Articles by JCS

Chiropractic Rear Window

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Chiropractic’s Rear Window

 While relaxing over the recent Christmas holidays, I spent way too much time in my recliner due to bad weather watching too many football games and too many Turner Classic Movies (TCM) that gave me too much time to think (no, not me).

Image result for Rear Window

I began to identify in particular with actor Jimmy Stewart’s character, Jeff Jeffries, in the 1954 Alfred Hitchcock suspense thriller, Rear Window with the beautiful Grace Kelly.

If you’re a fan of this Hitchcock film, Jefferies was in a wheelchair nursing his broken leg spying on his courtyard neighbors in the many apartments he viewed from his rear window, each with their own story to tell.

As my mind slowly lapsed into a similar housebound coma with the help of a few too many pints of Guinness, I imagined viewing my diverse chiropractic neighbors each with their own story to tell.

  • Instead of the dancing girl featured in one apartment window, I imagined flashy philosophers preaching the laurels of a lasting purpose and higher income.
  • Instead of an unknown budding pianist writing music, I could see researchers writing their scientific studies that also fall on deaf ears as do most research papers.
  • Instead of the newly-weds in one apartment, we might see enchanting motivational speakers giving love to their clients.
  • Instead of a lonely heart pining away in her apartment, I could see many solo-practitioners worrying about their own futures.
  • Instead of Raymond Burr planning and covering-up the murder of his wife, I envisioned headlines of Katie May’s passing and the viral media blaming her chiropractor.
  • In many chiropractic windows, I could see the various technique gurus touting their methods.
  • In one chiro apartment, I can see “Free Spinal Exams” and “NOOPE” ads to lure patients.
  • One window views anti-vaxxers while another shows pro-meds chiros.
  • In another window was a “Joint Chiropractic” office sign, suggesting weed is the treatment of choice.

Indeed, chiropractic’s rear windows are a showcase for a variety of entertaining stories. As Forrest Gump might say, “Chiropractors are like a box of chocolates, you just never know what you’ll get.”

Nonetheless, these rear windows still fail to tell the real story about chiropractic the public needs to learn.

The American Dream

After my holiday hallucination from watching a few dozen football games that began to all look alike after a while, I also watched the annual holiday TCM classic movies, especially those produced by Frank Capra who embellished the "American dream personified."

If you’re an old movie buff too, you certainly will recall these Christmas classics all with the theme of David fighting Goliath.

Text Box: In Frank Capra’s 1939 Oscar-winning Mr. Smith Goes to Washington, Jefferson “Jeff” Smith (Jimmy Stewart) discovers Senator Joseph Paine (Claude Rains) has been corrupted by political boss Jim Taylor (Edward Arnold). Capra tugged on the viewers’ emotion when Senator Jeff Smith faints while staging a filibuster to expose the graft he found in Washington, DC, encouraged by his girlfriend-mentor, Jean Arthur.

 


In the 1941Capra classic, Meet John Doe, he (Gary Cooper) fights corrupt newspaper publisher D. B. Norton (also played by Edward Arnold) who began a smear campaign after John Doe threatened to expose his corruption. Again, Capra pulled at the viewer’s heartstrings when John Doe was about to commit suicide by jumping off the Empire State building only to be saved by the support of Barbara Stanwyck and his followers.

Text Box:
The 1946 Oscar-nominated and Capra’s personal favorite, It’s a Wonderful Life, featured Savings & Loan upstart George Bailey (Jimmy Stewart) who is undermined by Henry F. Potter (Lionel Barrymore), the bad guy/banker and richest man in town who tries to bankrupt Bailey’s S&L. George was ready to jump off a bridge until Clarence, his angel, rescues him by showing him what life would be like in Bedford Falls without him, proving he does have a wonderful life with his friends and family including his wife, Donna Reed.

These TCM classic movies made me think of the same grit thousands of chiropractors must have had during the mass arrests of 12,000+ DCs in the first half of the 20th century when chiropractors went to jail to protect our art, science and philosophy.

Instead of grit, however, today we see too many DCs going to jail for insurance fraud, sexual harassment or drug abuse, along with the occasional murder, that taints our profession’s image.

The Mystery Science Profession

      

Similar to an Alfred Hitchcock suspense movie, few people understand the hidden dynamics lying beneath the surface of  chiropractic. Undoubtedly the most valid documentary about chiropractic is Doctored (2012) by producer Jeff Hays and director Bobby Sheehan. According to Jeff:

“With Doctored we're attempting set a new standard in this genre, to raise the bar and raise the level of discussion. We're excited to see who follows us, who else will add to the conversation, with humor, talent, story, and heart.” 

