The Chiropractic Report Editor: David Chapman-Smith LL.B
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The Chiropractic Report www.chiropracticreport.com Editor: David Chapman-Smith LL.B. (Hons.) July 2014 Vol. 28 No. 4 Media Criticism – Whether and How to Respond A. Introduction Startling $496 Million Wasted on Chiro- practors”.1 As the title implies, Salzberg HIROPRACTORS, EVEN argued that the government expendi- allowing for the injustices they C ture for chiropractic services for seniors have suffered as they have matured into under the Federal Government’s Medi- an established healthcare profession, care plan was a serious waste of funds. remain extremely sensitive to criticism. There was no basis for chiropractic Actor and comedian Alan Thicke, best subluxation, said Salzberg. Chiropractic known for his role as the father Jason was “invented out of thin air” and was Seaver in the television series Growing “highly dubious”. All the usual com- Pains, dropped a one line comment in plaints were there, including the threat that show in the early 1990s dismissing of stroke and the anti-vaccine stance of chiropractors as “quacks”. He and the some chiropractors. Even the National ABC were deluged with mail and phone Institutes of Health (NIH) allocation of calls from angry chiropractors. There any funding for research on chiroprac- was talk of revenge and boycotts, and tic or other forms of alternative medi- there was strong opposition from many cine was, said Salzberg, “an egregious in the profession when Thicke was pro- waste of money.” Professional Notes posed as a keynote entertainer for the There were hundreds of responses from Steroid Injections for Stenosis Chiropractic Centennial Celebrations in Washington DC in July 1995. individual chiropractors, facilitated Epidural glucocorticoid injections are by modern online technology inviting The facts of the matter are that off- widely used to treat symptoms of lumbar comment on the article. These led to a screen Thicke has always been a spinal stenosis, a common cause of pain July 1 article in Dynamic Chiropractic strong supporter of the profession. Dr. and disability in older adults. Typically titled How to Respond When the Media Joanne Thicke of Brampton, Ontario they also include an anesthetic. They Criticizes Chiropractic: Do’s and Don’ts.2 in Canada, his sister, is a chiropractor. are thought to relieve pain by reducing The well-qualified authors of this, pub- As a comedian used to puncturing the lished under the byline Research: Not nerve-root inflammation and ischemia. egos of all individuals and occupations, Just for Scientists Anymore, are: More than 2.2 million of these are per- he was surprised at the extreme over- formed annually under the US Medicare reaction of the profession. • Dana Lawrence, DC, MEd, Senior Director, Center for Teaching and program. Rates and costs have increased (Calmer heads prevailed. Thicke was Learning, Palmer College of Chiroprac- by almost 300% over the past two invited to the Centennial, and was such tic. Dr. Lawrence has served as Editor decades. a success in Washington, DC that he for several scientific journals, including Are these injections effective, are they was also invited to the Palmer College the Journal of Manipulative and Physi- safe? Until now there have been some celebrations in Davenport in Septem- ological Therapeutics (JMPT), and pub- uncontrolled studies suggesting short- ber). lished a number of textbooks. term benefit for some patients, but no 2. The problem with over-reaction to • Christine Goertz, DC, PhD, Vice- rigorous controlled trials. media criticism is that it aggravates the Chancellor of Research and Health situation, hindering rather than help- The first such trial, a multicenter US study Policy, Palmer College of Chiropractic. ing the profession. A response based on by Friedly, Comstock et al. published on Dr. Goertz also serves on the Board of emotion, rather than rational comment July 3 in The New England Journal of Medi- Directors for the Patient Centered Out- on the exact issues and best evidence cine, compares injections of glucocorti- comes Research Institute (PCORI), a makes you an easy target. coids plus the anesthetic lidocaine with Federal Government-sponsored senior injections of lidocaine alone and reports 3. And now to the present and the advisory body on the relative effective- minimal or no short-term benefit – and reason for this article. In April Forbes, ness of different healthcare treatments greater risk of adverse events. an influential American magazine, and which of these should be covered published an article by Steven Salz- by government programs, including continued on page 4 berg titled “New Medicare Data Reveal Medicare. Main Article continued from page 1 doesn’t need a defence” say Lawrence The Chiropractic Report is an international review and Goertz, quite correctly. The chi- of professional and research issues published six ropractic profession is now part of the times annually. You are welcome to use extracts well-established fabric of American from this Report. Kindly acknowledge the