The Dark Ages of Medicine
By
JCS
Why has it taken over 110 years for this evidence to come forth? Except for chiropractic patients and spine researchers who understand the value of chiropractic care, many in the public haven’t learned this lesson due to a very extensive propaganda campaign conducted by the American Medical Association that was revealed with its conviction in federal antitrust court in Chicago in 1987.
This is a dark chapter in medical history that few people are aware of, but one that has shaped your attitude about my profession more than you can ever imagine. Indeed, many of the younger MDs are unaware of this deplorable action by the AMA although it is the source of the anti-chiropractic sentiments taught in medical schools.
Unfortunately, talking about chiropractic to some folks is as controversial as talking about race, religion or politics—people have strong bias one way or the other. Sometimes when I mention that I’m a chiropractor, some folks reply, “I don’t believe in chiropractic.”
Some MDs still ridicule patients who seek referrals to chiropractors, scaring them with unsubstantiated fears and outright lies. You know this is true since you and I have heard it many times.
As you can imagine, the chiropractic profession is certainly not for the faint of heart, especially when people flash back to old prejudices and unrealistic images they’ve heard from the past misinformation. Indeed, a chiropractor needs a strong back and a thick skin as well as a healing touch. And chiropractic patients also need a strong backbone to withstand the ugly opinions they often hear from their MDs and friends who criticize chiropractic care although most of them know nothing about our treatment—they simply parrot the medical bigotry learned from their own MD.
So where does this skepticism come from? It didn’t come from our patients who have always given chiropractors high satisfaction rates, nor did it come from the public health service or government agencies that regulate chiropractors.
Nor has it come from researchers who have stated that spinal manipulation is a “proven treatment” for back pain. “This treatment (using the hands to apply force to the back to ‘adjust’ the spine) can be helpful for some people in the first month of low back symptoms. It should only be done by a professional with experience in manipulation.”[1]
This skepticism is not by chance, but it is the result of a campaign going back to the 1960’s by the AMA to misinform the public as well as to hurt the chiropractic profession, a campaign whose intent was to “contain and eliminate” chiropractic. It was an array of illegal dirty tricks that were never revealed to the public by the media since many were also co-conspirators in this criminal boycott.
The ugly details of this boycott were revealed in evidence during an antitrust trial in federal court in Chicago that began in 1976, and ended with the AMA being found guilty of conspiring against chiropractic.
My goal is to discuss this antitrust trial and the impact it has had upon my profession, and it will explain why Americans face an epidemic of back pain today that has only gotten worse over the years.
So let me give you a quick history lesson that may help provide some facts and perhaps change your mind about my profession.
First of all, hands-on spinal care is not new: the history of spinal biomechanics has its origins in antiquity. Egyptian documents written in the 17th century BC described spinal care. By the time of Hippocrates in the 4th century BC, physical means such as traction was being used to correct spinal deformities. The Renaissance produced Leonardo da Vinci who accurately described the anatomy of the spine. The first comprehensive treatise on biomechanics was published by Giovanni Borelli back in 1680, who is considered the “Father of Spinal Biomechanics.”
In many European countries “bonesetters” have treated strains and sprains of the spinal column since time immemorial as a trade passed down from father to son for many generations.[2] Even Queen Victoria who suffered with migraines allegedly was treated by a spinal manipulator.
The origin of chiropractic began is a similar fashion in America when DD Palmer re-discovered the art of spinal manipulation in 1895 and his teachings were carried on by his son, BJ Palmer.
Today, there are over 80,000 licensed chiropractors in 88 countries around the world serving millions of people daily. This age-old art has finally come of age with 35 accredited colleges around the world teaching the science, art, history, and philosophy of this natural form of health care; right here in Georgia we have one of the largest chiropractic colleges in the world.
As you can see, the art of spinal manipulation has been around forever as a valued healing art. It is not a new treatment; in fact, it’s older than most medical treatments, nor is it dangerous or unscientific as the AMA portrays it to the public. Despite the AMA’s opposition, spinal manipulation has emerged as one of the safest and most effective treatment methods for back pain.
