Articles by JCS
Discriminatory attitudes still exist
Special to the Telegraph
Every year on the remembrance of Dr. Martin Luther King Jr., I recall his poignant speech that said to judge a man by the content of his character and not by the color of his skin. While I applaud his effort to end racial segregation/discrimination, as a health-care provider, I must admit that a discriminatory attitude still exists in hospitals and in many health-care programs, but it's not concerning the treatment of black patients or the discrimination against black medical doctors. Unlike racial segregation, it is still politically-correct to discriminate against doctors of chiropractic.
The public may be unaware that segregation still exists in public hospitals until patients ask for a chiropractor to treat them. As well, workers' compensation programs and the military health services routinely discriminate against doctors of chiropractic despite state and federal laws that give patients legal access to chiropractors.
Sadly, a Jim Crow attitude still very much exists in the medical field that discriminates against doctors of chiropractic and segregates them outside the mainstream health-care delivery system. Indeed, it is the last bastion of segregation that goes unnoticed by the media.
For example, did you know that not one doctors of chiropractic is on any medical staff at any hospital in Middle Georgia? The medical society still bars its biggest competitor by denying staff privileges to doctors of chiropractic despite a federal court decision that directly prohibits public hospitals from discriminating against chiropractors.
For the uninitiated, in 1987 the Northern District Court of Illinois, Judge Susan Getzendanner in the case of Wilk et al. v. AMA et al. ruled in favor of the chiropractic plaintiffs that the AMA and their associated medical groups conducted an illegal boycott of doctors of chiropractic from public hospitals despite medical evidence that showed manipulative therapy was more effective than anything the medical world had to offer patients for the epidemic of back pain. Yet, neither Houston County or Bibb County have doctors of chiropractic on staff.
Considering the revenue from spine surgery ranks ahead of heart surgery in many hospitals, a lot of money - an average of $50,000 for a lumbar fusion - would be lost to hospitals if doctors of chiropractic were able to treat these pain cases before surgery is done. One local orthopedist told me that Macon is now considered the back surgery capital of Georgia, and it ranks fourth on the list nationally.
In terms of scientific research, every major study done in Europe, England, Canada and the U.S. have all concluded the same - that for the vast majority of back problems, spinal manipulative therapy is preferred over back surgery. Yet spine fusions have tripled in the last few years despite a 70 percent failure rate.
In regards to Military Health Services, the same Jim Crow attitude exists locally at RAFB. Despite former President Bill Clinton signing into law HR 5408 for fiscal year 2001 calling for chiropractic health care for members on active duty, not one active military personnel locally has been referred to doctors of chiropractic.
In 2003 President George W. Bush signed into law a similar bill allowing vets to receive chiropractic care through the DVA, but not one vet has received care due to the stonewalling by Dublin VA hospital personnel despite the requests of many of my own patients.
Indeed, the military medical stonewall is still very high and forces patients to live in pain or seek ineffective spine surgery.
I would think the public, patients and employers should be outraged if they knew the facts. To be sure, the discrimination against chiropractors in our hospitals is a very expensive problem facing all Georgians.
Recently in The New England Journal of Medicine, spine researcher Richard Deyo, MD, in his article, "Spinal-Fusion Surgery - The Case for Restraint," mentioned "spinal-fusion operations rose by 77 percent between 1996 and 2001 the financial incentives for surgeons, hospitals may have synergistic effects-- the market for spinal implants and devices is estimated to be $2 billion a year, with an annual growth rate of 18 to 20 percent-- yet there is no acceptable evidence of the efficacy of any form of fusion for degenerative lumbar spondylosis, back pain, or instability."
According to research study from Johns Hopkins Medical School titled "Unintentional and Musculoskeletal Injuries Greatest Threat to Military Personnel" "...in all three branches of the service, injuries and musculoskeletal conditions still adversely affected the health of service members and troop readiness more than any other single diagnosis."
Obviously our local hospitals, workers' comp programs, and the military medical corps still have an outdated attitude about chiropractic care despite the laws, overwhelming scientific research, governmental recommendations and positive clinical outcomes.
Not only has this archaic attitude thwarted the efforts of chiropractors to help patients with back pain, but it also has led to higher costs for all medical insurances, WC premiums to employers, and TRICARE for taxpayers who must foot the high costs of medical care, especially ineffective spine surgeries and the resulting disability claims.
Since our consumer society is built on the concept of free enterprise on a level playing field and now that evidence-based health care supports the most cost and clinically-effective treatments, the boycott of chiropractic care in these delivery programs is deplorable.
Here is a clear-cut example that discrimination is still rampant in Georgia and it costs millions of dollars in ineffective treatments and patient disability. When will society judge chiropractors by their good work and not by prejudices from yesteryear?