not paying for the drug in these settings (owing to the work of case managers), in M&Ms when poor outcomes or significiant interactions result, or even in malpractice awards (Vioxx anyone?).
McDoctor said:
Nope, statins are absolutely accepted as the standard of care.
From Up-to-date:
---
CLINICAL TRIALS Thus far, six large primary prevention trials with cholesterol lowering agents have been published:
World Health Organization (WHO) Cooperative Trial which used clofibrate10,577 patients.
Lipid Research Clinics Coronary Primary Prevention Trial which used cholestyramine 3806 patients.
Helsinki Heart Study which used gemfibrozil 4081 patients.
West of Scotland Coronary Prevention Study Group which used pravastatin 6595 patients.
AFCAPS/TexCAPS trial which used lovastatin 6605 patients.
ASCOT-LLA trial which used atorvastatin 10,305 patients.
The mean demographics of the participants were relatively similar in the first four trials.
Gender only men were studied
Age 46 to 55 years
Total cholesterol 248 to 290 mg/dL (6.4 to 7.5 mmol/L)
HDL-cholesterol 46 mg/dL (1.2 mmol/L)
Triglycerides 159 to 177 mg/dL
Blood pressure 121/80 to 141/90
Percent current smokers 36 to 56 percent
The AFCAPS/TexCAPS trial enrolled both men and postmenopausal women who had average mean serum total and LDL cholesterol concentrations (221 and 140 mg/dL [5.7 and 3.9 mmol/L], respectively) and relatively low HDL values (36 mg/dL [0.94 mmol/L]).
The ASCOT-LLA trial (the lipid lowering arm of a larger trial) enrolled hypertensive men and women with at least three additional cardiac risk factors who had total serum cholesterol concentrations 251 mg/dL (6.5 mmol/L). The subjects had average mean serum total, LDL, and HDL cholesterol concentrations (213, 131, and 50 mg/dL [5.5,3.4, and 1.3 mmol/L], respectively).
Each of these trials showed benefit in the treated group. It is useful to consider the first three trials separately from the later trials. The three initial trials demonstrated significant reductions in coronary events (25, 19, and 34 percent, respectively) (show figure 2). The time to significant benefit varied from 1.5 years in the Helsinki Heart Study to three years in the WHO Cooperative Trial.
Effect of early trials on mortality These initial trials did not demonstrate a reduction in coronary mortality. This could be explained in part by sample size: in both the Lipid Research Clinics Trial and the Helsinki Heart Study, the sample size was calculated on the power to detect all combined (fatal and nonfatal) CHD endpoints, not fatal endpoints alone.
A more disturbing feature of these early primary prevention trials was an unexpected increase in mortality from noncardiovascular causes in each of the studies. Noncoronary death increased 31 to 42 percent, cancer death increased 18 to 24 percent in the WHO Cooperative Trial and the Helsinki Heart Study, and total mortality increased 25 percent in the WHO Cooperative Trial with no significant change in the other two studies. These changes were statistically significant only in the WHO Cooperative Trial, which was also the largest of these studies.
The higher death rate from noncardiac causes raised a concern regarding the safety of cholesterol-lowering therapy, particularly in a relatively low-risk population. This concern confounded management guidelines for primary preventive therapy in hypercholesterolemic subjects, until they were addressed in the West of Scotland Coronary Prevention Study.
West of Scotland Coronary Prevention Study The WOSCOPS trial was designed to evaluate the effect of pravastatin (40 mg/day) for five years on the rate of nonfatal MI and CHD death in 6595 men with hypercholesterolemia and no prior evidence of MI or cardiac revascularization. The study patient characteristics in this landmark trial included:
Men aged 45 to 64 years.
Total cholesterol concentration above 252 mg/dL (6.5 mmol/L) on initial screening.
LDL cholesterol above 155 mg/dL (4.0 mmol/L) on visits two and three and above 174 mg/dL (4.5 mmol/L) but below 232 mg/dL (6.0 mmol/L) on one occasion after dietary therapy for four weeks.
Patients who were randomized to pravastatin and were adherent to therapy showed the following change between baseline and end of study lipid levels:
Total cholesterol fell 20 percent from 272 to 218 mg/dL (7.0 to 5.6 mmol/L).
LDL-cholesterol fell 26 percent from 192 to 142 mg/dL (5.0 to 3.7 mmol/L).
HDL-cholesterol increased 5 percent from 44 to 46 mg/dL (1.14 to 1.19 mmol/L).
Triglycerides fell 12 percent from 162 to 143 mg/dL.
The results, based upon intention to treat principles, can be summarized as follows:
Nonfatal MI or CHD death 31 percent risk reduction (p<0.001).
Nonfatal MI 31 percent risk reduction (p<0.001).
All cardiovascular deaths 32 percent risk reduction (p = 0.033).
Total mortality 22 percent risk reduction (p = 0.051).
Coronary interventions with angiography, coronary artery bypass graft, or percutaneous transluminal coronary angioplasty were also reduced by 31 to 37 percent (p<0.01).
The above benefits were independent of other predictors of outcome including smoking, diabetes, nitrate consumption, ECG abnormalities, blood pressure, family history of CHD, angina pectoris, and the total cholesterol/HDL cholesterol ratio. Thus, the absolute benefit of therapy was greatest in subjects with the highest baseline risk.
------
Keep in mind, the JCAHO mandates statins as secondary and tertiary prevention (http://www.jointcommission.org/NR/rdonlyres/D94EDCD4-1187-443C-A359-5AB70DC35161/0/2o_AMIT2.pdf). BTW - where is the practice oversight equivalent of the JCAHO for chiropractic?
McDoctor said:
I not "threatened" by alternative medicine. In fact I see some aspects of it as very useful. But chiropractic, in my opinion, is different, because it seeks to advance itself by advertising as PCPs to the public. As pointed out earlier in the thread, chiropractic practice acts are, in some states, quite broad, and rather scary. Now, I hope to go into emergency medicine, and that field is not in "competition" with chiropractic at all, so that is not my concern. But, I do see patient advocacy as a key component of practice, and it is there that my concerns rest. Are there "good" chiropractors out there, sure. But is there any oversight, protection from, or detection of the bad ones?
