Weigh in on Washington

by

Weighing in on Washington

It was a cold and blustery week with snow on the ground in mid-March when chiropractors converged upon Washington, DC, for the DC2017 conference of the American Chiropractic Association, Association of Chiropractic Colleges & Research Agenda Conference, and World Federation of Chiropractic that will go down as the most impressive conference in the history of the chiropractic profession with 1,500 participants from 29 countries.

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Aside from being hit by a gale-force blizzard, this conference could not have occurred at a more fitting time to discuss chiropractic with congressmen during the hotly contested Trumpcare debate waged on Capitol Hill.

At the DC2017 gala I felt like Forrest Gump who experienced many fortuitous events in his life with a stellar list of exceptional speakers, fascinating workshops, and research award winners all making for a memorable week of education and camaraderie.  

As Forrest might say, DC2017 was like a box of chocolates—you  just never know what you will learn or the extraordinary people you may encounter, such as Keith Charlton (Australia), Dave Newell (England), Nicholas Thalen (Sweden), Øystein Ogre, President of the European Chiropractors Union (Norway), Richard Brown, Sec-General of the WFC (Great Britain) and Leslie Hewitt, Women of Wellness Talks (California), to name just a few of the extraordinary colleagues I met.

Plus, there were my usual friends who regularly attend these events such as Mike Schneider, Stephen Perle, Kelli Pearson, Donald Murphy, Ted Carrick, David O’Bryon, Bill Meeker, Bill Morgan, Carl Cleveland, Vern Saboe, Mike Flynn, Gerry Clum, Rick Cole, Dana Lawrence, and the dynamic duo of Claire Johnson and Bart Green, just to name a few of the “shakers and movers” along with the “thought leaders” in our profession I’ve grown to admire.

National Press Club

An added feature of DC2017 was the F4CP’s sponsored session on opioid abuse at the National Press Club (NPC) briefing to launch its campaign: Save Lives. Stop Opioid Abuse. Choose Chiropractic. You can view this 90-minute program online.

Let me weigh in on a few issues after viewing this NPC briefing.

The most notable speaker at the NPC briefing was Dr. Marc Siegel of FOX News. Dr. Siegel was extremely honest when he blamed the opioid epidemic on his own colleagues and pharmacists; he also admitted MDs have only 9 hours of education on “back.” I almost fell out of my seat when he said, “We’re getting a growing awareness of two things: the abuse of back surgery and the abuse of opioids.”

Click on arrow to begin video.

Dr. Marc Siegel on FOX News after his appearance at the NPC.

Most remarkably he was very supportive of chiropractic care and other nondrug therapies as part of an integrative teamwork to solve the pandemic of pain and opioid abuse. He certainly is not totally anti-meds stating his preference for muscle relaxants that may help some. He also mentioned his wife, another MD, once told him “chiropractors are the only doctors who absolutely Do No Harm.”

If only more MDs thought this way…

Other notable speakers included:

  • Wayne Jonas, MD, President and CEO, Samueli Institute 
  • David Thomas, PhD, Program Officer, Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse
  • Linda Porter, PhD, Director, NIH’s Office of Pain Policy and Co-Chair of the Interagency Pain Research Coordinating Committee (IPRCC) Working Group
  • Jan Chambers, President, National Fibromyalgia and Chronic Pain Association (NFMCPA) 

I particularly enjoyed Jan Chamber’s personal WOC story. She suffered with excruciating pain from fibromyalgia and was bed-ridden for 16 months before her husband suggested she see a local DC. She mentioned many fibromyalgia patients suffer from neck injuries beforehand, which was her case. Now she is well and thoroughly convinced of the value of chiropractic care in this disease.

DCs MIA

I was delighted to see the National Press Club (NPC) briefing, long overdue and a step in the right direction to gaining recognition in the earned media that has long opposed, defamed, or ignored chiropractors (which, incidentally, is the subject of my new book, To Kill a Chiropractor).

The history of chiropractic in the media is replete with yellow journalism that continues to this day. For example, when was the last time you’ve seen an in-depth, fair and balanced article about the benefits chiropractors bring to the pandemic of back pain and opioid abuse? Of course, you never have, an issue I explain in my new book.

Unfortunately, the NPC-F4CP briefing did not lead afterwards to an avalanche of positive articles in the earned media; it was an attempt to crack the media nut, but it did not happen without mixed reviews along with a little controversy, too.

While watching this NPC briefing, my first impression questioned why Laura Carabello (left) was selected to be the spokesman for our profession at this video event instead of Dr. Sherry McAllister, the Executive Director of the F4CP. One might think the ED of the foundation should be the spokesman, not a consultant or vendor.

