Chief Medical Officer States: "We don't have any intention of supporting them (WCA) or giving them guidance or leadership."
A second article has appeared in the World Chiropractic Alliance's (WCA) Chiropractic Journal regarding a "Subluxation Panel." In the August issue, a front page headline story declared: "WCA to chair AHCPR subluxation panel." A subsequent interview by Dynamic Chiropractic staff with the director of the Agency for Health Care Policy and Research (AHCPR), J. Jarrett Clinton, M.D., revealed that there was no such panel sponsored by the AHCPR (please see "AHCPR Responds to WCA's Misleading Announcement" in the September 1, 1992 issue of Dynamic Chiropractic).
In its September issue, among other things, the WCA claims that the purported subluxation panel was "moderated by the Chief Medical Officer of the U.S. Agency for Health Care Policy and Research," Stephen H. King, M.D. Again, the editorial staff of Dynamic Chiropractic phoned the AHCPR, this time conducting an interview with Dr. King regarding the second article.
When asked whether he had in fact acted as moderator of the WCA meeting in St. Louis, Dr. King stated that he did not call or moderate the meeting. He went on to say: "The meeting was called and moderated by Terry Rondberg. I would not have called me a moderator or the head of the agency, that tends to be an irritation to the people I work for. My personal position is any time a provider group wishes to have us speak about guidelines, we will accommodate it. That is different from supporting it, moderating it, leading it or guiding it."
Dr. King made it clear that he spoke before the WCA group as he would for any other group of providers interested in developing guidelines. When asked what he thought of the meeting and if the AHCPR planned to attend any future meeting conducted by the WCA he replied: "I have no idea what they are going to do now. It's not something the agency felt it would be involved with at all. I do think they are going to have a hard time using the rules of evidence that they are required to go on."
The AHCPR is very interested in facilitating the development of practice guidelines within all health care disciplines. Dr. King had in fact heard about the Mercy Guidelines, but stated: "I have not been involved (with the Mercy Guidelines), but I think others in the agency have."
Unfortunately, the two misleading articles have caused a certain amount of concern within the AHCPR regarding the chiropractic profession as a whole, Dr. King explains: "A number of people have asked if we are assisting this group (WCA) in their development of guidelines. That's not true. We don't have any intention of supporting them or giving them guidance or leadership. I don't think this is helpful. I can't determine who's right. All I'm faced with is this discourse. I'm a little concerned about what appears to me to be a wider gulf between what seemed to be a single guild (profession)."
When Dr. Rondberg was contacted for an interview regarding the apparent discrepancies between what the WCA reported and what the AHCPR stated, Dr. Rondberg agreed to a written interview. Unfortunately, after receiving the questions in writing by fax, Dr. Rondberg declined to provide answers.
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.