PublicHealth and 611 - Does this post mean I am now the ghost of Foughtfire reincarnated? 😉
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I'll agree that a straightforward scientific approach seems to be lacking in chiropractic medicine. The same can be said for a fair share of techniques and principles used in Osteopathic Manipulative Medicine. Its interesting that the AOA seems to put the largest amount of money into advertising and advocating for the aspect of Osteopathic Medicine (manipulation) that has the least amount of evidence to support it use. I'm not sure why these organizations don't put their money where their mouth is, so to speak, and pour more resources into research and less into the glossy advertisements that accompany my monthly complimentary copy of the J.A.O.A.
There is a significant lobbying effort to expand the rights of Chiropractor's to prescribe medications, so I do wonder why they don't pour more money into research as well. Is there a fear that one claims will be unfounded? The more I think about it, maybe I should be more critical of alternative treatments.
Looking at the above post, its amazing the degree that we have scrutinized the link between cholesterol and Statins and cardiovascular disease. Is it any wonder that patients seem (misguidedly) fixated on their cholesterol as the end-all be-all indicator of whether or not they will die of heart disease.
There is a significant lobbying effort to expand the rights of Chiropractor's to prescribe medications, so I do wonder why they don't pour more money into research as well. Is there a fear that one claims will be unfounded? The more I think about it, maybe I should be more critical of alternative treatments.
Looking at the above post, its amazing the degree that we have scrutinized the link between cholesterol and Statins and cardiovascular disease. Is it any wonder that patients seem (misguidedly) fixated on their cholesterol as the end-all be-all indicator of whether or not they will die of heart disease.
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McDoctor said:
Excellent post. I think you deserve a Wikipedia entry for it! 😉
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Squad51 said:
He lives! You're less emotional about this issue, though.
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dnw826 said:
I loved st louis. It's not a "city" at all. Wonderful communities with all kinds of great stuff to do with and without kids. The Kirksville College of Osteopathic Medicine is a very highly regarded program. A friend of mine goes there 🙂.
plus many chemist jobs in stl.
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A chiropractic response to lack of research is often that they have been prevented from receiving funds for many years. You have to remember that chiropractic wasn't really allowed to participate in such things till 1988. this was when the ruling against the AMA came out and said they couldn't "talk bad" about chiropractic. On the one hand, that ruling dealt with affecting interstate commerce, not the validity of the science. On the other, it makes sense that they have a "lack" of research.
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USCguy said:
Right. Establishing the NCCAM has helped this effort along.
http://clinicaltrials.gov/search/te...practic+therapy)+[TREATMENT]?recruiting=false
http://nccam.nih.gov/news/19972000/030398.htm
Check out the links above http://www.ccgpp.org/index.htm
http://www.ccgpp.org/articles.htm for efforts to standardize chiropractic practice guidelines. This information usually flows from sound research.
More info: http://www.chiro.org/research/ABSTRACTS/Chiropractic_Research_Agenda.shtml
shorrin said:
3 of my favorite docs went to Kirksville, but isn't it relatively far from St.Louis? I only live 2.5 hours away from St.Louis, and there are good parts...and bad ones. I am mixed about the area. I LOVE Ste.Genevieve, though (hour south).
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dnw826 said:
Hey, get a thread! J/K. 😉
USCguy said:
The lawsuit had absolutely NOTHING to do with research. Chiropractic colleges (then and now) were always free to do research. They have chosen not to as it was commonly felt that "innate" was not measurable scientifically. And the lawsuit did NOT validate chiropractic as a methodology. A little background is in order here. In 1976, various chiropractors began a series of lawsuits against the AMA, other professional organizations, and several individual critics, charging that they had conspired to destroy chiropractic and to illegally deprive chiropractors of access to laboratory, x-ray, and hospital facilities. Most of the defendant groups agreed in out-of-court settlements that their physician members were free to decide for themselves how to deal with chiropractors. In 1987, federal court judge Susan Getzendanner concluded that during the 1960s "there was a lot of material available to the AMA Committee on Quackery that supported its belief that all chiropractic was unscientific and deleterious." The judge also noted that chiropractors still took too many x-rays. However, she ruled that the AMA had engaged in an illegal boycott. She concluded that the dominant reason for the AMA's antichiropractic campaign was the belief that chiropractic was not in the best interest of patients. But she ruled that this did not justify attempting to contain and eliminate an entire licensed profession without first demonstrating that a less restrictive campaign could not succeed in protecting the public. Although chiropractors trumpet the antitrust ruling as an endorsement of their effectiveness, the case was decided on narrow legal grounds (restraint of trade) and was not an evaluation of chiropractic methods. She basically decried chiropractic, finding that "The study of how the five original named plaintiffs diagnosed and actually treated patients with common symptoms was particularly impressive. This study demonstrated that the plaintiffs do not use common methods in treating common symptoms and that the treatment of patients appears to be undertaken on an ad hoc rather than on a scientific basis. And there was evidence of the use of cranial adjustments to cure cerebral palsy and other equally alarming practices by some chiropractors." But she ruled on a strictly legal basis that the boycott of chiropractic by the AMA was an illegal antitrust action. So your argument that the AMA prevented research is a spurious one.
Worse yet is the supposition by many on this board that research hasn't been done. It has, chiropractic just doesn't like the findings. There are several key studies, summarized by the NCCAM here: http://nccam.nih.gov/health/chiropractic/#app1 but the bottom line is that for LBP it is as effective as medical care, and it is not effective at all for any other condition - despite many poorly designed or controlled studies that purport that it is.
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An entertainingly biased, and amusingly inaccurate, interpretation of the judge's findings. For those interested in accuracy, and facts,------
Below is the Summary(from the actual court order) The entire order can be found at:
http://www.chiro.cc/files/amavschiro.pdf
Summary of Judge's Opinion and Order
On August 27, 1987, Judge Susan Getzendanner, United States District Judge for the Northern District of Illinois
Eastern Division, found the American Medical Association, The American College of Surgeons, and The American
College of Radiology, guilty of having conspired to destroy the profession of chiropractic in the United States.
