The silliest kerfuffle ever?

I’m Dr. Horrible. I have a PhD in Horribleness!

Is that the new catch phrase?

Makes me think of Ducks Breath Mystery Theater’s “Ask Dr. Science”
“and remember, he’s not a real doctor”
“I have a master’s degree…In science”

Context. Damn it, how about a little context?

The AP guide is founded, way back when, on a pretty reasonable idea: that honorifics are contextual. It really doesn’t matter, if you’re visiting an aircraft carrier, that you hold an Army commission at rank O3 — in that context, “Captain” has one and only one meaning, and every single dude with Navy eagles on his uniform can find another title while aboard unless he is the Captain.

Likewise in an academic environment — Orac’s medical credentials aren’t the ones that count, but his PhD does. In a hospital it’s the other way ’round, since calling someone “Doctor Isis” might lead to confusion where there’s a lot at stake.

Then there’s the general public …

The AP rule was based on the notion that the only doctoral title that the general public regularly deals with is the medical one. Makes sense — you wouldn’t have wanted my childhood buddy’s father Chaz addressed as “Doctor” in a social context, never mind the PhD in physics. Someone might take his casual comments about health seriously — not a good idea [1].

If you’re on a plane and the Captain (there’s that word again) comes on and asks “Is there a doctor aboard [2],” I don’t think it matters if the current Nobel Physics laureate is in Row Five. On the other hand, Dr. Isis should probably ring the call button — but that’s because she’s worked as an emergency medic, not because of the PhD [3].

[1] Actually, I take his opinions quite seriously — sharp dude. But not in any authoritative sense.

[2] Some of that “is there a doctor aboard” is getting a bit dated. Fact is that a lot of MDs aren’t terribly well prepared to do emergency field work. $HERSELF recently shared a “Call 911!” moment at the grocers with a pediatrician; the MD was taking vitals while $HERSELF maintained airway and spinal stabilization, then helped the FD crew pack the victim for transport. No reflection on the MD: she’s doubtless a wonderful pediatrician, but fieldwork is something else again. I’m somewhat curious regarding Orac’s self-confidence for situations like highway accidents.

[3] Been there, done that. Talk about the Flight From Hell, several hours out over the Atlantic.

Growing up in a society that’s really high on titles (and not getting them right was a big social doo doo) I was very surprised (taken aback, insulted, bothered by) how the Dr. in the US is commonly only used to address your doctor, or maybe for a university professor. Especially if you slaved away in grad school for years earning a real scientist’s title, as compared to most MDs who spent three months of chart comparison to get the title to go with the education, that’s a bit of a downer.
To illustrate the different attitudes, I remember the big discussion in my hometown whether professors at the new local 4 year school (without the rights to give advanced degrees) actually justified the Prof. title ;).

‘Doctor” is supposed to mean an person who has studied a lot in any field. The original meaning had nothing to do with treating sick people or being a physician. I agree that it is more rude to NOT call a PhD ‘Dr.’ unless they request it.

It really doesn’t matter, if you’re visiting an aircraft carrier, that you hold an Army commission at rank O3 — in that context, “Captain” has one and only one meaning, and every single dude with Navy eagles on his uniform can find another title while aboard unless he is the Captain.

This situation, though, actually serves to illustrate the OPPOSITE of your point, since an Army captain on board ship is properly addressed as Major. When greater clarity is required between holders of the same honorific, one of them is granted a courtesy promotion. Etiquette does not allow demotions for such a purpose – and etiquette does consider Dr. to Mr. to be a demotion.

German custom would be to address him as Prof. Orac; you only use the “highest” title. If he’d be formally introduced, both the PhD and the MD count equally, as Prof. Dr. Dr. (based on the fact that in Germany the medical license is independent of the Dr. title, you have to pass a State Exam to practice medicine, the Dr. med is the academic title). Btw, in Germany the Dr. is part of the name (in your passport) and the it’s a criminal offense to use the title without it being conferred by an accredited university. That degree from the University of southern North Dakota doesn’t fly there.

Mu wrote: “Btw, in Germany the Dr. is part of the name (in your passport) and the it’s a criminal offense to use the title without it being conferred by an accredited university. That degree from the University of southern North Dakota doesn’t fly there.”
Or any American University based on current law. My brother-in-law is an MD in Germany, but never completed his PhD, thus not called doktor. A well respected researcher I know, who is a professor with two PhDs, in formal settings is introduced as Herr Prof. Dr. Dr. {FirstName} { Lastname}

Little misunderstanding there – he’s not an MD in the German sense (assuming he’s German). He finished medical school, and became an “Arzt”(doctor). He didn’t finish a Dr. med., so he’s not a Dr. There was a period during the 70’s when it was popular in certain political groups to not get your Dr.; not having one is probably not the best sales tactic, but it doesn’t prohibit you from practicing.
In the US, the MD and the license to practice medicine are inevitably linked.
Regarding the mentioning of titles, it used to be the only professors were those who where teaching at a university, and to do that you needed the follow the proscribed path of “Promotion-Habilitation-Berufung” (roughly dr. title, assistant professor, tenured professor). Again, during the above mentioned time of “get rid of titles”, or at least make them count less, a lot of people were appointed professor who didn’t follow that path. Therefor, the formal mentioning of Prof. Dr. titles is the polite way of saying “he’s a real professor”.

Vermonter here. We are a very small state. In various contexts, I have spoken to Howard Dean over the years. Sometimes I called him “Governor”, once “Doctor”, and usually “Howard” Vermont is a rather civil, yet informal, culture. I am sad to report that my state licenses frakking naturopaths, but happy to note that Medicaid here will no longer cover chiropractic.

There is no reason someone who’s spent the time mastering a PhD field should not be addressed as “Doctor”, I agree.

My problem is when people who have an academic doctorate abuse it to deliberately try to make people think they’re actually medical doctors, in order to gain some perceived higher status. My dad holds a PhD in chemistry, and any time he interacts with medical professionals, such as when he’s visiting someone in the hospital, he’ll introduce himself to the nurses as “Doctor”, with slight emphasis on the word. He isn’t a medical doctor, but it’s clear that he expects people in that specific setting to assume he is, and he wants them to treat him with extra deference. It might not be outright unethical, but it’s certainly pretty damn shady.

Any time someone uses their doctorate to try and gain extra credibility in an area in which their doctorate is meaningless, it bugs me. “I’m a PhD in Physics, so you should give my statements about economics extra weight.”

Dr. Biden though, and everyone else who’s put in the work to get that status, deserves the address in general conversation, no question.

D.C. Sessions explained that very well. Better, in fact, than I could have.

This is common newspaper usage. The newspaper I work for reserves “Dr.” for physicians, surgeons and dental surgeons.

That avoids the problem of deciding whether naturopaths and chiropractors are equivalent to physicians and surgeons.

No newspaper ever called George McGovern “doctor” although he has a Ph.D.

Any time someone uses their doctorate to try and gain extra credibility in an area in which their doctorate is meaningless, it bugs me.

Sort of like Dr. Laura?

I do the exact opposite of your dad, Terry. If I’m at a hospital I don’t want anyone calling me doctor (PhD in materials science), since I don’t want to be confused with a physician.

Sorry, but if it’s common usage it’s not adhered to very consistently. Which would make it NOT common usage. PhDs are routinely referred to as Dr. in most newspapers I’ve ever seen. Some very quick checking turned up examples in the New York Times and Wall Street Journal, among others.

Your example is also completely beside the point; referring to Senator McGovern as Dr. McGovern would be inappropriate in general anyway. (An example of the “use the highest applicable honorific” principle.)

This reminds me of the one character who is simply known as The Doctor. I am referring to Doctor Who.

I am reminded of an incident when he was asked “well, what kind of doctor are you?” and his reply was “every kind of doctor”.

There was other incident was when a human had become infected by a Krynoid and required some serious kind of amputation which he refused to do, delegating it to one of the humans. Some one did turn to him and ask him why wasn’t he doing it, after all, he was a doctor, and he said that he wasn’t that kind of doctor.

I am a medical student in the UK. Several of my peers already have non-medical academic doctorates, but are prohibited from being referred to as “doctor” in the hospital as this would unjustifiably confuse patients as to the extent of their knowledge.

Ironically, surgeons here are called “Mr.” according to tradition, and the title is definitely used in a way that makes it sound like an honorific.

RE:

PhDs are routinely referred to as Dr. in most newspapers I’ve ever seen. Some very quick checking turned up examples in the New York Times and Wall Street Journal, among others.

The NYT and WSJ have their own stylebooks. Newspapers that follow the AP Stylebook don’t use any honorifics other than Dr., and it’s reserved exclusively for medical doctors unless, as Dr. Biden has done, the person in question “prefers” that they be referred to in that fashion.

The NYT does not follow the AP Stylebook, and it uses honorifics for EVERYONE. If you notice, on second reference, the Times always says “Mr. So-and-so,” or “Ms. Whats-her-name,” while papers that follow AP only use “So-and-so” or “Whats-her-name” on second reference.

The AP Stylebook is the style bible for roughly 90 percent of papers in America, and most that have their own still follow largely on the AP Stylebook’s lead. The NYT and WSJ are exceptions on the use of honorifics.

Dr. Orac wrote, It’s mighty hard to see how one would do original research of any validity based on pseudoscience,

First, you have to lower the standards. Then you have the blinding procedure, that is probably similar to the Oedipus method, but the eyes are chosen randomly – at least the first eye would be chosen randomly. The second eye would be chosen by default, but double blinding is the standard. Perhaps best to just ignore the ridiculous claims of pseudoscientific research.

As for the titles, would I go with Dr. Rogue Medic, Rogue Dr. Medic, or Rogue Medic Dr.? Well, I’ll never be a doctor anyway, unless somebody gives me an honorary doctorate. I can guess that the insistence on being addressed as doctor for an honorary doctorate would lead to an even more amusing comment stream. 🙂

This has been pointed out on other sites, but did anyone ever have a problem with Dr. Martin Luther King or Dr. Henry Kissinger?

Those media sources don’t refer to Nobel winning theoretical physicists as MR. XXX do they?

Maybe it is a medical thing. Consider Dr. Evil; you know, he didn’t spend six years attending evil medical school to be called mister, thank-you very much.

I can’t help but think, based on the comments on German usage and law, that it’s rather amusing when a gathering of Nobel laureates in physics and chemistry can’t legally call each other “Dr. Soandso” for lack of qualifications.

Karl, the JD is very similar to the MD; a US title conferred upon finishing law school. Most German jurists for example don’t carry a Dr. title, since the Dr. jur. is one of the more arduous titles to get. Usually, the honors go from Dr. ing > Dr. jur > Dr. rer. nat. > Dr. phil > Dr. med., based from the (perceived or real) difficulty to obtain them.
On a side note, in Germany, asides from the MDs, it was the chemists that were most likely to finish with a PhD, due to the absolute dominance of PhD level chemists in the German chemical industry prior to the 1990’s.

Orac,
We’ve broached this subject before and again I ask, because you have an MD, PHD, should we be calling you Doctor, Doctor?

The ND after a naturopath’s name stands for Not a Doctor.

Also, if a homeopath claims to have a PhD, it’s understood that it stands for Phony Doctor.

Doctor, Doctor! It hurts when I do this.

Doctor, Doctor! It hurts when I do this.

Then don’t do that.

This is common newspaper usage. The newspaper I work for reserves “Dr.” for physicians, surgeons and dental surgeons.

But what do you do instead? If you referred to me as “Mr. O’Hara”, I would feel you were either ignorant of my status, or being insulting. OTOH, if you referred to me as “O’Hara”, I wouldn’t have a problem (well, assuming the context was right to not use titles).

Incidentally, my “proper” title is Docent, but that’s relatively obscure. I only mention this because it means that you should call me Doc. O’Hara.

(I’m not a medical doctor, although my PhD is in pathology. Of cereals)

After reading these comments, I think that anyone intelligent or hardworking enough to understand the Germany system of degrees and titles deserves whatever the highest German title is.

“Doctor doctor please, oh the mess I’m in”

It’s all very simple.

If you are a medical doctor you are always a doctor. Even if you are retired – or dead.

If you have a doctorate in geophysics then you are a doctor in the geophysics department you work in. You can be a doctor outside of academia but it makes you a pretentious twat.

If you are a nurse with a Ph.D you are not called doctor in the hospital to avoid the obvious confusion.

If you have a doctorate from a mail order college (like our very own Gillian McKeith) then you are a quack and a charlatan.

If you claim to have a doctorate in homeopathy or some such nonsense then you are also a quack and a charlatan. You cannot possibly research something which does not exist. Full stop.

(I will make a concession here for stuff like theology on the basis that is is part of anthropology/social science. It’s still rubbish though).

If you are a professor you do not need the doctor title as in general a Professorship trumps a doctorate (and in any case the latter is usually a pre-requisite for the former).

In general non-medicos calling themself doctor outside of an academic environment is a bit naff and, like cliches, should be avoided like the plague.

Simple.

Mrs Biden can call herself anything she wants – as long as she is entitled to the honorific. It may obviously reflect on our view of her ego though. I would have though that in the social standing stakes Mrs Vice President was pretty much a trump card but maybe she doesn’t want the reflected glory.

Why then does the Times say Dr. Martin Luther King and Dr. Henry Kissinger?
Dr. Jean Kirkpatrick pointed this sexism out a long time ago.

Dr. BB

I appear to be the only dinosaur on this board. But in every institution of higher learning I attended, the Doctor Professors followed the rule I was taught by my uncle, who was himself one of them: namely, that it was silly, pretentious, and simply Not Done to use the “Doctor” title when one was the holder of a Ph.D. (Or a dozen of them, for that matter.) Not socially, and not in the classroom, not ever. The rule covered men and women, the distinguished and the less distinguished alike. The reason, he explained, was that one simply assumed that one’s colleagues had doctorates, and there was no call to make a display of it.

To insist on the title yourself, therefore, marked you as a pretentious twit. To use it to an academic degree-holder by accident was to make it clear that you didn’t know the rules, and people would flinch and, if possible, correct you quietly where you could avoid too much embarrassment.

It’s just a social convention, of course, and entitled to no higher standing than any other social convention. But to this day, I prefer the reverse-snobbery of the implicit, “Everyone here either has a doctorate or is capable of having one, so let’s not make a fetish of it” of the old rule to the implicit (and sometimes not so implicit), “I worked hard for this degree, and people had goddamned well better acknowledge my work and high rank in their form of address to me” of the new one.

From the NorthJersey.com article

Mr. Withakay: I can’t speak for anyone else, but for my own part, I fear that I must have been less than clear. I didn’t mean to argue that there was any point at all to physicians using the “doctor” title. It’s just a social convention, and as far as I know not one in controversy. (I do object to it, or would, if physicians demanded to be called “Doctor” while using the first names of those from whom they’re demanding it. But happily, I haven’t encountered that particular and obnoxious phenomenon.)

Is it the contention that medical doctors are special, and that anyone with a “plain old PhD” isn’t worthy of the respect given by the title doctor?

Not as far as I’m concerned. It’s more the reverse-snobbery, aristocratic sense that no one worthy of respect needs a special title to remind themselves or those around them of their status. I grant that I’m old-fashioned about this, but in the world I come from giving the person with that Ph.D. the title “doctor” is not in fact to show them respect. And at worst — that is, where they’ve made it clear it matters to them — it’s to condescend to their pathetic insecurity. Which is not something I like to do to people whom I think worthy of respect.

O’Hara, in my paper, you’d be O’Hara.

We’ve pretty much gotten away from using honorifics for anybody, not even Rev. for preachers, and — to my surprise — not Father for Catholic priests.

Dunno why. The only written policy is as I’ve stated above.

An architect friend of mine tried to get ‘A.I.A’ used as a standard whenever talking of ‘real’ architects, and I think there is a genuine need to distinguish between professional engineers and garbage engineers, and I occasionally use ‘P.E.,’ but most people don’t know what it represents.

I was surprised that my JD qualified me for a graduate program that required a doctoral degree. I always assumed it was an accident of antiquity that the D in JD stood for Doctor – would never in a million years have thought to address a holder of a JD as Dr. Anything. Law school is just not comparable to a true doctoral program.

I’m learning a lot in these comments, actually. Didn’t know some consider Professor a greater honorific than Dr. – I always thought of it as more an occupational designation.

On the pompousness question, I’m with the commenter who wrote that it’s polite to use the title a person prefers, but not polite for that person to make a stink about it if you don’t.

Actually “Dr Robinson”, outside strictly academic circles (and often within) I much prefer ‘David’ or ‘DC’ to ‘professor’. Titles sound so pompous.

Dr Aust is referring in part, to my comment (at the bottom of page 3), on an article in the Economist.

“Anyone who has been following this dialogue, would, I think,have supposed that “Dr Robinson” was a medical graduate of the distinguished Northwestern University Medical School.”

. . .

“it seems that she is not medical at all, but a chiropractor who is a graduate of a quite different organisation, the Northwestern Health Sciences University, which encompasses the Northwestern College of Chiropractic and the Minnesota College of Acupuncture and Oriental Medicine.”

The real problem arises because of the corruption of universities that allows them to give degrees with names like “Doctor of Chiropractic” in the first place. Once that has been done there it is, I suppose, legal to use the title. But in many places, it is illegal to use the title so as to give the impression that you have are qualified in medicine when you are not. I have noticed before that chiropractors are very touchy about this. When it was discussed in the New Zealand Medical Journal, threatening letters arrived from lawyers. Luckily the feisty journal fended them off.

The question of the strict legality (or otherwise) of using a title is not exactly the same as the question of whether its use is misleading, either intentionally or unintentionally. The latter is context-dependent.

In many countries, the chiropractic colleges formally graduate practitioners with Bachelor degrees, e.g. styled “B Applied Sci (Chiro)”. For such folk to style themselves “Dr” would be grossly misleading and – in many countries – illegal. Even for practitioners with “doctoral” degrees in CAM modalities like chiropractic, they are still NOT the conventional physician that most members of the public would be expecting if they fetched up at a medical-looking office with the sign “Dr Wotsisname” hung over the door. So to say “Dr” in a healthcare setting, without any further information, is misleading. Unless, of course, you are a conventional MD (or equivalent), which is the “default” assumed meaning of “Dr” in a healthcare setting.

Many of the practitioner associations officially endore this position: for instance, the New Zealand Chiropractic Board’s Code of Ethics says:

2.3 The use of the title ‘Doctor’ must be qualified, for example, John Doe, Dr of Chiropractic or Dr John Doe, Chiropractor. Failure to qualify the use of the title ‘Doctor’ may contravene the provisions of this Code.

The point of the articles that are linked from David Colquhoun’s blog (links above) is that the practitioners of acupuncture, osteopathy and especially chiropractic routinely contravene such rules – in one recent study in New Zealand, 80% of all chiropractors surveyed (most of who have BAppSci degrees) simply styled themself “Dr” in their advertising, with no qualification of this whatsoever.

It is obviously a less critical setting, but posting repeatedly on a forum discussing alternative medicine as “Dr”, and never making clear that it is a doctorate of chiropractic, might also strike some people as potentially likely to mislead.

If anyone is still following this (which I doubt), I again invite them to read through the posts on the Economist thread (again, link in David Colquhoun’s post above), and see who they think “doth protest too much”.

