Blind Spot

by

Chiropractic’s Blind Spot

In mid-March I attended the DC2017 in Washington DC that had 1,500 people from 29 countries. It was a great seminar with interesting speakers and research award-winners, but the Life Vision seminar hosted by Life University exceeded it in content, context, and character.

I feel fortunate to being able to attend both of these fantastic seminars, meeting new colleagues and hearing dynamic speakers.

I must admit I was leery about Life Vision because I assumed this seminar may be a new version of Big $id’s DE Seminars. Indeed, the ghost of spirit past was in the air when speakers mentioned $id’s mantra—“serve for the sake of serving…” At least no one did the “Money Hum”! (Although I thought Dean Depice and Chuck Ribley were ready).

I was happily proven wrong in my assumptions especially on Friday night with the enlightening and powerful performances by Zach Bush, Andrew Wakefield, Gil Bigtree (the producer of VAXXED) and Guy Riekeman. These speakers lifted my consciousness on controversial issues to new heights of social relevance for chiropractors that I’ve never heard in my 35-year career attending seminars.

It’s one thing to learn of new research as I did at DC2017, but it’s another thing to learn how to change the world. To say the least, Life Vision was powerful; moreover, it was transformational.

The Big Funnel

Jason Deitch’s Social networking in Two Minutes Per Day, and Beau Pierce’s “Digital Practice Builder” program, The Power of Social Media, was just what I needed to hear. Their 5 Step Process and guest speakers were a helpful eye-opener to implement various strategies on Facebook.

 One important concept was the “funnel” concept of marketing and to have as many funnels into your practice as possible, such as LBP, neck, pediatrics, geriatrics, sports, nutrition, etc.

Twice I’ve heard a comment by Dr. Riekeman that has stuck in my mind—“we’re not about bones, but about the nerve system”—neuroplasticity, functional neurology, positive psychology and neurophysiology—all components of the Big Idea.

I agree those are the higher levels of our science and philosophy. Just as Maslow spoke of the Hierarchy of Needs, these Big Ideas are the same to our profession. If you remember my book, The Medical War, I wrote of these concepts and even coined a new term, “Type B” disorders of the brain, as well as discussing Type M and Type O disorders that chiro care is known to help.

No Pain, No Gain

Realistically, the biggest funnels to most practices are not these important concepts. The “foot in the door” for the majority of our patients starts with neck and back pain, particularly LBP.

As the biggest funnel to our profession, why Life hasn’t exploited this paradigm shift in spine care is perplexing to me. With its facilities and staff, this should be a no-brainer to have Life University develop a Spine Center of Excellence that is plastered all over Atlanta and the Southeast with billboards and FB ads.

This is the missing “elephant in the seminar.”

Strategy

It’s time to give Emory a run for its money.

A Life Spine Center of Excellence could position itself similar to the Cancer Treatment Centers of America that markets itself as a natural solution to cancer; we could do the same thing as the nondrug, nonsurgical solution to back pain and opioid epidemics. Of course, some of these LBP patients would be funneled to other areas such as functional neurology, etc., but the main bait on the hook is LBP.

As you may know, Emory University has a Spine Center run by Scott Boden, MD, renowned researcher who was involved in the seminal MRI research in 1990 that found “bad discs” in pain-free people.

We can use his own words to market against his own Emory Center.

Dr. Boden clearly stated his skepticism about the “bad disc” diagnosis and the need for surgery:

“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.”[1]

His study has been replicated in 31 other studies that the Mayo Clinic cited in its systematic review in 2014, yet no one is telling the public about these ‘bad discs’ in pain-free people. The Mayo study concluded:

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

Indeed, this ‘bad disc’ diagnosis is the biggest scam in medicine—a red herring used by every orthopedist/spine surgeon to railroad patients into surgery. Take a look at this chart from Mayo that shows the ubiquitous prevalence of ‘bad discs’ in asymptomatic people.

As you can read, by the time someone is 50 years old, there is an 80% chance of degenerative disc disease, but they have no pain.

Coincidentally, Dr. Sanjay Gupta at CNN also works at Emory but has never mentioned Boden’s work to his viewing audience, an issue I discuss in my new book in the chapter, “Banned at CNN.”  This cover-up could work to unglue this Emory conspiracy about medical spine care as well as unseat Gupta as “America’s most trusted doctor.”