In a 101-page opinion, Judge Getzendanner ruled that the American Medical Association and its co-conspirators
had violated the Sherman Antitrust Laws of the United States. Judge Getzendanner ruled that they had done this
by organizing a national boycott of doctors of chiropractic by medical physicians and hospitals using an ethics ban
on interprofessional cooperation.
Evidence at the trial showed that the defendants took active steps, often covert, to undermine chiropractic
educational institutions, conceal evidence of the usefulness of chiropractic care, undercut insurance programs for
patients of chiropractors, subvert government inquiries into the efficacy of chiropractic, engage in a massive
disinformation campaign to discredit and destabilize the chiropractic profession and engage in numerous other
activities to maintain a medical physician monopoly over health care in this country.
Judge Getzendanner ruled:
I conclude that an injunction is necessary in this case. There ore lingering effects of the conspiracy; the
AMA has never acknowledged the lawlessness of its post conduct and in fact to this day maintains that it
has always been in compliance with the antitrust laws; there has never been an affirmative statement by
the AMA that it is ethical to associate with chiropractors; there has never been a public statement to AMA
members of the admission made in this court about the improved nature of chiropractic despite the fact
that the AMA today claims that it made changes in its policy in recognition of the change and improvement
in chiropractic; there has never been public retraction of articles such as "The Right and Duty of Hospitals
to Deny Chiropractor Access to Hospitals"; a medical physician has to very carefully read the current AMA
Judicial Council Opinions to realize that there has been a change in the treatment of chiropractors and the
court cannot assume that members of the AMA pore over these opinions*, and finally, the systematic,
long-term wrongdoing and the long-term intent to destroy a licensed profession suggests that an injunction
is appropriate in this case. When all of these factors are considered in the context of this "private attorney
general" antitrust suit, a proper exercise of the court's discretion permits, and in my judgment requires, an
injunction. (Opinion pp. 11).
Evidence in the case demonstrated that the AMA knew of scientific studies implying that chiropractic care was
twice as effective cis medical care in relieving many painful conditions of the neck and back as well as related
musculoskeletal problems. The court concluded:
There also was some evidence before the Committee that chiropractic was effective - more effective than
the medical profession in treating certain kinds of problems such as workmen's back injuries. The
Committee on Quackery was also aware that some medical physicians believed chiropractic to be
effective and that chiropractors were better trained to deal with musculoskeletal problems than most
medical physicians. (Opinion pp. 7)
The Opinion found:
The AMA and its officials, including Dr. Sammons, instituted a boycott of chiropractors in the mid-1960s by
informing AMA members that chiropractors were unscientific practitioners and that it was unethical for a
medical physician to associate with chiropractors. The purpose of the boycott was to contain and eliminate
the chiropractic profession. This conduct constituted a conspiracy among the AMA and its members and
an unreasonable restraint of trade in violation of Section I of the Sherman Act.
The AMA sought to spread the boycott to other medical societies. Other groups agreed to participate in the
boycott by agreeing to induce their members to forego any form of professional, research, or educational
association with chiropractors. The defendants which knowingly joined in the conspiracy were ACS, ACR,
and AAOS. None of the defendants established the patient care defense. The plaintiffs are entitled to
injunctive relief against the AMA, ACS, and ACR, but not against AAOS or Dr. Sammons. The court shall
conduct further proceedings regarding the form of the injunction. The actions of the other defendants,
Chiropractic Antitrust Suit Wilk, et al., v. AMA, et al. 2
Provided by Chiropractic Canada www.chiropracticcanada.com
JCAH and ACP, were taken independently of the AMA boycott and these defendants did not join the
conspiracy. Accordingly, defendants JCAH, ACP, AAOS and Dr. Sammons are dismissed. (Opinion pp. 2)
The Committee on Quackery disbanded in December 1974 and considered its activities a success:
The AMA believed that chiropractic would hove achieved greater growth if it had not been for the
Committee's activities. (opinion pp. 4)
The Court of Appeals stated that enforcement of a code of ethics was not necessary to obtain compliance with the
boycott:
The anti-competitive effects of the boycott were generally conceded by the defendants' expert, William J.
Lynk of Lexecon, Inc. Some of the anticompetitive effects acknowledged by Mr. Lynk include the following:
it is anti-competitive and it raises costs to interfere with the consumer's free choice to take the product of
his liking; it is anti-competitive to prevent medical physicians from referring patients to a chiropractor; it is
anti-competitive to impose higher costs on chiropractors by forcing them to pay for their own x-ray
equipment rather than obtaining x-rays from hospital radiology departments or radiologists in private
practice; and it is anti-competitive to prevent chiropractors from improving their education in a professional
setting by preventing medical physicians from teaching or lecturing to chiropractors. Mr. Lynk agreed that
in an economic sense a boycott such as the one described by plaintiffs raises the costs of chiropractic
services and creates inefficiencies and economic dislocations. (Opinion pp. 6)
The anti -competitive effects of the AMA boycott were established by defendant's witnesses:
The activities of the AMA undoubtedly have injured the reputation of chiropractors generally. This kind of
injury more likely than not was sustained by the four plaintiffs. In my judgment, this injury continues to the
present time and likely continues to adversely affect the plaintiffs. The AMA has never made any attempt
to publicly repair the damage the boycott did to chiropractors' reputations. (Opinion pp. 10).
ORDER
Based on the findings of fact and conclusions of low set forth in this opinion, the case is dismissed against
defendants JCAH, ACP, AAOS, and Dr. Sammons, and an injunction shall issue against defendants AMA, ACS,
and ACR. The plaintiffs and the AMA, ACS, and ACR, are directed to confer on the form of injunction and to report
to the court on the progress of those discussions. The case is set for an in-chambers conference on September 4,
1987 at 3:00 P.M.
It is so ordered.
August 27, 1987
Susan Getzendanner
United States District Judge
Below is the Summary(from the actual court order) The entire order can be found at:
http://www.chiro.cc/files/amavschiro.pdf
Summary of Judge's Opinion and Order
On August 27, 1987, Judge Susan Getzendanner, United States District Judge for the Northern District of Illinois
Eastern Division, found the American Medical Association, The American College of Surgeons, and The American
College of Radiology, guilty of having conspired to destroy the profession of chiropractic in the United States.
