Articles by JCS

Taboo Chiropractic

Unmask and Reframe

Taboo Chiropractic

By

JCS

“Everybody knows chiropractic is an unscientific cult and if you don’t know this too, then something is wrong with you.”

While this bigotry may sound harsh to the 22 million Americans who use chiropractors every year, it was the mantra of the American Medical Association for decades. Indeed, as the last bastion of acceptable bigotry, this medical prejudice lingers on today in most quarters of our healthcare delivery system.

Whereas sexism and racism have diffuse origins, medical bigotry has a clear origin, albeit unknown by most. Like a super bug virus, this bias continues to infect the minds of many people who, in fact, could benefit from the chiropractic brand of spinal care as researchers now admit.

No leaf was left unturned in the medical war to demean chiropractors and to sway public opinion. The AMA did everything it could to blackball chiropractors, from destroying their public image with blatant propaganda, to boycotting their presence in hospitals, and limiting their role in the mainstream healthcare delivery system like workers’ compensation programs, Medicare, the Veterans’ Administration, and military health programs.

Throughout this period in the early 1970s, members of the AMA’s Committee on Quackery made speeches across the country with disparaging comments to build opposition to chiropractic. Dr. Joseph A. Sabatier, chairman of the COQ, hailed from Louisiana, the only state by the early 1970s that had not yet licensed chiropractors. Chiropractors either had to pass the medical examination to practice or else practice illegally as most did. The chiropractic licensing act was not passed until 1974 that protected chiropractors.

Sabatier told a gathering of the Michigan State Medical Society officials that “rabid dogs and chiropractors fit into about the same category…they killed people.”[1] He also said that “it is very important to point out to members of the medical profession that it is considered something less than totally unethical to refer a patient to a chiropractor for any purpose whatever.”[2]

The supposed danger of chiropractic care was another issue the AMA promoted but again they could not prove it in court. In fact, the AMA warned witnesses against using this claim in court. An official of Blue Shield wrote “Doyl Taylor...urged that we stay clear of attempts to show [chiropractors’] civil malpractice suits.  With the relative weight in numbers against physicians he felt we’d by playing with dynamite.” [3] 

The statistics prove that chiropractic care was safer than medical care, but this fact did not stop the Committee on Quackery from telling people that chiropractors were rabid dogs and killers. The masters of deception would not let the facts stand in their way of misinforming the public or their own members with yet another Big Lie.

This war plan included training the impressionable “young physician in his formative years” to boycott doctors of chiropractic. Sabatier stated, “It would be well to get across the point that the doctor of chiropractic is stealing his [the young physician’s] money.”[4] In essence, this war was always about money, and the COQ used it to frighten their rank and file members.

In an article titled, “Competition: The Surprising Swing to Non-Physicians,” from the trade journal, Medical Economics, were complaints of competition with chiropractors.  It warned physicians of the loss of income to chiropractors:

It’s not enough that the ranks of doctors are ballooning. The numbers and varieties of your non-physicians competitors are also swelling: Doctors of chiropractic… are moving in on what was once your exclusive domain.[5]

Without a doubt, money was the primary motive in this medical war, not patient safety or clinical care as the AMA claimed. Additionally, the AMA’s was confident that it would be immune to antitrust action because it was a “learned profession.” However, that bubble would soon burst and expose the medical monarchy to legal action.

The decisive moment in culpability occurred in 1975, when the U.S. Supreme Court ruled in the case of Goldfarb v. The Virginia State Bar that learned professions are not exempt from antitrust suits.  The Goldfarb case alleged price fixing among real estate attorneys in violation of Section 1 of the Sherman Antitrust Act. The Supreme Court found that the bar association's activities constituted a classic case of price fixing. It rejected the contention that Congress never intended to include “learned professions” within the meaning of “trade or commerce” in Section 1 of the Sherman Act. Moreover, the Court held that such anticompetitive activities were not exempt from the Sherman Act as “state action.”[6]

This landmark decision would open the door to the courtroom for chiropractors to challenge the AMA’s boycott, expose their illegal tactics, and reveal their injustices. But it would take a few more essential and coincidental events to make a realistic legal challenge–finding the evidence and the witnesses who would stand up in court to make the case against the medical profession. After all, taking on “the most terrifying trade association earth” as Harper’s magazine once dubbed the AMA, was a daunting task.[7]

Operation Sore Throat

At the height of the medical war in 1972, the chiropractic profession experienced a serendipitous windfall from a most unlikely group that would change the course of the medical war by giving chiropractors the ammunition for its first major counterattack. This event was, by today’s standard, a “WikiLeaks” incident that implicated the AMA with their own words pilfered from their own files.