Another questionable issue was the lack of any DCs on the speaker list. Inexplicably, Ms. Carabello compounded this omission when she mentioned there were no DCs on the speaker list on purpose, stating this is “no rah-rah seminar for chiropractors,” hoping to portray independent support from real doctors.

What was the press corps to think of her comment?

If I were a member of the press corps in the audience, I would have been confused why a briefing sponsored by the Foundation for Chiropractic Progress did not include a single DC or a prominent chiropractic researcher, educator or elected official to inform the press of our profession’s progress!

Can’t chiropractors speak for themselves?

Presumably the press corps is already well-aware of the opioid crisis, but after this NPC briefing, they are undoubtedly still confused how chiropractors can help. Although the medical WOC testimonials were nice, they did not explain why or how DCs can help people avoid opioid painkillers.

There was no mention chronic musculoskeletal disorders (LBP, neck, extremities, headaches, OA) are the leading reasons for prescription painkillers, all conditions chiropractors help with nondrug therapies, namely manipulative therapy, nor was there any mention of joint dysfunction, vertebral subluxation, spinal-somatic reflexes or any physiologic explanation of spine-related problems whatsoever.

Indeed, it might have appeared to the NPC press corps that chiropractors had nothing to add clinically to this national conversation—there was no scientific explanation in laymen terms how chiropractic care can help patients with chronic pain.

I daresay the NPC crowd would have enjoyed the insights of Scott Haldeman, David Chapman-Smith, Gerry Clum, Bill Meeker, Christine Goertz or any of our more notable speakers, showing the media members we do have very bright and articulate spokesmen who can speak with authority about the possible role of chiropractors to lessen the epidemic of opioid abuse as well as the paradigm shift in back pain treatments in general.

Perhaps this is the outcome of the event coordinator, Ms. Carabello, who is not a DC, not a researcher, and not an educator—she simply doesn’t know how to ask the right questions about the logic of chiropractic care. Although well-intentioned, she was way in over her head.

Without a doubt, DCs were MIA at this important press briefing and continue to play second fiddle to MDs as healthcare authorities.

Is this the foundation’s idea of “chiropractic progress”?

The NPC briefing should have been a springboard to the larger issue of unnecessary medical spine care, not only opioid abuse that is no longer a secret. I had hoped the F4CP press briefing might lead the charge to vetting the downside of medical spine care (drugs, shots, surgery), deemed by a leading spine journal editor, Mark Schoene, as a “national disaster” and the “poster child” of inefficient spine care.

Don’t you think his comment would have piqued the attention of the press corps?

Instead of simply jumping on the anti-opioid bandwagon that is old news by now, by attacking the medical spine industry and Big Pharma’s clandestine program to create this Pharmageddon, it would have added more sizzle to this briefing. As it were, other than Dr. Siegel’s FOX news segment, little else was evident afterwards in the mainstream media.

Valentine’s Day Gifts

As fate would have it, this NPC briefing would have been an excellent opportunity to tout our brand of spine care as America’s primary spine care providers by virtue of our training, nondrug methods, and expertise since spinal manipulation was recommended on February 14, 2017, just a month before the DC2017 conference, as a front-line treatment by the updated American College of Physicians (ACP) guidelines.

The F4CP could not have planned a better time for this media bombshell to explode, but failed to exploit this serendipitous event. The foundation might have had our chiro researchers explaining their research studies, such as Christine Goertz, Heidi Haavik, Mike Schneider, Mark Studin, Scott Haldeman, Stephen Perle, Donald Murphy, to name just a few of our most articulate researchers.

Again by coincidence, two other news releases concerning drugs for back pain and sciatica were released on the same weekend or shortly after the conference. On March 17, 2017, television news reported Ibuprofen can increase heart attack risk by 31%. On March 23, 2017, another news release from the New England Journal of Medicine found Pregabalin (Lyrica) for acute and chronic sciatica was no better than placebo.

This string of events should have been promoted as the Waterloo for the medical spine care model that is quickly losing the high ground to dwindling supportive evidence. That one comment would have gotten more media attention than anything the MDs said.

Instead of putting our best foot forward showing the superiority of chiro care over medical spine care as the ACP new guideline also suggests, we stumbled backwards by avoiding the preemptive opportunity to educate the press corps of this medical mess of ESI and spine fusions in spine care.

Again, perhaps this oversight was the result of a consultant, Laura Carabello, and a generous benefactor/vendor, Kent Greenawalt, in charge at the F4CP who aren’t well familiar with the paradigm shift in spine care.

