Articles by JCS

Wilk Deja Vu

                                                                                                   


Word count: 3263

Wilk Déjà Vu Down Under

A nightmare that could happen to any DC anywhere is happening now in Australia where a pediatric chiropractor is being skewered in the court of public opinion. This scenario could happen to any chiropractor in the world as we’ve previously seen concerning the stroke issue in Canada, the UK, and the US.

What was initially an educational YouTube video of Dr. Ian Rossborough adjusting a colicky infant suddenly became a sensational news item gone viral stoking apoplectic fear in the public sector by biased news reporters and deranged rhetoric from medical demagogues.

Public Safety Ruse

Once again we see history repeating itself and hopefully we can learn a lesson from history to help in the present media skirmish Down Under.

This media sensation of Ian Rossborough, DC, a renowned Melbourne pediatric chiropractor, has become the target of another medical assault as Americans experienced for nearly a century.

Due to the lack of any real smoking guns to make a case, the chirophobic medical media manufactures fictitious motives to fuel their war against chiropractors, such as protecting “patient safety” and halting “unscientific treatments,” neither of which have ever been proven in a court of law but linger on as urbane myths spread by biased reporters.

Indeed, this is clearly another case of classic demagogic journalism that has these main characteristics:

  1. misrepresent the issue of a victim-less non-crime (remember no baby was hurt),
  2. mischaracterize pediatric chiropractic as “dangerous” and “unscientific,”
  3. not allow any chiropractor to rebut these allegations or show the supportive research for pediatric care.
  4. Instead, they push hot emotional buttons among the public suggesting babies are being abused and damaged with “cracked backs”,
  5. then stir people to react against chiropractors with bogus sanctions and calls for “public safety.”

This classic demagoguery Down Under is a medical Don Quixote fighting a straw man. This technique has been used throughout history in highly charged emotional issues where a fiery, entertaining "battle" and the defeat of an "enemy" may be more valued than critical thinking or understanding both sides of the issue. Certainly, this string of Chicken Little journalism articles in the news was anything but “fair and balanced.”

Don’t Confuse Us with the Facts

This is not the first time DCs were accused of abusing babies. It is, however, the first time this allegation went viral across Australia and around the world.

 According to George McAndrews, lead attorney in the Wilk v. AMA trial, this tactic was raised in the courtroom in 1976 by the AMA attorney who asked Dr. Mike Pedigo, a plaintiff-chiropractor, if he ever did a “hangman’s break” on an infant:

“Please remember that the AMA raised the issue of Dr. Pedigo adjusting infants during the trial and it went absolutely no where after he demonstrated how gentle the procedure was after Max Wildman [lead attorney for the AMA] asked him if he ever performed a ‘hangman’s break’ on a child. 

“The issue is: should millions of babies throughout the world be denied relief from musculo-skeletal pain and colic just because MDs are not qualified to diagnose or care for the malady as efficiently or effectively as the chiropractor?”[1]

Time and time again AMA witnesses who testified at Wilk would make claims similar to those now heard in Australia that chiropractic was “an unscientific cult” without any proof other than their opinions to justify its boycott against chiropractors. Apparently after telling their lies about chiropractors for years, they began believing their own lies.

But issue after issue was proven misleading or totally false by attorney McAndrews, who submitted evidence and expert witnesses contradicting the medical propaganda that chiropractors were “dangerous”, “poorly trained”, “rabid dogs”, “killers” and “utterly ridiculous”.

Is this not the same baseless accusations we now hear Down Under? As examples of misinformation:

  • Dr. Frank Jones, said “I think that this is an unnecessary and seemingly almost cruel process that there is actually no evidence to support.”[2]
  • Dr. John Cunningham who said “There's not many things that make an orthopedic surgeon emotional, but when you see a premature baby having its back cracked [implying fracture], it literally makes my eyes water.”[3]
  • Pediatrician Dr. Chris Pappas said “no scientifically proven benefits of chiropractic manipulation for young babies and children exist.”[4]

I would love to hear these three medical curmudgeons repeat this misinformation under oath at deposition considering there is ample research for pediatric chiropractic care and there was no injured baby with its “back cracked.” Indeed, this is a victim-less non-crime that has erupted into a witch hunt.