I only ask my students to call me Doctor. I’m still young enough to need either a tie or title to distinguish myself from some of my students. And I won’t wear ties due to being around lovely chemicals, plus they are disgusting means of transferring pathogens. Next time you see a “real doctor” (as the public often refers to MDs) ask when they last washed the tie was. The one that they wear to see all of their patients, day in, day out. Bleah.

My close family members use doctor sometimes as a loving tease. Outside of class, though, I’m Robert to pretty much everybody, unless they demand to be called Doctor.

Of course, if I were interviewed for a newspaper, and it was relevant, I would expect to be called either Dr. or have PhD appended to my name.

————

“Another Chiropractic Physician”

You are not a physician without an MD. You are a quack. You “practice” a non-scientific medical scam. How a 19th century magical belief can claim to be a medical profession is a failure of the law to protect the consumer from fraud.

Call yourself a doctor if you want, but it is just another grab for legitimacy for a snake oil profession. A master electrician is closer to being a doctor than a chiropractic or naturopath or homeopath (soo soo suk to Dune readers).

Back in the 1800’s, it is true that chiropractic could not explain how it worked. . . any more than medicine could. It is ridiculous to say that the practice of chiropractic has not advanced since then. Plus, chiropractic never claimed to be magic, that was medicine. Medicine was the profession that used to ascribe various maladies to the malice of the local witch and would treat fevers by bloodletting. Both professions have come a long way, but both still have a long way to go. If you think medicine is perfect, please fill me in on how to cure cancer, eradicate HIV, and counteract the effects of Trisomy 21. Nobody is perfect, but we’re trying. Only a completely uneducated . . . . . would refuse to look for or acknowledge the relevant information.

Okay, in the United States, the term “physician” is used for Cardiologists, Chiropractors, Dentists, Family and General Practitioners, Oncologists, Osteopaths, Podiatrists, Rheumatologists, and a whole laundry list of doctors. Looks like chiropractic is there! As an exercise, I suggest that the next time you go to the hospital, you grab a list of all of the doctors practicing there. If you aren’t planning a visit to the hospital any time soon, check out the “meet the doctors” section of their website. Then, call up all of the ones who have “DO” after their name instead of “MD” and tell them that they are not real doctors or “physicians”. Come on, it’ll be fun.

Dr. Aust. So, we can look you up and see that you are a PhD and not a physician. As opposed to Dr. Robinson, who we can look up, and see that he is a DC and not an MD. Wait, how is this different?

How is what KIND of doctor one is germane to a conversation about Dr. Biden asking the press to refer to her as “Dr”? How is what KIND of doctor one is germane to a conversation about acupuncture? Or homeopathy? Unless one happens to be a Doctor of Acupuncture (trained in China) or homeopathy or whatever? The first comment about chiropractic was NOT made by Dr. Robinson, he was talking about acupuncture! Last time I checked, neither he nor Professor Colquhoun nor you have any training in acupuncture. . . so how is ANY of your training pertinent?

Although your reference is by an individual who has been repeatedly discredited in scientific circles, I actually agree that the chiropractic profession may overutilize x-ray. It may stem from the fact that Medicare (and other insurances) used to REQUIRE that x-rays be taken as a part of the exam prior to treatment. Sure, too many doctors of chiropractic still use these old guidelines. There might even be some that do it for the money. Can you tell me how many pediatricians prescribe antibiotics on the first visit for children with middle ear pain even though the American Academy of Pediatrics states, clearly, that this treatment is NOT recommended? http://www.aap.org/publiced/BR_EarFluid.htm
Or how many general practitioners immediately prescribe antihypertensives, even though the guidelines say that the initial approach should be diet and lifestyle modifications for between 6 weeks and 6 MONTHS depending upon the case? Might this have anything to do with the $13 billion spent on advertising and “physician education” (including luncheons, cruise conferences, and free gifts and prizes) by the companies that sell the antibiotics and antihypertensives? I don’t think that the majority of medical doctors (or doctors of osteopathy or dentists or whatever) can be accused of this type of accepted unethical behavior, nor can the majority of doctors of chiropractic. I think the majority are trying to help people, and they all get a bad name from the few bad ones. Maybe I am idealistic, and all of the doctors really are bad. Wow, that’s a scary picture.
We, chiropractors, are trying to work to improve our profession, and we are doing it without the major drug company funding that pays for tons of research for medicine. So when you are perfect, you can point a finger at me, but until then, you have to acknowledge that we are all working on it. This includes the surgeon doing the laminectomy (which does not have evidential support) and the chiropractor doing his adjustment and providing stretching exercises (which has some, but not enough, evidential support), both of whom are doing their best to relieve a patient’s low back pain.

And if you still can’t read the studies or examine the evidence, then at least get a life.

To begin with, I am female.

Please be careful to clarify that the ability of a doctor of chiropractic to function cooperatively with an obstetrician or in solo capacity is NOT a standard component of the basic education, any more than it is part of the basic education of a general practice MD. Sure, we all get the minimum outline and could “catch” if need be, but to actually be qualified to deliver a baby requires additional education beyond the preliminary 8 years. In addition to the extra educational requirements, there is a limited number of jurisdictions where this is permissable within the scope of chiropractic practice.

Everyone is pointing fingers at each other, and that is neither warranted nor productive. I am really not interested in being drawn into it, and would appreciate if I could be left out of it. Thank you.

Robster. . . why are you specifically being intentionally and deliberately rude? Have I said anything to make you believe that I am “ascientific”, other than that I am a doctor of chiropractic? You call me a “quack” and say ridiculous things like “Did I step on a duck?”, but do you know ANYTHING about the way I practice? I am working to improve the chiropractic profession. What are you working on in this regard besides being a jerk? I don’t know you, and you don’t know me. . . so let’s try to focus on the debate at hand.

I was not implying that the faults within medicine are support for CAM. I was calling for all of these practices to have to support themselves with evidence, including medicine. We are willing to do it. Are you? It looks to me like you want to sit there and point out all of the weaknesses of CAM and use them as support for medicine. I say, let them all do the research and we’ll see who comes out best for each condition. It won’t be chiropractic for everything, but I know it will be for some.

Actually, there is still no medical cure for cancer. Any doctor (any one who actually provides patient care) will tell you that the best you can hope for is remission, but that the cancer is not gone and can re-emerge at any time.

There are medical drug treatments for HIV, but a 2005 study done by UNAIDS found that 2/3 of HIV patients in developing countries (where HIV infection is highest) and an unknown percentage of those in industrialized nations still successfully use CAM for symptomatic relief and for the management of opportunistic infections. Wanna go tell that AIDS patient that the health care helping him survive is fake?

Articles you might enjoy, from real medical journals!!!!
Spine Volume 33, Number 4S, Supplement to February 15, 2008
– this entire journal reviews the neck pain task force report completed at the request of the UN and WHO reviwing ALL types of treatment for neck pain and associated conditions in response to the UN’s declaration of 2000-2010 as the Bone and Joint Decade. Two of the articles, begining on pages S170 and S176 respectively, show that there is no greater association between chiropractic visist and VBA strokes than between allopathic visits and VBA strokes, and that the associations of both are really low. Looks like you are the one using outdated and incorrection information here.

The Spine Journal Volume 8, Number 1
– This is also a supplemental issue, this time dealing with Evidence-Informed Management of Chronic Low Back Pain. This reviews spinal manupulative therapy for the treatment of CLBP, but also adjuctive analgesics, epidural steroid injections, facet injections, intradiscal electrothermal therapy, lumbar extensor strengthening exercises, lumbar stabilization exercises, massage, minimally invasive nuclear decompression, prolotherapy, certain types of surgery, etc. Then, it compares all of these treatment options. . . and guess what?!? SMT comes out among the best of the options.

Before you try to dismiss these, note that the research was NOT done only by DCs, but by MDs and PTs and DOs and PhDs and DCs; some of the best and most respected individuals in their fields spending YEARS on these studies, and the two journals listed are international and integrative.

And hey, who denied anything about germ theory or the benefits of good hygienic practices? Do you have a lot of chiropractors promoting or engaging in bad hygienic practice around where you live? Seriously? A bunch of smelly chiropractors running around?

So, to recap:
– real medical journals show that chiropratic works for the conditions indicated
– real medical journals show that chiropractic does not cause strokes
– modern practice of chiropractic has come a long way in the last 100+ years
– saying ridiculous and unsupported things like this make you look like an uneducated jerk. If you want to claim “basic scientific literacy”, try reading something on the topic before you shoot your mouth off.

Robster
Where did you get your definition of chiropractic from? It is not one that I heard in 8 years of studying to be one, in 15 years of practice, nor one I can find in any reputable source or through internet search engines. How can you present this as “THE DEFINITION” when it appears that you just made it up?

There are no more “antivaccination” doctors of chiropractic than “antivaccination” average people. There are the loud people who scream and everyone hears, and then there is everyone else. I have never told a patient not to vaccinate their child, but I have a lot of patients who come to me, their doctor, for advice on the issues they hear about them. I, like my colleagues, provide information and tell the parent that it is a choice they need to make for themselves.

Chiropractors don’t wash their hands between patients? What?!? That is not true of any of the chiropractors that I know. What are you basing your accusation on? Plus, if you can find a doctor of chiropractic (or medical doctor or doctor of osteopathy or dentist) who is lazy and negligent and doesn’t, how can you infer from this that they don’t believe in germ theory? I would say that they are just lazy and lousy doctors.

There are bad practitioners in all fields. I am working to improve the standards and thus elimiate the “bad ones” in my profession. I happen to love what I do, however, which is why I have a “real” degree as a Doctor of Chiropractic. This is like asking a dentist why they didn’t become a shrink. Maybe because they don’t want to.

I am licensed to perform physiological therapeutics, which is not the same as Physical Therapy, but does include some similar things like exercise and some rehab. A major difference is that a doctor of chiropractic is a federally recognized, primary care, portal of entry physician and a physical therapist is not, (whether they are still working based on an old bachelor’s degree, a masters, or the relatively new Doctor of Physical Therapy degree). This is based on additional years of education in things like diagnosis, neurology, pharmacy (yes, we learn it, even though we don’t prescribe) and is the reason why you don’t need a referral to see a chiropractor and you do need one if you need to see a PT, or to see the PT for more than a month, in some states.

Stephen Barret is a joke, and everyone knows it. Previous literature shows an assocation between chiropractic adjustments and VBA stroke, but even the old stuff doesn’t show a causative relationship. Plus, the association is higher between GPs and stroke than chiropractic and stroke; (for those without basic scientific literacy, this means that people who have neck pain and headaches because they are having a stroke or one is pending often go to see doctors, and that they may go choose to see a chiropractor, not that the chiropractor or medical doctor they are going to see actually caused the stroke). That is old news.

The research I referenced were high quality studies. They were comprehensive reviews of all common treatment options for neck pain and low back pain, respectively. This includes both allopathic and complementary options. They were all reviewed independently, and then comparatively. They also accounted for both pragmatic and fastidious trials.

I think the point has been made, however. You are “too busy” to verify that what you are saying is false. You think that you can just make up whatever you want based on limited or very old information and even on rumors. You have your prejudices, and they alter your perception of reality. Trying to dicuss this with you is like trying to reason with an antisemite or a KKK member or any other person with a baseless prejudice. I think we should maybe just be done now.

Yes, the tests historically used to “screen out” potential stroke victims have been found to be pretty darn useless. This is because there are very few cases in which a chiropractic adjustment could possibly cause a VBA stroke! You have a higher risk of having a stroke when looking over your shoulder when backing out of your garage! If chiropractic DOESN’T cause strokes (any more than routine angioplasty does. . . and actually, even less), then how are you supposed to test for patients in whom chiropractic adjustments might cause strokes?!? This is a ridiculous argument. This is like saying that allergen tests are useless because they don’t detect my allergy to peanuts because I don’t have an allergy to peanuts!

Your first bookmarked article says that there is a “vocal element” within chiropractic that is anti-vaccine, but that this is a “minority” of chiropractors. Your second article is a incredibly unscientific, self-reported survey of Canadian Students. The survey questions were not even included as an annex! Even that one found that, “most students reported that in general they agreed with vaccination” and “most students reported positive attitudes toward vaccination”. Is this not exactly what I said? How in the world do you think that these articles support your opinion? Did you even read them? I know a lot of chiropractors and, like your articles support, the majority of them are not anti-vaccination.

Chiropractic services are now a part of the VA system based on a study conducted by the Department of Defense medical service (the allopaths!) examining the cost-effectiveness and efficacy of chiropractic care in a study that took place within the VA service over 2 years. When the report of the study came back so overwhelmingly positive, the DOD decided to include chiropractic services. Looks like this was the allopaths who forced politicians to include chiropractic.

Well, your “post hoc rationalization” is exactly what the allopaths say, too, when one of their patients has a VBA stroke in their office or within the next week, or even in the waiting room before being seen. Guess the professions are in agreement on that point.

Chiropractors practice evidence based methodology, too. There is actually a significant body of quality research out there on the efficacy of chiropractic treatment. I would like to see more, of course, but my profession is working on it.

I did not call you a nazi. I said you had a blind, unjustifiable prejudice which you would refuse to reconsider even when presented with irrefutable evidence that you are wrong. There is a difference. Hitler was malicious, not stupid.

aCP, If you could show me irrefutable evidence, I would change my mind, but you haven’t done that. You have offered a couple papers and your own word, against that of the verified existence of several large “straight” chiropractic organizations.

The existence of those papers does not mean that the link to stroke is debunked, only that there are competing views within the scientific literature. You also seem to be horrified that I consider my students and their training in the biological sciences to be more important than your ego.

As back pain often has a cyclical pattern, and not much is good for its treatment, with many placebo based methods having similar levels of effect, I’m not sure that I would be using that as an example of accomplishment.

So, please do educate me as to what you have integrated into your practice to make it more scientific other than imitating PT? Acupuncture, supplements, homeopathy, oriental medicine?

Well, I stopped by the library on my way home and emailed myself a few articles, and lo and behold, the emails came through sans attachments. I’ll try the same with a thumb drive tomorrow. Bleah. I have a feeling that it will be an interesting read, though, from the glance I did get to take.

@antipodean,

That is why it is a silly kerfuffle. We really don’t have a standard. As a practical matter, it helps to limit the honorific to medical professionals. As has been pointed out, in an emergency people calling for a doctor are not seeking an English major. Nor, in a serious emergency, would one want to be tended by a chiro.

another Chiropractor February 24, 2009 7:04 AM

Not surprisingly, you are profoundly ignorant.

For starters, yes, subluxations exist; just not the chiropractic kind. Chiros were forced to admit that in the 1960s.

To continue, med school is four years after the undergrad years you would count; plus another 4 (or more) years of specialization before one can be licensed. You morons can be licensed to play doctor (after four years, often sans an undergad degree) without ever treating a sick patient.

Yes, PTs are not licensed as primary care physicians; but you, less-educated chiros, don’t deserve that appellation, either. You just have it because of political clout and, even more ignorant, legislators.

Do you think that DD Palmer cured deafness by adjusting the thoracic spine? That is the enduring foundation of your cult.

Your “doctorate” is as realistic as a “doctorate” in astrology (which point may be lost on you).

I cited Ernst’s review claiming chiro is useless, why not cite reliable information showing he is wrong. I won’t hold my breath.

@antipodean “Actually Joe we do have a standard. Or at least we used to.

The standard is research-based higher degrees are doctorates. You have to teach the world something new.”

That standard is no longer operational. Today, most doctorates are technicians whose “something new” derives from the professor for whom they work. That was a result of the government recognizing (after WWII) that we won because of our advanced science/technology.

They (the Feds) started providing money for research, and the professors began needing bodies in their labs. Anybody who is willing to work for a pittance (for a while) qualifies for a PhD today in many “militarily useful subjects”.

I find it useful to know that someone I call “doctor” can diagnose and treat an illness.

Joe,
You are actually completely incorrect. Historically, there was only one definition of subluxation, and it was the allopathic profession which changed the definition. They didn’t deny the old definition, they just wanted to change it. Check the article “The search for subluxation: An Investigation of medical literature to 1985” by Dr. Terrett. The article was written in 1987, and I apologize, but I can’t remember where it was from.

Sorry, but you’re wrong on the med school thing. One of my friends from undergrad went to the Creighton Medical school, started the same week I did, and she was done in 3 years. At that point, she had never treated a patient. From there, she was known as “Dr. xxxxx” and began her internship, followed by residency, during which she learned to work with actual people. This is exactly what I said. Following a 4 year undergrad course, Chiropractic school was 5 semesters of academic classes, then 2 years of classes while simultaneously treating patients in University based clinics and then public clinics (the hours of class decresing and hours in clinic increasing each semeter) and then a semester of clinic, only, where I was practicing but still under the license of a supervising physician. After that, I graduated. I was required to take 5 different licensure exams (4 written, one practical – check out http://www.nbce.org) and I was licensed and could call myself “doctor”. (Wait! My friend could call herself “doctor” BEFORE ever treating a patient and I couldn’t do it until after 2 1/2 years of working with live patients!) I then began a two-year preceptorship, in which I was a doctor, but was still working with another, more experienced physician. After that, I was able to practice on my own. Try actually knowing something about the educational systems before you make comment, or you just look like an idiot.

You give my profession way too much credit if you think we have that kind of political clout. We are a small group of practitioners, most of whom are not politically active, so how would we have “clout”? Less than 1/3 of chiropractors are in ANY professional association, and in 2005 the American Chiropractic Association donated about $350,000 to various political campaigns while the lobbyists for the American Physical Therapist Association donated just shy of $1,000,000 and the American Medical Association trumped us all with over $6,000,000 in donations to politicians. I won’t assume that you can do basic math, so I’ll let you know that in comparison, we have no shot of buying clout when you compare those numbers, because 6 million is much, much larger than 350,000. The advances in health care legislation with regard to chiropractic have occured in spite of political clout, not because of it.

Robster,
I did read past the abstract, but I think that we have proven that you can’t read. The table you are referring to did not say that the patient was 12 times more likely to have a stroke due to chiropractic manipulation, but that of the 818 VBA strokes occuring in Canada over the course of the 5 year period, 12% of those under the age of 45 had seen a chiropractor within 24 hours preceding their stroke (note that not all of these 12% would have received manipulative treatment) as compared to the 11.21% of those patients under 45 of the 818 patients who had VBA stroke who had seen their allopathic doctor within the 24 hours preceding their stroke (check the table on the next page). This means that the risk of having a stroke is, statistically significantly, the SAME whether you see a chiro or an allopath, not 12 times as much. This is what the discussion says, as well as the statement that ‘in the month before their stroke, only 2% of the cases had seen only a chiropractor, 2.4% had seen a chiropractor and an allopath, and 51% had just only seen an allopath.’ The remaining 44.6% had not seen a doctor in the month before their stroke. Oh my God! If I were too stupid to understand these results, I might be able to convincingly argue that you are 25 times more likely to have a stroke upon visiting your allopath than your chiropractor! Agh! In truth, the the association is about the same, just that about 25 times the number of patients who had prior symptoms choose to see an allopath than a chiropractor.

