MD, PhD, FMedSci, FSB, FRCP, FRCPEd

Preston Long’s book has featured on this blog before. It is truly an important contribution to the literature on chiropractic, and I recommend that anyone with an interest in the subject should read it. Harriet Hall wrote about it even if you think you’ve heard it all before, there are revelations here that will be new to you, that will elicit surprise, indignation, and laughter.

In a way, an even better ‘recommendation’ comes from someone who previously made numerous vile comments on my blog, Eugen Roth: In my opinion the close relationship that the author has with both Stephen Barrett and Prof Edzard Ernst makes this book just another part of the witch hunt against chiropractic which was initiated more than 50 years ago… In my opinion Prof Ernst and Dr Barrett have continued this witch hunt over many years and have now teamed up with the author to try and give credence to their misguided message. I have no ‘close relationship’ with Long, and his book is not a witch hunt; it is a factual and fascinating of chiropractic abuse, fraud and make-belief.

Chiropractors are in many ways not that different from other health care professionals. Most of them, like Preston Long, go into their profession with all the very best intentions; they study hard what is being taught at Chiropractic College; they pass their exams and set up a practice to earn a decent living. During their career, they subsequently treat thousands of patients, and many of them perceive some benefit. Those who don’t fail to return and are quickly forgotten. Over the years, chiropractors thus become convinced that their interventions are effective.

In several other ways, however, chiropractors differ from conventional health care professionals. The most fundamental differences, I think, relate to the facts that chiropractic is based on the erroneous dogma of its founding fathers, and that chiropractors fail to abide by the rules of evidence-based medicine and practice. Preston Long writes eloquently about many other rules which some chiropractors fail to abide to in addition.

D.D. Palmer, the ‘inventor’ of chiropractic, believed that all human illness was the result of ‘subluxations’ of the spine which impeded the flow of the ‘Innate’ and required correction through spinal adjustments. To his followers, this new approach to healing was the only correct one – one that could cure all health problems. When these assumptions were first formulated, more than a century ago, they might not even have appeared entirely ridiculous; today, in the face of an immense amount of new knowledge, they can easily be disclosed as pure fantasy and chiropractors who believe in Palmer’s gospel have become the laughing stock of all health care professionals.

Some chiropractors are therefore struggling to free themselves from the burden of Palmer’s nonsensical notions. But this struggle rarely is entirely successful. After all, chiropractors have been to Chiropractic College where they memorised so many falsehoods, were kept from numerous important truths, and failed to acquire the essential skills of being (self-) critical. As a result, most find it virtually impossible to completely recover from the ‘brain-wash’ they were submitted to at the beginning of their career. And even if some courageous innovators, one day, managed to expunge all the falsehoods, myths and bogus claims from their profession, the obvious question would still be, how would such a ‘chiropractic minus woo’ differ from physiotherapy?

Most chiropractors have very little inkling what evidence-based practice amounts to; the good intentions that once motivated them have long given way to the need to make money. They are unable to critically assess their own activities, and all the bogus claims they have been exposed to are thus endlessly and profitably perpetuated. The principles of medical ethics have remained alien to most of them. In fact, ‘evidence-based chiropractic’ is an oxymoron: either you abide by evidence – in which case you cannot possibly conceive the idea of adjusting spinal ‘subluxations’ – or you believe in the myth of ‘subluxations’ in which case your practice is not evidence-based. Long is right, I think, when he states: the most efficient way to protect against chiropractic mistreatment is to avoid chiropractors altogether.

Whenever someone dares to criticise their bizarre interventions, chiropractors react with anger, personal attacks, defamation or even libel suits. One argument that is voiced with unfailing regularity in such a context is the claim that the critic lacks the knowledge, insight and experience to be credible. External criticism is thus usually completely ignored.

Preston Long has been a chiropractor himself, and therefore his authority, inside knowledge and expertise cannot be undermined in this fashion. He knows what he is writing about and has been an eye-witness to most of the abuses he reports in his book. His comments are not criticism from the outside; they are thoughtful insights, hand-on experiences and first-hand accounts of fraud and abuse which originate from the very heart of chiropractic. It is this fact that makes this book unique.

Preston Long’s book provides a most valuable perspective on the education, training, thinking, misunderstandings, wrong-doings and unethical behaviours of chiropractors. He also gives valuable instructions on how we can protect ourselves against chiropractic abuse. It would be nice to think that Long’s outstanding and in many ways constructive criticism might contribute to a much-needed and long over-due reformation of chiropractic; but I would not hold my breath.

107 Responses to Chiropractic abuse and how we can protect ourselves from it

  • Thinking_Chiro says:

    Professor Ernst wrote: “…the good intentions that once motivated them have long given way to the need to make money.”
    Blue Wode wrote: “I think that completely nails the problem.”
    If my only motivation was money, my patients would have walked a long time ago. They Know! Everything I do is about my patients and helping my patients. If I do that properly then the money looks after itself.

    The most important line above is:
    “They are unable to critically assess their own activities”
    I agree 100%. Chiropractic needs more self criticism without the fundamentalist subluxation true believers shouting you down and calling you a traitor. Self criticism, evaluation and reassessment leading to change is called Progress. Subluxation is Stagnation!
    The subluxation brainwashing is dependent on which institution. Over 20 years ago I was taught subluxation only in the context of chiropractic history at Macquarie University. I am sure Prof Ernst and Blue Wode are well aware of which instutions are fundamentalist subluxationists and which have moved on.

    “Some chiropractors are therefore struggling to free themselves from the burden of Palmer’s nonsensical notions. But this struggle rarely is entirely successful”
    I have always focused from the outset on best practices and latest up to date approaches and have actively developed a medical referral base. Developing doctors trust has taken years. Most of those who I graduated with have a similar story. I market myself to my referring doctors as another approach available to them in the treatment of chronic spinal pain and we communicate constantly.

    “Most chiropractors have very little inkling what evidence-based practice amounts to…”
    Call me anal but before the internet I used to keep a filing cabinet full of research articles photocopied and filed under relevant headings. I used to subscribe to 6 journals (4 non-chiro). Now I use Mendeley Desktop and store and sort all relevant research at the click of a mouse (Bliss). I now bookmark the current issue page of over 20 journals that I love. The pace of change is accelerating and if I stopped reading journals I would quickly be in trouble.

    There are good chiro’s and bad chiro’s, good doctors and bad doctors, good physio’s and bad physio’s. It is a case of Caveat Emptor.

    • Blue Wode says:

      Thinking_Chiro wrote: “Chiropractic needs more self criticism without the fundamentalist subluxation true believers shouting you down and calling you a traitor. Self criticism, evaluation and reassessment leading to change is called Progress. Subluxation is Stagnation!”