Unfortunately, no notable discussion has followed this film. Although Doctored dramatized the impact of medical bigotry and power of Big Pharma upon our society, it failed to show the actual harm of medical incompetence upon patients who followed the medical advice not to seek chiropractic care.

The medical war against chiropractic is a story with more twists than any Capra movie, but unlike these TCM classic movies, the chiropractic story still remains a topic never dramatized to the American public. All they know is decades of medical propaganda defaming our profession.

While Jeff Hays and Bobby Sheehan’s movie opened the door for a discussion, it remains closed to most Americans because the medical-media is controlling the discussion and little is being said how chiropractic care can help this pandemic of pain.

The chiropractic profession has never had a champion to confront the medical bigotry. We have no Capra heroes like John Doe or Jeff Smith or George Bailey. Nor do we have a real-life hero like Fredrick Douglas, Betty Freidan, Martin Luther King Jr., Sidney Poitier or Steven Spielberg to state our case to the public. Nor do we have a civil rights movement to bring our case before the media—we have no #Chiropractic Matters.

Many people are aware of the animosity raging between the medical vs. chiropractic professions and to this day I still hear these chirophobic epithets in my office.

For example, recently the local city mayor, a former colonel at Robins AFB near my office, had lunch with the new Commanding Officer who mentioned at their luncheon he later was to get epidural steroid injections for his neck pain. The mayor/retired colonel is a 25-year patient of mine and very informed because he has read my book, The Medical War Against Chiropractors.

So he then suggested to the new CO to see me first for an adjustment.

The new CO’s reply was shocking: “My medical staff says chiropractic is quackery.”

This explains why in the 37 years I’ve worked next to this base I’ve never gotten one WC referral or TRICARE patient when the prevailing military medicine attitude is so wrong, yet it remains acceptable on base because it’s been stated many times for years that people take is as military gospel.

Indeed, when it comes to chiropractic care, “Don’t Ask, Don’t Tell” seems to remain in effect at RAFB.

 People simply do not understand the history of chiropractors, the medical war, the benefits we offer, nor do they understand the underhandedness of the AMA today to keep this truth away from the public with a complicit media controlled by the AMA and Big Pharma.

Indeed, when was the last time you’ve seen an in-depth, fair and balanced article about the nondrug benefits the chiropractic profession brings to those suffering with chronic back pain, the leading disability in our nation?

Never!

Elephant in the Professional Image

As a sociologist, let me suggest our profession is also to blame—we have been negligent on defending ourselves despite the supportive evidence and negligent about explaining chirophobia to the public—why they think the way they do about chiropractors.

 While our PR folks produce nice WOM ads and social media tweets, the underlying societal attitudes about chiropractic have never been addressed. Why are we avoiding this issue?

Without any public explanation of our plight, it would be equivalent to ignoring the impact of racism in the African-American community’s struggle for equality or the impact of sexism in the effort to break the glass ceiling for women.

For our leadership to dodge the chirophobia issue we’ve faced for a century is to ignore the most important issue to move the public’s empathy for our dilemma as well as to understand why we have been marginalized despite the supportive research and guidelines recommending our brand of care.

 “Ah-ha” Moment

If Capra were to make a movie about the chiropractic struggle, he would not ignore the most poignant aspect of the medical war – the chirophobia that continues to haunt our image from a century of medical defamation and dirty tricks.

It would be similar to ignoring the anti-Semitism of Nazi Germany in its genocide against Jews (among others). Although the public now deplores the persecution of Jews, they don’t understand the demagoguery by the AMA’s EVP Morris Fishbein, the Medical Mussolini, who originally began the defamation our reputation.

The AMA board in 1932 officially adopted Fishbein’s goal to destroy chiropractic, the first step that later materialized into its Final Solution by the Committee on Quackery in the 1960s.

According to historian Walter Wardwell:

“Eight years ago [in 1932] officials of the American Medical Association met in secret conclave in Chicago and adopted the slogan ‘Chiropractic must die.’  They gave themselves ten years in which to exterminate it.”[1]

This deplorable medical mindset and illegal persecution is the untold story the public must learn before we are to be understood, vindicated, and accepted in the eyes of the public. It’s past time to come out of the closet with more than a WOC celebrity or witty tweet.

For example, whenever I have a new patient who is a bookworm (those who bring their own books or Kindle into the office), I always give them a copy of my book, The Medical War Against Chiropractors. It’s a cheap and effective investment to educate and transform patients. You might give it a try yourself.

