The excellent blog, Passive Aggressive Notes has a submission from a reader who rejected his chiropractor. Clay decided not to go back after the doctor refused to show him his x-rays unless Clay attended a seminar about payment plans and treatment options. A few days later he got a note that said:
Dear Clay,
Thank you for taking the time to chat with my office staff the other day regarding your care here at [redacted] Chiropractic.
I am sorry that you do not take your health seriously. When you decide to make your health a priority, please know we are available to help you.
I urge you to take good care of your health and contact us immediately if you run into any problems. It’s been a pleasure to be of service to you.
Oh, no! He’s not taking it seriously!
Spinal Manipulation [Passive Aggressive Notes]
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That is the most childish letter I’ve ever seen by a “professional.” Great stuff…
When I missed a well-child checkup for my son and called a month later to schedule it, the receptionist asked why I had missed it. I told her we’d just been busy and it got away from us. She replied, “So you don’t put your child’s health as a priority in our life?” I was so mad, I answered, “Apperantly not.” Then hung up. Never went back.
Doctors (chiro’s included) should be there as a medical advisor, not as a guilt trip and a dictator for what’s best for my family’s health.
Anyone else think this sounds a bit like a mob threat?
“Sorry you don’t take your health seriously, it could be useful if you were in, say, a car crash, while you were driving on the highway late at night.
See you soon!
XOXOXOXOXO
Chiro”
My wife and I went to a consultation and he gave us a slide show that ended with:
“If you don’t choose chiropractic you are gambling with your health”
“Uh…honey…let’s go”
@Git Em SteveDave thinks a friend with weed is better: oh please, not the “chiropractic is fake medicine.” Tell that to the millions who visit them for relief from pain that they can get no other way.
Wow… look at the chiropractic hatred…
So we are clear I am a chiropractor. Well, I was before I went to law school. I was a damned good chiropractor who made a business out of helping people who had legitimate issues. The irony is that I did not ascribe to the “you have to come into my office fifteen times this month” school of thought. I treated what I found, was honest with my patients, and did not attempt to practice outside of what I was taught in school.
The end result of so many DCs flooding the market with their questionable brand of healthcare (like the DC in the article)? I could no longer make an honest living. In the end I was $100,000 in debt with student loans, had a professional degree that was worthless outside my field of study, and I could not find work. All because I had this foolish idea that I could actually help people without the use of dangerous pharmaceuticals.
And for those that think chiropractors are not “real doctors” I challenge you to look at the curriculum of an accredited school. If you think that getting a DC is easy, you are SADLY mistaken. The four years I spent in chiropractic school made law school look like a walk in the park. I have never struggled with a more rigorous academic challenge in my life, including completing my BS in Chemistry while working full time.
There are many chiropractors out there who do great work. There are tens of thousands of people who would not be able to get out of bed each day without the good work their DCs have done. You are all casting a rather accusatory net over all chiropractors, and I would bet that the vast majority of you have never set foot in a chiropractor’s office. You’re just buying into the hype that the allopathic medical establishment has fed you (ie “there is no problem out there that cannot be solved with the broad application of drugs”).
The real problem with chiropractic is the management companies who train these DCs to be “better business people”. This includes high pressure tactics to get more visits out of people and ways to subvert the already shrinking insurance companies for more money. I have never agreed with that logic and left the profession for that exact reason. But that does not belittle the fact that chiropractic care works for many people.
We have an expression in the legal field that applies equally to chiropractic – “everybody hates a lawyer until they NEED one.” Chiropractic bashing is not new, and will likely never go away so long as there are DCs out there not properly educating the public and not putting their patients before their Mercedes payments. I saw more than my share of people who came to my office with tears in their eyes when they walked in our front door and a smile on their face when they left.
I can assure you that the next time you twist and lift a garbage can full of lawn clippings and feel your back pop you will understand what I mean… and when your DO tries to inject lidocaine into your back or your MD gives you Vicodin and muscle relaxers instead of treating the SOURCE of the problem, you will begin to see the light.
I like how so many people are talking about M.D.s being “real” doctors.
apparently, there are no bad M.D.s and they don’t want to just pump you full of whatever is the latest new drug they are getting spiffed for….
not to say there aren’t alot of good doctors…. but thats the undertone i was picking up on here…
There are plenty of chiropractors who are good people who charge reasonable prices and don’t promise to fix everything. The problem is that the chiropractors who act in the opposite way are very loud, as well as chiropractors who don’t promise the moon to patients but push other agendas separately, like weight loss/cleansing programs.