Rockin’ in the Ballroom

Aside from the NPC briefing, there were many other excellent shows at DC2017 that rocked the International Ballroom.

The Blue Zones spoke of the longevity societies around the world and Steven B. Wiley of The Lincoln Leadership Institute at Gettysburg spoke of transformational management with his poignant humor and references to the battle of Gettysburg that left many in the audience with tears in our eyes.

Speaker of the House, Rep. Paul Ryan, spoke via Skype to the plenary session at DC2017 about his own experience with his back attack. He gave a shout-out to Dr. Bill Morgan, the original Capitol Chiropractor and now president of Parker University, as our best lobbyist who put him back on his feet.

On another positive note, the First Lady of chiropractic research, Christine Goertz, not only won the Scott Haldeman Award for Outstanding Research worth $10,000, she wowed the audience with her show about her clinical trial studying the effectiveness of chiropractic care for active-duty military personnel with low-back pain. This study was one of three included as part of a $7.4 million, seven-year grant from the Department of Defense.

          If Christine is the First Lady, then Greg Kawchuk laid claim as Prince Charming as the most dynamic chiropractic speaker at the conference. He spoke on Innovation in Chiropractic, the need to re-brand our profession and, most importantly, the need for Unity and tolerance for different viewpoints— in Washington political terms, the need for bipartisanship. “We don’t control who we are as a profession,” he said, “the commUNITY does.”

Dr. Kawchuk was followed on stage by another award winner, Dr. Heidi Haavik from New Zealand, who has done important research concerning the CNS and vertebral subluxation. She has produced a fascinating webpage where she offers for free her E-book, “The Reality Check: A quest to understand Chiropractic from the inside out” and her Chiropractic Fact Sheet, “7 Facts you did not know about chiropractic.”

“It’s essential that we as a profession have a new conversation about what effect we actually have on the brain and body. To have this conversation you need to know what has been done, research wise, on this topic. Therefore I am giving you my eBook. Enjoy! Lots of love, Heidi.”

The WFC Award 2017 went to Jan Hartvigsen from Denmark for his huge impact on MSK Research and the importance of this research to the chiropractic profession. Jan and his Danish DCs are making great inroads into research and education. DCs in the USA have a lot to learn from our Danish colleagues in terms of integration into the mainstream.

Chiropractic Gridlock

As a leader in evidence-based research, Dr. Kawchuk’s speech was a surprising and most welcomed call for bipartisanship in our profession, a topic many abhor.

Invariably, there was also a display of partisan politics, which is not surprising since Capitol Hill is known for gridlock and the lack of bipartisan cooperation.

Let me get on my bandwagon to discuss this argument that needs to find a resolution or absolution if we are to have union of our profession with different ideologies, just as our Founding Fathers agreed upon an underlying social premise in the United States to form a more perfect Union — the freedom of choice.

Text Box: Ayla Azad As example of the ongoing discord in chiropractic, the panel session, “Science and Semantics: the Future of Subluxation,” focused on this core conflict.

One panelist Ayla Azad, the president of the Ontario Chiropractic Association, spewed vitriolic comments urged on by the encouragement of some members in the audience. While she may have been entertaining to some, many in the audience, like me, were shocked by her disrespect.

Intolerance, not mutual respect as Dr. Kawchuk espoused, was her mantra. Divisiveness and ridicule, not unity, was her goal.

Upon hearing her comments, I wondered if I was attending a Trump political rally with epithets mocking Muslim believers, Mexican immigrants and Syrian refugees. She definitely did not present herself as a statesman at an international professional conference exchanging novel ideas or new research.

Indeed, this was a low-point for an otherwise uplifting conference. I understand the skepticism toward chirovangelism since I worked at Life College under the dictatorship of Sid Williams, so I am perfectly aware of the downside of that extreme position.

On the other side in this war of words, Dr. Rob Scott, provost from Life University, gave a novel explanation of a vitalistic viewpoint that I had not heard before.

Unbeknownst to the audience, Dr. Scott received a PhD in applied physiology from the University of Minnesota where he investigated the impact of chiropractic adjustments on cerebral vascular hemodynamics.

As you can see, he embodies a balance between the art, science, education, research and philosophy of chiropractic; in other words, he is not a chirovangelist or a demagogue, ya folla? He is a very articulate spokesman who presented his side of the debate without rancor.