      I suspect that most chiropractors intuitively know that self-criticism could herald their demise. Quackwatch’s Stephen Barrett (MD) sums up their dilemma very succinctly in the ‘Spine Salesmen’ chapter of the book, The Health Robbers:

      Quote
      “If a chiropractor limited his practice to musculoskeletal conditions such as simple backaches, if he were able to determine which patients are appropriate for him to treat, if he consulted and referred to medical doctors when he couldn’t handle a problem, if he were not overly vigorous in his manipulations, if he minimized the use of x-rays, and if he encouraged the use of proven public health measures, his patients would be relatively safe. But he might not be able to earn a living.”

      Thinking_Chiro wrote: “The subluxation brainwashing is dependent on which institution. Over 20 years ago I was taught subluxation only in the context of chiropractic history at Macquarie University. I am sure Prof Ernst and Blue Wode are well aware of which instutions are fundamentalist subluxationists and which have moved on.”

      The subluxation brainwashing can be very subtle…
      http://forums.randi.org/showpost.php?p=5404275&postcount=14

  • Preston Long says:

    Their patient base is dwindling and other groups are infringing on their minute piece of the alternative medicine pie. Each patient must be maximized because they truly don’t know when the next one is coming in.

  • Gary Linemaker says:

    Subluxation theory is not taught in any European Chiropractic programs. There is some programs in the U.S. where they teach that non-sense. Prof Ernst really seems like to promote his own dogma:

    In several other ways, however, chiropractors differ from conventional health care professionals. The most fundamental differences, I think, relate to the facts that chiropractic is based on the erroneous dogma of its founding fathers, and that chiropractors fail to abide by the rules of evidence-based medicine and practice.

    It’s like I would keep writing about how Medicine that it’s all about Homeopathy because there is some true believers who practice according homeopathic principles.

    It’s all about witch hunt or non-sense on this blog.

    • Edzard says:

      FROM THE PREVIOUS POST [COMMENT BY BW]

      Professor Ernst wrote: “The very first article on chiropractic listed in ‘Medline’ was published 100 years ago in the ‘California State Journal of Medicine’ without the…One hundred years later, it seems to me, not a lot has changed”

      You’d think that in the wake of the British Chiropractic Association’s very public and unsuccessful attempt to sue Simon Singh for libel that, at the very least, UK chiropractors would have cleaned up their act by now. However, the Alliance of UK Chiropractors (AUKC), which claims to be the largest chiropractic association in the UK, has since adopted the International Chiropractors Association (ICA) Best Practices documentation [ https://www.facebook.com/pages/Alliance-of-UK-Chiropractors/151897244826008?v=info ] which, among other policies, supports 27 indications for chiropractic radiography including…

      spinal subluxation
      birth trauma (forceps)
      facial pain
      skin diseases
      organ dysfunction
      eye and vision problems
      hearing disorders

      …and recommends a basic care plan for simple uncomplicated axial pain (neck pain, back pain, etc) consisting of 25 visits over 8 weeks – with the presence of ‘complicating factors’ (including family/relationship stress, lower wage employment, and wearing high-heeled shoes) warranting a recommended additional 12-visit blocks of care. Here is the link to the ICA Best Practices documentation: http://www.icabestpractices.org/chapter-docs.html

      The AUKC also surveyed its membership in 2010, the results of which revealed that, of over half of its members who took the time to complete this online survey,

      82.9% felt that the vertebral subluxation was not an historical concept

      95.4% thought that chiropractic philosophy should be taught in the chiropractic colleges

      and 90.5% found that, in their experience, chiropractic was effective for conditions outside those mentioned in the Bronfort Report. [NB. The AUKC made a submission to the CAP Copy Team at the Advertising Standards Agency in April 2010 for a further 28 conditions not included in the Bronfort Report to be reviewed and accepted.]

      Ref: http://www.ebm-first.com/chiropractic/uk-chiropractic-issues/1827-alliance-of-uk-chiropractors-october-2010-newsletter.html

      So, chiropractic in the UK remains remains riddled with pseudoscience even although many countries outside the UK view it as being respectable. Unfortunately, this veneer of respectability prevails because of a widespread lack of awareness that the General Chiropractic Council’s original guideline on the chiropractic vertebral subluxation was quietly altered in favour of chiropractors:
      http://www.ebm-first.com/chiropractic/uk-chiropractic-issues/1825-subluxations-still-no-evidence.html

      All in all, it’s not hard to imagine the enormous amount of quackery that’s still being foisted on unwitting chiropractic patients in 2013.

  • Blue Wode says:

    Gary Linemaker wrote: “Subluxation theory is not taught in any European Chiropractic programs.”

    That’s incorrect. Look at the Meric Chart behind the Principal of the UK’s McTimoney Chiropractic College:
    http://www.mctimoney-college.ac.uk/

    And here’s the subluxation-friendly Barcelona College of Chiropractic in Spain:
    http://www.bcchiropractic.es/eng/quiropractica/ciencia.htm

    Read why both colleges are promoting pseudoscience: http://www.chirobase.org/05RB/BCC/11g.html

    As for other chiropractic colleges in Europe, it’s quite possible that they do teach subluxation theory – just not blatantly. Note that there are at least 329 terms that either relate to, are synonyms for, the subluxation or aspects of the Vertebral Subluxation Complex:
    http://forums.randi.org/showpost.php?p=5404275&postcount=14

    • Jorma Kärtsy says:

      So you don’t know do they teach subluxation theory in Chiro schools of Europe. You read web and hope mention about Chiro philosophy means that they teach subluxation as science not as a part of history. Then you can refer other sceptics blog where he says something about meric system, which is not taught too. It was just one of the theories decades ago. Please, read current papers and text books. One of the very basic could be Haldeman (Ed.) Principles and Practice of Chiropractic. You can always send your address via email and send it for you. It may be christmas gift if see it so.

      You also write”: As for other chiropractic colleges in Europe, it’s quite possible that they do teach subluxation theory – just not blatantly. Note that there are at least 329 terms that either relate to, are synonyms for, the subluxation or aspects of the Vertebral Subluxation Complex.”

      Well, then this subluxation hunt should be also towards Medical, Physiotherapy and Osteopathic professions. Most of terms are used more other professions. I know as a practisinfg Chiro and quire recent graduate that Chiros are mostly using term facet joint syndrome nowadays. Also see if put it to pubmed it’s used by all professions

      http://www.ncbi.nlm.nih.gov/pubmed/?term=facet+joint+syndrome

      If can’t send you Christmas gift I hope you read and refer current literature. Think it is how it’s done in science.

