Unethical Chiropractors

[Gollum1985]

I saw a Facebook live video of a chiropractor performing a neck adjustment on a child with downs syndrome. She explained that the reason for the child's condition was unknown, but since it's a neurological issue. Once she gets rid of subluxation then the body will self heal. I think what she is doing is unethical, because we all know her adjustments will not cure the child's autism. I often see more nonsense like this from other chiropractors who often post anti-vaccine and claim their way is better than medicine. I believe it is time we come together and put our foot down on chiropractors who do this.

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[mimelim]

This is no worse than what many physicians do, or podiatrists, etc. Certainly doesn't make it right, but welcome to the real world, where people try to make money, even if it isn't by helping people.

 

[SurfingDoctor]

Guess they don't know that children with Down Syndrome are at risk for atlanto-axial instability.

I even use c-spine precautions when intubating them.

But you unfortunately can't stop parents for being foolish either.

 

[Goro]

I saw a Facebook live video of a chiropractor performing a neck adjustment on a child with downs syndrome. She explained that the reason for the child's condition was unknown, but since it's a neurological issue. Once she gets rid of subluxation then the body will self heal. I think what she is doing is unethical, because we all know her adjustments will not cure the child's autism. I often see more nonsense like this from other chiropractors who often post anti-vaccine and claim their way is better than medicine. I believe it is time we come together and put our foot down on chiropractors who do this.

Unethical chiropractor?

Redundancy there.

 

[Staphylococcus Aureus]

Downs syndrome patients are even more vulnerable but chiros have unethical practices all the time (cracking infants, anti-vaccine, etc) and for the most part have always been at odds with scientific medicine. I don't know why they've gotten away with it for so long but from my experiences no one is interested in stopping it, quite the opposite sadly, as public interest in quackery continues to skyrocket and slowly embraced by physicians and academic centers, a la cash only cleveland clinic "wellness" center.

 

[username456789]

I saw a Facebook live video of a chiropractor performing a neck adjustment on a child with downs syndrome. She explained that the reason for the child's condition was unknown, but since it's a neurological issue. Once she gets rid of subluxation then the body will self heal. I think what she is doing is unethical, because we all know her adjustments will not cure the child's autism. I often see more nonsense like this from other chiropractors who often post anti-vaccine and claim their way is better than medicine. I believe it is time we come together and put our foot down on chiropractors who do this.

Just FYI, Down Syndrome and autism are two different things.

 

[IsWhat]

Prescription medication Kills thousands of people per year in America, but a little neck crack by a chiro and people lose their minds...

In all seriousness - i'm not a huge fan of chiropractors myself, but let's stop acting like modern medicine in its current form is all sunshine and rainbows.

 

[Perrotfish]

Prescription medication Kills thousands of people per year in America, but a little neck crack by a chiro and people lose their minds...

In all seriousness - i'm not a huge fan of chiropractors myself, but let's stop acting like modern medicine in its current form is all sunshine and rainbows.

Medicine is an evolving scientific practice. It has risks and benefits, and as time goes on we are improving the therapies, so that the ratio of benefits to risks increases. It is ethical to accept the risks, as long as the ratio of benefits to risks is appropriate.

Chiropractors, acupuncturists, energy healers, homeopaths, spiritual healers, and all similar practitioners of magical thinking don't have benefits. They're fake. They don't improve with time, because they are based on disproven theories of how the world works. Any risks at all, therefore, are completely unethical.

 

[IsWhat]

Medicine is an evolving scientific practice. It has risks and benefits, and as time goes on we are improving the therapies, so that the ratio of benefits to risks increases. It is ethical to accept the risks, as long as the ratio of benefits to risks is appropriate.

Chiropractors, acupuncturists, energy healers, homeopaths, spiritual healers, and all similar practitioners of magical thinking don't have benefits. They're fake. They don't improve with time, because they are based on disproven theories of how the world works. Any risks at all, therefore, are completely unethical.

I mostly agree with you, but to say all of these forms of healing are fake is being a little disingenuous. The real problem is when chiropractors and the like step outside of their training and market their techniques as something they are not.

 

[Ismet]

I saw a Facebook live video of a chiropractor performing a neck adjustment on a child with downs syndrome. She explained that the reason for the child's condition was unknown, but since it's a neurological issue. Once she gets rid of subluxation then the body will self heal. I think what she is doing is unethical, because we all know her adjustments will not cure the child's autism. I often see more nonsense like this from other chiropractors who often post anti-vaccine and claim their way is better than medicine. I believe it is time we come together and put our foot down on chiropractors who do this.