Jerry McAndrews, DC, the International Chiropractors Association Executive Director (and brother of George McAndrews), received from an anonymous agent a book, In the Public Interest, written by William Trever, believed to be a pen name.  Dr. McAndrews also noted that “the book was not truly copyrighted but was printed in someone’s basement.”[8]

Text Box: 1972: cover photograph William Trever, author, In the Public Interest Dr. McAndrews personally met with a secret representative of Trever who sold him the rights to the manuscript for $2,500.  Adding to the clandestine affair, the carrier would not give McAndrews a name to make a check out to, so I went to the bank and had a cashier’s check made out to cash.  I then had 15,000 copies printed and made them available to the International Chiropractic Association membership.  The only change I made to the newly printed copies was to remove the swastika from where it overlay the medical caduceus on the cover of the original version.”[9]

This book contained actual photocopies directly from the AMA’s files revealing its war against chiropractors–the smoking gun needed to pursue legal action. What made this book and its clandestine nature more fascinating was its alleged ties to the Church of Scientology. The animosity between L. Ron Hubbard’s Church of Scientology and the AMA began in the 1950s when the AMA attacked his Dianetics as psychological pseudoscience. In 1968, the AMA had published an article, “Scientology–Menace to Mental Health,”[10] written by Ralph Lee Smith, the same freelance writer paid by the AMA in 1969 to write At Your Own Risk, The Case Against Chiropractic.[11]

Basically, the AMA accused Scientology of practicing psychiatry without a license, so Hubbard simply turned Dianetics into a religion to escape medical persecution. He then retaliated with his own investigative department, the Guardian's Office, which carried out numerous covert operations against a range of opponents of Scientology, in particular, the AMA.

 Allegedly, members of the Church of Scientology pilfered the secret documents from inside AMA headquarters. The release of this sensitive internal information became known as “Operation Sore Throat,” and Scientology’s espionage to reveal medicine’s conspiracy instigated a medical Watergate.

In The Public Interest proved to be a treasure trove of evidence—a true smoking gun that proved the AMA’s campaign to destroy chiropractic with actual internal documents. With this insider information, the chiropractors were finally given the conclusive proof needed to wage a counter attack against the AMA, but the chiropractic profession still needed actual plaintiffs who had been harmed to come forward and withstand the scrutiny expected from the army of medical attorneys.

Chester Wilk, DC, who was to be the lead plaintiff in the antitrust case, wrote of this serendipitous event:

The negative propaganda against chiropractic became more dishonest than ever yet we still did not know its source. And then we got our answer when an underground book surfaced exposing the AMA entitled, “In the Public Interest” by William Trever. The book provided photocopies of many of the AMA’s secret internal memos exposing its covert and sinister plot to destroy the public image of chiropractic through dishonest negative propaganda for the prime intent of “containing and ultimately eliminating chiropractic.” These were frightening words and I was the intended target.[12]

The motivation of the author, William Trever, was very clear in his disgust of the AMA:

Behind the closed, guarded doors of the AMA headquarters there is an elite and secretive group of men who have worked with the diligence, tenacity, shrewdness and deceit of the KGB, Gestapo, and the CIA combined. This book is a chronological, historical, factual outline of this medical government’s scheme and activities concerned with misleading the public and legislators in their attempts to do away with chiropractors. [13]

Although chiropractors are now the third-largest physician-level health profession in the world, by no means do we get one-third of the news despite the $100 billion back pain epidemic. In fact, it is a rare event when anything is written in behalf of my profession, no doubt due to the medical control of health news in the media as well as an inherent medical prejudice among newsmen.

Despite this apathy and neglect, there are newsworthy stories concerning chiropractic that could have a great impact upon lowering healthcare costs and improving patient outcomes. There are also human interest stories about the many chiropractors who paid a huge price to keep this healing profession alive.

Just as The Help showed the harm racism did to black housekeepers in the Jim Crow South in the early 1960s, the medical profession’s assault on the chiropractic profession was painfully similar for the thousands of chiropractors arrested and whose reputations were unfairly stigmatized by medical bigotry and illegal activities.

Like the civil right activists beaten and jailed in Selma in the early 1960s, chiropractors experienced the same brutality and ostracism. 12,000 were arrested and many went to jail for the chiropractic profession in the first half of the 20th century, a note never mentioned in the annals of American history books.

This profession was built on the dedication of those men and women who had the courage of their convictions from DD Palmer who was the first and spent 17 days in jail in 1906 to EJ Nosser, the last man to be jailed in Louisiana in 1975.

Think of the saga of two chiropractic “jailhouse martyrs” that occurred in New York in 1949. Katherine “Kitty” Scallon and her husband, Mack Scallon, were chiropractors in Manhattan (their patients included Ambassador Joseph Kennedy). They were jailed simultaneously when they refused to desist in the hoax of practicing of medicine without a license; neither prescribed drugs or did surgery. Their crime was using chiropractic care before New York had a scope of practice law for chiropractors.

Kitty Scallon said from the Women’s House of Detention in 1949. “Being here [in jail] is sometimes like a bad dream…but I’d throw my shoulders back and be ready and willing to make any sacrifice to help free our beloved science.”[14]

Aside from the freedom to practice their beloved chiropractic without harassment, Americans fail to realize a Founding Father and Signer of the Declaration spoke of the need to have freedom of choice in healthcare. Just as the Constitution guarantees freedom of religion, conversely it guarantees freedom from religion.

Dr. Benjamin Rush, MD, foresaw what has happened today in American healthcare—the formation of a medical “undercover dictatorship” that aptly describes his own profession. “Unless we put medical freedoms into the Constitution, the time will come when medicine will organize into an undercover dictatorship.”[15]

That time has certainly arrived. Chiropractors are fighting the medical dictatorship that Dr. Rush foresaw, albeit not undercover anymore. Dr. Rush understood the same need for medical freedom as well as freedom from a medical monarchy:

The Constitution of this Republic should make specific provision for medical freedom as well as for religious freedom. To restrict the practice of the art of healing to one class of physicians and deny to others equal privileges constitutes the Bastilles of our science. All such laws are un-American and despotic. They are vestiges of monarchy and have no place in a republic. [16]

The freedom he speaks is not only freedom of treatments. As a chiropractor, I believe it is a freedom to believe in a different school of thought, the freedom of science, and the freedom to practice without discrimination and pejoratives hanging over our image from medical propaganda. Indeed, there are more ways than only drugs and surgery to help sick people get well.