Your comment on the methods is just shockingly stupid. The methods were designed to examine standard chiropractic and allopathic practice, accounting for the variety of options a physician might pursue. Perhaps we will have to agree to disagree on this point, but I am going to stick to my opinon that the methods are pretty good, as it is backed up by 139 editors, 7 highly respected authors (none of whom is “just a DC”) and the 14+ national health care agencies and universities who thought the methods were good; rather than you, the guy who can’t even appear to read the discussion of the article, let alone interpret the data.

I am not familiar with Dr. Crislip, but I’ll be sure to check that out when I have time. I’ll even give you that he’s a real doctor (although I don’t know yet) because in my opinion, a real doctor is who who helps patients through diagnosis and treatment, like I and Dr. Crislip may do, and you don’t. Funny that you should accuse me of just reading the abstract, when you are the one who didn’t even read that first article, let alone the others. Oh, and while we’re on that topic, your link to Mark Crislip is actually to an article by Harriet Hall which MENTIONS Crislip. The article is anti-chiropractic, no bones about it (see, I can make stupid jokes, too. . . but no one is laughing) but even that article says in the very first paragraph that “The risk is very small”.

Perhaps you should read the rest of the spine articles. Having already addressed the risk of serious complications (again and again and again), the other articles will speak to the statistically significantly superior efficacy of certain treatments (chiropractic among them)to the other options examined and found to be lacking.

If what I said sounds like what came from the FCER pamphlet, it is probably because WE ARE QUOTING THE SAME STUDY! Good God, do you read anything before you try to post it up here? In that vein, do you have any response to my comments about the last two articles you posted here? The ones about antivaccination beliefs within the chiropractic profession? In case you forgot, those were the two that completely supported my point and not yours.

Can you PLEASE read a few things and try to get it right before posting things on this thread? It is getting pretty old just having to fact-check and correct you every single day. This isn’t even a discussion anymore, and it’s getting boring. I love having animated discussions with people with opposing views, it’s interesting, and helps stretch the mind. . . I don’t argue with my 5 year old niece, however, because she doesn’t really have the necessary skills yet because, well, she’s 5.

Try the first link, aCQ. Internet = serious business.

Bawwwww some more. Table 3. Highest odds ratio is for individuals under 45 seeing a chiropractor within 24 hours. People under 45 should not be having strokes. But hey, nice appeals to authority there. Just because something gets past editors does not mean that it is correct. In this case, Spine should be embarrassed. If you could be embarrassed, you would be. Check the introduction, as well. Seeing a chiropractor is noted in a previous study to be associated with VBA strokes.

Finally, in respect to introduction, the authors point out that others have suggested that VBA stroke patients may seek care from a chiropractor because of neck pain and headaches. I’ll just say this. If chiropractors are not able to recognize a stroke and don’t immediately respond by sending a patient to the ER, then they are not worthy of being called physicians. It still sounds more like a post hoc rationalization to me.

As to the Busse article, where vaccination attitudes of chiropractic students were surveyed, they became more antivaccination over their time in the program. How a student can go through a supposedly medical based program and go from a disappointing 40% antivax attitude to an astounding 60% antivax is beyond me. The percentage that are solidly antivax went up quite a bit as well.

Do they not include such things as basic biology or micro in these programs? I would be stunned if a single student to come out of my bio dept would be so scientifically illiterate. Do you think that you could find a medical school in the US where half of the students don’t think vaccination is a good idea? Chiropractic students simply don’t know their biology, and they apparently aren’t getting it at chiropractic schools. You may be the exception, but wow, you guys start out not so bright and go down from there.

If you want the specific questions, email the authors. It isn’t that uncommon for people to not include the survey questions in the body of the article. Methodologically, a Likert-type scale would have been more useful, but thats a design issue that they didn’t look into.

Tell ya what, if you chiropractors could manage to look at the same xray and pick out the same “subluxation,” you might have some credibility. Thats why you are a quack in a quack field. Instead, you (OK, maybe just the bad chiropractors, not angelic you) just run through a script about how the patient needs to keep coming back forever for adjustments.

Complaining that those mean old allopaths changed the definition on you is an excuse. As science advances, we refine definitions to remove false information. You still believe that chriropractic subluxations are real.

You keep complaining about how we are a bunch of girly preskool nazis, but you just can’t stay away. You know you love it. (I’d say don’t quit your day job and leave the jokes to us, but chiropractic is the joke, just lacking a certain stroke of genius. lots of strokes, though) Oh, and I am a real doctor, with a real PhD in a real academic medical field, but I don’t pretend at being a physician. You on the other hand, pretend at being a reformer in a practice made up by a magnetic healing scam artist.

I am curious, though, and as I asked earlier, what else have you incorporated beyond PT into your practice? Homeopathic remedies, supplements, accupunture? You attacked me for not knowing about how you practice, so now I am asking.

I’m working my way through some of the articles you suggested, and I’m not too impressed with some of them, and despite what you may think, I don’t check to see if the author is a dC or PhD or MD before I read it.

aCQuack wrote “I may express my opinion here, but at least I am IN the [cult], which means that maybe I know a little more about it than you do.” Sure, and psychics know more about their business than you do (in all probability). It doesn’t make them factually correct. As far as knowing your cult, I have been following it more than 30 years.

Don’t get me wrong, when chiros are not snapping necks and causing strokes, they may be competent masseurs (masseuses). It is the delusions of grandeur (and, extra cost) to which I object.

I may be an idiot; but I would never waste time and money “studying” fairy-tale subluxations, as you have. At least, I have evidence for the tooth fairy (there was a dime under my pillow for every tooth I lost). There is not even that much evidence for the chiro subluxation. And, no, whatever you think, it is not visible on X-ray.

How Can Chiropractic Become a Respected Mainstream Profession? http://www.chirobase.org/01General/respect.html A lament and criticism by chiros.

They could drop all the quackery and almost be massagers. (Massagers need to recognize some conditions that should be referred to a doctor.) Or, they could hire competent faculty and train for PT licensure. I don’t think the typical chiro is able to qualify for the latter.

Joe,
Do you think that changing my quote makes you more credible? Also, the use of the [] marks in a quote are to change the tense to allow the quote to flow more correctly in the larger context, not to just change whatever you want to change. . . so I guess we know that you’re an idiot who also doesn’t know how to speak / write English.

Robster,
I reject the article from Ernst not just because I deem it to be unacceptable, but because it has been discredited by a large group of physicians and researchers due to it’s clear bias and lack of scientific credibility or integrity. Even if it was just me, however, I would point out that if you feel you have the right to dismiss some of the research I have proposed, then I also have the right to dismiss some of the research that you have proposed.

I will make a note of your opinion that I am not a real doctor, but my doctoral degree, license, training, and the laws of my jurisdiction say that you are wrong. I won’t expect you to change your mind, but I’ll be glad that you have no basis for your opinion other than your bias, and your opinion in this realm doesn’t count for diddly-squat.

If a patient presented with ALL of the symptoms of a VBA stroke, or presented WHILE they were having the stroke (which is when all of those symptoms emerge) then yes, any trained practitioner should be able to recognize them. As the majority of patients present PRIOR to their stroke, however, when they may just be having a headache or dizziness, then it seems a little more reasonable that it could be missed. Also, you might know this if you actually treated patients, but it is not reasonable to make the assumption that patients seeing allopaths were going in for their strokes anymore than it is reasonable to assume they would be seeing the chiropractors for the same reason. Patients present with symptoms (i.e. headache or neck pain), not diagnoses. Patients don’t think, “Hmm, I have a headache, most likely a stroke! Better take myself in. . .” Patients present with prodromal symptoms, that is how it works in the vast majority of the very few cases in which this occurs.

The percentage of patients who had a stroke within a day after seeing their practitioner was statistically the same whether they chose to see a chiropractor or an allopath. The assumption that they were seeing the allopath for treatment for that stroke is unsupported in the literature, and even if it was true, then all it does is say that allopaths do a crappy job of treating these patients as they all went ahead and had strokes anyway. If that is the case, then no one can treat them, and I don’t happen to believe that this is true. Either way, however, neither of us have evidential support for our opinions, all we have is the fact that the association is the same between chiropractic and allopathic practitioners with regard to this type of stroke.

I am glad that you can admit that your original interpretation of the Spine articles was incorrect. I have alleged that you would never admit that you were at all incorrect, so I stand corrected. I am not sure why you accuse me of being unable to make the same admission, however, as I have never said or done anything to support that accusation. Perhaps we are just back in the playground, and you’re rubber and I am glue.

Perhaps you say The Spine Journal is junk because you want to have it be junk. Remember that you said the same thing about the Spine task force report at first, too. I never expected you to aknowledge the evidence, so if you are willing to admit that this is legitimately done research which allows you to, begrudgingly, admit that chiropractic “may work for some kinds of back pain” (even though the articles you are willing to give minimal credence to are about neck pain and the associated conditions) then I am content.

You say we need to fix our educational system by including, “classes and training by real doctors on organic disease processes, some microbiology and biochemistry would be nice, add a residency requirement”, etc. Excellent! Then we are in agreement. I was taught by real doctors (PhDs, MDs, some mutiple degree holders, including some DC, PhDs). I had several years of study on diagnosis, pathology, clinical pathology, immunology, infectious disease, etc . . .all taught by two instructors, one who was an MD and the other who was a DC,PhD pathologist. I had microbiology, taught by a PhD in Micro, although the lab instructor was a Masters in micro with a PhD in education. My Biochem instructor was a PhD biochemist, although I will admit that in lab she also had a DC to assist, and I am not aware of that DC having another degree, as well. As we have already established, we do complete internships, externships, and residencies. So now there is no reason not to “accept” me, right? I feel so loved. As far as “adjustments” go, Doctors of Osteopathy do something that is somewhat similar, and they are “accepted”, so I think we are good there. Also, there is a difference between something lacking evidence, and something else which has evidence against it. I will admit that there is only anecdotal evidence (case studies) supporting chiropractic treatment for asthma. Consequently, I do not make this claim and treat this condition in my clinic. There is not evidence saying that it doesn’t help control symptoms, however, so I will refrain from making the accusation that this is a sham for the time being. Perhaps when there is some funding available for research, we can know the answer with any certainty at all.

Hmmm, innate intelligence, the idea that the body has the ability to heal itself. This is not a phrase that I like or use, as it has horrible connotations and history. It is, however, an idea that is rooted into the philosophies of all physicians. My grandmother had a hip replacement, and the surgeon cut her open, chopped out a chunk of bone, replaced it with metal and plastic, and stiched her back up secure in the knowledge that her skin and tissue would grow back, the blood vessels would reroute, and that her body would “heal” itself. Casting a broken bone is the same idea. . . create an environment in which the body will heal itself (the bone will re-join) most correctly. The bones will heal over if they are not casted, but most likely not in the right way. Should I call up the guy who casted my mother’s arm and accuse him of quackery because he just expected that bone to heal itself? I agree that some people take it too far, or say things that are just stupid because either they believe it or because they don’t know how to express it correctly. I think that the people who take it too far are doing a disservice, both to patients and to those of us who practice correctly and are forced to share the same title.

Okay, on to dirty tables.

Both of your studies are on teaching clinics, one at Parker, the other at National. In both of these situations, it is the responsibility of the custodial staff to clean the tables, much like at any other hospital. When was the last time you saw your GP scrubbing down a table? Don’t get me wrong, I am not trying to pass the buck here. I was taught to wipe down the table and wash my hands between patients, and I did so. I still do! Perhaps the instructors and students should be reprimanded for being lazy, and the custodial staff should be dismissed. Much as I would dismiss the custodial staff and reprimand the doctors presented in the article, “An outbreak of methicillin-resistant Staphylococcus aureus in a large medical center.”, Am Surg. 1983 Apr;49(4):179-81, and “An outbreak of infection with a gentamicin and methicillin-resistant Staphylococcus aureus in a neonatal unit.” J Hosp Infect. 1980 Sep;1(3):221-8, or “Outbreak of gentamicin-methicillin-resistant Staphylococcus aureus infection in an intensive care unit for children.”, J Hosp Infect. 1986 Jan;7(1):21-5. or “Gentamicin-methicillin-resistant Staphylococcus aureus: epidemiology and containment of an outbreak.”, J Hosp Infect. 1986 Mar;7(2):130-6. They are all guilty of being lazy, whether chiro or allopath, and should all be held accountable.

Thank you for bringing out the article about colonic irrigation. I have never had to have this done, thank goodness, but as the age for colonoscopy approaches, I am not looking forward to it. Colonic irrigation (a.k.a. enema) is not a part of the chiropractic scope of practice in colorado, so although the article you mention (NEJM 1982) is in a chiropractic clinic, it is good to note that the licensure under which the procedure was done was not a chiropractic one. I appreciate you taking the time to point out that there are lazy, dirty practitioners in all physician professions. This doesn’t make it better, as no one should be guilty of this offense, but I appreciate you making the point that the laziness is a characteristic of the person, not the profession. There are lazy, dirty people. Unfortunately, some of them happen to be doctors.

I have not said that you cannot make comment on chiropractic. I have only said that in the absence of personal experience or a resonable background understanding, you should be careful about presenting your opinion as fact when you have no support for it. You may choose to not go see a chiropractor, and you can say that this is because you don’t want to waste the time to find a good one. Although the odds would be in your favor, as the majority are “good ones”, that is your choice. Why do you feel that you are so important that you have the right to demand that other people agree with you? Especially when you have no actual experience with it? I do not demand that people seek chiropractic care, but as I have scientific evidence (even moderately acceptable to your standards) that my treatment is beneficial to some individuals with some kinds of pain conditions, I will continue to offer this care to individuals who seek it. If they want what I can do, I will be here, with clean hands, a clean table, good technique, and an ethical practice.

I wish you well with the rest of your life, and ask only that you remember that there is research out there, even if you are too busy or just uninterested, and refrain from initiating this kind of ridiculous, unprofessional attack again in the future.

Robster,

Good God, I thought I had tried to end this conversation courteously respecting difference of opinion, but here you are, still on the attack. Do you really have nothing better to do with your time? I thought you were so busy with your students? If this is really a desire to continue discussion, that is one thing. If you are just desperate to have the last word, can you please just let me know? I promise, it’s not that big of a deal to me.

You continue to misread, misinterpret, and misrepresent the information in the study. What I have said, and will say again, is that in the under 45 group, the odds of having a stroke within a day of seeing a health care practitioner are statistically the same whether the practitioner seen was a chiropractor or an allopath. This is all I have said, and I say it based on the information contained in table 3 (related to visits to chiropractors) AND table 4 (related to visits from non-chiropractors). Do you really not know how to read a study or is this intentional? Ignoring data which is inconvenient is an old trick by unethical researchers used to manipulate statistics to support a conclusion which would be otherwise unsupported. Can you draw a conclusion based on ALL of the data (or even just tables 3 and 4) or do you want to continue to insist on only telling half of the story? How am I wrong when I talk about the association and how it compares to the parallel associations? What is it that you want me to admit? That the odds are higher in those under 45 than those over 45? That is a ridiculous comparison because they are two totally different patient populations. Compare the under 45’s with the under 45’s and the over’s with the over’s. It is pretty easy to look up, try WebMD.com, but the risk of VBAI stroke dramatically decreases in individuals over the age of 45 due to decreased flexibility of the spine following the dessication of the nucleus pulposis beginning around the age of 40. I assume that this is why the division in patient populations was made at that particular age.

It is plausible that a violent twisting of a neck (a la ninja style) could damage a vertebral artery leading to a VBAI stroke. This is not proven, however, as it would be pretty unethical to have a trial group in which you tried to induce damage in them. Independent research supported by Health Canada has measured the forces applied during the cervical adjustment, and when done properly there is no way that they would be considered “violent”. . . not even when I was back in school and was the practice patient for people just starting out. It is also possible that a very mild movement could dislodge atherosclerotic build-up or exacerbate a pre-existing aneurysm resulting in a stroke. These mild movements may include leaning your head back into a salon sink, doing yoga, basic range of motion tests performed by a PT, or yes, a chiropractic cervical adjustment.

Your assessment of the “clean tables” articles do not extend to hand washing. In none of the articles did they check to see if the practitioners had clean hands. As far as non-sterile environment is concerned, this is clearly a universal problem, as the other papers I offered show. I am not denying that this is a problem, but I will insist that it is not a uniquely chiropractic problem.

My response to the phrase “innate intelligence” is what I was taught in school, and is the fundamental understanding of nearly every chiropractor I have ever talked to about it. . . although I will admit that this is not many as we don’t all get together and discuss “innate”. You admit that my understanding is plausible and based in known science, but say that the “straights” think differently. How would you know? You admit that you’ve never seen one. If there are some “wackos” out there blogging or writing their own newspapers to say something different, what makes them uniquely chiropractic? There are blogs out there about building bombs and time travel and supporting hate crimes. The vocal minority is not the standard on which a society is judged, nor should it be the standard on which a profession is judged. There have been a few paedophile priests and pastors. . . do you assume that everyone associated with a church is a danger to your child?

I did get a quality education and as I went to school with several thousand other students over the course of the 10 terms quite a few years ago, I am clearly not the only one. The standards have been improving in chiropractic schools across the country and the world for decades. Not all of them are perfect yet, but they are being directed to improve or be shut down. Your statements are based on rumors that weren’t even really true when they were first started 40 years ago, and they really are not applicable today. Note, I completely agree that improvement of educational standards in chiropractic is of priority, and I support the development of education in all health care professional fields. Get better, or get out. . . but I apply that standard to everyone.

” You can accuse me of making ridiculous unprofessional attacks, but I’m not the one practicing a medical unprofession, worthy of ridicule.”

Wow, way to make my point for me. You are engaged not in debate but ridiculous, unprofessional attacks unsupported by any legitimate evidence.

You still have not answered by questions as to why you think your personal, unsupported opinion is so important that you should be able to demand that other people agree with you. Your eloquent response “What?” followed by a personal insult was not quite sufficient to address the actual question of on what do you base your pretended authority?

You admit that the results are positive, but qualify them as weak. That is fine. I would hold that you clearly don’t know how to read or analyze literature, but in any case, how does weakly positive become negative when you accuse me by saying “negative results are positive to you”? If it is positive, however weakly you may (incorrectly) allege, then how am I holding negative to be positive? It is already positive!

You are making a completely false statement when you say a pharmaceutical with a rare risk of stroke would be removed from the market. 30% is considered the reasonably acceptable range for “moderate to severe” complications as a result of appropriate use of pharmaceuticals according to the FDA. This is why things like Gardasil and every single statin drug is still in the market. Since Gardasil was released in 2007, there have been 3,461 “moderate” or higher adverse events reported that were deemed to be “associated” (not to mention however many were reported that showed insufficient evidence of association) and there have been at least 8 deaths. Not only is Gardasil still on the market, it has been mandated for females under the age of 14 in various jurisdictions, despite the fact that the only safety data is on women between the ages of 18-25. Every single statin has the KNOWN complication of rarely causing the debilitating disease Rhabdomyolisis, in which the body’s muscle tissue is autoconsumed, resulting in major complications including death as the body eats it’s own heart. Blood pressure can be controlled with diet and lifestyle in nearly every case, yet statin prescriptions are handed out like candy . . . despite the serious but rare side effect. If you knew anything about pharmacology, you would never make such a moronic statement. You cannot possibly really be a toxicologist, which means that this entire conversation has been ridiculous because you are, fundamentally, a liar.

