MD, PhD, FMedSci, FSB, FRCP, FRCPEd

Chiropractors are notorious for their overuse and misuse of x-rays for non-specific back and neck pain as well as other conditions. A recent study from the US has shown that the rate of spine radiographs within 5 days of an initial patient visit to a chiropractor is 204 per 1000 new patient examinations. Considering that X-rays are not usually necessary for patients with non-specific back pain, such rates are far too high. Therefore, a team of US/Canadian researchers conducted a study to evaluate the impact of web-based dissemination of a diagnostic imaging guideline discouraging the use of spine x-rays among chiropractors.

They disseminated an imaging guideline online in April 2008. Administrative claims data were extracted between January 2006 and December 2010. Segmented regression analysis with autoregressive error was used to estimate the impact of guideline recommendations on the rate of spine x-rays. Sensitivity analysis considered the effect of two additional quality improvement strategies, a policy change and an education intervention.

The results show a significant change in the level of spine x-ray ordering weeks after introduction of the guidelines (-0.01; 95% confidence interval=-0.01, -0.002; p=.01), but no change in trend of the regression lines. The monthly mean rate of spine x-rays within 5 days of initial visit per new patient exams decreased by 10 per 1000, a 5.26% relative decrease after guideline dissemination.

The authors concluded that Web-based guideline dissemination was associated with an immediate reduction in spine x-ray claims. Sensitivity analysis suggests our results are robust. This passive strategy is likely cost-effective in a chiropractic network setting.

These findings are encouraging because they suggest that at least some chiropractors are capable of learning, even if this means altering their practice against their financial interests – after all, there is money to be earned with x-ray investigations! At the same time, the results indicate that, despite sound evidence, chiropractors still order far too many x-rays for non-specific back pain. I am not aware of any recent UK data on chiropractic x-ray usage, but judging from old evidence, it might be very high.

It would be interesting to know why chiropractors order spinal x-rays for patients with non-specific back pain or other conditions. A likely answer is that they need them for the diagnosis of spinal ‘subluxations’. To cite just one of thousands of chiropractors with the same opinion: spinography is a necessary part of the chiropractic examination. Detailed analysis of spinographic film and motion x-ray studies helps facilitate a specific and timely correction of vertebral subluxation by the Doctor of Chiropractic. The correction of a vertebral subluxation is called: Adjustment.

This, of course, merely highlights the futility of this practice: despite the fact that the concept is still deeply engrained in the teaching of chiropractic, ‘subluxation’ is a mystical entity or dogma which “is similar to the Santa Claus construct”, characterised by a “significant lack of evidence to fulfil the basic criteria of causation”. But even if chiropractic ‘subluxation’ were real, it would not be diagnosable with spinal x-ray investigations.

The inescapable conclusion from all this, I believe, is that the sooner chiropractors abandon their over-use of x-ray studies, the better for us all.

131 Responses to Chiropractors’ use of X-rays

  • Professor Ernst wrote: “I am not aware of any recent UK data on chiropractic x-ray usage, but judging from old evidence, it might be very high.”

    Well, the regulator certainly doesn’t seem to know much about what’s going on in that regard:

    Quote:

    From: Paul Ghuman
    General Chiropractic Council

    16 December 2011

    Dear Trisha

    Many thanks for your request for information under the Freedom of Information Act (FOIA).

    My apologies for not responding earlier. Under the Act, the authority is not required to produce information in order to satisfy a request.

    I can confirm that the GCC do not hold information in relation to:

    a. The number of registered chiropractors with radiological equipment
    b. The number of radiological investigations carried out by registered chiropractors per annum. (Estimates or approximations acceptable if accurate information is unavailable)
    c. The number of HPC registered radiographers working within GCC registered chiropractic establishments

    I am sorry that we cannot satisfy this request.

    https://www.whatdotheyknow.com/request/use_of_radiological_equipment_2

  • As they have no conventional radiological training, ANY use of ionising radiation is over use.

  • Since chiropractic Xrays are looking for mythical entities, their use cannot be used to inform treatment – a central requirement of radiological protection regulation. I fail to understand why chiropractic X-raying is not seen as illegal. Essentially, every X-ray is an assault.

    http://www.quackometer.net/blog/2009/01/is-chiropractic-x-raying-illegal.html

  • See this

    http://www.ncbi.nlm.nih.gov/pubmed/19407674 esp Table 2 re x-rays

    Thoughts?

  • In reply to Cherry Black:
    Radiology and radiography training is a large part of the chiropractic curriculum in Australia. Licences to own and operate xray equipment are regulated under the Enviromental Protection Agency, separate to the chiropractic boards and they are very tough. It meets conventional radiography training and is taught by radiographers. The radiology training is also taught to a very high standard with the standard text used being: Yochum and Rowe “Essentials of Skeletal Radiology”. Dr Lindsay Rowe co-wrote the book while still a chiropractor which is highly regarded by medical radiologists.
    https://www.nwhealth.edu/conted/distlear/faculty/rowe.html
    Interesting story, while studying medicine he was not given an exemption from radiology and when the radiologist came in to give the lectures and saw Lindsay in the audience he was shocked. Lindsay ended up giving some of the lectures, but the uni still made him sit the exam at the end.
    In reply to Andy Lewis:
    I do not blanket screen all new patients with xray. There must be a valid clinical reason like Chronic spinal pain (with or without referred or radicular symptoms), trauma, suspected pathology, unresponsive to care etc. This is same as the policy taught and enforced at Macquarie University. Since I specialise in chronic spinal and musculoskeletal conditions I often get patients coming in with a large pile of xrays, CT’s and MRI’s going back years (I don’t comment on the pile, I just look at the lot). There are five medical radiologists in close proximity to my practice so refer out for xrays. The attached radiologists report is also invaluable. On average I also see 2 spinal metastasis per year( the spine is the third most common site for metastatic cancer). Xrays are a valuable diagnostic tool and most definitely NOT assault!

    • I’m not sure if you mentioned this or not but the Yochum and Rowe Book is used in Medical Schools. Yochum is one of the top Radiologists.Period.

  • Well compared to the overuse of x-rays/CT scans in hospitals for every little ding, bruise, tummy trouble and non-specific issue. Not to mention the dentists x-raying children’s heads, eyes, brains, pituitarys, thyroids, etc. every six months, the x-rays that chiropractic doctors take are miniscule. Two or four AP and Lats. When people are referred from the hospital, it used to be that they couldn’t carry their films, there were so many and so heavy. Of course, there is good revenue for the troubled hospitals. Today, it is now on a CD, so the patient doesn’t notice the over-exposure anymore, but the cost has gone up.

    But here non-issues become issues, of course.

    • so, you think that this is a justification for chiro’s over-use of x-rays? interesting! where did you pick up your elementary logic?

      • You’re basing this comment on that silly ( and I do mean very silly) study. I see overuse in both camps but now especially by medics.

      • Edzard, your comments wreak of your own bias in a similar fashion to your research papers which predominantly cite your own papers continuing the cycle of opinionated bias. From the paper your cite above, there would only be a 5% reduction in x-ray requests which is minimal. Yet you follow this with ridiculous unjustified assumptions. If the same study was applied to the Medical profession, I’m certain the overall reduction in unjustified imaging would far outweigh what the Chiropractors do.

        The guidelines for conventional x-ray referral by Chiropractors are strict and complement that of the Medical justification for imaging. You will not see a significant difference between the two, so whatever you apply to Chiropractors, you should apply across the board and remove your extraordinary bias which stinks.

        • Research Doc wrote: “Edzard, your comments wreak of your own bias in a similar fashion to your research papers which predominantly cite your own papers continuing the cycle of opinionated bias.”

          Professor Ernst addressed that point eight years ago:

          Quote
          “To exclude one’s own work in systematic reviews would be woefully unscientific.”

          Ref: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1472718/

        • ResearchDoc said:

          Edzard, your comments wreak of your own bias in a similar fashion to your research papers which predominantly cite your own papers continuing the cycle of opinionated bias.

          Ahhhh…there’s nothing like a personal attack to help make your point, is there?

    • To compare spinal x-Ray to skull or knee or chest x-Ray is invalid. Spinal X-rays are not very useful and dosage of radiation is sky high in comparison. It’s about 45x the dose of a chest x-Ray and 30x dose of a skull xray. Plus it’s use is not high for detecting mets, will miss 50%. MRI is a far more useful tool (in the right hands) and only for imaging patient with either specific low back pain (I.e. Nerve root pain, infection, spondylolythesis) if pain does not resolve after 6/52 or if they present with a red flag. The vast majority 90-95% of patients have NOnspecific LBP and imaging should be avoided as it over medicalises and promotes disability. So a figure of 20% on first contact being imaged using radiography is not acceptable and in fact likely negligent.

  • SkepdicProf – it’s worrying that you believe that an X-ray is an X-ray. You compare dental X-rays with AP and Lat lumbar spine X-rays as though they were somehow equivalent.
    The difference in dose is enormous.
    http://www.ncbi.nlm.nih.gov/m/pubmed/18679095/

    Typical dental X-ray exam = roughly 0.005 mSv
    Typical ‘two or four APs and Lats’ = somewhere in the range of 2-7 mSv.

    • Stephen Ward,
      Chiropractic doctors almost never x-ray children. An exception might be trauma or scoliosis according to protocols. Often they already come in from referral from the hospital or orthopedic or pediatrician, already carrying their imaging studies. Then, no more for years.

      Millions of children are x-rayed daily by the dental industry on a daily basis. Each child has new ones taken every six months looking for the tiniest speck of decay. The often use Panorex full mouth x-rays. Developing neurological tissue are particularly sensitive to any amount of x-ray. Then comes the full menu of chemical entrees they use in their trade like anesthesia, sealants, etc.

      It is worrisome that you are not worried about this.

    • You didn’t list a CT scan, nor the amount of radiation being in an airplane for comparison.

  • I think the issue is the clinical reasons for taking the Xrays by anyone. If they changes the clinical picture, rule out pathology or help with the treatment and benefit the patient, then fine. If they are a blanket screening procedure regardless of the patients complaint and history or don’t change the clinical picture then don’t do them. There are many recent papers discussing this issue.

  • There has been a significant reduction in the use of chiropractic X-ray in the UK in recent years that is in line with a reduction seen in general medical practice. This, I believe is due to several reasons including better availability and reduced cost of MRI and the introduction of evidence-based guidelines highlighting the limitations of plain X-ray for conditions such as low back pain. In addition in the UK colleges teaching chiropractors radiology and radiography the concept of subluxations has been abandoned some years ago. I accept that this is not necessarily the case for chiropractors graduating from North America although this is also changing.