Actually, these comments are the ranting of misguided, ill-informed and biased MDs who willingly misled the public and press in order to defame their competition, just as we found in the Wilk v. AMA case. It should also be noted at trial Mr. McAndrews successfully presented medical educators such as John McMillan Mennell, MD, who testified about the poor quality of medical education in musculoskeletal disorders, an issue still prevalent today.

The following excerpt from the Wilk court transcript illustrates the medical mindset we are still experiencing forty years later:

Among the many witnesses was John C. Wilson , Jr., MD, chairman of the American Medical Association ’s Section on Orthopedic Surgery (and subsequently president of the defendant AAOS).  His testimony demonstrated that medical bias, not patient care, was at the center of this professional boycott. 

The chiropractic treatment that the medical profession criticized most heavily was spinal manipulation therapy (SMT), a subject Dr. Wilson admitted he knew nothing about. Considering manipulation has existed since antiquity around the world, his ignorance of this ageless healing art was shocking although indicative of the medical boycott of chiropractic care.

The following deposition of Dr. Wilson by Mr. McAndrews shows his contempt and hostility that practitioners of chiropractic face even today:

Q:  Is it possible to manually move a spinal joint through a range of motion?

A:  I simply cannot answer your question in that context.

Q:  Can you answer the question in any context including your own?

A:  No, because this is not a frame of reference in which medical doctors think, and we don’t relate to turning spinal joints around through manipulation.  That is the chiropractic concept and we don’t understand it.  We don’t relate to it.  We don’t know what you are talking about.

    Q:  Have you ever done any research into that?

A:  No.  And I don’t have any desire to do any research into that or any other cult.

Q:  I am not really talking about cults now.  I am talking about the manual manipulation of spinal joints.

A:  No.  I have no interest in or desire to pursue the manipulation of spinal joints as a theory.

    Q:  Why?

A:  Because I don’t believe in this kind of thing.  I don’t know of any scientific basis that would cause me to pursue this as a way to help people.[5]

Wilson freely admitted he was ignorant of the concepts of joint play and manual manipulation of the spine, yet he had the audacity to condemn it as unworthy of his investigation. 

To make his testimony more ironic, in 1967, just a few years before his deposition, Wilson had written an article in JAMA admitting the deficiencies in medical education concerning treatment for low back pain and sciatica: 

“Even the abundant and significant advances resulting from the medical profession’s emphasis upon research have failed abysmally to relieve modern man of one of his most common and bothersome afflictions, low back pain…treatment of low back pain is inconsistent and less than minimal…MDs often displayed a disturbing ignorance of the cause and treatment of low back and sciatic pain, one of mankind’s most common afflictions.” [6]

Although Dr. Wilson was painfully honest in his appraisal of traditional medicine’s inability to diagnose and properly treat back pain, his gross condemnation of chiropractic concepts illustrated how his bias superseded his intellectual honesty on clinical issues.  Recall this comes from a professional who prided himself on a so-called objective scientific attitude.

Another huge legal hurdle for the medical attorneys was they had no injured patients to prove their “patient safety” allegation. Mr. McAndrews also remarked about the lack of witnesses for the medical defendants to testify they had been hurt by a chiropractor:

None of them have come through that door. They were not brought in so you [the jurors] could see them testify. They haven’t brought in a patient. You’d think if all of these patients have been injured, some would come in here and say they were injured by a chiropractor. Not one walked through the door.”[7]

Judge Getzendanner ruled the AMA had failed to prove its “patient safety” defense. In fact, she found “Most of the defense witnesses, surprisingly, appeared to be testifying for the plaintiffs” [aka, admissions against interest]:

“Taking into account all of the evidence, I conclude that the AMA has failed to meet its burden on the issue of whether its concern for the scientific method in support of the boycott of the entire chiropractic profession was objectively reasonable throughout the entire period of the boycott.”[8]

Déjà Vu Down Under

Aside from “patient safety,” another ploy was the AMA’s demand to boycott chiropractors by threatening physicians and hospitals with the loss of licensure if they cooperated with DCs for the good of patients.

