March 20, 2012
Fareed Zakaria
One CNN Center
Atlanta, GA 30303
RE: Chiropractic Care in Healthcare Reform
Dear Fareed:
Your recent TIME article and CNN program about healthcare in America encouraged me to communicate with you how my profession can help reduce costs and improve patient outcomes.
At a time when costs are soaring out of control in medicine, the public isn’t being allowed access to information about low-cost alternative approaches. As a 33-year practicing chiropractor, first let me explain how the medical boycott of chiropractic has prevented the full utilization of our effective, safe, inexpensive, and scientifically-supported healing art to reduce costs and improve outcomes.
Citation Laundering & Acceptable Prejudice
Despite the fact that chiropractic is the third-largest physician-level health profession in the world, it receives next to no airtime to teach viewers the benefits of our brand of spinal care. Just as there are glass ceilings in corporations for women and people of color, there remains a boycott of chiropractors in the healthcare delivery system as well as an inherent bias in the media.
Recently a serendipitous event occurred on NPR that may explain this entrenched media bias against chiropractic. In a March 18, 2012, interview broadcast on “On the Media,” guest Patrick Ball inadvertently alluded to the problem we chiropractors face in the media, a phenomenon he called “citation laundering” of erroneous facts that are passed on as “perceived wisdom” by other newscasters.
(http://www.onthemedia.org/2012/mar/16/calculating-body-counts)
A case of the medical media bias against chiropractors is well-established, yet unknown to the public. Since the 1960s, the AMA’s Committee on Quackery promoted the belief that “everybody knows chiropractic is an unscientific cult.” However, during a federal antitrust trial (Wilk v. AMA), when their feet were held to the fire in the witness box, the medical leaders could not prove this allegation; they were simply repeating lies from their own propaganda.
Although this medical “citation laundering” is untrue, it remains unchallenged as the prevailing “perceived wisdom” that continues despite the newfound research supporting chiropractic care. This inaccurate reporting of chiropractic also undermines our rightful role as the cultural authority as primary spine care practitioners, thereby forcing unsuspecting patients into more costly, less effective, often addictive, and disabling medical treatments.
This obvious medical bias has become an “acceptable prejudice” as coined on Jon Stewart’s The Daily Show. This bias is no different than other inaccurate stereotypes in the media that women and people of color have long faced, too.
However, although racism and sexism have been rejected as “perceived wisdom,” to date no one in the media has challenged the medical prejudice against chiropractors and other CAM providers.
The Untold Story of Chiropractic
Not only is chiropractic terribly misrepresented in the medically-controlled media, it remains a fascinating human interest story that has been ignored by the lay media. Few people realize that chiropractors were among the first civil right activists in our nation who also paid a brutal price for their demand for equality in healthcare.
Chiropractors suffered injustices similar to other minorities— segregated by an AMA edict; boycotted by hospitals, discriminated against by civic clubs, state universities, insurance companies; unjustly thrown into jail, and stigmatized in the media even by such notables as Ann Landers.
Indeed, chiropractors weren’t only forced to sit in the back of the medical bus, they were often thrown under the bus. Few people understand that in the first half of the 20th century, over 12,000 chiropractors were arrested over 15,000 times for simply bringing a new health profession to the public.
My new book, The Medical War Against Chiropractors, brings to light the sordid history of this medical persecution of chiropractors, a story the AMA would prefer left in the dark of its closet.
I also reveal the new research that vindicates chiropractic care as more effective than anything the medical world offers for the majority of back pain cases (but certainly not all cases such as cancer, fracture, serious infections or true disc ruptures). This is a huge and costly $100 billion problem that 90% of Americans will face.
Professional Amnesia
However, just as blacks still feel the bias of racism, chiropractors still face barriers by MDs who control the media’s health programs, including CNN’s Dr. Sanjay Gupta who has both misrepresented my profession as well as ignored the many newsworthy articles critical of unnecessary spine fusions as mentioned by The Wall Street Journal, The New York Times, Bloomberg News, NPR and MSNBC.
As both a neurosurgeon and CNN’s medical director, Dr. Gupta has an obvious conflict of interest to protect his neurosurgery colleagues by ignoring this critical newsworthy issue. Indeed, can Dr. Gupta explain why CNN has not had one article on the epidemic of unnecessary spine surgery?
Anthony Rosner, PhD, diagnosed such journalists as suffering from “professional amnesia” when they inexcusably forget to inform patients that chiropractic care is a recommended option to the often-ineffective medical methods.
Indeed, the proof is mounting despite Dr. Gupta’s forgetfulness. On June 6, 2006, the CBS Evening News aired a segment, “Attacking Rising Health Costs,” stating 30-40% of surgeries are unnecessary, mainly spinal fusions, angioplasty, hip replacement, and knee replacement. The problem, according to Dr. Elliott Fisher of The Dartmouth Institute of Health Policy, is that patients are not given good information to make an “informed consent” decision as to alternatives and the inherent risks of each medical procedure.
As well, other medical groups now recommend chiropractic care, such as the 2007 American College of Physicians/American Back Pain Society Guidelines on the Diagnosis and Treatment of Back Pain that endorsed acupuncture, manipulation, and other CAM treatments for low back pain. (Chou et al., Annals of Internal Med., 2007, vol. 147 no. 7)
Even the North American Spine Society states online that “[f]usion under these conditions is usually viewed as a last resort and should be considered only after other conservative (nonsurgical) measures have failed,” a fact Dr. Gupta has failed to tell his viewers. (http://www.knowyourback.org/Pages/Treatments/SurgicalOptions/SpinalFusion.aspx)
Apparently the last thing Dr. Gupta wants is to admit that spine fusions are unnecessary and ineffective in many cases as the leading research data now show. Nor does he want to admit that chiropractic care, his arch rivals in spine care, has been proven effective by researchers.
Whether or not Dr. Gupta wants to inform his viewers, there is a huge paradigm shift occurring in spine care. For example, 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 an enormous 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.
www.bcbsnc.com/assets/services/public/pdfs/medicalpolicy/lumbar_spine_fusion_surgery.pdf
Equal Time
Also apparent is that CNN does not follow the Fairness Doctrine to allow the opposing party to have airtime to refute misinformation. My previous two pleas have fallen on deaf ears to CNN executive Richard Davis, EVP of News Standards and Practices, and to Dr. Sanjay Gupta to allow me to respond to his allegations and omissions. I’ve attached for your review my second notice of my complaint, which is self-explanatory.
There are many untold yet newsworthy issues about chiropractic that would greatly lower healthcare costs as well as give people a freedom of choice to non-drug and non-surgical treatments. The public needs to learn for the epidemic of back pain that the medical methods of addictive opioid drugs that cause 15,000 deaths annually, expensive epidural steroid injections have been shown no more effective than placebo, and costly spine surgeries based on an outdated disc theory are now deemed as inappropriate in most cases by modern guidelines.
The public also needs to hear, perhaps for the first time, that chiropractors survived the medical war to “contain and eliminate” their profession and that researchers now endorse conservative hands-on care as the first avenue of treatment for the epidemic of back pain.
On my website, www.medicalwaraginstchiropractors.com, is a 10-minute radio interview that will give you a short overview of this issue as well as give you insight into the continuing medical war against chiropractors.
I know you are a busy man, but I do hope to hear back from you on this matter.
Regards,
JC Smith, MA, DC