      • Blue Wode says:

        @ Jorma Kartsy

        If what you’re saying is true, then it doesn’t seem to have much bearing on chiropractic practices in the real world – i.e. once chiropractors have graduated, they seem compelled to migrate to the ‘dark side’ in order to earn a decent living. For example, the most recent survey of chiropractors in the UK showed that traditional chiropractic beliefs (chiropractic philosophy) were deemed important by 76% of the respondents and 63% considered (the mythical) subluxation to be central to chiropractic intervention.
        http://www.ebm-first.com/chiropractic/uk-chiropractic-issues/1188-the-scope-of-chiropractic-practice-a-survey-of-chiropractors-in-the-uk.html

        • Mojo says:

          A few months ago a poster on the JREF forum claimed that chiropractic doesn’t use the concept of the chiropractic subluxation any more, and “that is why in the US the term chiropractors most commonly use is nonallopathic lesion as a more accurate descriptor of what chiropractors treat most commonly”. The “nonallopathic lesion” turned out to be indistinguishable from the chiropractic subluxation.

        • Jorma Kärtsy says:

          Please,see survey on 2004. http://www.gcc-uk.org/files/link_file/ConsultTheProfession.pdf

          There 90% of Chiros of UK support evidence based practice. Personally, don’t understand what rest of Chiros are supporting, but they might be these subluxation- people. There is some, but they are great minority after all.

          I think you have understood that survey (survey link is not working, so can’t read it) a bit wrong. If someone were asking my opinion about traditional beliefs and subluxation I would say it is all relevant and central in historical and philosophical perspective of Chiropractic. Subluxation is not relevant on scientific perspective because there is more commonly and widely used terms like, facet joint syndrome. Facet joint syndrome is not cause of all diseases, so there is what makes it history.

          I’m very happy to show my personal ‘dark Chiro graduate side’ and send you Christmas gift as promised. Just email your address to janimikko@gmail.com

          Maybe then your personal survey shows that there might be still one out there, who is not 100% on dark side. Don’t make diffrence do you believe it or not. And you see money is not everything at least for me, because Principles and Practice of Chiro is a bit expensive gift. Anyway, hope you would read it and refer it and not web pages so much any more. We can chat more clearly then.

          Hope hear you soon.

          • Edzard says:

            the 2004 survey showed nothing about what actually chiros do; it merely revealed that 90% of UK chiros CLAIM to support EBP (the other 10% must have been too daft to understand this leading question). if anyone were to survey how many actually ADHERE TO it, the figure would be close to 0% [but, as nobody has done this research, I am speculating, of course].

          • Björn Geir says:

            Chiro’s in Iceland are educated on both sides of the Atlantic ocean. All of them more or less use the subluxation theory in one way or another to “sell” their practice.
            Two of them who say they are educated in Sweden (Scandinavian College of Chiropractic) and England (Anglo European College of Chiropractic) respectively, are using this video to promote their practice: http://www.youtube.com/watch?v=-pphodsWboY The video is a blatant promotion of the subluxation theory as basis for CP.
            They also have a poster on their facebook site that says: 95% of infants have misalignment of their spine (!) after birth for which chiropractic should be used. This is nothing less than preposterous, or what?
            They also advertise their services for a score of childhood problems including asthma, bedwetting, behavioral problems, sleeping disorders and more.

            I see no mention of subluxation or pediatric medicine on the websites of the named institutions where these men say they studied, so either these institutions are hiding something or these chiro’s must have picked up their practice-building scheme somewhere else and are going against what they should have learnt at school?

          • Jorma Kärtsy says:

            @ Edzard’s next post.

            So there is not any single one in profession who is not practising EBP. No single one. Not even people who are preparing clinical guidelines.

            How about medical doctors, Osteopaths, Physiotherapist and so on. Could you give me estimation percentage of practitioners practising EBP?

          • Jorma Kärtsy says:

            @ Björn

            That is exactly problem of Chiro profession: some people are far better salesman than healthcare practitioners. But after all is not 100% of Chiros, not even 10%. Think this business aspect is more global problem and is come across all professions. In medicine it’s called medicalisation. Not just Chiro’s.

            There is recent speech of Chairman of American Chiropractic Assocation. Message of the biggest organisation is very clear.

            http://www.youtube.com/watch?v=8Y3y7JU_jzA

            Could other people (excluding you Prof Ernst) respect opinion, that 100% of Chiros are not wacko, subluxation-based, high-volume practitioners who promote themselves as a miracle healers?

            By the way, Sweden school is not accrediated Chiro school at all as well as McTimoney and School of Barcelona which just hold 5-year candidate status.

            http://www.ecunion.eu/default.asp?pid=396

            EACC is decent school so these Chiro’s in Iceland have has they ideas somewhere else. We have couple as well in Finland so really know what you speaking about.

          • Edzard says:

            the speech of your president is interesting; he seems to argue against subluxation but for chiros acting as primary care physicians, if I understand him correctly. I find this odd. how can chiros pretend to be primary care physicians? this only works, if one accepts the Palmer dogma of all diseases being caused by subluxation. and it only makes sense, if one accepts that chiros can treat asthma, GI-problems, otitis etc. in my view, this is as far removed from EBP as it gets.

  • Olle Kjellin says:

    That’s a really impressive list of synonyms to “subluxation” in the JREF Forum. I was particularly intrigued by “Abnormal dysfunction”. What, then, is a “Normal dysfunction”?

  • Thinking_Chiro says:

    Preston Long wrote: “Their patient base is dwindling and other groups are infringing on their minute piece of the alternative medicine pie. Each patient must be maximized because they truly don’t know when the next one is coming in.”
    My practice is based on medical referrals. 80% of my new patients are from doctors. One doctor alone has sent me over 250 patients over the years. Doctors are often like a high maintenance blond girlfriend, a lot of work, but worth the effort. They also ultimately see 100% of the population.

    Blue Wode Wrote: “The subluxation brainwashing can be very subtle…
    http://forums.randi.org/showpost.php?p=5404275&postcount=14
    There is a lot of accepted medical terms in that list. A precise diagnosis and subsequent care plan is preferable to an all encompassing subluxation and generic care plan which is diagnostic braindeath.

    Prof Ernst pointed out the overuse of xrays, and I agree. In my practice there must be a valid clinical reason and not everyone is referred for xrays. I do not blanket xray! Most of my patients are medical referrals so they are instructed to bring in all their imaging to their initial consultation. It is common to get a pile 2-3 cm thick of plain films, CT’s and MRI’s going back years. I find it annoying that the clinical presentation has not changed and the medical treatment hasn’t changed, but year after year high dose CT’s. I keep my mouth shut and just look at them all. (I’m not going to bite the hand that feeds me!) Another gripe of mine is that the doctors have taken all the radiologists reports out. (Thank god for digital) The overuse of advanced imaging is a big issue in medicine at present (Over exposure and skyrocketing costs). The list of indicators cited by Prof Ernst which includes spinal subluxation, birth trauma (forceps), skin diseases, organ dysfunction, eye and vision problems, hearing disorders etc. Facepalm! Is this about some chiropractors trying to expand their scope of practice. Will they want prescribing rights next? Facepalm again!