We now see the same antitrust violation emerging Down Under with the recent call by the Royal Australian College of General Practitioners telling its members not to refer patients to chiropractors. RACGP Dr. Frank Jones is leading this witch hunt by writing to health ministers from all eight states and territories urging a "unified response" to the chiropractic treatment of infants and making outlandish comments in the media to incite baseless public furor against chiropractors.

Frank Jones, the President of the College, states in his letter that “continuation of these chiropractic services represents a public safety risk.”

Okay, Dr. Jones, please present the research to support your belief. Instead, he seems to rely upon the fallacy often used by MDs, “Trust me, I’m a doctor!”

Indeed, this case is clearly Wilk déjà vu Down Under. Perhaps the antitrust laws are different there, but this boycott is a shameless attempt to monopolize the healthcare market by defaming their main rivals with unproven allegations.

Judge Getzendanner mentioned such slander in her Opinion:

“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.”[9]

The judge described the conspiracy as “systematic, long-term wrongdoing, and the long-term intent to destroy a licensed profession.”[10] She ruled, “By labeling all chiropractors unscientific cultists, injury to reputation was assured by the AMA’s name-calling practice,”[11] which was exactly the goal of the medical Goodfellas—to defame its main competition, to invalidate chiropractic  expertise/treatments, and to capture the healthcare marketplace.

It’s All About Money

Judge Getzendanner admitted in a 1991 interview that the medical war was primarily a turf battle about money, not about safety. "Absolutely," she confessed. "Chiropractors compete with doctors. There's no question about it: it's basic competition."[12]

Considering the estimated $700 million in lost revenues to chiropractors during the AMA boycott from 1962 to 1980, the legal costs were just the cost of doing business for the AMA. There was no mea culpa to the public, no tabula rasa, no reparations were paid to the chiropractors, no one at the AMA went to jail, and the AMA experienced relatively little punishment other than legal fees and paid a $300,000 donation to the Kentuckiana Children’s Center.

Fortunately today the chiropractic profession has numerous studies to support its practices, we have scope of practice laws to protect our patients and ourselves from medical persecution, we have legislation to include our services in many publicly-funded health programs, but what we still don’t have is a strong voice to disseminate our viewpoint in the media or to defend our profession from unwarranted allegations in this war of words.

Medical Gods Must Be Crazy

As fate would have it, this pathetic panic over pediatric chiropractic care coincided with two more important healthcare issues over patient safety by medical treatments that Drs. Jones and Cunningham failed to bring to the public’s attention, undoubtedly hoping these two scientific articles would blow over without public attention.

One is an article in the Medical Journal of Australia questioning the rash of back surgeries and the other from the British Medical Journal concerns medical errors as the third-leading cause of death in the U.S (and, undoubtedly, Down Under, too). Both of these interesting topics have a greater impact on the public than pediatric chiropractic, but both have gone unmentioned in the mass media.

A shocking article indicting spine surgery was published simultaneously during the same week as the attack on Dr. Rossborough in the Medical Journal of Australia, “Perspectives: Surgical management of low back pain[13] by Leigh Atkinson, Wesley Pain and Spine Centre, Brisbane, QLD, and Andrew Zacest, Department of Neurosurgery, Royal Adelaide Hospital, Adelaide, SA.

The authors stated “Spinal surgery for chronic low back pain is controversial, and the disproportionate number of fusions in private hospitals is unexplained.”

