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).

Monday, December 05, 2005

The Manipulable Lesion -- A Chiropractic Rose By Any Other Name (Part 2)

Part Two of Dr. Badanes' piercing analysis of chiropracTIC's identity problems.

It is an entry in a recent exchange on the Healthfraud Discussion List that is worth sharing. I have partially anonymized it. It is written by ex-chiropractor John Badanes, DC, PharmD (more about him later). He comments on some remarks by a chiropractor (Dr. W, a reformist chiro who believes that chiropractic can be saved):

The Manipulable Lesion -- A Chiropractic Rose By Any Other Name (Part 2)

And, it's not like chiropractors aren't STILL scratching their heads after more than 100 years about how to re-package a turn-of-the-19th-century Subluxationism such that it fits into their 21st century vision of a Brave New Chiropractic World. For example, Dr. W -- whom you may recall as the other half of the P/W chiropractic tagteam --expressed his apparent frustrations with his antler-wearing colleagues relatively recently (excerpted in a post of mine appended) in one of those Real Chiropractic Forums in which chiropractic scientists gather ... the chiroSCI-list.

Frankly, I forget the specifics of the thread entitled, "Re: mission statement," but no doubt, there was plenty of the usual back-and-forth about just how much Subluxation can be included in any chiropractic "mission statement" before someone is going to recognize the chiropractor in the "chiropractic." When it comes to creating "mission statements," this revealing exercise has been acted-out many times by chiropractors "prn" in their effort to state, for a particular record, exactly what it is that "chiropractic" is all about.

It seems to me that the mission of "chiropractic" REMAINS the survival of the chiropractic organism. Somehow, though, I don't think stating this so plainly is going to fly in any of the contexts in which we see chiropractic "mission statements" ... such as with professional organizations and chiropractic schools. Still, in case you hadn't noticed, most chiropractic efforts can be explained by this sort of self-serving chiropractic narcissism -- "chiropractic" and chiropractors being at the center of whatever it is they're selling.

Anyways, here's that "mission statement" post:
From: teo@*****.org
Subject: Re: mission statement
Date: March 4, 2003

>>>> Dr. LW:
>>>> Why can't we accept that we're treating what's
>>>> already defined and run with it?

I'm guessing it's because physical therapists (PTs) and MDs _already_diagnose and manage these injuries and disorders.

Chiropractic identity is no small thing. When you eliminate whatever is unique to "chiropractic" -- the Chiropractic Subluxation and "Thuh" Adjustment --you're left with a very run-of-the-mill hands-on physical therapeutic manual modality. This is just a portion of what any PT might offer, for example. So, to "run with it," as you say, by simply tossing the Power and Glory that is "chiropractic" --arguably, this would be professional suicide.

In other words, if your best solution to the Chiropractic Problem is to train DCs to become "osteopaths," then I would offer that the "D.O." (like the PT) is already well integrated into health care. Why then, a chiropractic duck?

>>>> What in the HELL is this obtuse, supposedly self-
>>>> preservationist, circular, self-defeating thought that in order
>>>> to maintain our "autonomy" that we have to treat the
>>>> subluxation?

Um, it is the bread and butter of "chiropractic" and chiropractors, in case you hadn't noticed. You can jump up and down in apparent protest, but there are good reasons why chiropractors haven't tossed their original neurosis in favor of acquiring a more grown-up secondary autonomy --one associated with straightforward diagnosis and management. Also, you're forgetting something obvious --that chiropractors are being trained to be licensed chiropractors who practice "chiropractic."

>>>> Our livelihood does NOT depend on treating this 'thing."

Actually, I'm not sure that you're correct about this. In fact, I would submit that "chiropractic" and chiropractors are a desirable commodity largely BECAUSE they pretend to offer an "alternative" to medicine. Realizing this, even your "most medical" chiropractic colleges are pushing to be primary care providers of Alternative Medicine. They are "Health Science" campuses, donchano.

There's a huge market for quackery, in case you hadn't noticed. What makes you think that when you remove chiropractic's foundation, the rest of its house won't simply topple. You think people are going to pay for prostitutes if they can't get any sex?

>>>> It depends instead on our "outcomes," which have been
>>>> demonstarted quite well. PTs do it every day and get the same
>>>> kind of results that we do...and guess what....they don't treat
>>>> "subluxations"!!

Well, if you say so about PTs, and all. In a society with limited health care resources, though, why then WOULD you want to duplicate the services provided by the physical therapist? As noted above, PTs are already well integrated into health care without any of the attendant problems associated with "chiropractic" and chiropractors. Knowing this, it sounds irresponsible and self-serving for chiropractors to insist, as they do, that they provide something unique --other than their quackery, that is.

So, the question of a "chiropractic" can be reduced to issues related to the role and necessity of quackery in medicine. I remember, for example, a letter to the editor --JAMA, I believe --written in the early 80s, in which an MD thought that chiropractors fulfilled the important role of seeing medicine's somatically hypervigilant and musculoskeletally neurotic patients, and/or those who had vague and chronic complaints that MDs neither wanted to bother with nor could do anything about. In these cases, an empty medicine is sometimes indicated --if you can afford it. Since health care resources ARE limited, I suppose you could argue that chiropractors provide this sort of pot to pee-in. At least, this was the MD's argument, as I recall.


John Badanes, DC, PharmD
LCCW '84, UCSF '97

Read Part One:

To see Dr. Badanes in action, check this out:

Adjusting the Joints: Video - PBS
Go to the "Adjusting the Joints" section. Then turn on your speakers and watch the video.

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