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Chiropractic News Digest #03-02

June 11, 2003

Chiropractic News Digest, edited by Christopher J. Erickson, M.D. and cosponsored by NCAHF and Quackwatch, summarizes scientific and political developments; enforcement actions; and other news relevant to the chiropractic marketplace.

Survey finds most chiropractors favor thermography, homeopathy, herbs. Dynamic Chiropractic has summarized a recent survey of the profession [Surprising agreement among DCs on issues of philosophy, practice. Dynamic Chiropractic, June 2, 2003]. Published by the Institute for Social Research at Ohio Northern University, the survey was underwritten in part by Dynamic Chiropractic and in part by Foot Levelers, two parties with a large financial interest in a broad, unified market of chiropractors. The survey found:

The large numbers of chiropractors favoring broad inclusion of nontraditional, nonmanual therapies suggests a loss of focus on chiropractic's claim to uniqueness, perhaps as a result of economic desperation. Chirobase maintains a referral directory for practitioners who eschew the "subluxation" concept, thermography, homeopathy, and a long list of other dubious practices.

ACA appeals Trigon lawsuit defeat. Chiropractors were handed another major defeat in their recent loss to Trigon Blue Cross Blue Shield. The ACA's equivalent of an "information minister," Vice President of Communications Felicity Feather, was characterized this loss as an "advance to the appeals court" [Trigon lawsuit advances to appeals court." ACA/Trigon Legal Action. May 1, 2003].

In expanded legal coverage, the ACA complained, "the 1994 AHCPR Guidelines were distorted by Trigon to remove any reference to chiropractic type adjusting or manipulation..." [Expanded legal coverage. ACA/Trigon Legal Action. May 1, 2003]. Chirobase has the full-text of the 1994 AHCPR low back pain reference for physicians and consumer booklet.

The ACA also argued that there was "clear evidence" of a "competency gap" between medical doctors and chiropractors based on a single test of a single University Medical Centers' interns on their first day, ignoring that most of them were probably not licensed or even done with licensure tests -- much less internship, residency, and board certification. [Freedman KB, and others. The adequacy of medical school education in musculoskeletal medicine. Journal of Bone and Joint Surgery 80-A:1421-1427, 1998] Moreover, the test was not administered to chiropractors.

The lead lawyer in the case, George P. McAndrews, represented the chiropractors in the antitrust suit brought by Chester A. Wilk, D.C., and others against the American Medical Association. McAndrews' brother, Jerome F. McAndrews, D.C. is the top individual contributor to the ACA legal fund, and a representative of the top corporate contributor. Peter McAndrews has an 8-year legal career, and also works on behalf of chiropractors and chiropractic issues as a partner in the firm McAndrews Held Malloy. In a call for fortitude (and continued financial support), ACA board chairman James Edwards, D.C., stated "Knowing that the Wilk case took 16 years to win and went through a similar appeals process, we weren't surprised that the judge came down in Trigon's favor."

Unprotected sex with prostitutes through "chiropractic" clinics. A new report suggests continuing problems with chiropractic-related prostitution in California: "The number of San Fernando Valley storefronts operating prostitution-related businesses has jumped 500 percent in the past year" with "[m]any of them are identifying themselves as aromatherapy or chiropractic parlors according to authorities." [Ryan Oliver. Hookers use new tricks. Los Angeles Daily News. May 26, 2003] According to the report, one woman who worked in such a business told authorities it was common to allow unprotected sex for an additional price if the customer requested it. A Los Angeles news team reported last year that dozens of alleged "mamasans' and women charged with prostitution had been arrested at more than a hundred chiropractors offices in Los Angeles and Orange counties. [Up Close: Doctor sex houses. KCAL9 News, Los Angeles. May 31, 2002]

Cuts in California's chiro workers compensation plans planned. California Insurance Commissioner John Garamendi was quoted as saying "I'm still trying to find an injured worker who has been released by a chiropractor." [Editorial Staff. Rebuilding workers comp. San Francisco Chronicle, May 25, 2003] Limiting chiropractic care is one of many reforms proposed to bring down WC costs in the state.

Report forecasts immense challenges for chiropractic profession. A recent report on the chiropractic profession has caused consternation [Cooper RA and others. Chiropractic in the United States: Trends and Issues. Milbank Quarterly 81(1)107-138, 2003]. Although it characterized chiropractic as the "vanguard of complementary and alternative medicine" the report noted equivocal results for chiropractic manipulations. The authors conclude, "Although patients express a high level of satisfaction with chiropractic treatment and politicians are sympathetic to it, this may not be enough as our nation grapples to define the health care system that it can afford." William Meeker, D.C.,.reviewed the report for Dynamic Chiropractic [Meeker W. A policy view of chiropractic Dynamic Chiropractic June 2, 2003].

The report comes on the heels of an editorial in the previous issue of Dynamic Chiropractic warning that "chiropractic must also be mindful of the inroads being made by other nonmedical providers." [Petersen DM. Chiropractic vs. medicine vs. massage: Use and perception. Dynamic Chiropractic, May 19, 2003] The editorial summarizes a recent study which found that massage was perceived by patients to be "very helpful" more often than chiropractic or conventional medical care for a number of conditions [Wolsko PM and others. Patterns and perceptions of care for treatment of back and neck pain: results of a national survey. Spine 28(3):292-7, February 1, 2003] It appears that fewer licensed massage therapists (LMTs) are working in chiropractic offices, but generating a greater share of their revenue.  Roughly 34% of chiropractors work in integrated practices, with 62% of those offering massage therapy, down from 76% in 2000, while gross revenue from LMTs & physical therapists nearly doubled from $20,000 to $37,000 [Fifth annual salary & expense survey results. Chiropractic Economics, May 2002]. 

Despite an estimate of 100,000 DCs by 2015, the number of massage therapists and acupuncturists could grow much more rapidly. With 250,000 massage therapists today, the relative business flexibility of LMTs may be complemented with more collective advantages as their ranks become more organized. These trends have not escaped MPAmedia, which now publishes MassageToday and AcupunctureToday in addition to Dynamic Chiropractic.

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This page was posted on June 11, 2003.