A Meeting to Remember with U.S. Rep. Austin Scott
This Op-Ed appeared in the Macon Telegraph on April 14, 2017
My meeting on April 10, 2017, with Rep. Austin Scott (R-GA) could not have been more shocking or disappointing.
I met with him to ask for an investigation into the boycott of chiropractic services at Robins AFB for active military in TRICARE as well as injured civilians in federal workers comp program (FECA). Over my 35-year career, I have never had any referral from the base nor have any DCs in middle Georgia.
Considering low back pain (LBP) is the leading disabling condition in the military and workplace, to boycott chiro care is to ignore the best nondrug treatment as the new guidelines recommend.
From the beginning, I felt a hostile vibe upon meeting Rep. Scott, starting with his dead-fish handshake to his body language, slouching in his chair while looking at me out of the corner of his eye. He seemed disinterested and detached, certainly not the Southern hospitality I expected from a public servant.
I prepared a 30-page dossier concerning the history of my correspondence with the base, including the TRICARE law signed by former President George Bush calling for RAFB to implement the chiropractic provision by Sept. 30, 2006. RAFB has still failed to do so.
In fact, only 20 of the 59 Air Forces bases in the US have chiropractors on staff although all bases were required to do so by law.
I also produced a FOIA request for fiscal year 2012 that showed of the 2,512 spine-related injuries at RAFB in its federal workers comp program, not one was referred to any chiropractor. I also mentioned the BRAC analysis showing RAFB ranked as the highest cost among WC patients of the five Air Logistic Centers, making Macon the back surgery capital of Georgia per capita.
I also shared with him the recent American College of Physicians updated guidelines on LBP that call for conservative care as the first-line treatments, but he didn’t seem interested, never touching the handouts I brought.
It quickly became apparent Rep. Scott was unfamiliar with the dossier on these issues I had given to his legislative aide, Cameron Bishop, at his Washington office in mid-March when I visited the Capitol. Assuming he had not seen it, I brought another one but he never looked at it. Perhaps if I had given him a check for $10,000 as I discovered the Orthopedic Surgeons Society had done, he might have been more receptive to me.
I spoke of the high rates of opioids, epidural shots, and the failure rate of lumbar spine fusions that have sparked growing concerns in the media, but he still seemed uninterested. I also mentioned the Mayo Clinic systematic review of MRI exams of asymptomatic patients that found “bad discs” in pain free people, as well as other pertinent bits of evidence in the paradigm shift in spine care. But again, he didn’t want to see the actual information.
None of this new data fazed this Republican representative. He never opened the dossier; he never looked at the new guidelines from the ACP. He was totally uninterested in my dossier information or what I had to say. He just sat there like a frog on a log.
I also pointed out to him that all three Army posts in Georgia (Benning, Stewart, and Gordon) already have DCs on staff, but he seemed to withdraw even more.
Finally he croaked, err, I mean, spoke, “Well, if the laws allow for it, then they should follow it.”
“That’s my point: the laws call for chiropractic care but the base has stone-walled this issue for years as my dossier correspondence material proves.”
For that matter, Rep. Scott also failed to respond to my letter of January 20, 2011, concerning DoD discrimination against chiropractic care.
Two years ago I also met with his legislative aide in Washington about this matter, but again never got a response from Rep. Scott. His location reputation is that he rarely responds to anyone’s letters. As one patient of mine, a local businessman told me, “He’s a career politician who’s only after the retirement plan.”
I also mentioned that some surgeons scare people into unnecessary spine fusion based on ‘bad discs.’ “If you don’t have my surgery you’ll be paralyzed and if you go to a chiropractor, he may paralyze you.”
If I had a nickel for every time I’ve heard that lie, I could retire.
Indeed, the ‘bad disc’ diagnosis is the red-herring that has led to thousands of unnecessary spine surgery as the Mayo Clinic study suggests, which said ‘bad discs’ are part of the normal aging process like grey hair. I actually had the Mayo Clinic chart showing ‘bad discs’ in pain-free adults, so I read out loud, “By the time you’re 50 years old, there’s an 80% chance of degenerative disc disease.” But he never looked at it, totally disinterested.