    The chiropractors that I work with, in a recent clinical audit, showed that X-rays were ordered or taken in less than 5% of cases. All X-rays taken or ordered have to be clinically justified and like all health care professionals ordering X-rays, must comply with the Ionising Radiation Medical Exposure Regulations (IRMER). Where taken or ordered they were usually to rule out conditions such as spinal compression fracture following trauma, spondylolisthesis, metastatic disease and infection. Additionally chiropractors working in NHS settings do not directly utilise X-ray at all.

    It is also worth pointing out that all X-ray facilities in the UK are registered with the HSE and must comply with IRMER guidelines and this includes training of chiropractors in both radiography and radiology. On the issue of the GCC holding information on the use of chiropractic X-ray I wonder if the GMC could provide similar information for the use of X-ray in private medical establishments?

  • This is a post graduate radiology course and not a radiography qualification. This allows McTimonney chiropractors to read and interpret imaging but not to order or take X-rays. McTimoney chiropractors do not receive radiology qualifications in their undergraduate courses either. Therefore as I said in the UK colleges teaching chiropractors radiology and radiography the concept of subluxations has been abandoned some years ago.

  • The courses that you have highlighted have been arranged by students themselves and are not delivered as part of their formal chiropractic education in the UK. Having studied for 4-5 years it is quite natural and one could say appropriate for them to be curious about other models of chiropractic that basically reflect the older “philosophical” approach. I suspect that this may influence some who may choose to practice in this way but the impression that all chiropractors work in this way is wrong and this is not what is supported by major teaching organisations or by many UK chiropractors.

    The suggestion that colleges are pretending to have dropped the subluxation approach if feel indicates paranoia on your behalf. Similarly the synonyms you suggest are meaningless although I note that our physiotherapists talk about joint dysfunction or tell patients they have hypomobility or hypermobility so I guess they must be practicing “subluxation theory” according to your logic.

    I don’t suppose you will accept my comments I just wanted to put the record straight and show how many chiropractors use X-ray in the UK rather than allowing this rather skewed view to prevail. However, I also do not wish to enter into a tedious debate with you that you twist and change to help you promote your agenda. Regards.

    • Andy wrote: “The courses that you have highlighted have been arranged by students themselves and are not delivered as part of their formal chiropractic education in the UK. Having studied for 4-5 years it is quite natural and one could say appropriate for them to be curious about other models of chiropractic that basically reflect the older “philosophical” approach. I suspect that this may influence some who may choose to practice in this way but the impression that all chiropractors work in this way is wrong and this is not what is supported by major teaching organisations or by many UK chiropractors.”

      Nevertheless, according to the most recent survey, most chiropractors in the UK are philosophy-based. See the right-hand column on p.149 here:
      http://wansbeckchiropractors.co.uk/pdf/Nov02.pdf

      Do you have any better data?

      Andy wrote: “The suggestion that colleges are pretending to have dropped the subluxation approach if [sic] feel indicates paranoia on your behalf…I also do not wish to enter into a tedious debate with you that you twist and change to help you promote your agenda.

      See http://edzardernst.com/2012/12/ad-hominem-attacks-are-signs-of-victories-of-reason-over-unreason/

  • I have reviewed thousands of x-rays taken by chiropractors and the only reliable observation is that most are undiagnostic or of poor quality. Many films were under exposed and useless. This did not stop the chiropractors from billing for the films or diagnosing subluxations on them. Most had pencil markings all over them from the chiropractor trying to mark subluxations. I have seen x-rays taken on infants to see the subluxatioons caused by the birthing process. Their equipment is usually old and outdated. I have seen recycled units from veterinarian offices leaking oil in the exam room. I have seen x-rays repeated on patients over many years with no improvement in the quality of the x-ray or appearance of improvement in the subluxation. Chiropractors in my experience take x-rays to market subluxations to their patients and because they are excellent financial resource.

    • I am certainly skeptical about many aspects of Preston Long’s statements. Can you substantiate any of your claims?

      “I have reviewed thousands of x-rays taken by chiropractors and the only reliable observation is that most are undiagnostic or of poor quality.”

      I have seen many patients come in with bad films from the local hospital or orthopedists. So My conclusion is that they are all bad from the medical industry? Why have you “reviewed thousands of x-rays taken by chiropractors”? Were you a radiology reviewer of some sort? This takes a lot of time. Even if you were, only radiologists review thousand of films.

      “Many films were under exposed and useless.”

      How many is many? Based on what? Are you a radiologist?

      “This did not stop the chiropractors from billing for the films or diagnosing subluxations on them.”

      How do you know that they billed for?

      “I have seen x-rays taken on infants to see the subluxatioons caused by the birthing process.”

      Chiropractic doctors don’t x-ray infants.

      “Their equipment is usually old and outdated. I have seen recycled units from veterinarian offices leaking oil in the exam room. ”
      How is it that you know about their equipment? Have you inspected thousands of offices? The various states do that and then certify radiology installations. Either they pass or fail.

      How would you know that it is a recycled unit from a vet’s office anyway? Did that occur once? Do you really expect us to believe that if a transformer was leaking oil, which they don’t, that a doctor would just leave it as is and continue using it and not fix or replace it?

      “I have seen x-rays repeated on patients over many years with no improvement in the quality of the x-ray or appearance of improvement in the subluxation.”

      Now that’s a good one. How is it that you can monitor thousands of other doctor’s patients and compare x-rays over “many” years?

      “Chiropractors in my experience take x-rays to market subluxations to their patients and because they are excellent financial resource.”

      Even if your “experience” tells you this, how do you gauge this? Personal opinion is interesting but not compelling, especially with your history of negativism towards your own chosen profession. I guess the same thing can be said about dental x-rays, orthopedist’s x-rays, hospital x-rays. If not marketing, then it is a well-known fact that they want to protect themselves in the event of a lawsuit. Have you inspected other doctor’s finances, too?

      I have brought up before that I am skeptical of Preston’s views. He made many extravagant claims in written form for the Connecticut hearings, then failed to show up to be cross-examined to back up and explain his claims. Not a good sign. His submitted accusations were then barred from use as evidence, hurting his cause irreparably . Anyone else who makes claims here is taken to task for not showing the references.

      Having him provide evidence of his claims, I am confident, would be a Long shot.

      I suppose I’ll hear from Blue Wode iin the unlikely event that EE let’s this post through.

      • aren’t you confusing SCEPTICAL with DEFENSIVE?

        • SkepdicProf wrote: “I suppose I’ll hear from Blue Wode…”

          Yes, here I am. I doubt you’ll read Preston’s book, Chiropractic Abuse – An Insider’s Lament, so I’ve lifted the following bio info from it. It goes a long way to answering your questions above.

          Quote
          “Preston H Long, D.C., Ph.D., is a licensed chiropractor who resides near Phoenix, Arizona. He is also an associate professor at Bryan University, where he teaches in the master’s program in applied health informatics. He is certified by the State of Arizona in physical medicine modalities and therapeutic procedures and is certified by the Association of Fraud Examiners, the National Association of Disability Evaluating Professionals, and the National Board of Forensic Examiners.
          Dr Long’s professional career has spanned nearly 30 years. In addition to treating patients, Dr. Long has testified at 200 trials; performed more than 10,000 chiropractic record reviews and 2,000 independent medical examinations, and has served as a consultant to the Federal Bureau of Investigation, the U.S. Department of Justice and the city attorney offices of Phoenix, Tempe, and Chandler, Arizona. In 2000, he was listed in Marquis Who’s Who in Medicine and Healthcare.
          Dr. Long received his bachelor of science degree from Cardinal Stritch University in 1980, his chiropractic degree from Cleveland Chiropractic College in 1984, and his doctorate degree in health services from Walden University in 2002. From 1985 through 1987, he maintained allied courtesy staff privileges at Scottsdale Community Hospital and served as a medical staffing reviewer. In 2005, the Arizona Supreme Court appointed him to a three-year term on the Foster Care Review Board. In 2009 he was awarded the Chiropractor of the Year Award by Victims of Chiropractic Abuse (VOCA) for “outstanding commitment to protect the rights of health of chiropractic patients”.”

          SkepdicProf wrote: “I am skeptical of Preston’s views. He made many extravagant claims in written form for the Connecticut hearings, then failed to show up to be cross-examined to back up and explain his claims. Not a good sign.”

          You already know that Preston failed to appear at the Connecticut hearings because of personal reasons. However, the fact that he has testified at 200 trials would suggest to most people that he’s not in the habit of not showing up.

          • You are right, Wode. I would never read this diary of a mad chiropractor “book” in a million years. I don’t have to read it to know that Preston is long on hated of his chosen profession. Do you?

            Who in the world would ever want to buy, much less actually read this “book”? The few anti-chiropractic extremists that hang out here instead of with their families might buy a few copies to add to their library, but they already don’t like non-drug approaches to health, the type that the chiropractic health care profession provides. Wode, do you really need another handbook showing you how you can do as much damage to another profession? Why don’t you start cleaning up your own industry?

            BTW, The American Council on Science and Health is long known to get their funding from, and are the barking dogs for, the chemical, drug, sugar, junk food, pesticide and other industries. So I, like many others, am very skeptical about the ACSH and things they would promote, like this “book”.

            As for Long’s extensive expertise, well that’s debatable. One can claim any numbers they want. Who can disprove it?

            I don’t know how it works where you live, but it is common here in the states, especially within the medical trade, for doctors who are disgruntled or can’t make it in practice to hook up with insurance companies or legal entities to do reviews or exams on other doctors – – for a tidy sum of cash, of course, for a few minutes work. They quickly realize that if they do these reviews for the insurance companies, then they don’t have to help heal annoying suffering humanity anymore. So now they are beholden to their masters and find exactly what their masters love to hear, namely to justify why the insurance companies shouldn’t have to pay the doctor’s bills on those pesky patients.

            Then another realization comes over the subservient doctor: If they don’t make whoever is paying them happy by finding what they want, the master will seek out another doctor who will be happy to comply. If the doctor isn’t being sent anymore exams/reviews, then he/she will have to go back to seeing patients again! OMG! Of course, this is a dismal prospect for those doctors who are not compassionate and caring and who are not exactly “people persons”.

            So doing 10,000 record reviews as Long claims, if that is true or even physically possible, and we have no way of knowing, can be very lucrative and he won’t have to talk to people anymore, hear their problems, help to restore their health and improve their lives with things like natural, drugless chiropractic health care that millions of people of all ages happily seek out and appreciate each year for themselves and their families.

            Perhaps Preston is in the habit of showing up only when he gets paid?

          • I am not often lost for words, but your comments do have this effect on me.

          • I’ve just run out of irony meters…

          • You are right, Wode. I would never read this diary of a mad chiropractor “book” in a million years. I don’t have to read it to know that Preston is long on hated of his chosen profession. Do you?

            I call this erasing one’s credibility.