Hope you know that there are physicians out there who are anti-vaccine.

 

[AlbinoHawk DO]

This is no worse than what many physicians do, or podiatrists, etc. Certainly doesn't make it right, but welcome to the real world, where people try to make money, even if it isn't by helping people.

Physicians and podiatrists that do this are acting outside what mainstream medicine teaches and expectations of their profession. Chiropractors on the other hand attend programs that active teach this nonsense and promote it heavily. Lets not pretend things are equal here.

Hope you know that there are physicians out there who are anti-vaccine.

"99.999% of cases are caused by X" "Did you know 0.001% are done by Y? Checkmate."

 

[mimelim]

Physicians and podiatrists that do this are acting outside what mainstream medicine teaches and expects of their profession. Chiropractors on the other hand attend programs that active teach this nonsense and promote it heavily. Lets not pretend things are equal here.


"99.999% of cases are caused by X" "Did you know 0.001% are done by Y? Checkmate."

How much non-academic medicine exposure do you have? Or rather how much non-big medical center medicine exposure have you had after understanding medical finance, referral, insurance, etc? This has nothing to do with what people are taught. This has to do with the fact that no matter what profession you are in, people are going to be people. They will put their interests over those of others, including patients if it means making more money. If it appears benign and they won't get caught, there will be people doing it. I certainly have had less exposure to chiropractors than physicians, so I certainly can not do a direct comparison, but the number who practice "mainstream medicine" in the community is vanishingly small.

 

[AlbinoHawk DO]

How much non-academic medicine exposure do you have? Or rather how much non-big medical center medicine exposure have you had after understanding medical finance, referral, insurance, etc? This has nothing to do with what people are taught. This has to do with the fact that no matter what profession you are in, people are going to be people. They will put their interests over those of others, including patients if it means making more money. If it appears benign and they won't get caught, there will be people doing it. I certainly have had less exposure to chiropractors than physicians, so I certainly can not do a direct comparison, but the number who practice "mainstream medicine" in the community is vanishingly small.

Your argument is an extended "I know more because I'm resident/attending and you are med student." However, appeal to self-authority doesn't prove anything. How about instead you show me statistics on how many physicians actually go out of their way to sell this quackery compared chiropractors?

 

[Staphylococcus Aureus]

I mostly agree with you, but to say all of these forms of healing are fake is being a little disingenuous.

Which one has practices that have been shown to be effective and safe, and have a basic scientific basis?

The real problem is when chiropractors and the like step outside of their training and market their techniques as something they are not.

I agree with you, unfortunately I've never seen an alternative practitioner that didn't market themselves as understanding things outside their (lack of or misinformed) training. Chiros pretending they have equal expertise to offer advice on vaccines as a pediatrician is a easy example.

 

[Perrotfish]

I mostly agree with you, but to say all of these forms of healing are fake is being a little disingenuous. The real problem is when chiropractors and the like step outside of their training and market their techniques as something they are not.

No, its all fake. Not 'not effective for all things'. Not 'lacking sufficient trials'. Fake. Bull****. A scam. Snake oil. And furthermore all of this crap is based on theories of biology and physics that are themselves fake.

There is no such thing as a subluxation. You don't have energy fields rotating through your body that you can poke with needles, heal with crystals, or shoot from your fingertips. Dilution with water doesn't make the medical effects of something stronger. A schoolteacher did not cure the common cold. Its all scam artistry and magical thinking.

You're going to be a physician. For most of this country you're going to be the only science that they get once they're finished with high school. Don't be wishy washy about this nonsense, call it out for the scam that it is.

 

[Perrotfish]

How much non-academic medicine exposure do you have? Or rather how much non-big medical center medicine exposure have you had after understanding medical finance, referral, insurance, etc? This has nothing to do with what people are taught. This has to do with the fact that no matter what profession you are in, people are going to be people. They will put their interests over those of others, including patients if it means making more money. If it appears benign and they won't get caught, there will be people doing it. I certainly have had less exposure to chiropractors than physicians, so I certainly can not do a direct comparison, but the number who practice "mainstream medicine" in the community is vanishingly small.

Honestly I have no idea what you're talking about. What physicians do you know that are practicing non-evidence based medicine for profit? I know a few that are 10 years out of date, and a handful of pill mills, but pretty much everyone I have been exposed to in the community is selling real, evidence based medicine. Can you give some examples of what you are seeing?