This article couldn’t have come at a more opportune time, but was completely ignored in the mainstream media. A related online article published by the MJA InSight newsletter on April 26, 2016, Spinal Fusion Surgeries Questioned, written by Charlotte Mitchell was painfully clear that the need to stop the tsunami of back surgeries is urgent:

“Spinal fusion surgeries for chronic low back pain are on the rise, despite the lack of research to back their efficacy, and experts are now calling for tighter guidelines, including a waiting period.”[14]

Dr. Richard Williams, orthopaedic surgeon and spokesperson for the Royal Australasian College of Surgeons, told MJA InSight that a key regulation should be that patients must wait a period of 12 months before a spinal fusion surgery was performed, noting "Most patients will recover after these 12 months” without any surgery.

Certainly the medical model for back pain has been an utter failure—addictive and deadly opioid painkillers, epidural shots, and spine fusions.

I can only imagine the astonishment of Dr. Cunningham to a year’s delay before doing fusions on his patients. Undoubtedly 90% of his low back pain patients would be well in a year’s time using chiropractic care, therapeutic massage therapy, and self-care home exercises among other nondrug alternative methods.

Professor Jeffrey Rosenfeld, senior neurosurgeon at the Alfred Hospital and director of the Monash Institute of Medical Engineering,  also mentioned for patients who do not have clear indicators for spinal fusion surgery (the “red flags” of cancer, fracture, infections), a non-invasive multidisciplinary approach is preferable, which includes chiropractors. “This will often give people better long-term pain outcomes than having multiple spinal surgeries.”[15]

Since turnabout is fair play, certainly the media should hold Dr. Cunningham’s feet to the fire to have him comment about the ineffectiveness of spine surgery, the proposed waiting period on surgery for a year, and the recommendation to refer these chronic back pain patients to chiropractors.

If watching a baby being gently adjusted with finger-tip precision by a 30-year practitioner will bring tears to Dr. Cunningham as he mentioned in the original article attacking Dr. Rossborough, I can only imagine the flow of tears from Dr. Cunningham following the release of this article in MJA calling for monumental restraints in spine surgery.

Compounding the impact of the MJA report of unnecessary spine surgeries, the British Medical Journal also released in May, 2016, another damning indictment in its report citing Medical error—the third leading cause of death in the US.[16]

The total for iatrogenic deaths in the United States annually is approximately 999,936[17] and 50,000 iatrogenic deaths annually in Australia.[18] Inexplicably, these deadly medical mistakes rarely make the news or go viral, but we know if chiropractors were responsible as the third-largest cause of death and killing nearly a million people, it would be headlines everywhere.

So, within a week’s time, two knock-out punches against the medical profession came from two notable medical journals, but we see no mention in the media. Is this shoddy journalism or medical bias not to embarrass the Don Quixote medical straw man warriors used to bash chiropractors?

Compounding the medical errors in medicine, the British Medical Journal[19] in 2013 published a similar article about the thousands of ineffective medical treatments, also appearing in The Washington Post,  Surprise! We don’t know if half our medical treatments work.[20]

This article posted on the BMJ’s website, Clinical Evidence, revealed their shocking study that 2,000 of 3,000 medical treatments are ineffective, unproven, or too harmful to use, yet this has never gone viral in the court of public opinion.

Again, imagine if two-thirds of chiropractic treatments were found to be the same bad medicine, we would hear the ranting of every medical man in the western world to ban chiropractic care and run chiropractors out of town on a rail.

These articles broach huge issues in medicine—unnecessary spine surgeries, the majority of medical treatments are just bad medicine, and the deadly prevalence of medical errors. It’s past time to hold the medical professionals accountable in the public spotlight for them to explain why there are so many spine surgeries, so many opioid painkillers, and why medicine in general is so dangerous but still used in this day of evidence-based healthcare.