  • In reply to Preston Long:
    All x-rays ordered must be for the patients benefit, not the chiro’s. “Chiropractors in my experience take x-rays to market subluxations to their patients and because they are excellent financial resource.” This is not a valid clinical reason and I agree with Preston that this is unacceptable. Strict guidelines and audits of chiropractors who own and operate xray equipment is done here in Australia. The EPA (Eviroment Protection Agency) does an inspection for compliance of x-ray equipment every 5 years. Old or outdated equipment will not be certified. I refer out for all my x-rays as its covered under medicare and the radiologists report and expert second opinion is invaluable. Additionally, not every patient is referred. As for unnecessary exposure of infants to ionizing radiation, Facepalm!
    As I said above:
    “I do not blanket screen all new patients with xray. There must be a valid clinical reason like Chronic spinal pain (with or without referred or radicular symptoms), trauma, suspected pathology, unresponsive to care etc. This is same as the policy taught and enforced at Macquarie University. Since I specialise in chronic spinal and musculoskeletal conditions I often get patients coming in with a large pile of xrays, CT’s and MRI’s going back years (I don’t comment on the pile, I just look at the lot). There are five medical radiologists in close proximity to my practice so refer out for xrays. The attached radiologists report is also invaluable. On average I also see 2 spinal metastasis per year( the spine is the third most common site for metastatic cancer). Xrays are a valuable diagnostic tool and most definitely NOT assault!”.

    COCA policies can be found here: http://www.coca.com.au/about/policies/

  • SkepdicProf wrote: “Wode, do you really need another handbook showing you how you can do as much damage to another profession? “

    It’s chiropractors themselves who damage their profession.

    SkepdicProf wrote: “Perhaps Preston is in the habit of showing up only when he gets paid?”

    Perhaps not. Science-based activists are known for giving their time and help very freely. This blog is a good example.

  • One more fact from my review of chiropractic x-rays concerns the reports sent with the films from a chiropractic radiologist. If the chiropractic radiologist stated the x-rays(s) were not of diagnostic quality and he/she recommended repeat films, I would always request those repeat films for a more thorough evaluation of the case. Not once, ever, could the treating chiropractor produce the repeat film(s).

  • Long is promoting his book here and he receives money out of any single copy he manages to sell. Money-money-money-in-paid-paid-paid.

    Blue Wode: You are confused with terms science and clinical evidence in healthcare. Healhcare professions like medicine are not sciences. And really not too well evidence based either

    http://clinicalevidence.bmj.com/x/set/static/cms/efficacy-categorisations.html

    Do you like to wipe out medicine because it fall category of clinical science?

    Please, learn terms and write proper Inglish.

    • Jorma Kärtsy wrote: “Long is promoting his book here and he receives money out of any single copy he manages to sell. Money-money-money-in-paid-paid-paid.”

      I think that the revenue from Preston’s book is likely to pale into insignificance when compared with the financial gain chiropractors undoubtedly enjoy from their countless fierce marketing campaigns. See, for example:
      https://www.facebook.com/FoundationforChiropracticProgress/app_402302179825041

      By the way, it’s interesting to note that, just as the Foundation for Chiropractic Education and Research decided on self-liquidation and filed for bankruptcy in 2009,
      http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=54144
      the chiropractic marketing group in my first link, the Foundation for Chiropractic Progress, received a record pledge of support:
      http://chiro.org/wordpress/2009/09/29/what-are-our-priorities/

      Jorma Kärtsy wrote: “You are confused with terms science and clinical evidence in healthcare.”

      Professor Ernst has already discussed that distinction, and its pitfalls, at some length on this blog.
      http://edzardernst.com/2012/11/what-is-and-what-isnt-clinical-evidence-and-why-is-the-distinction-important/

      Here’s a small summary:

      QUOTE
      “Clinical experience is notoriously unreliable…When their [clinicians’] patients get better, they assume this to be the result of their treatment, especially if the experience is repeated over and over again. As an ex-clinician, I do sympathise with this notion which might even prevent practitioners from losing faith in their own work. But is the assumption really correct? …when it comes to therapeutic efficacy, clinical experience is no replacement for evidence. …What clinicians witness in their routine practice can have a myriad of causes; what scientists observe in a well-designed efficacy trial is, in all likelihood, caused by the treatment. The latter is evidence, while the former is not…only with reliable evidence can we tell with any degree of certainty that it was the treatment per se …We all agree that helping the patient is the most important task of a clinician. This task is best achieved by maximising the non-specific effects [e.g. placebo], while also making sure that the patient benefits from the specific effects of what medicine has to offer. If that is our goal in clinical practice, we need reliable evidence and experience. Therefore one cannot be a substitute for the other, and scientific evidence is an essential precondition for good medicine.”

      Jorma Kärtsy wrote: “ Healthcare professions like medicine are not sciences. And really not too well evidence based either http://clinicalevidence.bmj.com/x/set/static/cms/efficacy-categorisations.html

      That is not true. It is clear that as much as 80% of modern medicine is evidence based:

      http://www.theness.com/neurologicablog/?p=51

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1314867/pdf/15160706.pdf (pp4-5)

      As for the pie chart in the link you gave, the recent publication of a similar one prompted the following comments:

      QUOTE
      “It is particularly ironic that CAM therapies are over-represented in the ‘not shown to be effective’ category, so if anyone should be concerned about lack of evidence it should be CAM practitioners rather than conventional medics.”
      http://www.dcscience.net/garrow-evidence-bmj.pdf

      • Blue Wode, you seem to very deeply and passionately involved in the chiropractic health care profession. I was wondering if you would care to share with us if are you employed in the health care field, and if you are do you hold a degree in chiropractic health care? If not, what area do you hold a degree in? Thanks very much.

        • If you have an issue with anything Blue Wode has said, then I’m sure he’ll be only too pleased to hear it.

          • Well, I was just trying to get a better sense of where Blue Wode is coming from. He may not have a doctorate degree in chiropractic health care from a chiropractic university, but I was interested in knowing if he was a doctor of any kind. It seems to me that he likely has no clinical experience either, which might account for his vortex of negativity.

          • VORTEX OF NEGATIVITY???
            do you not confuse ‘negativity’ with critical evaluation?

        • I don’t think he is a chiropractor – chiropractors are usually not capable of critical analysis of chiropractic; and you prove that point very well.

        • What exactly is a degree in chiropractic health care? Any degree course that necessitates a suspension of critical thinking while it teaches magical thinking isn’t science and it certainly isn’t health care; it’s a business degree with a fancy title.

          Furthermore, the accuracy of a statement is not determined by the qualification level of the issuer. E.g. Wikipedia does not hold a degree in anything yet it contains a great deal of very useful information that can be independently verified, as do these invaluable sources of information:
          http://www.skepdic.com/chiro.html
          http://rationalwiki.org/wiki/Chiropractic

          Emily Rosa debunked therapeutic touch when she was aged nine:
          http://en.wikipedia.org/wiki/Emily_Rosa

          Chiropractors should consider themselves most fortunate that Emily chose to debunk therapeutic touch and not chiropractic.

        • Funny how ‘Blue Wode’ fails to comment or mention any formal health care or medical care qualification, but likes to display himself as an expert on both. Quoting someone else’s blog or website who agrees with your paradigm of thinking also does not make you an expert. Nice try.

          • Lachlan wrote: “Funny how ‘Blue Wode’ fails to comment or mention any formal health care or medical care qualification”

            Irrelevant.

          • no, you don’t understand: ONLY CHIROS ARE COMPETENT TO COMMENT ON CHIROPARACTIC!!!
            this ensures that there will never be any competent criticism of this form of quackery – we all know that chiros are not taught to be critical.

          • Lachlan said:

            Funny how ‘Blue Wode’ fails to comment or mention any formal health care or medical care qualification, but likes to display himself as an expert on both. Quoting someone else’s blog or website who agrees with your paradigm of thinking also does not make you an expert. Nice try.

            If Blue Wode ever says something about chiropractic that is incorrect, I’m sure he’ll be only too pleased to be corrected by you or someone else. So, has he said something that is wrong so far?

          • it is so much easier to play the player rather than the ball, isn’t it?

          • It certainly is when you don’t have any good answers!

  • In reply to Edzard:
    Thankyou for inserting “usually” into the above reply.
    In reply to SkepdicProf:
    If you read through Blue Wode’s and Edzard Ernst’s blogs and comments you will see that they are very well written and referenced. They don’t blow a lot of hot air. I was once like you, angry and frustrated with them. More attacks from the righteous high priests of the medical temlpe who should focus on the many problems within medicine and leave us alone. Unfortunately or fortunately, the more I read, the more I agreed with them and I couldn’t ignore them. Edzard discusses the topic well here: http://edzardernst.com/2013/10/five-methods-for-avoiding-progress-from-criticism/

    The way I practice now is different to the way I practiced last year and it is vastly different to the way I practiced 20 years ago. I don’t work in my practice, I work on my practice and it is constantly evolving as best practice and the latest evidence presents itself. If the subluxation “true believers” directed their passion towards research and proved what they claim, then I would take it onboard. Instead, the more threatened they feel, the more deeply entrenched and vocal they are becoming. (You could say that Billy De Moss is Blue Wode’s and Edzard’s chiropractic love child/frankenstein. Oh why, Oh why have you done this to us guys. Oh the pain!)
    The issue of xrays discussed here is also important. 20+ years ago I xrayed every patient, drew lines all over them, gave my patients glossy printed report of findings etc etc. Now, I only refer if there is a valid clinical reason as I said above and they are for the patients benefit.

    Chiropractic has a poor record of critical self examination. Instead of trying to shoot the critics (internal and external), we should accept it, learn from it and change and evolve!

    • Thank you for your perspective, Thinking Chiro. Problem is, if you notice the “references” they cite, are usually pointing to anti-chiropractic propaganda that was written from they own anti-chiropractic pals with a long history of — anti-chiropractic activities. A little self-serving don’t you think?

      No problem with criticism. The problem is with so-called “professionals” from the medical trades who have created a 24/7 cottage industry specifically intended to denigrate and invalidate all non-medical approaches to health care and strike fear in the minds of those who may be thinking of straying outside of the drug-based corral. Chiropractic health care is just one of their favorite targets because it is very popular with millions of families and people of all ages who know that natural, non-drug approaches to health is not just normal, but is a necessity.

      Chiropractic health care is being expanded in the military, is hugely popular at all sports venues plays a major role in all Olympics.

      You don’t see it yet, Thinking Chiro, but there are critics who criticize and there are “critics” like the ones here who engage in anti-chiropractic activities and whose full-time goal is to demonize chiropractic health care and dehumanize chiropractic doctors. Their ultimate vision is a chiropractic-free world where you are driving a bus.

      So, think again, T.C.

  • Have subluxations been addressed? If so please forward the link, thanks.

