The Federation of State Medical Boards of the United States, Inc. was recently presented with a report and recommendations from the Special Committee on Health Care Fraud.1 This report directed state medical boards in "evaluating, investigating, and prosecuting physicians engaged" in questionable health care practices. The thrust of the report is to squelch "unconventional medicine" practiced by MDs. Eleven recommendations were made to state medical boards to identify, investigate, evaluate, bring disciplinary action, legislate, educate and collaborate. The report's conclusion sums it up:
"It has been estimated that up to $100 billion is lost to health care fraud in the United States annually (Stern, 1994). Medical interventions that do not conform to prevailing scientific standards are becoming increasingly popular. It is estimated that in 1990 Americans made 425 million visits to providers of 'unconventional' medicine, exceeding the number of visits to all US primary care physicians, at a cost of approximately $13.7 billion (Eisenberg et al., 1995). It may be recognized that some alternative therapies may be beneficial and therefore warrant further investigation and possible integration into mainstream medical practice. However, because of the lack of reliable scientific evidence and clinical validation, safety has not been established for most of these modalities. Questionable health care practices can pose significant risks to the public safety, either by causing direct patient harm, or indirectly, by being needlessly expensive, delaying a more effective treatment, or from being administered in an incompetent manner. This proliferation of questionable health care practices and promotions will continue if left unchecked and unregulated. State medical boards are charged with protecting the public from the unprofessional, improper, incompetent, unlawful, fraudulent and the deceptive practice of medicine (Essentials. Section I) and, therefore, state medical boards must assure that physicians practice responsible medicine."Under its recommendation on evaluation, the report suggests that medical boards utilize organizations such as the National Council Against Health Fraud (NCAHF) to "provide reliable information."
"To consumers: Chiropractic theory is nonscientific, and most chiropractors have not been taught to practice on the basis of the same body of knowledge about health and disease recognized by health scientists around the world.The report to the medical boards also suggests obtaining information to "provide a foundation for research into questionable health care practices" from the following resources:"To Legislators: Recognize that legislatures have the greatest power to control chiropractic practice. Regulatory agencies and the courts can only enforce the laws passed by legislative bodies.
"To Attorneys and Law Enforcement Agencies: Recognize that litigation offers an effective means to bring reform to chiropractic.
"To Medical Doctors, Dentists, and Other Scientific Health Care Providers: Limit your professional association to chiropractors who reject the cultism and pseudoscience of chiropractic and meet the criteria for scientific practitioners as suggested by NCAHF."
Reader's Guide to Alternative Health Methods, Zwicky, John F, PhD, Hafner, Arthur W., PhD, Barrett, Stephen, MD, and Jarvis, William T., MD. American Medical Association 1993.Note that Drs. William Jarvis and Stephen Barrett are authors or editors of three of the above books and are founding board members of the NCAHF. And while The Health Robbers is no longer available in most bookstores, that hasn't kept Dr. Barrett from expressing his viewpoint. He has put "Quackwatch" on his website. His web page "Don't let Chiropractors Fool You" comes complete with a photograph and description of a patient "proven to have been killed by neck manipulation."Alternative Medicine: What Works, Fugh-Berman, Adriane MD, Odonian Press, 1996.
The Vitamin Pushers: How the "Health Food" Industry is Selling America A Bill of Goods, Stephen Barrett, MD, and Victor Herbert, MD, JD, 1994, NY: Prometheus Press.
The Health Robbers: A Close Look at Quackery in America, edited by Stephen Barrett, MD and William T. Jarvis, PhD, Foreword by Ann Landers, 1993. NY: Prometheus Press.
HealthSmarts, John H. Renner, MD, 1990, Health Facts Publishing, 300 E. Pink Hill Road, Independence, MO 64057-3220.
The Honest Herbal, 3rd Edition, Varro E. Tyler, PhD, 1993, Pharmaceutical Products Press, Division of The Haworth Press, Inc., 10 Alice St, Bighampton, NY 13904-1580.
Examining Holistic Medicine, edited by Douglas Stalker, PhD and Clark Glymour, PhD, 1985, Prometheus Press, NY.
For years, these same people and organizations have tried to convince the public to stop seeing "nonscientific" chiropractors (and other providers); to stop using vitamins, homeopathic remedies, etc. Despite their intense efforts, the trend towards "alternative" care has not only continued, but grown dramatically.
And while people like Drs. Barrett and Jarvis have been unable to stop the public from making its own health care choices, they are not completely without success. It appears that state medical boards may now decide that chiropractic and other forms of "alternative" health care are unsafe in the hands of an MD. Perhaps they have a point.
One can only hope that after the NCAHF and other groups finish educating the medical boards about the dangers of "manipulation" and other forms of care, that they will move on to the physical therapy boards.
Reference
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.
