Beware
On the same shift I saw two very sick patients, both of whom were under the care of chiropractors before they decided to pay us a visit in the Emergency Department. The first was an old woman with a one week history of dyspnea, chest pain, and a cough. Her chiropractor had diagnosed her with a “displaced rib,” and had been dilligently popping it back into place every day for the previous week. After a simple set of vital signs revealing low blood pressure, a slow heart rate, and a slightly low temperature, not to mention a chest x-ray which showed a huge unilateral pleural effusion, it was not hard to come up with the diagnosis of pneumonia with sepsis.
“He [the chiropractor] said she didn’t have a fever and she wasn’t coughing anything up,” said the sister.
A little knowledge is a dangerous thing. I’m sure chiropractors study a little bit about infectious diseases somewhere in their four years of training but that’s not the same thing as recognizing a constellation of symptoms and responding appropriately.
The second patient was a 70-year-old man who finally came in after a week of ineffectual adjustments for “muscle aches” and general malaise which had evolved, by the time we saw him, into a vague intermittant chest pain related to exertion but which the chiropractor insisted, apparently, was some kind of subluxation. The EKG told the true story, an evolving myocardial infarction. My patient would have probably died if his son hadn’t raised the alarm and insisted his father see some real doctors.
Is this kind of dangerous ignorance typical of all chiropractors? Probably, although some are probably quicker to push the panic button than others. Sending a patient to the Emergency Department costs them nothing after all, and you can always get the patient back if he lives. I note with interest that some people consider chiropractors to be primary care and that many chiropractors would like this recognition for themselves. The problem is that, their laughable primary treatment modality aside, chiropractors are not qualified to be primary care physicians because they know nothing about it. There are, of course, incompetent medical doctors but they tend to stand out. Incompetence seems to be the norm among chiropractors, at least from my perspective and from some of the patients I see.
Look, it’s not rocket science. Chiropracty is based on treating imaginary defects of the spine, called subluxations, by manipulation. These so-called defects, which are also common in people who are not sick, are believed by chiropractors to cause disease and dysfunction of organs. Again, this is an example of a little knowledge being dangerous. Chiropracty was invented at a time when physicians were just beginning to understand the role of nerves and particularly those of the autonomic nervous system. The metaphor proposed by David Palmer, the father of chiropracty, to explain disease might have sounded credible 100 years ago but it no longer fits with objective reality. It is only a dogged faith among its practitioners and the credulity of its patients that allows it to survive. And survive it does like an old painted whore, displaying a new wig and a few new trinkets, but still an old painted whore.
Now, as to whether a visit to a chiropractor makes you feel better, I don’t care. Lots of things make people feel better including having their back cracked. When I was a young Marine on the island of Okinawa, the local barbers provided a vigorous back and neck cracking after a haircut. Did it make me feel good? You betcha.’ A medical specialty? No way. I understand you can get the same thing nowadays with a happy ending but I don’t believe it requires a medical degree. The point being that not everything that feels good or makes us happy is medicine. Endorphins, those magical happy chemicals that along with placebos and quantum mechanics are the last refuge of qauckery, are over-rated. Feeling good is not the same thing as being well, an important concept that gets obscured in the expanding dust cloud from the stampede to well-being.
Sounds Like a Personal Problem
Strictly speaking, your well-being is not a medical problem except for the part of it that is effected by your real medical problems; a difficult concept for many in the Complementary and Alternative Health community to grasp. Improving your health improves your well-being but not the other way around. To believe it does would be to say that vigorously wagging a vicious dog’s tail will improve its disposition. You might feel good about it but he’ll still sink his teeth into your ass.
The tail does not wag the dog which is why most of Complementary and Alternative Medicine, as it focuses on well-being, is so ridiculous. Medicine is by necessity reactive. We treat objective medical problems, either early in their course as is the case with primary care, or late in the game in the more overtly reactive medical specialties like interventional cardiology and Emergency Medicine. Your well-being, as it is dependent on hundreds of factors most of which are decidely non-medical is your own business, more of a personal problem really, and not something that needs to be or even can be addressed by your doctor. This is why the largest consumers of Complementary and Alternative Medicine are people who are not really sick but only playing at it. They have a vague disquietude about the course of their increasingly materialistic and spiritually bankrupt lives which manifests as nebulous symptoms, eagerly interpreted and accepted as perturbations in their qi or an unbalanced chakra, and then healed by some combination of cheap Eastern mysticism and dime-store science. Complemenatary and Alternative Medicine provides them with an alibi, not therapy, in much the same way that recycling and shopping in trendy organic coops gives the same patients an alibi for their increasingly materialistic lifestyles.
Imagine trying to throw some Ayurvedic therapy at the typical census of patients in the Emergency Department. It just won’t work with sick patients who have subjective complaints resulting from objective medical problems. All the chanting in the world is not going to cure a yeast infection or diagnose meningitis unless if helps steady the hand holding the spinal needle. (Because it does feel kind of creepy sticking a long needle into somebody’s back the first twenty times you do it). Your well-being, your opinion of your disease, your spirituality, and your ability to laugh and spread happiness and sunshine are completely useless in the face of a real disease. This is why there are no Complementary and Alternative Medicine emergency departments. That is, because their patients self-select for credulity. To open up your CAM practice to random patients with real complaints would put the lie to most of what you do, not to mention opening you up to all kinds of legal jeopardy for practicing fake medicine.