As more proof of double standard at play in the medical media, Michael R. McKibbin, a veteran chiropractor in Attadale, Western Australia, for years has written of this medical war against chiropractors and the thousands of iatrogenic medical deaths Down Under:

“I circulated many-many articles to our mainstream media and legislators without anyone blinking an eye. They know that there is a covert iatrogenic epidemic and refuse to forewarn future predictable generations of thousands of victims. How callus is that? And now the bastards weep crocodile tears about the baby who was safely adjusted and successfully relieved of colic.”[21]

Call to Arms

Obviously the progressive chiropractors Down Under must band together to fight this unholy medical-media war. Apparently they cannot count on the national association to be of help, just as the American Chiropractic Association bailed out of joining in the Wilk v. AMA battle. In fact, it was George McAndrews brother, Jerry McAndrews, DC, the executive director of the International Chiropractors Association, who was the driving force to litigate the AMA, a fascinating story I included in my book.

I urge you to join Dr. Phillip Ebrall on his blog to keep abreast of this battle.

Certainly a court case looms to resolve this medical persecution. I would love to see another Wilk case with the interrogation of outspoken medical blowhards as we’ve already witnessed with Drs. Cunningham, Jones, and Pappas. I would love to see the plethora of research validating pediatric chiropractic care. I would love to see the futility of medical attorneys to find anyone hurt by a pediatric chiropractor, and I would love to hear patient testimonials how a colicky baby was helped.

I would also love to see a deposition of these yellow journalists just as Mr. McAndrews skewered columnist Ann Landers who was a covert shill for the AMA.

Keep in mind what Benjamin Franklin said to the Signers of the American Declaration of Independence, "We must hang together, gentlemen...else, we shall most assuredly hang separately."

If that doesn’t motivate you, perhaps another Franklin quote will:

By Failing To Prepare, You Are Preparing To Fail...

 

 

 



[1] Private communication with JC Smith on May 19, 2016.

[2] Doctors speak out against chiropractors treating children,” by Ann Arnold from the program “RN” on the Australian Broadcasting Corporation network, April 22, 2016.

[3] Doctors speak out against chiropractors treating children,” by Ann Arnold from the program “RN” on the Australian Broadcasting Corporation network, April 22, 2016.

[4] Watching a chiropractor work on a baby’s spine is worse than it sounds By Vanessa Brown and Rebecca Sullivan, News.com.au, April 26, 2016

[5] JC Keating, Wilk et al.  v. AMA et al., trial deposition, p. 57.

[6] JC Wilson,  “Low Back Pain and Sciatica: A Plea for Better Care of the Patient, Chairman's Address,” JAMA, 200/8, (May 22, 1967):705-712.

[7] G McAndrews closing argument, 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;. p 7076-88.

[8] Ibid. p. 7.

[9]  Opinion p. 10

[10] Associated Press, “U.S. Judge Finds Medical Group Conspired Against Chiropractors,” New York Times (1987)

[11] S Getzendanner, US District Judge, Permanent Injunction Order Against the AMA (Sept. 25, 1987), published in JAMA, 259/1 (January 1, 1988):81

[12] Bryan Miller, Chiropractors vs. AMA, Chicago Reader ,June 27, 1991

[14] Charlotte Mitchell, Spinal fusion surgeries questioned, MJA InSight, 26 April, 2016

[15] Charlotte Mitchell, Spinal fusion surgeries questioned, MJA InSight, 26 April, 2016

[16] Medical error—the third leading cause of death in the US

BMJ 2016; 353 doi: http://dx.doi.org/10.1136/bmj.i2139 (Published 03 May 2016) Cite this as: BMJ 2016;353:i2139

[19] http://clinicalevidence.bmj.com/x/set/static/cms/efficacy-categorisations.html

[20] Sarah Kliff, Surprise! We don’t know if half our medical treatments work!, Washington Post, Jan. 24, 2013

[21] Private communication with JC Smith, May 24, 2016.


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