 

[mimelim]

Your argument is an extended "I know more because I'm resident/attending and you are med student." However, appeal to self-authority doesn't prove anything. How about instead you show me statistics on how many physicians actually go out of their way to sell this quackery compared chiropractors?

No, I genuinely asked you what you are basing your counter claims on. There are plenty of medical students that have had extensive exposure to healthcare in the United States many of whom can easily say that in their anecdotal experience what I have talked about is not their experience.

My argument is that in my experience, physicians are no different than any other profession. Certainly in academic circles things tend to be different, but out in the community where 90%+ of healthcare is administered, if people see an opening, they take it. That is my experience. I asked if you had experience that countered that since you seem so adamant about this and we both know there is no "data". Given how much stronger your assertions and opinions you really should be the one providing "statistics".

 

[mimelim]

Honestly I have no idea what you're talking about. What physicians do you know that are practicing non-evidence based medicine for profit? I know a few that are 10 years out of date, and a handful of pill mills, but pretty much everyone I have been exposed to in the community is selling real, evidence based medicine. Can you give some examples of what you are seeing?

Cardiologists performing non-heart based caths. If I had to guess, ~50-60% of the lower extremity endovascular work that I have seen performed by community based cardiologists is completely unwarranted. Maybe could excuse the diagnostic work, but the number of people with stents in places they should not be or for the wrong reasons is astounding. The reimbursement difference between diagnostic vs. PTA is so high that I have watched with my own eyes physicians choosing to PTA lesions that are in no way flow limiting. I could write an entire essay on this one, but won't. Vascular surgeons are guilty of this as well, as are IR, but not nearly to the same extent.

Interventional nephrology. We have good data to show that pre-emptive PTA is not beneficial in working AV access, but you will find centers left and right performing q3month "fistulagram to make sure everything is okay", why? Because the global period is 90 days, so they can bill for another procedure at 90 days. Same issue as with cardiology, you get paid a lot less for performing just an fgram, so the number of PTA and stenting is absurd.

Nephrologists and dialysis centers? While most of the attention is paid to David/Fresenious and non-physician greed, lets not pretend that the dialysis units owned by or owned by proxy are clean. When you control the patients, where they go, their treatment and directly benefit financially, there are serious issues. The number of patients I have come across that have been pushed away from transplant by nephrologists is astounding.

Vein clinics. Vascular surgeons are big in this, but so are IR, internal medicine, Derm, really anyone that figures out that they can invest 50k in a laser and can burn every GSV that comes into their office. If you go into a vein clinic, they will tell you that you need your vein ablated. Even if it isn't refluxing. Even if you have zero signs of venous insufficiency. Even if you haven't had the common insurance mandated 3 month trial of compression stockings. They will recommend to get your vein ablated. I have had several patients lose their bypass options because a vein that I personally duplexed was ablated in patients with ARTERIAL disease.

How about peritoneal dialysis? Far less profitable for people performing the procedure, but a viable options for many and often the better option. Patients are routinely not told about it and our numbers compared to every other country in the world shows this.

Atherectomy? (anyone doing PAD)

IVC filters?

Hyperbaric oxygen therapy?

Follow reimbursement changes and you will see remarkable correlation with what people are doing. All of us focus on our niche and most of us don't know what we don't know. I am sure there are many arenas in medicine that I have zero exposure and zero concept of how people exploit it. I certainly know that vascular surgeons are far from immune from this and even asking more academic or more grounded physicians, why they don't do something about it or say anything, it is because they will lose their referrals from those physicians. I have found that when I don't understand why a physician did something in the community, the best and first question to ask is, "who benefits financially from this?" The majority of the time, it makes a heck of a lot more sense afterwards. I'm sure that I am over calling things based on my own internal biases, but given how many other obvious examples there are and basic human nature, I find it ridiculous that physicians think that somehow physicians (and only physicians) are immune to this.

This isn't about people performing "non-EBM" medicine, the vast majority of medicine (or at least surgery/procedures) is not backed by randomized clinical trials. There is always a certain amount of physician discretion that goes into this. And that discretion is heavily influenced by industry and financial incentives from the government and insurance companies.

 

[sloh]

Western medicine is not infallible. It does seem like we are moving in the direction towards being more evidence-based though. A relevant thread below.

Modern Medicine does little to extend life

"Great article discussing how life is really only extended through smoking cessation, physical activity, stress reduction, weight control and good sleep.

