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The Exciting Conclusion

On the slim chance that you’ve been perched on the edge of your seat wondering how the New Mexico appellate court ruled on chiropractic prescription privileges, whether the Council on Chiropractic Education got approved for another three years as an accrediting agency, if NCCAM ever came clean about spinal manipulation, and the fate of Brandon Babcock, DC, at the hands of the judicial system, here are your updates.

Prescription privileges for New Mexico chiropractors

A surprisingly titillating tidbit about New Mexico “advanced practice” chiropractors.

As discussed in previous posts, New Mexico “advanced practice” chiropractors succeeded in getting limited prescription rights. The statute specifically says they can:

prescribe, administer and dispense herbal medicines, homeopathic medicines, over-the-counter drugs, vitamins, minerals, enzymes, glandular products, protomorphogens, live cell products, gerovital, amino acids, dietary supplements, foods for special dietary use, bioidentical hormones, sterile water, sterile saline, sarapin or its generic, caffeine, procaine, oxygen, epinephrine and vapocoolants.

However,

Dangerous drugs or controlled substances, drugs for administration by injection and substances not listed [above] shall be submitted to the board of pharmacy and the New Mexico medical board for approval.

Apparently, the Chiropractic board couldn’t read the plain language of the statute and blew off this requirement, even though their own lawyer told them they couldn’t. This got them hauled into court by the medical and pharmacy boards. The International Chiropractors Association joined the fight.

The New Mexico Court of Appeals has now ruled unanimously that the chiropractors violated the statute in failing to get the required approval. This means they can’t inject any of the substances listed above because delivery by injection automatically kicks these products into the drug category.

The chiropractors remain undeterred. They attempted to get the legislature to broaden prescription rights this year, including controlled substances, but failed. At the heart of this effort is Bill Doggett, DC, who is committed to primary care physician status and full prescription rights for chiropractors. He was also instrumental in getting the limited prescription rights chiropractors now enjoy.

Let’s see what Doggett has in mind in the way of PCP practice and prescription rights if he eventually gets his way with the legislature. Back before the Court of Appeals quashed his hopes, Doggett planned to begin offering a procedure to regenerate healthy vaginal tissue. As quoted in an on-line article from the Foundation for Vertebral Subluxation subtitled “[Doggett] Says Chiropractors There [in NM] Are Already Providing Gynecological Exams”), Doggett stated:

It’s actually a PRP (plasma rich protein) procedure that DC’s in NM will be able to do when they settle the ICA suit. Using a proprietary technique, the growth factors in platelet-rich plasma (PRP) are extracted from that blood sample and injected into an area near the clitoris and into a the [sic] area of the upper vagina that is most important for the sexual response (the O-Spot) using a patent-pending procedure. Because these areas have been numbed with a local anesthetic cream, patients experience little or no discomfort during the procedure.

To be fair, Doggett isn’t the only health care provider pushing this procedure. It is being promoted by a group of MDs who will train physicians and nurse practitioners to use their system. (Also available, the Vampire facelift.) Best I can from the website, which has a soft-porn quality to it, there has never been a clinical trial of the O-Spot technique. Did Doggett complete the O-Spot training? I don’t know, but a search for his name does not show up in their list of providers.

Council on Chiropractic Education will probably get another three years

In my last post we looked at the battle among various chiropractic factions over continued recognition of the Council on Chiropractic Education (CCE) as the accrediting agency for chiropractic schools. According to a press release from the International Chiropractors Association (ICA), the National Advisory Committee on Institutional Quality and Integrity (NACIQI) has voted to continue the CCE’s recognition for another three years. Significantly, there were three dissenting votes. The NACIQI is an advisory body and the final call is up to the US Department of Education.

According to the ICA, there were a “large number of witnesses” at the December 12th hearing, including 18 students and more than a dozen private practitioners. “The majority of those speaking expressed deep and well-documented issues and concerns with the CCE’s standards, policies and procedures and highlighted the degree to which division over the direction of the CCE has come to dominate debate within the chiropractic profession.”

