MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

Adverse events have been reported extensively following chiropractic.  About 50% of patients suffer side-effects after seeing a chiropractor. The majority of these events are mild, transitory and self-limiting. However, chiropractic spinal manipulations, particularly those of the upper spine, have also been associated with very serious complications; several hundred such cases have been reported in the medical literature and, as there is no monitoring system to record these instances, this figure is almost certainly just the tip of a much larger iceberg.

Despite these facts, little is known about patient filed compensation claims related to the chiropractic consultation process. The aim of a new study was to describe claims reported to the Danish Patient Compensation Association and the Norwegian System of Compensation to Patients related to chiropractic from 2004 to 2012.

All finalized compensation claims involving chiropractors reported to one of the two associations between 2004 and 2012 were assessed for age, gender, type of complaint, decisions and appeals. Descriptive statistics were used to describe the study population.

338 claims were registered in Denmark and Norway between 2004 and 2012 of which 300 were included in the analysis. 41 (13.7%) were approved for financial compensation. The most frequent complaints were worsening of symptoms following treatment (n = 91, 30.3%), alleged disk herniations (n = 57, 19%) and cases with delayed referral (n = 46, 15.3%). A total financial payment of €2,305,757 (median payment €7,730) were distributed among the forty-one cases with complaints relating to a few cases of cervical artery dissection (n = 11, 5.7%) accounting for 88.7% of the total amount.

The authors concluded that chiropractors in Denmark and Norway received approximately one compensation claim per 100.000 consultations. The approval rate was low across the majority of complaint categories and lower than the approval rates for general practitioners and physiotherapists. Many claims can probably be prevented if chiropractors would prioritize informing patients about the normal course of their complaint and normal benign reactions to treatment.

Despite its somewhat odd conclusion (it is not truly based on the data), this is a unique article; I am not aware that other studies of chiropractic compensation  claims exist in an European context. The authors should be applauded for their work. Clearly we need more of the same from other countries and from all professions doing manipulative therapies.

In the discussion section of their article, the authors point out that Norwegian  and Danish chiropractors both deliver approximately two million consultations annually. They receive on average 42 claims combined suggesting roughly one claim per 100.000 consultations. By comparison, Danish statistics show that in the period 2007–2012 chiropractors, GPs and physiotherapists (+ occupational therapists) received 1.76, 1.32 and 0.52 claims per 100.000 consultations, respectively with approval rates of 13%, 25% and 21%, respectively. During this period these three groups were reimbursed on average €58,000, €29,000 and €18,000 per approved claim, respectively.

These data are preliminary and their interpretation might be a matter of debate. However, one thing seems clear enough: contrary to what we frequently hear from apologists, chiropractors do receive a considerable amount of compensation claims which means many patients do get harmed.

48 Responses to Finally a piece of meaningful chiropractic research: compensation claims against chiropractors

  • Professor Ernst wrote: “I am not aware that other studies of chiropractic compensation claims exist in an European context. The authors should be applauded for their work. Clearly we need more of the same from other countries and from all professions doing manipulative therapies… one thing seems clear enough: contrary to what we frequently hear from apologists, chiropractors do receive a considerable amount of compensation claims which means many patients do get harmed.”

    According to the U.S. 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

    You’d think that chiropractors would have their own adverse event reporting systems in place by now. At the very least, they need to close this loophole as a matter of urgency:
    http://www.ebm-first.com/chiropractic/risks/1842-letter-from-britt-harwe-president-chiropractic-stroke-awareness-group-csag.html

  • Prof. Ernst said:
    “However, one thing seems clear enough: contrary to what we frequently hear from apologists, chiropractors do receive a considerable amount of compensation claims which means many patients do get harmed.”

    Could you please explain why professional indemnity insurance for chiropractors in Norway is 4500 NOK (£380) per annum? If the compensation claims were indeed considerable one would expect this to reflect chiropractors’ insurance premium, wouldn’t you agree?

    • interesting!
      do you also know the premiums for doctors, physios, osteopaths?