CABGs, Stents, Statins, etc have done almost nothing to extend life despite spending 100s of billions to trillions on this stuff.

Interesting to think about.

The PROBLEM I have is picking on IPM EXCLUSIVELY without looking at the BIG picture of EVERY procedural field. IPM like EVERY OTHER FIELD THAT IS PROCEDURAL has INCREASED UNNEEDED PROCEDURES DRAMATICALLY to maintain higher salaries. There are MANY fields that are WORSE than IPM including Orthopedics, Back Surgeons (Neuro, Ortho), Inteventional Cardiologists (Stents, Ablations), CV surgeons, Urologist in prostectomies, etc in terms of a cost basis and morbidity basis towards society in terms of excessive unneeded procedures.

Anesthesiologists are also very guilty for facilitating many unnecessary procedures while exposing patients to general anesthesia at geriatric ages.

However, this is ALSO a societal problem where docs are UNDERPAID with just a salary so are pressured into doing procedures as well. Docs should be WELL COMPENSATED considering their time involvement and top student status and changing the game halfway on them is immoral as well to drop salaries dramatically.

My defense of IPM is towards people like that clown on the Anesthesiology board who is trying to make a case that IPM are just evil people that just do narcs for interventions only while ignoring his little involvement in doing mostly unnecessary fusions, TKRs, arthroscopies, etc while exposing patients to toxic anesthetics or maintaining a higher salary by "noncompetitive practices" with CRNAs.

Everyone lives in glass houses in medicine." -Dr. Commonsense

 

[zero0]

What's more, isn't down syndrome a contraindication for cervical? My fellow bone wizards can chime in.

 

[zero0]

Guess they don't know that children with Down Syndrome are at risk for atlanto-axial instability.

I even use c-spine precautions when intubating them.

But you unfortunately can't stop parents for being foolish either.

Yup, beat me to it.

 

[AlbinoHawk DO]

No, I genuinely asked you what you are basing your counter claims on. There are plenty of medical students that have had extensive exposure to healthcare in the United States many of whom can easily say that in their anecdotal experience what I have talked about is not their experience.

My argument is that in my experience, physicians are no different than any other profession. Certainly in academic circles things tend to be different, but out in the community where 90%+ of healthcare is administered, if people see an opening, they take it. That is my experience. I asked if you had experience that countered that since you seem so adamant about this and we both know there is no "data". Given how much stronger your assertions and opinions you really should be the one providing "statistics".

You're the one making the claim that physicians are no different than chiropractors when it comes to this. You make the claim, you back it.

Data exist on everything these days. Trust me, we can all play the "experience in healthcare" game and it won't mean anything. I have never been to a physician's office in my life that has peddled naturopathic bs, anti-vaxx, supplements or homeopathy besides one osteopath in San Francisco.

 

[Staphylococcus Aureus]

Why is "modern medicine isn't infallible" the response when someone points out a chiropractor that is blatantly doing potential harm? If I post a homeopathic fanatic story, will the focus here be to remind me that antibiotics aren't infallible?

 

[kb1900]

You're the one making the claim that physicians are no different than chiropractors when it comes to this. You make the claim, you back it.

Data exist on everything these days. Trust me, we can all play the "experience in healthcare" game and it won't mean anything. I have never been to a physician's office in my life that has peddled naturopathic bs, anti-vaxx, supplements or homeopathy besides one osteopath in San Francisco.

There's plenty of sell out docs. To think otherwise is naive. I'd speculate that they are a much smaller % of the population of physicians than that of chiropractors.

For some reason they love California.

How's this for one? Doc owns a cash for weed "practice" in CA to cash in on that 'medical' marijuana $$. You can go online to his website which says explicitly what to say on the phone, call the office, and he emails you a prescription and a host of vendors/dispensaries.

Would you say this is practicing EBM? Or just cashing in on a illegal substance's high recreational demand in a bubble.

What about docs that work on the VIP floors of hospital that don't stand their ground and give into overtesting, catering to the whims of each pt's demand even when it opposes sound medical knowledge?

I skimmed the thread so I'm not sure what you're arguing exactly. That unethical docs don't exist or that they don't exist at the same level as chiropractors? Because, no, I don't think that study exists in medical journals

 

[AlbinoHawk DO]

There's plenty of sell out docs. To think otherwise is naive. I'd speculate that they are a much smaller % of the population of physicians than that of chiropractors.

For some reason they love California.