As far as osteopaths, in my experience, nowadays a lot of them don’t practice tradional osteopathy and just use it as an alternative to an MD.
Also, acupuncture and Chinese herbs really do work. As with everything else, you just need the right practitioner.
It seems like 90% of people who think chiropractors are quacks have never been to one. They always know a “friend of a friend” whose chiropractor is a quack. I’m sure there are some out there, like this stupid guy.
I didn’t think much of it, until my back locked up and I couldn’t stand up straight. I went to one and he showed me my x-rays right away. It turned out I have scoliosis and no M.D. had ever found it.
He didn’t say he could cure it, or anything else, but he could ease the pain. After a few visits it was much better. I didn’t have to go again for years. By then, I’d moved to another city and found another one. He also hasn’t scammed me. I only have to go maybe once a year.
My wife also had a back problem she didn’t know about, until one day she was in major pain. It was so bad she couldn’t walk, so she went to an M.D. All he did was give her two or three prescriptions for strong painkillers and told her to wait until it got better.
She went to my chiropractor, and he actually helped her. She has one leg longer than the other, and no M.D. had ever noticed it. She hasn’t had to go back in a year, either.
I had a TrueGreen ChemLawn guy tell me I must not care about my landscaping because I didn’t take their offer on some tree fertilization. Suddenly, I stopped caring about TrueGreen Chemlawn, completely.
This kind of “if you don’t use us, you don’t care about X” type of threats and insinuation makes me insure I don’t care about that provider of services anymore. That’s one of the fastest ways to lost my business.
@Sasha_Pie: My grandfather had a Chiro work on him. He’s had severe arthritis for years, and that visit put him in a wheelchair for months. He was always a very self-sufficient person up until that point, and emotionally it crushed him. He’s passed away now, but I have no doubt that chiro took several years off his life, as well as the quality of the time he had left.
@ericole: Popularity is not proof of efficacy. The problem is that often a lot of the diseases “treated” by chiropractic, alternative medicine, and the like have subjective symptoms. So it’s hard to tell whether it actually helps all those people or if they are just choosing to ascribe relief they subjectively feel to the treatment. You have to do a controlled experiment to determine whether it really works, and it’s hard to do that with something like chiropractice. Like I said, I’m sure it “works” for some people, but I’m not sure that it’s much better than a good massage.
@BrotherMonk: Chiropracters are not “real doctors” in my mind until they provide a scientifically plausible theory for why their treatments can be used to treat anything beyond muscle and bone pain. And provide evidence that they are better than other similar treatments like massage or physical therapy. I’m not buying into any “hype” the “allopathic” medical community has fed me. I’m just saying that if their stuff works, they should be able to at least provide a theory of how it works that isn’t utter BS when evaluated in the context of scientific biology and medical science.
@CPC24: Anecdotal, subjective experience is not proof of efficacy, nor do I need to use one to know that a lot of their theories are ludicrous. I know that it will kill me to drink a vial of cyanide, and I don’t need to “experience” that myself to know it.
Like I said, I’m sure they do help some people feel better. But I’m very skeptical that they do anything a highly experienced massage therapist couldn’t do.
@johnva: My chiropractor has never claimed to be able to treat anything beyond muscle, bone, and nerve problems. Is he a “real” doctor?
@johnva: Oh, and as for the “subjectivity” thing you mentioned… I saw my mom’s “before” and “after” x-rays. There was definitely an objective change.
@HeartBurnKid: Real doctors are trained in treating a lot more than that. Why are DC’s supposedly so heavily trained in a variety of things (they always like to claim they know as much as MDs do) if they can’t treat anything beyond that?
I’m not saying that there isn’t some measurable change that takes place. An objective change may result from chiropractic treatment, just like it might from a massage. I was saying that the reason for the POPULARITY of chiropractic is because it treats subjective symptoms that are hard to quantify. So people may “believe” it worked even if their pain relief had nothing to do with the chiropractor.
Wait.
Isn’t it illegal to refuse a patient their medical records?
