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Dynamic Chiropractic – May 19, 1997, Vol. 15, Issue 11

Health Care Fraud, Medical Incompetence, and/or Stupidity? You Be the Judge

By Chester Wilk, DC
Health care in the U.S. faces a major crisis and is heading for a meltdown. Can the AMA be the culprit behind the problem? Consider these well-documented facts:

1) Low back pain is the number one health care expense in the U.S., costing $80 billion a year.

It's the second most common ailment seen by general health care practitioners. Spinal disc surgery is the third most frequently performed surgery. "CBS News" reported that there are 80,000 unnecessary disc surgeries done annually in the U.S.

A wide variety of treatments are being used for low back pain, some good, and others bad, if not outright dangerous, and hence the U.S. Office of Public Health commissioned the Agency for Health Care Policy and Research (AHCPR) to study back pain and set practice guidelines. A panel of 23, supported by a staff of 200 leading back experts, researched the tens of thousands of studies in the low back pain literature, and selected only the finest scientifically-based "hard" studies available. They concluded that spinal manipulation (94 percent of which is done by chiropractors) is clearly superior to any other treatment for low back pain. The AHCPR published guidelines saying that conservative spinal manipulation should be tried first before using many of the more drastic treatments. It also criticized surgeons for doing excessive disc surgeries.

How did the AMA respond? It rejected the government guidelines, retained a couple MDs and a medical writer, and five months later published its own guidelines, dubbing them the "latest information on all treatment options," yet excluding any reference to spinal manipulation! The AMA guidelines excluded a method of treatment recommended by the AHCPR's prestigious gathering of more than 200 experts. Is this deliberate exclusion of an already proven superior method? Can this be considered protectionism against potential lawsuits for excessive and inappropriate surgery if these government guidelines were used in court? Suppose a health care practitioner deliberately withheld surgery from someone with cancer, while respectable studies indicate that surgery is the best treatment. Would this not be malpractice? Is doing excessive surgery, while ignoring safe and effective conservative spinal manipulation, any different? Does this justify a congressional investigation of the AMA for health care fraud by exclusion? You be the judge.

The AMA didn't stop there. It successfully lobbied Congress to have funds withdrawn from the AHCPR, and put political pressure on the agency to scuttle future guidelines.

The AMA supported an amendment to the antitrust laws in 1996 which said:

"(3) the conduct of any member of such network for the purpose of providing such health care service under such contract to such extent, shall not be deemed illegal per se. Such conduct shall be judged on the basis of reasonableness, taking into account all relevant factors affecting competition, including the effects on competition in properly defined markets." This would exempt MDs from the "per se" rule, the strictest antitrust rule against price fixing, boycotts, and collusion, and replace it with a watered down "rules of reason." The Congressional Budget Office said of the bill: "... the net effect of the legislation actually would be to increase anti-competitive behavior," and that it would be "raising the costs of government programs and reducing revenues." While the AMA certainly has the right to petition, can this legislation be so jaundiced and motivated by greed that it has disrespect for the truth and contempt for the welfare of suffering humanity? You be the judge.

2) Dr. Irvin Hendryson, an orthopedic surgeon and former trustee for the AMA, conducted some controlled trials within a military hospital during WWII comparing the results of medical and chiropractic care. His study showed that chiropractic care should be included in all military orthopedic wards. He sent the findings of his study to the AMA for their evaluation. The report sat in the AMA's files for 50 years until it was subpoenaed during chiropractic's lawsuit against the AMA. The AMA propagated anti-chiropractic statements contrary to the evidence within its own files. Was the AMA grossly incompetent, or devious and dishonest? You be the judge.

3) The New Zealand government conducted an extensive 20-month study on chiropractic which took a commission to Australia, Canada, the U.S. and Great Britain, interviewing hundreds of the world's leading educators, scholars, researchers and physicians. The massive study compiled 3,638 pages of transcripts and 1.6 million words taken under oath. The commission's conclusion was that chiropractic is a vital, scientific-based, safe and clinically effective form of health care that should be utilized in all hospitals as part of the health care team.