How's this for one? Doc owns a cash for weed "practice" in CA to cash in on that 'medical' marijuana $$. You can go online to his website which says explicitly what to say on the phone, call the office, and he emails you a prescription and a host of vendors/dispensaries.

Would you say this is practicing EBM? Or just cashing in on a illegal substance's high recreational demand in a bubble.

I skimmed the thread so I'm not sure what you're arguing exactly. That unethical docs don't exist at the same level as chiropractors? Because, no, I don't think that study exists in medical journals

Then you need to do better than skim. There is no study on doctors being "unethical" but surely there are surveys on how many doctors believe vaccines are bad or prescribe homeopathic remedies or something else. Like I said, literally chiropractors get taught naturopathic/homeopathic/anti-vaxx in their curriculum. Physicians are not. Unsurprisingly the amount of physicians doing the same is not anywhere near the same ballpark.

Yeah, some doctors are pushing weed practice in CA to make money, but how many are there? 100 of them? 1000? How many is that compared to all doctors practicing medicine? Also, I'd never put them in the same umbrella of anti-vaxxers and homeopath peddling doctors.

 

[NotYou20]

What's more, isn't down syndrome a contraindication for cervical? My fellow bone wizards can chime in.

Yeah it's an absolute contraindication for cervical hvla due to hyperlaxity of the alar ligament.

 

[kb1900]

Then you need to do better than skim. There is no study on doctors being "unethical" but surely there are surveys on how many doctors believe vaccines are bad or prescribe homeopathic remedies or something else. Like I said, literally chiropractors get taught naturopathic/homeopathic/anti-vaxx in their curriculum. Physicians are not. Unsurprisingly the amount of physicians doing the same is not anywhere near the same ballpark.

Yeah, some doctors are pushing weed practice in CA to make money, but how many are there? 100 of them? 1000? How many is that compared to all doctors practicing medicine? Also, I'd never put them in the same umbrella of anti-vaxxers and homeopath peddling doctors.

I don't disagree. I feel all that was being said is that the ethical grey areas in attending practice are far more nuanced than in homeopathy which is a more explicit scam. And perhaps based on experience, these ethical grey areas are entered more often than attendings would ever care to admit.

But yeah I think it's a no brainer that MDs and DOs will have a approaching non-existent level of being anti-vac etc. but that wasn't what was being countered directly. And I think physicians as a whole somewhat fail the public by not continuously making active statements against the quackery out there.

But that doesn't mean physicians are uniquely immune to crossing the line. Just that being less than purely ethical takes on a different much more nuanced form a lot of times in practice. And pouting that out doesn't discount or really argue against what you're saying at all - just contextuallzes it.

 

[libertyyne]

Physicians and podiatrists that do this are acting outside what mainstream medicine teaches and expectations of their profession. Chiropractors on the other hand attend programs that active teach this nonsense and promote it heavily. Lets not pretend things are equal here.

Here is some unethical behavior reported on this is not an isolated place either.

The Cost Conundrum

 

[libertyyne]

On a separate but related note, how much overlap is there between omm and chiropractic techniques?

 

[AcademicNeurosurgery]

Just FYI, Down Syndrome and autism are two different things.

Shame on @mimelim and @Goro for letting this slide to the 5th post.

 

[libertyyne]

Shame on @mimelim and @Goro for letting this slide to the 5th post.

Dual Diagnosis of Down Syndrome & Autism - National Down Syndrome Society

 

[deleted407021]

On a separate but related note, how much overlap is there between omm and chiropractic techniques?

It's my understanding that chiropractors are mostly out there doing HVLA.

 

[AcademicNeurosurgery]

Dual Diagnosis of Down Syndrome & Autism - National Down Syndrome Society

I get that, but there was no transition in the patient story or mention of the patient having both. Basically, OP mentioned that the kid has DS and whatever the chiropractor was doing wouldn't cure the patient's autism. And my post was in jest.

 

[Stagg737]

You're the one making the claim that physicians are no different than chiropractors when it comes to this. You make the claim, you back it.

Data exist on everything these days. Trust me, we can all play the "experience in healthcare" game and it won't mean anything. I have never been to a physician's office in my life that has peddled naturopathic bs, anti-vaxx, supplements or homeopathy besides one osteopath in San Francisco.

I've been to several physicians' offices that promote BS weight loss plans and know of literally dozens who promote some form of snake-oil remedy. Just look up stats for physicians promoting hCG diets, there's literally thousands of them. Here's a directory which includes locations in every state as a starting reference:

HCG Doctors Directory - Find HCG Doctors and HCG Clinics

 

[Stagg737]

On a separate but related note, how much overlap is there between omm and chiropractic techniques?

