Telephone Survey of Chiropractic Practices (2004)

James R. Laidler, M.D.

During the past few years, I have observed several academic chiropractors refer to a “growing" chiropractic reform movement. However, they have not been able to provide any data about its extent. After I mentioned this during a high-school class I teach on critical thinking, the students decided to survey see how local chiropractors viewed several issues for which their profession has been severely criticized: (1) inappropriate use of spinal x-rays, (2) treatment of ill-defined “subluxations,” (3) unsubstantiated “maintenance care,” (4) craniosacral therapy, (5) treatment of newborn infants, (6) advocacy of chiropractic newborn care, and (7) failure to recommend vaccinations.

After developing the questions, the students used a telephone directory (Qwest Dex Directory, 2004 edition) to locate practitioners in or near Portland, Oregon, and used a pseudo-random number generator on a calculator to select which ones to call. On September 2, 2004, the students called 48 offices, posing as potential patients. Four offices were eliminated because they answered with a machine or voice mail, and 2 numbers were no longer in service. Following a script, the callers said that they had recently moved to the area and were looking for a chiropractor. Then they asked their questions as neutrally as possible. If asked, they said that they had seen a chiropractor in the past, and they gave noncommittal answers to other questions. All questions were answered by a member of the chiropractor’s office staff, who sometimes consulted with the chiropractor. Here are the survey results:

Question

Yes

No

Unsure

1. Does the chiropractor routinely take spinal x-rays at the first visit?

41

0

1 ("usually")

2. Does the chiropractor treat vertebral subluxations?

40

0

2 (chiropractor unavailable to answer question)

3. Does the chiropractor recommend maintenance adjustments?

41

0

1 recommends on "case by case" basis

4. Does the chiropractor offer craniosacral therapy?

38

1

(chiropractor unavailable)

5. Does the chiropractor treat newborns?

29

13

0

6. Does the chiropractor recommend treatment for newborns?

37

0

5 (chiropractor unavailable)

7. Does the chiropractor recommend routine vaccination for children?

0

28

14 (chiropractor unavailable or unwilling to state “yes” or “no” on telephone)

Conclusion

This survey found a 100% incidence of beliefs and practices that are unsubstantiated or clash with extablished scientific knowledge. This suggests that the chiropractic reform movement has had little or no significant effect in the Portland metropolitan area. I hope that similar surveys will be conducted in other communities.

This article was posted on September 14, 2004.