    • I would expect them to have a low premium, given that only an idiot would consult a chiropractor with a serious disease. The potential for harm is likely to increase with the severity of disease. A doctor who misses a cancer, leading to death, has caused substantial harm, but a chiropractor who delays referral is unlikely to be held as culpable since nobody in their right mind would expect a chiropractor to act as a primary care physician.

      The valid comparison would be with the professional indemnity premiums for sports physiotherapists or some other profession related primarily to non-invasive treatment of musculoskeletal pain.

  • EE, there are many chiropractors in the world who have Phd’s from very respectable universities. Scott Haldeman M.D. PhD. is an obvious example, as is Charlotte LeBoef-Yde. To get their PhD’s they must have done research that is more than just meaningful, it must be very good. For you to entitle your post the way you have done, shows an absolute arrogance and lack of research on your behalf. Shame on you.

  • That is a good article on a very important topic. We have had a similar discussion here in the Medical Journal of Australia not long ago:
    https://www.mja.com.au/insight/2014/7/support-chiropractor-reporting
    There is no adverse event (AE) reporting here for chiro’s, physio’s or GP’s in private practice. The Orthopod, John Cunningham, made a very good proposal in the above articles comments section. A serious AE is going to end up in the hospital emergency department, so a systematic, standardised collection of information/form, that is then referred to the relevant board for investigation is a great idea. This is to apply to all professions. The physio’s have dodged a bullet on this issue and they know it, but the debate in regards to chiropractic has just highlighted the necessity of a standardised AE reporting system for everyone!
    The above article cited by Prof Ernst has also highlighted the importance of informed consent. This has been a common law requirement here for all health professions since approximately 2000. Here is an article from chiropractic academic and researcher Bruce Walker from Murdock University on the subject:
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2051308/?tool=pmcentrez
    I agree with Prof Ernst, we need more of these articles. Here is a recent article that is very relevant
    SafetyNET: An interdisciplinary research program to support a safety culture for spinal manipulation therapy
    http://www.europeanintegrativemedicinejrnl.com/article/S1876-3820%2814%2900091-2/abstract

  • It is always amazing to me that a profession that see’s less than 8% of any given country population receives such fear driven skepticism from one that is almost 100% involved in patient care. Instead of worrying about a profession that does not utilize pharmacology, surgical intervention and vaccination(where most serious fatal injury occurs), Ernst should worry about protecting the public from his own profession which by the way is notorious for not reporting adverse events. Ernst is nothing more than a chiropractic hater and there is no research that would ever change that. His opinions are merely his own and in most cases not founded on anything scientific. As someone very involved in malpractice I have seen very little severe injury and when injury does occur it is usually self limiting in a short period of time. Yes informed consent is absolutely necessary and yes there are practitioners who may be guilty of delaying an appropriate referral but, that occurs both ways. How many unnecessary pain management injections, opiate prescriptions and surgical procedures are done each year crippling people and creating life long disability when something as simple as a referral to a competent Chiropractor could have prevented such invasive treatment? It is about time we stopped pointing fingers and come to the conclusion that medicine is not all knowing and that alternative healthcare is not only safe and effective but here to stay. It is a shame that someone with such pedigree and knowledge would waste so much time attacking a profession that has done nothing more than serve humanity for 117 years.

    • Chiro-hater? no, only if you don’t know the difference between hate and criticism!
      His opinions…? As far as I can see, this post was about evidence, not opinion.
      (Anthony was the President of the ‘International Chiropractic Pediatric Association’ – say no more!)

      • That’s exactly right. I do not hide who I am from anyone. Unlike your comments and identity. I guess your beliefs in one man’s OPINION equals science in your closed minded little world. Good luck and Happy Holidays.

        • Anthony J. Carrino said:

          That’s exactly right. I do not hide who I am from anyone. Unlike your comments and identity.

          Whose comments and identity?

