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, January 16, 2005

No justification for the existence of chiropractic

Allen Botnick DC wrote:


It seems to me that there is little justification of having an entire profession devoted to manipulating lesions that don't exist. Other scopes such as pain management can be easily co-adopted by having physical therapists take postgrad training in manipulation for the few legitimate conditions where it would be indicated.

What unique important niche do you see for chiropractors that would justify an entire profession?

My reply:

I couldn't agree more. My contention is that the success of the individual, ethical, science-based chiropractor, is not a sufficient counterweight in the scales to justify the continued existence of the chiropractic profession. Its faults are just too heavy. I may refer to such a chiropractor, but I wouldn't dare to recommend that one of my patients "try chiropractic". The risk of them falling into the hands of a typical chiropractor is far too great.

DCs often use the invalid argument, that patient satisfaction, in and of itself, justifies their existence. But quacks use the same argument to justify their use of voodoo, witchcraft, homeopathy, iridology, reflexology, healing, and many other forms of so-Called "Alternative Medicine" (sCAM) and quackery. All of these practices can count millions of followers. Which only proves that millions of people can easily be fooled.

No, other arguments must be used to justify the right to exist as a profession, just as a number of questionable practices commonly used by most DCs today nullify the right of their profession to exist. It also justifies using the term "quackery", when describing the practice of those who use these questionable practices.

Some of these wide-spread practices and attitudes are: invalid philosophy; misuse and overuse of manipulation; spread of misinformation; use of indoctrination and suggestion; uncooperative; unethical marketing; exploitation of the confusion regarding their "doctor"/"physician" status; attempting the treatment of organic illness; anti-vaccination propaganda; treatment for colic, otitis media, allergies, diabetes, etc.; delayment of effective and necessary treatment by MDs; avoidable and unnecessary treatment of those who would improve anyway without intervention; unnecessary treatment of asymptomatic individuals; misuse of x-rays; use of alternative therapies, etc.

Chiropractic is an illegitimate profession. It was conceived in ignorance by a misguided megalomaniac and developed by his son into a self-aggrandizing marketing machine that could only produce a flood of quackery. With such a start, the history and development of the profession has been doomed to be problematic, and that's putting it mildly!

To make matters even worse, it considers itself to be the only correct and complete healing art, and thus the rightful heir to the position as leader of the health care system. Other systems of care have always been ridiculed by chiropractors, except those with a similar, bioenergetic, biotheological view of things. (It would be stupid to criticize someone else who shares one's own faulty views!) But since it is illegitimate, its attempts to achieve acceptance have looked more like what they in reality have always been: attempts to push the rightful heirs aside and usurp their rightful positions in the health care team, since, as a chiropractor wrote to me:

"The only team chiropractic knows is a chiropractic team."

But no matter how much it tries, chiropractic can't be legitimized. It is genetically defective.

It may be asked: "Aren't there some redeeming qualities about chiropractic?" No, not as a profession. It is troublesome and expendable. As individuals, DCs are just as different as any other professionals. While most of them are experts at spinal manipulative therapy, and when it is truly [rarely] necessary can perform it properly, that does not justify the existence of their profession.

Since chiropractic is now becoming more similar, in some respects, to Physical Therapy, any possible excuses for justifying the continued existence of chiropractic as a unique, separate profession anymore are totally nullified.

Since that which is unique about chiropractic is negative, what can justify its continued existence as a separate profession? Even as a "separate" profession, I see no justification for its existence at all.

Ross Sargent defines it this way:

"Chiropractic - a therapy that where it is effective it is unoriginal, and where it is original it is in fact a religion and of no medical value." (see Faith-Based Medicine)

The fact that chiropractic has, by intense lobbying and the use of political manipulation by chiropractic-friendly legislators, won legal recognition in many states and certain nations, should not - by DCs, the public, or legislators - be mistaken for real acceptance and respect from other health care professionals. Such acceptance and respect can not be legislated. It can only be earned through admirable, cooperative behavior and scientific credibility. The chiropractic profession has yet to meet both of these criteria. As long as it does not do so, it has no right to exist.

A reality check reveals that chiropractic, as it now exists, would not have much of worth, scientifically speaking, to contribute to any merger or affiliation between the chiropractic and Physical Therapy professions. Its "uniqueness" and one-sidedness are neither needed nor wanted. That which is left, is already provided by Physical Therapists.

I once wrote this comment:

"IMHO, NACM-minded DCs need to abandon the old "ship" completely and find another name for their new "ship"."

To which a reform-minded chiropractor responded:

"They can't... it's already called 'physical therapy.' In fact, PTs represent perhaps the greatest potential threat to 'chiropractic' and chiropractors that I can think of (besides insight, that is). If they as a group ever decided to 'embrace' manipulative therapy by adding to their baseline requirements for graduation, after the battle-dust between the professions cleared, there would be no requirement for a separate profession called 'chiropractic.' IOW, whatever it is that chiropractors CLAIM is valid biomedically about what they do, the so-called (and much overrated) 'baby' in chiropractic's turbid bath-water, would ALREADY be a part of what physical therapists could offer. And that, as they say, would be that."

