Taboo Chiropractic

Unmask and Reframe

Taboo Chiropractic

By

JCS

“Everybody knows chiropractic is an unscientific cult and if you don’t know this too, then something is wrong with you.”

While this bigotry may sound harsh to the 22 million Americans who use chiropractors every year, it was the mantra of the American Medical Association for decades. Indeed, as the last bastion of acceptable bigotry, this medical prejudice lingers on today in most quarters of our healthcare delivery system.

Whereas sexism and racism have diffuse origins, medical bigotry has a clear origin, albeit unknown by most. Like a super bug virus, this bias continues to infect the minds of many people who, in fact, could benefit from the chiropractic brand of spinal care as researchers now admit.

No leaf was left unturned in the medical war to demean chiropractors and to sway public opinion. The AMA did everything it could to blackball chiropractors, from destroying their public image with blatant propaganda, to boycotting their presence in hospitals, and limiting their role in the mainstream healthcare delivery system like workers’ compensation programs, Medicare, the Veterans’ Administration, and military health programs.

Throughout this period in the early 1970s, members of the AMA’s Committee on Quackery made speeches across the country with disparaging comments to build opposition to chiropractic. Dr. Joseph A. Sabatier, chairman of the COQ, hailed from Louisiana, the only state by the early 1970s that had not yet licensed chiropractors. Chiropractors either had to pass the medical examination to practice or else practice illegally as most did. The chiropractic licensing act was not passed until 1974 that protected chiropractors.

Sabatier told a gathering of the Michigan State Medical Society officials that “rabid dogs and chiropractors fit into about the same category…they killed people.”[1] He also said that “it is very important to point out to members of the medical profession that it is considered something less than totally unethical to refer a patient to a chiropractor for any purpose whatever.”[2]

The supposed danger of chiropractic care was another issue the AMA promoted but again they could not prove it in court. In fact, the AMA warned witnesses against using this claim in court. An official of Blue Shield wrote “Doyl Taylor…urged that we stay clear of attempts to show [chiropractors’] civil malpractice suits.  With the relative weight in numbers against physicians he felt we’d by playing with dynamite.” [3] 

The statistics prove that chiropractic care was safer than medical care, but this fact did not stop the Committee on Quackery from telling people that chiropractors were rabid dogs and killers. The masters of deception would not let the facts stand in their way of misinforming the public or their own members with yet another Big Lie.

This war plan included training the impressionable “young physician in his formative years” to boycott doctors of chiropractic. Sabatier stated, “It would be well to get across the point that the doctor of chiropractic is stealing his [the young physician’s] money.”[4] In essence, this war was always about money, and the COQ used it to frighten their rank and file members.

In an article titled, “Competition: The Surprising Swing to Non-Physicians,” from the trade journal, Medical Economics, were complaints of competition with chiropractors.  It warned physicians of the loss of income to chiropractors:

It’s not enough that the ranks of doctors are ballooning. The numbers and varieties of your non-physicians competitors are also swelling: Doctors of chiropractic… are moving in on what was once your exclusive domain.[5]

Without a doubt, money was the primary motive in this medical war, not patient safety or clinical care as the AMA claimed. Additionally, the AMA’s was confident that it would be immune to antitrust action because it was a “learned profession.” However, that bubble would soon burst and expose the medical monarchy to legal action.

The decisive moment in culpability occurred in 1975, when the U.S. Supreme Court ruled in the case of Goldfarb v. The Virginia State Bar that learned professions are not exempt from antitrust suits.  The Goldfarb case alleged price fixing among real estate attorneys in violation of Section 1 of the Sherman Antitrust Act. The Supreme Court found that the bar association’s activities constituted a classic case of price fixing. It rejected the contention that Congress never intended to include “learned professions” within the meaning of “trade or commerce” in Section 1 of the Sherman Act. Moreover, the Court held that such anticompetitive activities were not exempt from the Sherman Act as “state action.”[6]

This landmark decision would open the door to the courtroom for chiropractors to challenge the AMA’s boycott, expose their illegal tactics, and reveal their injustices. But it would take a few more essential and coincidental events to make a realistic legal challenge–finding the evidence and the witnesses who would stand up in court to make the case against the medical profession. After all, taking on “the most terrifying trade association earth” as Harper’s magazine once dubbed the AMA, was a daunting task.[7]

Operation Sore Throat

At the height of the medical war in 1972, the chiropractic profession experienced a serendipitous windfall from a most unlikely group that would change the course of the medical war by giving chiropractors the ammunition for its first major counterattack. This event was, by today’s standard, a “WikiLeaks” incident that implicated the AMA with their own words pilfered from their own files.