Then walk away aCQ. You can’t because you like the abuse. I do admit that it is getting boring, bringing you to your discipline’s leavings on the carpet, rubbing your nose in it, and seeing no practical understanding.

I looked over the article (yet again), and think you should look at how the stats were computed. Primary care physicians (PCP) numbers are computed differently than chiropractic numbers. They don’t compare the way you think they do. The authors even point this out, including the point that the PCPs are probably treating strokes, while the chiropractors may be causing them. Since other papers have come to similar conclusions, I will go with the totality of the research. Chiropractic practice is an important and avoidable risk factor for the rare event of VBA stroke by dissection.

Yes, the populations of under 45 vs over 45 are different, which is why table 3 is so incredibly important. A rare event would disappear in the over 45 group, due to the naturally increased risk. Since strokes are so incredibly rare in the under 45 group, they are a more sensitive demographic to injury. Compare the table 3 and 4. In table 3, your risk of stroke decreases the longer it has been since chiropractic visit, suggesting that the injury more often than not occurs at the visit. This makes sense, as VBA dissection, a torn artery, is something that should show up very, very soon. On the other hand, risk of stroke goes up dramatically as time goes by post PCP visit, which suggests that the injury is not happening at the doctor’s office.

Furthermore, if a stroke happens sometime during the year, at random, you would expect the chances of it happening to increase as time passes. A careful reading of the paper will reveal this. I’m not sure why it escaped the authors, but have a strong suspicion why it does for you. Your bias is a perversion of the Hippocratic oath. Instead of “First, do no harm,” it has become, “We can do no harm.”

A further weakness of this study is that we don’t know about the patient history of said individuals. Are the patients visiting the physicians high risk to start with, and the patients of the chiropractors, are they the worried well?

So, how many Newtons are required to complete a passive hanging (no drop, commonly used in suicides, often causes death due to VBA injury)? 686. How many Newtons go into a Chiropractic adjustment? The number I have found is a mean of 264 Newtons over 145 milliseconds for all adjustments. Thats 41.4% of a fatal hanging, all in 1/8 of a second, but without the muscle resistance that comes with an unrelaxed neck. The good news is that that isn’t enough to kill all the patients, but the bad news is that it is likely to result in killing some. Now, if you happen to have specific numbers as to the mean force of cervical manipulations, I’d be happy to use more specific calculations.

How would I know what straight chiropractors believe, when I haven’t met one? I have read what they write, and think that anybody so completely divorced from reality should not be able to practice medicine. Chiropractic needs to excise this anti scientific tumor from its educational system, something that obviously is not being done, based on the Brusse paper. With estimates of active antivax chiropractors between 10 and 30%, and students leaving a supposedly mixer school with a 60% negative view of vaccination, and the two largest chiropractic associations having a stealth antivax position, you need to fix this issue, not act as though it is a surprise to learn that it exists. Your response to learning of quackery is a tolerant, out of sight, out of mind attitude that it occurs in all fields, not that said quacks need to lose their right to practice. Do you not have any care for the dignity of your practice? The Brusse article is not a rumor, even though 50% of students over an entire school with no understanding of the value of vaccines to public health is apparently fine and dandy to you.

I nowhere demand that anybody agree with me. Like I said, you are hallucinating, and your self manipulation has destroyed your sense of humor.

I may not have been clear enough for you. RCT with sham arms are the best tool for examining these procedures. RCT with sham procedures tend to come out negative, which is typical for a procedure with a weak or placebo based effect. These are the strongest tools we have for separating placebo based pseudoscience from real effects. Comparative studies are a weak positive, which combined with RCT with sham studies says that not much is that good for treating back and neck pain. I see this as an overall negative with the occasional bright spot, which suggest that we need more research into the area, while you see it as a resounding success. I expect more RCT with shams to be negative, which you will ignore, and a mix of weak ups and downs for comparative studies, which will be complete validation from your viewpoint.

I’m also not alone in this view, as other meta analysis studies are out there which find no significant effect for treating lower back pain with manipulation, Assendelft et al (Ann Intern Med. 2003;138:871-881) for example. Because these authors are capable of separating placebo from real, it is of far more value than The Spine Journal, and shows that the weak positive trumped by Spine is just as validly interpreted as a negative. Meta analysis is useful in getting a feel for the field, but you need to look at the study design and not just the conclusions.

On to your assault on my area of expertise. I study cancer drugs and how to make them less toxic by combination chemotherapy and dosing patterns. My area is not the bureaucratic end, so I am curious as to where you got the 30% figure, as it doesn’t jive with what I remember from my classes. Mind you, we didn’t spend our times memorizing rules that we could look up if it was cogent to our field. Also, pharmacology is the study of how drugs work, not how they are regulated, but since you can’t prescribe, like a real doctor could, I’m not surprised that your training would tend to be about the evils of drugs instead of the benefits and mechanisms of action, along with possible side effects.

The cost and benefit have to be compared, so a competitor for let’s say, aspirin, when properly used, would need to have a very low risk profile, as the benefit is small (aches, pain, migraine, fever, anti-platelet). Hence, COX2 inhibitors flopped because they had higher risks for rare but serious cardiac events. However, more serious disease processes, such as cancer or HIV/AIDS, would warrant a much higher risk of serious side effect. Also, I fully expect statins to go out of style because they just don’t work all that well for most people.

Even if this is a guideline for basic approval (which I severely doubt), it certainly doesn’t apply to real world, post marketing phase of study.

Since nothing works as well as chiropractic (haha, sham treatment = nothing), the risk of stroke is a factor that would seriously call into question the practice of chiropractic neck manipulations. The risk benefit ratio is enough that a drug company would likely start a recall out of fear of litigation, or even due to it, although it might take a few years to get the ball rolling. This is especially true when other treatments with similar efficacy and cost (PT) and less severe side effects are available.

Thats why I don’t think your 30% is a hard and fast rule. I’d accept 30% moderate to severe side effects for an excellent anticancer drug, but not for a headache or back pain drug.

Also, your Gardasil lines sound suspiciously like they were cribbed from an antivax source. Hmmmm. A closet antivax chiropractor? Inconceivable. (Don’t worry, you won’t get that quote. You would need a sense of humor.) Perhaps you need to go back and look at that data as well. Would you mind citing your source on this as well? I have seen similar figures, but with clinical explanations on why said events occurred, and whether they were truly linked to the vaccination.

But hey, I’m just a 5 year old, lying, goose stepping “allopath” supporter.

another Chiropractic Physician:

Sorry, but you’re wrong on the med school thing. One of my friends from undergrad went to the Creighton Medical school, started the same week I did, and she was done in 3 years. At that point, she had never treated a patient.

ORLY?

From the Creighton web site regarding the clinical years:

Students will average no more than 80 hours per week during a clinical rotation.
Students will average at least one day off (24 hours) in every seven while on a clinical rotation
Post call (over night) students must be excused from clinical responsibilities after required teaching sessions are completed. Students must be allowed a minimum of 10 hours off after overnight call for rest.

Only 80 hours a week? What pussies! In my day it was every third or every second night call, and no one bothered to do the math for the hours cuz we LOVED EVERY MINUTE OF IT!!!!111!!!!

Chirodude, it is my clinical impression that your pants just caught fire.

From there, she was known as “Dr. xxxxx” and began her internship, followed by residency, during which she learned to work with actual people. This is exactly what I said.

Phallus flambée!

Following a 4 year undergrad course, Chiropractic school was 5 semesters of academic classes, then 2 years of classes while simultaneously treating patients in University based clinics and then public clinics…

Sounds hardcore! You wuz prolly up all night monitoring unpredictable subluxations, getting stat pages to the ER for acute drops in qi, making agonizing decisions with family members over whether to crack a back or maybe just crack a back a little…

Admit it aCP: You’re full of poo.

Oh, some part of your story is true. Perhaps you’re applying to chiro school, or you’re currently a student, or your SO is a chiro…

Well it has been fun following along.

Robster,
Each one of us is asking the other why they keep writing, but clearly you are as involved as this as I am.

You are deliberately making claims that the paper in question does not support. You are also throwing out inccorrect statements, such as, “if a stroke happens sometime during the year, at random, you would expect the chances of it happening to increase as time passes”. This stroke is less common in older individuals. Furthermore, if a patient presents to a practitioner with “impending stroke symptoms”, it is more likely that the event would occur soon. The ones who had an event 2-4 weeks later are representative of that part of the population for whom the stroke came on suddenly without symptoms. Not even you could argue that a chiropractor had torn a vertebral artery with his “vicious” cervical adjustment and the patient bled from the vertebral artery for 30 days before finally having their stroke.

If 686 Newtons is the absolute minimum needed to kill oneself, then it is self-evident that 41% of that minimum force would not successfully kill oneself, not even just “some” of them. However, those numbers are not even correct, as manipulations (depending upon grade, I-V) vary in force but never come close to 264 N. “Manual forces applied during cervical mobilization” JMPT 2007 quotes, “Mean peak forces (grade I, 21.8 N; SD, 15.0; grade II, 34.9 N; SD, 20.9; grade III, 58.2 N; SD, 27.5; grade IV, 61.0 N; SD, 29.9)”. Meaning that a Grade IV manipulation rings in at just about 11% of the force you say will kill someone (with a SD of 2%, of course). Personally, I don’t think I have ever gone above a grade III in a neck, and even that felt like I was really working the guy over to me. Another article, “The effective forces transmitted by high-speed, low-amplitude thoracic manipulation”, in Spine 2001 shows grade V’s in the Thoracic Spine show force of 238.2 N, although of course that is not in the neck. Now where did you get your number from? And was that study done on cervical spine adjustments? I think this data shows that I am correct in my statement that a cervical spine adjustment is far from “violent”.

A greater proportion of the general population is anti-vaccination than the proportion of chiropractors. You know this as well as I do. Chiropractors are still people, and they have the right to believe as they like. I actually don’t know any anti-vaccination chiropractors, but I do know they exist and have never denied it. It is a far smaller proportion of the practitioner population than you allege, however, and as you have yet to provide data to the contrary, perhaps we can agree to disagree.

Both chiropractic professional organizations contain within their constitutions language saying that we recognize the benefit of immunization to public health, but are against MANDATORY vaccination. This is not a stealth anti-vaccination stance, but rather support of transparency in health care and patient rights. Would you like it if the AMA tried to mandate chiropractic adjustments for the care and prevention of headaches? No, of course not. Basic patient rights dictate that no individual is required to submit to any medical procedure. This is the same bill of rights that the AMA supports.

With regard to my statements about the FDA, try reading their Code of Federal Regulations, Title 21, Volume V, Part 314. It’s a fascinating read. As to my comments about Gardasil, as I have stated, I don’t actually know any anti-vaccination chiropractors, and that data comes from the Vaccine Adverse Event Reporting System website, under the Health and Human Services Division. I won’t put the link here, as always, but it is a pretty easy dot-gov site to find. They have a searchable database where you can check out each of the more than 240,000 events that have been reported since Gardasil was released. Of course, not all of these are “moderate to severe” or “severe”, so we won’t worry about most of them. Clearly, I didn’t learn any of this in my pharmacology class at school all those years ago, as regulation is not a fundamental part of that subject, although it is related, of course. Guess my any “evil drug” leanings I have didn’t come from my training. . . and since I haven’t actually made any “evil drug” statements, I don’t know what you’re basing your allegations on. My reporting of statistics is in response to your statement (the one I called “moronic”), and as it says at the top of this page, “a statement of fact cannot be insolent”.

Oh, and I never said you WERE a 5 year old, just that you are acting like one. I did say you are a liar, and that statement still holds, since acceptable levels of adverse events is a pretty core component of the science end of toxicology. The beaurocrats may determine which level is “acceptable”, but it is still up to the science side to make that number happen. If you were dealing with combination drug toxicology, you would be aware of what the acceptable levels are.

Is this sufficient sourcing of my facts?

Dr. Benway,
Your Creighton link talks about the clinical activity limitations. . . the part done after the academic coursework. I never said that Creighton students didn’t do clinical activity, nor did I cast aspersions on their work ethic. How, therefore, is this quote related at all to the conversation? Furthermore, if you check the page on the med school curriculum, it will run you through the 4 years prior to residency (check the quote “Having been exposed to the breadth of medicine in the third year, the fourth year prepares students for residency and provides a chance to explore their own interests in specialized areas of medical practice.”) which outlines the three years of academic coursework, the year of internship, and the subsequent residency.

Admit it, it kind of sounds like you’re the one full of poo, huh. God, I love when I’m right.

Oh, and as we have already established, I am a chiropractor who has been in practice for nearly a decade. Not sure why you think I am an applicant or a student, but I assume it’s because of your apparent limitations.

As to the confusion of category levels. . . first of all, it is alphabetical, not intending to indicate any particular level (see alphabet for confirmation). With regard to the idea that it recognizes some professions by degree (i.e. Doctor of Chiropractic) and others by specialization (i.e. cardiologist), this is something I noticed as well. However, I assume they were looking to list “kinds” of doctors, (and all D.C.s happen to be Doctors of Chiropractic) not necessarily degrees (which is why they have “General Practitioner” not “M.D.”). However, since this is a federal regulation document and I haven’t had the chance to call up the U.S. Surgeon General to ask why they did it this way, I guess I will admit that my assumption is no more likely to be right than any of the crap that you just posted. . . although it is considerably more logical and courteous.

aCP:

which outlines the three years of academic coursework, the year of internship, and the subsequent residency.

You are confused. Med school is four years: two pre-clinical, two clinical involving direct care of sick patients. One graduates with an MD after 4 years.

Residency is entirely separate. There is no internship or residency during medical school.

Med students apply to residency programs in their third year. Just like applying to med school, it’s a long process involving flying around the country for interviews, letters of recommendation, essays, and so on.

The first year of residency, aka “pgy1” or “post graduate year 1” is also called the “internship” year. Residency programs vary in length from 3 to 6 years.

In summary:
4 years of college
4 years of med school (2 basic science, 2 clinical)
4 years of residency (1 year internship, 3 years residency)

This “friend” of yours who finished med school in 3 years without treating any patients wasn’t a close friend, I take it.

I am always amused to receive the alumni correspondence from the university from which I obtained my PhD. It addresses me as Miss. Link! If they can’t even get that right, what hope is there for the rest of society?

Dr. Benway,
Your link doesn’t indicate “M3” on it anywhere, and since we obviously don’t care what the other person thinks, I would suggest that we leave it at this and allow any interested party to follow the link themselves and read it. As for my friend, I am going to go ahead and trust the person who actually went there, rather than some random guy of unknown credentials who is posting randomly on a blog, sound good? If your statement is correct, and the 4 years of “med school” is actually only 2 years of classes followed by 2 years of “clerkships” / “rotations”, then you’re right, it is nothing like chiropractic school. . . since following my 4 years of undergraduate college, I had to spend a hell of a lot more than just two years in classes learning how to be a doctor.

Robster,
Are you just starting to name call because you can’t actually defend your position? I present evidence, and point out your failings, so you just call me “a quack” or any of the other insults you have thrown out? As a hint, from one professional to someone who really wishes that they were, insults don’t actually support and argument, and they don’t really make you look good, either. I will suggest to you, as well, that we are unlikely to change the other person’s mind, so why don’t we let the smart people go read it themselves and draw their own conclusions, you can have your interpretation, and I together with all of the rest of the people will have ours. The horse is dead, let it be.

I love that your “scienctific sources” is the practice act on the website of an insurance company! What, you couldn’t actually find the study? Regardless, the for-profit insurance company’s website does actually reference a study, so let’s talk about that one. . . The website does quote that “the mean force of all manual applications was 264 Newtons” including more than just cervical adjustments. As the studies which are actually a little more specific, you can see that this is about right for a thoracic adjustment, much, much greater than a cervical adjustment, and much lower than a lumbar adjustment . . . which makes sense given the size of the bones in that area and the associated structures including variability of tissue thickness. Trust me, you need a lot less force to adjust the low back of a 19 year-old college track athlete than to adjust the low back of a 250 lb truck driver. You’ll have to trust me, I guess, as you have no experience or expertise in this area.

You say chiropractors are injuring patients. . . but you also said that the force of a cervical adjustment was 264 Newtons, so I guess we know that you’re full of crap. If you want to claim that chiropractors are hurting people, I say prove it.

Hmm, I know a rule. . . but didn’t you already admit that you have no knowledge in the application of the laws to the science of pharm? And since I clearly do (and can back up my statements with verifiable references) isn’t the logical conclusion that it is I who know the real world application and not you? Does it hurt you to be so wrong all the time? To have it clearly proven that you are a liar who knows nothing about the topic?

The VAERS system was designed a long time ago by the allopathic profession together with Health and Human Services to improve post-marketing surveillance and improve patient safety. It is actually very useful in getting an actual hold on adverse event reports, as that is the purpose it was designed for. Seriously, go to the site and numbers of reports and the reports themselves are all right there. You can’t argue it is the “mean old chiropractors” who are making it up, as we are not the ones filing the reports! It is used primarily by the FDA to regulate and track post-marketing surveillance. Are you seriously suggesting that the Health and Human Services division has been in a 40-year-long conspiracy to promote an anti-vaccination stance to the benefit of the crazy chiropractors? If you were speaking out loud, I would suggest that you think first and then speak, but I am not sure how best to translate that for the written word. Maybe think before turning on the computer?

In your highly irrelevant opinion (as you don’t work with patients), mandatory vaccination is a “stealth cover” for being antivaccination. For people with doctoral degrees who work with patients, this is the exact verbiage used on the federal patient bill of rights. You can check it out online, or do what you seem to prefer to do and just make stuff up.

You know nothing about me, and as such, I would prefer that you not attribute your verbiage to me. In the first place, you sound reasonably uneducated most of the time. After that, I would just say that as you don’t know me, you shouldn’t pretend to understand me. I would not personally get a flu shot, as even allopathic doctors know that it is pretty useless and the big push comes from the pharmaceutical companies, not the medical community. Most allopathic doctors I know don’t get one, either. I do agree that things like the polio vaccine did have benefit which outweighed the risk, and I even financially support the R&D fund trying to create a vaccine for HIV. This is a little more sophisticated than what you said, so I’ll understand if it’s a little over your head, but the other people can probably understand.

Nice, you are back to the allegations that all DCs are unethical. Here I thought we had made such progress. Looks like you are back to just mudslinging and slander. Even I admit that there are as many unethical doctors of chiropractic as there are medical doctors. Looks like you can’t even prove that.

With regard to your claims about anti-vaccination, forgive me if I call your bluff on this one, as you think the patient bill of rights used by the AMA is a “stealth anti-vaccination stance”. I can’t find any claims of antibiotics causing autism, except on another blog thread, which accuses chiropractors of making this claim. Can’t actually find a chiropractor making it, though. Wow, a doctor providing health care for kids. That clearly is scandalously unethical. Innate intelligence has already been discussed, and you agreed that the explanation given was representative of real processes. Nerve energy is a component of the study of phychneuroimmunology, which I know is way beyond your IQ. Even dentists stop using fluoride in kids over the age of 16, and that is just the dentists who still use it at all. Check out the stance of the dentists on the ADA website. Adjustments can relieve middle ear pressure, but no one is saying they can eliminate a bacterial infection. Of course, most kids with earaches don’t actually have bacterial infections, according to the American Academy of Pediatrics position on their website.