  • Blue Wode wrote: “I am interested to know why you are also known as Bear Grylls”

    I am interested, Sherlock, to know why you are trying to figure out who I am and why you are trying to “out” me here?

    • I’m not trying to figure out who you are, I already know who you are. As far as I can see, you don’t seem too concerned about concealing your identity, not least due to your presence on Twitter:
      http://edzardernst.com/2014/01/visceral-manipulation-you-couldnt-make-it-up/#comment-53997

      I merely stated that I was interested to know why you are also known as ‘Bear Grylls’. IMO, it’s an odd comparison given that Bear Grylls has always managed to overcome any difficulties in his path.

      • Wow, Wo. Excellent. I am impressed! You are good.

        You are as wrong as wrong can be about who you think you know I am, but you are good. Just letting you know this now so you can avoid further embarrassment as a result of your misguided ‘identity crisis’.

        • SkepdicProf wrote: “You are as wrong as wrong can be about who you think you know I am”

          Then you are both cast from the same mould. For example, you have raised the issue of Preston Long’s non-appearance at the Connecticut Board of Chiropractic Examiner’s Hearing on Informed Consent in the comments sections of at least three separate blog posts here, even letting the following slip in one…

          Quote
          “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.”

          http://edzardernst.com/2013/11/chiropractic-abuse-and-how-we-can-protect-ourselves-from-it/#comment-52864

          With regard to Stephen Perle (whom you claim not to be), I find it intriguing that he participated in the above hearings. Moreover, the number of people attending the hearings was fairly small. Indeed, readers can get an idea of the numbers in the following short video segment in which the head of the Connecticut Chiropractic Council, a trade group, refuses to directly answer a question about neck manipulation:
          http://www.youtube.com/watch?v=LdVMjnaY6L4

          I think what can be deduced from that is that SkepdicProf is happy to be associated with other dubious colleagues.

          Anyway, I hope that it’s true that SkepdicProf isn’t Professor Stephen Perle ( https://twitter.com/smperle ) of Connecticut’s University of Bridgeport Chiropractic College, because if it transpires that he is, then he has just lost all his credibility.

  • Honestly it is SO SAD that you guys dedicate your time to this Blog, I cant believe you actually spend so much of your valuable time in this life sitting at your computer on your ass making comments in regards to someone who disagrees with you. I actually feel sorry for you guys. Regardless of the topic, whether it be any alternative health care profession. The life of a constant critic, be it helpful in the eyes of that person, is also sad and lonely (apart from your internet buddies). And bad for your health (limited evidence available). Sorry guys.

    Im sure one of you will shortly comment upon this or another comment ive made in an attempt to discredit me to your followers, just know that it honestly doesnt bother me, because ill be happy, outside in the ‘s-u-n-s-h-i-n-e’. Enjoying my life and what time I may have left. While you will still be in your room, in the dark writing a reply to this. Best of luck.

  • congratulations!
    you have just created the ultimate non-argument.

    • Lachlan, it doesn’t take long to counter most chiropractors’ arguments. Indeed, it’s often a copy and paste job unless the science has recently changed.

      As for the rest of your comments, they are all conjecture. You know nothing about my life.

  • Blue Wode wrote: “Then you are both cast from the same mould. For example, you have raised the issue of Preston Long’s non-appearance at the Connecticut Board of Chiropractic Examiner’s Hearing on Informed Consent in the comments sections of at least three separate blog posts here, even letting the following slip in one…”

    Oy, Woe. Once you get hold of something, you just don’t let it go. OK by me. But personally, I think your OCD slip is showing.

    Yes, that was an interesting clip. Every event has interesting moments. If you want to have a load of good belly laughs, watch the segments with the so-called “experts” from the medical and legal trades, namely the circumcision MD from Montreal or the female attorney from Florida. Hilarious! They really could have used Preston Long’s help.

    Fortunately, Woe, they were trounced and even the board under the guidance of the Assistant Attorney General entered into the official record that the MD’s testimony was unreliable. I thought that was a lot kinder than his past reviews where he was banned from the hearings or accused of engaging in a “deliberate course of lies and deceit” like they found in New Zealand. Ouch!

    But a good time was had by all and everything turned out just fine. Sorry you had to miss it.

    Anyway, the bottom line is that spinal manipulation, being the non-drug approach that it is, was found once again to be one of the safest, if not THE safest, forms of health care available today. Which, of course, is why around the world, millions of people and families of all ages seek out Chiropractic Health Care. It is expanding in the U.S. military system and is huge in all sports especially the Olympics because the athlete won’t fail the drug test. Just makes sense.

    • @ SkepdicProf

      With regard to the Connecticut hearings, I think it’s important for readers to understand that they resulted in a 4-1 vote against a requirement for chiropractors to gain informed consent from patients regarding the risks of treatment. The four members who voted against the ruling were chiropractors, with the dissenting vote coming from Jean Rexford, executive director of the Connecticut Center for Patient Safety. According to Janet Levy, a chiropractic stroke survivor and founder of Victims of Chiropractic Abuse, Inc. who gave testimony at the hearings, the Chiropractic Board of Examiners was missing two of three public members required by law. Jean Rexford also commented “…they relied on one study. It’s time to really take a close look at how all these boards are being run. We have way too many foxes watching the henhouse”.

      However, according to Jann Bellamy (JD) it could be a pyrrhic victory for chiropractors…

      Quote
      “What does this ruling mean? The Board’s declaration that there is no risk of cervical artery dissection and stroke following manipulation is a finding of fact and not binding on the courts. As is their ruling that informed consent does not require a warning. Under Connecticut law, whether a warning of risk is required is determined by the “reasonable patient” standard, that is, what would a reasonable patient consider important in making his decision whether to undergo a particular procedure. One of the very purposes of the reasonable patient standard is to prevent practitioners from setting low standards and then claiming they’ve abided by their profession’s standard of care. Imagine the chiropractor sued for failure to warn who erroneously thinks he’s been inoculated against malpractice claims by following the Board’s ruling. Surprise! As a matter of fact, the hearing transcript and videotape are now in the hands of plaintiffs’ personal injury attorneys, who will mine it for useful information. A couple of years ago the American Justice Society (formerly known as the Association of Trial Lawyers of American) started a chiropractic interest group (that is, interest in suing chiropractors for personal injury). The section collects and distributes such information for AJS members. The chiropractors may have won this battle, but they could be losing the war.”
      http://www.sciencebasedmedicine.org/not-to-worry-chiropractic-board-says-stroke-not-a-risk-of-cervical-manipulation/

      It’s also worth mentioning here that three members of the Connecticut Board of Chiropractic Examiners were recently caught breaking the law and the state Department of Public Health orders compliance:
      http://c-hit.org/2011/03/09/state_finds_three_members_of_chiropractic_board_violated_law/

      SkepdicProf wrote: “Anyway, the bottom line is that spinal manipulation, being the non-drug approach that it is, was found once again to be one of the safest, if not THE safest, forms of health care available today.”

      Well certainly Stephen Perle, who attended the Connecticut hearings, seems to think so. Readers can listen from 8:17 in here where he pushes the (deeply flawed) Cassidy study whilst showing no overall cautious attitude: http://ontheotherhand.podbean.com/2010/09/30/episode-2-dr-stephen-perle-discusses-chiropractic-and-stroke/

      The reality is that with no reliable reporting systems in place, and only a handful of unimpressive studies to wave about, it’s becoming increasingly obvious to people who care about science that any claims by chiropracators that spinal manipulation is safe are very definitely not true.

      SkepdicProf wrote: “…millions of people and families of all ages seek out Chiropractic Health Care”

      Sadly, millions of people and families are unlikely to know when they’re being duped:
      http://web.archive.org/web/20110723060336/http://www.crhp.net/article1.html

      SkepdicProf wrote: “It is expanding in the U.S. military system”

      That may be so, but it isn’t in the UK. The Ministry of Defence refuses to endorse it:
      http://www.ebm-first.com/chiropractic/uk-chiropractic-issues/2067-hands-for-heroes-ministry-of-defence-refuses-free-chiropractic-care-worth-p45-million-for-veterans.html

      SkepdicProf wrote: “…and is huge in all sports especially the Olympics because the athlete won’t fail the drug test”

      The athlete is not likely to be helped either, especially when there are a good supply of physios about. In other words, superstition is rife among athletes. If they thought a witchdoctor would boost their performance, they’d bring one in. Having a chiropractor on hand to crack a few joints could simply be another form of pulling on ‘lucky socks’.

  • One case of chiropractic x-rays I reviewed concerned a chiropractor that I knew & went to school with. He & his wife had just had a new baby boy. Believing the stories of the traumatic birth process causing subluxations from his brethren, he took a Davis series on his 2 month old son. The single purpose was to detect and treat his sons silent killing subluxations created by the birthing process. Chiropractic philosophy was strong in this one.

  • Hello Wode, Sorry this response took so long, I was attending a conference on natural health care for pregnant women and also non-drug approaches for children. But since you brought all this up, I thought you might appreciate me correcting your misconceptions and also to help the readers to understand what actually took place, if they are interested. BTW You couldn’t tell from your kitchen a world away, but the hearings were well attended.

    Blue Wode wrote: “The Chiropractic Board of Examiners was missing two of three public members required by law.”
    Well, Woe, there were public members, but they had to leave unexpectedly due to various personal circumstances. One left for California for a new job before the hearings were over and the final vote was taken. So what do you want? They couldn’t start over. Besides all parties gave the OK to proceed, the chiropractic ladies, their lawyers, even Jean Rexford. You couldn’t tell from watching a world away in your kitchen, but the Assistant Attorney General was there guiding everything along and everything was checked with him for proper procedures and even he said it was OK, too. BTW the public members that had to leave later said the final decision was the correct one and they would have voted with the chiropractic doctors on the board. One even wrote this to the board to enter into the minutes.

    You see, what everyone realized from the hearings was that it was not about safety or even informed consent, but rather to further the agenda of a vocal few to continue their propaganda to do as much damage as possible to the chiropractic health care profession in the public’s mind, similar to what you do here. I know you like to blame chiropractic doctors and chiropractic health care for all the problems of the world, including climate change, but this was a mutually agreed-upon decision.

    Blue Wode wrote: “Jean Rexford also commented “…they relied on one study. It’s time to really take a close look at how all these boards are being run. We have way too many foxes watching the hen house”.
    Well, Woe, what do you expect? The chiro-hatin’ crowd didn’t provide any studies of any value or noteworthiness for Ms. Rexford to wave about or for the Board to consider. Testimony submitted by a circumcision expert from Canada who has previously been banned by courts and has engaged “in a deliberate course of lies and deceit” in the past, according to the Royal New Zealand Commission, along with lawyer Jann Bellamy from Florida, with no background in health care (except by marriage) or science or any experience interpreting studies, left poor Ms. Rexford standing there empty-handed at their final fact-finding before the vote. All she could contribute was that the ladies testimony was compelling.
    BTW, even Ms. Rexford voted to approve an addition to the official record that the testimony given by the circumcision MD from Canada, Murray Katz, was “unreliable”.