A Reader Writes: “Hey, Panda, I notice you’re not posting as much. Are you losing interest in your blog?”
Well, no. But I have a real job now and I don’t have the time I once had. While it’s true that I don’t work as many hours now as I used to during my two intern years (new readers will have to do a little digging in the archives for an explanation), when I am at work I am really working and I no longer have the odd hour or two here or there that I managed to squeeze in while I was working longer hours but not technically working all the time. I mean, call was usually pretty busy when I was doing it but I still managed, by sacrificing a little sleep (which would have been interuptted anyways and not worth much), to knock out what I hope were interesting articles that you folks enjoyed reading.
As an aside, my pet peeve are people who send me private emails saying that this or that particular article was not as interesting as previous articles. Hey, I’ve got close to 200 articles on this blog (search the newly catagorized archives) and if you think it’s easy filling every paragraph with completely new and mind-numbingly original ideas than you need to get yer’ own blog and have at it. I do what I can.
But I digress. The point is that while I work fewer hours now and fewer total days per month, my schedule is kind of screwy and as I find myself frequently out of sync with my family’s schedule, it’s hard to find time to write. I enjoy it, of course, and as I feel almost obligated to keep churning out what some of my kinder critics refer to as the usual crap I will keep writing and I beg your indulgence, oh my faithful readers, as well as your patience. And if you have any questions about the whole medical career shooting match go ahead and email them to me.
In the meantime, you may as well peruse the selection of blogs on the right sidebar. I don’t just put anybody on that list. Every blog listed there has some quality that makes it stand out, in my mind, from the crowd and they are all, in their own way, a little subversive.
I include Kevin, MD on the left sidebar because he is an institution as is the Student Doctor Network. Over!My!Med!Body! is well written, informative, and a good way to keep up with what The Man is teaching medical students. It’s sort of the anti-Medschoolhell.
FYI, the noun is “chiropractic,” not “chiropracty.”
What do you think about spinal manipulation when it is performed by osteopaths (DOs)?
Brad, check Panda’s archive. I think you’ll find he has an even higher opinion of osteopathic spinal manipulation than of the work done by chiropractors.
I can understand your anger, we have the same problem in India. 60% of the population still visits an ayurvedic doctor before coming to a real physician. Eastern medicine may have some benefits, but it shouldn’t replace real medicine and science.
I enjoy your writing – it’s very engaging and makes me laugh. I don’t mind if you don’t post as frequently or if some posts are shorter, etc. That’s just how it goes in blog land. I agree with you that treating pneumonias and heart attacks with spinal adjustments is insane. But as I read your words I always hope that (to use the dog analogy) you do get to wag your tail every now and then. Perhaps the satisfaction of treating a pneumonia or MI is what wags your tail? Still – we faithful readers wish you “sunshine and happiness” in the midst of the science that saves. Keep up the great writing.
I commend your taking a strong stand on chiropractic and couldn’t agree more. Yes, it can make you feel good. Yes it can relieve a back spasm or neck ache but the idea that chiropractors are primary care physicians or should be using adjustments for internal organs is just kooky. I had a patient once who was treated for 4 months by a chiropractor for his leg pain, which worsened despite adjustments and expensive herbal supplements. He hobbled in with a cane and in one visit I saw it was very serious and after an xray, diagnosed metastatic lung cancer. He died within 2 months and was 44 years old.
Just took care of a lady with vertebral artery dissection from spine manipulation. 28 years old, had BL infarcts of the cerebellum, almost certainly will never be the same.
I’m a believer in CAM so long as the practitioners realize their own strengths and weaknesses.
“I’m a believer in CAM so long as the practitioners realize their own strengths and weaknesses.”
Beautifully said. Couldn’t agree more.
“Just took care of a lady with vertebral artery dissection from spine manipulation. 28 years old, had BL infarcts of the cerebellum, almost certainly will never be the same.”
Wow. That’s rough.
If anyone wants a good blog that is updated almost daily (he’s mostly retired now) would be the Surgeon’s Blog, by Sid Schwab. He’s even got a book.
I loved this post. I was a big believer in ersatz “healing” until something went wrong. My daughter was diagnosed with Type 1 diabetes and was and is kept alive by brilliant doctors, big pharma, and a great and modern children’s hospital.
It was the absolutely unforgiving nature of the disease that opened my eyes to the beauty of modern medicine. There is no amount of chanting, praying, or manipulation that is a substitue for life sustaining insulin.
It seems to me that insulin dependant diabetes is the one condition the charlatans won’t come near. The condition is too black and white, and left untreated is deadly every time.
Fabulous! Thank you for this intelligent and frank post.
I agree with your assertion that chiropractors et. al. are not qualified primary care providers, and likely have no ability based on their training to recognize or treat emergent medical problems.
I question your assertion (if I understood you correctly) that ‘feeling good’ has no benefit in terms of a person’s health. Its not going to protect me from contracting malaria next time I go to Zambia, for example, but if the desire to ‘feel good’ or ‘be happy’ drives me to improve my experience of stress in life, eat better, exercise, etc., doesn’t it stand to reason that I will be less likely to suffer some of the big chronic problems like diabetes and heart disease?