A fair amount, but the basis for using the techniques and the founding ideas are different. The pure chiropractors believe in subluxation, meaning that all illnesses come from misalignment of the spine and that by bringing the spine back into proper re-alignment the body can "cure" pretty much any medical condition (even chronic illnesses like diabetes...).

OMM is founded on 4 principles:

1. The body is a unit; the person is a unit of body, mind, and spirit.
   
   
2. The body is capable of self-regulation, self-healing, and health maintenance.
   
   
3. Structure and function are reciprocally interrelated.
   
   
4. Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation, and the interrelationship of structure and function.

Pretty open for interpretation, but generally speaking very few people i've talked to make claims that OMM is actually going to cure major conditions, mostly that it can help with acute MSK issues or help provide some initial relief or help kick-start the healing process (considering how great I always felt after OMM lab I definitely buy the relief part). Some of it does have actual research which backs it up, most of it needs more research, and some of it imo is complete garbage (cranial and Chapman's points for example). Some OMM techniques actually have more crossover with physical therapy than chiropractics.

The other thing to keep in mind is the degree to which the ability of HVLA to help/heal someone is taken. Most DOs I've talked to think HVLA can help with either acute issues (think, "oh, I slept funny and now my back hurts") or provide temporary relief without actually fixing the underlying problem. On the other hand, a lot, maybe most, of the chiropractors I've talked to think they can completely fix someone's problems through HVLA or subluxation. Maybe this was more than you wanted, but I think it gives a little bit of a background on the difference between how OMM is taught to DOs versus what chiropractors are taught.

 

[libertyyne]

A fair amount, but the basis for using the techniques and the founding ideas are different. The pure chiropractors believe in subluxation, meaning that all illnesses come from misalignment of the spine and that by bringing the spine back into proper re-alignment the body can "cure" pretty much any medical condition (even chronic illnesses like diabetes...).

OMM is founded on 4 principles:

1. The body is a unit; the person is a unit of body, mind, and spirit.
   
   
2. The body is capable of self-regulation, self-healing, and health maintenance.
   
   
3. Structure and function are reciprocally interrelated.
   
   
4. Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation, and the interrelationship of structure and function.

Pretty open for interpretation, but generally speaking very few people i've talked to make claims that OMM is actually going to cure major conditions, mostly that it can help with acute MSK issues or help provide some initial relief or help kick-start the healing process (considering how great I always felt after OMM lab I definitely buy the relief part). Some of it does have actual research which backs it up, most of it needs more research, and some of it imo is complete garbage (cranial and Chapman's points for example). Some OMM techniques actually have more crossover with physical therapy than chiropractics.

The other thing to keep in mind is the degree to which the ability of HVLA to help/heal someone is taken. Most DOs I've talked to think HVLA can help with either acute issues (think, "oh, I slept funny and now my back hurts") or provide temporary relief without actually fixing the underlying problem. On the other hand, a lot, maybe most, of the chiropractors I've talked to think they can completely fix someone's problems through HVLA or subluxation. Maybe this was more than you wanted, but I think it gives a little bit of a background on the difference between how OMM is taught to DOs versus what chiropractors are taught.

So similar techniques, maybe some similar theory, but different claims on degree of efficacy?

 

[Stagg737]

So similar techniques, maybe some similar theory, but different claims on degree of efficacy?

Some of the same techniques, certainly similar (as far as I know OMM encompasses a wider variety of techniques). Differences in theory in terms of degree to which the techniques are therapeutic. Different claims about degrees of efficacy based on differences in foundational principles. At least that's my take on it.

 

[username456789]

Dual Diagnosis of Down Syndrome & Autism - National Down Syndrome Society

So?

Also, one more group to add to the list of quackery: "chronic Lymes [sic] disease doctors."

First of all, there is nearly a 100% correlation between calling it "LymeS" and not having the disease. But there are a lot of docs out there fleecing a vulnerable population (chronic pain/fatigue and depressed) by fake diagnosing them with "chronic Lymes disease" and pumping them full of stiff they don't need. The new trend is to convince patients of "coinfections" with things like anaplasmosis and such....all the more reason to follow closely and take more meds.