    However, according to Jann Bellamy (JD) it could be a Pyrrhic (capitalized) victory for chiropractors…
    Quote, etc. etc.

    Well here in the U.S., anyone can sue anyone for anything. Even signing informed consent with all warnings about everything doesn’t inoculate anyone from being sued.

    Blue Woe wrote: Jann Bellamy: “As a matter of fact, the hearing transcript and videotape are now in the hands of plaintiffs’ personal injury attorneys, who will mine it for useful information. A couple of years ago the American Justice Society (formerly known as the Association of Trial Lawyers of American) started a chiropractic interest group (that is, interest in suing chiropractors for personal injury). The section collects and distributes such information for AJS members. The chiropractors may have won this battle, but they could be losing the war.”

    Well, Woe, where is the huge increase of lawsuits predicted by Jann? Why haven’t the insurance premiums gone up. In fact, they are going down in many areas since chiropractic health care uses no drugs or surgery, unlike medical errors that continue to kill 800,000 – 1 million Americans every year like clockwork. That’s like 8+ fully loaded jet planes crashing daily from the medical industry! More in one year than in the history of most U.S. wars combined spanning generations. That’s why millions of people around the world seek out chiropractic health care for themselves and their families everyday.

    Blue Wode wrote: “It’s also worth mentioning here that three members of the Connecticut Board of Chiropractic Examiners were recently caught breaking the law

    Well, Woe, why is that worth mentioning other than to demonstrate that as a propagandist and provocateur you are prone to hyperbole? The law that these ‘scofflaws’ was breaking was for…an improper sign on their office! OMG!

    You see, after losing the whole shooting match at the board, on the legislative level with their pet senator on a leash and finally in the courts, the anti-chiropractic ladies went a little nutty and tried to fan their last glowing ember before it died out in a desperate last-ditch effort to do some damage before they fled the state. They filed hundreds of complaints, nothing to do with injuries from chiropractic health care, just to be a nuisance.

    But if the state cracked down on the few hundred chiropractic doctors whose signage wasn’t up to specs, then they would have to also crack down on thousands of medical ‘scofflaws’, too. It just wasn’t happening. So they updated the laws to reflect modern times and integrative practices with chiropractic doctors and the medical trades (they even employ physio technicians) working harmoniously together which everyone loves, well everyone except you and EE and a few other retired MDs, that is.
    Blue Wode wrote: “any claims by chiropractors that spinal manipulation is safe are very definitely not true.”
    Yes it is safe. No drugs or surgery. See the reference above about the war-dead vs. dead from medical care.

    SkepdicProf wrote: “…millions of people and families of all ages seek out Chiropractic Health Care”
    SkepdicProf wrote: “It is expanding in the U.S. military system”

    Blue Wode wrote: “That may be so, but it isn’t in the UK. The Ministry of Defence refuses to endorse it:

    According to your link, in my view, it looks like they were not asked to endorse chiropractic health care, but rather something that could be construed as a commercial venture, IMO. As I said earlier, I think you may be prone to hyperbole.

    SkepdicProf wrote: “…and is huge in all sports especially the Olympics because the athlete won’t fail the drug test”
    The athlete is not likely to be helped either, especially when there are a good supply of physios about. In other words, superstition is rife among athletes. If they thought a witch doctor would boost their performance, they’d bring one in. Having a chiropractor on hand to crack a few joints could simply be another form of pulling on ‘lucky socks’.

    Well, Woe, I don’t agree that you know better than they do what helps their performance. I find your premise that athletes are all a bunch of stupid idiots to be, frankly, disgusting.

    • SkepdicProf wrote: “You see, what everyone realized from the hearings was that it was not about safety or even informed consent, but rather to further the agenda of a vocal few to continue their propaganda to do as much damage as possible to the chiropractic health care profession in the public’s mind, similar to what you do here.”

      Why is it not right that the public and patients should have sufficient historical information on the apparently very real documented dangers of chiropractic treatment? Where is your cautious attitude?

      SkepdicProf wrote: “The chiro-hatin’ crowd didn’t provide any studies of any value or noteworthiness for Ms. Rexford to wave about or for the Board to consider.”

      That depends on how “value” and “noteworthiness” are interpreted. It brings to mind section 146 (p.55) of the Statement of Claim of Sandra Nette, a Canadian tetraplegic chiropractic victim:

      Quote:
      “Incredibly, and, acting in bad faith, the College [Alberta College and Association of Chiropractors] attacked the new and surprisingly high number of vascular accidents associated with chiropractic services that were published in the medical literature and reported in the media by demanding a level of evidence it has never demanded of itself. It maintained that the causal link between strokes and chiropractic adjustment remained unproven.”
      Link: http://www.casewatch.org/mal/nette/claim.pdf

      In other words, many chiropractors – and their regulators – seem to find it acceptable to rely on anecdotal or weak evidence where it supports chiropractic treatment, but where similar, or more robust evidence suggests that serious complications (e.g. stroke) can result from chiropractic treatment, they are quick to dismiss it. No prizes for guessing why.

      SkepdicProf wrote: “Well, Woe, where is the huge increase of lawsuits predicted by Jann? Why haven’t the insurance premiums gone up.”

      Lawsuits take time, and many people will not have enough money to pursue them. As for insurance premiums, they’re not likely to be going up because, unlike MDs, chiropractors largely deal with ‘heartsink’ patients who have non-serious and/or self-limiting conditions (even if chronic). Also, the US (where the majority of chiropractors practice) has no chiropractic adverse events reporting system, so insurance actuaries have less data to go on when calculating the risks.

      A timely reminder here for readers: It’s probably true that chiropractic injuries are rare, however such injuries wouldn’t be occurring at all if chiropractors adhered to ethical practice and abandoned spinal manipuilation in view of its risks outweighing any perceived benefits.

      SkepdicProf wrote re the UK Ministry of Defence and chiropractic: “According to your link, in my view, it looks like they were not asked to endorse chiropractic health care, but rather something that could be construed as a commercial venture, IMO. As I said earlier, I think you may be prone to hyperbole.”

      I don’t think so. The NHS doesn’t endorse chiropractic either, regardless of any commercial venture. If you read the first link within the link I gave you’ll see that the MoD says “Both in Service and in the NHS the Government is firmly committed to ethically sound evidence based therapies and interventions i.e. it sponsors services where there is evidence that they work. The evidence is usually obtained from reports of suitably designed studies in the published peer reviewed medical literature. As chiropractic care has not been endorsed by the NHS it is considered that it is not appropriate for the Department to raise awareness of ‘Hands for Heroes’ amongst Serving and ex-Service personnel.”
      Link: http://www.hands-for-heroes.org/support-files/mod-reply-may-11.pdf

      “I find your premise that athletes are all a bunch of stupid idiots to be, frankly, disgusting.”

      I didn’t say that they were “all a bunch of stupid idiots”. What I said was that *superstition* was rife among them. Like most people, athletes are likely to be unaware of their errors of reasoning:

      Quote:
      “If only ignorant and gullible people accepted farfetched ideas, little else would be needed to explain the abundance of folly in modern society. But, as James Alcock discusses elsewhere in this issue of SRAM, many people who are neither foolish nor ill-educated still cling fervently to beliefs that fly in the face of well-established research. Trust in the further reaches of complementary and alternative medicine (CAM) is a case in point. Paradoxically, surveys find that users of unscientific treatments tend to have slightly more, rather than less, formal education, compared to non-users. How are we to account for the fact that college graduates, and even some physicians, can accept therapeutic touch, iridology, ear candling, and homeopathy? Experts in the psychology of human error have long been aware that even highly trained experts are easily misled when they rely on personal experience and informal decision rules to infer the causes of complex events. This is especially true if these conclusions concern beliefs to which they have an emotional, doctrinal, or monetary attachment. Indeed, it was the realization that shortcomings of perception, reasoning, and memory will often lead us to comforting rather than true conclusions that led the pioneers of modern science to substitute controlled, interpersonal observations and formal logic for the anecdotes and surmise that can so easily lead us astray. This lesson seems to have been largely lost on proponents of CAM.”

      That quote is lifted from the introduction to the essay, Social and judgmental biases that make inert treatments seem to work, which was written by the late Barry Bayerstein, formerly of the Brain-Behaviour Laboratory, Department of Psychology, Simon Fraser University, Burnaby, British Columbia. The entire essay can be read here:
      http://web.archive.org/web/20110723060336/http://www.crhp.net/article1.html

      On that note, thanks to Preston Long below for his enlightening summation which seems to be aimed at SkepdicProf’s own errors of reasoning.

  • In argumentation theory, an argumentum ad populum (Latin for “appeal to the people”) is a fallacious argument that concludes a proposition to be true because many or most people believe it. In other words, the basic idea of the argument is: “If many believe so, it is so.”
    This type of argument is known by several names,[1] including appeal to the masses, appeal to belief, appeal to the majority, appeal to democracy, appeal to popularity, argument by consensus, consensus fallacy, authority of the many, and bandwagon fallacy. Wikipedia

    Chiropractic is not any different then any other special interest group, they influence lobbyists, politicians & advertisers with money to achieve their goal. Legislative and populace influence does not provide for scientific scrutiny.

  • Well, Woe, it seems that the chiropractic-deniers failed to produce the so-called ‘proof’ or produce any proper expert witnesses at the Connecticut hearing or even failed to show up at all? As a result, they left empty-handed, but are still very much ticked-off, years later. After all, they only have themselves to blame.

    Yes, that was very sad for Ms. Nette. But the courts released most all of the parties from the suit including the province of Alberta and the Queen of England. Next, they dismissed the entire class-action lawsuit as classless. This was even announced at the Connecticut hearing. Only the doctor was left and they have hashed it all about and came to an amicable settlement after it was revealed that he made a terrible decision to forge a document. Fortunately, it now seems that Ms. Nette is doing quite a bit better from her tetraplegia, thank God. You never hear of a tetraplegic making such a remarkable recovery. Clearly, a testament to the incredible power of the body’s wonderful innate healing ability.