Such research among others like the recent CDC report on opioid painkillers is the reason why the ACP issued new guidelines because there is too much abuse of opioids, epidurals, and spine surgery.
Rep. Scott then blurted out, “There are good chiropractors and bad ones,” apparently as justification for his negative attitude towards chiropractors. What was his point?
I replied, “And there are good orthopedists and bad ones.” I could not believe this petty bickering with my US Representative.
I asked Rep. Scott if he knew anyone who has had a positive outcome from spine fusions, which seemed to anger him more. Again, he glared at me and then said, “Yes, I know many, many, many people who have successful back surgeries.”
“Well, you must be exceptional considering one study found 75% of spine fusions failed to return patients to work after two years, and most are still taking opioids. Plus, every guideline on low back pain discourages surgery unless conservative care fails to help.”
My comment awakened him from his look of boredom and then he blurted out, “I think you’re prejudice against orthopedic surgeons.”
I was shocked and could only think this is the pot calling the kettle black. Anyone half-way familiar with the 100-year long medical war against chiropractors knows his comment is foolish—equivalent to blaming African Americans for racism.
“Not at all, but I am prejudiced against unnecessary opioids, epidurals, and spine fusions. I refer to orthos when necessary, but I also see the bad results of many failed surgery victims who come to my office.”
Still glaring at me he then said, “You should have done your homework on me.”
Actually I did visit his website and discovered Rep. Scott is so far to the right on the political scale he probably thinks Ronald Reagan was a hippie from California because his politics were too moderate for this Southern redneck from the Tea Party.
“I did, but why do you ask?”
Then the truth came out, “My dad is an orthopedic surgeon.”
Finally I understood his resentment towards me. His bias could no longer be contained, but I wanted to redirect the conversation back to the issues.
“This isn’t about your dad or orthopedic surgeons; it’s about RAFB following the law to offer active military members access to chiropractors and allowing injured civilian workers the right to choose chiropractic care in workers comp as the laws allow.”
“You made a blanket condemnation of all orthopedic surgeons.”
Once again he made another inaccurate account of my presentation.
I turned to his assistant who was taking notes and asked, “Did I ever say that?” knowing full well I had not. He didn’t say a word.
“I am talking about unnecessary spine surgery done before conservative care is first used, just as the guidelines recommend.”
I pointed to my books, “I have all that information in my books if you’re interested,” but it was obvious he had the attitude, “Don’t confuse me with the facts.” His mind was made up with medical prejudice ingrained from a lifetime of medical misinformation, no doubt, from his father.
Obviously this meeting was going nowhere fast. He seemed very mad by now, refusing to be swayed by the laws, the evidence, or my plea that RAFB must follow the law or explain why.
He also said he would not call for an investigation into this matter. As far as he is concerned, there is no need to determine if RAFB is following the law or not about chiropractic care. Again, I felt like an African American asking George Wallace to investigate racism on the base.
Finally, as he and his staffer were almost pushing me out the door and with his eyes shooting darts at me, he warned me, “the next time you meet with somebody, you should be nicer.”
Once again I was shocked and turned to his aide and asked, “When was I not nice?”
I never raised my voice although I did bite my tongue a lot. I did correct his misstatements and his ignorance of the issues, and corrected his embellishments about what I had said.
I replied to his snide remark, “I expected you to take this information professionally, not personally.”
After all, he’s the public servant, not me.
Obviously blood is thicker than water, especially when it comes to an orthopedist’s son and a chiropractor.
Indeed, this meeting with Rep. Scott is one I will never forget.
The very next day another breakthrough occurred when the Journal of the American Medical Association published articles also touting the benefits of spinal manipulation:
- Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain Systematic Review and Meta-analysis
April 11, 2017
Neil M. Paige, MD, MSHS; Paul G. Shekelle, MD, PhD, et al.
JAMA. 2017;317(14):1451-1460. doi:10.1001/jama.2017.3086
· The Role of Spinal Manipulation in the Treatment of Low Back Pain
April 11, 2017
JAMA. 2017;317(14):1418-1419. doi:10.1001/jama.2017.3085
NPR April 11, 2017