        • You live on another planet and you are deluted in matter of science. Please, do not even say this word, I don’t think you know what this mean.
          However, I understand perfectly that you want to defend your business : money is god. As always, instead of answering critisism by evidence, there is the dodgy ‘look there, a plane !’.
          By the way I love (in the same paragraph) : “that a profession (chiro) that see’s less than 8% of any given country population” and “surgical intervention and vaccination(where most serious fatal injury occurs)”. Well, when you get 92% of the population you might get more adverse effect… Of maybe is just that people seeing M.D are actually truely ill (I mean, they don’t have some imaginary subluxation but a disease). So, two things : I would really see the number of fatal injury by vaccination and the ratio of live saved by surgery versus number of fatal injury (caused by surgery, and not by the injury itself). Well, next time you break your leg my guess is that you are not going to see a chiro… Hypocrite.

  • Well done Anthny Corrino for spelling it out to Ernst – who I understand has the distinction of being the only ‘professor of complementary medicine’ without any qualifications in the fields he ‘advises’ on (NB. advises = criticises) …! If I am wrong about this lack of qualifications please let me know… and please be serious – what memberships of proper professional bodies does he hold…a few hours ‘study’ whilst doing medicine really doesn’t count! He has done nothing but slate many of the professions (particularly chiropractic) other than allopathic medicine – which is his background… what a surprise!!! I know of no serious or knowledgeable academics who take his comments seriously. I have yet to read anything constructive in his diatribe/attack on chiropractic. If he was a serious academic really interested in the public’s health he would probably address the reports that allopathic medicine – his chosen field – is the 3rd leading cause of death in the US and probabaly all of the western world… but no, he tries to attack the other professions and appears to avoid any face to face discussions in front of cameras/knowledgeable audiences. A cynic might think he was paid by the drug companies to particularly attack chiropractors because their patients respond so well that they have so little need for painkillers and nsaids after treatment. I remember reading that Ernst was criticised by The Lancet editor Richard Horton who, in a 29 August 2005 letter to The Times, wrote: “Professor Ernst seems to have broken every professional code of scientific behaviour… ” Later Ernst retired early from his post at Exeter because the funding was thankfully withdrawn. Let us hope that in the near future we get some serious and knowledgeable academics investigating the various types of medicine such as chiropractic and acupuncture with a view to finding out just how much good these professions can do.

  • Dr Scott wrote: “If I am wrong about this lack of qualifications please let me know”

    If you read his blog bio, you’ll learn that Professor Ernst has received hands-on training in acupuncture, autogenic training, herbalism, homoeopathy, massage therapy and spinal manipulation:
    http://edzardernst.com/about/

    Dr Scott wrote: “He has done nothing but slate many of the professions (particularly chiropractic) other than allopathic medicine – which is his background”

    For “slate” read ‘critically assessed’.

    Dr Scott wrote: “I know of no serious or knowledgeable academics who take his comments seriously.”

    Could it be that you don’t know many impartial, science-based critical thinkers?

    Dr Scott wrote: “If he was a serious academic really interested in the public’s health he would probably address the reports that allopathic medicine – his chosen field – is the 3rd leading cause of death in the US and probabaly all of the western world”

    Here’s medicine’s answers to its critics:

    Part 1
    http://www.sciencebasedmedicine.org/answering-our-critics-part-1-of-2/
    Part 2
    http://www.sciencebasedmedicine.org/answering-our-critics-part-2-of-2-whats-the-harm/

    And here’s a snippet from Death by Medicine:

    QUOTE
    “Doctor-bashers use their numbers to argue that alternative medicine is safer. Maybe it is. I suppose not treating at all would be safer still. It depends on how you define “safe.” To my mind, a treatment is not very “safe” if it causes no side effects but lets you die. Most of us don’t just want “safe:” we want “effective.” What we really want to know is the risk/benefit ratio of any treatment. The ironic thing is that all the statistics these doctor-bashers have accumulated come from the medical literature that those bashed doctors have written themselves. Scientific medicine constantly criticizes itself and publishes the critiques for all to see. There is NOTHING comparable in the world of alternative medicine.”
    Link http://www.sciencebasedmedicine.org/death-by-medicine/

    Dr Scott wrote: “He tries to attack the other professions and appears to avoid any face to face discussions in front of cameras/knowledgeable audiences.”