I once wrote to Dr. Gupta suggesting a series on CAM:

“CNN would do the nation a huge service to have a regular series on different approaches such as the different spinal therapies done by chiropractors to help not only with the back pain epidemic, but with other health concerns and alternative treatments, such as acupuncture, homeopathy, naturopathy, to name but a few. There is a treasure trove of possibilities to explore in the wide world of complementary and alternative medicine, a ripe opportunity presently ignored by the mass media.”[2]

Of course, I received no response from him. Again this proves my point that nearly all health reporters, certainly Dr. Gupta included, are MDs who suffer from the typical medical bias, aka, chirophobia, and will never promote their competitors just as Republicans will never promote Democrats.

This media cover-up is a huge issue that Life needs to exploit since the research is now on our side, but no one is telling the public.

This link between Dr. Boden’s research and Dr. Gupta’s failure to mention it should be a huge marketing strategy to expose this scam. Dr. Boden has stated his skepticism about the “bad disc” diagnosis and the need for surgery, an opinion the public fails to know because Gupta hasn’t told anyone, a bone of contention I’ve written to him about.

Dr. Boden also has admitted most primary care physicians are inept on MSD. “Many, if not most, primary care providers have little training in how to manage musculoskeletal disorders.”[3]

Certainly his comment opens the door to DCs as primary spine providers in a society where 80-90% will have a back attack sometime in their life. We’re talking about a $100 billion market in LBP.

Dr. Boden’s admission about MD ineptness is a big problem considering over 60% of prescription opioid use involves various musculoskeletal disorders, such as chronic low back (30%) and neck pain (5.2%), extremity pain (22.5%) and headaches (4.1%), conditions that chiropractors may help with nondrug treatments.[4]

Dr. Tom Frieden, director of the CDC, also admits MDs are the problem, “The prescription overdose epidemic is doctor-driven. It can be reversed in part by doctors’ actions.”[5] Just don’t hold your breath to expect MDs to refer these patients to DCs.

However, since MDs don’t refer, we must lay claim to this market by going directly to the public.

The National Pain Strategy also mentioned MDs are ill-prepared to manage chronic pain:

“Physicians are not adequately prepared and require greater knowledge and skills to contribute to the cultural transformation in the perception and treatment of people with pain.”[6]

Mark Schoene also makes the case primary care medical practitioners are actually dangerous to patients:

“One can make the argument that the most perilous setting for the treatment of low back pain in the United States is currently the offices of primary care medical practitioners—primary care MDs.” [7]

Mr. Schoene is not alone in his skepticism.

Richard Deyo, MD, MPH, agrees:

“Calling a physician a back-pain expert, therefore, is perhaps faint praise—medicine has at best a limited understanding of the condition. In fact, medicines’ reliance on outdated ideas may have actually contributed to the problem.”[8]

We could not have prayed for such incriminating comments by medical spine experts. If we had said the same things, we would be laughed at by the public and press.

As George McAndrews has often told me, the best offense he used at Wilk were the “admissions against interest” when MDs admitted they were inept in spine care or knew nothing about chiropractic care. Even Dr. Marc Siegel at FOX News admitted on air that MDs have only 9 hours on the “back” as he put it.

We should use this tactic again.

Gifts of Knowledge

There is now more ammunition for chiropractors than ever before to shoot down these medical hotshots at Emory. The chiropractic profession is enjoying a wave of new scientific support lately as well as a string of articles critical of medical spine care.

But what good is this information if we don’t use it to change the world? We have finally been given the gifts of science and expert comments; now we must use them to transform society.

But it will take more than a FB ad or a billboard to convince the chirophobic public and skeptical press.

To remind you, here is the litany of new research touting our services:

These shocking studies came on the heels of other paradigm shifting news about other medical spine care treatments:

  • FDA publication, “Epidural Corticosteroid Injection: Drug Safety Communication”: Risk of Rare but Serious Neurologic Problems.” The FDA warning clearly states: “Corticosteroids are not approved by FDA for injection into the epidural space of the spine.”[10]
  • A 2014 study by the Centers for Disease Control (CDC), “Opioid Painkiller Prescribing,” found MDs prescribed 259 million prescriptions for opioids, equivalent to one for every American adult.[11] Each day, 46 people die from prescription painkillers in the U.S.[12] 2,500 teenagers every day start using prescription painkillers, leading to a new wave of addicts. [13]
  • On March 13, 2017, the news media also reported Ibuprofen to be no better than placebo for back pain and can increase heart attack risk by 31%.
  • On March 23, the media reported Pregabalin (Lyrica) for acute and chronic sciatica was no better than placebo; in fact, the incidence of adverse events was significantly higher in the pregabalin group than in the placebo group.

