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Dynamic Chiropractic – June 4, 2007, Vol. 25, Issue 12
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Dynamic Chiropractic

One Step Forward, Two Steps Backward

The Latest Reasons to Support a National Public Relations Campaign

By Peter W. Crownfield, Executive Editor

With each testimonial by a professional athlete or entertainer who attributes their success to, among other things, chiropractic care, the profession takes a small but significant leap forward in terms of public acceptance.

Unfortunately, the ringing endorsements seem to be followed quickly by negative assessments of chiropractic that threaten to overwhelm the positive press the profession receives. In essence, for every step forward, we take two steps backward. For the latest examples, consider the May 2007 issue of SELF magazine and the March 19, 2007 issue of U.S. News & World Report.

SELF Magazine: Scare Tactics

Readers need look no further than the title and introductory teaser to this article before forming a negative opinion of the chiropractic profession. "A Deadly Twist" begins with the following: "Chiropractors are causing strokes in young, healthy women. Read this before your next appointment." And with a few uninformed strokes of his pen (read: keyboard), the author may have made millions of potential patients frightened of chiropractic care.

The first 10 paragraphs tell the story of Christa Heck, "a 43-year- old mother of four from Mahopac, New York, [who] had been seeing a chiropractor on and off for 20 years to treat headaches and lower-back pain." According to the article, she suffered a stroke after two visits to a new chiropractor recommended by a friend. Also profiled briefly throughout the article are three other chiropractic patients who suffered strokes following neck manipulation.

The title, teaser and horror stories undoubtedly will do enough damage on their own, especially for readers unfamiliar with the benefits of chiropractic care. However, the article does include a few positives: comments from ACA spokesperson William J. Lauretti, DC ("A stroke following a manipulation is phenomenally rare") and Wouter I. Schievink, MD, director of the vascular neurosurgery program at Cedars Sinai ("It's not a simple black-and-white issue that someone who visits the chiropractor and then suffers a stroke can say clearly it's the chiropractor's fault. It's not always clear what came first, the dissection or the manipulation").

Perhaps the most positive comment in defense of chiropractic comes from Dr. Lauretti, who says, "A good chiropractor doesn't merely grab people's necks and crack them. You take a thorough exam. If there is a history of dizziness, stroke, visual or auditory disturbances, and to a certain extent a history of migraine, I'm going to be much more cautious." According to the article, Christa Heck complained of dizziness, nausea and headache after receiving her first cervical adjustment. (Note: For more information on the potential consequences - albeit rare - of inadequate patient examination prior to neck manipulation, read "Quebec Coroner Attributes Patient Death to Chiropractic Adjustment,". Surely that bit of negative press won't help endear the public to chiropractic, either.)

The SELF article also contains basic historical information about chiropractic that isn't particularly slanted. However, let's not overlook some of the other comments that might push readers away from your office door:

  • "Cervical manipulation is a preposterous thing to do, and it should be banned." - Mehdi Kazmi, MD, assistant clinical professor of neurology at Albert Einstein College of Medicine.
  • According to Sharon Mathiason, whose daughter "fell into a coma on her chiropractor's table minutes after a neck manipulation she received for a tailbone injury ... and was dead three days later," "[A]t the hospital, we were bombarded with doctors coming into the waiting room and saying, 'Don't you know that [if you go to the chiropractor], never let them touch you above the shoulders?'"
  • "Victims of Irresponsible Chiropractic Education and Standards (VOICES), a fledgling advocacy group comprising families of 60 victims of chiropractic stroke, five of whom have died ... is urging Congress to ban cervical manipulation."
  • "In SELF's online poll, more than 20 percent of women who visited the chiropractor said they felt no better afterward. Eight percent said they felt worse. Injuries that can occur on a chiropractor's table include soft tissue damage, joint dislocations and bone fractures in the neck and back. The most common problem is disk injury in the neck or lower back, which can be extraordinarily painful."