    • @ SkepdicProf

      Three facts that you cannot evade:

      First, there are no chiropractic adverse event reporting systems in the US (where the vast majority of chiropractors practice). Despite the US National Quality Forum listing 28 ‘never events’ healthcare mistakes that should never happen and need to be reported – with death or serious disability from spinal manipulation is listed at no. 16 – chiropractors do not have to report this because they have a loophole. That is, the National Quality Forum demands it of clinics and hospitals but no reporting is mandated for individual doctor’s offices where 99% of spinal manipulation is done.
      http://www.ebm-first.com/chiropractic/risks/1842-letter-from-britt-harwe-president-chiropractic-stroke-awareness-group-csag.html

      Second, bearing the above in mind, according to the US National Practitioner Data Bank, between September 1, 1990 and January 29, 2012, a total of 5,796 chiropractic medical malpractice reports were filed. Common reasons for the lawsuits were strokes and other injuries.
      http://www.hg.org/article.asp?id=29867

      Third, reports of deaths after chiropractic treatment are about three times the number of deaths from trovafloxacin, an excellent antibiotic abandoned in the U.S. as too dangerous.
      http://www.sciencebasedmedicine.org/compare-and-contrast/

      SkepdicProf wrote: “You never hear of a tetraplegic making such a remarkable recovery. Clearly, a testament to the incredible power of the body’s wonderful innate healing ability.”

      You forget that *thanks to chiropractic* Sandra Nette is likely going to have to suffer from a range of neurological deficits for the rest of her life. How wonderful do you think that is?

  • Blue Wode, and don’t forget chiropractic malpractice carriers refuse to provide data on the number of claims filed, settlement amounts etc.

  • Thank you, Preston.

    To get back on topic:

    Andy wrote: “…all X-ray facilities in the UK are registered with the HSE and must comply with IRMER…”

    FYI, UK chiropractors’ compliance has been found wanting in that department. The following has been lifted from the GCC’s open agenda and papers for its 3rd February 2014 meeting (see from p.27 onwards):
    http://www.gcc-uk.org/about-us/council/agendas-meeting-papers-and-minutes.aspx

    QUOTE

    In September 2006 two of the enforcement agencies and the HPA requested a meeting to discuss their concerns, with particular regard to employers’ written procedures, as follows:
    In summary, the Ionising Radiation (Medical Exposure) Regulations 2000 have been in place now for six years. While chiropractors may be acting in good faith and relying on the advice they have been offered, the situation regarding compliance with the Regulations, where it has been tested, is poor. The indications are this could well be widespread and cannot be allowed to continue. I am therefore writing to you, as the Regulatory Body for chiropractors, for support in progressing this matter with the appropriate professional bodies.”

    In January 2010 the HSE Radiation Team requested a meeting with the GCC to discuss the following problems regarding compliance by chiropractors with the Ionising Radiation Regulations 1999:

    Lack of understanding of the role of HSE and the powers of its inspectors;
    Poor standards of training radiation protection;
    Failure to designate radiation controlled areas; and
    Poor quality assurance of x-ray equipment.

    9. In April 2010 the GCC published advice for chiropractors on the Ionising Radiation Regulations 1999, prepared by the HSE.

    11. In June 2010 the enforcement agencies requested a meeting with the GCC to discuss the issues that had emerged as a result of inspection visits to chiropractic practices with x-ray sets. They made clear that what they had found in respect of a range of compliance issues was not satisfactory.

    Issues
    2011 Council noted that the enforcement agencies and the GCC have looked to the profession over a substantial period of time to make progress on identified concerns relating to compliance with IRMER. The GCC has repeatedly sought to facilitate progress. Council was extremely concerned that the enforcement agencies continued to find problems with compliance by chiropractors with the relevant ionising radiation legislation, as required by the GCC’s Code and Standard and the law.

    [ENDS]

    I’ve looked, but can’t find any recent, good data to confirm that compliance has improved significantly. Perhaps Andy can provide some for us. Meanwhile, as individual chiropractors apparently evade accountability for their sloppy standards, I hope that no patients are being harmed.

  • Blue Wode wrote:
    “I’ve looked, but can’t find any recent, good data to confirm that compliance has improved significantly. Perhaps Andy can provide some for us. Meanwhile, as individual chiropractors apparently evade accountability for their sloppy standards, I hope that no patients are being harmed.”

    Wow, Woe, thank you for spending time combing the internet looking for this ‘damning’ evidence.

    Yes, I guess every profession has areas that need improvement. Even the medical and physio trades. CT scans and x-rays are widely overused and abused by hospitals and many others in the pay-per-service, for-profit medical industry. Huge unnecessary cancer risk from this. Even mammograms are over-recommended, cause more cases of breast cancer and are often misread. They put us to shame. You just don’t look in other area.

    Fortunately, as you pointed out earlier from the law advertisement in your recent link farm, that chiropractic health care has only 5796 malpractice reports filed in 22 years — an enviable safety record! Only 263.5 per year. That ain’t bad. Many of those are without basis so the number is likely much smaller.

    The medical industry, I am guessing, has many more than that PER DAY along with 800,000 – 1 million Americans killed EACH YEAR from preventable errors according to public records, as I have said several times already. That’s a HUGE number. That doesn’t even count the ones who died from ‘proper’ care and ‘successful’ surgeries. The medical industry itself is responsible for creating millions of hospitalizations that shouldn’t have been necessary, ensuring HIGHER BILLS and ensuring the health of the hospitals that they work for as they all get paid for their mishaps and bloopers. The officially accepted system is all screwed up, eh?

    The “death” reports you indicated from spinal manipulation are unreliable and trumped up by the legal trades and the chiropractic deniers like yourself. I hate to sound like a broken record, but they had their chance to prove it in Connecticut, but either failed to produce any reliable evidence or just failed to show up. So what happened?

    The lesson here is that you do take your life in your hands having any spinal manipulation done by poorly trained physios as they only take a weekend class once or twice a year and then return to their employer on Monday and attempt to practice their new-found but highly unfocused ‘skills’. Very dangerous. Don’t do it. No. Not a good idea.

    Chiropractic doctors complete 5000 hours at a chiropractic university to satisfy their doctorate degree and perform very skillful, precise and specific adjustments which, as Blue Wode pointed out, is why the safety record is regarded as one of the safest, if not THE safest record of all of the health care professions. That’s why it is widely sought after by Olympic and professional and school athletes, as well as the military and millions of adults and children all over the world.

    Hope this helps.

    • SkepdicProf wrote: “Fortunately… chiropractic health care has only 5796 malpractice reports filed in 22 years — an enviable safety record! Only 263.5 per year. That ain’t bad. Many of those are without basis so the number is likely much smaller.”

      The number is likely to be far larger than 5,796, not least because most people don’t understand that strokes caused by chiropractic neck manipulation can be delayed for up to 30 days (so they won’t make the association), and many won’t have the time, money, or inclination to file suit.

      SkepdicProf wrote: “I hate to sound like a broken record…”

      Yes, I’m sure you do. Chiropractors are usually forced to resort to that tactic when they can’t defend their arguments.

      SkepdicProf wrote: “The lesson here is that you do take your life in your hands having any spinal manipulation done by poorly trained physios as they only take a weekend class once or twice a year and then return to their employer on Monday and attempt to practice their new-found but highly unfocused ‘skills’. Very dangerous. Don’t do it. No. Not a good idea.”

      I think you need to do a bit more learning before attempting to teach other people lessons. Bearing in mind that the majority of chiropractors are subluxationists, and that the public generally has no understanding of the two different practice styles of chiropractors, three chiropractic academics at the University of Glamorgan in the UK (David Byfield, Susan King and Peter McCarthy) have asserted the following:

      Quote
      “To view primary health care as eliminating discrete little lesions (subluxation) is truly missing the point and shouldn’t take more than a couple of weekends to master.”

      IMO, that confirms that physiotherapists practicing spinal manipulation will be a far safer bet than chiropractors. BTW, the three academics more or less admitted that the successes derived from the chiropractic clinical encounter owed much to non-specific (placebo) effects:

      Quote
      “…it has [also] been shown that patients are very pleased and satisfied with chiropractic care whether they get better or not….Furthermore, it has been said that chiropractic’s greatest contribution to health care has been the development of a solid doctor-patient relationship. So, let’s not kid ourselves. It may not be what we say…..but simply the way in which we say it that stimulates some measurable change in patient’s general health care status. Some studies support this view.”

      Ref: http://tinyurl.com/32odolf

      Prophetic words. IOW, their view looks like it’s on its way to becoming a reality:
      http://www.bodyinmind.org/spinal-manipulative-therapy-a-slow-death-by-data/

      • Blue Wode wrote:
        “The number is likely to be far larger than 5,796, not least because most people don’t understand that strokes caused by chiropractic neck manipulation can be delayed for up to 30 days (so they won’t make the association), and many won’t have the time, money, or inclination to file suit.”

        30 days? What connection? If no one knows this, Woe, then how do you know it? No proof of your assertions were provided by the ladies, lawyers or MDs at the Connecticut hearings. Of the 800,000 strokes each year in the U.S., none are associated with spinal manipulation. Thousands are directly associated with medical care from drugs and surgery. Why doesn’t this raise your ire?

        Blue Wode wrote:
        “I think you need to do a bit more learning before attempting to teach other people lessons. Bearing in mind that the majority of chiropractors are subluxationists, and that the public generally has no understanding of the two different practice styles of chiropractors, three chiropractic academics at the University of Glamorgan in the UK (David Byfield, Susan King and Peter McCarthy) have asserted the following:…
        Admittedly, there are some in the fizzeo trade who are caring, well-meaning professionals. A few specialize in more serious things, but for the most part, they are still mid-level technicians who rely on the the orthopedist to keep them in business and who basically crank people’s shoulders around and make them bounce over-sized balls for an hour when they are not putting heating pads on sore bums of pensioners.

        Contrary to your assertions, it is a dangerous path for them to administer spinal manipulation Monday morning after a weekend course or two to try their hand at it. It just doesn’t add up to being a far “safer bet” as you claim.

        Yes, the public doesn’t understand a lot of things that only you do, but they should be given enough credit that they understand what they want, and that is non-drug approaches to health and well-being and a desire to normalize and optimize brain and nerve function through these safe, drugless methods like chiropractic health care.

        Blue Wode wrote:
        “Prophetic words. IOW, their view looks like it’s on its way to becoming a reality:”

        So some physios, one with a PhD, can’t wrap their medically-oriented, pain relief heads around spinal manipulation and manual therapies and feel bad that they can’t cure back pain as well as a bottle of pills, eh? How small-thinking is that? But that’s the physio trade for you. Well I guess that sounds the death knell for all hands-on, non-drug approaches then. Sad news.

        • SkepdicProf wrote: “30 days? What connection? If no one knows this, Woe, then how do you know it?”

          30 days was a ballpark figure I’ve seen used by the scientific community a few times in the past. Here, however, are a couple of citations for you:

          Pathologist Michael R. Sherman, M.D., described what he observed during the autopsy of a chiropractic patient who died of a stroke:

          Quote
          “Examination of the right vertebral artery clearly indicated it had been subjected to significant prior trauma, most likely as a result of the initial series of cervical manipulation…The left vertebral artery exhibited what we believe to be the early…lesion, which, given time and repeated trauma in the form of manipulation, could evolve into a [condition] identical to that of the severely compromised right vertebral artery…It appears, in this case, that the prior manipulation the subject had undergone was the most significant and, indeed, the sole risk factor for the subsequent [stroke]…This study indicates that significant pathologic changes may not be immediately apparent…occur in vertebral arteries.”