Second link. . . we have already discussed innate. I don’t personally recommend “monthly check-up visits”, but those who do sound remarkably like the dentists who recommend that you come in every 6 months or you will get cavities and gingivitis, etc. When the dentists first started doing this, everyone thought they were crazy, too. (Why go to the dentist? Nothing hurts and needs to be pulled yet!)

I was not around 115 years ago when D.D. Palmer adjusted Harvey Lillard, so I guess I can’t say what happened. Were you? I do know that there is testimony from the time from Mr. Lillard himself, and the people around him, who all said he had been deaf and could now here. I have never had personal experience like that. There were actually two fairly recent news stories, however, that you can find in on youtube, which are similar. In one, a guy went blind in one eye for years and allopathic medicine couldn’t figure out what was wrong and fix it, and then when he got adjusted, his eye started watering and a few hours later he got vision back. The other one is also someone who was deaf. If those are legitimate (and I am not speaking for or against them) then they would be incredibly rare situations, but you can’t call someone unethical for repeating them. Are you unethical when you reference historical testimony, too?

Oh, and with regard to the “non-existent subluxations”, check out the definition on the Aetna page you referenced. Seems like your source thinks they exist.

So the 3rd, 4th, and 5th meet your standards. ( I didn’t say selling supplements in office is unethical. I said that I personally that I don’t do it because I see it as a conflict of interest. I feel the same about the physical therapists who sell therabands, etc. to their patients. This is not considered unethical, I just find it personally distasteful.)

The 6th site seems to refer to a lot of case studies. Do they give references? I realize that most websites don’t, but maybe they are better than most. If you check the literature there are case studies about chiropractic in all of these cases. Clearly they are not definitive evidence, but a website that references published, peer-reviewed case studies can hardly be called unethical. The stuff on CD4 count comes specifically from an ongoing study at the University of Toronto, I do know that. The Autism-Vaccine link is a widely held hypothesis (I personally reserve judgment, as it is yet unproven), and we have already addressed your reading of “anti-vax BS”.

However, since you haven’t actually provided any references or actual names, despite multiple requests, it is just as likely that you are once again just making it up.

Maybe we are working with a difference in terminology. Did you know that unethical is defined (in the dictionary) as “not conforming to approved standards of social or professional behavior.”? This means if the behavior exhibited does conform to the approved standards (i.e. the law, the scope of practice, etc) then it is not unethical. Hmm, is that still too complicated? Try this: Something is not unethical just because you don’t like it. You are not the authority. Almost no one cares what you personally think.

@another Chiropractic “Physician”,

They’ve clearly got your goat. Please continue digging.

Stay tuned! There is a comment waiting for approval by the resident supercomputer. Good travels, Orac.

Same duck time, same duck channel!

Dr. Benway. – Yes, as the link you provided says, in the 4th year the student is prepared for residency through choosing “one critical care selective from an approved list, either one additional critical care selective or a primary care sub-internship, one surgery selective from an approved list, and twenty-four elective weeks.”(note this was a bulleted list that I converted to text format) Hmm, looks like 3 years of classes followed by year four composed of selectives and internship, followed by residency. Oh, and I never changed my opinion to “Now they spend too much time with patients and not enough time in class!” I said that you were claiming that. That is what is meant by starting the sentence with “If your statement is correct. . .” both preceded and followed by statements to the effect that your statement is NOT correct.
Robster – You say I deserve to be made fun of, but what is that if not a personal attack? Oh, and I don’t say that if you saw patients you would know X as an appeal to my authority, but in an attempt to courteously allow you an excuse for your otherwise inexcusable ignorance.
You accuse me of holding the position that, “any movement of the neck except for one done by a chiropractor could cause a stroke.” I have never said this. I have repeatedly stated that a chiropractic adjustment is no MORE likely to be a contributing factor than other, similarly rated motions. Is this really that unclear or are you deliberately misunderstanding? You claim that the under 45 group is somehow the answer, based on statistics that you are twisting, when in patient care this is clearly not the case. The under 45 goups is not “more sensitive”. Perhaps I want to leave the dead horse alone both because I am embarrassed for you and because I don’t have time to walk you through Stats 101.
What part of “I love” indicates annoyance for you? I was serious. I love that in this conversation in which you think you are more “scientifically minded” than I am, your source of information is Google! This is not annoyance, it was glee. Okay, however, it is fine. We both agree that I provided you with satisfactorily “better” information. On what, however, do you base the claim that ¼ hanging deaths is due to VBA disection (when annecdotal evidence says that the vast majority are actually due to suffocation)? For that matter, from where did you get the number 686 as the force of drop causing death in a suicindal hanging? Who did the study assisting people with suicide so that they could measure the Newtons of force during the process? Also, what the heck do you mean by “stressed neck”? Are you talking about muscle tension? Sources are good, if you please. Also, I understand that we have clearly established that basic statistics are beyond you, but if the 686 number is the minimum amount of force required (presuming that is a good study which took into account genetics and personal history) then no, 11% is not sufficient to kill anyone. Let’s try this again. If 686 newtons is the MINIMUM to kill you, then 61 newtons, being MUCH LESS THAN THE MINIMUM will not be sufficient, ever, as it is no where even close to the minimum. This is what minimum means. How can you possibly say that the totality of the evidence supports you when not even your own evidence does.
Oh, and we already provided references for the 30% adverse acceptance rule, which is the standard in post-marketing surveillance testing results presentation to the FDA. I provided you with a link, in writing, to the FDA website that says this, verbatim, in clear language which requires no interpretation. Have you just not had a chance to read it yet? Or are you directly and deliberately lying here? Also, on what are you basing the accusation that chiropractic refuses to police itself or allow others to do so? We were thrilled to be a part of NCCAM, and we are constantly applying for federal funding to do research. Those of us who are ethical are the most outspoken against the unethical, as they are ruining our reputations. What the hell are you talking about?
The claims submitted to the VAERS system are (presumably) regulated by the doctor who submitted them. As these doctors are allopaths, presumably you are alleging that these MDs and DOs are “stealth anti-vaccination opinion holders” who are submitting fraudulent reports. Oh, and as it appears to be your opinion that the VAERS system is profoundly unreliable, and the rest of the health care community still uses it, perhaps we’ll just have to let that one go.
Okay, now you say a bunch of stuff that is just dumb and irrelevant. Oh, and I am crushed that you insulted my sense of humor, as it is particularly relevant to the conversation at hand. I am aware of the movies “The Princess Bride” the show “South Park” and a bunch of the other stuff you have referenced. I will admit that I am less familiar with Futurama and Caddy shack. I am sorry that I don’t watch TV and I don’t think that quotes from such sources are relevant or funny in an academic debate. I will refrain from being shocked that the person who claims to be too busy to find evidence to support their claims has time to sit around and watch profane adult cartoons.
Actually patient participation is the definition of a statement against mandatory vaccination. If the patient gets to decide, it is not mandatory. If it is mandatory, then the patient gets no say and is therefore not participating in the health care decision. Can you please at least join me up here at the 3rd grade reading comprehension level?
Practice standards in all professions, chiropractic included, dictate that x-raying in children should only be done if absolutely necessary, as in to visualize a fracture. Also, it is a chest film if shot one way (with a different kVp and MaS) and a bone film if shot with different settings. I realize that you know nothing about radiology, but chiropractors would only shoot a chest film for something like pneumonia or a suspected pancoast tumor, if they had not already referred these cases. To the next statement, as children are as likely to be in car accidents as much as the parents who are driving them and are more likely to be hurt given that the seatbelts are not designed for the smaller frame, I would say that yes, some children can benefit from chiropractic care. Children also fall out of trees, get injured in sports, and lots of other stuff, too.
Yes, if the earache is due to increased middle ear pressure, releasing that ear pressure will remove the cause of the earache. Oh, and the average cost of a chiropractic visit in Connecticut, for example, is $38, including assessment and treatment. The base cost for 15 minutes with an allopath, not including any tests that might be performed or prescriptions that might need to be paid for separately is $76. Hmm, that looks like chiropractic is cheaper. . . much cheaper. Check out a few more insurance company websites and get their fee schedules. This shows how much is paid to each practitioner for each service rendered.
Oh my God, I had a typo and wrote “phychneuroimmunology” when it is “psychoneuroimmunology”. Clearly I am a moron. The consolation for me will have to be that at least you are, too, as you misspelled it, too, and forgot the first “o”. With regard the concept, however, I suggest you check out the work of Candace Pert, PhD, pharmacologist graduate from the Johns Hopkins University School of Medicine. This, of course, if you decide to take a break from watching cartoons.
“When someone believes in one extremely unlikely concept, they probably believe in lots of them.” WHAT?!? That is like saying that someone who believes in Vishnu probably believes in Zeus and the divinity of Jesus. That is so stupid that I don’t even know how to respond.
Thank goodness, I have found the person who was actually there, performing the modern scienctific inquiry, and can tell us the true story of D.D. Palmer! Yes, they are anecdotes, but to claim that a person referring to the anecdotes is unethical is ridiculous. Anecdotes in healthcare, by definition, are non-case-study “experience” used in conjunction with things like published research to design health care. Go ask your friend the local MD if s/he relies on both published research and his experience and “annecdotal evidence” (taken with a grain of salt, of course) to provide care, and I am pretty sure he or she is going to say yes. Oh, and I didn’t direct you to youtube as a scientific source, but just as the easiest place I knew of for you to find the archived news reports. News reports are not science, but they sometimes try to report on science. It is not perfect, and there is always bias to be accounted for. . . but I figured that someone who watches “South Park” was probably pretty familiar with youtube and would be able to use it as a tool.
Yes, false testimony is unethical, but there is no evidence that this testimony (either the old, Lillard stuff, or the new stuff out in the last six months) is false. . . other than the fact that you, with your infinite authority, say that it is.
DCs do not have to “be insured by law”. Yes, we have to carry malpractice insurance like every other doctor, but a chiropractor must voluntarily choose to sign a contract with an insurance company to be paid by that insurance company. A doctor, any doctor, can choose to only be paid in cash and then either allow the patient to bill their insurance company for reimbursement or just handle the costs. Most of us choose not to do this, however, despite the fact that insurance companies are notoriously difficult to work with regardless of what profession you are in, because we want to make things more convenient for the patient. There is no law which dictates that the insurance company must recognize chiropractic. I hate to say it again, but if you treated patients and worked with insurance companies, or even took the time to look up a statement before you just spit it out there, you would know this.
Actually, there is a movement within the chiropractic profession to split the profession into “chiropractors” and “chiropractic physicians”, much like we have “osteopathic physicians” in the U.S. and some in the U.K. and “osteopaths” for the rest of the U.K. and the rest of the world. I would prefer to see the entire profession improve, but in the absence of that, I support the split. I have clearly stated my views about the distasteful element in my profession, but you continue to ignore that and say whatever you want, so I am probably wasting my time writing it again here.
I wait with baited breath for you to turn off “Futurama” and look into the Canadian HIV study. As I said, however, it is ongoing, so you won’t find concrete results just yet.
Some studies disprove the autism-vaccine link, and some studies prove it. Rather than doing what you do and choosing to believe just what conforms to the opinions I already hold, I will maintain that it is a hypothesis still in study, and hopefully time will tell. I take no side on the issue, currently, as DEFINITIVE evidence is not yet available. Is this not similar to your rejection of the Spine articles, in part, because old studies with shorter duration and smaller patient size say something else?
Conflict of interest, by definition, is not unethical. This is why research papers have a section where the researchers are obliged to disclose any interest they might have in the results (i.e. one of the researchers previously worked for the company producing the product under review.) Conflict of interest is something that must be accounted for to compensate for bias and ensure ethical behavior. As far as useless procedures and unethical billing practices are concerned, I agree that these are unethical behaviors. Where we disagree, however, is in what you consider to be “useless”, however. I will continue to work from the available evidence base, and you can do that thing that you are doing.
As I have stated, I very rarely watch TV, and as such am not familiar with the show you have referenced. If I have time, I will see about tracking it down. I have been so busy reading case studies, RCTs, and federal case regulations, and addressing your unfounded and false statements here, however, that I haven’t had time to keep up with your intense viewing schedule. With regard to the activator, there is research on that, quality research and RCTs, because it is easy to account for the placebo effect there since you can more easily perform a “sham” adjustment with that instrument than in traditional manual adjusting. I don’t know what the video says (and as a quick question, do you know how old it is?), but there is a little background for you to look into. . . after you get through all of the rest of this stuff, of course.

Wow. This thread is rapidly becoming an epic… and so protracted as to resemble the Chiropractic equivalent of the Battle of Stalingrad (with aCP playing the German Army). It really needs to be preserved somewhere as a monument to the scale of Back-cracker putting-the-telescope-to-your-bad-eye-and-claiming-“I-don’t-See-A-Thing” – or indeed to the blind-eyed-ness of AltMed “professionals” in general.

I’d love to try and appropriate the credit for initially annoying our Chiropractic friends about a month (!) ago (and here), but really have to take my hat off to Robster for his eloquence and indefatigability – kudos, brother.

As to the natural (or in my case irresistible) tendency to get facetious / sarcastic with people like aCP, the quote I like to wheel out for such occasions comes from the 1920s Nobel Laureate in physiology A.V. Hill:

“Laughter is the best detergent of nonsense”.

PS For a brief account of the circumstances under which Hill made this remark, check this obituary of Hill’s pupil, Nobel Laureate Bernard Katz – end of p 2 and start of p 3.

aCQ,

You claim that the under 45 group is somehow the answer, based on statistics that you are twisting, when in patient care this is clearly not the case. The under 45 goups is not “more sensitive”. Perhaps I want to leave the dead horse alone both because I am embarrassed for you and because I don’t have time to walk you through Stats 101.

Ummm, yes, under 45 is more sensitive. Over 45 has more strokes by nature. Lots more. So a rare event would be hidden by the bigger number. My common sense is tingling…

I was perusing comments on another blog and came across some details that are very interesting. First, Cassidy, the first author of the paper under discussion, has admitted to causing a stroke (lateral medullary syndrome) in a patient of his. That sounds like an excellent reason to try to sweep the truth under the rug.

Second, he was sued for asking an employee to manipulate (heh) the stats in a paper to produce the results he wanted.

“in or about September 1998, and contrary to all normal and appropriate practices and procedures in regards to independent medical research, she was instructed by Cassidy to produce certain statistical results that would support the end conclusion desired. Specifically . . . Cassidy instructed her to produce results and graphs that would support the conclusion that an injured person’s time (date) of settlement is a good proxy for the person’s time (date) of recovery” (Statement of Claim, In the Court of Queen’s Bench for Saskatchewan, Judicial Centre of Saskatoon, between Dr. Emma Bartfay, plaintiff, and The University of
Saskatchewan and Dr. J. David Cassidy, Defendants. Filed May 21, 1999, Q.B. #1679 of 1999).”

The insurance company that paid for the study to be performed allegedly attempted to influence the study as well. “Yong-Hing alleged that SGI‚ the province’s only motor vehicle injury insurer, which funded the study‚ wanted its contributions to pay for certain study expenses in a way that “could well be interpreted as an attempt by SGI to disguise the destination of Saskatchewan residents’ money” (Letter from Dr. Ken Yong-Hing, Professor and Head of Orthopedic Surgery, University of Saskatchewan, to Colin
Clackson, President, Saskatchewan Trial Lawyers Association (Nov. 3, 1996) (on file with author).”

But for some reason, Barret and Erntz are the vilest of enemies to science, a claim for which you only hint at support for, but never explain.

Add this to the simple fact that the author’s methodology is of exceptionally poor design, looking not at patient’s records, but at billing records, and we can conclude that this paper isn’t all that impressive. I suggest that it hides the truth, but not very well. Its all right there to see in table 3.

Who did the study assisting people with suicide so that they could measure the Newtons of force during the process?

Study? Thats just physics. 70kg average human male, so 70*9.8=686 Newtons. Passive no drop hanging. Is that a minimum to kill, no. But this also means that a type IV manipulation is 11% of a fatal passive hanging.

On what, however, do you base the claim that ¼ hanging deaths is due to VBA disection (when annecdotal evidence says that the vast majority are actually due to suffocation)?

Forensic Sci Int. 1984 Aug;25(4):265-75. 1/4 still leaves lots of room for suffocation. But I can understand how a chiropractor would salivate at finding people that actually want to join a study on hanging. You would get to actually hang people instead of simulating it! I’m sorry to not have pointed out your misinterpretation of this detail sooner. 686 will do the job, but is it what you call the “minimum?” Obviously not, or chiropractors wouldn’t be causing strokes.

Also, what the heck do you mean by “stressed neck”? Are you talking about muscle tension?

Muscle tension, yes, whatever. Muscle tension would increase the amount of force needed to cause injury. Without it, our heads would flop around. Relaxation would decrease the force needed.

Oh, and we already provided references for the 30% adverse acceptance rule, which is the standard in post-marketing surveillance testing results presentation to the FDA. I provided you with a link, in writing, to the FDA website that says this, verbatim, in clear language which requires no interpretation.

And you still don’t understand cost and risk vs benefit. The market won’t accept higher risk in comparison to what is already already available. The market wants what you are doing to have similar or better efficacy than what is already available. Since you can get similar effect from similar cost PT, or even sham treatment, the risk is unacceptable. In fact, no benefit above sham makes a small risk of stroke become a risk/benefit ratio approaching infinity when compared to low risk treatment. Chiropractors should not be allowed to adjust the neck in this manner.

I will refrain from being shocked that the person who claims to be too busy to find evidence to support their claims has time to sit around and watch profane adult cartoons.

Sorry. I’m just cooler than you, and it isn’t often that a geek gets to say that to somebody. Sometimes I have lots of papers or exams to grade, sometimes I don’t.

Also, on what are you basing the accusation that chiropractic refuses to police itself or allow others to do so?

http://www.sciencebasedmedicine.org/?p=3
http://www.sciencebasedmedicine.org/?p=196

We were thrilled to be a part of NCCAM, and we are constantly applying for federal funding to do research. Those of us who are ethical are the most outspoken against the unethical, as they are ruining our reputations. What the hell are you talking about?

Thrilled to be part of NCCAM. Are you really trying to argue that you are worthy of being part of the EBM world or that you are worthy of scorn? You are happy to be alongside the worst of pseudoscience scams? If chiropractic were real, do you really have to compete with homeopaths? You are willingly and proudly associating with a the best example of crap ever.

Actually patient participation is the definition of a statement against mandatory vaccination. If the patient gets to decide, it is not mandatory. If it is mandatory, then the patient gets no say and is therefore not participating in the health care decision. Can you please at least join me up here at the 3rd grade reading comprehension level?

Sorry, second grade. I gave you too much credit. I really don’t think you are even capable of getting this. The decision may be made in the doctor’s office by the patient, but the mandatory part is external to the doctor/ patient relationship.

Practice standards in all professions, chiropractic included, dictate that x-raying in children should only be done if absolutely necessary, as in to visualize a fracture. … To the next statement, as children are as likely to be in car accidents as much as the parents who are driving them and are more likely to be hurt given that the seatbelts are not designed for the smaller frame, I would say that yes, some children can benefit from chiropractic care. Children also fall out of trees, get injured in sports, and lots of other stuff, too.