    80% of the population will experience recurring back pain. 1 in 7 pateint visits to the doctor is for back pain. General Practitioners admit that they are frustrated by chronic back pain, lack knowledge of the spine and do not like seeing it in their practices. Working with doctors, there are huge future here! First though there needs to be TRUST and that took me years!

    • Blue Wode says:

      @ Thinking_Chiro

      Re “The subluxation brainwashing can be very subtle…
      http://forums.randi.org/showpost.php?p=5404275&postcount=14

      You wrote that there is a lot of accepted medical terms in that list, but, unfortunately, as far as patients are concerned those terms are entirely meaningless while the mythical chiropractic subluxation is anything sciency-sounding that chiropractors need it to be. IOW, it’s another example of the chiropractic bait and switch:

      Quote:
      “Chiropractic is perhaps the most common and egregious example of the bait and switch in medicine. The deception begins with the name itself – ‘chiropractic’ fails the basic test of transparency because it is not unambiguously defined…someone may go to see a chiropractor and think they will be seeing a medical professional who will treat their musculoskeletal symptoms, but in reality they will see the practitioner of a cult philosophy of energy healing…The bait – claims that chiropractors are medical practitioners with expertise in the musculoskeletal system. The switch – practitioners of discredited pseudosciences that have nothing to do with the musculoskeletal system. A more subtle form of the bait and switch among chiropractors is the treatment of musculoskeletal symptoms with standard physical therapy or sports medicine practices under the name of chiropractic manipulation. Ironically, the more honest and scientific practitioners among chiropractors are most likely to commit this subtle deception. The problem comes not from the treatment itself but the claim that such treatments are ‘chiropractic’. Using techniques like massage, range of motion exercises, strength-building exercises, and mobilization of joints are all legitimate science-based techniques used by physical therapists and physicians with specialties in physiatry, orthopedics, and sports medicine. Some chiropractors also use similar techniques – and with good results. But by doing so and calling it ‘chiropractic’ it legitimizes the pseudoscientific practices that are very common within the profession – like treating non-existent ‘subluxations’ in order to free up the flow of innate intelligence.”

      Link: http://www.sciencebasedmedicine.org/the-bait-and-switch-of-unscientific-medicine/

      Thinking_Chiro wrote: “Working with doctors, there are huge future here! First though there needs to be TRUST and that took me years!”

      The way things are going, I would venture that it’s going to take chiropractors – as a whole – many decades, if not centuries, to reach the point where they can be univsersally trusted, although I doubt they’ll be around by then.

  • Alan Henness says:

    Olle Kjellin said:

    I was particularly intrigued by “Abnormal dysfunction”. What, then, is a “Normal dysfunction”?

    It’s a dysfunction in the normality of normal functionality. Obviously… :-)

  • L. Barton says:

    If chiropractors are all so keen on treating their customers with stuff like exercise and lifestyle advuce, why are they not all retraining as physiotherapists (physical therapists in the US) ?

  • Thinking_Chiro says:

    Blue Wode wrote: “Chiropractic is perhaps the most common and egregious example of the bait and switch in medicine”.
    The classic example of this in Australia was the “Free Spinal Checkup, or Initial Consultation “Now $27 usually $160″. This has been banned here, yet I saw it on a sign outside a chiro’s office on the way home last month. I went in and informed him of the change in the law. He took the sign down. I checked his website and it was still there, so I called and its now gone. Like in medicine it is annoying that legislation has to play catch up with the cowboys. I do not use the term subluxation and I do not promote it.

    “The way things are going, I would venture that it’s going to take chiropractors – as a whole – many decades, if not centuries, to reach the point where they can be univsersally trusted”
    I don’t universally trust all doctors. There is one GP that my family has been going to who is superb and I won’t take my children to anyone else. Change/trust happens in the medical trenches one doctor at a time. It is always a case of Caveat Emptor. Does a GP refer to any old specialist or does he refer to a specific specialist? Doctors don’t universally trust all doctors. I have one GP who for years only refers headache patients. No chronic low back pain etc. I’m his headache go to guy. I’ve tried to educate him in my reports but it hasn’t worked. I have talked to my referring doctors and the doctors I see every day in the medical centre where I work and they are all well aware of the differences between chiro’s. They also talk/gossip amongst themselves like a bunch of old women. I know everything that goes on in medicine in Sydney being in a medical centre. We have a meeting every morning before the first patient over Cappuccino’s and discuss our patients , case studies, current research, office problems etc. I get referrals from doctors who I have never communicated with, yet they know all about me. One even drew a map on A4 from his office to mine recently and told the patient to go straight there. If subluxationists think that they can practice in blissful isolation then they are delusional.
    There is a lot of baggage attached to the word chiropractor. I address that baggage with my doctors and patients. What I do is definitely not subluxation repackaged in medical terms!

    Blue Wode Quoted: “The problem comes not from the treatment itself but the claim that such treatments are ‘chiropractic’. Using techniques like massage, range of motion exercises, strength-building exercises, and mobilization of joints are all legitimate science-based techniques used by physical therapists and physicians with specialties in physiatry, orthopedics, and sports medicine. Some chiropractors also use similar techniques – and with good results. But by doing so and calling it ‘chiropractic’ it legitimizes the pseudoscientific practices that are very common within the profession – like treating non-existent ‘subluxations’ in order to free up the flow of innate intelligence”.
    Are all NSAID’s the same? Are all blood pressure medications the same? I market myself to my doctors as another approach to the treatment of chronic back pain etc. No one approach helps everyone and patients need to find the approach that works best for them. Doctors understand that.

    L. Barton wrote: “If chiropractors are all so keen on treating their customers with stuff like exercise and lifestyle advice, why are they not all retraining as physiotherapists (physical therapists in the US) ?”
    Different approaches help different people and if I cannot hepl a pateint I will refer them to a physio who I work well with or send them back to their doctor with advice on the next step like spinal injections if the physio also cannot help. If I am not addressing lifestyle/work ergonomics/exercise issues etc that are causing the back pain I am not doing my job properly.

    • Blue Wode says:

      Thinking_Chiro wrote: “If subluxationists think that they can practice in blissful isolation then they are delusional. There is a lot of baggage attached to the word chiropractor.”

      And therein lies chiropractic’s big problem.