To Brad:
There is a HUGE difference between spinal manipulation performed by osteopaths and by chiropractors: osteopaths have the appropriate medical training to recognize a serious medical issue when present and manage it appropriately. Also, you would be hard pressed to find a DO who will tell you that your CAD can be treated with OMM alone, whereas most chiropractors will tell you they could (even if they wouldn’t.)
I agree with most of your comments on chiropractic care, although it does have its uses.
My mother herniated her L5 (the disc right above your sacrum) when I was 12. Her options were surgery to fuse her spine or physical therapy to try and put the disc back into place. After 6 months of PT with no results, her riding instructor mentioned that she might want to see a chiropractor.
Mom went down to the clinic, being vehemently opposed to surgery, and the chiropractor started working on her back. Slowly but surely, my mother started to see results which she had never seen during her PT sessions. Now she’s completely healthy and throws around 50 pound bags of horse feed with ease. She still throws out her back every once in a while (doing stupid stuff like picking up her shoes) but with chiropractic care, she can actually stand up straight.
But using chiropractic for anything other than your back? Sorry, but that’s just plain crazy, and my mother will be the first to say so.
“Slowly but surely, my mother started to see results which she had never seen during her PT sessions.”
And of course we know that improvement was do to the quackapracty and not just do time and natural healing alone. (not)
I had a cold once, and sure enough after 3 days it wasn’t getting better, then i took a zpak and ‘voila’, healed it was. therefore it was definitely a bacterial infection, right? (duh).
I also once sprained my ankle, and i was told by a friend to bang my head against the wall once daily for two weeks. sure enough, after 2wks the sprain was better. so headbanging is definitely an effective treatment for an ankle sprain.
Thank you for this post. I am continually appalled by the number of people who use CAM in place of actual medicine.
I love this blog! It keeps my morale up while I study receptor subtypes and drug antagonists. (Yeah, I’m one of those annoying pre-meds.)
“I had a cold once, and sure enough after 3 days it wasn’t getting better, then i took a zpak and ‘voila’, healed it was. therefore it was definitely a bacterial infection, right? (duh).
I also once sprained my ankle, and i was told by a friend to bang my head against the wall once daily for two weeks. sure enough, after 2wks the sprain was better. so headbanging is definitely an effective treatment for an ankle sprain. ”
Just wanted to say this comment had me laughing out loud.
To Jerry:
After watching my mother spend 6 months in the shape of the number seven (to imagine, think of standing next to a counter top, bent over at the waist while leaning your arms for support on the counter top) yeah, I’d say it was an improvement, and not just due to “time and natural healing”. Every time she goes back to the chiropractor after she screws up her back, she gets better as well.
For the most part, chiropractors *are* quacks. They have very little standardized training, and most firmly believe in the chiropractic treatment can cure cancer bullshit that you’ll find all over a chiropractic clinic. However, if you *can* find a good one, they can help keep your spine in line. That’s it. Just your spine. Nothing else. I wish I could get all of those crap leaflets out of their office so people would just use chiropractic for what it’s good for.
(As I’m writing this, my mom is lying on her foam blocks that she used to relax her back muscles every night and help her spine line up correctly, given to her by whom? The chiropractor.)
It’s interesting to read these accounts of people using CAM and chiropractic therapy as primary. I’d never thought of this occurring, mostly because my medical experience is limited to working in medical clinics geared towards people who have no form of primary care.
Happyman? I disprove of your scientific methods! You should have waited until your sprain *should* have healed, and them when it hadn’t healed, banged your head against a wall. Then I’d believe your miraculous discovery. 😉
Oh, and Panda? I hope you enjoy spending time what time you can get with your family. I’ll miss reading as many new posts from you, but I understand that work and family come first!
I’m getting old, and I know that a certain amount of self-discipline — in diet, daily exercises, some vitamins, etc — are my best bet for continued good health. All of that has been an important part of my life all of my life — marriage, giving birth to and raising seven children, a professional career and the wonderful hobby of flying small aircraft. Most of the time I was poor and working more than one job at a time, which wonderfully sharpens the mind toward a healthy lifestyle. I’m always a little in awe of those who would skip the basics (except intermittantly) but will pour money and time into alternative medicine practices, “New Agey” stuff.
Since doing a mountain of research for my novel (which isn’t pro or con with respect to alternative medicine), I just want to continue to clarify CAM – Complementary Alternative Medicine. Complementary means that it’s used alongside allopathic medicine, not in place of allopathic medicine. It’s an important distinction because while a patient is getting chemo treatments, for instance, they’re also working with biofeedback (with the full knowledge to their doc). As big a believer in integrative medicine as I am, I would never advocate anyone other than an MD as my primary physician.
But you see, CAM is all bunk and not supported by anything remotely resembling evidence. The best that can be coaxed out of every legitimate study of every CAM modality you can think of is that it is slightly (extremely slightly) better than placebo if that. Since this is the case, why bother and why throw scarce health care dollars out the window? The Lord knows we waste enough money in real medicine without adding to the problem.