    I understand that he’s been invited to give a talk at the AECC in the near future. Previously gave one to the General Chiropractic Council (GCC), although the GCC has chosen to conceal his answers to its questions from public view:
    http://edzardernst.com/2013/02/research-in-chiropractic-seems-in-a-dismal-state/#comment-9071

    Dr Scott wrote: “A cynic might think he was paid by the drug companies to particularly attack chiropractors because their patients respond so well that they have so little need for painkillers and nsaids after treatment.”

    Apparently chiropractic patients do just as well with sham treatment for acute low back pain (there’s no good evidence that chiropractic helps any other condition):
    http://www.ebm-first.com/chiropractic/research-and-efficacy/2163-spinal-manipulative-therapy-for-acute-low-back-pain-update-of-the-earlier-cochrane-review-first-published-in-january-2004.html

    Dr Scott wrote: “I remember reading that Ernst was criticised by The Lancet editor Richard Horton who, in a 29 August 2005 letter to The Times, wrote: “Professor Ernst seems to have broken every professional code of scientific behaviour… ” Later Ernst retired early from his post at Exeter because the funding was thankfully withdrawn.”

    Here’s what really happened (see comments):
    http://www.quackometer.net/blog/2010/04/police-investigate-the-princes-foundation-for-integrated-health.html

    (A lot more to it than ‘Dr’ Scott would have us believe.)

  • Just as I thought. “Hands on training…” so no professional memberships and no actual real qualifications… translates as “no qualifications whatsoever”. A bit like a physiotherapist who has a few lectures on one disease and does a ward round with a consultant seeing a patient with that disease… and then thinks she is “qualfied” or a ‘doctor’ because she has ‘had some hands on training”…!

    Blue Wode misses the point with his awkward defence of medicine. I am not saying drugs and surgery are not important! What I am saying is the Ernst gets his publicity, often with spurious self research not confirmed by anyone else, about ‘alternative’ medicine but never addresses the shortcomings and dangers of allopathic medicine.

    Ernst always chooses the biased trials to show chiropractic in a bad light. He incudes poor qulaity trials or trials that presume simple manipulation is the same as expert chiropractic manipulation so ‘manipulation’ is shown to be largely useless or no better than other poor quality treatments. Did he support and quote the ridiculous claims published in The Times and other newspapers and medical journals that stated there was proof of chiropractic in Germany causing death and paralysis? Then, when it was proven NONE of these patients had ever consulted a chiropractor and had only seen medics and physio-type practitioners who, when they casued great harm with their inexpert manipulative techniques, explained that they had used ‘chiropractic manipulation’ to blame the chiropractic profession?!! Did he or any of the newspapers or journals apologise for their glaring error afterwards?

    Reputable people and journals admit mistakes and rectify them.

    Alas many serious academics consider that Ernst has done nothing to advance science. He has simply stirred up age-old professional bias and allowed unprofessional pseudo-scientific people and journals to have some fun… and him to have the limelight.

    • it take this to show that chiropractic is not helpful against paranoia.

      • Let me quote: “People with paranoid personality disorder are generally characterized by having a long-standing pattern of pervasive distrust and suspiciousness of others. A person with paranoid personality disorder will nearly always believe that other people’s motives are suspect or even malevolent. Individuals with this disorder assume that other people will exploit, harm, or deceive them, even if no evidence exists to support this expectation.”

        And who do you think would fit that bill?

        Would someone with the surname Ernst come to mind?

        I am so surprised!

        I also very much doubt consulting a chiropractor (or osteopath or acupuncturist) would be helpful for paranoia.
        Well done to Ernst for pointing out something actually true…!
        Maybe a psychiatrist would a stand a chance of helping… but alas their success rate is probably very low… although as yet no ‘Ernst-style attack’ on any of their claims (NB they are medical and thus perhaps beyond his brief) has happened as yet.