In a 101-page opinion, Judge Getzendanner ruled that the American Medical Association and its co-conspirators
had violated the Sherman Antitrust Laws of the United States. Judge Getzendanner ruled that they had done this
by organizing a national boycott of doctors of chiropractic by medical physicians and hospitals using an ethics ban
on interprofessional cooperation.
Evidence at the trial showed that the defendants took active steps, often covert, to undermine chiropractic
educational institutions, conceal evidence of the usefulness of chiropractic care, undercut insurance programs for
patients of chiropractors, subvert government inquiries into the efficacy of chiropractic, engage in a massive
disinformation campaign to discredit and destabilize the chiropractic profession and engage in numerous other
activities to maintain a medical physician monopoly over health care in this country.
Judge Getzendanner ruled:
I conclude that an injunction is necessary in this case. There ore lingering effects of the conspiracy; the
AMA has never acknowledged the lawlessness of its post conduct and in fact to this day maintains that it
has always been in compliance with the antitrust laws; there has never been an affirmative statement by
the AMA that it is ethical to associate with chiropractors; there has never been a public statement to AMA
members of the admission made in this court about the improved nature of chiropractic despite the fact
that the AMA today claims that it made changes in its policy in recognition of the change and improvement
in chiropractic; there has never been public retraction of articles such as "The Right and Duty of Hospitals
to Deny Chiropractor Access to Hospitals"; a medical physician has to very carefully read the current AMA
Judicial Council Opinions to realize that there has been a change in the treatment of chiropractors and the
court cannot assume that members of the AMA pore over these opinions*, and finally, the systematic,
long-term wrongdoing and the long-term intent to destroy a licensed profession suggests that an injunction
is appropriate in this case. When all of these factors are considered in the context of this "private attorney
general" antitrust suit, a proper exercise of the court's discretion permits, and in my judgment requires, an
injunction. (Opinion pp. 11).
Evidence in the case demonstrated that the AMA knew of scientific studies implying that chiropractic care was
twice as effective cis medical care in relieving many painful conditions of the neck and back as well as related
musculoskeletal problems. The court concluded:
There also was some evidence before the Committee that chiropractic was effective - more effective than
the medical profession in treating certain kinds of problems such as workmen's back injuries. The
Committee on Quackery was also aware that some medical physicians believed chiropractic to be
effective and that chiropractors were better trained to deal with musculoskeletal problems than most
medical physicians. (Opinion pp. 7)
The Opinion found:
The AMA and its officials, including Dr. Sammons, instituted a boycott of chiropractors in the mid-1960s by
informing AMA members that chiropractors were unscientific practitioners and that it was unethical for a
medical physician to associate with chiropractors. The purpose of the boycott was to contain and eliminate
the chiropractic profession. This conduct constituted a conspiracy among the AMA and its members and
an unreasonable restraint of trade in violation of Section I of the Sherman Act.
The AMA sought to spread the boycott to other medical societies. Other groups agreed to participate in the
boycott by agreeing to induce their members to forego any form of professional, research, or educational
association with chiropractors. The defendants which knowingly joined in the conspiracy were ACS, ACR,
and AAOS. None of the defendants established the patient care defense. The plaintiffs are entitled to
injunctive relief against the AMA, ACS, and ACR, but not against AAOS or Dr. Sammons. The court shall
conduct further proceedings regarding the form of the injunction. The actions of the other defendants,
Chiropractic Antitrust Suit Wilk, et al., v. AMA, et al. 2
Provided by Chiropractic Canada www.chiropracticcanada.com
JCAH and ACP, were taken independently of the AMA boycott and these defendants did not join the
conspiracy. Accordingly, defendants JCAH, ACP, AAOS and Dr. Sammons are dismissed. (Opinion pp. 2)
The Committee on Quackery disbanded in December 1974 and considered its activities a success:
The AMA believed that chiropractic would hove achieved greater growth if it had not been for the
Committee's activities. (opinion pp. 4)
The Court of Appeals stated that enforcement of a code of ethics was not necessary to obtain compliance with the
boycott:
The anti-competitive effects of the boycott were generally conceded by the defendants' expert, William J.
Lynk of Lexecon, Inc. Some of the anticompetitive effects acknowledged by Mr. Lynk include the following:
it is anti-competitive and it raises costs to interfere with the consumer's free choice to take the product of
his liking; it is anti-competitive to prevent medical physicians from referring patients to a chiropractor; it is
anti-competitive to impose higher costs on chiropractors by forcing them to pay for their own x-ray
equipment rather than obtaining x-rays from hospital radiology departments or radiologists in private
practice; and it is anti-competitive to prevent chiropractors from improving their education in a professional
setting by preventing medical physicians from teaching or lecturing to chiropractors. Mr. Lynk agreed that
in an economic sense a boycott such as the one described by plaintiffs raises the costs of chiropractic
services and creates inefficiencies and economic dislocations. (Opinion pp. 6)
The anti -competitive effects of the AMA boycott were established by defendant's witnesses:
The activities of the AMA undoubtedly have injured the reputation of chiropractors generally. This kind of
injury more likely than not was sustained by the four plaintiffs. In my judgment, this injury continues to the
present time and likely continues to adversely affect the plaintiffs. The AMA has never made any attempt
to publicly repair the damage the boycott did to chiropractors' reputations. (Opinion pp. 10).
ORDER
Based on the findings of fact and conclusions of low set forth in this opinion, the case is dismissed against
defendants JCAH, ACP, AAOS, and Dr. Sammons, and an injunction shall issue against defendants AMA, ACS,
and ACR. The plaintiffs and the AMA, ACS, and ACR, are directed to confer on the form of injunction and to report
to the court on the progress of those discussions. The case is set for an in-chambers conference on September 4,
1987 at 3:00 P.M.
It is so ordered.
August 27, 1987
Susan Getzendanner
United States District Judge
wayttk said:
WOW! You really should put the disclaimer to your post that the sections in bold are NOT part of the court order. There was NEVER a finding that chiropractic was "twice as effective" as traditional medical care. There is NO QUESTION that the AMA actively worked against chiropractic. There is no question that the plaintiffs provided anecdotal evidence that chiropractic worked. But there were not the findings of effectiveness you claim.