Big Pharma has flooded society with narcotic painkillers to the point that Thomas Frieden, MD, Director of the CDC, admitted that physicians had essentially supplanted street corner drug pushers as the most important suppliers of illicit narcotics.[14]

Aside from the opioid Pharmageddon, back surgeries are another big scam. Research now shows most disc fusions are ineffective based on a debunked ‘bad disc’ premise.

  • A study by JT Anderson, et al.[15] in the research journal Spine, noted the poor outcomes of disc fusion in two groups—spondylolisthesis and degenerative disc disease (DDD). 

This study had an incredibly low bar for success that most patients still could not reach. A case was considered “successful” in this study if a patient could return to work within a two-year limit and work at least six months, although many were still taking opioids for nearly a year postoperatively.

 This study revealed rather pitiful success rates – only 36 percent for spondylo and 24 percent for DDD cases were able to return to work after two years of recovery. Conversely, this means nearly 2/3rds of the spondylo and 3/4ths of the DDD patients did not return to work by two years.

The Anderson study concluded:

“Our study is support of the conclusion that DDD is a questionable indication for spinal fusion. Given the generally poor outcomes of this study, future studies should determine if lumbar fusion surgery is an effective treatment modality in similar patients.”[16]

Hopefully with this string of events, the chiropractic profession may be approaching the elusive tipping point of scientific validation after decades of medical slander and obstruction by the AMA.

However, the media will not tout this paradigm shift, so we must do it ourselves. It’s now time to put the shoe on the other foot.

Considering the issue of back pain affects nearly everyone sometime in their life and has become the #1 disabling condition in the nation, military, workplace, and the world, this huge issue remains a quandary because the public remains unaware their local family MD is a part of this problem, not the solution, and surgeries are based on an outdated premise.

This is a ripe market to capture via news releases and appearances on the local TV stations. Of course, I’m certain Jason can create a FB ad campaign with pithy titles such as:

  • Seeking nondrug and nonsurgical answers to your back pain? See Life Spine Center of Excellence.
  • Want to avoid back surgery? Come to the Life Spine Center of Excellence.
  • Still suffering from failed back surgery? See Life Spine Center of Excellence.
  • Tired of opioid painkillers and afraid of addiction? See Life Spine Center of Excellence.
  • New American College of Physicians guidelines on low back pain recommend spinal manipulation. Learn more at the Life Spine Center of Excellence.
  • North American Spine Society recommends SMT for herniated discs. Learn how the Life Spine Center of Excellence can help you.
  • Your back pain can be helped without drugs, shots or surgery. See Life Spine Center of Excellence for details.

Transformational Students

This program would be an excellent training for your elite undergrad or graduate students. If you haven’t already, a comprehensive team of multi-disciplinary practitioners skilled in various methods could offer patients a holistic approach to managing these often lifelong chronic ailments.

For your students, it would give them experience in various chiro techniques that are known to help LBP cases, such as Gonstead, Cox Distraction, Kennedy Decompression, SOT, Pettibone or whatever effective methods now exist. The point is to give students a broad-scope armament to use with different types of cases rather than trying to fit all patients into their singular scheme of treatment.

Aside from teaching the most effective methods for LBP, for that matter, if you want to be totally inclusive, this program should include therapeutic massage, acupuncture, physio-therapeutics, rehab, and Cognitive Behavioral Therapy (CBT).

Such a training program for students and graduates from other colleges would also expose them to your Bigger Ideas—neurophysiology, neuroplasticity, positive psychology, and functional neurology.

It would also expose them to the medical war they are about to enter but know little about. Before they can transform patients, we must transform the students (and faculty).

While attending my booth at the Life Vision seminar, I met many Life students who were very impressive in appearance and attitude—a good looking group of young people. But I also found them to be naïve about the medical war and the defamation they will soon encounter—a fact of life every DC embraces upon graduation.

I gently informed them about chirophobia by using a better known prejudice, racism. As you mentioned in your Friday night talk, the “backstory” is as important as the dialogue.

Our backstory is medical bigotry that permeates our society and is undoubtedly the biggest clog in our funnel of new patients who get siphoned off to the medical railroad.