  • SkepdicProf says:

    Why did Preston Long fail to appear at the Connecticut Board of Examiners hearings as he had requested and was scheduled? His entire written testimony was then thrown out. He just didn’t show up when he had the chance to present his all of his so-called ‘evidence’. Just failed to appear. Strange.

  • Blue Wode says:

    SkepdicProf wrote: “Why did Preston Long fail to appear at the Connecticut Board of Examiners hearings as he had requested and was scheduled? His entire written testimony was then thrown out. He just didn’t show up when he had the chance to present his all of his so-called ‘evidence’. Just failed to appear. Strange.

    It is nobody’s business why Preston Long didn’t appear at the Connecticut Board of Examiners hearings.

    Here are the facts:

    Quote
    “Dr. Long provided information to the Board. The Board ruled that his information was relevant and pertinent to these proceedings. For personal reasons, he’s been unable to appear. The parties interested in his testimony have sought permission to substitute someone, who is prepared to come here and adopt his testimony under oath, thus crossing the threshold of admissibility, in terms of the guarantees that an oath gives, as to reliability.”

    See page 38 here:
    http://www.vocact.com/legislative_testimony/docs/Hearing%20-%20Transcript%20Day%20One.pdf

    It is nobody’s business why Preston Long didn’t manage to appear at the hearings.

    • SkepdicProf says:

      Hi, Thanks for the transcript, Wo. I am not sure why you left out the important part that Long’s testimony was marked by the Assistant Attorney General for identification only and not used as evidence. I guess you are not familiar with this.

      Page 47: MR. SHAPIRO (Connecticut Assistant Attorney General) : Attorney Leonhardt, we’ve heard all we’re going to hear on this now. We’ve heard all we’re going to hear. I would recommend to the Board that the objection be sustained and that Exhibit 27 be marked for identification only. We’re just dealing with 27, and I would recommend to the Board that they mark that for identification only.”

      The Assistant Attorney General also denied a Dr. Katz and Bellamy to substitute for him which was the correct ruling.

      Page 49 “Dr. Long’s request to appoint Dr. Katz to present submission is denied. The notice was clear from the Board, that people, who wanted to present evidence, would have to be there to adopt their testimony under oath.
      In this particular case, Dr. Long applied as an individual to present testimony, and he’s not available for Cross-Examination.”

      So it is pretty clear that Long had his chance present his evidence and missed the boat when he failed to show up without an excuse. It was a huge tactical error as they failed to present a strong case and lost. If he had been available, it might have saved the day for them, but he didn’t. Sorry.

      That is why I am skeptical of this author and his book and think it would be enlightening to all if he (Long) cleared up a few mysteries. Just my opinion.

        • Blue Wode says:

          @ SkepdicProf

          Haven’t I pointed out already that having a substitute crossed the threshold of admissibility?

          Re: “So it is pretty clear that Long had his chance present his evidence and missed the boat when he failed to show up without an excuse.”

          What is it that you don’t get about “For personal reasons, he’s been unable to appear”? See page 38:
          http://www.vocact.com/legislative_testimony/docs/Hearing%20-%20Transcript%20Day%20One.pdf

          • SkepdicProf says:

            It was admissible according to the lawyers for the stroke ladies, but not admissible, except to ID it, according to the Assistant Attorney General of the state of Connecticut. They even banned Katz and Bellamy, who conveniently showed up but was kept silent, two elderly MDs from substituting for him to answer questions about Long’s testimony. Did you miss that part?

            It just seems so inopportune for Long to take a personal day on what could have been the biggest day in the life of an anti-chiropractic extremist. I think that he was afraid that his testimony wouldn’t stand up to scrutiny. Just my opinion.

            Were you involved with this, Wo. You seem to have taken a very obsessive compulsive interest in all of this.

          • Edzard says:

            again your biased and increasingly insulting opinion only to poison the well!
            “obsessive compulsive interest”? are you sure? it was you who came up with this unrelated topic to tarnish the reputation of someone you now chose to call “an anti-chiropractic extremist”, simply because he is disclosing some of the fraudulent activity of your profession.
            I suggest you stop digging because you are in a hole.

      • Edzard says:

        I can think of a million reasons why someone cannot be present for a hearing; you chose one and I suspect it reflects much more on you than on Long

  • SkepdicProf says:

    He chose not to stand behind his submitted testimony in Connecticut, so it was viewed with skepticism and ruled inadmissible. Same thing here I’m concluding. Thought, since he chimed in earlier, he would do the same now as an opportunity to clear the air, unless he has something to hide. That was our conclusion during the hearings that he asked to appear before when he failed to show. Something to hide.

    Why are you speaking for him? It’s his book.

  • Thinking_Chiro says:

    Blue Wode wrote: “And therein lies chiropractic’s big problem.”
    The subluxationists think that the baggage is what makes chiropracTIC unique or as Billy De Moss rants “Keep it pure”. (God I hate the TIC’s and TOR’s that they use, they have to rely on gimmics to validate what they do by creating a buzz word).
    Critics of chiropractic are provided ample ammunition by these cowboys, but we are not all like them and I do not accept that they are the voice of our profession. I deal with these issues and address them with my doctors, patients, community, association, registration board etc and here.

    • Edzard says:

      I do realise that you are not all like “them”, but you need to realise that they are so vociferous that from the outside they must be perceived as the voice of your profession. and as you do not manage to shut them up, you are seen to tolerate them.

  • Thinking_Chiro says:

    In reply to Edzard: I agree that they are bloody loud and difficult to shut up. A classic example of this is Jennifer Barham-Floreani, an Australian chiro who is talking at CalJam alongside Wakefield, Mercola, Dr Tenpenny, De Moss et al in March. She just did a podcast with De Moss where she says “the loudest voice wins”. I havn’t listened to Wakefields yet, it is 40 mins. I will need a couple of strong cappuccino’s first!
    http://californiajam.org/podcast/
    Australian chiro’s are now banned from promoting antivaccination, yet in the podcast she does just that. Diciplinary action and deregistration by AHPRA would not shut her up but it would stop her being associated with my profession.
    I enjoy corresponding with you, pity we are on opposite sides of the world, talking to you in real time would be great.

  • Preston Long says:

    As I read through the posts I find most interesting thing of all the participants. There are ones that show who they are and those that don’t. It appears to be very one sided approach. Do supporters of chiropractic lack the courage and personal conviction to share their identities? Is it easier to attack when you have no skin in the game.

      • Blue Wode says:

        @ SkepdicProf

        Isn’t that the pot calling the kettle black?

        Re Preston Long’s questions “Do supporters of chiropractic lack the courage and personal conviction to share their identities? Is it easier to attack when you have no skin in the game”. There’s very good reason why some people prefer to blog and/or comment under a psuedonym:
        http://scienceblogs.com/insolence/2011/08/22/the-consequences-of-blogging-under-ones/

        BTW, SkepdicProf, it’s “hear, hear”. Its use is a short, repeated form of “hear ye and hear him”.