Nevertheless, the AMA turned its political and propaganda guns against this art and chiropractors in particular for no good reason other than to create a medical monopoly through illegal dirty tricks that made the Watergate burglars look like a bunch of amateurs.
The history books will never mention that chiropractors were jailed over 15,000 times in the first half of the 20th century for allegedly “practicing medicine without a license” although chiropractors never used drugs and surgery as everyone knows. Ironically, their real crime was getting people well without drugs or surgery.
Chiropractors were finally protected legally from vindictive medical societies after passage of state laws to create a separate scope of practice for chiropractic, which occurred here in Georgia in 1924 and the last state being Louisiana in 1974, but not before the damage was done with its scorched earth policy to destroy the reputations of those pesky chiropractors who wouldn’t go away.
The following chapter of medical history is a black eye that has never been adequately told to the public by the news media and I doubt historians will teach this to medical students at Mercer Medical School. This case was not just an antitrust case where one competitor tried to corner the market; it was a blitzkrieg of cultural, economic, and political might by the AMA to destroy the chiropractic profession completely.
This 11-year federal trial not only found the AMA guilty, but most shocking were the tactics, language, and attitude of the AMA as noted in the trial’s evidence, which appeared eerily reminiscent of German Nazis in World War II—in this case, the trial focused on the AMA’s Final Solution to “the chiropractic problem.”
For example, listen to the very words of the AMA’s Committee that was established by its Board of Trustees for the sole purpose “to study the chiropractic problem” and whose prime mission was to
“first, the containment of Chiropractic and, ultimately, the elimination of Chiropractic.”
Simply substitute the word “Jewish” for “chiropractic” and you can understand the mindset of these medical men led by Morris Fishbein, MD, who was the executive secretary of the American Medical Association and editor of the Journal of the AMA for 25 years.
Fishbein called chiropractors “rabid dogs” and “killers,” but had no proof that chiropractors were dangerous. He portrayed chiropractors as members of an “unscientific cult, caring about nothing but taking their patients’ money,” when, in fact, emerging research of case studies proved that chiropractic care was scientific, effective, and chiropractors were the cheapest of all spinal doctors. Nothing Fishbein said was true, but the media and public had no idea he was lying. After all, he was the voice of the AMA for 25 years.
As the leader of the AMA, his propaganda was so embedded into the mainstream press that he was honored in 1937 on the cover of Time magazine as the AMA’s guardian of health when, in retrospect, he was simply a bigoted yellow journalist and medical demagogue out to destroy all competitors. He was also referred to as the “Medical Mussolini” who openly attacked all alternative health care. Lest we forget that Time magazine also honored Adolph Hitler as Man of the Year in 1938 and in 1939 Joseph Stalin received this award too. Apparently fascism was popular back then, including here in America.
Once state laws were passed to protect chiropractors from the frivolous lawsuits, the court records revealed that the AMA broadened its war against chiropractic in other ways, such as:
- distributing propaganda to the nation’s teachers and guidance counselors to discourage students from seeking a career in chiropractic,
- eliminating the inclusion of chiropractic from the U.S Department of Labor’s Health Careers Guidebook,
- establishing specific educational guidelines for medical schools regarding the “hazards to individuals from the unscientific cult of chiropractic.”
- punishing community colleges that offered pre-chiropractic programs,
- revoking the license of any MD who referred to or accepted referrals from chiropractors,
- encouraging hospital staffs to bar chiropractors, and
- discouraging radiologists from accepting requests from chiropractors to x-ray their patients.
Indeed, the AMA did everything it could to blackball chiropractors by throwing them in jail, destroying their public image with lies, boycotting their presence in hospitals, colleges, and in the mainstream healthcare delivery system, and using the media to disseminate its propaganda. It was the AMA’s Final Solution to the Chiropractic Holocaust.