      • Dr Scott wrote: “What I am saying is that Ernst…never addresses the shortcomings and dangers of allopathic medicine.”

        That’s not where his area of expertise lies.

        Dr Scott wrote: “Did he support and quote the ridiculous claims published in The Times and other newspapers and medical journals that stated there was proof of chiropractic in Germany causing death and paralysis? Then, when it was proven NONE of these patients had ever consulted a chiropractor and had only seen medics and physio-type practitioners who, when they caused great harm with their inexpert manipulative techniques, explained that they had used ‘chiropractic manipulation’ to blame the chiropractic profession?!!”

        I understand that chiropractors in Germany are part of a group of unregulated lay complementary therapists known as “Heilpraktiker”. However, German medical doctors (some of whom will go one to specialise in orthopedists) can undertake around 4 weeks of training and study manipulation as part of their CPD in order to practice what they term “chirotherapy”.

        The study you mention shows that there may be a connection between vad and stroke. Here is the full text of the study:
        http://www.chiro.org/Professional_Regulation/reuter_u06.pdf
        Reuter U and others. Vertebral artery dissections after chiropractic neck manipulation in Germany over three years. Journal of Neurology 256:724-730, 2006

        And here’s some interesting comment on it:

        QUOTE:
        “In 2006, the Journal of Neurology published a German Vertebral Artery Dissection Study Group report about 36 patients [24 F/12 M, mean age 40+11 years] who had experienced vertebral artery dissection associated with neck manipulation [16].
        Twenty-six patients developed their symptoms within 48 hours after a manipulation, including five patients who got symptoms at the time of manipulation and four who developed them within the next hour. In 27 patients, special imaging procedures confirmed that blood supply had decreased in the areas supplied by the vertebral arteries as suggested by the neurological examinations.
        In all but one of the 36 patients, the symptoms had not previously occurred and were clearly distinguishable from the complaints that led them to seek manipulative care.
        This report is highly significant but needs careful interpretation. Although it is titled “Vertebral dissections after chiropractic neck manipulation . . . ” only four of the patients were actually manipulated by chiropractors. Half were treated by orthopedic surgeons, five by a physiotherapist, and the rest by a neurologist, general medical practitioner, or homeopath.
        It is possible—although unlikely—that the non-chiropractors used techniques that were more dangerous than chiropractors use in North America. The authors suggested that the orthopedists’ treatment was safer, but there is no way to determine this from their data. Regardless, the study supports the assertion that neck manipulation can cause strokes—which many chiropractors deny.”
        Ref: http://www.quackwatch.org/01QuackeryRelatedTopics/chirostroke.html

        So, two things:

        1. There are strong indications that neck manpulations/adjustments cause VAD, no matter who administers them.
        2. I would venture that MDs/orthopedists, and MD chirotherapists in Germany, are far more conscientious about reporting bad outcomes than chiropractors.

        Bottom line: Necks should be left alone. The risks of neck manipulations/adjustments far outweigh the benefits.

        • Usual assumptions and bias!

          With 95%+ of all manipulatins done by chiropractors around the world and if you really think that the gentle manipulations done by them are so terrible… where are all these dead and maimed people hiding? I would guess that there are something like 7,000,000 neck manipulations done each year by chiropractors (NB. I must state that am simply guessing here – I have absolutely no proof of the exact figure) so there should be mountains of unfortunate people lying in hospital or morgues… but no, it is our medical profession which consistently paralyses and kills patients. But good old ‘medically trained’ Ernst never attacks them.

          You mentioned “That’s not where his area of expertise lies”.… but I understood he was trained as a medical doctor… I don’t know if he qualified or not… so this should be his area of expertise! So why can’t he stick to the little area of expertise he aparently has rather than stepping out of his field into the unknown and commenting on professions where he has either no expertise or maybe “a couple of weeks hands on experience”.

