The Chiropractic Report www.chiropracticreport.com Editor: David Chapman-Smith LL.B. (Hons.) January 2009 Vol. 23 No. 1 CAM or Mainstream? Where is the Chiropractic Profession, Why is This Important? A. Introduction Declaration calling upon all countries to recognize and regulate CAM profes- OMPLEMENTARY anD alter- sionals and for the closer integration of native medicine (CAM) is a term C TM/CAM and “conventional medicine coined by the Scottish physician and providers” as in China. 2 homeopath David Reilly in 1987. It has subsequently been used by the medi- b) The second recent event is the cal profession, and therefore health- December 10 publication by the care policy makers and the media, to National Center for Health Statistics describe all healthcare interventions (NCHS), US Department of Health not generally taught in medical or para- and Human Services (DHHS) of its medical schools – including those of 2007 survey on the use of CAM by the chiropractic profession. Americans – use by each of adults and children during the past 12 months. 3 Since the 1980s there has been a dra- There is much that is good news for the matic increase in the use of CAM in chiropractic profession: the developed world, and chiropractic has been seen as the leading example • As in the last survey by the NCHS, in of a profession making the transition the year 2002, CAM was used by a large from CAM to mainstream care. Has the percentage of the population – by about Professional Notes CAM label or identity been a help or 4 in 10 (38.3%) of adults during the 12 Padraig Harrington Interview a hindrance to chiropractic, and what month period. Padraig Harrington should be done about it at this point in • This was principally for the musculo- of Ireland has just time? skeletal problems that represent a large been voted Golfer of Two recent events illustrate the signifi- part of chiropractic practice – with the Year by his col- cance and complexity of these ques- back problems (17.1%), neck problems leagues on the PGA tions: (5.9%) and joint problems (5.2%) lead- ing the way. Tour. In 2008 he won a) The first is the World Health Orga- 2 of the 4 majors nization’s Congress on Traditional • Chiropractic care appears to be the – the British Open Medicine held in Beijing November 7-9, single most common “therapist-based and the US PGA Championship. 2008. Traditional medicine (TM) is the intervention” used by adults and chil- For the past 12 years Harrington has term WHO uses for CAM. In opening dren. been accompanied on tour by Australian the Congress, WHO Director-General However on a careful reading there is chiropractor Dr. Dale Richardson, and the Dr. Margaret Chan, addressed the rea- much that is a concern and that drives December issues of the FICS News (the sons for “the striking increase” in the one to the conclusion that institutional quarterly publication of the Fédération use of CAM in affluent societies, and bias against the chiropractic profes- Internationale de Chiropratique du Sport, called for governments to adopt policy sion is alive and well within the DHHS. the international body representing to promote the use of TM/CAM in pri- Prime examples are: sports chiropractic) carries a fascinating mary care in their national healthcare • Definition. The new report says that 1 interview with Harrington and Richard- systems. “by definition CAM practices are not son. Highlights include: Manual healthcare generally, and chiro- part of conventional medicine because • Before he had regular care from Dr. practic in particular, were a major part there is insufficient proof that they are safe Richardson, Harrington was missing 4 or of the Congress with the World Federa- and effective” (emphasis added). That is 5 tournaments a year from chronic golf- tion of Chiropractic (WFC) organizing a new and disturbing definition. It is also ing injuries – now he doesn’t lose atten- one of the four technical symposia – a indefensible. According to the report two-day Symposium on Manual Meth- dance at any. doctors of chiropractic seem to be the ods of Healthcare. During the Congress most commonly used CAM providers • He had a quite serious hand injury government delegates from 72 WHO in the US, they are principally used by member countries passed a Beijing patients for musculoskeletal disorders, continued on page 4 Main Article continued from page 1 and there is at least as much evidence ern medicine (e.g. chiropractic, mas- The Chiropractic Report is an international review supporting the safety and effectiveness of sage therapy, osteopathy) and many of professional and research issues published six chiropractic management for these dis- self-help approaches (yoga, weight loss times annually. You are welcome to use extracts orders as there is for any “conventional programs, relaxation techniques, spiri- from this Report. Kindly acknowledge the source. 