This neo-Nazi attitude became evident during deposition in the Wilk antitrust case conducted in 1978-9 by the chiropractors-plaintiffs’ attorney George McAndrews of Dr. John C. Wilson, former Director of the American Academy of Orthopedic Surgery, who testified as follows:
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.
By his own admission, Dr. Wilson basically admits his ignorance of the concept of manual manipulation of the spine, yet he has the gall to condemn it as unworthy of his investigation. Sadly, his narrow mind still exists today despite the increasing evidence that conservative care for spinal problems is as effective if not more effective than anything the medical world has to offer.
An example of the AMA’s propaganda campaign against chiropractors included syndicated newspaper columnist Ann Landers, who ridiculed chiropractors in exchange for favors from the AMA, including a paid vacation to China.
In a court deposition, Landers admitted she had been paid by the AMA to write articles condemning chiropractic as an “unscientific cult.” When confronted by intelligent rebuttals to her columns from satisfied patients and chiropractors who refuted her misinformation, she recruited the help of the AMA to write responses under her byline.
No stone was left unturned by the AMA’s goon squad to hurt the chiropractic profession. The AMA made this fight personal when chiropractors were barred from joining their local Rotary Club, for example, because MDs would be forced to quit for fear of associating with chiropractors, consequently chiropractors were rarely asked to join civic or golf clubs. Don’t think racism was the only reason for exclusion from white country clubs; chiropractors were blackballed as well as Jews and women.
This discrimination was obvious and had to come to an end, so in October 1976, led by Chicago attorney George McAndrews, plaintiffs Chester Wilk, James Bryden, Patricia Arthur, and Michael Pedigo, all licensed chiropractors, filed an antitrust suit against the AMA in the Northern District Court of Illinois, now known as the Wilk Trial. This was the showdown that beleaguered chiropractors had long awaited with the medical supremacists.
In order to defend its anti-competitive policy, the AMA’s defense focused on the issue of “patient safety,” to which Judge Susan Getzendanner later opined that many of the medical witnesses actually testified in behalf of the chiropractors-plaintiffs:
“Dr. Per Freitag, a medical physician who associates with chiropractors, has observed that patients in one hospital who receive chiropractic treatment are released sooner than patients in another hospital which does not allow chiropractors…
Dr. John Mennell, an orthopedist and medical professor, enlightened the court of the value of spinal manipulation in his testimony at the Wilk trial:
“In the spine there are about 137 synovial joints…If you don’t manipulate to relieve the symptoms from this condition of joint dysfunction, then you are depriving the patient of the one thing that is likely to relieve them of their suffering.”
Dr. Mennell also testified that the average classroom hours spent on the musculoskeletal system by the average physician is “zero to 4 hours.” In comparison, the average chiropractic education is over 2,000 hours in the study of the musculoskeletal system.
Judge Getzendanner also mentioned:
“Even the defendants’ economic witness, Mr. Lynk, assumed that chiropractors outperformed medical physicians in the treatment of certain conditions.”
After 11 years of legal wrangling on September 25, 1987, Judge Getzendanner issued her opinion that the AMA had violated Section 1 of the Sherman Act.[3] Also convicted with the AMA were the American College of Surgeons and the American College of Radiologists.[4]
(Wilk v. American Medical Ass’n, 671 F. Supp. 1465, N.D. Ill. 1987).
Judge Getzendanner ruled that the AMA and its officials were guilty, as charged, of attempting to eliminate the chiropractic profession with a “lengthy, systematic, successful and unlawful boycott” designed to restrict cooperation between MDs and chiropractors in order to eliminate the profession of chiropractic as a competitor in the United States health care system.[5]
Judge Getzendanner also noted that:
“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.”
So true: the AMA and its members never made any attempt to repair the damage to the reputations of chiropractors. This is the lingering bias from this illegal campaign by the AMA that has never been openly repudiated. Indeed, this attitude still thrives among many MDs who fan the flames of bigotry among patients in order to continue to marginalize the back pain market.