Yet the medical prejudice still stands in our way at every turn. For over a century the medical war against chiropractors has been waged despite the failings of medicine to combat the diseases plaguing Americans. Just as the war on drugs has failed, so too has the medical war on cancer, heart disease, obesity, back pain, and arthritis.

Ironically, the largest of all medical wars and the only one remotely successful has been the war against chiropractors. During the height of this war in the 1960s, the AMA’s Committee on Quackery was formed to carry out the “ultimate objective of the AMA theoretically… the complete elimination of the chiropractic profession.”[17] This committee fostered an “everybody knows chiropractic is an unscientific cult” belief that remains today a wink-wink attitude among medical bigots.[18]

Although it is politically incorrect nowadays to be racist, sexist, anti-Semitic or homophobic, I have never heard any news pundit speak out against chiropractors being called “quacks” by chauvinistic medical professionals or being segregated from hospitals. Unlike racism, however, medical bigotry continues unabated in this country.

Scientific Vindication

Ironically, research now shows chiropractic care is superior to medical care for most spine-related disorders (SRDs), a fact untold by the media, swept by MDs under the medical rug, and remains unknown by the unsuspecting public.[19]

For example, in regards to SRDs, the latest evidence has incriminated medical treatments of opioid drugs, epidural steroid injections, and spinal surgeries. Over the last 20 years, numerous studies have cast doubt on the medical management of low back pain, yet the medical establishment has virtually turned a blind eye in lieu of profits.

Here are some shocking words from honest medical men who admit to the inappropriate medical care for SRDs. Gordon Waddell,  DSc, MD, FRCS, author of The Back Pain Revolution, harshly criticized the affect of medical management:

 Low back pain has been a 20th century health care disaster. Medical care certainly has not solved the everyday symptom of low back pain and even may be reinforcing and exacerbating the problem. ...It [back surgery] has been accused of leaving more tragic human wreckage in its wake than any other operation in history.” [20]

Another distressing article, “Are We Making Progress?” by Glenn Pransky, MD, Jeffrey M. Borkan, MD, Amanda E Young, PhD, Daniel C. Cherkin, PhD, discussed the ineffective spine treatments, clinical iatrogenesis, and the “Low Back Pain Medical Industrial Complex” at the Tenth International Forum for Primary Care Research on Low Back Pain in June 2010 at the Harvard School of Public Health in Boston, Massachusetts.

Concerns about ineffective treatments and iatrogenesis were discussed at greater length here than at any previous Forum since the Forums began in 1995. Research results may have led to reduction in the use of potentially harmful and unproven therapies such as bed rest and intradiscal therapy, but other harmful treatments may have taken their place, especially in the United States.

Despite explosive growth in the number, range, and quality of investigations of LBP in primary care since 1990, there was a sense at recent Forums that progress in reducing the medical and economic impact or burden of suffering from LBP has been disappointing. Few treatments presented at earlier Forums withstood the test of randomized controlled trials, and the “LBP epidemic” remains a burden in Western countries. Evidence-based guidelines and systematic reviews flourished, but seem to have had little impact on actual primary care practices.[21]

Richard Deyo, MD, MPH, a leading spine researcher and outspoken critic of spine surgery now at Kaiser Permanente Professor of Evidence-Based Family Medicine at Oregon Health and Science University in Portland, Oregon, mentioned to The New York Times that the spine profession is ignoring this call for restraint of ineffective medical care:

People say, “I’m not going to put up with it,” and we in the medical profession have turned to ever more aggressive medication, narcotic medication, and more invasive surgery.[22]

Spine researcher Chien-Jen Hsu, MD, admitted in the journal Spine:

By far the number one reason back surgeries are not effective and some patients experience continued pain after surgery is because the lesion that was operated on is not, in fact, the cause of the patient’s pain. [23]

This alludes to a major change in the back pain business—the suspect disc theory as the cause of back pain. This paradigm shift dates back to 1990 when orthopedist Scott Boden found no correlation between abnormal discs and patients with and without back pain. In a follow-up study in 2003, Boden reaffirmed his previous findings:

It should be emphasized that back pain is not necessarily correlated or associated with morphologic or biomechanical changes in the disc. The vast majority of people with back pain aren’t candidates for disc surgery.[24]

Dr. Maureen Jensen’s study also confirmed early suspicions that herniated discs were “coincidental” and not the holy grail of back pain causation:

The relation between abnormalities in the lumbar spine and low back pain is controversial. We examined the prevalence of abnormal findings on magnetic resonance imaging (MRI) scans of the lumbar spine in people without back pain.

On MRI examination of the lumbar spine, many people without back pain have disk bulges or protrusions but not extrusions. Given the high prevalence of these findings and of back pain, the discovery by MRI of bulges or protrusions in people with low back pain may frequently be coincidental.[25]

Raj Rao, M.D., director of spine surgery in the Department of Orthopaedic Surgery at the Medical College of Wisconsin, also spoke of this paradox in spine imaging:

You can look at the MRIs of two people, both showing degenerative discs, but in one case there is little to no pain, while in the other, extreme pain. On the other hand, you can see a healthy spine but the patient has severe pain.[26]

Despite the new research undermining spine fusions, this erroneous non-evidenced-based disc theory remains very much alive in the medical profession that is unwilling to forego this lucrative fusion surgery nor are they willing to have chiropractors compete on a level playing field for these cases.