From the order (the actual text, not an opinion - I added the bold effect but not the words):
"The next element is whether the concern for scientific method in patient care is objectively reasonable. In connection with this element of the patient care defense, the parties have devoted a substantial amount of effort in attempting to prove that chiropractic was either good or bad, efficacious or deleterious, quackery or science. At the time the Committee on Quackery was operating, there was a lot of material available to the Committee that supported its belief that all chiropractic was unscientific and deleterious. In fact, there was a substantial amount of evidence on which the Committee reasonably could conclude that chiropractic was based on the single cause of disease theory, despite some contrary evidence that the theory had been disavowed by modern practitioners."
Also from the order (the actual text, not an opinion - I added the bold effect but not the words):
"Most defense witnesses agreed that some chiropractic treatment is efficacious -- although certainly no one involved in this case, including the plaintiffs, believes that chiropractic treatment should be used for the treatment of diseases such as cancer, diabetes, and infections. It is hard to pinpoint when the changes in chiropractic testified to by AMA witnesses occurred, but it is likely that they occurred while the boycott was still in effect. Thus the AMA's own evidence suggests that at some point during the boycott there was no longer an objectively reasonable concern that would support a boycott of the entire chiropractic profession.
The plaintiffs clearly want more from the court. They want a judicial pronouncement that chiropractic is a valid, efficacious, even scientific health care service. I believe that the answer to that question can only be provided by a well designed, controlled, scientific study such as the one urged by the United States Congress' Office of Technology Assessment in its review of the New Zealand Report. In 1980, the AMA House of Delegates urged that such a study be done. No such study has ever been done. In the absence of such a study, the court is left to decide the issue on the basis of largely anecdotal evidence. I decline to pronounce chiropractic valid or invalid on anecdotal evidence."
The plaintiffs clearly want more from the court. They want a judicial pronouncement that chiropractic is a valid, efficacious, even scientific health care service. I believe that the answer to that question can only be provided by a well designed, controlled, scientific study such as the one urged by the United States Congress' Office of Technology Assessment in its review of the New Zealand Report. In 1980, the AMA House of Delegates urged that such a study be done. No such study has ever been done. In the absence of such a study, the court is left to decide the issue on the basis of largely anecdotal evidence. I decline to pronounce chiropractic valid or invalid on anecdotal evidence."
Not "twice as effective" (as your opinion piece claimed) but not an indictment either. But what should be interesting to a DC such as yourself who believes the scope of chiropractic is much more than NMS (and by your own words, you will act outside of your scope when the mood suits you) the judge specifically restated the plaintiffs (chiropractors) claims as "no one involved in this case, including the plaintiffs, believes that chiropractic treatment should be used for the treatment of diseases such as cancer, diabetes, and infections."
BTW - chirowebs.net is hardly an unbiased source.
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Squad51 said:
Perhaps they should reconsider the part about infections: http://www.ncbi.nlm.nih.gov/entrez/..._uids=16630981&query_hl=3&itool=pubmed_docsum
PublicHealth said:
Did you read this article? It suggests that chiropractors may be spreading infections, not curing them...
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Squad51 said:
Which is why if they expanded their scope of practice to include antibiotics, they may be able to treat the infections caused by their adjusting tables!
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wayttk said:
When research funding is dry, I guess this is the type of stuff you resort to doing.
wayttk said:
Actually, I don't like it or not. I've only read the abstract but the premise and methodology seem sound. But... since you made me look, the lead author is an instructor of microbiology at National. And he is a DC. No Ph.D., no Sc.D. A DC. Yep, I want to learn microbiology from a DC, talk about academic in-breeding.
Here is the faculty "list" for National: http://www.nuhs.edu/show.asp?durki=519 Not all that impressive...
PublicHealth said:
Actually research funding is pretty flush for National of late. My guess is that this is more motivated by the need to somehow validate the microbiology department of a chiropractic college by peer reviewed publication. Which is a real challenge given the ethical rules laid down by most IRBs (including National's - I've never suggested their research was unethical) for human participation and the extremely limited scope of chiropractic practice in dealing with infections.
Maybe they should hire wayttk, he can do anything!
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Squad51 said:
Yeah, people with Ph.D.'s from UPenn, University of Illinois, University of Chicago, Loyola University, Notre Dame, Medical College of Ohio, Washington State University are completely clueless. And all those people with doctoral degrees in chiropractic and naturopathic medicine, what the hell do they know?
You need to have an M.D. from an Ivy League medical school to be impressive in my book. Give me a break.
Oh, and you forgot to comment on the credentials of one of the co-authors of the paper noted above. Here are his credentials:
Jaya Prakash - Professor, Pathology, Microbiology, Public Health
Chair, Department of Basic Sciences
M.B.B.S., University of Poona, 1983
M.D., University of Poona, 1986
Specialist Microbiologist: American Academy of Microbiology, 1995
PublicHealth said:
Oh come on, they list 81 faculty, of those two are MDs (both from overseas schools, neither with board certification listed). One of those is seemingly an "expert" in everything as he (as you point out above) is not only the Chair of Basic Sciences but is also a full professor in Pathology, Public Health and Microbiology. That is far more broad than any faculty I've ever met. But lets continue (so far we are at 2/81), of the rest 11 have doctorates other than DC or ND. So 13/81 total have academic credentials. Yep, that is impressive. Several only have certificates, and even their deans list "Certified Strength Conditioning Specialist" credentials - oh boy! I'm fairly certain most of my medical school professors had their CPR cards, but our website isn't as good, so I guess I'll never know...
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Squad51 said:
Just because someone has a different doctoral degree (e.g., DC, ND) does not mean that they're poor clinicians.
DOs have to deal with the "oh, you're not a real doctor, though" crap all the time. My take on it is that if you have a doctoral-level degree, then you're an expert in that field, whether it's medicine, osteopathic medicine, chiropractic, optometry, or whatever. Naturally, schools of chiropractic and naturopathic medicine (e.g., National) will employ more chiropractic and naturopathic physicians than MDs or DOs.