          If he has forgotten all his medical training then perhaps he should fade away and stop his diatribe.

          I would have thought that anyone taking the job title of “professor of complementary medicine” would have been unbiased and tried to both look at each profession with an open mind… commenting on both the positives and the negatives. Alas Ernst completely failed in this. How many constructive, pro-the-profession papers did he ever write? Perhaps his brief from his employers/sponsors was simply to attack the other professions?

          Statistics show that manipulation done by other professions with their much shorter traning (how an you compare 4 weeks with the four to six years training a chiropractor has!) is considerably more dangerous!

          Why would Ernst not have a go at them instead? Oh I forgot… they are not the establishment, the marionettes of the drug companies! A cynic might conclude that “his masters have not given him permission to do this?” “It is not his brief…”

          You note the authors considered that it was unlikely that the manipulation done by other professions was less dangerous…. Oh dear… Thirty two case v four is obviously not in the slightest bit significant in their eyes! Had it been the other way around I think they might have highlighted this statistic!

          You are aware that chiropractic is not regulated in Germany so the report does not mention whether these practitioners were simply calling themsleves chiropractors and practising in the heilpraktike group rather than actually being qualified with degrees in chiropractic from a recognised university/college of chiropractic. When I first read the reports on this, I understood that none of the “chiropractors’ were actually properly qualified. I seem to remember that only the Telegraph published an (albeit very tiny) apology to the chiropractic profession many weeks later. The Times did not. The medical journals did not.

          Many of these ‘scientific’ reports you like to quote/believe are based entirely on hearsay and the recollections of neuropsurgeons and neurologists (who should report and declare their vested interest in decrying any profession that takes their private patients away from them…) who state that “oh yes I have had lots of patients damaged by manipulation” etc etc. Typical non-scientific garbage.

          Neck manipulation is far less dangerous than neurosurgery for the same conditions! Would you not agree that thhe damage/paralysis rate for neurosurgery for a C5-6 or C6-7 disc prolapse can be as high as 2%… and other areas often have a higher risk. These are often the same condiotions treated by chiropractors… with perhaps the risk of damage being one case per 250,000 treatments. If chiropractors only succeed in gaining good outcomes in 60% of the more difficult cases this is a massive reduction in iatrogenic damage/paralysis/death…! We also know that a cervical fusion often results in a secondary disc problem at the adjoining level c. ten years down the line necessitating either chiropractic treatment or another (risky) fusion.

          People shouldn’t throw stones in glass houses…

          I have enjoyed our chat, but regret that I have to sign off for now… I am going away on holiday until the second week in January. I hope you have an excellent Christmas and New Year and look forward to Ernst coming up with just one positive paper on chiropractic (you chose this particular profession after I commented on Anthony Corrino’s comments – and it certainly is his favourite area to attack)… and just one paper criticising our “orthodox” allopathic medical profession… and then (hopefully) he will retire and we can have more constructive papers published by serious unbiased researchers.

          All the best for 2015.

  • Dr. Ernst,

    Postural examination of multiple photographs show a left and anterior rotation of your atlas relative to your skull. Perhaps a specific (non-manipulative) atlas orthogonal adjustment will help to clear your head. Of course, I must admit that further examination may be necessary to find the absolute degree of this spinal subluxation.

    Sincerely,

    A caring friend

    • Ghosh am I glad to finally have found a caring friend – even one who has examined multiple photographs [must be an admirer!?!]

      • Oh Dr. Ernst. You know, I truly do admire you. I admire you the same way I admire characters like Bill O’Reilly or
        Glenn Beck. People that have made it far in the public light and have become a reputable source for many. People so afraid of change that they lump everyone who disagrees with them in the same category and calls them “bonkers.” Oh wait, that was actually you.
        I am genuinely curious about what you think is happening when people get long lasting health benefits (including, but not exclusively, pain relief) after a chiropractic adjustment. Because at this point in your career you must know that this does happen. It must be frustrating to not be able to rationalize this repeatable event. I hope your response is not that “they would have gotten better anyway.” I need more than that from you. I mean for God’s sake look at all of those letters after your name.