source. Subscribers may photocopy the Report or order society with wide acceptance. Like all additional copies (.80 cents each, plus shipping professions chiropractic has its crit- – minimum of 20 copies) for personal, non- ics, but there is no longer any need to commercial use in association with their practices. defend its existence. However, neither the complete Report nor the majority or whole of the leading article may be Goertz and Lawrence speak primar- reproduced in any other form without written Lawrence and Goertz reviewed the ily to an American audience, but their permission. responses from the profession and comment is equally valid internation- The opinions and statements in this publication are those of the individual authors alone, not the explained: ally. Chiropractic is well-established in Editorial Board, World Federation of Chiropractic or a) Many responses were emotional from many countries. It is recognized and any other organization. “impassioned chiropractors”, displaying regulated by legislation in over 40 coun- Subscription: for rates and order form, see page 8. hurt feelings. These were often based on tries. The World Health Organization • Visit www.chiropracticreport.com has explicit policy supporting the inclu- • Call 416.484.9601 beliefs about chiropractic, not of value • Email us at [email protected] in this context, rather than evidence. sion of chiropractic in national health 3 Many featured ad hominem attacks care systems. There is now a sound, Editorial Board research evidence-base for the safety Alan Breen DC, PhD, England against the author rather than response Raul Cadagan DC, PT, Argentina to his specific allegations. “Feels good, and effectiveness and cost-effectiveness Ricardo Fujikawa DC, MD, Brazil but does not address the substance of of chiropractic services wherever they Scott Haldeman DC, MD, PhD, United States are provided. See more on this below. Donald Henderson DC, Canada the article.” Nari Hong DC, South Korea b) Many other responses addressed the b) Do not attack the medical or other Gary Jacob DC, MPH, LAc, United States professions. First, that does not address Dana Lawrence DC, United States issues and provided links or references Charlotte Leboeuf-Yde DC, PhD, Denmark to scientific articles. Some of these were the issue and is therefore ineffective Craig Morris DC, United States strong. Others were not, demonstrating and beside the point. Second, although Lindsay Rowe DC, MD, DACBR, Australia little understanding of the relevance there will always be some MDs preju- Hossein Sabbagh DC, Iran diced against DCs – and vice versa – Louis Sportelli DC, United States and weight of the evidence quoted. Aubrey Swartz MD, United States other health professionals should and c) While good responses are needed, Yasunobu Takeyachi DC, MD, Japan must be seen as colleagues in this era. poor responses are damaging. Media, Changes of mailing instructions should be sent to There is ever-growing interdisciplinary including the Internet, “thrive on con- The Chiropractic Report, 203–1246 Yonge Street, acceptance and integrated care. Toronto, Ontario, Canada M4T 1W5, troversy” which drives traffic, sales and telephone 416.484.9601, fax 416.484.9665. monetizing of sites. The editor of Forbes As an example Lawrence and Goertz Printed by Harmony Printing Limited, 416.232.1472. and the author know this and can pick refer to various integrated settings in Copyright © 2014 Chiropractic Report Inc. and choose what they want to highlight the US, including the Veterans’ Admin- ISBN 0836-144 and respond to. istration centers which now have not only chiropractic clinical services but “Most news articles today now end with also postgraduate residencies for chiro- response” as any other chiropractor to text that usually says something like, practors. As one further example of this broad and unsupported criticisms such “Do you agree that chiropractors waste growing interdisciplinary acceptance as those by Salzberg in Forbes. However, half a million dollars a year? Click here of chiropractic services, a recent survey that response must be suppressed in an to post your comments!” reported 75% of Canadian orthope- evidence-based world. “When you do, you had better make dic surgeons approve of having their a) Do make sure you are calm as you sure you have your facts straight.” patients screened as to need for surgery prepare and write your response. Accordingly Lawrence and Goertz by non-medical primary care profes- b) Do ensure that you understand the 4 provide a list of do’s and don’ts when it sionals such as chiropractors and many author’s main point, why (s)he is mak- comes to media responses. This issue chiropractors have such relationships ing it, and the evidence given in sup- of The Chiropractic Report reviews with them. port. Do the same for secondary claims. and expands upon these. It then refers c) Do not let your emotions govern c) Do list your counterclaims to these to some of the best evidence used on your response, feeling that criticism of points, and for each counterclaim orga- important or controversial issues.