          Ref: Sherman MR, Smialek JE, Zane WE. Pathogenesis of vertebral artery occlusion following cervical spine manipulation. Arch Pathol Lab Med.1987 ;111:851–853.
          http://www.ncbi.nlm.nih.gov/pubmed/3632303?dopt=Abstract

          Quote
          “…symptoms may develop after many uneventful manipulations… the pathogenetic mechanism involves vertebral artery dissection at the atlantoaxial joint with intimal tear, intramural bleeding, or pseudoaneurysm that can lead to thrombosis or embolism.”

          Ref: Frisoni GB, Anzola GP. Vertebrobasilar ischemia after neck motion. Stroke.1991 ;22:1452–1460.
          http://stroke.ahajournals.org/content/22/11/1452.abstract?ijkey=a98468e46677e943cca5500b2ba1387dd36c069e&keytype2=tf_ipsecsha

          SkepdicProf wrote: “Contrary to your assertions, it is a dangerous path for them to administer spinal manipulation Monday morning after a weekend course or two to try their hand at it. It just doesn’t add up to being a far “safer bet” as you claim.”

          I disagree. Physiotherapists’ use of spinal manipulation is vastly more judicious than that of chiropractors (who also attend weekend courses), so it would be a safer bet.

          SkepdicProf wrote: “Yes, the public doesn’t understand a lot of things that only you do, but they should be given enough credit that they understand what they want…”

          That still doesn’t prevent most people from being ensnared by deceptive healthcare practices and being made to believe that the interventions associated with such practices were responsible for any positive outcomes they may have experienced. Many people have poor reasoning abilities. See:
          http://web.archive.org/web/20110723060336/http://www.crhp.net/article1.html

          • @Blue Wode

            I am afraid “SkepdicProf” may not have the education to comprehend these complicated medical and anatomic terms. Maybe it would be better to explain the vertebral artery intimal tears and subsequent buildup of intramural thrombosis in terms more suitable for elementary school?

          • Blue Wode wrote:
            “That still doesn’t prevent most people from being ensnared by deceptive healthcare practices and being made to believe that the interventions associated with such practices were responsible for any positive outcomes they may have experienced. Many people have poor reasoning abilities.”

            Yes, psychiatry and chemotherapy come to mind and are excellent examples of what you warn of.

  • I recently had a discussion with a gynaecologist who was complaining of a number of patients referred to her for suspect findings in the pelvic area found by chiropractors on x-rays. One lady had gone to the chiro for isolated neck pain and ended up with a week of panic over cancer suspicion, two unnecessary CT scans and gynaecological specialist examination. The gyno had a hard time convincing the poor lady that she was all right.

    • Interesting ‘story’, Bjorn. I am sure there is more to the ‘story’. Members of the medical trades, including gynos, are always finding things that don’t exist and referring to their school buddies for unnecessary and expensive tests, scaring the daylights out of nervous patients, only to find that everything is OK or they get unnecessary surgery. Then they are considered to be thorough. Happens all the time, hundreds of times a day.

      You hear of a ‘story’ which may or may not have ever happened that way, but since it supposedly involved a chiropractic doctor, well then, it is newspaper headlines and your knickers get all in a knot. Maybe your short circuits are more of a reflection of the company you keep hanging out with here.

      Maybe it is time to be Bjorn again.

      • @SkepdicProf

        No it is the other way around. Doctors actually go out of their way to avoid unnecessary tests, apply knowledge and sense and do the best for each patient as they would for themselves. They actually care about their patients as fellow human beings, and they treat them as they would their own family. At least in my part of the world where doctors are well educated, caring and respectful. The story I relate here is real and honest. Doctors are not greedy and deceiving as you seem to think they are. Where do you get such ideas from? Do you live in an underdeveloped, dictatorially repressed part of the world where professional people have poor education and behave like mistreated animals? It must be hard on you when you need the help of a real doctor. I do not think your chiropractor friends are going to do much for say, a life threatening meningitis or help you with a treatable lymphoma for example.
        You obviously know very little about the real world and you seem to have a heavy prejudiced grudge against the medical profession that precludes your rational and meaningful participation in this dialog.
        Please spare us your bigoted foolery. It contributes nothing.

        • Bjorn wrote:

          “Doctors actually go out of their way to avoid unnecessary tests, apply knowledge and sense and do the best for each patient as they would for themselves. They actually care about their patients as fellow human beings, and they treat them as they would their own family. At least in my part of the world where doctors are well educated, caring and respectful. The story I relate here is real and honest. Doctors are not greedy and deceiving as you seem to think they are. Where do you get such ideas from? Do you live in an underdeveloped, dictatorially repressed part of the world where professional people have poor education and behave like mistreated animals?”

          Listen, Bjorn. For every second-hand chiropractic story you have, I have 100 medical industry stories. They care about their patients like they are family, so do chiropractic doctors and others who use non-drug approaches to health care.

          Borg wrote:
          “Do you live in an underdeveloped, dictatorially repressed part of the world where professional people have poor education and behave like mistreated animals?”

          Some would call the U.S. that. Here, medical school costs a fortune as does overhead and malpractice for the medical trades once they are turned loose on the public. Here it is called fee-for-service, meaning the more services they perform, the more fees they collect. Do less, get paid less and downsize from BMWs and take the kids out of private schools. More tests, better defense in malpractice lawsuits, too. Here this is called business as usual.

          As for meningitis and lymphoma, allopathic doctors do life-saving procedures. That’s where the true art of medical care comes in. That’s where I want to go. The emergency departments do amazing things saving accident victims lives. Organ and finger/hand/corneal/hair transplants are miracles. I take my hat off to the microsurgery specialists and ED docs. But I would also use non-drug approaches for health care and give my body every chance for recovery after the crisis to get healthy. Most would.

          Bjorn wrote:
          “you seem to have a heavy prejudiced grudge against the medical profession that precludes your rational and meaningful participation in this dialog. Please spare us your bigoted foolery. It contributes nothing.”

          Prejudice? Grudge? Bigotry? I learned it all here! I thought I was doing rather well. 🙁

          • SkepdicProf wrote: “…every second-hand chiropractic story you have, I have 100 medical industry stories”

            Of course you will. It’s hardly surprising when you consider that medicine is the largest of the healthcare professions, with chiropractic coming a poor fourth (7% utility in the US) after dentistry and physical therapy. But why should the (the narrow field of) chiropractic sit back and postpone putting its house in order until medicine’s cleaned up its act? Why hasn’t chiropractic set an example and weeded out its large quack contingent?

        • @ Björn – You obviously do not live in the US. Here’s how I can tell:

          – There are lots of unnecessary tests. And conversely, tests that should be run are not.
          – I’m really hoping that doctors treat their families way better than their patients.
          – Knowledge and sense is secondary (if used at all) to recipe prescriptions.

          These are generalized statements. There are some great docs in the US. They are very hard to find, and even harder to get into. Most that you can make an appointment with, are not worth it. A much better strategy would be to stay healthy. Of course that’s always true, but in the US a trip to the doc should be followed by some good quality time with google. I’d say “trust but verify”…but sadly, at this point it is simply “verify”.

          Here’s what you got right:
          – They don’t seem to be greedy.
          – They don’t seem to be deceiving.
          – It is very hard when you need the help of a real doctor. For emergency situations, it’s a gamble that you’re going to get anything better than a lowest level doctor.

          Here’s where I have no idea what you’re thinking:
          – “I do not think your chiropractor friends are going to do much for say, a life threatening meningitis or help you with a treatable lymphoma for example.” I don’t know a single person that would think that. Perhaps elsewhere they do.

          Here’s what actually contributes nothing:
          – “You obviously know very little about the real world and you seem to have a heavy prejudiced grudge against the medical profession that precludes your rational and meaningful participation in this dialog.”
          – “Do you live in an underdeveloped, dictatorially repressed part of the world where professional people have poor education and behave like mistreated animals?”

  • SkepdicProf wrote [re deceptive healthcare practices]: “Yes, psychiatry and chemotherapy come to mind and are excellent examples of what you warn of.”

    No, they’re poor examples. Psychiatrists, as trained MDs, are able to prescribe medications that stabilise mental health conditions. As for chemotherapy, it does work. It’s not always a cure, but it can shrink tumours and prolong life in patients who choose it. IOW, both therapies are able to deliver specific effects.

    • Blue Wode wrote:

      [Re: psychiatry and chemotherapy] No, they’re poor examples. Psychiatrists, as trained MDs, are able to prescribe medications that stabilize mental health conditions”

      Hmmm. Guess you didn’t know that all of the mass shooters of schools, movie theaters, etc. that we grow here were on psychotropic medication prescribed by the psychiatry profession for conditions that they may not even have had since there are no tests for these so-called ‘psychiatric diagnoses’. Medications whose known side-effects are violent behavior and suicidal tendencies. The shooter of the school in Connecticut had Asperger’s syndrome, a high-functioning level on the autistic spectrum. They don’t normally do things like what he did. But being on a medication that messes with the brain, and not enough time with his father, it is believed, likely lit the fuse in his mind that led to the well-known atrocity.

      “Of course you will. It’s hardly surprising when you consider that medicine is the largest of the healthcare professions, with chiropractic coming a poor fourth (7% utility in the US) after dentistry and physical therapy. Why hasn’t chiropractic set an example and weeded out its large quack contingent?”

      Physical therapy? I think you mean of the doctorate level professions, then that excludes physio. In the U.S., chiropractic health care is the third largest health care profession and the largest, licensed profession today that doesn’t utilize drugs.

      But if we are so small then why have you and others here devoted so much of your life to our small profession? We appreciate you sharing your marriage, family and professional time devoted to us and to demonizing the chiropractic health care profession, but I think the wife, kids and your patients would have appreciated even more, the years you and others here have spent on this misguided campaign.

      Blue Wode wrote:
      “Why hasn’t chiropractic set an example and weeded out its large quack contingent?” Hey, let’s not get nasty. We are all trying to be civil here. We have set an example by being one of the safest forms of health care and not killing over 800,000 victims each year from errors as the ‘practice’ of medicine does. Are they too big for you to go after?

      • @ SkepdicProf

        Re the ‘shooters’. We don’t know the minutiae of their medical histories and neither do you, so what you say is pure speculation. It also completely ignores the vast numbers of people who are helped by psychiatric medications.