PublicHealth said:
Get over the "poor me" thing. DOs are real doctors. And I am certain if you looked at your basic sciences faculty, a greater percentage than 13/81 have Ph.D.s or Sc.D.s.
You can't use DCs to academically validate the DC. It is a circular argument. And while I disagree with your assertion that "just because someone has a different doctoral degree (e.g., DC, ND) does not mean that they're poor clinicians" (because I don't accept these as true doctoral degrees), the DCs listed are NOT all teaching clinical skills. Lots of the basic science faculty are "only" DCs. So much for the academic rigor you and others have discussed so often in other threads...
For example:
Antonio Bifero - Instructor, Microbiology (one of two listed microbio faculty)
B.S., University of Illinois at Chicago, 1995
B.S., D.C., National University of Health Sciences, 2002, 2003
Terry M. Elder - Instructor, Chiropractic Practice, Prerequisite (one of four "prerequisite" faculty, of whom only a lecturer has a Ph.D.)
D.C., Cleveland Chiropractic College, 1987
Simone J. Joseph - Lecturer, Anatomy, Massage (one of four listed anatomy faculty. But also one of more than 30 "massage" faculty. Apparently a "happy ending" is more difficult to teach than is anatomy!)
B.S., University of Toronto, 1997
B.S., National College of Chiropractic, 2000
D.C., National University of Health Sciences, 2002
Stephen C. Lee - Assistant Professor, Physiology (one of five listed physiology faculty and he is a Master's degreed assistant professor?!?)
B.S., M.S., Louisiana Tech University, 1971, 1974
Marc McRae - Instructor, Biochemistry, Prerequisite (another one of the four "prerequisite" faculty, but he is the SOLE listed biochemistry faculty! But hey, the education is the same...)
B.Sc., B.A., University of Waterloo, 1991, 1997
B.S., D.C., National University of Health Sciences, 1999, 2001
M.S., University of Bridgeport, 2002
Certified Nutrition Specialist
Diplomate: American Clinical Board of Nutrition
Given that the number of faculty dedicated to teach anatomy equals the number teaching prerequisites, one has to wonder how the prereqs are actually considered as "pre"requisite.
But thank you for your post. I finally understand why you defend chiropractic so rigorously. Look, I'm sorry that the public sometimes confuses the two degrees (DO and DC). But the answer to that is not to attempt to elevate chiropractic into something it is not. That only disrespects the education you are working to hard to obtain. Do you really want to sit back 5+ years from now, after finishing school, internship and residency, only to hear your arguments parroted back to you - that a DC knows everything you know and should be able to do everything you do, with only three years of training?
BTW - are you really attempting to debate a comparison of academic rigor between MD/DO programs and chiropractic?!?
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Squad51 said:
More of Squad posting nonsense. As an example--
Below is the NUHS anatomy faculty:
Dept. of Basic Sciences / Anatomy
Jaya Prakash, MD, SM (NRM)
Chair, Department of Basic Sciences
630-889-6459, [email protected]
Cindy Belles, PhD
Instructor
630-889-6668 [email protected]
Gregory D. Cramer, DC, PhD
Professor
630-889-6536 [email protected]
Susan A. Darby, PhD
Associate Professor
630-889-6534 [email protected]
Simone J. Joseph, DC
Lecturer
630-889-6454 [email protected]
M.A. Khan, MD
Instructor
630-889-6535 [email protected]
Deborah Terry, DC
Lecturer
-----------------------------------------------
And this is the NUHS physiology faculty:
Dept. of Basic Sciences / Physiology and Biochemistry
Jaya Prakash, MD, SM (NRM)
Chair, Department of Basic Sciences
630-889-6459, [email protected]
Robert Appleyard, PhD
Associate Professor
630-889-6593 [email protected]
James A. Christiansen, PhD
Professor
630-889-6574 [email protected]
Robert Frysztak, PhD
Associate Professor
630-889-6504 [email protected]
Stephen Lee, MS
Assistant Professor
630-889-6576 [email protected]
Marc McRae, MS, DC
Instructor
630-889-6592 [email protected]
Joseph Stiefel, DC
Lecturer
These are but two examples of, squad not having a clue in his declarations. Says alot about his credibility.
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wayttk said:
Actually, I gave my source (http://www.nuhs.edu/show.asp?durki=519). If you don't like it, take it up with the webmaster. But let's look below to see how "off" and inaccurate I was...
On the webpage I cited more than 30 faculty are listed for "massage" but only 7 (by your research) in anatomy. That seems about right for a chiropractic college I suppose.
Now, by your post, the anatomy department has two of seven faculty that only have their DC, and two are MDs only, leaving a minority to actually hold the generally accepted Ph.D. degree. BTW - I would be leery of an MD teaching anatomy at a medical school without extensive research experience. Given the Dr. Prakash seems to head every department at National, it is unlikely he holds this expertise in anatomy. The ratio of qualified teachers is the issue, your post doesn't change that problem.
Now, as for the other section, umm, read the heading "Dept. of Basic Sciences / Physiology and Biochemistry". So, I suppose if you lump physiology, biochemistry and basic sciences together WE AGREE (I said 1 in biochem, 5 in physiology, and Dr. Prakash over basic sciences as a group).
Now the "Dept. of Basic Sciences / Physiology and Biochemistry", also has only three Ph.D.s, one MD (Dr. Prakash, shared with other departments), an MS as an assistant professor, and two DCs. Wow, that is really an academic powerhouse team - and they are covering two or three subjects (it is hard to tell) and only Dr. Marc McRae, MS, DC is listed as teaching biochemistry on either page.
wayttk said:
Just another example of a chiropractor reading the first line of something and deciding they know it all. Speaks volumes as to credibility. Especially when in his own post our numbers fully agree in one section and agree on the point of merit in the other - but I will accept that web page I cited appears to be incomplete with regard to anatomy faculty.
Try again wayttk!
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National is not representative of all chiropractic programs. Have a look at this basic science faculty list: http://www.bridgeport.edu/pages/2227.asp
PublicHealth said:
But you and others have held out National as the par excellance of chiropractic education. 611 has all but stated not to trust any chiropractor who didn't train there. Which is it?
