Chiropractic is yet again garnering accolades from the press. Philadelphia Magazine, a monthly publication with a circulation of approximately 128,000, featured an in-depth, well-researched article, "The New Medicine," in its May 1993 issue. The article details the benefits of chiropractic care, as well as other "alternative therapies" such as acupuncture, homeopathy, massage therapy, and hypnosis. Each therapy has its own sidebar featuring the comments of a practitioner within that discipline.
Author Carol Saline begins the article on a persuasive note by quoting the New England Journal of Medicine study which reported that in 1990, Americans made an estimated 425 million visits to providers of "nonconventional therapy," spending $10.3 billion of their own money. But the unconventionality of these treatments, particularly chiropractic, may soon be a thing of the past. Ms. Saline reports on the $2 million funding for research authorized at the Office of Alternative Medicine (OAM), a branch of the National Institutes of Health (NIH). She quotes the OAM's director Dr. Joseph Jacobs: "We'd like to find what conditions could best be helped by alternative medicine. For example, we could use better studies to show how chiropractic makes back pain more manageable."
Chiropractic care is given fair treatment in the article, and the author comments on the fact that chiropractic has broken away from other alternative therapies in terms of credibility: "If you're one of those skeptics who still think alternative medicine will never be anything but just that, consider the case of chiropractic." She then focuses attention on the public's ever-increasing acceptance of chiropractic over the past 20 years: "... it has moved from being viewed by most people as weird and even dangerous to a position of relative acceptance by both the medical and lay communities. Chiropractic is now the third-largest primary health care profession in the Western world, led only by medicine and dentistry." The author also notes the 14 accredited chiropractic colleges in the U.S., and the high standards of those programs.
Citing studies which reflect the effectiveness of chiropractic, the article outlines the RAND study's conclusion that manipulation is appropriate for low-back pain. The article also describes the Australian study which found that 30 patients randomly chosen for chiropractic care from a group of 85 people with a long-term history of migraines improved radically within seven visits.
The article assures readers that chiropractic care is quite safe. Addressing the supposed risk of chiropractic treatment, the author compares chiropractors' yearly malpractice insurance fees (roughly $3,000) to those of orthopedic surgeons (about $50,000), explaining that because chiropractors are rarely sued, their insurance fees remain low. Again trying to dispel the myth that chiropractors hurt patients she writes, "There is a remote risk of stroke occurring from neck manipulation, but it happens in two to three cases per million treatments, compared with 150,000 cases of paralysis per million neurosurgical neck operations."
For the sidebar on chiropractic, the author chose Philadelphia chiropractor Basil B. Snyman. Ms. Saline's association with Dr. Snyman began three years ago when she was writing a piece about chiropractic. To learn more about chiropractic, she become a patient of Dr. Synman's and subsequently wrote articles about the profession. She was satisfied with the treatment and has remained a patient. The prominence and longevity of Dr. Snyman's practice -- he has been at his Center City office in the heart of Philadelphia for 18 years -- certainly gives him credibility. The sidebar provides a fairly thorough description of what chiropractors do, describing Dr. Snyman's (and chiropractic's) holistic treatment regimen: "What he does, after x-rays, a history and an examination, is embark on a program of spinal manipulation (sometimes with electrotherapy and ultrasound) along with diet, exercise and nutrition suggestions." It also features a photo of Dr. Snyman treating a beaming patient -- terrific PR for chiropractic.
The article explains that most of Dr. Snyman's patients are suffering from back problems, "and by the time they reach him, fed up and desperate, they've been through the medical mill." Patients are often surprised when they get relief for a problem that is completely different from the complaint that brought them to the chiropractor in the first place.
Emphasized in the article is chiropractic as an alternative to surgery, chiropractic's maintenance and postoperative benefits, and the relief chiropractic can offer for neck pain and headaches. When suggesting a method for choosing a DC, the author advises readers to "rely on the recommendation of a satisfied friend" and provides the telephone number of the Pennsylvania Chiropractic Society (PCS).
"We've come a long way," said Dr. Snyman when discussing the article. "At least we've come to the point where we don't get bashed like we used to."
But typically, there are a few questionable comments mixed with the positive ones in the article. As Dr. Synman remarked, "All the articles about chiropractic have some left-handed comments." For example, the author makes this statement about subluxations: "Someone likened them to a unicorn: sounds great but nobody's ever found one." And after explaining how DCs believe that relieving pressure on the nerves along the spinal cord will restore health, the author writes skeptically, "Maybe so, maybe not. But if you limp into a chiropractor's office with shooting pains in your leg and walk out straight and pain-free, do you care that he believes that he can use the same technique to cure a cold?"
Overall, the article reinforces the fact that the profession has steadily built up the public's trust. Although chiropractic is still grouped with "alternative therapies," the profession is steadily breaking out of this constraint and moving toward primary status.
The profession continues to grow: more patients and more DCs. In Pennsylvania, the article reports, "the increase in chiropractors is rampant" with 3,500 DCs licensed in the last 15 years. As chiropractic numbers grow and as the profession carves out a larger slice of the health care market, the task as always remains to offer quality care. Positive article of this nature don't hurt either.
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.