The AMA essentially ignored the prestigious study and continued its hostile conduct. Could the AMA have been ignorant of this widely published international study, or does the AMA have contempt for the truth? You be the judge.

4) A 10-year British government study utilizing randomized control trials and a scientifically established method of pain measurement, found that chiropractic care was more effective than medical care by as much as a 2-1 margin of superiority. The finding made headlines in England. The AMA ignored the study. Could the AMA be so inept or incompetent that it accidentally overlooked the study, or was it just contempt for the truth and intellectual dishonesty? You tell me.

5) The rising cost of health care has been a major national concern. The California industrial back injury study compared chiropractic and medical results, showing that chiropractic cut work loss in half. An Oregon workers' compensation study also showed how chiropractic cut work loss in half. Both studies were widely published and both showed a 2-1 therapeutic superiority of chiropractic over medical treatment.

6) A study of thousands of nonsurgical back ailments in Utah showed how chiropractic care outperformed medical care by a 10-1 margin in compensation costs. Average chiropractic costs were $68; average medical costs were $668 in the care of the same kind of conditions. It's in the public record. Shouldn't all health care providers enthusiastically embrace such an incredible accomplishment?

7) The Italian government conducted a clinical study on more than 17,000 patients within 22 medical back pain clinics, finding that chiropractic care reduced work loss by 75.5 percent, and hospitalization by a whopping 87.6 percent. Shouldn't these findings create excitement within the medical community?

8) AV-MED, the largest HMO in the southeastern U.S., headquartered in Miami, sent 100 cases of chronic back sufferers to a local chiropractor to conduct a clinical outcome study. Eighty percent were medical failures. The chiropractor had an 86 percent treatment success with that group. The most notable results in this group were 12 cases diagnosed by a team of surgeons as needing disc surgery. All 12 of these cases were corrected with chiropractic spinal adjustments within three weeks, saving the HMO hundreds of thousands of dollars, plus needless pain and potential complications of major surgery. If these kinds of results don't create interest and excitement within the medical community, then what does it take?

9) A leading Chicago orthopedic surgeon and professor at Northwestern University testified under oath in our trial against the AMA that patients in the orthopedic ward at the JFK Hospital were being sent home well 7-9 days sooner than at Lutheran General Hospital, because they were getting chiropractic adjustments. Shouldn't these kinds of results arouse enthusiastic support for chiropractic? Ironically, JFK Hospital was purchased by another hospital, and the chiropractic department was eliminated.

10) A medical/chiropractic research clinic at the University of Saskatchewan used chiropractic adjustments on a test group of patients who had suffered for seven long years with chronic low back pain. With chiropractic care, 87 percent got their first relief in seven years; on revaluation a year later, they remained pain free.

Most of us have read or heard the propaganda attacks against chiropractic, but what we don't hear from these same sources is that the head of a RAND Corporation study found that chiropractic has more scientific studies to support it than does medicine; that it is safer (according to actuary tables); more cost effective (according to workers' comp. studies); enjoys a three times better patient satisfaction ratio over medicine (based on a Western Medical Journal poll); has superior college facilities, found to be even better than medical schools (according to a leading medical authority); and that government studies show it is therapeutically superior within its realm. Have you ever wondered why these facts are not publicized by the critics of chiropractic? Is it that the political medical community knows the truth about the advantages of chiropractic, but capitalizes on the public confusion and mind set so deeply entrenched in our society? Again, you be the judge. You will find the complete documentation of these facts in my book Medicine, Monopolies and Malice, published by Avery Publishing Group.

I never cease to be amazed at how our society tolerates so much misinformation and scandalous abuse of rational, safe and effective health care. The truth needs to be exposed honestly and candidly.

I welcome being a guest on any radio, TV or newspaper interview to discuss these facts. At a time of great health care crisis, I don't know of a more important and provocative subject for public discussion.

Chester Wilk, DC
Chicago, Illionois

Click here for previous articles by Chester Wilk, DC.

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