But, this is wishful thinking on _my_ part ;')".

I think he's right. While I still support all attempts to reform the profession, I also think that it is ultimately futile effort. I have never yet seen a truly successful attempt to make significant reforms. The reactions to reform attempts have usually been attempts to save face, not reform. What reform attempts can do positively is to make the public and susceptible chiropractors and students aware of the dangers and deceptions of the profession as it is now. Attempts at reform should be seen as a rescue mission, not for the profession, but for the individuals caught up in it. They need to get out while they can, before the ship gets sunk, and the situation IS going to get much worse than it is now.

Another, more realistic, possibility, would be to re-educate willing DCs, using a tailor-made, shortened education designed to transform them into Physical Therapists. This would demand extensive re-education and re-programming, tantamount to un-brainwashing. This would constitute an absorption by the Physical Therapy profession of the best chiropractic candidates.

In light of the high educational standards and opportunities which PTs already enjoy, this should not be seen as a step down for DCs, especially since their claim to be equal with MDs is unjustified, as well as confusing to the public. For those who still desire to be called "Doctor", it is possible, as a Physical Therapist, to earn a legitimate Doctoral degree in Physical Therapy (D.PT), as well as PhD and ScD.

The best option, as I see it, is for DCs to either start over and become MDs, or become PTs.


A few quotes to ponder:

"Unsupported by science, chiropractors must either fall back upon Palmer's pantheistic views or admit that the "subluxation" theory is erroneous. Without the subluxation theory, chiropractors are reduced to manipulative therapists practicing a very limited modality shared by osteopaths, physiatrists, sports trainers, physical therapists and others. Without the theory, chiropractic's claim that it is a unique and comprehensive "alternative" to standard medicine is lost." - William T. Jarvis, Ph.D.


"B.J. Palmer considered chiropractic to be a business, not a profession. He advised DCs to advertise and to sell their patients on the philosophy of chiropractic. Chiropractic education is proprietary (i.e., a business of its own). Unlike physicians, DCs do not go into residency programs after graduation. They are dumped on the marketplace to survive by whatever means necessary. Having been taught to be entrepreneurs, many sell whatever they can to make money. DCs regularly invade fields of health care in which they have no real skill (e.g., dietetics, physical therapy, sports medicine, pediatrics, and even veterinary medicine). Despite the obvious conflict of interest involved, many DCs sell dietary supplements, homeopathic remedies, herbal remedies, and other items directly to their patients. DCs take formal courses in practice-building that teach methods of deception. Consumers are often no match for the schemes and scams DCs invent." - William T. Jarvis, Ph.D.


A subluxation-based chiropractor has this to say:

"....chiropractic, without its unique philosophy, is just another therapy... an inferior therapy at that... a watered down duplication of services already being rendered by better trained personnel. Chiropractic without its philosophy is unnecessary... it serves absolutely no purpose whatsoever, in which case it should be absorbed or dissolved by the medical profession. . . . . .

But I have already pointed out that these chiropractors are duplicating services (inferiorly) that are already provided by better trained personnel.

Orthopedics? Chiropractors practice it inferiorly to orthopedists.

Physical therapy? Chiropractors practice it inferiorly to physical therapists.

Neurology? Chiropractors practice it inferiorly to neurologists.

Sports medicine? Chiropractors practice it inferiorly to medical doctors.

Locating, analyzing, and correcting spinal subluxations? All health professionals are practicing it inferiorly to most chiropractors. (I say most chiropractors because some health professionals... PT's, DO's, even some MD's, are better at palpating spines and offering corrective forces than some DC's I know.)" - Robert Lincoln, DC

Rarely have I found a subluxation-based chiropractor expressing the truth so clearly. (He also wants to continue to practice subluxation based chiropractic, philosophy and all.)


"Unfortunately, I do have to say that I do understand why academics would be concerned about chiropractors "preaching nonscience to gullible undergraduates." Our profession is full of technique gurus, acupuncturists, and chiropractic philosophers preaching nonscience to gullible chiropractors! . . .

"You indicated that you are interested in how "we as a profession" should handle this. We as a profession can't handle this, because we are not willing to commit to a science and evidence-based paradigm of practice. . ." - Dr. Fred Kourmadas, DC, MS


"The closer I look at chiropractic, the more it slips through the grasping fingers of my mind. It is maddening, there's "no there there". A huge edifice built on less than sand. So visible, so present, so vocal, that it just looks like "there must be something to it", yet, like gods and unicorns and subluxations, I can find no reason for chiropractic except as a self-perpetuating fancy. I think the tiny minority of rational chiropractors should cut their losses and quit trying to reform this quagmire of quackery and cultism. " - JeanneE Hand-Boniakowski


"Chiropractic is to science, what Scientology is to religion. It is just as much a pseudoscience, as Scientology is a pseudoreligion."


"Since that which is unique about chiropractic is an illusion; What right does chiropractic have to exist? Unique illusions are the legitimate tools of magicians, not of health care professionals." -


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