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).

Friday, November 12, 2004

Chiropractic Education - by John Badanes, DC, PharmD

Chiropractic Education
By John Badanes, DC, DPharm

Compared to getting into medical school, matriculating to chiropractic school is a breeze. Only two years of undergraduate pre-requisites are needed with passing grades in the required courses. Many chiropractors have taken their basic science pre-reqs at schools that offer special 6-weekend courses in each. There is no equivalent in 'chiropractic' of the MCAT (Medical College Admissions Test), which considered alone is not a good predictor of what KIND of doctor you will be, but IS an indicator of a certain level of intellectual function (disturbingly absent in the chiropractic profession). I was accepted to a 'good' chiropractic school with only a phone call since I already met the requirements and had the tuition money. I was the one to suggest that they actually meet me personally for an interview to make sure I wasn't a mass-murderer.

A persons' character and especially their intellectual interests and motivation are not carefully considered in the application process. Chiropractic schools are essentially trade schools, tuition dependent, and generally can not afford to be picky about 'choosing' who's admitted. And because the schools require the tuition to remain 'open,' they also can't afford to LOSE anyone, who, even at a chiropractic school, is below par. I believe the quality of the entering student has bearing on the ultimate product.

The faculty at chiropractic schools generally do not have real expertise in the areas they teach. Quite often, they are DCs who have done their best to put together a course in pathology or diagnosis, but have no experience (as a medical doctor) beyond the textbooks they used and the DCs who taught them. Basic sciences: My biochemistry and physics teacher maintained that you weighed less when you picked one foot off the ground and that there was no gravity on the moon. Microbiology: When asked about the size of a virus, the professor maintained it was "very small," but wasn't quite sure if it was bigger than an atom, or not. A fungus was defined as the 'green stuff' that appears on cheese left too long in the refrigerator. Clinical sciences: The OBGYN course is currently taught by a DC who believes that new-borns need to be Adjusted to treat the neck trauma incurred at birth.

Being at clinic can be like having a free ticket to "Ripley's, Believe It or Not." The atrocities that go on daily in the name of 'The Chiropractic' are too many to enumerate: using non-medically diagnostic x-rays to locate the (conceptual) Chiropractic Subluxation; "Adjusting" the first cervical vertebra on a patient who has fainted (as an emergency measure); faculty DCs, who when asked to confirm an arrhythmia on a patient, telling a student not to worry about it (since the instructor has no idea what to listen for) and that 'Thuh' Adjustment will take care of The Problem; and on.. and on.

Chiropractic outpatient clinics, where the so-called 'clinical' training takes place are not affiliated with any hospital. Students do NOT see the patients they've only read about, so that their clinical judgement and opinion about a rash, a bump, or even a pain is almost worthless. The faculty DCs are generally Adherents of a particular Chiropractic Technique and so frequently only know a portion of their already narrow chiropractic approach. For example, a teacher who practices NUCCA Technique only analyzes and treats 'malpositions' of the first cervical vertebra. Any patient complaint is presumed to be a misalignment of the first cervical vertebra and is "corrected" with what's called a 'Triceps-Pull,' a robotically tense, slow and convoluted maneuver so byzantine in concept and application that, well, you'd have to "See it, to Believe it!" If a student spends their entire clinic life "mastering" such an irrelevant medicine, how does this speak to the issue of training for primary care, or even a back specialist? Where is this information represented on the comparison list?

Finally, I am not aware of any required clinical internship or residency (as with MDs) for chiropractors above and beyond their relatively minor clinic exposure and the irrelevant clinical antics to which I referred earlier. Leaving out this three to five years training that most MDs undertake AFTER graduating four years of medical school is perhaps the most grotesque, but no less naive, misrepresentation of the lists comparing MD and DC medical educations. But there's a qualitative subtlety which may be missed if we only focus on this obvious quantitative difference. This relates to the relationship of the chiropractor and the MD to the course-work that's listed.

Remember, that the Vitalism that informs much of Chiropraxis both historically and hysterically, is virtually unrelated to scientific medicine. Hence, the medical and science courses that ARE listed for chiropractors represent little more than a theatrical prop, like the white jacket and stethoscope needed to "Play a doctor in real (insurance-reimbursable) life." Medical education, on the other hand, represents the fundamental and basic underpinning of the diagnostic and therapeutic strategies and skills MDs will develop and apply throughout their practice career. Chiropractic students *STILL* argue about why they have to take all this "medical stuff" knowing very well how easy it is to trade-in the complexities of biochemistry, nerve trespass, and patient management for the more lucrative world of Body Chemistry, Nerve Interference, and Practice Management once they graduate.

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