Confessions of a Quackbuster

This blog deals with healthcare consumer protection, and is therefore about quackery, healthfraud, chiropractic, and other forms of so-Called "Alternative" Medicine (sCAM).

Sunday, September 12, 2004

Chiropractors need re-education!

The following is written by a former chiropractor who is now a medical student [all emphasis - PL]:

I can vouch for the need for re-education! Although I tried to practice an evidence based practice model for treating mechanical spinal conditions as a chiropractor, I found that because in my chiropractic training I had not been exposed to actual sick patients and never seen people with medical conditions that cause spinal pain and headaches (90% all visits to chiropractors, after all) , my management of patients tended to look for red flags that I had never actually seen, looking for diagnosis that I didn't really consider too likely to happen.

Looking back, I'm glad that I never missed anything big! It seems ridiculous to put somebody in a position professionally to be looking for something they have never actually seen! One trip to the neuro-ICU is all it would take to see it all, that that never happens in chiropractic training.

In medical school I have seen people with upgoing Babinski's, clonus, hyper-reflexia or arreflexia, non-responsive pupils, night pain, fevers, chills, cranial nerve palsies etc etc that I only ever read about in books when I was in chiropractic college. Now that I have seen these things and realize that they do happen and what it actually looks like, I feel confident that I would actually recognize these things when I see them again and have a good understanding of the proper work-up for these signs and symptoms. My chiropractic training did not do this for me, and as a result I had a very skewed view on things.

The chiropractic approach is basically to determine one thing: can this person have spinal manipulation or not? The chiropractic marketing gurus convince chiropractors that EVERYBODY needs it, no matter how the patient presents. Chiropractors actually start to believe it the more they hear it and tell each other this.

For supposedly being "neuro-musculo-skeletal specialists" I realize now how limited my clincal training as a chiropractor was. It really is a joke in my opinion. Chiropractic clinical exposure in chiro college is very limited, mostly restricted to well people with a mechancial problem. There is very little teaching about rehab exercise at all. So much emphasis is placed on the almighty adjustment it is just ridiculous.

There is an underlying mistrust of the medical profession permeates throughout chiropractic, which I feel is because of this isolation in training from the rest of the health care professions. Chiropractors, in my opinion, do not truly understand sickness and disease since they work with mostly healthy people who have a simple mechanical problem for the most part. I know that I didn't appreciate as much about health and disease as a chiropractor that now I am gaining in my medical education. PT's see a lot in hospital rotations, so they understand more about pathological conditions than chiropractors. I think if chiropractors ever had the chance to do hospital rotations that a lot of the misunderstandings about the medical profession that chiropractors have would lessen; and if chiropractors would just admit that they have a very limited scope of practice and stick to it, most MD's wouldn't have big issues with people with back pain trying a few manipulations.


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