The Reusable Clichés of Chiropractic
Stephen Barrett, M.D.
Reprinted from Private Practice Magazine
Whenever chiropractic is attacked by an outsider, it claims that its attacker is biased. Whenever it is embarrassed by quotes from within its own profession, it claims they are not representative. The letter from Gerald M. Brassard, DC, executive vice president of the American Chiropractic Association (ACA) in the December 1982 issue of Private Practice was true to form.
His comments were a response to "Chiropractors: Inching Ahead" (Private Practice, May 1982). An identical but longer response in the September 1982 ACA journal of Chiropractic carries no author's name, but is described in its introduction as "written with input from ACA's professional staff. . . a pertinent document, useful in your own research and interaction with media in your community."
ACA's professional staff used to include Eric Baizer, a former in-house public relations consultant at ACA headquarters. Baizer said he "wrote propaganda" until he couldn't stand it anymore and gives a definition of an ACA rebuttal: "Rebuttals prepared by the ACA's professional staff employ stock answers and reusable clichés--what one writer termed 'factoids'—statements designed to resemble facts. For example, if someone attacked the quality of chiropractic education, we would point out that chiropractors attend colleges accredited by an agency recognized by the U.S. Department of Education-implying that the schools must be of high quality. How good are chiropractic curricula? How qualified are the instructors? Are the inspections of the colleges thorough? These are the kinds of issues best left unexplored."
Consider the close examination of the following two ACA factoids in Brassard's responses:
1. "In chiropractic, as in all the healing arts, diagnosis serves as the basis for determining the type of treatment necessary,"
Dr. Brassard was quoting from the Council on Chiropractic Education and the Accreditation Process for Chiropractic Colleges. But chiropractors cannot agree among themselves about how to diagnose or even whether to do so. The majority of chiropractors now acknowledge that factors other than spinal difficulty are important in the disease process. Some chiropractors make appropriate referrals to medical doctors. Chiropractic schools use standard medical textbooks in some of their coursework. But visits to chiropractic offices make it clear that most chiropractors diagnose quite differently from scientific practitioners.
From 1973 through 1974, the Lehigh Valley Committee Against Health Fraud sent a healthy 4-year-old girl to five chiropractors for a "check-up." The first said the child's shoulder blades were "out of place" and found "pinched nerves to her stomach and gallbladder.'' The second said the child's pelvis was "twisted." The third said one hip was "elevated" and that spinal misalignments could cause "headaches, nervousness, or equilibrium or digestive problems." The fourth predicted • 'bad periods and rough childbirth" if her "shorter left leg" was not treated. The fifth not only found hip and neck problems, but also "adjusted" them without bothering to ask permission. When I saw her at age 11, the girl was feeling fine and appeared to be developing normally.
From 1979 through 1980, the committee sent a healthy 29-year-old housewife to four more chiropractors for check-ups. The lint diagnosed "atlas subluxation" and predicted "paralysis in 15 years" if the problem was not treated. The second found many vertebrae "out of alignment" and one hip "higher" than the other. The third said the woman's neck was "tight." The fourth said the misaligned vertebrae indicated the presence of '' stomach problems." All four recommended spinal adjustments on a regular basis, beginning with a frequency of twice a week.
Another committee volunteer, a healthy 36-year-old housewife, visited seven other chiropractors. The first found "minor structural problems" in the neck, mid-back and lower spine regions and recommended four to six treatments. The second found nothing wrong. The third said the woman's left hip was lower than her right hip, adjusted a few areas of her spine, and suggested she return if she felt "sluggish." The fourth said her right hip and several vertebrae were "twisted." The fifth chiropractor thought there might be a serious problem with a "pinched nerve" in the neck that could cause "sinus trouble," but he could not be sure without an X-ray. The sixth, who called himself a "herbologist," used muscle-testing to diagnose a "vitamin C deficiency" and indicated he could do extensive nutritional testing if requested. The seventh thought there was a hip problem, adjusted it, and recommended an X-ray examination for further diagnosis.
In 1981, Mark Brown, a reporter for the Quad-City Times, Davenport, Iowa, had a similar experience with dozens of his area's chiropractors—all of whom told him he was a chiropractic case. One chiropractor concluded that Brown had "some sort of nutritional deficiency" after touching a potato, an egg, a magnet and some pills to various parts of his body while testing the strength of various muscles. Another used a small lead shield to help determine that "nerve energy" had become "congested" as a result of a malfunction of Brown's diaphragm. Another diagnosed and quickly corrected a "hiatal hernia." Others diagnosed a "compression fracture" of the fifth cervical vertebra, "ocular lock," and "ileocecal valve syndrome." One morning a chiropractor told Brown his right leg was shorter than his left, but later the same day, another chiropractor found the left leg shorter than the right.
2. "Practice-building seminars are not endorsed or sanctioned by the American Chiropractic Association. Practice-building organizations are strictly private enterprise operations over which organized chiropractic exercises no control . . . professionals in many aspects of health and the law attend practice-building and management seminars."
The comparison with medical practice management seminars is particularly odious when chiropractic sources suggest the following:
Dr. Williams is now president of the International Chiropractors Association, the second-largest chiropractic group; and chiropractic schools are quite willing to accept donations from the Parker seminar equal to 10 percent of the fees from first-time attendance of their graduates. Both Drs. Williams and Parker also run chiropractic colleges.
- "Keep in mind that we don't want to feature 'well' or 'cure' too soon or too strongly because the patient won't show up for the next visit because he thinks 'I'm ready to quit; I am well.' He is never well-just better," according to "Dynamic Essentials of the Chiropractic Principle, Practice and Procedure," by Sid Williams, DC.
- "If in doubt about the payment or the return of the patient, take only the smaller X-rays on the first visit but ostensibly X-ray fully," publicized the Textbook of Office Procedure and Practice-Building for the Chiropractic Profession, by James W. Parker, DC.
- "Write notes on good chiropractic literature. Write on the literature with a red pencil: 'John, this man cured my headaches. Go to him!' or 'Bob, this is the best doctor in this whole town! He cured the back problem that I have had for the past 15 years!' Then take this literature and lay it all over town: in phone booths, on people's desks, etc. This can be done very easily, and will bring you many new patients. Be sure to stamp your name, address and phone number on the literature," advised "Secrets of a Practice Building Consultant: 1,000 & One Ways to Attract New Patients," by Peter G. Fernandez, DC.
- Learn the real dynamic power of a successful nutrition practice-not some superficial scheme. Worth millions of dollars in a lifetime of practice," promised an advertisement for "The Triple Your Income Nutrition Seminar.
The ACA is quite correct when it says that organized chiropractic exercises no control over practice builders. Not one has even been censured or expelled by a major chiropractic organization. Baizer reports, "During my year at ACA headquarters, its director of professional relations told me in no uncertain terms that practice builders were good for the profession."
It is true, as the ACA states, that organized chiropractic has never "sanctioned or endorsed" what is taught at practice-building seminars. But neither has any chiropractic organization ever made a serious effort to warn the public about what is being taught at these seminars. Before chiropractors can be taken seriously by real health professionals, they will have to develop standards and accountability.
This article was posted on January 27, 2018.