        • SkepdicProf says:

          Well, thank you, Woe. Your are right. I was thinking it was a British thing, so “here, here” sounded nice and sounded like it would work. But “hear, hear” does make more sense. Thanks for correcting me. It is a nice diversion from the usual preoccupation with doing as much damage to the chiropractic profession as possible that is usually found here.

          • Alan Henness says:

            SkepdicProf said:

            It is a nice diversion from the usual preoccupation with doing as much damage to the chiropractic profession as possible that is usually found here.

            I don’t think the chiropractic profession needs any help with that.

  • Thinking_Chiro says:

    I don’t post my true name as the subluxation true believers are quick with the personal attack. I am sure Blue Wode and Prof Ernst have been subject to plenty of personal attach and vitriol over the years, we just don’t see it as it just doesn’t make it past moderation onto the forum.

  • Blue Wode says:

    Jorma Kärtsy wrote: “Could other people (excluding you Prof Ernst) respect opinion, that 100% of Chiros are not wacko, subluxation-based, high-volume practitioners who promote themselves as a miracle healers?”

    According to the data, somewhere between 1-30% of chiropractors are ethical and evidence-based – at least that’s what the chiropractors who participate in the various surveys claim. However, as those chiropractors are likely to be from the more scientifically conscientious element, the true number could well be nearer 1%.

    As for European chiropractors, let’s not forget that the President of the European Chiropractors Union, Øystein Ogre (DC) – who is heavily involved in developing chiropractic education throughout Europe – claims that a successful chiropractor “is being that person, the spinal expert in your area, that parents will consult when they are worried about their sick child”. See from 2:30 in here:
    https://www.facebook.com/permalink.php?story_fbid=685575191468899&id=391254640900957

    That says to me that ‘Dr’ Ogre sees, and is lobbying for, chiropractors to be general primary healthcare practitioners in Europe. Interestingly, he’s been in Finland this past week to meet up with the Finnish health minister:
    https://www.facebook.com/pages/ECU/391254640900957#!/photo.php?fbid=771905512835866&set=a.415834015109686.116947.391254640900957&type=1

    • Jorma Kärtsy says:

      @Blue Wode

      Thank you for 1%. I’m very pleased. I’m fascinated how your webpage material covers comprehensive study about ethical prevalence of profession as well. I will meditate on that my friend.

      Do you have opinion about physios with same matter? In this country (Finland) probably 1% is able to read and understand research, hopefully, due to language barrier (-;

      However, I’m still full of xmas spirit and happy to send book gift for you. Promise hand on bible: I’m not a Chiro agent or give your personal details anywhere. Just like to show gesture of good-will from ‘dark-side’. Even with risk that our profession ethical % might drop because book can always be made of paper produced from rainforest trees.

      However, thank you for your comments.

      • Blue Wode says:

        Jorma Kärtsy wrote: “Do you have opinion about physios with same matter? In this country (Finland) probably 1% is able to read and understand research, hopefully, due to language barrier”

        It would appear that physios are far more judicious in their use of spinal manipulation. FYI, here in the UK only a few work in private practice with most working for the NHS. If you see one on the NHS, they will take a thorough history and then will usually prescribe exercises and hot/cold packs and lifestyle modifications, and try to have you independent of them as soon as possible. In other words, they don’t have to rely on a dodgy business model to make ends meet because they’re already salaried and on NHS premises.

        As for your claim that most physios in Finland aren’t able to adequately read and understand research, here’s a stat about chiropractors which is interesting: In a recent *international* web survey of chiropractic students about evidence-based practice (a pilot study in which of an estimated 7,142 student recipients of invitation letters, 674 participated in the survey), most respondents reported having access to medical/healthcare literature through the internet, but only 11% read literature every week and 21% did not read literature at all:
        http://7thspace.com/headlines/374600/international_web_survey_of_chiropractic_students_about_evidence_based_practice_a_pilot_study.html
        Of the 6,468 students who didn’t reply, it would be interesting to know how many couldn’t be bothered to, and how many were hard at work studying evidence-based practice.

        Jorma Kärtsy wrote: “However, I’m still full of xmas spirit and happy to send book gift for you.”

        Thank you, but I already have all the chiropractic books I need.

        • Jorma Kärtsy says:

          I don’t how good is say Physio are good and Chiros bad. It’s little bit like saying Finnish are good and you there in your Island are bad. It seems so for me after five years there, but there is always good and bad in any cohort. And depent on just personal opinion.

          I would not like to comment on any research according abstract, but here we go. Lower than 10% response rate not very good. I would understand result worrying sound result: 11% read literature every week and 21% did not read literature through internet at all so that it’s perfectly normal during 1st and 2nd years to concentrate on basics like anatomy and physiology and basic texts. I didn’t read read research papers YET via internet during first years. Too much to do with basics. Makes sense with also numbers. Final year students start read papers every week (-about 10%) and first year students don’t do it YET. Hope make sense.

          And for your late ECU president video and scandalous describtion of successful chiropractor “is being that person, the spinal expert in your area, that parents will consult when they are worried about their sick child”. I think he is speaking about being succesful for recent graduates on that context that local community know you, trust you and you are able to make impact on health of these people. Children might be seen like sign of trust not like Chiro’s especially like to treat children or take over GPs job.

          Other thing which came into my mind were how you have time to chat via internet and write your blogs. When do these people work or is this your work? Maybe so and who is paying. Is it pharmacy industry who benefit most on that kind scandalous blogs?

          Like you wrote: Professor Ernst wrote: “…the good intentions that once motivated them have long given way to the need to make money.”

          I think that completely nails the problem.

          Merry xmas. Hope you are not on ‘dark-side’.

          • Blue Wode says:

            Jorma Kärtsy wrote: “I don’t how good is say Physio are good and Chiros bad. It’s little bit like saying Finnish are good and you there in your Island are bad. It seems so for me after five years there, but there is always good and bad in any cohort. And depent on just personal opinion.”

            But you asked me for my *opinion*. Remember you said “Do you have opinion about physios”. I then gave you my opinion based on my general observations of the available data.

            Jorma Kärtsy wrote: “Final year students start read papers every week (-about 10%) and first year students don’t do it YET. Hope make sense.”

            Remember, less than 10% of 7,142 chiropractic students responded to the survey despite academic officials and registrars at 26 participating chiropractic educational institutions forwarding them an initial invitation email and *two reminders*. I just hope that the huge number of students who didn’t respond were engrossed in their studies.