        • “I am genuinely curious about what you think…”
          Well, I think that professionals should be able to discuss the scientific issues rather than posting a comment which is 100% ad hominem.

          • Dr Brad wrote: “I am genuinely curious about what you think is happening when people get long lasting health benefits (including, but not exclusively, pain relief) after a chiropractic adjustment).”

            @ Dr Brad

            I suggest that you have a slow read through this:

            Why do ineffective treatments seem helpful? A brief review
            http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2770065/

          • I find that funny coming from you. Are you not inspiring a riposte with titles such as this? You have a sense of entitlement that you feel gives you poetic license, but you get upset when someone wants to hand the sarcasm back.

          • DR. BRAD
            I am always trying to discuss the issues at hand, and I am not upset – I merely made an observation about your comment which I think was both correct and warranted.

  • @ Blue Wode

    You truly believe that this article is the end-all-be-all to why chiropractic care is helpful for people? It is easier for you to believe that that many people can basically trick themselves into thinking they are feeling better? I have personally seen patients with trigeminal neuralgia (Tic Douloureux) have a complete resolution of symptoms after chiropractic care. I find it much harder to believe that someone can simply positively think his or her way out of that condition. Also, do patients with complaints of total numbness into their fingers suddenly imagine that they have feeling again?
    I find it more scientifically plausible that structural and functional changes occur in the human body that allow symptomatic improvement.

  • Akbar P
    I went through this entire post and I read and listen to critics of such. Only have one thing to mention here to all interested
    and that is ” I am a chiropractor and have been for the last 24 years”. I have ran practices in San Francisco, Oakland, San Jose for 22 years and I am presently practicing overseas. I have ran very busy and successful practices all along and have treated close to 25000 people throughout the years. My offices’s data shows that roughly about 13% of it all was work related and personal injury cases and the remainder of the files have been people from all walks of life. As I have stated earlier, I practiced in the US for 22 years and not even one single malpractice claim and not a single complaint with the Board of Chiropractic Examiners.

    Edzard Ernst’s article therefore is meaningless to me. I am aware that cervical chiropractic manipulation is potentially harmful but that is all there is”potentially”. Yes it does happen extremely rarely, but the risk and the occurrence is nowhere even close to the risk of internal bleeding secondary to use of simple Asprin. With the claims made by Dr. Ernst and alike, I should be in great deal of trouble by now and yet there are many many excellent chiropractors out there who evaluate and treat and help even more patients that I ever did and they do not find these numbers and figures reasonable. The only profession in the word that does not harm at all is doing nothing, I assume. Coming up with these numbers and trying to create a public hysteria is only leading me to believe that Bias if nothing else is the motive.

  • Thanks for your post Alan
    Simple, I have been doing it for 24 years. As I mentioned earlier, I have no complains not even one (formal complaint that is) . Could you possibly say that no one has suffered from blood loss as a result of Aspirin in 24 years. Besides, I am just objecting to the statements made by Dr. Ernst on top of this conversation regarding 50% of patients experiencing side effects from chiropractic treatments. I am certain that some people report worsening of symptoms following manipulative therapy for a short period of time but I do not consider that a side effect it simply is a response to a mechanical move that their body is not familiar with but even that does not happen 50% of the time. I am also certain that occasionally people may experience severe side effects, but I have not experienced that in my years of practice. I simply believe that there is a great element of exaggeration at work here. I don’t see you questioning the author Dr. Ernst about that? right?

