National Press Club

Alternative Facts

“If you don’t read the newspaper, you’re uninformed.

If you read the newspaper, you’re misinformed.”

Mark Twain, author, humorist

The F4CP has chosen to launch its National Campaign, “Save Lives. Stop Opioid Abuse. Choose Chiropractic,” on Tuesday, March 14, 2017, 3:00 – 4:15 PM at the National Press Club.  This is a fantastic opportunity for chiropractic profession to showcase our role in this opioid pandemic to the national press corps.

If you are unable to attend this press conference, there will be a LIVE webcast of the event. You can register to watch the press briefing at http://www.f4cp.com/pressclub2017/.

KEY PRESENTERS:    

• Marc Siegel, MD, Professor of Medicine, New York University School of Medicine, Medical Director of Doctor Radio at NYC and SiriusXM, FOX News Medical Correspondent, Columnist for Los Angeles Times, New York Post, Slate, FoxNews.com, National Review Online, Forbes Online, and Member of the Board of Contributors, USA Today
• Myra Christopher, Director, Pain Action Alliance to Implement a National Strategy (PAINS)
• Wayne Jonas, MD, President and CEO, Samueli Institute 
• Larry Boress, President and CEO, Midwest Business Group on Health and Executive Director, National Association of Worksite Health Centers 
• David Thomas, PhD, Deputy Director, Division of Clinical Neuroscience and Behavioral Research, National Institute on Drug Abuse, NIH Pain Consortium 
• Linda Porter, PhD., Director, NIH’s Office of Pain Policy and Co-Chair of the Interagency Pain Research Coordinating Committee (IPRCC) Working Group
• Jan Chambers, President, National Fibromyalgia and Chronic Pain Association (NFMCPA) 
• Kent Greenawalt, CEO, Foot Levelers, Inc. 
• Doug Obetz, DC, Representative, Standard Process 
• William Meeker, DC, MPH, President, Palmer College of Chiropractic – San Jose Campus and F4CP Advocate 
• Gerard Clum, DC, President Emeritus, Life Chiropractic College West and F4CP Advocate 
• Laura Carabello, Principal, CPR Strategic Marketing Communications and F4CP Advocate
• Richard Brown, Secretary-General, World Federation of Chiropractic (WFC)

Poster Session

• James Whedon, DC, MS, Director of Health Services Research, Southern California University of Health Sciences and Instructor, The Dartmouth Institute for Health Policy and Clinical Practice

I applaud the upcoming press conference arranged by the F4CP in Washington, DC, and hopefully it will inform the press corps the role chiropractors can play to help this opioid epidemic since they are almost certainly unaware of the historical facts in this medical war that has marginalized chiropractors from fully helping in this fight against drugs.

Say No to Drugs

This opportunity may be analogous when former First Lady Nancy Reagan taught schoolchildren to “Just Say No” to drugs in 1982; little would she know the real danger in 2017 would not be street drugs, but pharmaceutical drugs. Indeed, while drug lord El Chapo may now be incarcerated, there are thousands of Dr. Chapos in our country freely dispensing dangerous drugs like Halloween candy.

Mrs. Reagan once said, “Understanding what drugs can do to your children, understanding peer pressure, and understanding why they turn to drugs is…the first step in solving the problem. If you can save just one child, it’s worth it.”[1],[2]

It’s also worthwhile if we can help chronic pain patients before they become addicted to prescription painkillers laced with medicinal heroin that have become the new scourge of many Americans, affecting people of all ages and social strata.

The danger of opioid painkillers was aptly stated by Donald Teater, MD, National Safety Council: “Opioids do not kill pain. They kill people.”

According to the CDC, today there are 13 million users, 2 million abusers, and 165,000 Americans have died since 1999 from opioid overdose.[3]

Now there is a new wave of addicts on the horizon considering one in five high school students abuse painkillers with 2,500 teenagers starting every day._[4] Indeed, the “walking drugged zombies” are here to stay.

More shocking facts: according to the American Public Health Association, every 19 minutes, someone in the United States dies from an unintentional prescription drug overdose.[5] Today one in 12 Americans can say they know someone who died from a prescription drug overdose. No other disease can make that claim.[6]

As President Trump might say, “The prescription drug epidemic is HUGE. So Sad!”

Chiropractic Alternative Facts

Certainly with the recent hullabaloo about “fake news” and “alternative facts,” I would not be surprised if the audience at the upcoming National Press Conference were to have serious trepidation about anything chiropractors might say after decades of derogatory “fake news” stemming from the AMA. 

Without a doubt, this NPC session is not starting with a clean slate.

If history is any indication, the NPC audience most likely have an embedded prejudice—chirophobia—against the chiropractic profession. I would not be surprise if many of chiropractic’s underlying concepts also appear as specious “alternative facts” to the press members compared to the status quo medical beliefs.