When finished, their usual response is: “I had no idea of this warfare.” It’s the “ah-ha” moment when they understand the issues we have faced over the years, the battles we fought, and the paradigm shift in medical spine care. Instead of “believing” in chiropractic, they finally understand our profession.

It overcomes their own skepticism—the mindset bred from years of medical dogma—and makes them into a warrior for our cause.

Instead of only “believing in” chiropractic, they now understand our profession. This intellectual epiphany is the tipping point we seek in order to capture the spine care market as the primary spine care providers to save people from opioids, epidural shots, and disc fusions.

As a sociologist might, if we are to tell the complete chiropractic story, there are four main issues to address:

  • The illegal medical defamation campaign creating chirophobia:

Few Americans are unaware of the AMA’s skullduggery of the chiropractic profession when it brazenly labeled chiropractors “killers” and “rabid dogs,”[2] sowing the seeds of bigotry and the fear of adjustments that we still see today and issues we’ve never resolved.

Public opinion is characterized as a “click,whirr”-- a stimulus and response situation. In our case, click on the topic of chiropractic and then, whirr, out rolls the pre-recorded medical tape, that is, the propaganda they’ve learned for nearly a century from the ilk of the AMA’s Committee on Quackery that is regurgitated daily by most MDs. Like racism in the South, it’s just they way they are bred that most cannot escape without some sort of epiphany.

Judge Susan Getzendanner at the Wilk v. AMA antitrust trial spoke about the whirr damage done to our reputation by the AMA:

“The activities of the AMA undoubtedly have injured the reputation of chiropractors generally…In my judgment, this injury continues to the present time and likely continues to adversely affect the plaintiffs.  The AMA has never made any attempt to publicly repair the damage the boycott did to chiropractors’ reputations.”

Let’s be frank: no other profession has endured the massive defamation campaign that “continues to the present time” as we chiropractors have suffered at the hands of the AMA. It was both untrue and illegal, but an effective ploy to destroy a competitor’s image in order to dominate the healthcare market.

It is past time we openly address the medical prejudice against chiropractors and media indifference, an embedded bias I have coined as ‘chirophobia’—the irrational fear, antipathy, contempt, prejudice, aversion, or hatred of chiropractors instilled by decades of medical bigotry.

  • The paradigm shift in spine care: “Bad disc” scam

Unquestionably the next most important message we should be telling the public and press is the charade of failed treatments in medical spine care. For some unknown reason, our PR has avoided addressing the important issue of the unprecedented spine care crisis with medical treatments unsupported by research.

While the medical haters cast stones at our house, numerous researchers have been alarmed at many medical spine treatments ranging from “promiscuous prescribers” at pain management clinics dolling out opioids like Halloween candy, “needle jockeys”[3] rendering epidural steroid injections never approved by the FDA for back pain and, of course, “spine surgeons gone wild” that now constitute the leading expense with the poorest outcomes.

On the other hand, chiropractic care is comparatively rated among the best in clinical and cost-effectiveness with higher levels of patient satisfaction.[4],[5],[6],[7]

Just 30 years ago we could not have said that, but today there is ample evidence of the medical mockery of spine care such as led to the opioid pandemic and trail of botched back surgeries.

This “bad disc” scam began in 1990 with Scott Boden’s with his seminal study, “Abnormal Magnetic-Resonance Scans of the Lumbar Spine in Asymptomatic Subjects: A Prospective Investigation”[8] and was confirmed in 2014 by the Mayo Clinic systematic review[9] that found “bad discs” in pain-free people.

I don’t understand why our associations haven’t made the debunked disc diagnosis a major scandal. When the Mayo Clinic speaks, people listen, but this major systematic review got little traction in the media and in our own PR.

Considering the pandemic of low back and neck pain equated in 2013 to $87.6 billion[10] and disc fusion surgery alone is a $40 billion annual hospital expense[11] affecting nearly 500,000 patients[12], this is a huge issue that could change the face of spine surgery and chiropractic care if the public only knew that “bad discs” were a normal part of the aging process and may have little to do with their back pain.

Imagine if the public knew this bad disc farce and heard the confession of Gordon Waddell, DSc, MD, FRCS, director of an orthopedic surgical clinic for over twenty years in Glasgow, Scotland, and consultant to the AHCPR panel, who wrote that back surgery “has been accused of leaving more tragic human wreckage in its wake than any other operation in history.”[13]

If the public understood this paradigm shift in spine care, they would realize they were lied to, misdiagnosed, misinformed, and mismanaged about their spine problems based on an outdated discogenic theory.