Now, if we’re in the business of placebo medicine then I demand the right to give my patients with nebulous complaints fancy-looking sugar pills with expensive names.
Biofeedback is a unique species of bunk but bunk just the same. I have no doubt that chemo patients will try just about anything but I betcha’ Roxycodone is several orders of magnitude better by any objective and subjective standard than biofeedback.
I’m not busting down on you but part of our training is to be able to discern the meaning of the results of research and also to dissect the scientific literature. If you don’t understand statistics, for example, you will never know whether studies have any validity and prove what they were trying to prove. Therefore, you could look at the large body of research into CAM and not realize that most of it is incredibly shoddy, biased, of insufficient power, or any combination of the above. Anecdote is fine but that’s also the realm of faith healers and other purveyors of snake oil.
“Anecdote is fine but that’s also the realm of faith healers and other purveyors of snake oil.”
It’s also the realm of scientists. Anecdotes are stories and so are case reports which are routinely published in medical journals. Sure the case report probably has more careful observation and attention to detail, but you can’t dismiss both entirely. They might both reveal something previously unrecognized.
Both have been important in the discovery of new diseases such as AIDS, Lyme disease and the West Nile Virus, just to name a few.
I can see some UT scientists sitting around drinking beer and talking about how they heard Billy Bob wagged this dog’s tail and got bitten. They think they might be on to something and such enough they publish “Interspecies Hormonal Interactions Between Man and the Domestic Dog†in the current issue of Hormones and Behavior, a biology journal.”
I know, Panda, you and I have gone ’round and ’round with this before. The plain and simple truth is that there are many docs with whom I researched that hold integrative medicine in high regard. Docs like Mehmet Oz, who is a leading cardiothoracic surgeons. He even wrote a book about it. I’ve mentioned him and other leading docs whose opinions differ from yours, but you never commented on it. That’s fine; I’m not here to debate you because I know you’ll never going to change your mind. What I’m trying to get across, and the main theme of my novel, is that our medical care is influenced by our doctor’s belief system, and I invite patients to ponder whether this is a good thing, a bad thing or a moot thing.
You deal in absolutes – approve of only what you can see under a microscope – much like my main character. I understand your mindset well. I just happen to think that you short-change a lot of possibilities that can enhance patient care. As an example, I wrote a post about Duke University’s study on accupuncture. Whether anyone agrees with it or not, it’s food for thought. As one grizzled doc said as we sat around swatting mosquitoes in the Peruvian Amazon, “In twenty-five years of practice, I’ve seen too much crazy shit not to believe there’s more to healing than what a microscope can see.”
Panda you and all the doctors need to realize that it takes a village to raise and rear society. When will all you greedy physicians realize that the poor need medical care as well. I propose a universal healthcare system that will take of all of Americans. I will make it just as easy and cheap to see faith based healers and CAM healers as licensed physicians. This will help alleviate the burden on healthcare. In the end wether you approach medical problems from a scientific or faith based ideology the patient DIES. No on has ever prevented death. Thus I say no more money for docs no more money for docs……………………….
Hilary08, don’t keep us in the dark! Please, reveal thy magical health care solution!
Whenever I read a comment string like this one I start to seriously think how much the world would benefit from the adoption of a minimum IQ requirement for reproduction.
One can dream…
IF ONE MORE F***ING PERSON REFERS TO PHYSICIANS AS GREEDY AFTER I AM GOING $160,000 OR MORE IN DEBT TO GO TO A STATE MEDICAL SCHOOL AND DEDICATING SOME OF THE BEST YEARS OF MY LIFE TO LEARNING TO CARE FOR PATIENTS AND BECAUSE I DEMAND TO BE REIMBURSED IN A FASHION THAT ALLOWS ME TO PAY MY BILLS (INCLUDING MY LOANS) I AM GOING TO HAVE A FIT.
Oops, looks like I just did.
And yes, I got that it was a joke “Hillary.” 🙂 One of my main complaints with the Democratic candidates is that there isn’t one who doesn’t act like universal healthcare is a panacea for all the country’s woes.
“Thank you for this post. I am continually appalled by the number of people who use CAM in place of actual medicine.”
Old Girl MD, are you thinking about why they go elsewhere? In any other type of business it would be a major consideration.
Lynn wrote “What I’m trying to get across, and the main theme of my novel…You deal in absolutes – approve of only what you can see under a microscope – much like my main character…”
Doesn’t -anyone- find it odd that those who push CAM the most have a financial stake in the matter? As an example, those who write books about CAM? Even forwarding the ‘debate’ about CAM puts money in the author’s pockets. I can see the retort – Doctors push ‘mainstream’ medicine just to put money in their pockets!
The difference is in the scientific proof. I loathe having to call CAM ‘medicine’, the only medicine that I acknowledge is medicine that is proven to work. I suppose this means nothing to those who distrust science, but I have nothing but pity for those sad souls.
Randall Sexton wrote “Anecdotes are stories and so are case reports which are routinely published in medical journals.”