“Dear Customer,
We are disappointed to hear that you do in fact care about your financial security and have decided not to bank with Bank of America.”
now that would be funny.
Chiros are quacks. Chiro school teaches you more about how to fleece patients than actually fix anything medical.
@SacraBos: Right, as if to tell us there aren’t any alternatives. It just screams “desperation pitch” when they say it. If you’re that desperate for business, you can’t be that good to begin with.
@donkeyjote: I can’t vouch for acupuncture as a healing solution, because I just don’t believe in it. But it does work for short-term relief, which is usually all it takes when your body is healing itself. The best case I know of is when my father threw out his back right before a cruise. It got worse and worse until he couldn’t walk, and the only relief was an onboard acupuncturist. That at least got him to a point where he could walk around, though still in pain.
Later on, when he had to go through the bullshit of waiting around for doctors’ appointments to actually get things diagnosed and fixed, he went every now and then to another acupuncturist so he could manage (pain pills weren’t an option, nor should they be the only option). If you consider the “science” behind acupuncture, it’s not really any different from a placebo if all it’s providing is relief, and that’s really the point.
People who believe it’s healing them, well, that’s a bit of a stretch guys. At least see a doctor or two and have some tests done, even if you think they’re as quackery as alternative medicine.
Note there are two kinds of chiropractors: the ones who view their profession as a form of basic physical therapy and the ones who believe in subluxation and that chiro is the cure to all that ails anyone. The former are well worth seeing for the sorts of issues that you would go to any physical therapist for, the latter are witch doctors at best.
@chrisjames: Well, acupuncture at least has a potentially plausible scientific explanation for why it might provide relief: the needles might stimulate the release of endorphins, which could help with the pain for a short time. So yeah, things that might have scientifically plausible explanations should be investigated. I just don’t buy the non-scientific “theories” behind a lot of this stuff.
@revmatty: Well, why don’t the supposed “good” chiropractors police their own? They should if they want their profession to be seen as respectable. They could lobby for laws banning chiros from treating diseases for which the only theory behind the treatment is “sublaxation”. Also, if they’re just glorified physical therapists, why do they constantly try to compare themselves to MD’s and call themselves “doctors”?
@BrotherMonk: If you go to a DO for the situation you described (wrenching your back while performing an unsafe lift of a bin of yard clippings) and ALL he or she does is inject lidocaine into your back, they didn’t pay much attention in school.
There are definitely DOs who went to an osteopathic school because that’s where they got in, but there are some who actually learn and use OMM. If you think chiropractors should be evaluated individually and not tarred with the same brush that’s used on the bad ones, you should probably offer the same courtesy to DOs.
@johnva: All medical alternatives–snake oil, prescription medication, herbal medication, surgery, osteopathy, physical therapy, magnet therapy, prayer, etc–deserve investigation. Scientific inquiry into the component parts, no matter how asinine they are, is how the field as a whole is improved. And, just because you can’t investigate the spiritual aspects of an alternative doesn’t outright disprove it scientifically, it’s just unverifiable. Though to me, an unverified practice is as good as a harmful practice when it comes to health.
On the flipside, I don’t need scientific inquiry to tell me to avoid the spine crackers. Good old common sense and self-preservation are enough.
Here’s what I know from the medical community: Chiropractic works as well as placebos do. If it seems to work for you, then great. Just don’t go broke doing it.
Acupuncture actually does show signs of providing significant pain relief. Acupuncture seems to cause the body to produce endorphins and such. But it doesn’t always work.
@revmatty: The subluxations ones are known as “straights” and the others who use physical therapy are “mixed”. The problem is that the ones who are mixed do provide a sort of legitimate service. But they provide it for the wrong reason. A physical therapist or Osteopath train to alleviate the pain and attempt to cure. The straights and the mixers train to balance the energies and other hokum, during which their manipulations may alleviate the pain, but it was almost a side effect. So yes, there are ones who do help people.
I bet that the actuaries could tell you who did the most harm. Can anyone compare the malpractice rates of Medical Doctors vs. Chiropractors?
I have heard stories of MDs being driven out of fields like obstetrics because of malpractice premiums. How much do the chiros pay?
I grew up in the insurance industry and an actuary can get risks down to what side of the neighborhood you live on, car color you choose, and choice of profession. Whichever person does more harm is probably paying the higher malpractice rates. Does anyone have this information?
