The bad news -- we lost!
The good news -- "chiropractic," "chiropractor" and "doctor of chiropractic" were used in every article that my name appeared, giving chiropractic good press.
I want all to know I appreciate all you have done for me in this campaign. I did all I could to win and all I could do for chiropractic. Short of getting more money, I left no stone unturned. I went over all possibilities in my mind and talked to Pam about anything else I could have done, and the only thing we needed to do better is dollars. That I have no control over. I personally put over $80,000 dollars into this effort and didn't have anything else to commit to the election. The winner outspent me five to one and at the end, he was running push polls on the telephone, television and in radio ads. He did mailouts 2-3 times a week. There was no way I could match his dollars.
How could I have won this race? Pure and simple -- money. As we all know, money rules, especially in this election. Some chiropractors were very generous and I appreciate them more than they will ever know, but the fact of the matter is money wins elections. Being in a profession that has never had a chiropractor in Congress, we need to become very aggressive and do what it takes to get one there. If every chiropractor (and there are 50,000 of us) had given 100 dollars, I would have had five million dollars for this race and would have won in a heartbeat. If 50,000 chiropractors had given just 10 dollars, I would have had 500,000 dollars and again would have won. However, neither occurred, and because I couldn't raise the necessary funds, the chiropractic profession will not see a doctor of chiropractic in congress.
I just want you to know I appreciate you all and I will keep you in my prayers.
Again thanks for your help and being a great friend.
Paul J. Phillips, DC
Dr. Koren under Glass
Editor's note: What follows are letters and excerpts of letters reacting to the U.S. Federal Trade Commission questioning the claims made in the chiropractic brochures of Koren Publications (see "FTC Questions Chiropractor's Claims" in the September 21st issue of DC).
"Compromising Our Credibility"
If, as it was stated, the Koren information in question is based on known flawed or incomplete research, why continue to solicit funds from chiropractors in a doomed fight with the FTC?
The statement, "The FTC could do what the AMA could not," was attributed to Dr. Koren. My actual impression of this statement was, "I am under attack for not having adequately represented my product in my role as a private entrepreneur, and now I want to call upon members of the chiropractic profession to protect me by warning them that the anti-chiropractic wolf is again at the door. Please send cash."
We have been down this road on previous occasions. One may recall discussions regarding the widely distributed and misleading publications comparing training of MDs and DCs in a previous issue of Dynamic Chiropractic. The accuracy of other forms of literature used by the profession for many years received attention during the Wilk testimony.
Chiropractors know of the effectiveness of chiropractic. In today's investigative environment, however, it is naive to believe that information distributed by all health care groups will not be subject to critical evaluation by many individuals and agencies. Promotion of evidence which is not completely supported injures the projection of the chiropractic message by compromising our credibility with an increasingly discerning public.
Eugene A. Lewis, DC
Greensboro, North Carolina
Does the FTC Have a "Covert Agenda"?
I would like to suggest a method of finding out if this present situation is one that pertains to Tedd Koren alone or is, as he states, one which concerns our whole profession.
If all is well and good between our profession (excluding Tedd) and the FTC, the profession should have no qualms about sending the FTC all of our patient educational material. Let's just get everybody and anybody who has pamphlets, videos, etc., to submit them to the FTC. Furthermore, let's get all the colleges to submit their catalogs as well. After all, if this is just a case of Koren deserving what he's gotten then there should be no reservations about my suggestion.
If, however, those doctors and groups have qualms about my suggestion, then I would propose that perhaps Mr. Petersen may have overstated his case somewhat. I personally find it hard to fathom that any government agency that attacks one of us should be given the benefit of the doubt. Rather, given the history of our profession and the crap we have had to go through, we should cast a jaundiced eye upon any encroachment upon our profession's ability to express itself ... If you really think that the government is "here to help you," consider the friendly visit of Kevlar-armored FDA agents who handcuffed one chiropractor in front of his patients, seized his files and shut down his office because he dared to not follow orthodox protocol.
... I cannot find it in me to believe that a governmental agency seeking to shut down one of the most successful distributors of chiropractic patient education is doing so with no covert agenda. We are supposed to believe that the FTC is acting out of pure and unadulterated concern for the well-being of the public. We are being treated like our art kills and maims millions, unlike our medical brethren whose proper actions only kill about 106,000 each year. Is it just me, or is it possible that now that "alternative medicine" is sought out more than "traditional medicine" that some interested parties might find it a good idea to silence the voice of the largest group of alternative practitioners on the planet?
Color me reactionary, but those in our profession who hold sway over the bully pulpit might be better advised to investigate or reªread some recent history before making assumptions regarding the supposed good intentions of faceless, unelected governmental entities who, thanks to our tax dollars, have bottomless pockets and limitless resources.
Charles A. Krieger, DC
Astoria, New York
"... we invite them to speak at conventions ... and they are magically granted expert status."
In January 1996, I had written a letter to one of our state organizations to give them some feedback on a recent continuing education seminar they had provided at the annual convention. One of the CE presentations during that convention was by Dr. Koren. He did not appear to have a specific topic, but rather presented Hollywood movie clips featuring chiropractic and various overhears discussing a variety of health issues including AIDS, the importance of drinking water, and miscellaneous chiropractic and medical topics.
My purpose in writing to the state organization in 1996 was to go on record in being dissatisfied with Dr. Koren's presentation regarding qualified CE seminars. Since it impacts directly on the recent issue with the FTC, I have excerpted it here:
"Dr. Koren seemed like a very pleasant fellow, but the thrust of his presentation in my opinion was just a hodge-podge of unrelated articles culled from a variety of print media. Some articles were from reliable sources, but others were just your average monthly circular variety. He gave them all equal weight.