A discerning physician will not change their practice based on a case report. They will read it and keep an eye out for further studies, cohort or RCT, that validate or disprove the case report. The same holds true for CAM, as the case reports are all it has going for it. All the better designed studies show no effect over placebo. The biases and low power of the ‘successful’ studies are obvious to anyone not reading these studies with a bias. The CAM pushers claim physicians are biased but the opposite is the reality of the situation.
a good chiropractor should sent a new patient with almost any complaint to an M.D. first. then he/she can schedule the patient to come back after serious illness has been ruled out. i wonder what percentage of chiropractors are ethical and do this . i hope i am not overestimating the intelligence of chiropractors about knowing what they know and when to refer.
its scary that so many americans are so dumb into believing that alternative medicine is better than traditional medicine. at the very least you would hope that the greater percentage of americans would first see an MD before embarking in alternative medicines, i have nothing against alternative medicine if it is used as an adjunct, not in place of, a good family physician.
Brilliant blog. Not much else to say. Keep up the great work. I will be bookmarking it for review throughout my medical education. Cheers.
sir!
my rib was adjusted by a practitioner of the bone moving arts and it cured my angina. the surgeons said i needed a bypass but i feel wonderful nowwszzzzzswzzzzzzzzzzzzz
> allopathic medicine
My understanding of this term is that it was coined about 125 years ago by a homeopath arguing that scientific or empirical physicians had a theory of disease just as he had, only they wouldn’t admit it. He was trying to put homeopathy, chiropracty, hydropathy, naturopathy, osteopathy and all the other “philsosphically” based approaches to
bilking patientstreating disease on an equal footing with the (increasingly successful) interlopers who were satisfied with telling their patients what they thought would help without spinning a yarn first about why it might help. For the record, I know that osteopathy has been subsumed into emperical or scientific medicine.One would think that medical doctors today would strenusously object to the term, but I am astonished to hear at least a few adopting it as a description of themselves, elevating CAM practitioners to their level less than a hundred years after the Flexner Report.
I had a patient with a history of prostate CA s/p a bit of radiation. Saw a chiropractor and the first manipulation fratured his brittle pelvis. It is not that I fully believe that chiropractors have no place. There is evidence that manipulation may benefit lower back pain. But that is about it. Seeing any doc frequently and having your back craked/rubbed etc feels good thus people come back. But for conditions outside of musculoskelatal controlled trials fail to find benefit like the classic NEJM article using sham manipulation vs chiropractic manipulation in asthma. No difference in outcome.
“I’m sure chiropractors study a little bit about infectious diseases somewhere in their four years of training”
You’re not usually so charitable, and with good reason. Wanna see something scary? Look here: http://www.rebuildyourback.com/chiropractic/school.php
Re: Healdoc’s comment on chiropractic ethics a couple of pages up –
I would be interested to know the chiropractic ethical code says about their relationship with conventional medicine. Unfortunately I’ve not been able to find anything using Google.
1) Are they required to consider that there may be a medical diagnosis for the symptoms which they see?
2) If they suspect the symptoms tally with a conventional diagnosis (e.g. the 2 examples in the blog) – then are they required to stop treatment and refer the patient to an MD?
You asked: “Is this kind of dangerous ignorance typical of all chiropractors?”
The answer is “no.”
Get off your high horse. There are physicians every bit as “ignorant” as chiros in misdiagnosis, not referring patients to specialists in time, etc. To lump all chiros into one category would be the same as lumping you into the same category with the a-holes who misdiagnosed three family members on seperate occasions along with the surgeon who f’ed up my grandfather’s surgery, causing him years of subsequent complications.
Get over yourself.
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(Alas, this is simply not true (allowing for outliers, of course). As even a basic doctor has to pass four years of medical school and a minimum of three years of residency every doctor is better educated in diagnosis and treatment of disease than every chiropractor. Period. You just have no idea of the difference in training between the two which is why I always say, “A little knowledge is a dangerous thing.” Chiropractors receive a shoddy, community college level education in medical science and specialize in a treatment modality that is, apart from the massage aspects of it, 100 percent, pure-D hokum and bunk. What, pray tell, do they leave out during all of those hours devoted to learning fairy tales and how are their weak, back-crackin’ clinical years in any way remotely similar to a medical student’s clinical years?
The idea that a chiropractor is qualified to diagnose anything is laughable. Like most sCAM artists, they diagnose and treat nebulous symptoms and are generally either outright cheats, ignorant, or both. The incompetant chiropractor is the norm, not the exception, by virtue of the ridiculous emphasis of their trade. I’d trust a chiropractor to dial 911 but that’s about it. -PB)
I stumbled upon your article regarding Chiropractic and it takes just about everything I have to write a response. Everyone is entitled to speak their mind and have an opinion- so of course I can respect that fact. However, I find that you need a little more information to be fully informed regarding this subject. I am a Chiropractor. I spent many long years sitting in a classroom and completing an internship just like you. In fact, in certain areas, we have more instruction time. It is absolutely true that we do not have a residency like M.D.s. No Chiropractor in my generation would claim that we are equivalent to M.D.’s because that is ridiculous. We do totally different things. Could I ever perform a surgery or reduce a fracture? No Could you assess musculoskeletal problems as well as I can? Probably not… I hope that makes a point. We are trained equally in physical diagnosis (classroom hours) and we refer patients when their condition is beyond our scope of practice. The Chiropractors you refer to in the specific cases above sound like the old school guys who do not have the same education and training that is required of Chiropractor’s today. Overall, it is so sad for me to read something like this.
