“We view subluxation as an entity or dynamic process that limits the full expression of health, be it, bio-mechanical, neurologically or other wise. When the body can not function at 100% for any reason is when opportunist ¨germs¨ take play and result in disease.
We are recognizing that germs are not the primary cause of disease, but the bodies inability to manage itself optimally and fight them off is…. no matter what the reason, we acknowledge that bio-mechanical, mechanical-neurological issues in the spine play a role in this. That´s it.”

This is so vague that it is meaningless. What is your basis for assuming that a biomechanical process can increase the body’s susceptibility to germs? Do you know of any evidence that a muscle strain in the back or a ruptured disk makes someone more likely to catch the flu? Is a patient with spondylolisthesis more susceptible to tuberculosis or AIDS? Do you think that a patient whose spine has been adjusted by a chiropractor could not be harmed by Ebola virus? What about illnesses that are not germ-related?

I think you are just rationalizing to find a hypothetical excuse for manipulating any patient you want to manipulate. You are describing a belief system, nothing more.

I am entering this new blog arena with hopes to help you in your thought processes here. I can not represent anyone other than myself, nor am I trying to defend any other professions. I did think however you may be interested in a deviation from your academic, outside in look at subluxation based chiropractors and get some real insight.

Don´t be fooled, I know I am entering the lion´s den here and will do my best to keep to topic if you will. Let´s stay on point with conceptual models, I will not get crazy over spelling, or issues of semantics but rather offer what I can as an average day in and day out practitioner. Is that reasonable?

There are so many points listed here before my involvement. I would rather not try and defend them all, nor want to really, not all my position.

Where I can start are with 2 issues:
1. Research: Let´s be real. Chiropractic is a private profession. No government grants, assistance or much benefits. Almost all the funding for education comes from tuition… 96% as apposed to the 4% from Stanford. No 3rd party grants, insurance money for studies…pharmaceutical money or the like so financially we are at a disadvantage of at least 10,000 to 1 dollar wise in that concern. So not an even playing field. We would love more research if we could get it done, and welcome it.
2. Subluxation as the cause of disease: That is a misunderstanding. We view subluxation as an entity or dynamic process that limits the full expression of health, be it, bio-mechanical, neurologically or other wise. When the body can not function at 100% for any reason is when opportunist ¨germs¨ take play and result in disease.
We are recognizing that germs are not the primary cause of disease, but the bodies inability to manage itself optimally and fight them off is…. no matter what the reason, we acknowledge that bio-mechanical, mechanical-neurological issues in the spine play a role in this. That´s it.

Let me just start there. Some neutral ground, room to play and hope we can all stay constructive. I look forward to hearing from you.

Well, I suppose I walked into that rebuttal! Never dare to contradict the point of citing a paper you haven’t read! But the thesis that “uncritical repetition” is bad is not hard to understand from your summary, and my answer to it is: just what exactly is so “uncritical” about the repetition of Hill’s criteria here?

I don’t think Dr. Crislip’s repetition was uncritical, and intelligent people don’t read anything uncritically, and I see no problem with contemplating an “early rough cut” … even if that is what Hill’s list is.

If the state of the art has advanced so far beyond Hill, then, by all means, let’s discuss that. But I see no need to exclude Hill’s list or Dr. Crislip’s discussion of it.

“I believe that very often attempts by intellectuals to describe the fallacies of very slick alt medders often has the opposite effect leaving the general public with the stereotypical impression of doctors alts love to paint,”

I couldn’t agree more whole-heartedly. I said something very similar to this is in a personal communication with one of the editors. Sites like SBM are great for the choir and, perversely, great for the opposition; not so much for the great unwashed. And it is the great unwashed who we really need to reach.

“Expository prose is an art, not a science. I cannot begin to imagine how one would construct a meaningful RCT to define ‘… the most effective ways to educate and communicate with the general public using the written word?’ There is an entire body of didactic theory and practice but I don’t know that much of it has solid scientific underpinning.

Beyond that the task at hand is much more complex than choosing the best locutions. First one has to identify the target audience, find a way to get their attention, communicate and educate, and get them to internalize the lesson and incorporate it into their thought processes.”

There are definitely objective ways to evaluate the efficacy of different methods of educating and communicating and they are obviously very different than RCTs or methods used to evaluate drugs.

I identified my target audience long ago. It is the group often referred to as the “mass market”, the “average consumer”, not the true believer. I also know from the media I’ve worked with that that is the same market they use me to target.

Based on experience with this group, I believe that very often attempts by intellectuals to describe the fallacies of very slick alt medders often has the opposite effect leaving the general public with the stereotypical impression of doctors alts love to paint, one which generates distrust not trust or even an openness to listen to them.

