In the November issue of Reader's Digest, there appeared the article, "Relieving Chronic Pain Without Drugs." Anxiously, I thumbed through the index to find the article, which I was certain would include some positive commentary about chiropractic. Guess what? To my dismay, chiropractic was not even mentioned. Rather than generate a hostile letter to the journalist and editor of the magazine, I decided to take another tack and write a thoughtful letter seeking input from the writer. My letter follows:
| December 2, 1996 |
Ms. Sue Browder
Dear Ms. Browder:
I just read your excellent article, "Relieving Chronic Pain Without Drugs," in the November 1996 issue of Reader's Digest. After finishing the article, I was struck with some questions and wonder if you would be so kind as to provide me with your professional insight into your thinking when you wrote this article. My reason for asking is to develop a better understanding of what might need to be done (from your perspective) in order to bring about an awareness of a profession that appears to be the invisible "giant" among the plethora of alternative care therapies.
In the past several months, Life ("The Healing Revolution"), Time ("Alternative Therapies The Frontiers of Medicine"), Psychology Today ("Natural Recovery, Let Acupuncture, Hypnosis, Nutrition, and More Help You Quit"), all have had excellent articles on alternative therapies. Reading these articles brought me to the realization that there was a common denominator.
In these prestigious popular magazines, in the excellent articles by the various writers and among the maze of therapies ranging from the believable to the bizarre -- from acupuncture to zen -- chiropractic was all but ignored. Having been a spokesperson for the chiropractic profession for 15 plus years, I am curious as to why this phenomenon is occurring at a time when the public is clamoring for answers, disenchanted with the drug approach, and recognizing the need for prevention and self-direction. All other therapies appear to be the fad and chiropractic is given one line if any mention at all. Perhaps seeking your input will provide me with a perspective on what may be occurring which I am not consciously observing. While this request may be a bit unusual, it is written with a curiosity that drives me to seek as many opinions and perspectives as I can.
The chiropractic profession has survived the "100-Year test," having been in existence since 1895 (engendering a sense of longevity and stability); being licensed in all 50 states; having the most sophisticated and accredited educational system of all the other alternatives; having done much in the way of research; being the largest and most organized of all the professions. Even in the article in which you quote Dr. David Eisenberg from the New England Journal of Medicine, chiropractic is by far the most widely reported "unconventional therapy" used by Americans. Despite this overwhelming development and widespread use, as well as cost effectiveness and high degree of patient satisfaction, chiropractic has been virtually all but left out of most of the articles currently appearing in the popular press dealing with alternatives. My question is why?
You may find it of some interest as a writer for Reader's Digest that I participated in a program with them in 1988 designed to raise the consciousness of the American population toward chiropractic. Enclosed are samples of the two inserts we placed in Reader's Digest in 1988, and they did in fact create some interesting reactions.
A public relations milestone occurred in December of 1994 when the Agency For Health Care Policy and Research (AHCPR) held a news conference and announced the release of the guidelines for Acute Low Back Problems in Adults. Spinal manipulation (chiropractors perform 94% of all manipulation) was one of the procedures suggest and recommended by this prestigious government panel, and many of the other therapies commonly employed had little or no scientific basis for their use: a shock, needless to say, to many who had made quantum leaps in assumptions about the effectiveness and basis of the use of these other therapies, i.e., traction, ultrasound, heat, to name a few.
Back to my reason for writing to you as a journalist. It is simply to ask you to help me understand the process by which a journalist researches an article on alternative or unconventional or complementary therapies and DOES NOT include a significant and substantial portion of the article to chiropractic? In other words, what is it that makes the reporter overlook the "GIANT" in the alternative and complementary arena and concentrate and write about all the other therapies which are less organized, less established, less validated by research and less utilized by the public? Has chiropractic gotten caught in that twilight zone of not being "unconventional enough" for unconventional therapies and not "orthodox" enough for mainstream medicine?
Perhaps by sharing the benefit of your thinking, we can target the necessary ingredients to insure chiropractic inclusion in articles which are targeted at informing the general public about alternative and complementary therapies. The wave of public support for such procedures has now taken on a "life of its own" and the demand by the public to know more, understand better, and utilize appropriately those procedures which will improve their health status and enhance their quality of life will be increasingly in greater demand.
Thank you for your consideration of this rather odd request, but I am convinced that by writing to reporters and health journalists seeking their input and the benefit of their thinking, we will learn more than by any other means. I will look forward to your response and hopefully share your reply with my colleagues who are also very much aware of the movement in the journalistic world toward positive articles on alternatives, and yet the one alternative that has met the stringent demands for accountability appears to be losing ground.