Jerry McAndrews, DC, the International Chiropractors Association Executive Director (and brother of George McAndrews), received from an anonymous agent a book, In the Public Interest, written by William Trever, believed to be a pen name.  Dr. McAndrews also noted that “the book was not truly copyrighted but was printed in someone’s basement.”[8]

Dr. McAndrews personally met with a secret representative of Trever who sold him the rights to the manuscript for $2,500.  Adding to the clandestine affair, the carrier would not give McAndrews “a name to make a check out to, so I went to the bank and had a cashier’s check made out to cash.  I then had 15,000 copies printed and made them available to the International Chiropractic Association membership.  The only change I made to the newly printed copies was to remove the swastika from where it overlay the medical caduceus on the cover of the original version.”[9]

This book contained actual photocopies directly from the AMA’s files revealing its war against chiropractors–the smoking gun needed to pursue legal action. What made this book and its clandestine nature more fascinating was its alleged ties to the Church of Scientology. The animosity between L. Ron Hubbard’s Church of Scientology and the AMA began in the 1950s when the AMA attacked his Dianetics as psychological pseudoscience. In 1968, the AMA had published an article, “Scientology–Menace to Mental Health,”[10] written by Ralph Lee Smith, the same freelance writer paid by the AMA in 1969 to write At Your Own Risk, The Case Against Chiropractic.[11]

Basically, the AMA accused Scientology of practicing psychiatry without a license, so Hubbard simply turned Dianetics into a religion to escape medical persecution. He then retaliated with his own investigative department, the Guardian’s Office, which carried out numerous covert operations against a range of opponents of Scientology, in particular, the AMA.

 Allegedly, members of the Church of Scientology pilfered the secret documents from inside AMA headquarters. The release of this sensitive internal information became known as “Operation Sore Throat,” and Scientology’s espionage to reveal medicine’s conspiracy instigated a medical Watergate.

In The Public Interest proved to be a treasure trove of evidence—a true smoking gun that proved the AMA’s campaign to destroy chiropractic with actual internal documents. With this insider information, the chiropractors were finally given the conclusive proof needed to wage a counter attack against the AMA, but the chiropractic profession still needed actual plaintiffs who had been harmed to come forward and withstand the scrutiny expected from the army of medical attorneys.

Chester Wilk, DC, who was to be the lead plaintiff in the antitrust case, wrote of this serendipitous event:

The negative propaganda against chiropractic became more dishonest than ever yet we still did not know its source. And then we got our answer when an underground book surfaced exposing the AMA entitled, “In the Public Interest” by William Trever. The book provided photocopies of many of the AMA’s secret internal memos exposing its covert and sinister plot to destroy the public image of chiropractic through dishonest negative propaganda for the prime intent of “containing and ultimately eliminating chiropractic.” These were frightening words and I was the intended target.[12]

The motivation of the author, William Trever, was very clear in his disgust of the AMA:

Behind the closed, guarded doors of the AMA headquarters there is an elite and secretive group of men who have worked with the diligence, tenacity, shrewdness and deceit of the KGB, Gestapo, and the CIA combined. This book is a chronological, historical, factual outline of this medical government’s scheme and activities concerned with misleading the public and legislators in their attempts to do away with chiropractors. [13]

Although chiropractors are now the third-largest physician-level health profession in the world, by no means do we get one-third of the news despite the $100 billion back pain epidemic. In fact, it is a rare event when anything is written in behalf of my profession, no doubt due to the medical control of health news in the media as well as an inherent medical prejudice among newsmen.

Despite this apathy and neglect, there are newsworthy stories concerning chiropractic that could have a great impact upon lowering healthcare costs and improving patient outcomes. There are also human interest stories about the many chiropractors who paid a huge price to keep this healing profession alive.

Just as The Help showed the harm racism did to black housekeepers in the Jim Crow South in the early 1960s, the medical profession’s assault on the chiropractic profession was painfully similar for the thousands of chiropractors arrested and whose reputations were unfairly stigmatized by medical bigotry and illegal activities.

Like the civil right activists beaten and jailed in Selma in the early 1960s, chiropractors experienced the same brutality and ostracism. 12,000 were arrested and many went to jail for the chiropractic profession in the first half of the 20^th century, a note never mentioned in the annals of American history books.

This profession was built on the dedication of those men and women who had the courage of their convictions from DD Palmer who was the first and spent 17 days in jail in 1906 to EJ Nosser, the last man to be jailed in Louisiana in 1975.

Think of the saga of two chiropractic “jailhouse martyrs” that occurred in New York in 1949. Katherine “Kitty” Scallon and her husband, Mack Scallon, were chiropractors in Manhattan (their patients included Ambassador Joseph Kennedy). They were jailed simultaneously when they refused to desist in the hoax of practicing of medicine without a license; neither prescribed drugs or did surgery. Their crime was using chiropractic care before New York had a scope of practice law for chiropractors.