According to Pran Manga, PhD, Canadian health economist who conducted two comparative effectiveness studies on low back pain, “There is an overwhelming body of evidence indicating that chiropractic management of low back pain is more cost-effective than medical management.” [27]

In an article by Jo Jordan, PhD, “Are There Any Effective Nonsurgical Treatments for Painful Disc Herniations?she wrote that spinal manipulation may be the “lone ray of light” for back pain treatment.[28] Her comment is just one among many that now vindicate chiropractic care in the form of spinal manipulation for the treatment of this worldwide epidemic of back pain.

By the end of the 1990s, evidence-based research from Europe and America recommended major changes to the management of patients with low back pain, including those diagnosed with disc herniation. Studies in the U.S.[29], U.K.[30], Canada[31], and Denmark[32] all concluded: back surgeries were excessive, and conservative care such as spinal manipulative therapy and active rehab were the best initial approaches to the vast majority of low back pain (LBP) problems.

“No clear evidence emerged that primary spinal fusion surgery was any more beneficial than intensive rehabilitation,” according to Jeremy Fairbank, MD, lead investigator, British Spine Study (UK BEAM). “And spine care providers should offer intensive rehabilitation enthusiastically, as it finds clear support in the scientific literature, and will prevent unnecessary surgery in a substantial proportion of patients.”[33]

TheBACKLETTER editorial staff also noticed the stubbornness of physicians to implement the new guidelines for low back pain, which includes the use of spinal manipulation as a first route of treatment before surgery:

Numerous international guidelines have endorsed the use spinal manipulation as a treatment for acute back pain—as part of an evidence-based treatment algorithm. But researchers have been slow to examine the impact of guidelines-based care in rigorous clinical trials—to see if an evidence-based approach actually works in real-world clinical settings.[34]

Despite the growing litany of research on the best treatments in spine-related disorders, this medical ruse against chiropractic care continues to this day. The medical media refuses to disclose the latest research showing the superiority of spinal manipulative therapy for the epidemic of back pain in this country that affects 90% of adults. Indeed, freedom of speech/information on medical matters simply does not exist in our hospitals, in the media, or in the healthcare delivery system because the medical society has no interest in giving up control of this lucrative market.


Nor does the news media ask why most public hospitals exclude chiropractors despite the fact they are licensed by every state. The fact that public hospitals are still controlled singularly by one trade association smacks of antitrust activity that flies in the face of free enterprise. It also stands in defiance of the Wilk antitrust trial, denying the public a freedom of choice in healthcare.[35]

The discrimination against chiropractors is well woven in our society on many levels, yet chiropractors have no public champion fighting our cause for equality. They have no Fredrick Douglas, no Betty Freidan or Martin Luther King, Jr. Nor do chiropractors have a newsman championing our cause—no Dan Rather, Bill O’Reilly, Wolf Blitzer, or Keith Oberman revealing the inequality of medical bigotry.

Rarely do members of the media speak of the hundred of thousands of failed back surgery patients or those addicted to opioid drugs for back pain. Never have I seen a prime-time news article on the vindication of chiropractic care after a century of abuse by the AMA. This is a newsworthy story befitting any underdog, but somehow has escaped the media’s attention.

To the contrary, the taboo against chiropractic continues and, if anything is said, it is generally bad or swept under the medical rug if it is good.

In this era of so-called evidence-based healthcare where science is supposed to be the guiding light, we would think the news media would be on chiropractic’s side. Yet, the medical powers ignore the positive public surveys in favor of chiropractors (Gallup[36], TRICARE[37], Consumer Report[38]). They ignore the comparative international studies recommending manipulation over drugs, shots, or surgery (AHCPR-US[39], Manga-Canada[40], NICE-UK[41]).

Chiropractors are constantly reminded that the real power behind this oversight is not the lack of scientific evidence as much as money and prejudice. As the Clinton and Obama healthcare reforms showed all, economic-based healthcare is the real power driving medical care, and behind that power is the medical prejudice that has been its mania for over a century.

The Origin of Medical Bigotry

Whereas sexism, racism, and anti-Semitism have diffuse origins, medical bigotry can be traced back to one person in particular in the annals of political medicine.

Morris Fishbein, MD, the executive director of the AMA from 1924 to 1949, was also known by his contemporaries as the Medical Mussolini due to his tyrannical leadership. For example, in 1925 Fishbein wrote: “Scientific medicine absorbs from them that which is good, if there is any good, and then they die.”[42]

And many good alternative health professions did die, such as homeopathy, naturopathy, true osteopathy, and although scathed, chiropractic did survive wounded in image and pride with over 12,000 members jailed in the first half of the 20th century.

After Fishbein was removed from power in 1949, his policy continued into the 1960s with the AMA’s Committee on Quackery that announced its goal to “contain and eliminate the chiropractic profession,”[43] inexplicably calling chiropractors “rabid dogs” and “killers.”[44] They had no proof, but disseminated propaganda nonetheless to damage the image of their rivals.

The Committee on Quackery institutionalized its prejudice and rested its power on Principle 3 of “The Principles of Medical Ethics” that stated: “A physician should practice a method of healing founded on scientific basis; and he should not voluntarily associate professionally with anyone who violates this principle.”[45] Under this admonition, ethical MDs were prohibited from referring to chiropractors for fear of being blackballed and losing their licenses.