I went to a chiropractor for a couple of weeks. My back was bothering me, probably due to picking up my kids. I knew at the time it was a scam, but I wanted to see if they could help me quickly.
After about 3 weeks (10 visits), I was feeling much better, I told the receptionist that I did not need to make another appointment, I was cured. Everyone in the office stopped what they were doing and just looked at me. I don’t think they had ever heard someone say that. One of the staff went to get the back cracker, and he came to talk to me immediately. I think he left a lady on the adjustment table.
I told him that I was cured and felt great. He wanted to discuss an ongoing treatment plan, and I told him that if I ever had problems I would be back.
Just the look on everyone’s faces when I said I was cured was priceless.
@Mr_Human:
@quail:
Make sure you actually read the article you are quoting before you quote it. That consenses from the NIH starts out with big red letters
“This statement is more than five years old and is provided solely for historical purposes. Due to the cumulative nature of medical research, new knowledge has inevitably accumulated in this subject area in the time since the statement was initially prepared. Thus some of the material is likely to be out of date, and at worst simply wrong. For reliable, current information on this and other health topics, we recommend consulting the National Institutes of Health’s MedlinePlus”
[consensus.nih.gov]
There are substantial problems with trying to quantify the benefits of acupuncture. “Pain” is extremely subjective and asking someone to rate how they feel before a treatment and to rate how they feel after a treatment on a scale of 1 to 10 can result in utter crap for data. I don’t doubt that people can leave an acupunctureist and feel like it has done wonders for your pain and this might be more than just the placebo effect. What is likely happening is a fare amount of relaxation. I am just kinda making some assumptions on this one, but I would expect that after the initial fear that this needle is going to hurt, the process is likely quite soothing. Also, all throughout the process you are going to have a person with fancy pieces of paper that have his name on them all over the wall telling you that this spot is going to do this.
Chiropractic HAS been found to have the same benefit for lower back pain as real physical therapy, and it also costs just about the same, but there is a real risk of serious, permanent damage from chiropractic that make physical therapy the obvious choice for treating lower back pain.
If a chiropractor tells you that he can make your other problems go away (disease, depression, ADHD) they are full of crap. You may feel that alternative medicine is helping you, but studies show that this is a placebo effect and there is no reason to throw your money down the drain for these solutions that are not helping you.
I’m going to chalk this one up to a simple English misuse. Was the chiropractic foreign? English is SUCH a difficult language to master!
Brothermonk:
I too am a chiropractor and could not of said it better myself.
Its true. I went to chiropractic school and it was the hardest thing I ever did. I received a Bachelor’s at a major university and also went to culinary schools that were breezes in comparison. I remember many of my chiropractic classmates that I would not want to be ten feet near their office even today. Chiropractic is like any profession in that there are good ones, bad ones, and very bad ones. Research the reputation and expertise of any chiropractor as you would research a mechanic you are taking your Ferrari in for a fix.
While it is true that a chiropractic treatment plan may not follow the “logic” of many allopathic treatment plans, thus is often confounding to many MD’s, there are a few warning signs that one should be aware of when considering chiropractic care.
Don’t ever agree to any “pre-payment” type plan. A good chiropractor will adjust his/her treatment plan according to how the patient is responding to treatment of specific conditions and this is rarely predictable. Even if a chiropractor believes that he/she can cure cancer or something with chiropractic, a good chiropractor will recognize their own scope of practice and not let their ego get in the way of referring or recommending a patient to proper specialist if/when chiropractic alone is not solving the problem. There is a fair amount of research that supports chiropractic care especially when it comes to musculoskeletal injuries and rehab. [www.fcer.org] as well as, the ACA at http://www.amerchiro.org/ are good sources to begin or review research. The peer reviewed periodical “Spine” often has articles from Orthopods, Osteopaths, PT’s and Chiro’s as well. Unless an MD is a Neurologist, Orthopedist, or PM&R Doctor they have little or absolutely no orthopedic training and even most PM&R Doctors remember little of their rehab training. PT’s, sadly, are at the mercy of whoever the MD is that prescribes Physical therapy and PT’s do not have the ability to diagnose musculoskeletal problems (often a source of frustration with PT’s that I’ve worked with in a hospital setting). Even the AMA acknowledges that an average chiropractor will better diagnose musculoskeletal disorders than an average MD. Being a patient in any doctors’ office today is much different than years ago. A patient must be smarter and more assertive when choosing any doctor as there is currently a flood of physicians in this country and many of the bad doctors be they MD’s, DO’s, or chiropractors are in it just for the money. Buyer Beware.