My hope was that she would respond and perhaps provide some insight into the thought process of this freelance reporter who has been writing for 25 years. On December 11, l996 Ms. Browder responded:
| December 11, l996 |
Dear Dr. Sportelli:
Your thoughtful letter arrived just as I had finished up a freelance story, so I am happy I could answer it right away. After interviewing a number of leading pain specialists around the country, I left it (chiropractic) out on purpose. A number of doctors simply told me straight out that chiropractic doesn't work.
Now as an objective reporter, I would certainly include chiropractic in any story on pain relief if there were enough scientific evidence to support it. What the profession needs to be included in these stories are a number of well-controlled scientific studies to prove that it works. You also need chiropractic to be recognized as a viable treatment at some major university pain centers.
Another thing that really did your profession a lot of damage, at least in my eyes as I was researching the Reader's Digest story, was the piece that came out in Consumer Reports. I do remember thinking, "Wow, if Consumer Reports is this negative and all these other doctors are too, I guess I'd better just leave it out." Chinese medicine is getting so much attention in the media partly because controlled scientific studies at major universities are proving (or at least suggesting) that it has some validity.
By now you may be tearing your hair and saying, "But we do have scientific studies, hundreds of them." If that is, indeed, the case, then your problem with the media is (at least in my opinion) quite easy to solve. Really start pushing all this scientific evidence for all it's worth. And give reporters at least, I mean at least, three top notch experts in three major universities across the country (we're talking about major research centers like Harvard). I can envision a whole batch of articles with titles like "New Views of Chiropractic" or "Grandmother was Right: Chiropractic Works." As a journalist, I would love to write stories like this if the information was solid and scientifically grounded.
The personal testimonials for chiropractic, as I'm sure you know well, are really quite convincing. Still, we do live in a scientific age, and science is what the editors I write for want. There is another problem, too. Chiropractic has the image among at least one or two editors I work with as being a "quack" medicine. Now, I know there are quacks in every profession. But when you have chiropractors claiming they can cure cancer (as unfortunately a few of them have), it give the whole profession a bad name. People really need to be told how to find legitimate practitioners and how to avoid the weirdos.
Having said all this, I will tell you that I'm getting ready to write another article on pain control for another national magazine. If you have some well-controlled scientific studies published in reputable medical journals and some university based practitioners, I would be more than willing to include chiropractic in the story. I am completely open-minded (albeit skeptical) about chiropractic. If you can enlighten me further, not with opinions, but science, I would love to hear more. Hope I haven't been too outspoken here, but you asked for an honest opinion and I've tried to give it to you.
Nothing Sue Browder said is new, and there is nothing she wrote we have not heard before, but coming from a third party I found it to be thought provoking. I called her to ask if I could use her letter in my upcoming column. She was hesitant, but then decided what she said was factual, from her perspective, and so why not give me permission to use her private letter for a public column.
What to do? Well, if we are to do what we have done in the past, some will cry out "SUE THE BAS----Ds!" Sue for what? Who knows, but suing is a common solution to resolving issues with the media. Others would suggest we use the "BOYCOTT THE MAGAZINE" approach and "show them how much economic power we have," as if it has worked in the past. Still others will want to vent their spleens in the most vitriolic scathing letter to the magazine attacking the reporter, the magazine, the editor, and perhaps even the parents who did the dastardly act of causing the birth of the reporter ... all of which will serve no useful purpose.
Hopefully there are those who will view Ms. Browder's response as an opportunity to recognize the fact that, agree or not, the reporter's perception is their reality. Unfortunately the perceived reality espoused by Ms. Browder is shared by many of her colleagues who incidentally write for hundreds of magazines and newspapers as freelancers or staff reporters.
The real issue is, what can we learn from this exchange and how can we positively influence the "Sue Browder's" of the world? When story ideas are conceived and chiropractic inclusion is appropriate, will the background "research" produce the needed evidence to warrant such inclusion?
My reason for reprinting this exchange was only to help bring about a needed awareness to the profession about the perspective of the media. In conversation with Ms. Browder, she related a story about an "editor" who is still reeling from the scathing letters received from chiropractors to an article which did not convey, in their opinion, a true representation of the profession. She assured me there will be no positive inclusion of any chiropractic story from that editor because of her experience in receiving hate mail and disrespectful communication, lack of professionalism and common courtesy by the DCs only serving to reinforce an already negative attitude.
The old adage, "Don't pick a fight with someone who buys ink by the barrel" is worth remembering. Over the years, I have personally seen letters to reporters, editors and others, which were not only embarrassing, but could only serve to generate such hostile reaction from the recipient that no possible good could come from the exchange save for the moment of pleasure and satisfaction enjoyed by the writer. The collective image of chiropractic is on the line with each letter and communication to the media. We do have opportunities to build and plant the seeds of tremendous stories -- what it will take is nurturing.
In the next column we will discuss ... never mind, just watch for it.
Louis Sportelli, DC
Fax: (610) 826-7500
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