Despite the AMA’s call that chiropractic was “unscientific,” they could not prove it. In fact, trial evidence from workers’ comp studies submitted by attorney George McAndrews during the Wilk antitrust trial showed that chiropractic care had a 2:1 superiority rating over medical care for low back pain. Still the AMA executives turned a blind eye to this evidence and continued to slander all chiropractors.

One of the AMA’s own board members, orthopedist Irwin Hendryson, admitted that chiropractic “has prospered through the years and it is a difficult thing to quarrel with success.”[46] He submitted a lengthy positive report that was squelched by the AMA for fear of being “misconstrued” as a medical endorsement of chiropractic care.[47]

This medical prejudice was embedded into the mindset in every medical school and certainly within the medical societies. Indeed, no MD could gain hospital privileges who espoused freedom of choice for patients to use chiropractic care.

This tomfoolery eventually led to the AMA’s Watergate—the landmark Wilk antitrust case brought by four brave chiropractors against the AMA et al. in 1976.[48] This eleven-year trial led federal judge Susan Getzendanner to find in favor of the chiropractor-plaintiffs. She also stated in her Opinion that “The AMA has never made any attempt to publicly repair the damage the boycott did to chiropractors’ reputations.”[49]

The damage was done and the AMA went on with its boycott as usual despite this little legal bump in their road to power. The AMA’s goal was to character-assassinate chiropractors, not view them as competitors on a level playing field to help patients or to work in public hospitals. As one AMA attorney admitted, “The ultimate objective of the AMA, theoretically, is the complete elimination of the chiropractic profession.”[50] 

Certainly at this point, scientific-based medicine was superseded by politically-based medicine, and remains so to this day.

My book speaks of this dark chapter of American medicine that few people understand and a story the AMA would prefer left in the dark.[51] For example, few people know that 12,000 chiropractors were arrested in the first half of the 20th century allegedly for practicing medicine without a license. This was a ruse because chiropractors never used medicines or surgery. The AMA’s real goal was to eliminate all competitors by any means, including a massive media propaganda campaign that included famed columnist Ann Landers to disseminate misinformation against chiropractors.

Surgical Scam

Aside from the genocidal nature of this medical boycott to eliminate chiropractors, the power of prejudice has led to one of the biggest medical scams ever perpetrated on the American public—the thousands of unnecessary spine surgeries now deemed to be ineffective, costly, and disabling. This alone should be a newsworthy story considering the half-million spine surgeries done annually.

This renaissance in spine diagnosis began in 1990 when research by Scott Boden et al. followed in 1994 by a supportive study by Maureen Jensen et al. found no clear correlation between disc abnormalities and back pain.[52],[53] Other medical researchers have revealed the fallacy of abnormal discs—the basis of spine surgery—as “trivial, harmless, and irrelevant.”[54]  

Despite the new research, warnings, and recommendations for non-invasive methods like chiropractic care, there are more spine surgeries done today than ever before. According to Richard Deyo, MD, MPH, “The most complex type of back surgery has increased dramatically between 2002 and 2007 with a 15-fold increase.”[55]

As to the reason for this increase, he concluded that “More people are interested in getting on the gravy train than on stopping the gravy train.”[56] Hopefully this gravy train will reach a dead-end soon to save millions of patients from unnecessary spine surgeries.

The business of back pain remains huge—a $100+ billion industry, the leading work injury, and the largest disabling condition in the country. While back pain may not kill you like heart disease or cancer, the wrong treatment like spine surgery may leave you disabled, depressed, and bankrupt.

The saddest part is research now suggests the majority of spine surgeries are risky, unnecessary, and terribly expensive; opioid drugs are addictive and epidural steroid injections shots are no more effective than saline solution.[57] Indeed, this medical fiasco has left many victims at a huge cost to society.

Medical voices now admit the damage spine fusions have done. According to Gordon Waddell, MD, noted author and orthopedic surgeon, “It [back surgery] has been accused of leaving more tragic human wreckage in its wake than any other operation in history.”[58] Rather alarming confession from a renowned medical author, yet an admonition the public rarely hears from their local MDs or from the medical media.

Unethical Journalism at CNN

Another example of the power of medical prejudice occurs daily. Other than a few small segments on chiropractic care, I have never seen any significant program on CNN concerning the benefits of chiropractic care. This is certainly not befitting the third-largest physician-level health profession in the country that holds an answer to this epidemic of back pain.

I searched the CNN website for programs by Dr. Sanjay Gupta and found one video that shamelessly smeared our profession with an exaggerated allegation that chiropractic care has caused hundreds of strokes:

  • Stroke after chiropractic care updated Wed June 25, 2008
  • Hundreds of people have had strokes after having their necks manipulated. Dr. Sanjay Gupta reports.

http://www.cnn.com/video/#/video/health/2008/06/25/gupta.chiro.stroke.cnn

I might add this video was taken down after I filed a complaint with Richard Davis, EVP at CNN.