Although the court pronounced the AMA guilty, no one went to jail and no apology was made to the public. The AMA simply wrote an explanation to its own members in its own publication to state it was now ethical to associate with chiropractors, made a nominal donation to a chiropractic children’s hospital, and paid court costs, but no real public apology ever occurred, no effort to reconstruct the damaged chiropractic image, nor a simple mea culpa to apologize for its past transgressions. The AMA simply swept this under the rug and the AMA’s campaign went underground for the past 40 years to contain chiropractic via insurance limitations.
It’s as if the Civil War ended but the South continued with its racist, slave society without any Reconstruction or World War II ended with the Nazis still in control.
The AMA obviously wasn’t sorry for the damage it did and it wasn’t sorry for being found guilty as charged since two objectives were accomplished—to ruin the reputations of chiropractors and to contain them to the margins of the healthcare system. The AMA didn’t eliminate chiropractors, but they certainly have worked to limit patients’ access to chiropractors.
American Bad Backs
Aside from the damage done to chiropractors’ reputations, what else can we attribute to the AMA’s campaign to eliminate chiropractors and their healing art?
Foremost, this “lengthy, systematic, successful and unlawful boycott” as the judge proclaimed, has led to the present epidemic of low back pain in America.
It seems paradoxical that Americans are so prone to back problems, doesn’t it? Could this be due to genetically inferior spines? Or could it be patients are not being told the truth about their back problems and the best treatments available?
I think we all know the answer by now. By discouraging the use of chiropractic care, the AMA forced people to use less effective medical treatments. This epidemic is in part a result of the medical society’s attempt to corner the market of back pain, but in this case, their methods have proven to be ineffective for the vast majority of cases as the recent researchers have concluded.
Imagine the epidemic of tooth decay and gum disease we’d see today if the AMA had been successful in ruining the reputation and practices of dentists.
Well, this is exactly what’s happened as a result of the AMA’s boycott of chiropractic to corner the market and, according to attorney George McAndrews:
“When patients are forced to take their health problems from a chiropractor to a medical physician who isn’t skilled in that area…that is a funneling of business from the most-skilled to the least-skilled providers.”[6]
Most people don’t realize the size and cost of this low back pain epidemic. The direct and indirect costs of back pain approach $100 to $200 billion annually in America according to RAND.[7]
Another recent study from the Decade of Bone and Joint Disorders reported in The Spine Journal by Scott Haldeman, DC, MD, PhD that the
- prevalence of chronic low back pain daily in the general adult population is estimated at 37%
- the 1-year prevalence is 76%
- the lifetime prevalence is 85%, and
- approximately 20% of sufferers describe their pain as severe or disabling.[8]
When 85% of Americans suffer from a chronic back problem in their lifetime, this is serious. When 37% of people suffer daily from back pain, this is an epidemic. When 76% of people will have a back attack during the year, this is a huge societal problem. When 20% are disabled, this is a huge work-loss issue.
I firmly believe this suffering and expense can be blamed on the AMA’s propaganda campaign to deny Americans the best form of spinal care done by chiropractors, especially considering when Timothy S. Carey, MD, admitted “Since the costs of back pain are rising, along with the number of cases, current treatments overall do not seem to be very effective.”
According to Dr. Scott Boden, Director of the Emory Spine Center,
“The best thing is to have an organized, integrated approach that uses state-of-the-art and cost-effective care.” [9]
Most guidelines for back pain such as the US Public Health Service suggest this integrated approach begins with non-invasive methods like spinal manipulation before drugs, shots and surgery.[10]
Instead, for the most part, patients are typically treated by their general practitioner with pain pills and muscle relaxants, then when that fails, patients are automatically referred to the surgeon’s office bypassing the chiropractor’s office, driving up the costs by ignoring the safer, cheaper, and more clinically-effective spinal care—spinal manipulative therapy.