Any M.D. should know better than to make such statements without truly researching the facts. Members within your profession make mistakes which kill hundreds of thousands of people each year and yet you think we are “dangerous”? As I previously stated, no Chiropractor of my generation would discount your abilities- so what gives you the right to do so towards us?
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(Bolded quotes are mine. You are most certainly not trained equally in physical diagnosis. First of all, your entire raison d’etre (subluxation as the cause of pathology) is hokum and bunk and as many hours as you no doubt waste at it is deducted from your knowledge of medicine. Additionally chiropractic schools are notorious for the shoddy nature of their instruction, superficial at best, as well as the very low academic standards for matriculants. Now, I have no doubt that you think you are as well trained in physical diagnosis as a real doctor and that your education is up to par with medical doctors but this is just another example of a little knowledge being a dangerous thing. I’d say that you probably don’t even have an idea of what you don’t know.
As for doing an internship “just like me,” not hardly. Ooh. I bet that chiropractic call is really rough. Not to mention all of those admitted chiropractic patients and those codes where the chiropractor strides into the room, pushes the MD out of the way, and restarts the patient’s heart with a deft crack of the back. Come on now.
As for doctors making mistakes, sure we do. But chiropractic is a mistake in totalilty and so worthless that it generally does as much real harm as it does good, namely very little. -PB)
Nowhere did I state that our education was the same as yours. No Chiropractor would imply that. I would invite you to do a little more research and open your mind. Chiropractors DO NOT believe that subluxation is the cause of all pathology- so again, you really do not understand the premise of my profession.
I have not been rude to you so your comments back are uncalled for and just show that unfortunately you will never see that there is room for all different kinds of people in healthcare. No Chiropractor would claim we are “like Medical Doctors” so I don’t know why you keep mentioning that and why you are so concerned about it.
I understand fully that I am not qualified to treat many conditions- hence the reason we are trained to recognize such situations and refer to Medical Doctors. However, we are fully qualified and extremely successful in treating many things. We help patients, albeit in a different way than you, but obviously you do not want to see that fact. Why can’t that be the bottom line? Isn’t it about helping patients? What does it matter to you if someone is helped by an adjustment for back pain rather than taking the NSAIDs you prescribed? If anything I should think if you have the patient’s best interest at heart you would want them to stay away from the drugs, side effects, and possible dependency if at all possible!
Just because our internships are different does not mean that what we go through is not valuable. We do not have to spend many years in residency because what we do is not as dangerous and of course we all recognize that your program is much more difficult. Physician’s Assistants, Nurse Practitioners, Nurses (etc. etc.) do not receive the same education as Medical Doctors. Are they worthless too? They have lesser standards for matriculants- should we just do away with those programs as well? We recognize when the intervention of an M.D. is needed just as they do- so why can’t you accept that?
(Physician Assistants, in case you don’t know, are rigorously selected into highly competitive programs where they learn to practice (real) medicine in conjunction with medical doctors who, as their title suggests, they “assist.” Some PAs function as primary care providers more-or-less independently because their training qualifies them to do it and they (like physicians) know enough to know what they don’t know. Nurses are not physicians, don’t claim to be be, and specialize in the practical aspects of patient care. We are completely dependent on them for most of the work that goes on in a hospital. They have their jobs, we have ours, and although I despise sports metaphors, it’s a team effort. Chiropractors and other CAM practioners are not part of the team and to imply that you are is ridiculous. The hospital would grind to halt without nurses and many rural areas would be without primary care if it wasn’t for PAs. Your ability to dial 911 does not make you a primary care physician and your education makes you singularly unqualified for it anyways. -PB)
It blows my mind that as a whole Medical Doctors can accept Physical Therapy as an option for musculoskeletal conditions and not Chiropractic. If you believe in PT- how could you not also believe that problems may exist with joint biomechanics? That is the premise of our profession.
(Physical therapy is evidence-based. Chiropracty is not. So sorry. -PB)
Again, no one would ever discount what you do so please do not make comments regarding our profession when your comments are based only on opinion, not on facts.
(Young lady, I discount and disapprove of many things that we do in (real) medicine…disapprove mightily as you might learn if you read more of my blog. As I point out however in my latest article, shortcomings and mistakes of medicine do not validate Complementary and Alternative Medicine. When you say to me, “Panda, the theory of subluxation as an etiology of desease is pure hokum and bunk and I actually run my practice more as a physical therapist I will take you seriously. As long as you cling to nonsense I won’t. -PB)
We do not claim to be Medical Doctors either- nor do we claim to practice medicine! We practice Chiropractic. While we do not have as much funding for research as PT, we do have plenty of evidence to support what we do. Why don’t you pick up a JMPT (Journal of Manipulative and Physiological Therapeutics, in case you don’t know..) and read it?!
By the way there is no such word as “Chiropracty”.
There is no need for you to respond as you do and feel so threatened by Chiropractors. We are not trying to or claiming to “be like you” and we would NEVER want to!
I am done trying to pry open your extremely closed mind.
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(I like the word “chiropracty.” I think I invented it. It has an old-fashioned, voodoo kind of feel to it, kind of like “necromancy.”
