Articles by JCS

Whistle to Blow


 

Another Whistle to Blow

There have been many embarrassing revelations in the news lately after whistle blowers exposed alleged scandals at the NSA, IRS, DOJ, DOD, FBI, and the CIA. Since this seems to be a trend, I want to blow a whistle at another national organization, the AMA, which has caused more actual harm to more people over a longer period of time at greater expense than the other organizations under attack.

Certainly I am not the first to criticize the AMA for its ineffective and expensive medical system; after all, we are in the throes of a healthcare crisis. While many writers have exposed the problems with medical care in America, as a chiropractor, I feel compelled to address this problem from my unique perspective.

Medical Iatrogenesis: Two Examples

To be frank, not all disease can be attributed to bad germs, bad genes, or bad food, but many can be attributed to bad policy. In fact, history will show that the top two illnesses plaguing Americans today—ischemic heart disease and the epidemic of back pain—can be laid at the doorstep of the AMA. Indeed, if this story were a movie, it would be hard to believe because it is so outrageous.

In 1930, the AMA jumped into bed with the tobacco industry in order to fund its political war chest to fight competition like chiropractors and to resist any government intervention to reign in medical expenses as we now see with Obamacare.

In return, tobacco manufacturers were allowed to use images of doctors in public ads, permitted to have vendor booths at medical conventions, and tobacco ads were placed in medical journals giving the AMA’s stamp of approval despite the emerging evidence of the dangers of tobacco usage.

[You can Google retro tobacco ads to find numerous examples of doctors endorsing cigarettes.]

The mastermind of this deal, the AMA’s executive director, Morris Fishbein, MD, admitted in 1948 that he had brought in nearly $5 million in revenue from tobacco advertisers.[1]

The medical profession prospered on both ends of this deal—on the front end it made millions in advertisements and on the back end it profited with treatments for the cardiopulmonary diseases caused by tobacco.

This travesty continued for 56 years until public clamor finally forced the AMA’s House of Delegates to divest itself of all ties with tobacco in 1986. After this illicit partnership ended, the AMA never repudiated its sordid deal that stays hidden in the medical closet along with other bad policies, such as its war against chiropractors.

The Political Cause of Back Pain

Not only were the ravages of heart disease and lung cancer never publicly attributed to the AMA’s love affair with tobacco, there is another leading worldwide burden that can be attributed directly to the political antics of the AMA—the epidemic of back pain that is now the #1 disabling condition in the world. [2]

Regardless of the many physical reasons (sport injuries, car accidents, worker comp. injuries, prolong sitting, bad lifting leverage) that may explain the many causes of back pain, the illegal policy of the AMA “to contain and eliminate the chiropractic profession”[3] only made it worse by discouraging the use of what is now considered one of the most effective treatments for back pain—spinal manipulative therapy, aka, chiropractic adjustments.

Considering the spinal column has over 300 joints, most back pain is now regarded as joint dysfunction, which explains why spinal manipulation works so well.[4] As Anthony Rosner, PhD, testified before The Institute of Medicine: “Today, we can argue that chiropractic care, at least for back pain, appears to have vaulted from last to first place as a treatment option.”[5]

 “Bad Discs” Debunked

Text Box: Morris Fishbein, MD, former AMA executive director, aka, Medical Mussolini.Not only did slander by political medicine add to this back pain pandemic by suppressing chiropractic care, the mainstay of medical spine industry—the “bad disc” diagnosis—has fostered the present pandemic of 600,000 annual spine surgeries despite research disproving this basic disc premise.[6]

The “bad disc” concept began to unravel in 1990 with the initial MRI spine research by Scott Boden, MD, who found disc abnormalities were common among people who had no back pain whatsoever. Dr. Boden also admitted, “Many, if not most, primary medical care providers have little training in how to manage musculoskeletal disorders.”[7]

The revelation of asymptomatic patients with abnormal discs led Richard Deyo, MD, MPH, to conclude the debunked disc theory often leads to a “false positive” misdiagnosis and “many of these abnormalities are trivial, harmless, and irrelevant,” so they have been dubbed “incidentalomas,” because they may be incidental to back pain and they are likely to lead to unnecessary surgery.[8]

In a 2013 spine study, the “bad disc” theory was once again debunked when MRI research found as many as 81% of pain-free people patients had a disc herniation, 89% had an annular fissure, and 95% had evidence of nuclear disc degeneration.[9] Yet they had no pain.

Some insurance payers tired of paying the huge bills from spine surgery are now listening to the researchers. In 2011, North Carolina Blue Cross/Blue Shield announced it will no longer pay for spine fusion if the sole criterion is an abnormal disc, which is now considered just a clinical finding and not a diagnosis.[10]

Apologies Due                  

In both of these cases of medical malfeasance—tobacco and back pain—the AMA purposely mislead the public knowing they were perpetrating policies that were hurting patients and chiropractors alike.

Certainly the AMA owes an apology to the public for condoning tobacco as well as railroading millions of back pain sufferers into spine fusions based on a disproved “bad disc” theory.

An apology to chiropractors is also warranted, including the 12,000+ who were unjustly arrested in the first half of the 20th century in the medical witch hunt.

Such an apology would not be without precedent. In 2008 with the impending election of black candidate Barack Obama, the AMA apologized for another embarrassment—its historical racism toward African-American medical doctors who were banned from joining local medical societies or the national AMA. [11]

However, while black MDs were forced to sit in the back of the medical bus, chiropractors were thrown under the same bus.

Just as whistleblowers have recently exposed the many scandals within federal organizations, it is past time to expose similar antics of the AMA for its brand of political Text Box: Lyndon McCash, DC, in jail in Oakland, Calif., in 1920, one of hundreds of California chiropractors incarcerated prior to passage of the Chiropractic Act in 1922.medicine that has caused so much harm, disease, disability, and bankruptcy.

Perhaps this will be the AMA’s legacy—a once proud humanitarian association of dedicated physicians led astray by greed, bigotry, and the ruthless policies of the AMA’s executive officers in order to become “the most terrifying trade association on earth.”[12]



[1] MS Mayer, “The Rise and Fall of Dr. Fishbein,” Harper’s Magazine, (Nov. 1949): 76-85

[2] Peter W. Crownfield, Back Pain Is #1 Cause of Disability Worldwide, Global Burden of Disease 2010 highlights the pressing need to prevent, treat spinal and musculoskeletal disorders. Dynamic Chiropractic – February 15, 2013, Vol. 31, Issue 04

[3] 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.

[4] G Cramer,  Dean of Research, National University of Health Sciences, via personal communication with JC Smith (April 29, 2009)

[5] Testimony before The Institute of Medicine: Committee on Use of CAM by the American Public on Feb. 27, 2003.

[6] Linda Carroll, Back surgery may backfire on patients in pain, msnbc.com,10/14/20

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

[8] Richard A. Deyo, MD, MPH and Donald L. Patrick, PhD, MSPH, Hope or Hype: The Obsession with Medical Advances and the High Cost of False Promises, AMACOM books, (2005): 36-37

[9] Kim JS et al., Prevalence of disc degeneration in asymptomatic Korean subjects. Part 1: Lumbar spine. Journal of the Korean Neurosurgery Society, 2013; 53(20:31-8.

[11] AMA apologizes to black doctors for past racism, by Lindsey Tanner, AP Medical Writer Thu July 10.

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


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