Slowly the truth about the effectiveness of spinal manipulation is emerging again. One study published in the October 2004 issue of Archives of Internal Medicine[11] compared four years of back pain claims from two groups: 700,000 health plan members with chiropractic care coverage were compared to 1 million members with doctor-only health plans without chiropractic care coverage, and they found that:
- Chiropractic care cut the cost of treating back pain by 28%.
- Chiropractic care reduced hospitalizations among back pain patients by 41%.
- Chiropractic care reduced back surgeries by 32%.
- Chiropractic care reduced the cost of medical imaging, such as X-rays or MRIs, by 37%.
This study shows when patients have direct and unencumbered access to chiropractors, the costs are dramatically lowered.
Unfortunately, the AMA isn’t interested in reducing costs nor is it interested in transferring these cases to chiropractors. Everyone, including ardent fiscal conservatives, should be enraged over the billions of dollars lost and the pandemic of pain caused by outdated medical policies that discriminate against the best form of spinal care—spinal manipulation.
Dr. Richard A. Deyo, a medical professor now at Oregon Health and Science University, was very frank about the motivation of spine surgeons. “More people are interested in getting on the gravy train than on stopping the gravy train.”[12]
By now you can see this degradation of chiropractors was not self-inflicted nor did it come from any public outrage. It is the total fabrication of the AMA to monopolize health care.
Indeed, chiropractic patients have always been satisfied with their local chiropractors. In fact, a 1991 Gallup recognized that
- Chiropractic care is more patient-friendly than medical care with three times the patient satisfaction rates.
- 90% chiropractic patients felt that their treatment was effective and met or exceeded their expectations.[13]
While the AMA’s propagandists were telling the public that chiropractors were dangerous unscientific quacks, in reality as you can see, nothing could be further from the truth.
For example, the issue of “patient safety” is still used by some local MDs to scare patients although it’s a deliberate attempt to divert an argument from the dangers of drugs, shots and surgery. For years the medical propagandists have told the public that “chiropractors might break your neck or paralyze you,” which is simply untrue and certainly a case of the pot calling the kettle black.
In fact, spinal manipulation is among the safest of all spine treatments compared to drugs, shots and certainly surgery. But when medical professionals scare patients with these lies, how are you to know the truth? This is how thousands of people are lured by false hope and misinformation into unnecessary back surgeries every year, many that are based on the outdated disc theory that experts now denounce as “incidental” as I presented in my first program.
I’ve never forgotten a conversation I had with a patient who was a nurse who assisted spine surgeons in the operating room in Macon. I thought it was interesting that she came to see me for her back pain, so I asked her why I kept hearing from some people that chiropractic care might paralyze them.
Her response stunned me when she said, “Oh, we’re taught to tell that to anyone who asks about going to a chiropractor.” She paused, and then added, “I don’t know why anyone believes me since I’ve never seen anyone hurt by a chiropractor, but I’ve seen lots of patients hurt by surgery.”
Obviously the malpractice insurance companies know who’s hurting who.
- A local neurosurgeon confessed to me his malpractice insurance costs $200,000 each year.
- A local OB-GYN admitted his insurance cost $60,000 annually.
- But my malpractice insurance costs only $1,600 a year.[14]
The facts are clear that chiropractic care is the safest of all spine treatments compared to drugs, shots or spine surgery.
While an occasional adverse effect might happen, it is pale in comparison to the side effects of drugs, shots and back surgery. According to researchers,
- the rate of clinical problems associated with spinal manipulative therapy 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, which is one in 600,000.
- It equated to one occurrence in 48 chiropractic careers.[15]
- The rate of stroke or paralysis resulting from spinal surgery is 15,600 per million.
- Even NSAIDs like Advil, aspirin, and Tylenol have shown to cause serious GI problems in 1,000 to 4,000 people per million, and reportedly 7,600 patients die annually from their use.[16]
It’s quite obvious who’s hurting who, and it’s certainly not the chiropractors!
As you can see, spinal manipulation is extremely safe in skilled hands, but some local MDs would have you think half of our patients leave in ambulances!