4,5 Subscribers may photocopy the Report or order medical” treatment. tual healing). additional copies (.80 cents each, plus shipping • No data on Chiropractic. Even more The definition used by Eisenberg et al. – minimum of 20 copies) for personal, non- disturbing is the downgrading of chiro- commercial use in association with their practices. from Harvard for their 1991 and 1997 However, neither the complete Report nor the practic from a profession to a technique national surveys in the US was “medical majority or whole of the leading article may be coupled with the gathering and report- interventions not taught widely at US reproduced in any other form without written ing of data on chiropractic and osteopa- medical schools or generally available permission. thy together, rather than each alone. The at US hospitals.” 6 In the U.K. the Brit- The opinions and statements in this publication are those of the individual authors alone, not the survey for 2002 asked the public about ish Medical Association’s definition of Editorial Board, World Federation of Chiropractic or its use of “chiropractic care”. The survey CAM has been “those forms of treat- any other organization. for 2007 asked about use of “chiropractic ment which are not widely used by the Subscription: for rates and order form, see page 8. or osteopathic manipulation”. orthodox health care professions, and • Visit www.chiropracticreport.com the skills of which are not taught as • Call 416.484.9601 2. Accordingly in this Report we look • Email us at [email protected] at facts on CAM. the significance part of the undergraduate curriculum of the WHO Congress and the new of orthodox medical and paramedical Editorial Board health care courses.” Writing on CAM Alan Breen DC, PhD, England DHHS National Survey, and what the Raul Cadagan DC, PT, Argentina chiropractic profession should do to in 1993 the BMA regarded acupunc- Ricardo Fujikawa DC, MD, Brazil accelerate its transition from CAM to ture, chiropractic, herbalism, home- Scott Haldeman DC, MD, PhD, United States opathy and osteopathy as the five most Donald Henderson DC, Canada mainstream – at a time when various Nari Hong DC, South Korea developments suggest that national developed CAM disciplines and those Gary Jacob DC, MPH, LAc, United States healthcare systems will have a place for with “the potential for greatest use Dana Lawrence DC, United States alongside orthodox medical care.”7 Charlotte Leboeuf-Yde DC, PhD, Denmark professions such as chiropractic and Craig Morris DC, United States naturopathy and traditional Chinese Accordingly the essence of CAM, which Lindsay Rowe DC, MD, DACBR, Australia medicine within mainstream services groups together many professions, Hossein Sabbagh DC, Iran – that is to say professions that offer therapies and products with no com- Louis Sportelli DC, United States Aubrey Swartz MD, United States a different philosophy of health and monality of principle, is that it is health Yasunobu Takeyachi DC, MD, Japan approach to the prevention and man- care methods not generally taught in Changes of mailing instructions should be sent to agement of some of the most prevalent the core curriculum of medical schools. The Chiropractic Report, 203–1246 Yonge Street, and chronic lifestyle disorders. The new US DHHS survey and report Toronto, Ontario, Canada M4T 1W5, lists 36 forms of CAM under four cat- telephone 416.484.9601, fax 416.484.9665. 3. Before we embark on that it should Printed by Harmony Printing Limited, 416.232.1472. be made clear that the CAM label or egories: Copyright © 2009 Chiropractic Report Inc. identity is one given to the chiroprac- • Alternative medical systems (e.g. acu- ISBN 0836-144 tic profession by others, rather than puncture, Ayurveda, homeopathy, natu- coined or accepted by the profession ropathy, traditional healers) “more natural, effective, relaxing, sen- itself. In 1996/1997 the WFC surveyed • Biologically-based therapies (e.g. sible and one can take an active part in its member national associations, then chelation therapy, diet-based therapies, it.” in approximately 80 countries world- natural products) wide, and found a strong consensus that b) However, CAM users do not reject • Manipulative and body-based thera- chiropractic should be viewed as an orthodox medicine and do not have pies (e.g. chiropractic, massage, move- integral part of mainstream healthcare “noticeably different health belief ment therapies) services, rather than complementary models compared with similar patients and alternative healthcare or medicine. • Mind body therapies (e.g. biofeedback, who are exclusive users of orthodox Respondents agreed, however, that meditation, yoga, tai chi, energy healing) medicine.” The studies show that CAM the profession was in fact viewed by 5. Why Patients Use CAM. This issue patients are a normal cross-section of government and medical authorities in has been examined most thoroughly the population shopping for health. 8 almost all countries as CAM. in Europe by Furnham and in the US Consumer commentators agree.