More than once I’ve explained to post-surgical patients why they are still in pain—joint dysfunction vs. bad disc. They were convinced their LBP was a “bad disc” as the surgeon said, but after the fusion, their pain remained, if not worse. Then it’s back to the surgeon for a “revision.”

Little did they realize they were subjected to the worse scam in medicine and, afterwards, their lives were still upside-down in chronic pain, disability, depression, joblessness and living on opioid painkillers—throw into this mix a bottle of alcohol and you have the formula for premature death via suicide.

  • The incompetence of most MDs in regards to back pain and MSDs:

Not only are MDs working on a bankrupt “bad disc” theory, the public has also not learned the shocking truth that experts now admit medical primary care physicians (PCPs) are “inept” in academic training on musculoskeletal disorders,[14] more likely to ignore recent guidelines,[15] and more likely to suggest spine surgery than surgeons themselves.[16]

Scott Boden, MD, director of the Emory Spine Center, admits, “Many, if not most, primary medical care providers (PCPs) have little training in how to manage musculoskeletal disorders (MSDs).”[17] He is being too kind in his assessment considering the trail of addiction and deaths they have left behind.

Mark Schoene, the 25-year editor of The BackLetter, an international spine research journal, makes the case primary care medical practitioners are actually dangerous to patients:

“One can make the argument that the most perilous setting for the treatment of low back pain in the United States is currently the offices of primary care medical practitioners—primary care MDs. This is simply because of the high rates of opioid prescription in these settings.

“As anyone who follows medical news is aware, excessive prescription of opioids for back and other forms of chronic pain has prompted a destructive epidemic of overdoses and deaths, with more than 17,000 deaths per year. And the opioid overtreatment epidemic has in turn kicked off a terrible wave of heroin addiction and overdose deaths.

“Low back pain has helped trigger a lethal and growing heroin addiction epidemic in the United States. How could that be? Unfortunately, it is easy to connect the dots.”[18]

Every DC can answer his question, “how could that be?”

It is very easy for chiropractors to “connect the dots” that has led to the present Pharmageddon. Forever we’ve seen the medical mismanagement of back cases that railroads them into addictive drugs, worthless epidural shots, and fusion surgery.

We’ve just never gone on the offensive to tell the public of this medical charade. And neurosurgeon Sanjay Gupta at CNN will never repeat the sentiments of Scott Boden or Mark Schoene to inform the public of this huge scam.

Undoubtedly, the average PCP knows he’s scamming the public posing as an expert on back pain and musculoskeletal disorders. MDs know their academic deficiency and clinical incompetence with back pain and MSDs, but are unwilling to admit this to their patients. They are aware of the dangers of opioid painkillers, but playing Russian roulette with patients is more ethical than referring them to chiropractors.

  • The role of the media to maintain the medical status quo:

Capra showcased the same political power of the press in two of his movies with Mr. Smith Goes to Washington and Meet John Doe when corrupt  newspaper publishers used the power of the press to sway public opinion against the heroes, not much different than today.

Of course, controlling this public debate implicates the rigged mass media that is controlled by biased medical reporters such as Sanjay Gupta who is sponsored by Big Pharma. Neither wants a non-drug solution to any problem broadcast on their programs, especially chiropractic for the pandemic of back pain, which explains why chiropractic is often slammed at CNN.  

We continue to see the poisonous reports condemning our profession when we witnessed the “gotcha” headline on the Dr. Oz program about the accidental death of Katie May, “Can Your Chiropractor Kill You?

The public will soon forget the content of the program that was deemed very fair, but people will long remember the headline that was disastrous to our image and cannot be undone. Many will long remember the word association of “chiropractors” and “kill” in the same sentence rather than the fair and balanced argument how safe chiropractic actually is, especially compared to medical spine care.

Nor has Dr. Oz posed the equivalent question: “Can Your Spine Surgeon Kill You?” that is a much more appropriate question to ask his viewers considering the data from the Gallup-Palmer research.

This chart is worth a millions words as a cautionary tale for patients to know, but one they will never see on the Dr. Oz Show.

Elephant in the Profession

Compounding the public’s ignorance of this medical war is the fact the chiropractic profession has been virtually mute on defending itself. The public and press may feel if we were truly wronged, why haven’t we complained as they see the LBGT or Black Lives Matter movements? Instead of fighting this medical bigotry, we seem to have taken a spoon to this knife fight.

Although WOC testimonials by celebrities and social media tweets may boost our spirits, these ads cannot address the underlying seeds of skepticism implanted by nearly a century of medical propaganda nor will it explain the paradigm shift in spine care.