• Instead of spinal problems stemming from “bad discs,” we speak of issues like “vertebral subluxation” or “joint dysfunction” (depending upon your orientation, of course).
• Instead of drugs, shots, and surgery, we speak of spinal adjustments and “hands-on” manual therapy as the best treatments for chronic back pain and other MSDs.
• Instead of “bad genes” and “bad germs,” we speak of “bad nerves” and “tone” as the cornerstones of health.
• Instead of dispensing “wonder drugs” to heal the body, many  DCs speak of the “wonders of the body to heal itself.”

Undoubtedly the most problematic “alternative fact” some chiropractors advocate is the anti-vaccine stance of natural immunity vs. artificial immunity, a valid concept to argue but very misunderstood and often ridiculed in the media. Perhaps President Trump’s appointment of RFK, Jr., as Vaccine Czar will shed new light on this controversial issue, especially the use of “cocktail” vaccinations.

As you can see, there is a huge difference in diagnosis, treatments and health concepts between both professions and, to be sure, the public and press members do not understand our “alternative facts” because we’ve never had a forum to discuss our nondrug and nonsurgical methods. Unfortunately, a 90 minute session at the NPC will only scratch the surface of these important issues.

Medical Endorsements

Nor has the press or public heard of the recent endorsements of chiropractic care by medical researchers. It might prove beneficial to provide the press club members with research studies, expert opinions, and guidelines for best practices that recommend our brand of “hands-on” nondrug care as the initial course of treatments.

The first major federal guideline was issued in 1994 by the U.S. Public Health Service’s Agency for Health Care Policy and Research (AHCPR) report entitled “Acute Low Back Pain in Adults” deemed spinal manipulative therapy (SMT) as a “proven treatment.” Its findings also confirmed the rare need for surgery (1 in 100 cases) except in the most severe “red flag” cases (fractures, cancer, serious infections or cauda equina).[7]

Although there are now many international guidelines recommending SMT as the first-line treatment of low back pain, undoubtedly the most surprising endorsement came from the North American Spine Society (NASS) in 2012.

This society of spine surgeons developed its Evidence-Based Clinical Guidelines for Multidisciplinary Spine Care Diagnosis and Treatment of Lumbar Disc Herniation with Radiculopathy[8] that admits spinal manipulation was found to be comparable to successful surgery:

The authors concluded that of patients with sciatica that fail three months of medical management, 60% will benefit from spinal manipulation to the same degree as if they undergo surgical intervention. For the 40% that are unsatisfied, surgery provides an excellent outcome.  Although this study is a randomized controlled trial, it provides case series (Level IV) therapeutic evidence that spinal manipulation is beneficial in treating patients with lumbar disc herniation with radiculopathy.

When the NASS guideline touts SMT as effective as surgery, obviously there is a new day in spine care, but such recommendations have not yet decreased the tsunami of drugs or the expensive and ineffective spine surgeries that are not medically necessary because the media has not told the public.

This situation was well expressed by David Elton, DC, and Thomas M. Kosloff, DC, co-authors of “Conservative Care: Ensuring the Right Provider for the Right Treatment”: [9]

“Research and guidelines are consistent and clear. We don’t need another guideline, we do need to help patients receive treatment from providers aligned with research/guidelines.”

Hopefully an informed and newly energized press corps keen on accusations of “fake news” may recognize this paradigm shift and potential cost savings to the national healthcare system in order to facilitate this transformation as the guidelines recommend.

Paradigm Shift

If the media were to understand the medical war against chiropractors and the paradigm shift in spine care guidelines, it would reduce the collateral damage of the hundreds of thousands of medical unnecessary spine fusions, opioid painkillers, and epidural injections.

It would also create the “ah-ha” moment when the media finally sees the light of this medical muck. If that were to happen, imagine these headline articles and news releases appearing in the news:

• Chiropractors say, “We’ve Got Your Back.”
• “Chiropractors Cry Foul.”
• The Chiropractor as Hero
• The Chiropractor Is Naked!
• Chiropractors Blame AMA for Healthcare Crisis
• Chiropractors Requests Apology from AMA
• Chiropractic’s Golden Opportunity
• “Docs Not Honest”: So what else is new and startling?
• Making A Financial Case for Chiropractic
• Chiropractic Angst: “Get Off Our Backs”
• Chiropractors say for back pain, “You Don’t Slip Discs, But You Do Slip Joints
• Chiropractors say for back pain, “Say No to Disc Surgery”
• Chiropractors are now: “Your Back Specialists”
• Chiropractors warn: “Back Pain is Epidemic”
• Chiropractors prove: “Chiropractic Care Effective”
• Chiropractors warn: “Medical Spine Gone Wild”

Tabula Rasa

However, before any positive, in-depth articles appear in the media, somehow we need to clear the air about the inherent medical bias against chiropractors and explain the history of chirophobia. Without a clean slate to address this bias, our “alternative facts” and “alternative treatments” most likely will fall on deaf ears.

It would be an understatement to say many members of the media have not been kind to the chiropractic profession. How could they be “fair and balanced” after hearing decades of medical muck about chiropractors from political medicine’s merchants of misinformation?