@johnva: You know, you’re really not worth arguing with at this point. You’re just looking for excuses now. You gripe that chiropractors claim to be able to treat everything, then when I point out that that’s not true of all chiropractors, you claim that the fact that they can’t treat everything is enough to prove they’re quacks.
Seriously, now, my general practitioner can’t treat a muscle tear. Does that make him a quack?
A surgeon can’t treat leukemia. Does that make him a quack?
A proctologist can’t treat tonsilitis. Does that make him a quack?
Face it, now, you’re just reaching for straws.
@HeartBurnKid: No, I’m not “reaching for straws”. My point was this: what is the point of going to a chiropractor, as opposed to a physical therapist, if the chiropractor isn’t any better than a PT person? The other chiros that DO claim to be able to do more are worse, because they can’t back up their claims. So chiros are either a superfluous profession or quacks (and the majority are quacks). Either way I can’t see why anyone would go to one.
Johnva, to go to a PT you have to be refferred to by an MD who provides the diagnosis thus you are paying twice as much. A PT cannot legally diagnose. A chiroprator has more training than a PT. I worked for a hospital as a PT aid when deciding on chiropractic or PT school. If anything, PT’s are second rate chiropractors whose power in the healthcare profession is neutered and dpendant on the refferals of other doctors. The only bebfit to being a PT is that you may get a little less hassle from insurance companies when you are trying to get your bills paid.
My father is a chiropractor and also does acupuncture. I had a pretty bad car accident a few years ago and after some acupuncture treatments that I was highly skeptical of, I got pain relief that even my Oxycontin prescription wasn’t giving. I don’t get adjusted too much as my back normally feels fine as it is, but to me a good Chiropractor is the first person I’d go to if I had a back injury that didn’t require immediate surgery. It helps that my dad did his internship at a large orthopedic surgeon’s practice and knows the limits of his scope of practice.
The fact of the matter is that like the old joke goes,
“What do you call the guy who graduates last in medical school?”
“Doctor.”
The same is true of the Chiropractic world. For what it’s work my dad was valedictorian of his class. Maybe that’s why I have such a positive view of it.
@BrotherMonk: “You’re just buying into the hype that the allopathic medical establishment has fed you (ie “there is no problem out there that cannot be solved with the broad application of drugs”).”
Really? You mean we’ve been telling patients that there’s no problem that we can’t fix with our drugs? Gee, I guess that orthopedic surgery we do isn’t actually real, see, we’re obviously just giving the patients drugs when they’re out.
I guess I better tell my MD colleagues in physical medicine that the therapeutic work they do with PTs every day is just part of that “hype” machine, too.
Thank you so much for enlightening me! My entire profession must be a sham now! I should never have gone for my MD!
@Johnyalamo: “Even the AMA acknowledges that an average chiropractor will better diagnose musculoskeletal disorders than an average MD.”
I’d like to see your source. I’ve been a member of the AMA for years, and while I’ve been more involved in the political and community service committees, that sounds like something that would make news.
@Johnyalamo: I don’t care about that, considering that if I go to a PT, it’s only going to be because my doctor told me to (I actually talk these things through with my doctor). When I did see a PT person, it was because my doctor sent me. I have no interest in getting diagnosed with anything by a PT or chiropractor.
@Johnyalamo: Oh, and I’m glad that insurance companies hassle chiropractors. Insurance is expensive and unaffordable enough without them paying for a bunch of quack treatments (which is what the majority of chiropractic seems to be). Healthcare dollars should be spent on things that are proven to work, not alternative medicine.
@colinjay: You bring up a good point – if you are looking for a good chiropractor, you should probably discuss it with a doctor you trust.
IIRC, The American Medical Association has said that chiropractic treatment can, for many people, be an effective treatment for low back pain.
@Monoplex: See, that’s what I remember hearing- not that chiropractors can do a ‘better’ job Dx’ing MSkel disorders than an average MD. I’m still hoping for that link, as mentioned earlier.
ugh. this “doctor” is a joke.