What I can't figure out is why anybody would want to do this as a physician. I'm not exactly sure where the moneymaking comes into play. From what I understand, it's not like there are additional procedures involved. It's just seeing a very frustrating slice of the general patient population more often. It sounds like a nightmare to me. But when those patients end up in my office for various ailments and tout their diagnosis of Chronic Lymes Disease (and clearly do not have any signs/symptoms of any form of Lyme disease), it's saddening.

All that said, it's still apples to oranges comparing physicians to chiropractors. The very foundation of chiropractic is spurious at best, and much of their fundamental teachings and principles are clearly not only not based on evidence, but largely contradict evidence and are steeped in utter nonsense.

No, medicine is not perfect. Yes, evidence based medicine is a tricky thing as some people will eschew the best treatments in order to make a buck (and hopefully not otherwise harm the patient). But chiropractic, homeopathy, etc are an entirely different game. It's irresponsible to suggest what they do is no different that what the majority of physicians do.

 

[libertyyne]

So?

Also, one more group to add to the list of quackery: "chronic Lymes [sic] disease doctors."

First of all, there is nearly a 100% correlation between calling it "LymeS" and not having the disease. But there are a lot of docs out there fleecing a vulnerable population (chronic pain/fatigue and depressed) by fake diagnosing them with "chronic Lymes disease" and pumping them full of stiff they don't need. The new trend is to convince patients of "coinfections" with things like anaplasmosis and such....all the more reason to follow closely and take more meds.

What I can't figure out is why anybody would want to do this as a physician. I'm not exactly sure where the moneymaking comes into play. From what I understand, it's not like there are additional procedures involved. It's just seeing a very frustrating slice of the general patient population more often. It sounds like a nightmare to me. But when those patients end up in my office for various ailments and tout their diagnosis of Chronic Lymes Disease (and clearly do not have any signs/symptoms of any form of Lyme disease), it's saddening.

Im unsure what in my comment prompted your response. It was merely a tongue and cheek reply to why no one called out OP on the weird transition from down syndrome to treating autism in the same patient. The possibility that the patient may have been appropriately diagnosed with both provided an out.

Although I agree with you in terms of over-diagnosis and stretching the diagnostic criteria to include larger and larger swaths of asymptomatic patients is problematic. I am unsure if money is a large component of that problem considering a vast majority of those diagnosis dont carry expensive interventions with them, nor do they entail intensive outpatient therapy which would increase billings. It seems that physicians just give into the patient's demands of characterizing and validating their subjective experience. Coupled with Direct to consumer advertising of things like restless leg syndrome this creates an atmosphere where it is sometimes easier to let the patient have their wish. Another thing before writing off these patients and providers as indulging in what seems like psychosomatic complaints and treating them as valid medical conditions is that medical science may be wrong, medicine was quick to dismiss bacterial infection as a cause of gastric ulcers and literally laughed at the proponents , and we laughed Semmelweis into an asylum. So there is obviously room for engagement, as long as it is a scientifically testable hypothesis. But what do i know im not even an M1 yet.

 

[jm192]

I dated a chiropractor, and they genuinely believe it.

They aren't lying to you, they just don't know that they're wrong.

She said that she felt MD's too often pushed meds and didn't try life-style changes. I offered her my office notes.
She said there studies about how adjusting could fix diseases x, y, and z. I'd be curious to see the studies.

But, truly, I don't believe they intentionally lie to mislead you. She was passionate about her knowledge base. I have no doubt she believed it with all of her heart.

 

[Gollum1985]

The patient was also diagnosed as autistic as well as several other issues. I should have provided more information. I have less of a problem if people will go see a Chiro for lower back pain or similar issues. However many chiros claim their methods can cure the flu, promote adjustments for all babies, etc. Which I believe needs to be stopped.

 

[WingedOx]

She said there studies about how adjusting could fix diseases x, y, and z. I'd be curious to see the studies.

If you want to see stuff that will make you want to abolish the DO degree and the COCA, page thru the Journal of the American Osteopathic Association.

 

[jm192]

If you want to see stuff that will make you want to abolish the DO degree and the COCA, page thru the Journal of the American Osteopathic Association.

In B4 Flame Warz.

Idk much about the DO stuff.

But she really couldn't even describe the studies she was describing outside of the results.

 

[libertyyne]

In B4 Flame Warz.

Idk much about the DO stuff.

But she really couldn't even describe the studies she was describing outside of the results.

I hear reiki does wonders for polio.