It is naïve to think the chiropractic profession can change its image simply via WOM ads or social media unless the earned media piggybacks as we witnessed with Donald Trump’s campaign. And the best mechanism to reach the earned media is with controversy, just as Trump used.

Instead of avoiding this issue, we should respond head-on to this medical bigotry since the facts fall in our favor. Instead of news releases about “proper back packs” or damage control articles a day late and dollar short, we should be slamming the media with releases concerning these controversial issues.

As I warned you, the Christmas vacation gave me too much time to think, but I could not think of anything more important than the untold story of chiropractors in the medical war that needs to be told.



[1] Wardwell WI. Alternative medicine in the United States. Soc Sci Med 1994;38:1061-1068. (Citing Reed L. The healing cults. Chap 3, Publ No.16 of the Committee on the Costs of Medical Care, p 5. University Press, Chicago, 1932

[2] Minutes from the “Chiropractic Workshop,” Michigan State Medical Society, held in Lansing on 10 May 1973, exhibit 1283, Wilk.

[3] http://chiropractorsforfairjournalism.com/Needle_Jockeys.html

[4] Richard L. Sarnat, MD, James Winterstein, DC, Jerrilyn A. Cambron, DC, PhD, Clinical Utilization and Cost Outcomes From an Integrative Medicine Independent Physician Association: An Additional 3-Year Update, JMPT, Volume 30, Issue 4, Pages 263-269 (May 2007)

[5] Manga P, et al. The Effectiveness and Cost-Effectiveness of Chiropractic Management of Low-Back Pain. Ontario Ministry of Health, 1993.

[6] Thomas M. Kosloff, DC, David Elton, DC, Stephanie A. Shulman, DVM, MPH, Janice L. Clarke, RN, Alexis Skoufalos, EdD, and Amanda Solis, MS, Conservative Spine Care: Opportunities to Improve the Quality and Value of Care, Popul Health Manag. Dec 1, 2013; 16(6): 390–396

[7] Davis MA, Yakusheva O, Gottlieb DJ, Bynum JP. Regional Supply of Chiropractic Care and Visits to Primary Care Physicians for Back and Neck Pain.”J Am Board Fam Med. 2015 Jul-Aug;28(4):481-90. doi: 10.3122/jabfm.2015.04.150005.

[8] SD Boden, DO Davis, TS Dina, NJ Patronas, SW Wiesel, “Abnormal Magnetic-Resonance Scans of the Lumbar Spine in Asymptomatic Subjects: A Prospective Investigation,” J Bone Joint Surg Am. 72 (1990):403–408.

[9] Brinjikji W, et al., Systematic literature review of imaging features of spinal degeneration in asymptomatic populations, American Journal of Neuroradiology, 2014, prepub ahead of print; www.ajnr.org/content/early/2014/11/27/ajnr.A4173.long.

[10] https://www.sciencedaily.com/releases/2016/12/161227134737.htm

[11] HCUPnet. Agency for Healthcare Research and Quality. Available at: http://hcupnet.ahrq.gov/HCUPnet.jsp. Accessed October 30, 2014.

R.A. Deyo / The Spine Journal 15 (2015) 272–274 273

[13] Gordon Waddell and OB Allan, “A Historical Perspective On Low Back Pain And Disability, “Acta Orthop Scand 60 (suppl 234), 1989.

[14] EA Joy, S Van Hala, “Musculoskeletal Curricula in Medical Education-- Filling In the Missing Pieces, The Physician And Sports Medicine,” 32/11 (November 2004).

[15] PB Bishop et al., “The C.H.I.R.O. (Chiropractic Hospital-Based Interventions Research Outcomes) part I: A Randomized Controlled Trial On The Effectiveness Of Clinical Practice Guidelines In The Medical And Chiropractic Management Of Patients With Acute Mechanical Low Back Pain,” presented at the annual meeting of the International Society for the Study of the Lumbar Spine Hong Kong, 2007; presented at the annual meeting of the North American Spine Society, Austin, Texas, 2007; Spine, in press.

[16] SS Bederman, NN Mahomed, HJ Kreder, et al. In the Eye of the Beholder: Preferences Of Patients, Family Physicians, And Surgeons For Lumbar Spinal Surgery,” Spine 135/1 (2010):108-115

[17] S Boden, et al. “Emerging Techniques For Treatment Of Degenerative Lumbar Disc Disease,” Spine 28(2003):524-525.

[18] the BackLetter, volume 30, number 10, 2015


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