Glad to know that those kids aren’t getting XRays, but without them, how do you find the mythical subluxation? Nervometer? Checking leg length? Touch alone? Obviously, none of these work, and abusing a child by neck cracking when PT is available is a bad choice. PT treats real problems without resorting to making up spinal issues. If chiropractors could tell the difference between before and after xrays, you might have something.

Yes, if the earache is due to increased middle ear pressure, releasing that ear pressure will remove the cause of the earache. Oh, and the average cost of a chiropractic visit in Connecticut, for example, is $38, including assessment and treatment. The base cost for 15 minutes with an allopath, not including any tests that might be performed or prescriptions that might need to be paid for separately is $76. Hmm, that looks like chiropractic is cheaper. . . much cheaper. Check out a few more insurance company websites and get their fee schedules. This shows how much is paid to each practitioner for each service rendered.

So? You could also teach a parent how to help relieve pressure once, give a pamphlet, not need to see the patient again unless the earache progresses to a much more serious condition, and never need the risk of neck cracking in a kid.

Oh my God, I had a typo and wrote “phychneuroimmunology” when it is “psychoneuroimmunology”. Clearly I am a moron.

Finally, we agree on something.

With regard the concept, however, I suggest you check out the work of Candace Pert, PhD, pharmacologist graduate from the Johns Hopkins University School of Medicine.

Does she believe that a magical, undetectable energy flows through nerves to induce healing and effect magical cures? No? But “straight” quacks sure do. But good for slipping in another appeal to authority.

“When someone believes in one extremely unlikely concept, they probably believe in lots of them.” WHAT?!? That is like saying that someone who believes in Vishnu probably believes in Zeus and the divinity of Jesus. That is so stupid that I don’t even know how to respond.

No. But if you believe in one non scientific thing, you do tend to believe in others. So Jesus leads to miracles, intercessory prayer, and in more extreme cases, possession, spiritual warfare, etc. 911 truthism leads to chemtrails, HAARP, etc.

Thank goodness, I have found the person who was actually there, performing the modern scienctific inquiry, and can tell us the true story of D.D. Palmer! Yes, they are anecdotes, but to claim that a person referring to the anecdotes is unethical is ridiculous.

How does a spinal manipulation restore function of a cranial nerve? Why hasn’t anybody else done this? Because Palmer was a scam artist before he invented chiropractic and after he invented it.

Go ask your friend the local MD if s/he relies on both published research and his experience and “annecdotal evidence” (taken with a grain of salt, of course) to provide care, and I am pretty sure he or she is going to say yes.

But if said anecdotal evidence (personal or otherwise) violates basic anatomical concepts and the doctor gives it more weight than science, said doctor is a quack. Jay Gordon is a quack, and considers personal anecdotal experience more important than everything else.

Oh, and I didn’t direct you to youtube as a scientific source, but just as the easiest place I knew of for you to find the archived news reports.

So there aren’t even documented case reports. No, but you seem to believe this stuff is possible and perhaps real. Why else would you bring it up?

Yes, false testimony is unethical, but there is no evidence that this testimony (either the old, Lillard stuff, or the new stuff out in the last six months) is false. . . other than the fact that you, with your infinite authority, say that it is.

Then why persist in pushing the existence of subluxations?

DCs do not have to “be insured by law”. Yes, we have to carry malpractice insurance like every other doctor, but a chiropractor must voluntarily choose to sign a contract with an insurance company to be paid by that insurance company.

And you don’t have issues with reading comprehension? I meant that you have to carry malpractice insurance, hence, be insured, not accept insurance payments.

Actually, there is a movement within the chiropractic profession to split the profession into “chiropractors” and “chiropractic physicians”, much like we have “osteopathic physicians” in the U.S. and some in the U.K. and “osteopaths” for the rest of the U.K. and the rest of the world. I would prefer to see the entire profession improve, but in the absence of that, I support the split.

Good. But you have to get rid of all the nutty stuff, not just some of it.

I have clearly stated my views about the distasteful element in my profession, but you continue to ignore that and say whatever you want, so I am probably wasting my time writing it again here.

More than anything, you are stuck denying that those elements exist.

I wait with baited breath for you to turn off “Futurama” and look into the Canadian HIV study. As I said, however, it is ongoing, so you won’t find concrete results just yet.

So no full report?

Some studies disprove the autism-vaccine link, and some studies prove it. Rather than doing what you do and choosing to believe just what conforms to the opinions I already hold, I will maintain that it is a hypothesis still in study, and hopefully time will tell. I take no side on the issue, currently, as DEFINITIVE evidence is not yet available.

Headdesk headdesk headdesk

Conflict of interest, by definition, is not unethical…

Not always, but the ones you find distasteful obviously are.

Where we disagree, however, is in what you consider to be “useless”, however. I will continue to work from the available evidence base, and you can do that thing that you are doing.

No better than sham. Useless. A person imitating a chiropractor would be as good. That has to be rough, knowing that those “8” years are worthless.

With regard to the activator, there is research on that, quality research and RCTs, because it is easy to account for the placebo effect there since you can more easily perform a “sham” adjustment with that instrument than in traditional manual adjusting.

So a spring loaded mallet can change the length of your legs? You won’t get into the reality based world with that. A spring loaded mallet is supposed to realign the bones of the spine? This is the most ridiculous thing I have seen in a well, really, since your post yesterday. OK, lets see those RCTs with sham. Pubmed didn’t exactly offer me much, but maybe the journals you are talking about aren’t listed.

I don’t know what the video says (and as a quick question, do you know how old it is?),

The video is from 2002. I said that. Reading comprehension.

———-

Thanks, Dr. Aust. 😀

aCQ,

I’m putting this request up front this time, because I really would appreciate your input. Would you terribly mind reviewing the Scientific American video? I would like clarification on the issues of leg length adjustment, how the activator is used, and if the statements from the chiropractic instructors were accurate.

Also, I would like to know what your reasons for objecting to Erntz and/or Barret are, other than being critical of chiropractors.

————

OK, one more time. In a population where stroke occurs fairly often, small changes in the incidence of stroke would be hard to detect. In a population where stroke is rare, that change would be easier to detect. Its simple.

Lets imagine we are looking at a shipment of two types of wine bottles. One type of wine bottle has thin glass walls, while the other has thicker ones. A careless worker drops a case of each, breaking a dozen of each type. If 300 of the thin wall bottles break out of 10,000, a dozen would be harder to notice. But for the thick walled bottles, 30 break normally out of 10,000, so the dozen accidentally broken stand out.

Hmm, looks like the were dropped as fraudulent. . . or did you not read that far.

Really? It was settled out of of court.

Searching pubmed for “chiropractic activator sham” gives 5 results. I want to see “real” activator treatment compared with fake activator treatment. I bet it won’t do anything compared to sham.

Your two references from sciencebasedmedicine are editorials by the same individual.

Relevence? I was pointing to those to demonstrate why I don’t think chiropractic polices itself for fraudulent practices.

Aetna doesn’t carry malpractice coverage, so they are clearly not an appropriate example to use in support of the statement, “chiropractors have to be insured and someone has to sell that insurance”.

Relevance? You couldn’t figure out the meaning of a simple sentence.

If I say that the distasteful elements in my profession make me very angry, how is this a denial of their existence.

And yet you persist in ignoring them or claiming that there just aren’t enough of them to be concerned with, while excusing the indoctrination of students in antivaccine beliefs.

Directing you to the work of Candance Pert is not an appeal to authority.

Does she have evidence of a metaphysical energy that flows through nerves and directs the healing process? An energy that that can be reestablished or enhanced by manipulation? No? So not only was it an appeal to authority, it was a misuse of her research.

If 686 newtons are REQUIRED TO COMPLETE a passive hanging, then more than that would over do it (yep, they would be super dead), and less than that is less than what is required to complete it.

Wow, sorry I misstated it. Within the bounds of this discussion, we don’t know how many Newtons are required to cause a VBA dissection, but since we do know that chiropractors do on rare occasions cause them, the range is probably much lower than 686 for some patients, but not for most.

Robster,

I will do my best to review the Scientific America video when I have free time, but to be honest, I don’t have a lot of free time and since I almost never watch TV, making time to watch something inherently non-scientific is not high on my priority list. If you have some quality research for me, I would be much more interested in that.

I object to Edzard Ernst because for the same reason everyone else does. He uses anecdotal evidence (which you are ready to dismiss when it is in support of chiropractic) and even uses it incorrectly, to support his claims. Furthermore, he makes comments that are specifically contrary to the available evidence. Dr. George Waddel (orthopedic surgeon and back pain specialist) perhaps said it well in his letter to the Editor published in the British Medical Journal in 1999 (Br Med J 3:18:263) when he dismissed Ernst’s work as “interprofessional confrontation under the guise of scientific objectivity”.

Stephen Barret, self-admittedly, was a failure at chiropractic. He was such a bad practitioner that in order to stay open, he would have had to lie, cheat, and steal. He consequently blames the profession and alleges that anyone else who is not such a failure is clearly lying, cheating, and stealing. I am sorry that he wasn’t good enough, but maybe I paid attention in class or just went to a better school or chose to practice my skill to better develop the cognitive and sensorimotor skills to physcially perform an adjustment, which means that I am able to succeed in an ethical manner when he couldn’t. He is mad because he is a failure. How could you possibly see him as a reliable source? Have you ever heard the phrase “sour grapes”?

Okay, I will accept your analogy of the glass bottles. The only problem is, in this particular, very rare type of stroke, the thinner glassed bottles are the young patients, not the old ones. This particular, VBAI stroke occurs MORE often in younger individuals. This is different than other types of stroke which are more common in the older crowd. There are many different “kinds” of strokes.

“sham” is not a good term to use in PubMed, as “sham” is not a common term to use in these kinds of studies. Try “control” or “placebo”.

The relevance is that an editorial need not be based on actual fact, and is no more reliable than a blog. It is this woman’s OPINION and her story that these things are true, and there is no way to verify that she isn’t lying or crazy or something in between. Editorials are not evidence. Plus, the fact that this woman claims to know what happened inside the board meeting makes me question her truthfulness. These meetings are closed, so she would not know if they decided to fine the doctor or place the doctor on probation or require that the doctor meet certain ethical guidelines.

With regard to the comment on Aetna. . . I said that they had a clear definition of some chiropractic terms, and you said that this was because the law required insurance to cover chiropractic and someone had to sell that insurance. You then tried to change to say you were talking about malpractice insurance, but again, I say that Aetna does not sell malpractice insurance, so no law related to malpractice insurance would have any affect on the policies of Aetna. Do you understand what I am saying here?

I do not ignore the “distasteful element” within the chiropractic profession. As I have said, so many times, I am working to improve the chiropractic profession from within. I do agree that there is a percentage within the profession that should be forced to improve or forceably removed. You claim that this is all chiropractors, however, and I disagree there. It is nowhere near all chiropractors, nor is it even close to half. I would still be concerned if it was even just one bad doctor, and I am actively doing something about it. This is what I have said before, and am saying again, and if you still cannot understand it when I put it in this simple and clear statement, then I don’t know what else to do to help you understand.

You, however, despite your claims that it is so many of us who are unethical, have yet to provide even one name.

Candace Pert. You clearly have not read her research. She delves into axonal flow, which is the actual fluid which goes forward and back within the axons of nerves, which carries nutrition, maintains the necessary electronic balance to allow the nerves to fire, carries elements necessary for the healing of damaged nerves, and which can be affected by external pressures, including physical pressures. Axoaxonal and retroaxonal flow are actual, real, verifiable physiological processes. I don’t call it “nerve flow” anymore than I refer to the scapula as the “shoulder blade”. Some doctors do, however, to help their patients understand. Really, try reading it. I think you’ll find it fascinating.

I accept that your misstatement about the 686 number. I am also still interested in where this number comes from because, despite your claim that it is “just physics”, I had to take some physics, and we never studied death by hanging. Furthermore, you would still need to find the force needed to actually “break” the barrier, anyway, and that calculation still needs to be based on a measurement somewhere.

I am going to be very careful in making the next statement, not because I am trying to unduly minimize a risk, but because I want to make sure that it is put into proper perspective. It is true that, in very rare situations, the movements associated with a chiropractic cervical adjustments performed on individuals with pre-existing factors, which may or may not be detectable in the absence of dopplar angiogram, can lead to or exacerbate an impending stroke. It is also true, however, that as many of the “delicate” (for lack of a better word) category of patients have this same, very rare stroke, due to exacerbations or causation of gentle neck movements performed by hairwashers at the salon, physical therapy modalities, or any doctor performing cervical range of motion as a component of an examination, as well as gentle neck movements performed by the patient themselves including, but not limited to, looking over their shoulder to back out of a parking space, brushing their hair, or having a sports “collision”. As I think, if nothing else, a chiropractic adjustment has significantly more health benefit than a wash-and-cut or driving, I disagree with the idea that this is an unreasonable risk.

Dr. Benway,
I chose not to respond to you because there is nothing more to say. We are looking at the same website, and despite the fact that I have copied and pasted the quote directly from the site in support of my statement, you will persist in insisting that it means something else. I have no interest in discussing it further, as it is not possible to discuss something logically with someone who is fundamentally illogical. I suggest thay anyone interested in deciding for themselves can go to see the website. If they cannot read, they can call the admissions department. Acceptable?

Stephen Barret, self-admittedly, was a failure at chiropractic. He was such a bad practitioner that in order to stay open, he would have had to lie, cheat, and steal. He consequently blames the profession and alleges that anyone else who is not such a failure is clearly lying, cheating, and stealing. I am sorry that he wasn’t good enough, but maybe I paid attention in class or just went to a better school or chose to practice my skill to better develop the cognitive and sensorimotor skills to physcially perform an adjustment, which means that I am able to succeed in an ethical manner when he couldn’t. He is mad because he is a failure. How could you possibly see him as a reliable source? Have you ever heard the phrase “sour grapes”?

HUH???

Are we talking about the Quackwatch guy?

That Steve Barrett is a retired psychiatrist. He never worked or trained in the chiropractic field.

I chose not to respond to you because there is nothing more to say. We are looking at the same website, and despite the fact that I have copied and pasted the quote directly from the site in support of my statement, you will persist in insisting that it means something else. I have no interest in discussing it further, as it is not possible to discuss something logically with someone who is fundamentally illogical. I suggest thay anyone interested in deciding for themselves can go to see the website. If they cannot read, they can call the admissions department. Acceptable?

In other words, you don’t know ANYTHING about how medical schools in the US operate. It’s a standard 4 year program: 2 years of pre-clinical education followed by 2-years of clinical education. It doesn’t matter what a website says. If Creighton didn’t follow that standard, they would not be accredited in the US.

aCQ,

I will do my best to review the Scientific America video when I have free time

Thanks. That I am asking you for verification of these procedures and viewpoints should demonstrate my skeptical nature. I want to make certain that the words of the chiropractic instructors are not being taken out of context.

I object to Edzard Ernst because for the same reason everyone else does…

I found said comment and the reply by Ernst and Assendelft, and link to it so that it can be read and examined by all. It seems that your “everybody” is the chiropractic community, and their biggest problem is that Erntz has constantly been critical of chiropractic. But since it has trouble beating sham treatment, its hard not to.

Stephen Barret, self-admittedly, was a failure at chiropractic…

Its pretty clear you don’t know who Barret is. Perhaps before you dismiss him outright as some greater evil, you should figure out who he is. I was actually expecting you to repeat the lie that he had had his license revoked. Mind you, that never happened, he retired after a successful career in real healthcare, and became an anti healthcare fraud advocate.

Okay, I will accept your analogy of the glass bottles. The only problem is, in this particular, very rare type of stroke, the thinner glassed bottles are the young patients, not the old ones. This particular, VBAI stroke occurs MORE often in younger individuals. This is different than other types of stroke which are more common in the older crowd. There are many different “kinds” of strokes.

You were so close… Detecting strokes of any kind caused by a specific activity is easier in the younger group.

“sham” is not a good term to use in PubMed, as “sham” is not a common term to use in these kinds of studies. Try “control” or “placebo”.

Odd. Acupuncture and sham gave me 544, and chiropractic sham gave me 56, but chiropractic activator placebo gave me one. Sham is a pretty descriptive term for a specific form of negative control in medical science.

Plus, the fact that this woman claims to know what happened inside the board meeting makes me question her truthfulness. These meetings are closed, so she would not know if they decided to fine the doctor or place the doctor on probation or require that the doctor meet certain ethical guidelines.

Again, really? Dr. Douglas Schnell Grove, Oklahoma was found guilty March 28, 2006 for the following: Violation of Title 59 Section 161.12(B)(1) by pleading nolo contendere to two counts of Aggravated Assault and Battery, as set forth in the First allegation of the complaint. (On file at the Board office). Respondent was in violation of Title 59 Section 161.12(B)(9) by obtaining a renewal license in a fraudulent manner. Found guilty by the Board of Examiners, fined in the amount of $750.00 for each violation, placed on probation by the Board to run concurrently with the probation imposed by the District Court of Delaware County in Case No. CF-2002-234, and ordered to complete (8) hours of Ethics before the termination of his probation. I think this depends on the state laws, and as to specific details, perhaps somebody told her. I’m pretty sure that such decisions have to be made public as a matter of public safety.

With regard to the comment on Aetna. . .

Whatever. Point is, you didn’t understand what I meant. Maybe I wasn’t clear enough for you. That seems to be a theme with you. So Aetna doesn’t sell chiropractic insurance, but they do pay for treatment of patients. Right? So why not use the chiropractic term? My point stands, either way.

I do not ignore the “distasteful element” within the chiropractic profession. As I have said, so many times, I am working to improve the chiropractic profession from within.

Color me unconvinced. You don’t have a problem with half of the students at a chiropractic school holding antivaccination views, with the percentage consistently increasing over their time as students (and are profoundly misinformed on the autism / vaccine connection, yourself). You find certain practices distasteful, but thats as far as you go. What is it that you are doing, other than protecting a procedure that several studies have determined to increase the risk of stroke in a young population.

I do agree that there is a percentage within the profession that should be forced to improve or forceably removed.

Good! Get to work! Start investigating! I’m an outsider, and not a patient, but you want me to do your legwork.

You claim that this is all chiropractors, however, and I disagree there. It is nowhere near all chiropractors, nor is it even close to half.

Back to the reading comprehension thing again. I didn’t say that, but dCs that use subluxation as their operating theory are doing something that does not match up with reality. dCs that claim to be able to adjust the length of a patient’s legs are committing fraud. dCs that are performing the kind of manipulation that can cause VBA dissection, when other procedures within the chiropractic field have the same effect, with greatly reduced risk, are needlessly putting their patients at risk. If that means all of you, so be it, but from my limited examination of the field, there are many that don’t do this.

I would still be concerned if it was even just one bad doctor, and I am actively doing something about it. This is what I have said before, and am saying again, and if you still cannot understand it when I put it in this simple and clear statement, then I don’t know what else to do to help you understand.

Great! So, why don’t you tell us what you are doing instead of just claiming it. In your own words, “there is no way to verify that [you aren’t] lying or crazy or something in between.”

You, however, despite your claims that it is so many of us who are unethical, have yet to provide even one name.