And dude, let it be. Trying to defend chiropractic education as similar or equal to MD/DO is a losing battle. Even the chiropractors here (except wayttk 👍 ) have already conceded the point. And we are debating DC, not DO. DOs are equal in every way shape and form to MDs.
BTW - could it be that Bridgeport is not representative of all chiropractic programs?
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Squad51 said:
Just to add more fuel to Squad's eloquent fire: did you notice that the "MDs" on chiro faculties appear to be overwhelmingly (A) ANCIENT (as in medical degree earned in the 40s or 50s) or (B) FOREIGN TRAINED (i.e., India or Middle East usually). I wonder if Mr. Prakash is actually licensed to practice medicine in the state in which he works? I wonder if he's licensed to practice medicine in any state in the US?
EDIT: https://www.idfpr.com/dpr/licenselookup/default.asp (No results for any J. Prakash). This guy is not licensed to practice in Illinois. Most likely, he's not licensed anywhere in the US. Probably never went through a residency.
Another comment, did you notice how many faculty members at NUHS earned their BS and DC degrees concurrently, a year apart, or ONLY hold the DC degree? How many MD/DO practitioners do you see who earn their BS degree and MD/DO degree a year apart or concurrently?
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ProZackMI said:
Perhaps he's an outlier?
http://www.yalepath.org/facultydb/id=MattieM.htm
http://www.bridgeport.edu/pages/2227.asp
PublicHealth said:
He may be, but he is one of two MDs listed on the National faculty website. Wasn't it you who raved on and on in other threads how DCs are trained by MDs and PhDs. Apparently not so at the often tauted as superior bastion of chiropractic education, National.
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PublicHealth said:
Regarding the Bridgeport faculty page you posted, of the 38 faculty members listed, 26 held ONLY DC degrees (basic and clinical sciences). One faculty member held an associate's degree in x-ray technology. One Assoc. Prof held only an MS degree. At my medical school, there were no instructors or clinical instructors with an associate's degree. I can't even think of an instructor who only held a master's degree, yet apparently even the high end chiro schools employ lowly AA educated x-ray techs to teach future "doctors"!
In summary, roughly 70% of the faculty listed on that Bridgeport website held only a DC degree (sans BS/MS)? What does that say?
ProZackMI said:
See here I will defend them a little. If we, for the sake of argument, accept the premise that chiropractic is a valid diagnostic and therapuetic modality (a premise I do not accept in real life), then one can only expect that a great deal of the clinical faculty will hold only the DC. Likewise in medical school, a great deal of the attending physicians for clerkships hold only the MD (and would likely be unfit to teach the basic sciences absent significant research work in a given area).
Where I think PH and others fall apart is in their assertions on other threads that attempt to validate the DC by claiming that chiropractic students are routinely taught by MDs and PhDs. At National that is simply not true. And National did recieve one of the largest recent NCCAM grants and seems to serve as the "excuse" for poor chiropractic performance on other threads, ("What did you expect from that poor, misguided DC. He didn't train at National. If he had, well, he would never have made that mistake..."). Now it seems PublicHealth, at least, has moved on to Bridgeport. What I still fail to understand is how they all stand so staunchly in defiance of basic facts!
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PublicHealth said:
Interesting. If you do a PubMed search on Dr. Mattie, he has 11 publications. Bridgeport is not listed as an author affiliation in any of them. I'm sure he is proud to be the ONLY MD on the Bridgeport faculty. He must teach a great deal in order for your previous assertions that DCs are trained by MDs to be true...
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Squad51 said:
The sections in bold ARE part of the order. I just chose to "bolden" certain sentences of the order. What I posted is word for word, the Judge's Summary and Order.
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The only MDs who teach at chiro schools are foreign medical graduate scrubs and lowball hacks who couldnt cut it anywhere else.
These are hte people who barely graduate med school at the bottom of the class from ****ty medical schools.
People who could barely match into family practice residency
Thats the ONLY people who would affiliate themselves with chiro
These are hte people who barely graduate med school at the bottom of the class from ****ty medical schools.
People who could barely match into family practice residency
Thats the ONLY people who would affiliate themselves with chiro
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MacGyver said:
MacGyver's back!
wayttk said:
No, what you posted was a "Summary of Judge's Opinion and Order", not "The Judge's summary of her opinion and order" (as such documents are not generally created). No, actually what you posted is chiro.net's summary. The actual court order would not refer to the judge in the third person nor would it reference itself as "(opinion pp.x)" Additionally, the order would reflect and cite the case law it relied on.
You may not like chirobase, but most of the unedited text of the actual 101 page opinion can be found starting here:
http://www.chirobase.org/08Legal/AT/at031.html
And here is the text of the appeal:
http://biotech.law.lsu.edu/cases/antitrust/wilk_v_AMA.htm
Again ANYONE can summarize and opinion, and at 101 pages this one begged for it, but anyone can interject their "spin" on it. My post was largely lifted from a different summary. Now the specific quotes in my second post were from the actual opinion (no spin, just the quotes). Unfortunately I don't have a public site with the complete, unedited opinion.
But hey wayttk, by all means keep posting. You are so far from reality that your ranting are the easiest proof yet on the lack of chiropractic education (love it when the other side in a debate proves my case for me!)
BTW - ProZack, do you have access to a site where you could post the WestLaw pdf of the opinion?
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Squad51 said:
The ghost of Fishbein haunts this thread!: http://www.yourmedicaldetective.com/public/237.cfm
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Squad51 said:
Since you are sooooo partial to chirobase, as the authority as to what is true, unbiased, and accurate, relative to chiropractic, here is their offer of the summary and order:
Wait!! Well, how can this be? ----------I can't believe my lieing eyes!!.......Somehow it is IDENTICAL to what I posted!! I even "bolded" the same parts for ya squad!! Despite your proferred (psuedo)"authority", it is indeed, part of the official legal document- not a chiroweb "opinion", upon which you prefer to opine.
Yup- yet again, the verbose, pseudointellectual *squad* looses yet more credibility, even when using his own source!!
