More Looney Tunes
To the Editor:
In a recent commentary, "FCER Forum: The Enduring Qualities of Looney Tunes" [Dynamic Chiropractic 2002 (Apr 22);20(9):16,18-9,35], Anthony Rosner,PhD, laments the "buckshot condemnation of everything chiropractic" offered by a Time magazine online columnist. We, too, were distressed by the way this element of the media distorted a recent critique of unsubstantiated claims for the value of chiropractic care offered by state and national professional associations in Canada and the United States (Grod, et al., 2001). Unfortunately, Dr. Rosner serves up more ammunition for this critic of chiropractic with his own buckshot spray of unsubstantiated claims:
"...the vast majority of other published studies in that same journal (JMPT)... have indicated that chiropractic treatments not only match the medical alternatives for treating such diverse conditions as back pain;20 carpal tunnel syndrome;21 cervicogenic, migraine and tension-type headaches;22-25 dysmenorrhea;26 premenstrual syndrome;27 infantile colic;28 enuresis;29 and even ear infections,30 but do so for longer durations after treatment and without the common, injurious or even fatal side of medications."
There's too much offered here to disassemble it all in a letter, but let us pick one from this medley of claims. Has chiropractic treatment been shown to be more effective, longer lasting or safer than medical treatment for enuresis? Not to our knowledge. Dr. Rosner cites a randomized, controlled clinical trial of adjusting (Reed et al., 1994) in support of his assertion. Yet, as reviewers have already noted (Haas, 1995; Keating, 1995), this study had both methodological flaws and over enthusiastic interpretations of results. The supposed benefit of adjusting was not greater than one would expect from support and encouragement of the parents of bedwetting youngsters, this based on previous studies of other methods. In fact, the data suggested that any benefit of adjusting fell short of what might be expected of some medications (e.g., desmopressin), and far short of what might be expected from behavioral methods of treating childhood nocturnal enuresis. However, since Reed, et al., did not specifically compare adjusting to any other established treatment method, Rosner's claim that chiropractic care imparts a longer acting or safer method of intervention for enuretic patients is speculative at best.
What logic can there be in replying to criticisms of unsubstantiated claims with more unsubstantiated claims? Looney tunes!
Joseph Keating Jr., PhD,
Homewood Professor
Canadian Memorial Chiropractic College
David Sikorski,DC,
Associate Professor
Southern California University of Health Sciences
References
Editor's note: This is a letter from a California high school senior to Governor Gray Davis, prompted by our April 8, 2002 article," Demise of the California Board of Chiropractic - A Gray Davis Conspiracy, or Lack of Campaign" (www.chiroweb.com/archives/20/08/01.html). Our article reported that Gov. Davis had made no appointments to the California Board of Chiropractic Examiners (CBCE) during his term; the terms of the two remaining DCs on the board had expired, and they were serving under a one-year grace period. In the April 22 issue, we reported that Gov. Davis had responded to our article (and the many calls and faxes to his office by chiropractors) by making two appointments to the board (one DC and one attorney), but three seats were still vacant. (See "California Governor Davis Responds to DC Article" on p. 43 of the April 22 issue, or go to www.chiroweb.com/archives/20/09/04.html.)
April 9, 2002From: Jennifer Parker
To: Governor Gray Davis
State Capitol Building
Sacramento, CA
RE: California Board of Chiropractic Examiners (CBCE)
I am a Temecula Valley High School senior taking a government class this trimester. I'm working on a project called "Participating in Government." My Dad is a very dedicated, caring and well-respected chiropractor. He practiced tirelessly for over 21 years and served thousands of patients. He now shares his wisdom and time assisting chiropractors with many aspects of their practice and business procedures. My Dad also served as a board member of the International Chiropractors Association of California for many years. I know he will join me in bringing statewide attention to the CBCE issue.The article I chose for my research project is informing every chiropractor in California and an unlimited amount of California voters about your "lack of action" in the appointments of chiropractors to the CBCE. You are holding applications and have not made a single appointment to CBCE during your entire term. The CBCE has not even been able to hold an official meeting since July 2001. You found the time to make 13 appointments to the California Medical Board, and seven other boards (including the Horse Racing Commission?!). "A functioning licensing board is vital for California chiropractors" for regulations, legislation and safeguarding the practice of chiropractic.