Since you subscribe to the concept of subluxation, I’d say you are skirting on the edge of bad ethics, or at least bad reasoning. Why have I not “named names?” I don’t want to fall into a libel/slander trap, thank you very much. I did, however, explain how a person could perform their own search for people that are more ducktor than doctor.

Candace Pert. You clearly have not read her research.

Actually, we studied the concepts of axonal flow in a neurotox class in depth, especially how drugs like taxol affect it. This isn’t innate energy or analogous to the flow of chi, and it isn’t being reestablished by popping joints, nor is it being impeded by mythical subluxations. You are misappropriating real research to prop up your claims. But maybe you interpret it that way, with your reading comprehension issues, and all. As a side not, a search for Pert chiropractic turns up nothing.

I am also still interested in where this number comes from because, despite your claim that it is “just physics”, I had to take some physics, and we never studied death by hanging.

I’ll write this slowly for you.

A 70 kg person exerts a force of 686 Newtons, suspended or not. In the following equation I will use 9.8 in place of the universal gravitational constant, mass of the earth, and distance from the earth’s center at sea level. 70 kg x 9.8 = 686 Newtons. Thats pretty basic stuff.

It is true that, in very rare situations, the movements associated with a chiropractic cervical adjustments performed on individuals with pre-existing factors, which may or may not be detectable in the absence of dopplar angiogram, can lead to or exacerbate an impending stroke.

HOORAY! FINALLY! And since you cannot predict who these individuals are, and lower risk procedures exist than said form of manipulation, why perform those manipulations? Lets say drug A has a lower risk ratio than drug B, and identical benefits and the same cost. Who, in their right mind, would use drug B?

As I think, if nothing else, a chiropractic adjustment has significantly more health benefit than a wash-and-cut or driving, I disagree with the idea that this is an unreasonable risk.

Thats your opinion. But since sham treatment is shown to be just as effective in many RCTs, I have to disagree with you. But even if you could beat sham therapy, when there is an acknowledged risk of stroke with treatment A, which is as effective as treatment B with no risk of stroke, a comparison between the two shows a disparity in risk vs benefit that is approaching infinity in scope.

Attacking hairdressers, whom I would suggest perform a more valuable service than any sCAM artist, which includes many (but not all) chiropractors, is a tu quoque fallacy. Hairdressers should develop lower risk procedures as well, but blaming them is not an excuse for malpractice.

As to your discussion with Dr. Benway, I checked the link he provided, and you are wrong. I feel sorry for you that it is this hard for you to admit that you could possibly be wrong in a functionally anonymous forum. What a sad person you are.

Finally, as to a lack of self policing, California found that it’s state auditing board was simply ineffective and was endangering patients. Thats just one (very big) state out of 50, but it does give you a bad reputation.

Sorry, forgot to include the quotes from your California article which say that “This represents a stark contrast to other state licensing boards, which make an effort to get the details of malpractice claims to see if discipline is warranted,” and “virtually all boards take only a matter of weeks” to investigate complaints, said Assemblyman Mike Eng, D-Monterey Park. “This particular board takes a matter of months and that is completely and wholly unacceptable.”

Looks like even your newpaper article author managed to check out the other boards to see that CA compares poorly. You would have seen this if you had read the whole article, rather than just the title, before posting it.

If we’re having trouble understanding the Creighton web site, we can look at another source.

From Wikipedia, about halfway down the page under “Curriculum”:

“Once admitted to medical school, it takes four years to complete a Doctor of Medicine (M.D.), or Doctor of Osteopathic Medicine (D.O.) degree program. The course of study is divided into two roughly equal components: pre-clinical and clinical.

“Preclinical study generally comprises the first two years and consists of classroom and laboratory instruction in core subjects such as anatomy, biochemistry, physiology, pharmacology, histology, embryology, microbiology, pathology, pathophysiology, and neurosciences. Once students successfully complete preclinical training, they generally take step one of the medical licensing boards, the USMLE, or the COMLEX.

“The clinical component usually occupies the final two years of medical school and takes place almost exclusively on the wards of a teaching hospital or, occasionally, with community-based physicians.”

another Chiropractic quack | March 12, 2009 12:04 PM wrote “Okay, so research says that there is at least SOME benefit to chiropractic cervical adjustments in SOME conditions …”

The real concern is whether your neck-snap is significantly better than safer procedures to justify the risk. Do you have any information on this?

Sorry, this, To claim that adjustments have an effect at all, we need to have evidence that they are real and do have a measurable negative effect on health. should read To claim that your “subluxations” and adjustments have an effect at all, we need to have evidence that they are real and do have a measurable, non placebo, negative or positive effect (respectively) on health.

aCQ,

You have yet to offer a single scientific paper showing that chiropractic manipulation has no benefit or is unreasonably unsafe. Editorials are not science. You have offered papers on other topics, of varying quality, but not actually anything on this topic.

Anybody can scroll up and see that this is incorrect. You must have hallucinated your way past them. It is interesting though, that you consider yourself a judge of the quality of a paper, but don’t recognize the problems with the Cassidy study.

The Webster Technique doesn’t adjust the fused bones of the sacrum. It has an effect on the juxtaposition of the sacrum on the innominates and, subsequently, to the ligaments that are attached to these bones which attach to, support, and suspend the uterus. This also includes nothing about any subluxations of the fetus. I am begging you, please, please try knowing ANYTHING about what you are trying to discuss on this forum.

Oh, so it doesn’t do anything at all. I don’t know about your skeleton, but my sacrum doesn’t exactly move that much in comparison to the pelvic bones… Do you have any evidence that the Webster technique actually works better than time? Breach presentation goes from 25% at 32 weeks to about 3% at full term. I would suggest that what you claim is an effective procedure is a pointless scam, playing on the fears of the mother. The improvement you see is nothing more than the baby moving normally. Perhaps if you could offer a paper demonstrating that the Webster technique does better than placebo or sham technique, your claim that “it works” would be more than the pragmatic fallacy.

Medical doctors can find alterations in position and motion in the bones of a joint. So can chiropractors. Why about this concept is tough to understand?

Nothing hard to understand here. You are wrong. Real medical doctors find real alterations, but only chiropractic quacks claim to be able to find chiropractic subluxations.

I am trying to use small words for you here! There is evidence that these things exist. Even you admit it! Where is the missing step for you?

On x-rays, chiropractors can’t reliably find the same chiropractic subluxation, and they can’t tell the difference between before and after treatment. That isn’t evidence that chiropractic subluxations exist, but rather that they don’t. What is truly humorous is that chiropractors use such ridiculous tools, like the nervometer, to find their subluxations.

In terms of the evidence you are looking for that alterations in bone position can have an effect on axonal flow, and at the risk of repeating myself yet again, I direct you to the research of Candace Pert!

Back to abusing real science again, are you? Searches of pubmed for chiropractic or subluxation and terms such as axonal flow or axoplasmic turn up nothing of use. You have a hypothesis as to why chiropractic might work, if your chiropractic subluxations were real. That’s it. That’s all you have, but you keep on pointing to Pert’s research as though it were proof of concept. You need evidence and data to demonstrate that your hypthesis is correct, not just dogged insistence.

On innate intelligence, you still haven’t actually said what it is that you think the other chiropractors believe this is? I asked that if you say that “innate intelligence” is described by a chiropractor as “mystical healing energy”, you provide a source verifying this claim, because it is not anything I have ever heard in my profession.

Really? I thought I was quite clear. And do you have no concept of the history of your profession? Where it came from or what the formative beliefs were? I can’t imagine being so completely separated from my curiosity as you are.

OK, again. Innate intelligence, is described by a straight chiropractor on this page using cultish, vitalistic terms and the words of the Palmers. Here is an article about the history of chiropractic, in a chiropractic journal, about innate intelligence. I am stunned that you claim ignorance of the history of your own practice.

I use a variety of disciplines as examples in the hope that perhaps if I use your words you will understand. Alas, it seems that you just can’t understand anything at all.

Go right ahead and try to prop up your failed sCAM. It isn’t working.

Robster,
I scrolled up, and didn’t find what I was looking for. Perhaps you could post the links again? Thank you.

Your sacrum doesn’t move in juxtaposition to your innominates? I am so sorry. I had no idea that you couldn’t walk. That is a ridiculous statement and no, the sacrum is not fused to the pelvic bones. If you don’t believe me, call your local PT. If you can’t find one with a DPT, even an MPT will be able to tell you that this is a normal motion associated with walking.

If you are looking for research about the Webster technique, try The Webster Technique: A Chiropractic Technique with Obstetric Implications. J Manipulative Physiol Ther. 2002 Jul-Aug;25(6): E1-9, Application of the Webster in-utero constraint technique: a case series. Kunau, PL. J of Clinical Chiropractic Pediatrics Vol 3 No. 1, 1998., or Chiropractic management of third trimester in-utero constraint. Forrester J. Can Chiropractor 1997; 2(3):8-13 (Special Section). I am sure that none of these will meet your standards, even the case study, but it might be of interest. Oh, and these are all indexed in PubMed, so I’m not sure how you could claim that you couldn’t find them. Plus, your stats are not very representative. Most breech babies will turn by 34 weeks, but very few of those who do not turn afterward without assistance, whether that be Webster Technique or ECV.

So real doctors find alternations in the position and motion of bones, but chiropractors find the exact same thing and they are fake? What is the difference? What do you think is the actual exact difference between what an MD finds and what a DC finds?

What the hell is a nervometer? That is something I have never heard of, nor can I google it. Google wants to change “nervometer” to “servometer”. The hits for “nervometer” include an anti-chiropractic website, and several sites about the new “nervometer” application for the I-Phone.

With regard to your rant about my hypothesis, I will have to accept that you are going to actually refuse to read the research and see how it applies. No, the research doesn’t talk about subluxation. The research talks about the amount of pressure needed to disrupt axonal flow. Other research talks about the amount of pressure created by osseoous malposition. Take them together and voila! If, in the future, you feel like using your brain, I suggest you follow these steps. First, read the research. Second, use logic to analyze the research. Third, understand what I am saying! This process will save you frustration and me the frustration of having to repeat myself.

I know the history of chiropractic, but as it is history not science, it has little to do with how I practice. This is similar to allopathic medicine, where the history which embraced concepts of religion, witchcraft, etc. is not longer applied in practice. (Now you’re mad at me that I’m not doing what you accuse my profession of?!? I don’t believe that something said 100 years ago still holds true so you’re upset and want to call me a quack? Make up your mind, either chiropractors believe all that old history stuff or they don’t. . . you can’t be mad at us for both!)

In your first site, the chiropractor talks about innate intelligence being the “force” which makes a sperm fertalize an egg, causes cells to divide, and heals you when you are injured (like skin cells regenerating to close a cut). You might not like the picture at the top or his subsequent rant against allopathic medicine (which I agree, is unnecessary but no worse than your rant against chiropractic) but how is what he talking about “mystical”? Do you deny that sperm finds eggs and skin cells divide in the absence of outside assistance? Do you believe that there is some allopathic treatment option which makes it happen? Your second article is an article about history. It even talks about the issues in the history and how it is no longer applicable. It even goes on to say that the term should be abandoned, as it has historically negative connotations. How do either of these support your allegation of “mystical healing energy”?

Sorry that today is a little short, there just wasn’t much worth addressing.

Robster,

Okay, first, before you start saying that “chiropractic subluxations” and “allopathic subluxations” are different, can you please tell me what the actual difference is? You cannot say “one is real and the other is fake (paraphrase)” unless you can show a difference. You ask me to admit that one is real and the other is fake, but you have yet to tell us what you are basing this on (other than the statement that real doctors find real ones and chiropractors find fake ones. . . logic so faulty that I can’t believe you were paying attention to what you wrote).

I am not aware of anything that is a “chiropractic subluxation”. I use the “subluxation complex” definition that is found in the International Classification of Disease, 10th revision. This does not specificy WHAT practitioner is diagnosing it, just what the diagnosis actually is. The ICD-10 was not written by any chiropractors, nor were there any on the review board. I am unaware of any chiropractors who do not use this definition. If you find any, specifically who are using old terminology, (instead of the generic term “straights”, which doesn’t actually mean anything anymore) then you can justifiably accuse them of being out of date.

All available research shows that the Webster technique does have a beneficial effect. I cannot comment on it personally, but that is what the reseach shows. There are a lot of treatment options, allopathic and chiropractic, which are not backed by placebo studies. Fortunately, the Webster technique is not one of them. See if you can find the study done in 2004 by Blue Cross Blue Shield of Illinois. I can’t find a link at the moment, but they took 5000 women, 2500 of whom were the “placebo control” group. It had some pretty significant results.

Never heard of a “nervoscope” either. Temperature can indicate areas of increased blood flow or muscle output, but not, as far as I have ever been aware, detect a subluxation.

The research is available to quantify the amount of pressure applied by a displaced bone on the nerve which disrupts axonal flow. Try Pathology of lumbar nerve root compression. Part 2: morphological and immunohistochemical changes of dorsal root ganglion. Kobayashi S, Yoshizawa H, Yamada S. Department of Orthopaedics, Fujita Health University, School of Medicine, 1-98, Dengakugakubo, Kutukake-cho, Toyoake, Aichi 470-1192, Japan [corrected] [email protected] and Pressure-induced interruption of axonal transport, Invest Ophthalmol Vis Sci. 1981 Jan;20(1):136-7 for that. Okay, so we have shown that pressure on a nerve has a negative effect on axonal flow. Next, to show that subluxation can cause this pressure, check out Axonal Lesions and Waltzing Syndrome after IDPN administration in Rats With a Conccpt-“Axostasis” By StII-MING CtIOU** and HENRIK A. HAItTMANN and the subsequent work by J.G. Greenfield. You will have to read the whole article, however, to get to the quote where they say,

“The instability of axoplasmic matter to various physical and chemical agents, of either endogenous or exogenous origin, was well illustrated in both human and eperimental neuropathology: (1) traumatic injuries; e.g. in dissection of the neurites n “damming” of nerve fibers, and in subluxation of spine; (2) vascular lesions; e.g. in encephalomalacia after hemorrhage and in nitrogen
embolism or “decompression sickness” (3) tumor compression; e.g. in the periphery of brain tumors . . .” etc.

Okay, so we have research that shows that subluxations change axoplasmic flow. Next question?

I used “force” in quotes, as I don’t believe that it is exactly the right term to use. However, you are not correct when you say it is “biochemistry” which causes an egg and sperm to unite or skin cells to divide and multiply. At minimum, these are physiological processes, which include biochemistry, but are much larger definitions. I ask you, then, what causes these physiological processes to proceed? They don’t “just happen”. There is a reason. I do not claim to know what this reason is, as I am not well-versed in the field of quantum theory, but what would you call it? I understand that you have little to no science background (despite your earlier claims) but no one in research is willing to accept that a physiological process (i.e. mitosis) “just happens”. It is not luck that sperm fertalizes an egg or blue eyed parents have a blue eyed baby. These are processes that occur according to specific processes, and some people might say that these processes are a force. I don’t, but it is a relatively simple concept to grasp.

Oh, and since you have such issues with reading comprehension, in that last sentence, by “they” I specifically mean chiropractic subluxations.

Wow, that was a lot of crap to sift through.

You still haven’t actually given a difference between the term “subluxation” used by different practitioners. To say that one profession can find them and the other can’t and therefore they don’t exist is illogical. Perhaps we can look at this another way. What part of a allopathic subluxation (the diagnosis itself, not the method used for detection) is missing from the subluxation referred to as a chiropractor? Yes, they might use different techniques of detection, but what is the actual physiological component of the allopathic diagnosis that is missing from the chiropractic?

I am not using a changed definition. It is “a lesion or dysfunction in a joint or motion segment in which alignment, movement integrity, and / or physiological function are altered, although contact between joint surfaces remains intact. It is essentially a functional entity, which may influence biomechnical and neural integrity”. The terms “subluxation” and “subluxation complex” are used pretty much interchangeably. You can also find it under fixation, lesion, biomechnical dysfunction, etc.

Maybe the term “nervoscope” was used to dumb down the procedure for a TV audience. I don’t know. The lack of rigor in TV is one of the reasons I don’t watch it. There is no recognized tool called a “nervoscope” in my state.

Yes, the Pathology of lumbar nerve root compression paper was not about chiropractic subluxations, nor did I say that it was. I said that it was evidence that a displaced osseous structure can disrupt axonal flow. I used OTHER information to show that a subluxation is an example of the displaced osseous structure. Try to read what I am saying. Since in reliable medical sources, like the ICD, there is no designation between “subluxation” and “chiropractic subluxation”, I guess I will stick with the experts and use the term “subluxation” as it is used in the research. I was not referring to the works of Greenfield that were listed in the references of that particular paper. I was referring to the other work that Greenfield did with relation to what are referred to as “spinal subluxations”. Also, since I have already accused you of searching for words and not really reading the articles, doesn’t it seem a little “rubber and glue”-like for you to recycle the comment now?

Animal physiology is shockingly similar to human physiology in many ways. This is what allows us to use bovine insulin or do drug testing in rats. Saying that a study showing effects in an animal population cannot be extrapolated to humans is. . . there are not words. Perhaps just this, “be careful, your ignorance is showing”.

Let’s see if I can bring this down to your level. Mitosis is a process through which (for example) skin cells can divide to heal a wound. The process is driven by a number of factors, including (as you say) many chemical signals. I ask you, however, to explain how your body can detect sensory input, process it, and release the right chemicals at the right times and respond appropriately to them? You also say that “Once the egg cell detects that a sperm cell has penetrated it, the cell’s membrane changes”, but may I ask you how this cell “detects” the penetration by the sperm?

I should clarify that I don’t really care if you answer or not. Also, this is not something that I discuss with patients. . . any more than the surgeon who cuts open someone on the table explains mitosis to the patient. I am simply attempting to break down why someone, when dealing with patients, might simplify the processes and say that “your body is intelligent enough to be able to heal itself when injured, unless the injury is too severe in which case you will need an intervention, like stitches.” This is the concept that I refer to as “relatively easy to grasp”.

Next point, I said physiological, not physical. Physiology and Physics, although they sound similar, are different branches of science.

Okay, here are some references to check out:
The effects of compression upon conduction in myelinated axons of the isolated frog sciatic nerve, Fern and Harrison. PMCID: PMC1181320 Yes, it is in frogs, but the nerves function similarly enough to be usable.

Degenerative changes following spinal fixation in a small animal model.Cramer GD, Fournier JT, Henderson CN, Wolcott CC. PMID: 15129196 Again, this is also in animals, but see the above statements. Also, this refers to “spinal fixations” not subluxations, but see my earlier comments. Spinal fixation is a term that is used interchangeably, as consistent with the definition of alteration in position or MOTION of bones in an articulation.

Wow, that was a lot of crap to sift through.

You still haven’t actually given a difference between the term “subluxation” used by different practitioners. To say that one profession can find them and the other can’t and therefore they don’t exist is illogical. Perhaps we can look at this another way. What part of a allopathic subluxation (the diagnosis itself, not the method used for detection) is missing from the subluxation referred to as a chiropractor? Yes, they might use different techniques of detection, but what is the actual physiological component of the allopathic diagnosis that is missing from the chiropractic?