"If it is in print, it seemed okay with him. So the professionalism of his presentation suffered accordingly. There are certain rules of textual criticism and valid research which he seemed to ignore or be unaware of. It is sad when the most interesting part of his presentation consisted of clips about chiropractors from old movies. I didn't find much that was valuable to my practice -- maybe that I need to drink more water -- but otherwise it seemed a meandering bit of fluff designed largely to advertise his line of educational stuff in the back of the room."
In spite of my protestation, this state chiropractic organization has continued to use Dr. Koren as a guest lecturer at state conventions and other continuing education venues. Your article prompts me to state that I feel this is another example of how we as a profession fail to clean our own house. We need to understand that outrageous claims without verification should not be tolerated within the chiropractic profession. As long as we tolerate questionable and unsupportable factors as being part of our profession, we will reap the negative publicity it brings.
Furthermore, some of our other chiropractic "gurus" -- whose names I will not mention but whom we all know -- continue to bring us ridicule and shame because of outlandish claims and voodoo philosophy. We seem to apply only one criterion before embracing them, and that is profit. If they claim to know how to increase our volume, or work less for more, or just make us feel "really good about ourselves," suddenly we invite them to speak at conventions, we buy their tapes and they are magically granted expert status.
My vote is that we cleanse the inner vessel. If we individually refuse to support the shady elements within our profession, they will wither away. I believe we need to let our individual voices be heard when we see things that taint us. We need to hold ourselves to a higher standard than we have done in the past. I would also encourage Dr. Koren to continue with his efforts, but to be more balanced in his zeal to support the profession. Before we choose to champion his cause with the FTC, wouldn't it make more sense to consider the fact that fundamentally the FTC is correct in requiring proof for health claims?
Garth Aamodt, DC
Grand Rapids, Michigan
Tedd Koren: A Simple, Three-Step Solution
Thank you for the thorough review of Tedd Koren's FTC problems. Assuming that the data provided in the unsigned editorial on the subject is factual, I have a very simple solution to these problems to offer both Dr. Koren and the profession at large.
Step one: Admit that while randomized controlled trials (RCT) equal research, research does not equal RCTs. Current courses in research methodology taught at major institutions of higher education, including chiropractic colleges, provide a hierarchal list of accepted research formats (AMA Manual of Style 9th edition, pp. 523-529). While it is true that the RCT format is currently held by many to be the gold standard, this list includes several other formats which are recognized as being valid and effective forms of research. The chiropractic research community is in desperate need of education in this simple fact, and apparently so is the FTC.
Step two: Challenge the FTC, in court if necessary, to make decisions regarding appropriate research support based upon these existing standards.
Step three: Get Dr. Koren to alter his literature to use references which exist in some of these other research formats. For example, the issue which exists around FTC stipulation B to Dr. Koren, stated in your editorial as "reduces the incidence in children of ear infection, allergies or tonsillitis," could be immediately resolved by citing either the "spinal manipulation" indexed pages of Dr. Michael Schmidt's 1996 book Healing Childhood Ear Infections, or the scores of published references he provides in those pages.
It's as simple as that!
Noel A. Taylor, MM, DC
"Let them know Koren doesn't stand alone."
As you may know, I have been very aware, at least from my vantage point, of the Koren issue. I was provided fax copies of correspondence between the FTC and Dr. Koren's lawyers, some of which reveal the FTC, at least recently, have their minds set and wish to disregard any concessions from Dr. Koren.
It is my opinion, after 20 years in the field, that there is no time like the present to stop a detractor, especially if their reach may go further than we would like. The FTC for whatever reason has chosen Dr. Koren's educational material for scrutiny and has requested changes, which would be a first for a federal agency as far as I know.
Since this problem was presented to the profession only a few weeks ago, it would be foolhardy for the ICA or ACA to knee-jerk a reaction and cry foul. But it should also be the nature of these institutions to foster vigilance and determine who requested and why such a federal investigation began at all. There are bigger issues the FTC should be concerned about. Is there an agenda by chiropractic detractors, such as orthopractic and others that have pulled on the ear of the FTC?
Every Koren publication was pulled from the Life University public clinic. If there was no threat -- no need for institutional concern -- why the concern and concerted effort to remove wellªwritten educational materials that were in place for years? The ICA child care seminars and conventions that are advertised in your and other journals will have to (if they are wise) review their statements, their research data and determine if the FTC rules apply. I don't know if you can see the trend, but as far as I can see, it is the best time to nip this in the bud.
... I hope you will consider your stand on this issue and that guidance comes from you rather than watching others from the side like the ACA or ICA. Great men lead while others follow. You have the means to spearhead a profession-wide investigation. Who initiated the process? Where was the nationwide threat that stimulated such a federal response? Why they didn't allow Koren to write the approved disclaimers and make the changes they agreed to? Who are the chiropractic experts that are being used to determine if Koren has done what they said -- crossed the line? Let them know that Koren doesn't stand alone.
... In conclusion, I appreciate your publication ... You are doing a wonderful service and I hope you will take leadership in this issue and go beyond the obvious and seek the truth ... But we sorely lack the real and hard research we need to appease the scientific community. It was always this way and unfortunately our funds limit anything other than what we see today.
Years ago we relied on any PhD who would stroke his diploma before our eyes and said "chiropractic" three times in a row. We paraded them around as our research saviors. Koren used this material which was well distributed and obtained and now that he is called to the carpet, he and we must change and look again at what we say or do. But should it be mandated by a federal agency? I think not.
Time is now for the ACA and ICA to begin the process of peer research and obtain a measure of credibility that will pass the scrutiny of all ... What was accepted then didn't cause a massive national plague or epidemic of new chiropractic patients that ruined the health and wellness of America, so consider your position. I hope you will review it well.
Joel E. Margolies, DC