In fact, a case can easily be made the media has taken the AMA’s position against chiropractors, beginning in the 1930s with Morris Fishbein, aka, the Medical Mussolini, continuing into the 1960s with syndicated columnist Ann Landers with her classic snide remark, “The truth is, he’d probably have been cured if he had fanned himself with goofus feathers.”[10]

Today we still hear medical curmudgeons taking cheap shots online at our profession with fake news writers such as Steven Salzberg at Forbes or television personality Dr. Sanjay Gupta at CNN.

Today we see examples of “citation laundering”[11] whereby writers misquote the facts, embellish each other’s stories, and pass them on as “perceived wisdom” by supposed experts who quote each other or parrot incendiary comments from other non-experts because they are controversial sound bytes that “bleed.”

Even a former chiropractic advocate, Dr. Oz, took a cheap shot at chiropractors with a “gotcha” headline that bled, “Can Your Chiropractor Kill You?” on a segment about the accidental death of Katie May.

Indeed, the chiropractic profession continues to fight with reporters and publishers who continue to misinform readers with medical muck or keep readers uninformed by ignoring the good news about chiropractic care.

Mute Media

Everyone in the chiropractic profession was astonished when the Katie May accident and the Baby Blunder Down Under both went viral around the world within days to impugn our collective reputation. Without any substantial damage control or pushback by chiropractic organizations, the medical muckrakers continue to pour salt into this wound.

Yet when patients die from medical errors, little is said in the mainstream media even after the prestigious British Medical Journal in 2016 published an editorial, Medical error—the third leading cause of death in the US.  The authors admit to a conservative estimate in the range of 251,000 victims per year, which equates to nearly 700 deaths per day due to medical mistakes by physicians or hospital staff members. [12]

Despite this shocking revelation, did you see it printed or spoken in the  mainstream media?

Nor did we hear the media clamor when the British Medical Journal in 2013 published a similar article about the thousands of ineffective medical treatments. Of the major newspapers, this article was mentioned only in The Washington Post, “Surprise! We don’t know if half our medical treatments work”.[13]

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.

On the other hand, if two-thirds of chiropractic treatments were found to be “bad medicine”, we would hear the ranting of every medical curmudgeon in the western world to ban chiropractic care and run chiropractors out of town on a rail.

Mayo Miffed

Another important study ignored by the mainstream media occurred in November, 2014, when the Mayo Clinic released its review, “Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations.”[14]

Usually when the Mayo Clinic issues a study, the press promptly reports the findings, but this extremely important Mayo review also failed to gain any traction in the media.

This Mayo review formed a consensus among 33 MRI studies from around the world that undermines the rationale for fusion surgery based on “bad discs” that we found in pain-free people.

This misconception is still used to lure unsuspecting patients into disc fusion surgery—“Look right here, I can show you the ‘bad disc.’ If you don’t have my surgery you’ll be paralyzed and if you go to a chiropractor, he’ll paralyze you.”

If only I had a nickel for every time I’ve heard that con-job I could retire a wealthy man!

This Mayo Clinic chart is clear that “bad discs” are part of the normal aging process, highly prevalent in people of all ages, often unassociated but coincidental with pain, and did not alone constitute the need for intervention—either surgery or epidurals:

“Our study suggests that imaging findings of degenerative changes such as disc degeneration, disc signal loss, disc height loss, disc protrusion, and facet arthropathy are generally part of the normal aging process rather than pathologic processes requiring intervention.”

These articles broach huge issues in medicine—unnecessary spine surgeries, the majority of medical treatments are just “bad medicine”, and the high and deadly prevalence of medical errors.

Yet the mainstream media has failed to inform the public of these huge studies that could change how the public perceives the medical profession.

Aside from informing the media how chiropractors can reduce opioid use, dependency, addictions, and death, is it possible to challenge the status quo attitude held by the media considering their inherent bias and dependency upon Big Pharma sponsors who want no mention of any nondrug solution to chronic pain?

People and the press still do not fully understand the value we bring to an ailing society rife with pain and stoned on painkillers, nor do they understand the massive and on-going defamation campaign to impugn the reputations of chiropractors.

Whether misinformed or uninformed, it is imperative to clear the air before anyone in the NPC audience can understand our profession with an informed attitude rather than the typical medical bias.

This would be equivalent Fredrick Douglas discussing slavery and racism at the NPC at a time before the Civil War when “negroes” were still considered worth 3/5^ths of a white man.

For too long, chiropractors have also been viewed as less than an MD in the eyes of many after the decades-long defamation campaign. Lead attorney for the chiropractor-plaintiffs at Wilk v. AMA, Mr. George McAndrews, submitted testimony from medical witnesses suggesting chiropractors were “dangerous”, “poorly trained”, “rabid dogs”, “killers” and “utterly ridiculous.”

Undoubtedly these sentiments still ring loudly among members in the media, just as racism is still very much a part of our national narrative.

So, how do we cleanse these comments from the minds of the media? This image problem may be one of the biggest issues to address at this press conference before our alternative facts are presented.