    Another observer Frank has also forwarded a link to my attention. Thank you. I again reiterate that my emphasis is on the fact that all of these so called reports have a degree of truthfulness in them but they also exaggerate a lot. I can not possibly be an exception to the rule here. There a a great number of other practitioners with few of no complaints here and if the disaster is a you portray, how do explain this. I invite you to watch Dr. Raymond Damadian’s Seminar on
    Cervico-cranial syndrome symposium listen to what he has to say about chiropractic treatments (inventor of MRI). Scot Rosa, D.C. has also been in practice since 1987 and he basically works with MS patients. Would you please look into it to see how many people have filed complaints against him?? or Scot Haldeman, M.D., D.C. Neurologist, Dr. Salimi, M.D, D.C. , I can provide a list of up to 100 people just off of my mind who have no complaints filed against them and they have been in practice almost as long as I have and some even longer. Lets face the truth that is all I am asking.
    All I anticipate here is for people to be realistic and not to exaggerate things beyond belief. The only harmless practice is not practice.
    Thanks all

  • Sep 20, 2013 Scientific American

    How Many Die from Medical Mistakes in U.S. Hospitals?
    An updated estimate says it could be at least 210,000 patients a year, more than twice the number in a frequently quoted Institute of Medicine report

    No the fact that Dr. Damadian did or did not directly invent the MRI machine does not mean that what he says about chiropractic is true but the man is a Scientist, A medical practitioner for over 45 years, a professor for over 40 years and
    he is directly investigating on a very crucial and sensitive subject in chiropractic profession and yes yes yes what he says could be correct about the efficacy of chiropractic treatments . We will look forward to the out come of his investigations . By the way do you have a number of a ball park to state how many people have been killed or seriously injured by chiropractors in the last over 130 years??? I have not hurt any one in over 25 years how many MDs could claim that????? and I am currently treating over 40 people a day and have been for the past over 20 years. Again I do understand and appreciate the fact that the potential is there for damages and injury but what is stated in most of these pages is simply over exaggeration of a minute risk.

    • Akbar Poorshafiee said:

      How Many Die from Medical Mistakes in U.S. Hospitals?
      An updated estimate says it could be at least 210,000 patients a year, more than twice the number in a frequently quoted Institute of Medicine report

      And what’s your point?

    • @Akbar
       
      I am not surprised you have not had an immediate response to your comment directly from Edzard. He must be sick to death of making the following points over and over and over again. You’ll find them on more than half the threads in this blog. Let me have a try in my own words.
       
      1. The absolute number of deaths is irrelevant. It is the risk:benefit ratio that matters. If a treatment has zero benefit then any level of risk is unacceptable.
       
      2. “I have not hurt any one in over 25 years how many MDs could claim that?????” Leaving aside the fact that this is anecdotal evidence, how do you know?! Do you monitor every patient who leaves your office and doesn’t return? Does any chiropractor make an effort to monitor possible adverse events sytematically?
       
      Why is there no formal system for monitoring adverse events, similar to the ones used in the USA (and elsewhere) for proper medicine? You found a figure for numbers of deaths in the USA: please tell us where you would look to find similar data for chiropractic. And please don’t tell us that’s because chiropractic is perfectly safe. There are enough published case reports to indicate the kinds of risks associated with spinal manipulations, including fatal outcomes.

    • @ Akbar Poorshafiee, B.Sc., D.C., I.D.E., Q.M.E. on Sunday 14 February 2016 at 16:42,

      “By the way do you have a number of a ball park to state how many people have been killed or seriously injured by chiropractors in the last over 130 years???”

      More importantly, what have they actually cured in the last 121 years (chiro was invented by the convict and magnetic healer Palmer in 1895)? I appreciate that English may not be your first language (the errors in your post make this obvious), however, don’t chiropractors have any training in primary school subtraction?

  • Your last statements are simply childish and not even worth commenting on. I speak and write four languages at this
    level and one at perfection. What is your level of education Mr. I know every thing ????

    • @Akbar Poorshafiee

      You seemed to have missed Prof Ernst’s credentials at the top of the page with further details on the About page, where such things are usually to be found (I’ll leave it to you to find it for yourself). And not that it’s the slightest bit relevant, but Prof Ernst is fluent in at least German, English and French – possibly more.

      I see you’re a chiro.

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