Without a doubt, the chiropractic profession still has a few bones to pick with the AMA. I was once described as “a chiropractor with a chip on his shoulder with an ax to grind” and I totally agreed.
Just ask yourself these questions:
- Who wouldn’t be shocked knowing the discrimination and criminal acts perpetrated upon my profession by the AMA?
- Who wouldn’t be troubled knowing the medical bias has perpetuated the “pandemic of pain” as Dr. Goodley mentioned?
- Who wouldn’t be upset to learn that Dr. Tim Carey said the tripling of back pain cases indicate the “current treatments overall do not seem to be very effective”?
- Who wouldn’t be angry to learn the US Public Health Service recommends spinal manipulation as a “proven treatment” while some MDs still tell patients that chiropractic care is quackery and will paralyze them?
Once you learn the truth about the medical vs. chiropractic warfare, if you’re a fair-minded person like most Americans, you too would be mad to learn the best form of back pain treatment was denied to patients for political reasons.
It’s time for you to appreciate the trials and tribulation of chiropractors who fought to save the great art of spinal manipulation. Instead of looking at chiropractors with a jaundiced eye as the AMA would prefer you do, you might give them a long-deserved pat on the back.
Chiropractors today should be heralded as the first healthcare reformists in America, long before it was politically correct. If it weren’t for the tenacity of the much maligned chiropractors, spinal manipulation would be a lost art today and people would have no freedom of choice in non-drug, non-surgical spine care treatments.
Our new president speaks of a new hope and change in America, and I say we need the same in healthcare. The present model of drugs, shots and surgery for the epidemic of back pain just hasn’t worked as the experts testified in my first show. Too many people have suffered too long and it’s time for a change, it’s time for new hope.
Once again, let me quote Anthony Rosner, PhD, when he 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.” [17]
Let me encourage you to take Dr. Rosner’s advice, reject the medical prejudice, understand the source of your skepticism, and discover for yourself the benefits of a healthy, well-adjusted spine.
Don’t stay trapped in old attitudes, old ineffective concepts, and old medical treatments. It’s time to think out of the box of drugs, shots and surgery and discover the new science of the old art of chiropractic spinal care.
Although the American Chiropractic Association has made great strides toward inclusion, chiropractors are still limited in Medicare, marginalized in Workers’ Comp programs, and limited in the VA and Military Health Services. We remain suspect as expert witnesses in PI cases, virtually ignored in the media (have you ever seen a DC as a health expert on CNN, FOX, MSNBC or any network news program?), research money for chiropractic is pennies on the dollar compared to medical grants, while colleges and governmental agencies still boycott chiropractic in their curriculum or as board members. To say that chiropractors have a bone to pick is an understatement.
Most of all, despite the Wilk et al. v. AMA et al. antitrust lawsuit that found the AMA guilty of an unconscionable boycott of chiropractors, the medical bigotry continues in its attempt to corner the back pain market. Indeed, the recent turn of events legally and scientifically that beg spine practitioners to think out of the box, the medical society has the lid tightly sealed with a “don’t confuse us with the facts” attitude.
One such skeleton that led to a public confession by the medical profession was its policy of racism toward black MDs. In July, 2008 the AMA’s House of Delegates finally announced a formal apology for its historical racism toward African American medical doctors.[18] Perhaps with the impending likelihood of our first black president, the AMA began hedging its bet not to still be seen as an elitist and racist organization and offered a contrite apology to its black members, albeit it too little, too late.
This is just one of many skeletons in the medical closet that deserve a confession and apology. I daresay it’s quite obvious while black MDs were forced to sit in the back of the medical bus, chiropractors were thrown under the wheels of the same bus. Indeed, if there are “niggers” in the healthcare professions, chiropractors can claim that epithet and few MDs would argue otherwise.
So, if the AMA is now willing to admit to its racist past, will the AMA also be as forthcoming about its illegal campaign of boycott and bigotry against the chiropractic profession and confess its irrational battle against chiropractors? Or is the medical ideology so embedded that reason and research cannot overcome the bigotry bred into the minds of many MDs?