However, the facts belie Dr. Gupta’s claim. According to research, the rate of iatrogenic problems associated with spinal manipulative therapy as rendered by doctors of chiropractic is only 1 in 5.85 million cases, which is less than the chance of stroke in a hair salon or being hit by lightning (one in 600,000). It equated to one occurrence in 48 chiropractic careers.[59]

Despite the overwhelming evidence of the comparative safety of chiropractic manipulation for neck problems, a dubious study from England with a sensational title, “Deaths After Chiropractic: A Review Of Published Cases,” by Edzard Ernst of the Medical School at the University of Exeter, once again raised the level of fear over chiropractic care. Despite his attempt to harm chiropractors, he noted only “Twenty-six fatalities were published since 1934 in 23 articles.”[60]

Considering these 26 fatalities over 77 years equates to 0.34 deaths per year, instead of sounding an alarm, Ernst should have praised chiropractic care for its obvious safety since this is an extremely low rate in comparison with equivalent medical methods such as neck surgery that has shown a 3-4% rate of complications for cervical spine surgery, which equates to 4,000-10,000 deaths per million neck surgeries.[61]

Obviously Dr. Gupta’s video about chiropractic care causing “hundreds of strokes” is odd considering it equates to one-third of a person annually at the most, yet he has made no attempt to correct his misinformation nor did he inform his audience of the thousands who die from spine surgery annually.

This is clearly unethical journalism. Obviously distorting the facts does not inform today’s health care consumer of the safety or efficacy of chiropractic care, clearly indicating his lack of objective and fair journalism. This unfair journalism is also a newsworthy event that has been reported to other news outlets, but ignored.

Call for Restraint on Back Surgeries

My second complaint was directed to another important issue—the rash of criticism about spine surgeries that Dr. Gupta has ignored. Considering he is a neurosurgeon, undoubtedly he is unwilling to incriminate his fellow spine surgeons about the rash of unnecessary spine surgeries or mention the dubious disc theory.

 In this era of evidence-based medicine, numerous MRI studies have shown the disc theory has been debunked, many medical critics have raised concern over these unnecessary surgeries kept alive by spine surgeons and, moreover, many news media now have investigated medical corruption by Medtronic. Yet Dr. Gupta has been strangely quiet on this important issue.

Over the last few months, there has been a few media exposés on spine surgery:

  • Surgery May Not Be the Answer to an Aching Back,” by Joanne Silberner, NPR, April 6, 2010.
  • Back Surgery May Backfire on Patients in Pain,” by Linda Carroll, MSNBC, Nov. 14, 2010
  • Top Spine Surgeons Reap Royalties, Medicare Bounty,” by John Carreyrou and Tom McGinty, Wall St. Journal, Dec. 20, 2010
  • Highest-Paid U.S. Doctors Get Rich with Fusion Surgery Debunked by Studies” by Peter Waldman and David Armstrong, Bloomberg News, Dec. 30, 2010.
  • Spinal Fusions May Cause More Harm Than Good,” by Terrance Pagel, Daily Health Report, Jan. 20, 2011
  • Medicare Records Reveal Trail of Troubling Surgeries” by John Carreyrou and Tom McGinty, Wall St. Journal, March 29, 2011

I find it odd the CNN ignores this newsworthy medical controversy while other reputable news media have exposed the ineffectiveness, greed, and questionable disc theory behind spinal surgery. These articles also spoke of the untold cost in human suffering as well as wasted revenues of these unnecessary surgeries. 

The obvious question remains: why hasn’t Dr. Gupta or another CNN special documentary covered this huge spine controversy, the call for reform, the hoax of the disc theory, or the recommendations for spinal manipulation? I believe medical bias is the main reason. Just like racial prejudice, the medical bigotry toward chiropractors is deeply ingrained into most MDs, including Dr. Gupta. To admit their rivals, those damn chiropractors, were right and the proud spine surgeons are wrong is too much to confess to the public.

Another paradigm shift away from spine surgery occurred when Blue Cross Blue Shield of North Carolina announced in January, 2011, that it would no longer pay for spinal fusion for back pain in the presence of only disc degeneration or disc herniation. This is a huge policy change that will hopefully have a ripple effect among all state BC/BS and other insurance companies to curtail payment for this epidemic of ineffective spine surgery. [62]

Yet, there has been no mention of this remarkable policy change by Dr. Gupta. Considering heart and back surgeries are the two largest revenue streams in hospitals, his omission continues to raise questions—why he refuses to report these landmark changes in spine care and insurance coverage that could greatly lower healthcare costs?

Dr. Gupta has ignored the monumental changes in treatment policy by national and international guidelines that recommend chiropractic care before surgery for non-specific low back pain. This began in 1994 with the US Public Health Service’s AHCPR guideline on acute low back pain[63], plus more recent guidelines including the North American Spine Society[64], the American Pain Society[65], and the Milliman Care Guidelines.[66]

All recommend spinal manipulative therapy as a first avenue for treatment and spine surgery as the last option, a point lost to most MDs who railroad patients into risky drugs, unnecessary shots, and expensive spine surgery despite the lack of support.

As you can see, the spine surgery scandal is huge, and has led to thousands of unnecessary spine surgeries performed each year costing millions in lost work days, billions of dollars in medical expense, as well as the incalculable human toll in suffering and depression by patients who never needed a spinal fusion. This also contributes to the opioid drug addiction we now face in the so-called Hillbilly heroin epidemic of patients who often seek intervention from failed back surgeries.

Considering the enormous scope of this spine scandal, Sanjay Gupta has completely ignored this troubling situation that affects hundreds of thousands of back pain patients annually and costs the healthcare system billions of dollars. While other national news organizations are criticizing this spine scandal, why hasn’t CNN’s leading medical reporter? Is he forgetful or prejudiced?

My contention is Dr. Gupta as a neurosurgeon obviously has a conflict of interest not to criticize the onslaught of spine surgeries since he and his colleagues greatly profit by this medical scam.