My family and friends throughout the U.S. have our incredible great health "thanks to chiropractic!" ... along with two million chiropractic patients in California (eight percent of the state's population). I will be one of thousands of graduating seniors this year eligible to vote in the upcoming California elections. I plan to make this topic known through a multitude of sources. I am urging you to respond to my letter and begin making the necessary appointments on behalf of the chiropractic profession.
I grew up in a very health-oriented family and live by the motto that chiropractors teach their patients, "If you wear out your body, where are you going to live?" Think about it.
Yours in Health,
Jennifer Parker
Dear Editor:
I note a letter from Dr. Mark Van Hemert,DC (www.chiroweb.com/archives/19/12/15.html) lamenting the fact that apparently he was dropped "like a hot potato" as a reviewer or panelist for the CCP Guidelines. He wonders how Dr. Christopher Kent chose not to have him "re-elected," when, as far as anyone can tell, there never were any "elections" in the first place. He seemed surprised that his questioning of Dr. Jay Holder's alleged bogus credentials and his desire to see more definitive language in the Guidelines fell on an unreceptive audience. He was surprised that alleged "votes" were taking place without any of the other panel members even being notified of such an event.
Is it possible that people have not figured out yet what the CCP Guidelines are? Are there still some in this profession who don't know what's going on? How could someone actually working on the CCP Guidelines be really fooled into believing that there was ever any real legitimate purpose for the CCP Guidelines? It was always intended to be a scam! Wake up and smell the coffee - it was a way to counteract the Mercy Guidelines, which actually did have a consensus of chiropractic experts, educators, scientists and scholars! But the Mercy Guidelines actually required a measure of accountability and dared to question some techniques and unproven methods within chiropractic.
Bottom line? We want more money! And open-ended guidelines make that easier than actually having to show what we do is based on good health care. Chiropractors of that mindset needed something that looked official so they could say to the insurance company; "These guidelines (CCP) support my voodoo technique," and ask "Whaddaya mean '200 visits are too many'?"
Look at the chief instigators of the CCP: Terry Rondberg, Christopher Kent, Patrick Gentempo, Jay Holder, and others of similar ilk, though lesser known. And what about practice gurus like Greg Stanley, David Singer, Chuck Gibson, Ian Grassam? Since when do they have the scientific background to qualify as experts on technique and science? I'm sure there were also some legitimate scholars who were duped into at least some minimal participation for whatever reason, though I wonder how many of them regret it now.
The CCP Guidelines were and are a joke. They are nothing but an attempt to put a scholarly spin on what is pure and simple money making pap and nonsense. Their only purpose was to open wide the doors to treat anybody, using any method, for as long as possible, with the least accountability as possible. Has anybody actually looked at the practice guideline publication? Read the "rag" sometime and show me what qualifications they put on anything! Was there some critical thinking applied to any method, or any parameters of care? Did they find any method or technique "investigational"? Did they raise substantive questions about frequency of care, or effectiveness of various methods and techniques? Was there anything they found to be ineffective or questionable? Absolutely not!
I think they could have saved a lot of paper if they'd just had a single page between the covers that stated; "These CCP Guidelines are issued as a pseudo-scientific response to the Mercy Guidelines. If any doctor of chiropractic wants to justify waving dead chickens over his or her patients while chanting to the druid gods, please feel free. We'll back you up with this "practice guideline," which will be carefully footnoted and documented, to allow you to cite them in reverential tones, when an insurance company doesn't want to pay for this essential "dead-chicken-chant" therapy."
In my opinion the CCP Guidelines are useless. It doesn't even make a good paperweight since it's little more than a brochure "on steroids." Take out the ad nauseum references, which I bet no one on the panel of experts even read, and other fluff, and you're left with even less. I have learned over the years in this profession that leopards don't change their spots. If you see the fingerprints of certain people, you can usually be assured that there are hidden agendas, drums of snake oil, pretense and hypocrisy. That's when I have to laugh to keep from crying. So - buck up, Dr. Van Hemert! You're well to be rid of them! "Hit the showers"and count it as a lesson better learned late than never.
Dr. Garth Aamodt
Grand Rapids, Michigan
gaamodt@home.com
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