            Jorma Kärtsy wrote: “And for your late ECU president video and scandalous describtion of successful chiropractor “is being that person, the spinal expert in your area, that parents will consult when they are worried about their sick child”. I think he is speaking about being succesful for recent graduates on that context that local community know you, trust you and you are able to make impact on health of these people. Children might be seen like sign of trust not like Chiro’s especially like to treat children or take over GPs job.”

            And I think there’s a hidden agenda. Chiropractors continue to treat children in the absence of good evidence and reliable adverse event reporting systems. ‘Catching them young’ – usually by misleading vulnerable parents – is a practice-building ploy designed to turn youngsters into lifetime ‘wellness’ patients. That’s what’s really scandalous. Chiropractic survives by perpetuating a cult mindset amongst its unwitting adherents.

            Jorma Kärtsy wrote: “Other thing which came into my mind were how you have time to chat via internet and write your blogs. When do these people work or is this your work? Maybe so and who is paying. Is it pharmacy industry who benefit most on that kind scandalous blogs?”

            I hope you realise that your thinly veiled accusation has just seen your credibility take a nosedive.

  • Jorma Kärtsy says:

    Maybe you should visit in European Chiro Union annual convention in Dublin on 29th-31st May. You could then fitness hidden agendas, children abuse, dogmas, cults, ploys etc. Tape it and we will publish it together in some way or other.

  • Jorma Kärtsy says:

    Could be a big debate what we hear on tape. Might take some decades to reach mutual conclusion.

    Please, read your books and papers if have any – skeptic blogs are not most convincing on evidence based debate.

    I get back to work tomorrow and you see I’m not sponsored by pharmacy industry so can’t keep writing this often. Maybe hear you one day. Hope subluxation don’t get you meanwhile!

    • Blue Wode says:

      Jorma Kärtsy wrote: “Could be a big debate what we hear on tape. Might take some decades to reach mutual conclusion.”

      I would suggest that you think very hard about what that says about chiropractic.

      Jorma Kärtsy wrote: “Please, read your books and papers if have any – skeptic blogs are not most convincing on evidence based debate.”

      Are you being serious? Skeptic blogs like this are a great place for evidence based debate.

      Jorma Kärtsy wrote: “I get back to work tomorrow and you see I’m not sponsored by pharmacy industry so can’t keep writing this often. Maybe hear you one day. Hope subluxation don’t get you meanwhile!”

      Don’t worry, the chiropractic subluxation won’t get me, or you. It doesn’t exist.

  • Preston Long says:

    As I read through the many posts it is very evident that numerous individuals opining their truths have never read the book. I find that academically lazy and intellectually dishonest. Any topic worthy of disputation should be done so without preconceived ideologies. There are numerous inaccuracies too. I know this is the internet but …………….

    • SkepdicProf says:

      So Preston, why didn’t you show up and enlighten us at the Connecticut hearings with your so-called “evidence”? You were all registered and we were waiting to hear you help us understand the error of our ways. Then — no show. Maybe things would have been different. The Assistant Attorney General of the State of Connecticut wouldn’t allow your written testimony to be read without you there to defend it. You let your team down. The wheels came off their jitney and they were sent packing empty handed back to Canada and Florida.

      Where were you? Sorry.

  • Olle Kjellin says:

    I read the whole book, carefully and with ever increasing feelings of horror. And it amazes me that chiropractic can still be allowed at all, and that even in a country like the USA where the strict-eyed FDA is supposed to safeguard the people against health fraud and where litigations seem to be an industry! How come?

    • SkepdicProf says:

      Easy to understand, Ollie.

      If they allow most of medical care that lacks reliable evidence for 85% of it’s procedures (with the notable exceptions of things like emergency medicine, organ transplants, microsurgery which are modern miracles) and kills 800,000 – 1,000,000 from preventable errors, making it the number one killer of Americans each year, then what’s the big deal about non-drug approaches like chiropractic health care that kills nobody in a given year? Millions are helped and are healthier and happier today. And they refer millions. And their medical doctors refer as well. Happens all the time. Simple.

          • Björn Geir says:

            @SkepdicProf

            You would have to hold the page upside down, be seriously biased or simply ignorant if you interpret this analysis (the clinical evidence thing in BMJ) as saying that 85% of medical procedures lack reliable evidence. Try putting on your glasses and read it again, specially the part about the “unknown effectiveness” category.

          • Alan Henness says:

            Yes, SkepdicProf, I just knew that was where you’d dredged the 85% from, but wanted you to confirm it. Actually, it was a toss up between that and the 1979 U.S. Congressional Office of Technology Assessment figure that’s also hilariously misinterpreted.

            Anyway, what Björn said. It’s amazing the number of times that page is not understood by proponents of quackery.

          • Vicky says:

            You’re also forgetting that they assess not only “conventional” but also “alternative” treatments – this pie chart practitioners of “alternative” treatments love to cite actually contains their treatments, too, and they’re not in the 11 %, or the 24 % slice! (btw: last time I checked 100 % – 35 % was 65 %)
            Let’s take this review for acute lower back pain as an example:
            Among others, NSAIDs (effective but associated with gastrointestinal adverse effects ->trade-off between benefits and harms, I guess); advice to stay active (likely to be beneficial); spinal manipulation (unknown); acupuncture (insufficient evidence to judge effectiveness ->unknown); bed rest (doesn’t improve symptoms more effectively than other treatments but produces quite a few adverse effects ->likely to be ineffective or harmful).
            Also (and both the text and the chart point that out) the extent to which treatments are used in practice are not assessed in this categorisation – effective treatments that are used frequently are given the same “weight” that seldomly used treatments are given, so it’s not 85 % (nor 65 %) of the procedures, but 65 % of the treatment options that aren’t supported, and some of those 65 % of treatment options are “alternative” treatments!

          • Alan Henness says:

            That’s a good point Vicky: his numbers don’t add up.

            So, SkepdicProf, which is it? Did you mess up the subtraction or did you get the 85% from the 1979 U.S. Congressional Office of Technology Assessment? Or did you just pluck it out of thin air?

    • SkepdicProf says:

      Yes, I can see how you wouldn’t like it. I don’t put much weight in the BMJ either. Plus, it can be confusing to lay people. Still preventable errors from modern medicine is the number one killer of Americans at approx. 786,000 each year vs. zero for non-drug approaches. (“where the strict-eyed FDA is supposed to safeguard the people”) No disputing that. I am sure it is the same ratio in your respective countries.