Tipping Point

As long as this acceptable medical prejudice permeates the mainstream media—from conservative FOX News and liberal CNN alike—chiropractic will not get its message out. The facts are clear that chiropractors offer the majority of spine patients a better, cheaper, and safer service, but patients are confused by medical bigotry that lingers on like racism and sexism.

The lack of attention in the mass media also poses a huge barrier to reposition the public to the chiropractic brand of spinal care. In the world of evidence-based spine care, the tide has turned against the massive amounts of drugs, shots, and spine surgery, but the public remains in the dark tainted by the medical bigotry against chiropractors who should be the primary spine care providers in this epidemic.

Until chiropractors have equality in all facets of American healthcare with a presence in all universities, equality in research funding, access and equal pay in private insurance coverage, and an equal presence in government health bureaucracies and health care news programming, there will be no peace and the medical war against chiropractors will continue.  This is the real healthcare reform this country needs to win the battle against back pain.

I ask that you in the media help in this war by exposing the new science vindicating the chiropractic profession as well as the unfairness in some media outlets such as CNN’s Dr. Gupta. Both are newsworthy topics that the American public will find interesting as well as useful in their own battle with back pain. This underdog David versus the medical Goliath is a fascinating story the public will be interested in learning, but we need a miracle breakthrough to have it happen.

Regards,

 

JC Smith



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

[2] Ibid. PX-1288, p. 2

[3] Ibid. PX-439.

[4] PX-322, p. 16

[5] “Competition: The Surprising Swing to Non-Physicians,” Medical Economics, (May 30, 1983)

[6] US Supreme Court: Goldfarb v. Virginia State Bar, 421 U.S. 773 (1975), argued 25 Mar. 1975, decided 16 June 1975 by vote of 8 to 0, http://www.answers.com/topic/goldfarb-v-virginia-state-bar-1

[7] M Mayer, “The Rise and Fall of Dr. Fishbein,” Harper’s Magazine, 199/1194 (Nov. 1949): 81.

[8] JF McAndrews email to JC Keating dated July 5, 2005, notes on “Wilk et al. vs. AMA et al. and The Century-Long War Between Chiropractic And Allopathic Medicine.

[9] Ibid.

[10] RL Smith, “Scientology—Menace to Mental Health,” Today’s Health, (Dec. 1968):34-39.

[11] RL Smith,  At Your Own Risk:  The Case Against Chiropractic, Simon & Schuster, (1969).

[12] Wilk ibid. p. 25 .

[13] W Trever, “in the Public Interest,” Scriptures Unlimited, Los Angeles, Calif., (1972):1

[14] Gibbons, ibid. p. 27.

[15] ER Booth, History of Osteopathy and Twentieth Century Medical Practice, Cincinnati: Caxton Press, 1905 (1924):312.

[16] ER Booth, History of Osteopathy and Twentieth Century Medical Practice, Cincinnati: Caxton Press, 1905 (1924):312.

[17] Memo from Robert Youngerman to Robert Throckmorton, 24 September 1963, plaintiff’s exhibit 173, Wilk.

[18] W Trever, “in the Public Interest,” Scriptures Unlimited, Los Angeles, Calif., (1972):11

[19] JC Smith, The Medical War Against Chiropractors, CreateSpace, copyright 2011 JC Smith

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

[21] D Cherkin, FM Kovacs, P Croft, J Borkan, NE Foster, B Oberg, G Urrutia, J Zaore. “The Ninth International Forum For Primary Care Research On Low Back Pain. International Organizing Committee Of The Ninth International Forum For Primary Care  Research On Low Back Pain And All The Participants,” Spine 34 (2009):304-307

[22] G Kolata, “With Costs Rising, Treating Back Pain Often Seems Futile” by NY Times (February 9, 2004)

[23] CJ Hsu, et al. “Clinical Follow Up After Instrumentation-Augmented Lumbar Spinal Surgery in Patients with Unsatisfactory Outcomes. In Journal of Neurosurgery,” Spine 5/4 (October 2006):281-286.

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

[25] MC Jensen, MN Brant-Zawadzki, N Obuchowski, MT Modic, D Malkasian, and JS Ross, “Magnetic Resonance Imaging of the Lumbar Spine in People without Back Pain,” NEJM, 331/2 (July 14, 1994):69-73

[26] P Garfinkel, “The Back Story,” AARP: the magazine, (July & August 2009)

[27] P Manga, D Angus, C Papadopoulos, W Swan, “The Effectiveness and Cost-Effectiveness of Chiropractic Management of Low Back Pain,” (funded by the Ontario Ministry of Health) (August, 1993):104

[28] J Jordan, et al., “Herniated Lumbar Disc,” BMJ Clinical Evidence, quote in The BACKLETTER® 25/7 (July 2010):76-77

[29] Bigos et al. US Dept. of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research, Clinical Practice Guideline, Number 14: Acute Low Back Problems in Adults AHCPR Publication No. 95-0642, (December 1994)

[30] Her Majesty’s Stationery Office in London in its Report of a Clinical Standards Advisory Group Committee on Back Pain (1994)

[31] P Manga and D Angus, “Enhanced Chiropractic Coverage Under OHIP As A Means Of Reducing Health Care Costs, Attaining Better Health Outcomes And Achieving Equitable Access To Select Health Services.” Working paper, University of Ottawa, 98-02.