As for not claiming to practice medicine, the lastest push from many of your minions is for chiropracty to not only to be used for primary care but even to have children as patients for regular adjustments.
Not too many kids with low back pain. What on earth are you treating in otherwise healthy kids? Ear infections? Asthma? Colds? Other medical complaints?
http://www.icpa4kids.org/why/whychiro.htm
I want you to explain this and why I should take any chiropractor seriously. -PB)
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I would be happy to discuss Chiropractic Pediatrics with you if you are seriously interested, but I really don’t feel like furthering this if you just plan to keep treating me like an un-educated fool.
(Har. So you’re one of those kind of chiropractors. Good Lord. You had me going there as you, in your best butch voice, demanded to be taken seriously as a medical professional who eschewed quackery. -PB)
I wouldn’t consider myself a “medical” professional- but a healthcare professional yes. I feel that you could really learn a lot about what I do and at least have an understanding of why we do it if you were open to hearing it. But I don’t want to waste my time explaining it if you don’t really want to listen, you know?
I hesitated to post here because the thread was so old, but I see an ongoing discussion. My wife has severe spinal problems. Cervically, she has degenerative disc disease (and bone spurs) and a few months ago required an anterior cervical discectomy. She credits the chiropractor she sees with “spotting the problem”.
Mind you, it could hardly have been otherwise. He was the guy she was seeing, he was the one adjusting her neck, and he was the one she first told about her neck pain. For all I know, his adjustments only contributed to the problem, as she didn’t have any neck pain or symptoms of nerve compression when she started seeing him. If she’d been getting her back pain (caused by three compressed lumbar discs) treated by a real doctor, it may have been identified earlier, and she would have at least saved a week in seeing our PCP and getting a referral to a specialist.
It was, in my opinion, the height of irresponsibility for her chiro to keep up with the cervical adjustments even after she was properly diagnosed — he was kept fully informed — but before the surgery. I understand that with the “spacers” (my wife’s term) and a titanium plate in place, he’s no longer doing that, but what the hell was he thinking before?
I strongly suspect that many MDs don’t say more against CAM for fear of driving patients away from legitimate care. My wife is fiercely loyal to her chiro and will hear no word against him no matter how rational. Her surgeon tried, but didn’t press the matter on seeing her reaction. She is, unfortunately, a True Believer. It was all I could do to pry her away from the chiro who was also prescribing homeopathic remedies.
Her lumbar discs have not improved, which should come as a surprise to no one but a chiropractor. Of course she feels better immediately afterward; a massage, which is always given before adjustment in this chiro’s office, will do that. But a day or so later it’s in as much pain as ever, alleviated only by her Fentanyl patches. Since she thinks of the chiro as “treatment”, it’s been years since she has had any real treatment for her back except for the Fentanyl, and it was only at my insistence that she did so just today. She was getting an MRI to check on her neck anyway, so she got an order for a lumbar image too. Hopefully her surgeon will have something to say about it.
After a serious car accident 20 years ago, (prior to our marriage) she also saw a chiro instead of a real doctor. I have to wonder if her current problems were caused, at least in part, by lack of proper care at the time.
Re some comments above: Anyone who says MDs are in it mainly for the money is an out-and-out liar. One of our closest friends is an MD; is wife is my oldest son’s godmother. It was only after he and his partner sold their practice to a large corporation (Columbia, I think) and began drawing a salary that he could afford to buy a house, which even then was hardly a mansion, or keep his kids in clothes that fit, or send them to college for that matter. For years his wife did day-care out of their house just to get them by. I think it was the prospect of college that finally prodded him to “sell out” as he put it.
And this was a guy who’d been in practice for well over 20 years in family medicine. No, this is not a profession for someone looking to get rich.
Great posting but you must have forgot to mention how many medical errors cause patients their lives in US hospitals each and every day…
If modern medicine has ALL answers to our health problems, why are there so many sick people still suffering and catching bacterial infections in hospitals?
I’ll be looking for your stats in the next blog…or better yet, i’ll post them myself if you are too busy.
(Knock yourself out. But if you had even an inkling of the complexity of the typical modern patient who is sick enough to be admitted and spend more than a couple of days in the hospital (because you have to be really sick to spend more than a couple of days) with their pathology textbook-like collection of comorbidities, their two-page list of medications, their advanced age, their completely unreasonable expectations, and often-times their totally oblivious families and guardians you would instead marvel that we manage to not make more errors than we do. Add to this the fact that physicians are spread pretty thin and you see what I mean.
But really now, the point is not that real doctors are perfect but only that we know enough to know what we don’t know. You can level all kinds of charges against physicians but being willfully ignorant is not one that will stick.  CAM practitioners, on the other hand, as their medical training is fairly shoddy for many reasons don’t even have the knowledge to know when they are in over their head.  Mistakes are one thing (and not every failed treatment is necessarily a mistake, you understand). Passing yourself off as a “doctor” to an unsuspecting public is another and is precisely what many chiropractors do when they purport to treat anything other than low back pain and the like (which they aren’t qualified to do either but that’s another story).