Thank-you for this additional opportunity to reveal your foolish, prejudicial, and ill-informed rants. Welcome to "reality" Squad----- it is what it is-----And no matter how you wish it to be different-----"FACTS is FACTS". Thanks for making the facts so apparent and unargueable.
http://www.chirobase.org/08Legal/AT/at01.html
Chiropractic Antitrust Suit
Wilk, et al., v. AMA, et al.
Summary of Judge's Opinion and Order
On August 27, 1987, Judge Susan Getzendanner, United States District Judge for the Northern District of Illinois Eastern Division, found the American Medical Association, The American College of Surgeons, and The American College of Radiology, guilty of having conspired to destroy the profession of chiropractic in the United States.
In a 101-page opinion, Judge Getzendanner ruled that the American Medical Association and its co-conspirators had violated the Sherman Antitrust Laws of the United States. Judge Getzendanner ruled that they had done this by organizing a national boycott of doctors of chiropractic by medical physicians and hospitals using an ethics ban on interprofessional cooperation.
Evidence at the trial showed that the defendants took active steps, often covert, to undermine chiropractic educational institutions, conceal evidence of the usefulness of chiropractic care, undercut insurance programs for patients of chiropractors, subvert government inquiries into the efficacy of chiropractic, engage in a massive disinformation campaign to discredit and destabilize the chiropractic profession and engage in numerous other activities to maintain a medical physician monopoly over health care in this country.
Judge Getzendanner ruled:
I conclude that an injunction is necessary in this case. There ore lingering effects of the conspiracy; the AMA has never acknowledged the lawlessness of its post conduct and in fact to this day maintains that it has always been in compliance with the antitrust laws; there has never been an affirmative statement by the AMA that it is ethical to associate with chiropractors; there has never been a public statement to AMA members of the admission made in this court about the improved nature of chiropractic despite the fact that the AMA today claims that it made changes in its policy in recognition of the change and improvement in chiropractic; there has never been public retraction of articles such as "The Right and Duty of Hospitals to Deny Chiropractor Access to Hospitals"; a medical physician has to very carefully read the current AMA Judicial Council Opinions to realize that there has been a change in the treatment of chiropractors and the court cannot assume that members of the AMA pore over these opinions*, and finally, the systematic, long-term wrongdoing and the long-term intent to destroy a licensed profession suggests that an injunction is appropriate in this case. When all of these factors are considered in the context of this "private attorney general" antitrust suit, a proper exercise of the court's discretion permits, and in my judgment requires, an injunction. (Opinion pp. 11).
Evidence in the case demonstrated that the AMA knew of scientific studies implying that chiropractic care was twice as effective cis medical care in relieving many painful conditions of the neck and back as well as related musculoskeletal problems. The court concluded:
There also was some evidence before the Committee that chiropractic was effective - more effective than the medical profession in treating certain kinds of problems such as workmen's back injuries. The Committee on Quackery was also aware that some medical physicians believed chiropractic to be effective and that chiropractors were better trained to deal with musculoskeletal problems than most medical physicians. (Opinion pp. 7)
The Opinion found:
The AMA and its officials, including Dr. Sammons, instituted a boycott of chiropractors in the mid-1960s by informing AMA members that chiropractors were unscientific practitioners and that it was unethical for a medical physician to associate with chiropractors. The purpose of the boycott was to contain and eliminate the chiropractic profession. This conduct constituted a conspiracy among the AMA and its members and an unreasonable restraint of trade in violation of Section I of the Sherman Act.
The AMA sought to spread the boycott to other medical societies. Other groups agreed to participate in the boycott by agreeing to induce their members to forego any form of professional, research, or educational association with chiropractors. The defendants which knowingly joined in the conspiracy were ACS, ACR, and AAOS. None of the defendants established the patient care defense. The plaintiffs are entitled to injunctive relief against the AMA, ACS, and ACR, but not against AAOS or Dr. Sammons. The court shall conduct further proceedings regarding the form of the injunction. The actions of the other defendants, JCAH and ACP, were taken independently of the AMA boycott and these defendants did not join the conspiracy. Accordingly, defendants JCAH, ACP, AAOS and Dr. Sammons are dismissed. (Opinion pp. 2)
The Committee on Quackery disbanded in December 1974 and considered its activities a success:
The AMA believed that chiropractic would hove achieved greater growth if it had not been for the Committee's activities. (opinion pp. 4)
The Court of Appeals stated that enforcement of a code of ethics was not necessary to obtain compliance with the boycott:
The anti-competitive effects of the boycott were generally conceded by the defendants' expert, William J. Lynk of Lexecon, Inc. Some of the anticompetitive effects acknowledged by Mr. Lynk include the following: it is anti-competitive and it raises costs to interfere with the consumer's free choice to take the product of his liking; it is anti-competitive to prevent medical physicians from referring patients to a chiropractor; it is anti-competitive to impose higher costs on chiropractors by forcing them to pay for their own x-ray equipment rather than obtaining x-rays from hospital radiology departments or radiologists in private practice; and it is anti-competitive to prevent chiropractors from improving their education in a professional setting by preventing medical physicians from teaching or lecturing to chiropractors. Mr. Lynk agreed that in an economic sense a boycott such as the one described by plaintiffs raises the costs of chiropractic services and creates inefficiencies and economic dislocations. (Opinion pp. 6)
The anti -competitive effects of the AMA boycott were established by defendant's witnesses:
The activities of the AMA undoubtedly have injured the reputation of chiropractors generally. This kind of injury more likely than not was sustained by the four plaintiffs. In my judgment, this injury continues to the present time and likely continues to adversely affect the plaintiffs. The AMA has never made any attempt to publicly repair the damage the boycott did to chiropractors' reputations. (Opinion pp. 10).
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You don't know what you are talking about. Us osteopathic physicians do similar tecniques that the chiropractors use and they are well researched and explained with anatomical, muscular, and neurological theory. (But you probably are too stupid to understand what a muscle spindle gamma loop is, or what muscle stretch receptors are.) If you don't believe us, come to a DO when you have arm/back/leg pain. After treatment you will feel much better and we can demonstrate objectively how the treatment worked since you will have a visible increase in range of motion.
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What do the "chiro-bashers" around here think about the following organization?: http://www.chiromed.org/