This is an ethical question the medical society refuses to answer. While the AMA is handing out apologies to its black members, I think the chiropractic profession is due one too, don’t you? (But I’m not holding my breath.)
If you don’t agree, than it can only mean medical bigotry is still very much alive. As I’ve experienced living in middle Georgia for the past 30 years, I’ve learned that redneck racists are very much alive here and proud of it despite racism being politically and socially incorrect today in most of the civilized world.
Unfortunately, Jim Crow, MD, is very much alive despite the multitude of research that supports chiropractic care as a legitimate, effective, and popular treatment for back pain problems. It must stick in the craw of many MDs to admit that chiropractors have prevailed despite the illegal boycott, dirty tricks, media bashing, and the intellectual snobbery that has cast them unfairly as outcasts and quacks.
Nonetheless, rational thinking doesn’t come into play for medical chauvinists. Just as racism doesn’t make sense, the prejudice of many MDs is perhaps more harmful since it affects the well-being of millions of Americans who suffer from this medical nonsense.
Over the past 3 decades I’ve come to a few confessions that I’d like to share with you because all is not well in the back pain treatment business. Despite the plethora of research condemning the management of back pain, despite the many international guidelines that recommend spinal manipulation, aka, chiropractic care, as a “proven treatment,” despite the high costs and low outcomes of drugs, shots, and surgery for this epidemic of back pain, nothing seems to improve despite the call for reform among a few courageous medical researchers and, of course, from those pesky chiropractors.
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[1] Bigos S. 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.
[2] Abhay Sanan, M.D., Setti S. Rengachary, M.D. The History of Spinal Biomechanics, (Neurosurgery, 39:657669, 1996)
Department of Neurosurgery, University of Minnesota Hospital System, Minneapolis, Minnesota.
[3] Wilk v. American Medical Assn, 671 F. Supp. 1465, N.D. Ill. 1987.
[4] When Healing Becomes A Crime by Kenny Ausubel, page 263.
[5] Wilk et al v AMA et al. US District Court Northern District of Illinois, No. 76C3777, Getzendanner J, Judgment dated August 27, 1987
[6] Judge Rules on Trigon’s Motion to Dismiss ACA Lawsuit, Dynamic Chiropractic, August 6, 2001
[7] Shekelle, Paul G., et al, RAND Corporation Report, The Appropriateness of Spinal Manipulation for Low-Back Pain, 1992.
[8] Scott Haldeman DC, MD, PhD, FRCP(C) and Simon Dagenais DC, PhD. A supermarket approach to the evidence-informed management of chronic low back pain. The Spine Journal, vol. 8, Issue 1, January-February 2008, Pages 1-7.
[9] Trubo, R. Fighting Back When Your Back Aches, WebMD.com, July 19, 2004.
[10] Bigos S. 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.
[11] Legorreta, A.P. Archives of Internal Medicine, Oct. 11, 2004; vol 164: pp 1985-1992.
[12] Reed Abelson, Financial Ties Are Cited as Issue in Spine Study, NY Times, January 30, 2008 .
[13] Gallup Organization, Demographic Characteristics of Users of Chiropractic Services. Princeton, NJ: Gallup, 1991.
[14] National Chiropractic Mutual Insurance Company, 2008.
[15] Terret AGJ Current Concepts in Vertebrobasilar Complications following spinal manipulation, NCMIC Group Inc, West Des Moines, Iowa, 2001.
[16] “What about serious complications of cervical manipulation?” The Backletter, 1996; 11:115.
[17] Dr. Anthony Rosner, former Director of Research at FCER, testimony before The Institute of Medicine: Committee on Use of CAM by the American Public, Testimony for Meeting, Feb. 27, 2003.
[18] “AMA apologizes to black doctors for past racism,” by Lindsey Tanner, AP Medical Writer Thu July 10.