As far as modern medicine claiming to have all the answers, there are no answers because there is no question. People get sick. They get sick in hospitals because they are laying in bed in close proximity to other sick people. It would be better to set up a hospital room complete with nurses, techs, and doctors in every sick person’s house but this would be prohibitively expensive. How bacterial infections validate chiropracty escapes me.-PB)
Michael: Modern medicine has *some* answers. No one ever said it has all of them; quite the opposite. CAM has NO answers.
Why do medical errors happen in hospitals? Because hospitals are full of very sick people for whom minor errors can be fatal. This is a situation with which a chiropractor, acupuncturist, or homeopath never has to deal, and these people have absolutely nothing to say, and no moral high ground from which to say it, to those who do.
The truth is…..can you take the truth? Chiropractic IS a scam profession, loaded with fraud, scams and dirt I have seen firsthand after graduating……go out and try to make an HONEST living today as a chiropractor? It’s a contradiction in terms…..forget it unless your wife drives an ambulance and your relatives are MD’s or PI attorneys. What a waste of time and money. I could write a book on this topic. The main point is that chiros are NOT doctors. I can teach a monkey how to move a bone! The sad part is that many chiros believe the brainwashing they received as gospel and actually do many a dis-service. If you know anyone who is even considering chiropractic as a “career” have them run the other way and place a blowtorch behind them to move far away!!
Ex Chiro and happy to say it!
i agree with the person who said, a little knowledge is a dangerous things, after seeing my doctor for a serious infection that he failed to diagnose for mrsa, i had it cultured myself, i discontinued the worthless antibiotics he took a guess at that would work, had no effect on mrsa, i was fortunate to know a very good natural path that got me on colloidal silver immediately and with in a week, mrsa was completed cured.
but according to the FDA, the colloidal silver i took is extremely dangerous, whats going on here, something isnt right. im proof of the validity of using colloidal silver. And then again, im sure the doctors know best, ha ha, yeah right
Why is it that MD’s have such a lack of knowledge of the human anatomy and muscular skeletal system think that popping pills for every ache and pain is a cure all. That actually leads to more problems and more pills. DC’s have more hours of education than MD’s not to mention a lower death rate. But a Chiropractor or a certified neruomuscular therapist can correct a patients problem without drugs and if the Chiropractor or therapist is educated they should know and will know when to refer the patient out to a compentent MD. According to my friend whom graduated form Harvard the only real MD’s come from Harvard and the others are just want a b’s. I have had MD’s and MD’s wives on my table and have told me not to go to certain hospitals because you would go in well and come out dead. i only hope one day the big drug companies that pad the pockets of doctors and insurance companies and politicians will crumble. And the patients will who pay so much for their health coverage will finally be in control of their health and wellness.
(Your entire comment is pure, high-grade bullshit. You might want to consider that I have a higher “death rate” than you because, and this should be obvious, I actually see people who are sick and at a risk of dying. As for chiropractors having more hours of education…well…what can I say? You believe it and nothing I say will change your mind. -PB)
FUCK YOU
Anyone know any good Chiropractors in the Los Angeles area?
Modern medicine is a for profit racket with very little to no concern for the care and well being of the patient. Its just a fact that doctors most medical doctors are arrogant and have god complexes. I work in the medical arena and have experienced this dilemma from both aspects, a medical interventionalist and as a patient. The only REAL providers whom truly care are nurses and technicians who are hourly wage earners. Not 6 figure pompus asses whom believe that all healing begins and ends with them.
Hmmmmm……strangely enough I must agree. I am an ICU nurse n periodically during my 10 years in the healthcare field I have had patients come from the O.R. requiring extensive care because of surgical mistakes and not because of debilitating conditions caused by diseases. I find myself doing all of the work and these, not all, but almost all, these premadonna MD’s take all the glory. I’ve yet to be thanked by one for the amount of care I put into “their” patients but you know what as long as the patient gets well enough to leave and live a better life because of the care they received by other fellow nurses and cna’s, that’s thanks enough. Panda bear u are a self centered narrow minded person whom believes everyone should believe the way you do and that’s ridiculous. Its about patient care and those whom care for them with respect to others.
Just when I thought educated idiots were on a decline, here you come! Let me give you some
common sense information, maybe you will get
it, maybe not.
First of all, Chiropractic has one primary goal, and that is improving the alignment of the spine for purposes of allowing better nerve flow between the brain and end organs
such as your heart, lungs, kidneys, etc..
Because the spinal chord passes through your
spine, sending and receiving nerve flow throughout your body, and these nerves pass through openings which are formed when two adjacent spinal bones are in alignment, and that any mis-alignment causes narrowing or closing of these canals, it only makes sense to be concerned with alignment. As these openings close and narrow, spinal nerves get irritated, inflamation in these areas can occur causing pressure to the nerves and
resulting blockage or interferance in normal nerve flow. Any of this making sense yet???
So it only makes good common sense that a body will function better and healthier if nerve flow in the spine is good! Pure chiropractic seeks not to diagnose or treat specific symptoms or conditions, rather to improve the over all integrety of the spine and nervous system, which allows the body to be more healthy, have less illness, and less
alignment related pain. I hope this opens your mind, if not then you are probably a Medical Quack with no hope for change or improvement. As for myself, I am thinking about becomming a Chiropractor and really helping people.