Val has referred to problems communicating with the general public and her efforts to find more effective ways of doing that. I think we should all be working on that or at the very least realize how important it is.

“Addressing nitpicking, I wrote, “How do you define ‘great writing skill’…”

You may well have been responding to nitpicking but you did so on a public blog so I feel no restraint from kibitzing.

Expository prose is an art, not a science. I cannot begin to imagine how one would construct a meaningful RCT to define “… the most effective ways to educate and communicate with the general public using the written word?” There is an entire body of didactic theory and practice but I don’t know that much of it has solid scientific underpinning.

Beyond that the task at hand is much more complex than choosing the best locutions. First one has to identify the target audience, find a way to get their attention, communicate and educate, and get them to internalize the lesson and incorporate it into their thought processes.

I worry that sites like SBM attract only their choirs and the magical thinkers who stand in polar opposition and are unlikely to be convinced by any level of proof. If you will pardon the comparison, the heated argument may be between the Democrats and the Republicans but often the election is decided by the independents.

So for me the more important question is: how do we identify those who can be convinced and how can we convince them.

We are marketing a way of thinking and so are the other guys. Ours is a rigorous way, sometimes difficult and requiring research and effort. Their way is easy and requires only ‘feeling’ and credulity.

Windriven responded, “What is your point in asking such an open-ended question?”

My point is that I have been doing a lot of writing over the past 15 years trying very hard to educate the general public about the need to verify supplement claims with independent evidence before believing them. I am also on the board of a non-profit health organization that is in the position of constantly trying to explain very complex issues to the general public. The bloggers here and many readers are also trying very hard to do that. However, IMO we need objective evidence, good studies, showing us how to do it and the best way to do it. I myself am not aware of any such studies although I would love to see them if they exist. If they don’t, I’d love to see them done because I think that evidence rather than opinions, feelings and beliefs is the best way to evaluate things, including things like how to effectively communicate. To put it another way, I find it ironic that people would insist on evidence to support medical claims, but not even consider the fact that evidence is needed to determine whether or not we are communicating what we want to communicate and whether or not we are doing it in the most efficient manner possible.

Nitpicking responded, “Rosemary, I’d prefer if you stated a specific objection rather than casting vague, implied aspersions. Speaking as an educator and professional writer.”

Nitpicking, I’d prefer if you didn’t read into what I write things that are’t there. I was not implying or casting aspersions. You used a term “great writing skill” which I asked you to define. Since you are an educator and professional writer, I would expect you would either be able to do that, refer me to a link if you think the topic is too detailed to cover in a comment, or simply say, “You know I’ve never thought about that, but I recognize it when I read it.”

I don’t have a reference but I have read that Ronald Bowers, a prosecutor with the Los Angeles DA’s office for about 40 years, was chosen by his office to start and head a division to develop visual aids for prosecutors and to learn and teach them how best to communicate complicated ideas to juries. That was done since it had been noticed that great oratory no longer convinces people the way it did in the past and because there were studies (I don’t have references) showing that people process auditory and visual input differently, visual impressions are remembered better and the best way to communicate to people is to use a combination of auditory and visual methods. In other words they found studies showing the best way to communicate in a courtroom, then developed and taught methods of communicating based on those studies.

I think that if we had that kind of evidence about written communication that it would go a long way in helping us accomplish our goals.

Thanks, I may be a teller of tales full of sound and fury that signify nothing, but I did already knew that was from Hamlet. (And yes, I know that’s Macbeth)

I was referring to the entire quote that adds “But you have to prove it to me” and asking if that part is original Mark Crislip or not.

Hamlet, Act I, Scene v

There are more things in heaven and earth, Horatio,
Than are dreamt of in your philosophy.

“One should say it doesn’t fit into our current anatomical understanding, rather than say it’s not possible.”

In science, it’s generally understood that when something is said to be impossible, it means that all our current understanding says that it is not possible or plausible, but that it is possible (however unlikely in any specific situation) that current understanding can change with new and better information- that’s the nature of science. The qualification is not really necessary.

Homeopathy is not plausible without nearly all current knowledge of chemistry, physics, and medicine being grossly wrong; the short hand version is that homeopathy is not plausible.

Added to my Random Quotes page. Am I correct in attributing it to Mark Crislip, or did somebody else think of it first?

Organ function is governed by the autonomic nervous system in concert with psychic, chemical, hormonal, and circulatory factors, independent of spinal nerves. What is at issue is the claim by chiropractors that vertebral misalignment or an elusive “vertebral subluxation complex” can be a cause of visceral disease and can be adjusted to “restore and maintain health.” Such subluxations have never been proven to exist.