Dr. Scott first mentioned he was somewhat gun-shy to speak again considering the last time he spoke at ACC-RAC in 2012 in Las Vega he was ambushed in the Q&A. In fact, I witnessed the verbal abuse disgorged by Dr. Tom LaBrot, now senior vice president of Clinical Services at ASHN, who claimed Dr. Scott was a “threat to humanity.” I am not exaggerating

The gall of LaBrot’s accusation was shocking at a professional meeting, not only by his wrath, but also by the irony coming from an officer of the leading “junk” insurance company using “bait and switch” policies with bogus guidelines that “squeeze care to expand profits” that are truly a real “threat to humanity” by exploiting patients and DCs alike.

As Forrest Gump might say, “Stupid is as stupid does.”

Diversity or Division?

Inexplicably, today we see more tolerance for instrument adjusting versus classic chiropractic hands-on care; plus, we see more acceptance for the introduction of prescription drug rights into our historically drug-free profession that would have been tantamount to sacrilege years ago than we see tolerance for philosophical differences.

Would we also expect to hear the same disdain for the LGBT community in chiropractic by the religious fundamentalists and political conservatives?

Probably not because sexual preference/identity is now politically correct. As comedian Stephen Colbert once said, “Five years ago the LGBT community was in the closet; today if you’re not gay, something’s wrong with you!”

Yet if someone wants to discuss the role of vitalism, spirituality, or the ‘god-factor’ in healthcare, all hell breaks loose with mockery and disdain for our colleagues of a different ilk. Indeed, this remains a tough subject that we must reconcile to move on.

Let me suggest everyone watch a YouTube video featuring the leading physician in this country, Francis R. Collins, MD, PhD, past director of the Human Genome Project and presently director of the NIH, “We Need Two Kinds of Truth: Why I Don’t Want Science or Religion to Win.”

Dr. Collins mentions:

“Surveys I have seen indicate about 40% of scientists believe in a God to whom one may pray in expectation of an answer…I think whether or not scientists are believers should not have a whole lot to do with how they conduct science.  The fact that I am a believer, as far as I am aware of, has had very little influence on my scientific work.” 

I remain perplexed that the majority of physicians and medical scientists are agnostic considering they work in the “life” sciences. Indeed, they seem to have taken the “bio” out of biology by refuting the presence of any “vital” force in health and the healing process.

It’s not even a matter of science versus religion, but a matter of tolerance. I would hope that I don’t have to be an atheist in order to be an evidence-based chiropractor or an evidence-based journalist.

I particularly like Dr. Collins’ remark, “The fact that I am a believer, as far as I am aware of, has had very little influence on my scientific work.” Or my clinical practice. Perhaps I’m being naive or optimistic (no, not me), and I’m sure to hear from those opposing my viewpoint.

Hang Together

Methinks we are drawing the wrong line in the sand to split and weaken our profession; we have much bigger foes to fight, such as the medical profession and the media bias. We certainly don’t need a Civil War in midst of the medical war against chiropractors.

Indeed, the United States would never have “formed a more perfect union” if everyone had to believe in the same religion or same political party or the same clinical techniques.

This war of words alone will never end the lack of bipartisanship. I say let the marketplace decide what type of service the consumers want and what type of DC they prefer, which is the present situation in medicine that offers a wide variety of ideology among practitioners from atheists to believers to those who just don’t care one way or another but still work together to maintain their hold on healthcare.

While I don’t care about anyone’s personal philosophy, religion or sexual preference, my main quandary about the vitalists is not their ideology, but why they ignore this huge market that we should capture.

Even those DCs claiming to be America’s primary spine care providers come under fire by “principled” DCs who have little interest in capturing a larger share of this huge LBP market that now accounts for $177 billion annually.

As the Gallup-Palmer and WFC Identity surveys discovered, our main PR pole is LBP. Although not as sexy as neurophysiology or vitalism, LBP is the public’s first foot into the door of most chiro offices.

Professionally, I suggest we lay claim to be the primary spine providers since the research and guidelines support this position. Instead of fighting inward, we need to make our case as Dr. Marc Siegel suggested that PCP MDs are inept in MSD, pain clinics are polluting communities with ESI and opioids, and spine surgeons have gone wild. The facts are clear on all counts. My books are filled with similar references from spine researchers around the world.

This gridlock reminds me of a quote attributed to Benjamin Franklin who said, “We must all hang together or most assuredly we will all hang separately,” an issue some DCs have yet to learn. Just as America was founded on freedom of religion and freedom from religion in order to form our union, I suggest our profession do the same.

As Forrest Gump would say, “That’s all I have to say about that.”

There were many other impressive events, notable people, and important issues at DC2017. All in all, it will be known as the best chiropractic assembly in our profession’s history. As Dr. Scott Haldeman urged, perhaps at the next joint conference there will be 5000 instead of 1500 attendees, hopefully including you, too.