If only chiropractors took medical science seriously…
I believe it was a study 5-6 years ago out of Spine Journal at: [www.spinejournal.com] . But yes, as you regular General Practicioner rarely has any Orthopedic training, and the average chiropractor has far more hours of neurological, ortho, Radiological and anatomical teaching hours in school, the average chiropractor was found to be a better diagnostician when it came strictly to musculoskelatal disorders.
And Johnva, it would be nice if the lawyers would police the lawyers and the Med doctors would police the med doctors. Hell, the police should police the police.
But quacks? Come on. Take a look at this: [www.licensingreform.org]
I had hoped we could all have a civil, intelligent and informed discussion about these issues without resorting to mockery and sarcasm. Always the idealist I suppose…
GearheadGeek, you are correct in pointing out that my statement did seem to overgeneralize the practice of Osteopaths. That was not my intent, and I apologize if it came across that way. My general practitioner for many years was a DO, and I was very happy with his depth of knowledge and skills as a diagnostician. Your comments are noted and I will try to continue to keep my mind open.
DoktorGoku, I certainly am not stating for the record that ALL medical doctors utilize pharmaceuticals exclusively to treat their patients. I am not so foolish as to make this kind of blanket statement. But I will say, having worked for several years in a personal injury law practice, that the vast majority of the medical doctors I have dealt with IN MY EXPERIENCE rely on a short list of muscle relaxers and pain medications to treat acute musculoskeletal injuries. Their primary interest is in treating the subjective pain and not always in determining the objective source of the pain. There is rarely talk of PT or rehabilitative work until much later in the process, and then only if their regimen of prescription drugs don’t do the trick.
On the subject of surgery, I have seen an increasing number of poorly performed surgical procedures that have resulted in patients with life-long complications as a result. In my humble opinion, surgery should be an option of last resort for individuals with musculoskeletal issues. While I am always open to new treatment options for those in pain, it would seem wiser to explore the variety of pain management options available before allowing someone to cut you open.
What I am amazed by is the simple fact that many people tend to overlook natural means of solving a problem as opposed to the old “magic bullet” idea that a brown plastic bottle full of pills is going to make them better. I was always trained to look at ALL forms of therapy objectively and to keep an eye open to the subjective statements from my patients. I was taught that the driving force behind treatment was always the wellness of your patient, and that included seeking the advice and care of practitioners from all disciplines and walks of life (what is commonly called the Holistic approach). The simple fact is, if a given modality works for a given individual, it cannot and should not be overlooked.
What amazes me even more is, eight years after I left the arena of chiropractic for the oh-so-glamorous life of an attorney, I STILL find myself defending my former profession.
An interesting read for those screaming “quackery” is found here
@BrotherMonk: “I certainly am not stating for the record that ALL medical doctors utilize pharmaceuticals exclusively to treat their patients. I am not so foolish as to make this kind of blanket statement.”
Yet, you said earlier: “You’re just buying into the hype that the allopathic medical establishment has fed you (ie “there is no problem out there that cannot be solved with the broad application of drugs“).”
That sounds like quite the blanket statement to me.
What you said in your last comment sounds a lot more reasonable, and yet, I’m sure I don’t have to explain that you worked in a personal injury law office, as you mentioned. That would be like somebody in Internal Affairs saying that all the police officers they worked with were corrupt. To quote the vernacular, that gets a screaming “Duh!”
Also, that last link you’ve posted for “those screaming quackery” isn’t exactly reliable. Not only is some of the stuff there hilarious, but I tend to put more trust in a scientific journal a random-looking 90′s era website.
@Johnyalamo: I’m still waiting for the actual link/document/etc. that proves what you said. I’m not going to do your research for you, and any decent doctor knows that you have to be able to back up anything you say or quote with direct evidence. Vaguely stating that it might be in a journal doesn’t help one’s case, it hurts it.
scientific journal instead of*
@StankGunner: Note also the fairly recent study that showed that *fake* acupuncture is about as effective “real” acupuncture, which sort of indicates that maybe you’re seeing placebo effect. See also RSI pain study. As noted above, pain is subjective.
Quackcast covers this topic in episode 27 nicely and he also discusses the use of brain imaging showing that while the perception of pain is decreased through the use of acupuncture (or placebo) the objective measures (range of motion, flexibility, etc) remain unchanged.