Perhaps most interesting is the following section of the article:

Statistically speaking, taking aspirin or another nonsteroidal anti-inflammatory drug for pain is potentially far more toxic than getting one's neck cracked; NSAIDs account for about 7,500 deaths per year, according to researchers from Stanford University in California. The difference is that aspirin is a scientifically proven pain reliever, and neck manipulation is not, says Brad Stewart, M.D., a neurologist in Edmonton, Alberta, with a special interest in chiropractic stroke. "The expectation of benefit is almost negligible. The risk, though small, is very real," said Dr. Stewart, one of whose patients had part of her brain removed after a cervical manipulation mangled both of her vertebral arteries. "You can't predict who this will happen to, and for that reason alone, it just shouldn't be done" [emphasis added].

So, if predictability determines whether cervical manipulation should be performed, shouldn't that standard apply to aspirin and other medications? Recognizing that prediction has value in research terms, surely there's no predicting, at least in general, who will suffer a side effect upon taking a drug to mask their pain. If that were the case, no one would ever suffer a reaction to a medication, because doctors would be able to predict if a medication would negatively affect each individual patient before prescribing it. And yet, that's certainly not the case; not for the 7,500 patients who die annually from NSAIDs, according to the SELF article, and not for hundreds of thousands of others who suffer life-threatening medication reactions, according to recent statistics from the Institute of Medicine. Do anywhere close to 7,500 patients die from chiropractic-related cervical manipulation annually?

The article concludes by returning to the story of Christa Heck, who apparently can no longer hold a job because of the damage inflicted by the New York chiropractor. She does spend time working with VOICES, the advocacy group bent on banning cervical manipulation.

The bottom line: For those not convinced if chiropractic is right for them, this article might turn them away forever. And thus, the chiropractic profession continues to fight scare tactics that threaten to push the public away from the care they so desperately need.

What's the Motivation?

By the way, the next time you're at a magazine stand, flip through the pages of SELF magazine, which, according to its Web site, "debuted 27 years ago as the first-ever magazine of total well-being, incorporating beauty and health, fitness and nutrition, and happiness and personal style all in one package" [emphasis added]. With that description of the publication in mind, why does the 246-page May issue, which features countless tips on health and wellness accompanied by brightly colored, warm layouts, include the chilling "A Deadly Twist," the lead image for which is an elevated adjusting table on a somber gray and black background?

Here's another question: Is SELF magazine indeed dedicated to "total well-being"? If so, one wonders whether the publishers understand and appreciate that chiropractic care contributes to the total well-being of countless thousands every day.

U.S. News & World Report: Why Become a Chiropractor?

Not nearly as jarring as the SELF article, but still potentially damaging in its own right, is an article in U.S. News & World Report. The article, "Time to Think Twice: Consider the Drawbacks of Popular Fields," offers the following glowing recommendation of chiropractic:

"Yes, you can treat patients without attending medical school. But the National Institutes of Health and other authorities have been skeptical of the effectiveness of chiropractic, which dims its professional standing. Many chiropractors also have to spend considerable time and money on marketing - and incomes are declining."

As an alternative career track, the article recommends a career as a physician assistant. "PAs get to do a lot of what doctors do, with less training."

While there is a certain degree of truth to the statement that marketing can be a major endeavor, at least for some chiropractors, the statement "Yes, you can treat patients without attending medical school" suggests chiropractors choose their career path essentially to avoid the rigors of conventional medical curriculum. This suggestion not only questions the motivation of chiropractic students; it also questions chiropractic educational standards and what it takes to become a doctor of chiropractic.

Tell the Real Chiropractic Story

Of course, the chiropractic profession has endured media critiques and criticism ad nauseum over the years. What is different now is that the profession has the opportunity to combat anti-chiropractic media reports with a national public relations campaign, one that tells the public the truth about chiropractic: the Campaign for Chiropractic, spearheaded by the Foundation for Chiropractic Progress. For the latest on the foundation's efforts to promote the benefits of chiropractic to the public, read Donald Petersen Jr.'s report of findings, "What the Profession Really Needs" (www.chiroweb.com/archives/25/12/12.html). To make a donation to the campaign, visit www.foundation4cp.com.

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