With that in mind, I asked the students to think of racism and the backstory of slavery, Civil War, Jim Crow laws, Civil Rights Act, and MLK, Jr. Of course, they were well aware of that backstory.

But when I mentioned chirophobia, they were clueless about our backstory consisting of Morris Fishbein, aka, the Medical Mussolini, nor did they know about H. Doyl Taylor, the Committee on Quackery, Stephen Barrett, Wilk v. AMA, George McAndrews, or any of the current players and events in our profession.

A few had seen Jeff Hays’ documentaries, but none had read my books. I can’t imagine how these millennials will be transformational when they are unaware of their own history and current politics. Again, it would be similar to young African-Americans who don’t know their own history—the events, people, and politics.

When I spoke with them, they were amazed at the content and scope of my books. I am still perplexed why my books are not mandatory reading at Life and every chiro college. Unless there are other equivalent books being used already, I am saddened that these young warriors are sent off to war without any understanding of the war itself.

The Big Pain Idea

Principally I consider myself a part-time amateur investigative writer, but the information I’ve accumulated in my career can now pay off with huge dividends if you were to develop a Life Spine Center.

This would augment your present programs and probably will become the biggest funnel for new patients, especially those in serious pain or failed back surgery. It will also be a newsworthy issue to challenge the sacred Emory University, Dr. Boden and Dr. Gupta. It will also give hope to the millions of people who are suffering with acute and chronic back pain.

Unless you are dead-set against embarking into the pain arena, I hope you will mull over my idea to begin a Life Spine Center of Excellence. It would expand your brand not only as the biggest chiro college with the most progressive programs, but would include a primary spine care program with the best trained graduates.

Remember: No Pain, No Gain.

[1] Boden, S et al. (2003) Emerging techniques for treatment of degenerative lumbar disc disease, Spine 28:524-525.

[2] http://chiropractorsforfairjournalism.com/Sanjay_Gupta_CAM_show.html

[3] http://www.medscape.com/viewarticle/860452

[4] Denise Boudreau, PhD, Michael Von Korff, ScD, Carolyn M. Rutter, PhD, Kathleen Saunders, G. Thomas Ray, Mark D. Sullivan, MD, PhD, Cynthia Campbell, PhD, Joseph O. Merrill, MD, MPH, Michael J. Silverberg, PhD, MPH, Caleb Banta-Green, and Constance Weisner, DrPH, MSW. “Trends in De-facto Long-term Opioid Therapy for Chronic Non-Cancer Pain,” Pharmacoepidemiol Drug Saf. 2009 December; 18(12): 1166–1175. doi:10.1002/pds.1833.

[5] http://www.medscape.com/viewarticle/860452

[6] S Boden, et al. “Emerging Techniques For Treatment Of Degenerative Lumbar Disc Disease,” Spine 28 (2003):524-525.

[7] http://iom.nationalacademies.org/Reports/2011/Relieving-Pain-in-America-A-Blueprint-for-Transforming-Prevention-Care-Education-Research.aspx, pp.5.

[8] Deyo, RA. Low -back pain, Scientific American, pp. 49-53, August 1998.

[9] https://www.spine.org/Documents/ResearchClinicalCare/Guidelines/LumbarDiscHerniation.pdf

[10] http://www.fda.gov/Drugs/DrugSafety/ucm394280.htm

[11] National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention, www.cdc.gov/vitalsigns/, July 2014.

[12] CDC Vital Signs, http://www.cdc.gov/vitalsigns/pdf/2014-07-vitalsigns.pdf

[13] http://www.drugfreeworld.org/drugfacts/prescription/abuse-international-statistics.html

[14] Centers for Disease Control and Prevention Press Release, CDC Vital Signs: Overdose of Prescription Opioid Pain Relievers—United States, 1999-2008; 2011: www.cdc.gov/media/releases/2011/t1101_presecription_pain_relievers.html.

[15] Anderson, Joshua T. BS; Haas, Arnold R. BS, BA; Percy, Rick PhD; Woods, Stephen T. MD; Ahn, Uri M. MD; Ahn, Nicholas U. MD, Single-Level Lumbar Fusion for Degenerative Disc Disease Is Associated With Worse Outcomes Compared With Fusion for Spondylolisthesis in a Workers’ Compensation Setting, Spine: 01 March 2015 – Volume 40 – Issue 5 – p 323–331

[16] http://journals.lww.com/spinejournal/Abstract/2015/03010/SingleLevelLumbarFusionforDegenerativeDisc.15.aspx

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