Kitty Scallon said from the Women’s House of Detention in 1949. “Being here [in jail] is sometimes like a bad dream…but I’d throw my shoulders back and be ready and willing to make any sacrifice to help free our beloved science.”[14]

Aside from the freedom to practice their beloved chiropractic without harassment, Americans fail to realize a Founding Father and Signer of the Declaration spoke of the need to have freedom of choice in healthcare. Just as the Constitution guarantees freedom of religion, conversely it guarantees freedom from religion.

Dr. Benjamin Rush, MD, foresaw what has happened today in American healthcare—the formation of a medical “undercover dictatorship” that aptly describes his own profession. “Unless we put medical freedoms into the Constitution, the time will come when medicine will organize into an undercover dictatorship.”[15]

That time has certainly arrived. Chiropractors are fighting the medical dictatorship that Dr. Rush foresaw, albeit not undercover anymore. Dr. Rush understood the same need for medical freedom as well as freedom from a medical monarchy:

The Constitution of this Republic should make specific provision for medical freedom as well as for religious freedom. To restrict the practice of the art of healing to one class of physicians and deny to others equal privileges constitutes the Bastilles of our science. All such laws are un-American and despotic. They are vestiges of monarchy and have no place in a republic. ^[16]

The freedom he speaks is not only freedom of treatments. As a chiropractor, I believe it is a freedom to believe in a different school of thought, the freedom of science, and the freedom to practice without discrimination and pejoratives hanging over our image from medical propaganda. Indeed, there are more ways than only drugs and surgery to help sick people get well.

Yet the medical prejudice still stands in our way at every turn. For over a century the medical war against chiropractors has been waged despite the failings of medicine to combat the diseases plaguing Americans. Just as the war on drugs has failed, so too has the medical war on cancer, heart disease, obesity, back pain, and arthritis.

Ironically, the largest of all medical wars and the only one remotely successful has been the war against chiropractors. During the height of this war in the 1960s, the AMA’s Committee on Quackery was formed to carry out the “ultimate objective of the AMA theoretically… the complete elimination of the chiropractic profession.”[17] This committee fostered an “everybody knows chiropractic is an unscientific cult” belief that remains today a wink-wink attitude among medical bigots.[18]

Although it is politically incorrect nowadays to be racist, sexist, anti-Semitic or homophobic, I have never heard any news pundit speak out against chiropractors being called “quacks” by chauvinistic medical professionals or being segregated from hospitals. Unlike racism, however, medical bigotry continues unabated in this country.

Scientific Vindication

Ironically, research now shows chiropractic care is superior to medical care for most spine-related disorders (SRDs), a fact untold by the media, swept by MDs under the medical rug, and remains unknown by the unsuspecting public.[19]

For example, in regards to SRDs, the latest evidence has incriminated medical treatments of opioid drugs, epidural steroid injections, and spinal surgeries. Over the last 20 years, numerous studies have cast doubt on the medical management of low back pain, yet the medical establishment has virtually turned a blind eye in lieu of profits.

Here are some shocking words from honest medical men who admit to the inappropriate medical care for SRDs. Gordon Waddell,  DSc, MD, FRCS, author of The Back Pain Revolution, harshly criticized the affect of medical management:

 “Low back pain has been a 20th century health care disaster. Medical care certainly has not solved the everyday symptom of low back pain and even may be reinforcing and exacerbating the problem. …It [back surgery] has been accused of leaving more tragic human wreckage in its wake than any other operation in history.” [20]

Another distressing article, “Are We Making Progress?” by Glenn Pransky, MD, Jeffrey M. Borkan, MD, Amanda E Young, PhD, Daniel C. Cherkin, PhD, discussed the ineffective spine treatments, clinical iatrogenesis, and the “Low Back Pain Medical Industrial Complex” at the Tenth International Forum for Primary Care Research on Low Back Pain in June 2010 at the Harvard School of Public Health in Boston, Massachusetts.

Concerns about ineffective treatments and iatrogenesis were discussed at greater length here than at any previous Forum since the Forums began in 1995. Research results may have led to reduction in the use of potentially harmful and unproven therapies such as bed rest and intradiscal therapy, but other harmful treatments may have taken their place, especially in the United States.