        SkepdicProf wrote: “Physical therapy? I think you mean of the doctorate level professions, then that excludes physio. In the U.S., chiropractic health care is the third largest health care profession and the largest, licensed profession today that doesn’t utilize drugs.”

        As I’ve illustrated before, physical therapists will soon see chiropractors demoted to fourth position (indeed it could already have happened)…

        QUOTE
        “…if chiropractic fails to specialize in an appropriate manner, there may be no justification for the existence of chiropractic when there are an adequate number of physical therapists providing manipulative therapy. Many physical therapists are now using manipulation/mobilization techniques. Of the 209 physical therapy programs in the US, 111 now offer Doctor of Physical Therapy (DPT) degrees… Physical therapy, by 2020, will be provided by physical therapists who are doctors of physical therapy and who may be board-certified specialists.”

        Ref. Can Chiropractors and Evidence Based Manual Therapists Work Together? The Journal of Manual & Manipulative Therapy, Vol.14 No.2 (2006) E14-E18
        http://jmmtonline.com/documents/HomolaV14N2E.pdf

        SkepdicProf wrote: “But if we are so small then why have you and others here devoted so much of your life to our small profession?”

        Because if most chiropractors had their way, they’d have their scope of practice expanded (and officially recognised) to enable them to dupe the public into believing that what they offer is on a par with MDs. I, and others here, are ensuring that doesn’t happen. IOW, we’re in the business of preventing a healthcare catastrophe.

  • @Blue Wode

    I can’t stop of clapping my hands when read your opinions.

    “IOW, we’re in the business of preventing a healthcare catastrophe.”

    Please, don’t think black or white. It’s not very scientific or uselfull – it was pretty black and white thinking about jews in Germany back in the days. It’s not name what make a catastrophe. it’s an individual.

    Or is it Big Pharma paying you need to make it so black or white?

    Maybe I should send you that book of Chiro Principles and Practice, because you should read something else than just skeptic blogs. Do you think that e.g. that book is 100% non-sense?

  • Jorma Kärtsy wrote: “Maybe I should send you that book of Chiro Principles and Practice, because you should read something else than just skeptic blogs. Do you think that e.g. that book is 100% non-sense?”

    Yes.

    QUOTE

    Chapter 1: Basic Principles and Practice of Chiropractic
    This introductory chapter describes the general causes and effects of the subluxation complex. The role of subluxation as an etiologic or perpetuating factor in disease is determined by the extent of the neuropathologic and/or biomechanical processes involved and how they relate to the creation, maintenance, or progress of such disorders.
    http://www.chiro.org/ACAPress/Principles_and_Practice_of_Chiropractic.html

    Maybe I should let you borrow my copy of Trick or Treatment? by Edzard Ernst and Simon Singh. After a thorough and impartial evaluation of all the scientific evidence for chiropracitc, they conclude on p.285:

    QUOTE
    “This treatment carries the risk of stroke or death if spinal manipulation is applied to the neck. Elsewhere on the spine, chiropractic therapy is relatively safe. It has shown some evidence of benefit in the treatment of back pain, but conventional treatments are usually equally effective and much cheaper. In the treatment of all other conditions, chiropractic therapy is ineffective except that it might act as a placebo.”

    If you want to argue about the tiny amount of evidence for chiropractic spinal manipulation for low back pain, and why exercise is just as good, you can do so here:
    http://edzardernst.com/2014/02/which-therapy-is-best-for-low-back-pain/

  • @Blue Wode

    Now you speaking about wrong book

    http://www.amazon.com/Principles-Practices-Chiropractic-Scott-Haldeman/dp/0071375341/ref=sr_1_1?ie=UTF8&qid=1393476158&sr=8-1&keywords=haldeman+chiropractic

    I already have Trick or Treatment book. Great novel.

    I argue that exercise combined with manual therapy and early activation is more effective than pain killers for low back pain.

  • Blue Wode wrote: “Re the ‘shooters’. We don’t know the minutiae of their medical histories and neither do you, so what you say is pure speculation. It also completely ignores the vast numbers of people who are helped by psychiatric medications.”

    Sure we know the minutiae. Minutiae is what the media covers. It was covered by the media here. Mentioned on many radio/news programs. All given psycho meds with negative/lethal side effects for a dubious diagnosis. Why did you miss it? A simple search would find this:

    https://www.google.com/search?q=mass+shooters+on+psychotropic+drugs&rlz=1C1RNNN_enUS387&oq=shooters+on+psychiatric&aqs=chrome.2.69i57j0l4&sourceid=chrome&espv=210&es_sm=93&ie=UTF-8

    “As I’ve illustrated before, physical therapists will soon see chiropractors demoted to fourth position (indeed it could already have happened)…”

    Indeed, we are not in competition with PTs. I applaud the who PTs are trying to upgrade their education and become like doctors with DPT degrees. But they want to be like physiatrists. Thank you for the compliment if you think they are trying to become chiropractic doctors with a doctorate degree. BTW, currently, only a small percent of physios have upgraded their qualifications with a DPT, while 100% of chiropractic doctors have a doctorate degree from a chiropractic university. I know the number is increasing and many of them will make good doctors.

    As for Sam Homola, sadly, his opinions were always considered to be odd and he was thought by many to be somewhat of a flake. He was never taken seriously and is long-since retired in Florida.

    Blue wrote:
    “Because if most chiropractors had their way, they’d have their scope of practice expanded (and officially recognised) to enable them to dupe the public into believing that what they offer is on a par with MDs. I, and others here, are ensuring that doesn’t happen. IOW, we’re in the business of preventing a healthcare catastrophe.”

    Well, looks like your bigotry is showing. So you think we are striving to be on a par with the MD crowd? That’s a good one. Being beholden to the MDs for your business, perhaps, has clouded your vision. The MDs and medical care is all about sick care and do a fantastic job.

    Chiropractic doctors, as are other holistic, non-drug approaches, are about health care. We don’t treat illnesses to make people less sick, we care for people so they can become healthier. This is something that you, apparently will never get, nor will most, including EE, with traditional allopathic training.
    Sorry.

    • SkepdicProf wrote: “Chiropractic doctors, as are other holistic, non-drug approaches, are about health care. We don’t treat illnesses to make people less sick, we care for people so they can become healthier. This is something that you, apparently will never get, nor will most, including EE, with traditional allopathic training.”

      Allopathic. Here’s why SkepdicProf continues to reveal himself:

      QUOTE
      “The term ‘allopathy’ was invented by German physician [and homeopath] Samuel Hahnemann (1755-1843). He conjoined allos ‘opposite’ and pathos ‘suffering’ as a referent to harsh medical practices of his era which included bleeding, purging, vomiting and the administration of highly toxic drugs…Hahnemann sought to replace allopathy with his ‘law of similia’ that treated ‘like with like’, a pre-scientific idea that he had discovered from reading ancient sources. Hahnemann had abandoned medical practice because of his inability to heal his patients by the methods of his era. He earned money by translating classical works into German leading him to ancient medical ideas. (Kaufman M. ‘Homeopathy in America: The Rise and Fall and Persistence of a Medical Heresy’, in Other Healers: Unorthodox Medicine in America, Ed. Norman Gevitz, Johns Hopkins, 1988.)

      -snip-

      Significance of a Misnomer
      Although medicine never accepted the label of allopathy, non-medical practitioners such as chiropractors, homeopaths, and naturopaths regularly misrepresent physicians as ‘allopaths’. This is usually done in order to make differences between their practice guilds appear based upon conflicting philosophies rather than ideology versus science. Opponents of medicine claim that they treat the underlying causes of disease, while MDs treat only the symptoms. Further, they claim that medicine suppresses the symptoms, thus interfering with the body’s inherent healing processes. A close examination reveals that this line of reasoning is only clever rhetoric. When they say they are treating the underlying causes, these vitalistic ideologists refer to a metaphysical life force rather than actual causes of disease such as viruses, bacteria, protozoa, genetic defects, radiation, chemical insult, and so forth.”

      Ref: http://www.ncahf.org/articles/a-b/allopathy.html

      BTW, SkepdicProf, re your accusation that Professor Ernst ‘will never get’ holistic, non-drug approaches, evidently you are unaware of his training in acupuncture, herbalism, homeopathy, and spinal manipulation (which he has applied clinically). That experience, coupled with his background as an MD (PhD) and research scientist, renders him more qualified than most to critically evaluate so-called holistic approaches.

      • Blue Wode wrote:
        “…reveals himself.” Yes, I am revealing myself. Whatever that means.

        I am skeptical about is your habit of Wikipedia-style link-farming, especially to an ex-psychiatrist’s website that he operates from his basement.

        Prof. Ernst was first trained in allopathy. Beholden to the pharmaceutical companies from poor student (fed free lunches, stethoscopes, books, funded school labs and equipment) to practitioner (free lunches, dinners, seminars, pens, pads, good pay for promoting their products, nice bonuses for giving a lecture, funded labs, etc., etc.) Everything is compared to that. He has never been totally weened off the pharmaceutical nipple. Why bite the hand that has fed him? This is the only perspective he knows. The well has been permanently poisoned.

        He may have learned about the other holistic, non-drug approaches, and even tried his hand at them, but his head will always belong to medicine. If he were to acknowledge that anything else worked, then that would mean that he would have to acknowledge that his many years sweat and toil of his med school training was wrong.

        Like it or not, that is just the way it is.

  • Chiropractic apologists lack any credibility.

  • Edzard says:
    “I should issue a warning at this point: insults and abuse will not be tolerated on this blog.”

    Thank you, Professor. Hear that , Henness?!

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  • I know of only two chiropractors that use x-rays. It sounds to me like we have an allopathic doctor who likes to dole out medications with an axe to grind against others in the medical profession whose techniques do not jive with their own.

    • you did not read the post!
      perhaps you should before you state nonsense!

    • And it sounds to me like you’re a chiropractor who likes to dole out a whole raft of nonsense for things like fake adrenal gland fatigue and detoxing. You do “wellness consulting.” You also sell kinesiology tape. You’re just protecting your dubious source of income from people calling you out on your pseudoscience.

      http://www.greeleywellnesscenter.com/wellness-consulting/

      By the way, you’re just as “allopathic” as Dr. Ernst. The term refers to everything that isn’t homeopathy and using that word only makes you sound like an uneducated, unscientific, uninformed pretend doctor.

      Your website is full of lies. You avoid the word “subluxation” but you hint at it. You’re also probably rabidly anti-vaccine based on your comments about “detox.”

      “My name is Richard Bauer, Doctor of Chiropractic. I have worked in the Chiropractic field for over 30 years. I am the best Spanish speaking Chiropractor in the Greeley area and offer a free 30-45 minute consultation and exam to new patients. I take the time to properly document and treat each and every symptom. Some patients may come in with certain symptoms at the beginning and have other symptoms appear over time. I will give full proper treatment to those symptoms.”

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