[32] C Manniche  et al. “Low-Back Pain: Frequency, Management And Prevention From An HDA Perspective,” Danish Health Technology Assessment 1/1 (1999)

[33] J Fairbank, et al., “Randomized Controlled Trial To Compare Surgical Stabilisation Of The Lumbar Spine With An Intensive Rehabilitation Programme For Patients With Chronic Low Back Pain: The MRC Spine Stabilisation Trial,” Spine Stabilisation Trial Group, BMJ  (2005):330:1233 (28 May),doi:10.1136/bmj.38441.620417.8F (May 23, 2005)

[34] “Evidence-Based Care That Includes Chiropractic Manipulation More Effective Than Usual Medical Care,” The BACKLETTER  editorial, 23/1 (2008):3.

[35] Chester A. Wilk, James W. Bryden, Patricia A. Arthur, Michael D. Pedigo v. American Medical Association, Joint Commission on Accreditation of Hospitals, American College of Physicians, American Academy of Orthopaedic Surgeons, United States District Court Northern District of Illinois, No. 76C3777, Susan Getzendanner, Judge, Judgment dated August 27, 1987.

[36] The Gallup Organization, Democratic Characteristics of Users of Chiropractic Services (Princeton, NJ:  The Gallup Organization (1991)

[37] Chiropractic Care Study, Senate Report 110-335 accompanying the National Defense Authorization Act for FY 2009; letter sent to Congressmen by Ellen P. Embrey, Deputy Assistant Secretary of Defense (September 22, 2009):2.

[38] “Relief for Aching Backs:  Hands-on Therapies were Top Rated by 14,000 Consumers,” Consumer Report (May 2009)

[39] Bigos et al. US Dept. of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research, Clinical Practice Guideline, Number 14: Acute Low Back Problems in Adults AHCPR Publication No. 95-0642, (December 1994)

[40] P Manga, D Angus, C Papadopoulos, W Swan, “The Effectiveness and Cost-Effectiveness of Chiropractic Management of Low Back Pain,” (funded by the Ontario Ministry of Health) (August, 1993):104

[41] The National Institute for Clinical Excellence (UK-NICE) 2009

[42] M Fishbein,  Medical Follies, New York, Boni & Liveright, (1925): 43.

[43] G McAndrews, “Plaintiffs’ Summary of Proofs as an Aid to the Court,” Civil Action No. 76 C 3777, Wilk, (June 25, 1987) Throckmorton, Howard, Taylor, and Monaghon Deps.

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

[45] PX-56, 156A

[46] Ibid. Letter by Dr. Irwin Hendryson to RB Throckmorton, PX-241, May 13, 1966.

[47] PX-240, p. 2

[48] Chester A. Wilk, James W. Bryden, Patricia A. Arthur, Michael D. Pedigo v. American Medical Association, Joint Commission on Accreditation of Hospitals, American College of Physicians, American Academy of Orthopaedic Surgeons, United States District Court Northern District of Illinois, No. 76C3777, Susan Getzendanner, Judge, Judgment dated August 27, 1987.

[49] Wilk et al. v. AMA et al., Opinion pp. 10

[50] Memo from Robert Youngerman to Robert Throckmorton, 24 September 1963, PX 173, Wilk v. AMA.

[51] JC Smith, The Medical War Against Chiropractors, www.medicalwaragainstchiropractors.com

[52] 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.

[53] MC Jensen, MN Brant-Zawadzki, N Obuchowski, MT Modic, D Malkasian, JS Ross, “Magnetic Resonance Imaging Of The Lumbar Spine In People Without Back Pain,” N Engl J Med. 331 (1994):69–73.

[54]Richard Deyo, MD, MPH and Donald Patrick, PhD, MSPH, Hope or Hype, The obsession with medical advances and the high costs of false promises. 2005 AMACOM books.

[55] J Silberner, “Surgery May Not Be The Answer To An Aching Back,”  All Things Considered, NPR (April 6, 2010)

[56] R Abelson, “Financial Ties Are Cited as Issue in Spine Study,” NY Times (January 30, 2008)

[57] Ann Rheum Dis. 2003;62:639-643

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

[59] AGJ Terret, “Current Concepts in Vertebrobasilar Complications Following Spinal Manipulation,” NCMIC Group Inc, West Des Moines, Iowa, (2001)

[60] E Ernst “Deaths After Chiropractic: A Review Of Published Cases,” Int J Clin Pract, 64/8 (July 2010):1162–1165

[61] Gueret G, Bourgain JL, Luboinski B., “Sudden death after major head and neck surgery,’ Curr Opin Otolaryngol Head Neck Surg. 2006 Apr;14(2):89-94.

[62] http://www.bcbsnc.com/assets/services/public/pdfs/medicalpolicy/lumbar_spine_fusion_surgery.pdf

[63] Bigos et al. US Dept. of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research, Clinical Practice Guideline, Number 14: Acute Low Back Problems in Adults AHCPR Publication No. 95-0642, (December 1994)

[64] Freeman MD and Mayer JM, NASS Contemporary Concepts in Spine Care: Spinal Manipulation Therapy For Acute Low Back Pain, The Spine Journal  2010 October; 10 (10):918-940

[65] Chou R, et al., Diagnosis and Treatment of Low Back Pain:  A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society, Low Back Pain Guidelines Panel, Annals of Internal Medicine 2007 October 2; 147  (7):478-491

[66]Milliman Care Guidelines for Lumbar Fusions, Low Back Pain and Lumbar Spine Conditions—Referral Management, www.allmedmd.com

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