      Here is another of many references on the web, this one written in a more readable style, especially for the average person and for those where English may not be their native language:

      http://www.businessweek.com/stories/2006-05-28/medical-guesswork

      BTW (by the way) If you have a reliable reference that says that all/most of medical interventions are backed by double-blind RCTs, please feel free to point us to it. Thanks

    • Björn Geir says:

      @Jorma.
      Maybe you need help with understanding English? Are you using Google to translate the article? For some languages it is notoriously unreliable.
      The whole text of the article is important in order to understand its message. Even if you only look at the graph it is difficult to see how one can misinterpret it so incorrectly.
      Try to find someone who can help you translate this BMJ-article properly to Finnish. Let us then know what you think when you have read it properly.

    • Björn Geir says:

      When I wrote this rather trivial correction I was guessing correctly that it would elicit a telling commentary. I was even right about the childish nature of the response.

      Happy holidays.

  • SkepdicProf says:

    No problem guys. English is very tricky. It has many exceptions to the rules. Easy to misinterpret things like articles and graphs.

    So, maybe you can provide the answer. What percentage of medical interventions are backed up by double-blind RCTs?

    • Edzard says:

      several studies show that ~80% of what is being regularly used in clinical practice is backed by sound evidence [http://www.ncbi.nlm.nih.gov/pubmed/15160706]

      • SkepdicProf says:

        Good thing or the 786,000 Americans killed each year by preventable medical errors would likely be much higher! Would you know how many thousands succumb to medical blunders each year in the U.K.?

        • Alan Henness says:

          Woah! We’re still trying to get you to properly understand why your 85% figure is wrong – do you now realise your errors?

          But you also still haven’t answered the question: what proportion of homeopathic treatment has reliable evidence behind it?

          • SkepdicProf says:

            Yes, thank you for helping me see the error of my ways. Happy to hear that the BMJ has declared it all good. Didn’t know it is all based on evidence. As for the homeopathy question — Don’t know.

            So, maybe you can answer my other question: How many in the U.K. are killed each year by preventable medical errors? In the U.S. it is 786,000 making the practice of medicine the number one killer of Americans yearly. Don’t know if they were killed by evidence-based vs. non-evidence-based medical interventions or just plain goof-ups using all the good evidence. Any idea? No one seems to want to address this. I would imagine the proportion to the population is similar to the U.S.

          • Alan Henness says:

            SkepdicProf said:

            Yes, thank you for helping me see the error of my ways.

            No need to thank me, but glad we’ve finally got that sorted.

            Except we haven’t. You never said how you managed to get the 85% figure from that page or whether you got it from somewhere else.

            It’s probably best to get this little problem fully resolved before moving on to the others.

          • Mojo says:

            Has he said where he got his figure of “786,000 Americans killed each year by preventable medical errors” from?

            By the way, it’s good to see that it’s down from the “800,000 – 1,000,000″ he claimed on 18th December. At the current rate of reduction it should be down to zero around the end of January.

  • Jorma Kärtsy says:

    @Edzard

    Several studies show that ~80%? Please, could you reference several and not only provide your own published opinion decade ago.

    What actually that backed by sound evidence idiom means?

    Which percentage of medical clinical practise (sound) evidence is backed up by double-blind RCTs?

      • SkepdicProf says:

        Nothing personal, EE, but I’m sceptical (god that looks so funny) that a member of the medical trades could analyze in an unbiased way how wonderful a job they are doing and how great everything is in their own backyard. It would not be a great stretch of the imagination to think that studies that were unfavorable to the outcome of the analysis were conveniently disqualified from the results. You know, like what the pharmaceutical industry is famous for.

        So, EE, as an MD telling us that all is OK in your industry seems to me to be bit self-serving. You know, like the wolf guarding the hen house.

  • Edzard says: ‘Chiropractors are in many ways not that different from other health care professionals. Most of them, like Preston Long, go into their profession with all the very best intentions.’

    Perhaps so, but please can we have the evidence that is the case? And does ‘most’ mean 51% or what?
    How can any one tell whether or not a chiropractor entered training wanting to be a quack and to defraud the public?
    Has any work been done on the motivation of chiropractors?
    Why have they not trained as osteopaths, physiotherapists, or doctors?

    Any answers (with evidence)?

    • SkepdicProf says:

      Well, again, Dick, I think it goes back to the death rate. Why become a member of the medical industry, with the highest injury and death rate and also the most monetary fraud? Who would want that. Of course, I take my hat off to those who are in emergency medicine, organ transplanting, microsurgery, etc. They are the exceptions and truly the ones who perform modern miracles.

      • SkepdicProf says:

        Dick, I think your question reveals more about your political agenda than anything else.

        I guess following your line of reasoning, one can also look at things from another perspective. Being the industry responsible for the greatest number of deaths of Americans, how can any one tell whether or not an MD entered training wanting to kill folks legally and to defraud the public funds?

        Has any work been done on the motivation of the medical trade?

  • Tpeel says:

    Mr. Ernst reminds me of Jekyll and Hyde. On the one hand he is well-published and so has the legitimate facade of a distinguished researcher and academic figure. Then he flips into his “I hate everything” mode and spews his hate-filled bile all over whatever he can’t stand. He throws tantrums like a 5 year-old. To me, this is just madness!

    It looks like he is acting out on those who he feels ‘done him wrong’. I think that this bipolar personality loses all credibility and is completely contrary to scholarly behavior. No wonder he was cut loose by the Royal Academy. After reading his rantings, one wants to take a shower! Just thought I would share that with you.

    Won’t be dropping by anymore.

  • Mike B says:

    Dr. Ernst,
    I am a chiropractic student at New York Chiropractic College. After reading your article I would like to give a brief description about what I learn in chiropractic school and I hope it may shed some light on what current chiropractors do. It is true that some chiropractors still strictly adhere to the teachings of D.D. Palmer but they are a dwindling number, as schools teach courses based on medical literature. We are taught strictly evidence based material and have many hours in the recognition and diagnosis of pathology. As you know, our main tool is the chiropractic adjustment. We know that hypomobilities in joints lead to degeneration of these joints and the surrounding tissues. This has long been known in the medical community. I will leave some journal articles at the end of my response that you may be interested in. By introducing movement back into these joints, chiropractors can effectively bring the joint back to its normal function. This understanding is at the crux of all that we do. Chiropractors are in health care for the same reason as any other medical professional. We want to help people get healthy. Our methods are different then medical doctors but what we do is not wrong or harmful.
    Videman, T., Connective tissue and immobilization. Key factors in musculoskeletal degeneration? Clin Orthop Relat Res. 1987 Aug;(221):26-32
    Tomanek RJ, Lund DD. Degenearation of different types of skeletal muscle fibers. II. Immobilization. J Anat. 1974 Dec;118(pt 3):531-41

    • Edzard says:

      “By introducing movement back into these joints, chiropractors can effectively bring the joint back to its normal function.”
      Can you provide some evidence proving that chiropractic adjustments normalise function of joints and other structures which, in turn, lead to significant improvements of health?

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