I am not using a changed definition. It is “a lesion or dysfunction in a joint or motion segment in which alignment, movement integrity, and / or physiological function are altered, although contact between joint surfaces remains intact. It is essentially a functional entity, which may influence biomechnical and neural integrity”. The terms “subluxation” and “subluxation complex” are used pretty much interchangeably. You can also find it under fixation, lesion, biomechnical dysfunction, etc.

Maybe the term “nervoscope” was used to dumb down the procedure for a TV audience. I don’t know. The lack of rigor in TV is one of the reasons I don’t watch it. There is no recognized tool called a “nervoscope” in my state.

Yes, the Pathology of lumbar nerve root compression paper was not about chiropractic subluxations, nor did I say that it was. I said that it was evidence that a displaced osseous structure can disrupt axonal flow. I used OTHER information to show that a subluxation is an example of the displaced osseous structure. Try to read what I am saying. Since in reliable medical sources, like the ICD, there is no designation between “subluxation” and “chiropractic subluxation”, I guess I will stick with the experts and use the term “subluxation” as it is used in the research. I was not referring to the works of Greenfield that were listed in the references of that particular paper. I was referring to the other work that Greenfield did with relation to what are referred to as “spinal subluxations”. Also, since I have already accused you of searching for words and not really reading the articles, doesn’t it seem a little “rubber and glue”-like for you to recycle the comment now?

Animal physiology is shockingly similar to human physiology in many ways. This is what allows us to use bovine insulin or do drug testing in rats. Saying that a study showing effects in an animal population cannot be extrapolated to humans is. . . there are not words. Perhaps just this, “be careful, your ignorance is showing”.

Let’s see if I can bring this down to your level. Mitosis is a process through which (for example) skin cells can divide to heal a wound. The process is driven by a number of factors, including (as you say) many chemical signals. I ask you, however, to explain how your body can detect sensory input, process it, and release the right chemicals at the right times and respond appropriately to them? You also say that “Once the egg cell detects that a sperm cell has penetrated it, the cell’s membrane changes”, but may I ask you how this cell “detects” the penetration by the sperm?

I should clarify that I don’t really care if you answer or not. Also, this is not something that I discuss with patients. . . any more than the surgeon who cuts open someone on the table explains mitosis to the patient. I am simply attempting to break down why someone, when dealing with patients, might simplify the processes and say that “your body is intelligent enough to be able to heal itself when injured, unless the injury is too severe in which case you will need an intervention, like stitches.” This is the concept that I refer to as “relatively easy to grasp”.

Next point, I said physiological, not physical. Physiology and Physics, although they sound similar, are different branches of science.

Okay, here are some references to check out:
The effects of compression upon conduction in myelinated axons of the isolated frog sciatic nerve, Fern and Harrison. PMCID: PMC1181320 Yes, it is in frogs, but the nerves function similarly enough to be usable.

Degenerative changes following spinal fixation in a small animal model.Cramer GD, Fournier JT, Henderson CN, Wolcott CC. PMID: 15129196 Again, this is also in animals, but see the above statements. Also, this refers to “spinal fixations” not subluxations, but see my earlier comments. Spinal fixation is a term that is used interchangeably, as consistent with the definition of alteration in position or MOTION of bones in an articulation.

aCQ

I guess we’ll just have to agree to disagree. My position is that something that cannot be reliably or repeatedly detected by chiropractors by any means is not real, while you protest that it is. You seem to fine with this being a basis for bilking the patient, and as someone who stands between bad practice and the patient community, your opinion does trump mine. Too bad for the patients.

Maybe the term “nervoscope” was used to dumb down the procedure for a TV audience. I don’t know. The lack of rigor in TV is one of the reasons I don’t watch it. There is no recognized tool called a “nervoscope” in my state.

So the instructor was using a tool that is not approved in all states? You just keep digging the hole for your profession deeper and deeper Just google nervoscope and see if you recognize what comes up. It may be known to you as a “neurocalometer.”

Yes, the Pathology of lumbar nerve root compression paper was not about chiropractic subluxations, nor did I say that it was. I said that it was evidence that a displaced osseous structure can disrupt axonal flow. I used OTHER information to show that a subluxation is an example of the displaced osseous structure.

Ah, no. You see you didn’t do that. First you have to prove that chiropractic subluxations are real, something that no chiropractor has managed to do. You did manage to quote mine a paper for the word subluxation, though. Congrats. You managed to do just as well as a creationist on his first day out.

Try to read what I am saying. Since in reliable medical sources, like the ICD, there is no designation between “subluxation” and “chiropractic subluxation”, I guess I will stick with the experts and use the term “subluxation” as it is used in the research.

Argument from dictionary. And said research has yet to demonstrate that subluxations are real.

Animal physiology is shockingly similar to human physiology in many ways. This is what allows us to use bovine insulin or do drug testing in rats. Saying that a study showing effects in an animal population cannot be extrapolated to humans is. . . there are not words. Perhaps just this, “be careful, your ignorance is showing”.

Never said it wasn’t. I pointed out that citing a letter to the editor on methodology isn’t good enough. How you got it in your head that I reject animal research is completely beyond any sane person. You halucinated that one, too.

You not only are cherry picking lines from papers, but you are deliberately lying about what I am writing. OK, that probably isn’t true. I really don’t think your reading comprehension is high enough for you to read what other people write, let alone misconstrue it. You really need to back off of self manipulation.

On to your next Olympian feat of reading comprehension failure.

Next point, I said physiological, not physical. Physiology and Physics, although they sound similar, are different branches of science.

I never said anything of the like. Your writing clearly (well, as clearly as you can manage) calls for a “reason.”

What you wrote…

I used “force” in quotes, as I don’t believe that it is exactly the right term to use. However, you are not correct when you say it is “biochemistry” which causes an egg and sperm to unite or skin cells to divide and multiply. At minimum, these are physiological processes, which include biochemistry, but are much larger definitions. I ask you, then, what causes these physiological processes to proceed? They don’t “just happen”. There is a reason. I do not claim to know what this reason is, as I am not well-versed in the field of quantum theory, but what would you call it? I understand that you have little to no science background (despite your earlier claims) but no one in research is willing to accept that a physiological process (i.e. mitosis) “just happens”. It is not luck that sperm fertalizes an egg or blue eyed parents have a blue eyed baby. These are processes that occur according to specific processes, and some people might say that these processes are a force. I don’t, but it is a relatively simple concept to grasp.

You specifically asked for a reason behind “physiological processes,” as though science has no understanding of what drives them, refusing the concept that they occur without outside influence. You want, based on the examples of mitosis and blue eyes as an heritable trait, a reason. There are materialistic reasons that can be quantified and are scientific, and vitalistic reasons that are no better than fable. Chiropractic is based on the vitalistic fable of subluxation, as told by the Palmers, where all bodily functions are controlled by the nervous system, something that is plainly and demonstrably false.

Let’s see if I can bring this down to your level.

You mean up to my level. I have a real doctoral degree.

Mitosis is a process through which (for example) skin cells can divide to heal a wound. The process is driven by a number of factors, including (as you say) many chemical signals. I ask you, however, to explain how your body can detect sensory input, process it, and release the right chemicals at the right times and respond appropriately to them?

So let’s go with mitosis. A cell receives a growth signal, based on protein based receptors either integrated into the cell membrane or present in the cytosol. This receptor protein undergoes a conformational change, binds the next protein member of the signal transduction pathway, and the signal gets passed down the line. If the signal is of a sufficient amplitude, several transcription factors and adapter proteins are recruited and transcription of a specific set of genes occurs. This set is based on sequences of DNA found in the vicinity of the target genes.

From this point, depending on the message strength (determined by the secondary structure present in the 5′ UTR of the mRNA), and length of the poly A tail, a specific amount of protein is produced for a specific amount of time, respectively. This protein is broken down on a specific schedule to prevent a message from being expressed longer than appropriate.

You also say that “Once the egg cell detects that a sperm cell has penetrated it, the cell’s membrane changes”, but may I ask you how this cell “detects” the penetration by the sperm?

Look up zona reaction. Is this your first exposure to these concepts?

I should clarify that I don’t really care if you answer or not.

Of course not. You won’t comprehend it anyway.

Also, this is not something that I discuss with patients. . .

How could you even attempt it? That isn’t an attack on your patients, but on your mental capacity. I don’t think you could understand it. I don’t say this out of malice, but because I am astounded that you could be so incredibly ignorant that no reason for these processes is needed beyond the evolutionary drive to survive long enough to successfully reproduce.

any more than the surgeon who cuts open someone on the table explains mitosis to the patient. I am simply attempting to break down why someone, when dealing with patients, might simplify the processes and say that “your body is intelligent enough to be able to heal itself when injured, unless the injury is too severe in which case you will need an intervention, like stitches.” This is the concept that I refer to as “relatively easy to grasp”.

But it isn’t intelligence that is driving this healing process. The body can heal itself, and yes, real medical intervention may be needed in some cases, but there is no reason to suggest a vitalistic process unless your patients like fairy tales.

What I want from you is not more and more papers that are not about chiropractic subluxations, but you claim are analagous, but proof that chiropractic subluxations are real and can be detected reliably enough to serve as a useful diagnostic tool.

If you want to continue offering up papers, try finding an animal model of chiropractic subluxation, not something like it, and demonstration that axonal flow is inhibited.

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Now, back to the antivzx tendencies of chiropractors.

At the ICA’s December 2008 “Super Conference on Pediatrics and the International Symposium on the Science, Art and Philosophy of Chiropractic,” Andrew Wakefield was the keynote speaker. Wakefield is a known academic fraud, who produced profoundly flawed work, claiming that the MMR vaccine caused autism. He faked his background research, faked his results, hid his conflicts of interest that he was working for lawyers to produce the paper, and had a competing vaccine patent. Wakefield has done as much as anyone to ensure that measles, mumps and rubella come back and sicken children, while scamming parents of autistic children looking for anything that could help make their children “normal” out of money that could go towards real therapy. This is the guy that the ICA’s pediatric group decided to celebrate and honor in the Bahamas.

Next, the ACA and the WCA are both closely alligned with Barbara Loe Fisher and the NVIC (a major antivax group), with both inviting her to speak at conferences and to be interviewed in their publications.

The two biggest chiropractic associations are proudly linked to antivax groups and fight against mandatory vaccination, the only thing that keeps community immunity high enough to prevent widespread outbreaks, while providing cover to those who either deny the efficacy of vaccines or prefer to leech off of society, thinking that they are avoiding risks for their children.

Deny all you want, but chiropractic has a cancer, and no amount of manipulation or adjustment will fix it. You have to cut it out.

Robster,

Ahh, I think we finally have a basis for miscommunication. You say that I “specifically asked for a reason behind “physiological processes,” as though science has no understanding of what drives them, refusing the concept that they occur without outside influence”. This is not actually anything like what I am saying. The concept of an intelligent design of the human body (i.e. innate intelligence”) is, by definition NOT outside influence. It is the scientific processes (“force”) through which the body sends out the right cytokines needed for mitosis or allows a B-cell to divide such that one of the new cells will retain immunological memory. Evolution is, of course, a factor (“force”?) in this process, but evolution happens over millions of years and if evolution were responsible for why an egg is fertalized none of us would be here because who would survive long enough to pass on their genetics for the next generation to improve upon to make the process effective and efficient? If Person A has eggs that DON’T get fertalized, there there is no offspring to benefit from selection.

A neurocalometer is a piece of medical equipment that was invented and used 100 years ago. It is not something in use now. Perhaps that part of the show was about chiropractic history? Also, shockingly, as each state has the right to regulate practice within itself, there are scope differences in all health care professions when you travel between states. This is the case for chiropractors, medical doctors, doctors of osteopathy, even veterinarians, dentists, and massage therapists.

The ICD is not a dictionary. How do you not fall down more? The ICD requires rigorous scientific evidence to validate the diagnostic categories and conditions. Check this out with either the ICD internation page, or directly with the American Medical Association, which publishes the US version. This thing is not a bunch of guys sitting in a room making up words. I wouldn’t expect you to know this, as it is something people learn in the course of education it is clear you never got. Try at least using Goggle, however, as that might help you out.

Okay, let’s look at mitosis again. You start off by saying “A cell receives a growth signal, based on protein based receptors either integrated into the cell membrane or present in the cytosol”. Great. What is the cause of the growth signal release? What are the processes which allow the appropriate amount of signal to be released to diffuse in significant enough quantity to cause the effect?

I am going to say once again that I do not care if you answer this in terms of the science behind the process. I already understand the processes and I don’t need you to copy and paste explanations from your encyclopedia. I appreciate that you are so incredibly insecure that you need to try to insult me so that you feel better about yourself, but it is really pointless. I can’t imagine that it gives you joy, and since I am not offended (despite your allegations that my pointing out that you are being unnecessarily and unsupportedly rude is evidence of my having taken great offense) It is really just a waste of space on this blog.

I am trying to make the point that nothing in the body happens in a vaccuum. All of these processes are interconnected and it is not a truly comprehensive explanation if it fails to acknowledge that the start of the explanation is not exactly the start of the process. There are processes (“forces”?) at work within the body, which are the explanation of how things happen.

Let’s try an example. I called my friend, the Creighton grad, and asked what she would tell someone if they asked her how cuts heal. She said that she would tell them that their skin cells will divide and multiply and fill in the cut so they close over. I asked her how she would respond to the question of why cells would multiply faster when there is a cut involved or why they wouldn’t just be multiplying like crazy all of the time resulting in way too many skin cells. Her response was “because those skin cells are pretty smart. They know when they need to divide faster.” This is something or something like that which you know doctors say to patients. (as a note, I asked her what she would say if a doctor asked her this questions, and she laughed and said that she would say they should already know). In any case, referring to those cells as “smart” is not so different from saying that the body is intelligent enough to heal itself or that we have an innate (inside of us) intelligence.

Spinal fixation is ONE of the kinds of subluxation. Therefore, an animal model showing the diagnostic features and deleterious effects of a spinal fixation is exactly what you just asked for. I have already provided this to you.

Can you please provide a reference for why you claim that the ACA is “closely aligned” with Barbara Loe Fischer? I can’t find any relationship, either on her website or on the ACA site. The closest I can find is an article on her and her work that was published in the JACA, which was actually written by a PhD, not a DC.

The ICA is 2000 chiropractors and chiropractic students from across the US, making them less than 3% of the chiropractic practitioner population. Not exactly a representative population, nor do they have any easily discoverable “alignment” to Fisher, a non-chiropractor.

We have already established the situation of the WCA. It is a group of less than 250 individuals, not all of whom are chiropractors, from around the world, some of whom are the backwards joke that you accuse us all of being. I would personally like to see them eliminated, as they are the ones you try to use an example when you accuse me of wrongdoing. They are a miniscule section of the profession and in no way can be used as representative of all chiropractors.

Seems strange to me that several of the bloggers seem to think that chiropractic physicians are not real doctors. Let’s see, Chiropractors graduate with 3950hours from their doctorate. We have Neurology, Biochem, Biology, etc. Every hour that we study except for 12 Pharm/Tox hours are spent on learning about how the human body functions. Medical doctors graduate with 3560 hours of study with over half of those hours being on medication alone. I graduated from chiropractic college myself and I have a cousin who just graduated from med school. I have been out for a year. We compared our courses of study and this is what presented. Now, let’s see. You want to call someone who can prescribe man made medications that have severe reactions in the human body and kill over 450,000 people per year a real doctor. But you want to call a chiropractor, where all of their study is on nothing but the human body and is only associated with one death every 3 years a quack. I was almost killed by one of the NATIONS LEADING CARDIOLOGIST because he wasn’t listening to my symptoms after putting me on a certain medication that has since been pulled from the market because only 2 of us that took the drug are still alive. Yet he can call himself a real doctor? I have gotten several people well and out of pain that medical doctors and their “potions” haven’t been able to cure. My cousin stated that in one of her first days of class the lead professor came in and stated” By going into this profession you will kill people. Accept the fact and get over it.” I don’t know about you, but why in the world would you want to go into a profession that feels that way and that the afore said is a proven fact. Where as in the chiropractic profession, yes we are taught a couple of manipulation techniques that could harm the VBA. With that being said, we are also taught that those are techniques in which you never use. I am not sure what the total number of chiropractic colleges in the US is right off the top of my head. But I do know this number. Parker Chiropractic College has been in practice for 26 years. In that time period, there have been millions of adjustments performed. THERE HAS NEVER BEEN A SINGLE CASE OF VAD OR STROKE RELATED TO ANY OF THE ADJUSTMENTS GIVEN. With that being said, every one of those adjustments were given by STUDENTS WHO WERE LEARNING THE TECHNIQUES! You would think that with that, if chiropractic was so harmful, there would have at least been ONE incident.

This blog entry reminded me of a teacher who I think is fantastic and to whom I would attribute my success as a computer scientist. BTW, any failures as a computer scientist would not be his fault.

If you called him at home, you didn’t dare ask for Doctor Ford. If you did, you usually were answered with the phrase “Which One?”

This was during the early 80s, but I still think it is a problem of sexism and I agree with some of the comments that if Doctor Biden was male then this would not be an issue.

Robster
You are an idiot.
I know many Doctors. They come in the form of Chiropractors, GPs, naturopaths etc etc and they prefer being referred to on a first name basis. There is no need to offend people who have put a lot of hard work and determination into achieving an education which enabled them to be referred to as DR. Sounds like you are a tad bitter of others being referred to by Doctor. At the end of the day who gives a flying shit…Dr numbnuts

I can’t resist:

Below is the text of an email the British Chiropractic Association or BCA) (the guys suing Simon Singh) have recently sent out to their 1000-odd UK based members.

Note ESPECIALLY number 8.

NB Special exercise for skeptic textual analysis:
Compare what this tells you the law says about use of titles (and other stuff) with the attitude of the chiropractors posting higher up the thread.

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STATEMENT

The BCA would remind members of their obligations under the Advertising Standards Authority (ASA) section 50 (relating to Health & Beauty Products and Therapies

Members are strongly encouraged to review their current marketing materials (whether they are paper- or web-based to ensure that they are compliant with both ASA and GCC (General Chiropractic Council, the statutory UK regulator of chiropractors) requirements. Note that the ASA has no jurisdiction over editorial materials placed on members own websites.

When reviewing your materials it may be helpful to consider the following:

1. Are there any claims made that cannot be justified by reference to evidence? Remember, the GCC requires chiropractors to practice evidence based care, which is defined as “clinical practice that incorporates the best available evidence from research, the preferences of the patient and the expertise of practitioners (which includes the individual chiropractor himself).

2. Be mindful of making promises that you cannot be sure of delivering on;

3. Be wary of listing conditions that are controversial and away from mainstream chiropractic care e.g. dyslexia/dyspraxia unless you have research to back this up. If you have made references to prolonged crying, sleep and feeding problems, breathing difficulties and frequent infections, as these are symptoms rather than condition specific, we suggest you remove these references.

4. Do not refer to yourself as a specialist in any particular form of chiropractic;

5. Do not use unfamiliar words for common conditions;

6. Do not unjustly criticise other healthcare professionals;

7. If you refer to subluxations, provide information to explain what they are.

8. Take care in the use of the Doctor title. Ensure that there is no way there can be any doubt that you are a chiropractor, and not a registered medical practitioner. Do not use the doctor title in paper advertising without explicitly stating that you are a chiropractor.

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For much more on this, Google “Chiropocalypse”