Despite explosive growth in the number, range, and quality of investigations of LBP in primary care since 1990, there was a sense at recent Forums that progress in reducing the medical and economic impact or burden of suffering from LBP has been disappointing. Few treatments presented at earlier Forums withstood the test of randomized controlled trials, and the “LBP epidemic” remains a burden in Western countries. Evidence-based guidelines and systematic reviews flourished, but seem to have had little impact on actual primary care practices.^[21]

Richard Deyo, MD, MPH, a leading spine researcher and outspoken critic of spine surgery now at Kaiser Permanente Professor of Evidence-Based Family Medicine at Oregon Health and Science University in Portland, Oregon, mentioned to The New York Times that the spine profession is ignoring this call for restraint of ineffective medical care:

People say, “I’m not going to put up with it,” and we in the medical profession have turned to ever more aggressive medication, narcotic medication, and more invasive surgery.^[22]

Spine researcher Chien-Jen Hsu, MD, admitted in the journal Spine:

By far the number one reason back surgeries are not effective and some patients experience continued pain after surgery is because the lesion that was operated on is not, in fact, the cause of the patient’s pain. [23]

This alludes to a major change in the back pain business—the suspect disc theory as the cause of back pain. This paradigm shift dates back to 1990 when orthopedist Scott Boden found no correlation between abnormal discs and patients with and without back pain. In a follow-up study in 2003, Boden reaffirmed his previous findings:

It should be emphasized that back pain is not necessarily correlated or associated with morphologic or biomechanical changes in the disc. The vast majority of people with back pain aren’t candidates for disc surgery.[24]

Dr. Maureen Jensen’s study also confirmed early suspicions that herniated discs were “coincidental” and not the holy grail of back pain causation:

The relation between abnormalities in the lumbar spine and low back pain is controversial. We examined the prevalence of abnormal findings on magnetic resonance imaging (MRI) scans of the lumbar spine in people without back pain.

On MRI examination of the lumbar spine, many people without back pain have disk bulges or protrusions but not extrusions. Given the high prevalence of these findings and of back pain, the discovery by MRI of bulges or protrusions in people with low back pain may frequently be coincidental.[25]

Raj Rao, M.D., director of spine surgery in the Department of Orthopaedic Surgery at the Medical College of Wisconsin, also spoke of this paradox in spine imaging:

You can look at the MRIs of two people, both showing degenerative discs, but in one case there is little to no pain, while in the other, extreme pain. On the other hand, you can see a healthy spine but the patient has severe pain.[26]

Despite the new research undermining spine fusions, this erroneous non-evidenced-based disc theory remains very much alive in the medical profession that is unwilling to forego this lucrative fusion surgery nor are they willing to have chiropractors compete on a level playing field for these cases.

According to Pran Manga, PhD, Canadian health economist who conducted two comparative effectiveness studies on low back pain, “There is an overwhelming body of evidence indicating that chiropractic management of low back pain is more cost-effective than medical management.” ^[27]

In an article by Jo Jordan, PhD, “Are There Any Effective Nonsurgical Treatments for Painful Disc Herniations?” she wrote that spinal manipulation may be the “lone ray of light” for back pain treatment.^[28] Her comment is just one among many that now vindicate chiropractic care in the form of spinal manipulation for the treatment of this worldwide epidemic of back pain.

By the end of the 1990s, evidence-based research from Europe and America recommended major changes to the management of patients with low back pain, including those diagnosed with disc herniation. Studies in the U.S.^[29], U.K.^[30], Canada^[31], and Denmark^[32] all concluded: back surgeries were excessive, and conservative care such as spinal manipulative therapy and active rehab were the best initial approaches to the vast majority of low back pain (LBP) problems.

“No clear evidence emerged that primary spinal fusion surgery was any more beneficial than intensive rehabilitation,” according to Jeremy Fairbank, MD, lead investigator, British Spine Study (UK BEAM). “And spine care providers should offer intensive rehabilitation enthusiastically, as it finds clear support in the scientific literature, and will prevent unnecessary surgery in a substantial proportion of patients.”^[33]

^TheBACKLETTER editorial staff also noticed the stubbornness of physicians to implement the new guidelines for low back pain, which includes the use of spinal manipulation as a first route of treatment before surgery:

Numerous international guidelines have endorsed the use spinal manipulation as a treatment for acute back pain—as part of an evidence-based treatment algorithm. But researchers have been slow to examine the impact of guidelines-based care in rigorous clinical trials—to see if an evidence-based approach actually works in real-world clinical settings.[34]

Despite the growing litany of research on the best treatments in spine-related disorders, this medical ruse against chiropractic care continues to this day. The medical media refuses to disclose the latest research showing the superiority of spinal manipulative therapy for the epidemic of back pain in this country that affects 90% of adults. Indeed, freedom of speech/information on medical matters simply does not exist in our hospitals, in the media, or in the healthcare delivery system because the medical society has no interest in giving up control of this lucrative market.