 

[Staphylococcus Aureus]

I have less of a problem if people will go see a Chiro for lower back pain or similar issues. However many chiros claim their methods can cure the flu, promote adjustments for all babies, etc. Which I believe needs to be stopped.

The attitude of "if people want to go for lower back pain that's fine" is one of the reasons medicine is so nonchalant on chiros. Has anyone ever seen a chiropractor that claimed expertise on back pain only? I'm sure there's a minority that does, but if you sit down with most chiropractors the anti-science backbone of their education will be evident.

 

[Stagg737]

In B4 Flame Warz.

Idk much about the DO stuff.

But she really couldn't even describe the studies she was describing outside of the results.

There are a small amount really good studies, and a lot of crap studies that grasp at straws. There's also a fair amount of studies that "prove" one thing, and then take liberties with interpreting what that means and extrapolate, which completely overshadows any legitimacy the study may have actually had. Also not sure if Ox has something against DOs or is just speaking in hyperbole, but most of us never actually practice OMT after graduation and would only consider using a handful of techniques if we actually did.

I hear reiki does wonders for polio.

Yea, but if you're really hardcore about it you'll get your patients into qigong so they can rebalance their energy themselves.

 

[RogueBanana]

One thing I've noticed about Chiros (and quacks in general) They really have their language nailed down.

For example, I was speaking with a good friend of mine who recently got accepted to chiropractic school. He spent a good 5 minutes to explain what could be summed up as :

"We hypermobilize joints and this stimulates the nerves to reduce pain"

He threw out words like nociceptor, mechanoreceptor etc... but when I asked him exactly how the stimulation of mechanoreceptors would reduce chronic pain (are you trying to take advantage of the gateway theory of pain? etc...)

he couldn't tell me why. Just that it worked.

We're I a layperson, I would probably have been impressed by his use of scientific terminology. Sure what he was saying didn't make much sense, but most people simply don't know the language enough to know better.


I always figured that's how you could tell a real doc from a quack,

The real doc will explain it simply to help you understand

The quack will try to impress you with language, but lacks substance.

 

[Matthew9Thirtyfive]

One thing I've noticed about Chiros (and quacks in general) They really have their language nailed down.

For example, I was speaking with a good friend of mine who recently got accepted to chiropractic school. He spent a good 5 minutes to explain what could be summed up as :

"We hypermobilize joints and this stimulates the nerves to reduce pain"

He threw out words like nociceptor, mechanoreceptor etc... but when I asked him exactly how the stimulation of mechanoreceptors would reduce chronic pain (are you trying to take advantage of the gateway theory of pain? etc...)

he couldn't tell me why. Just that it worked.

We're I a layperson, I would probably have been impressed by his use of scientific terminology. Sure what he was saying didn't make much sense, but most people simply don't know the language enough to know better.


I always figured that's how you could tell a real doc from a quack,

The real doc will explain it simply to help you understand

The quack will try to impress you with language, but lacks substance.

If you can't explain it to a child, you don't really understand it.

 

[AlbinoHawk DO]

I don't disagree. I feel all that was being said is that the ethical grey areas in attending practice are far more nuanced than in homeopathy which is a more explicit scam. And perhaps based on experience, these ethical grey areas are entered more often than attendings would ever care to admit.

But yeah I think it's a no brainer that MDs and DOs will have a approaching non-existent level of being anti-vac etc. but that wasn't what was being countered directly. And I think physicians as a whole somewhat fail the public by not continuously making active statements against the quackery out there.

But that doesn't mean physicians are uniquely immune to crossing the line. Just that being less than purely ethical takes on a different much more nuanced form a lot of times in practice. And pouting that out doesn't discount or really argue against what you're saying at all - just contextuallzes it.

But then you're not saying much of anything if all you're saying is some doctors go into gray areas of what is ethical or EBM. Still, you're categorizing things as equal. There are different degrees of what is dangerous and what is just wasteful for patients. Anti-vax can literally kill children, whereas some unnecessary EKG will only be a waste of time and money to the patient/insurance company.

 

[RogueBanana]

But then you're not saying much of anything if all you're saying is some doctors go into gray areas of what is ethical or EBM. Still, you're categorizing things as equal. There are different degrees of what is dangerous and what is just wasteful for patients. Anti-vax can literally kill children, whereas some unnecessary EKG will only be a waste of time and money to the patient/insurance company.

To be fair, mimelim referred to unnecessary surgeries that have severe implications (ie abalating the vein that would be used for bypass)

Not just run of the mill EKGs that might cost the patient an extra 2 minutes