If the CCE’s recognition is continued by the Department of Education, the battle is hardly over. The ICA vows to “hold the CCE accountable to their pledge on governance reform negotiations.” And no doubt the rest of the dissidents will be holding the ICA accountable on its pledge to hold the CCE accountable. We’ll be watching.

NCCAM still manipulates spinal manipulation

Over a year ago, the post “NCCAM manipulates spinal manipulation” decried the misinformation about spinal manipulation and chiropractic on NCCAM’s website. The main criticism was that the information rests on the false assumption that chiropractors always use spinal manipulation for the same purposes as other health care practitioners. NCCAM’s discussion failed to tell consumers that chiropractors may purport to “detect” subluxations and use spinal manipulation to “correct” these subluxations. NCCAM also presents only the chiropractic view of the risk of cervical artery dissection following neck manipulation. Finally, it naively assumes that chiropractors who “specialize” have adequate education and training in these “specialties” and that they will appropriately prescribe dietary supplements, including having sufficient knowledge of supplement-prescription drug interaction. In other words, NCCAM does an extremely poor job of applying its supposedly “rigorous” research standards to the subject of chiropractic.

Well, they can’t say they didn’t know better, because after the post appeared I told them. Here’s the rather mealy-mouthed response I got:

Dear Ms. Bellamy:

Thank you for your e-mail to the National Center for Complementary and Alternative Medicine (NCCAM) about your blog post commenting on our Center’s spinal manipulation and chiropractic information.

We appreciate your thoughtful input on our information. We will keep your comments on file for future reference when we next update our content on these practices. Our goal is to produce accurate and informative publications, so we routinely review and update the information on our Web site.

To develop our materials, we use information from a wide range of science-based resources, which include peer-reviewed journals from PubMed, Federal Government Web sites, and subscription databases. Then our publications go through a review process, which includes reviews by experts in the field. We list at the end of each publication the references that we used to develop it.

Thank you for taking the time to write to us.

Sincerely yours,

Terry Evans
NCCAM Clearinghouse

I don’t know what NCCAM’s definition of “routinely review and update” is, but it apparently does not fall within the parameters of (almost) two years. The last update of the article on chiropractic was in February, 2012, and my complaint (the post was in July, 2012) did not inspire them to take a second look at their information. The spinal manipulation article was updated this year, but simply perpetuates the same misinformation. So much for NCCAM’s promise to “maintain a strong commitment to providing objective and authoritative evidence-based information to the public and health care professionals.”

Functional Endocrinology practitioner Brandon Babcock sentenced

In “CAM Docket: Functional Endocrinology Update,” we reported that Utah chiropractor Brandon Babcock was going to trial on 11 felony charges related to his functional endocrinology practice. He faced up to 30 years in prison if convicted. Babcock was found guilty of six counts of exploiting the elderly in October and was sentenced in early December to six months in jail.

Babcock lured patients with free “gourmet dinners” at which he pitched his “diabetes breakthrough.” Then, without their knowledge or consent, he signed them up for a credit scheme to finance their bogus treatments. It is not clear from the news story how much of the exploitation charges had to do with the financial shenanigans and how much had to do with his practice of functional endocrinology.

Over in Colorado, the medical board’s order to cease and desist directed against Babcock’s fellow chiropractor and functional endocrinology practitioner Brandon Credeur is, as best I can tell, still in effect. The medical board charged Credeur with practicing medicine without a license after he received a very light slap on the wrist from the chiropractic board. His Functional Endocrinology of Colorado website is still up.

Apparently chiropractors remain undeterred by these events. Within the last couple of months a chiropractor came through Tallahassee offering a free dinner and talk on the wonders of Functional Endocrinology for diabetes. I thought about going but just couldn’t stomach the idea.

Happy New Year!

If your New Year’s Eve plans include a free gourmet dinner make sure you know who’s picking up the tab. Whatever you do, have a safe and CAM-free evening.

Posted in: Chiropractic, Health Fraud, Legal, Politics and Regulation

Leave a Comment (28) ↓

28 thoughts on “The Exciting Conclusion

  1. windriven says:

    “[T]he Foundation for Vertebral Subluxation subtitled “[Doggett] Says Chiropractors There [in NM] Are Already Providing Gynecological Exams”

    That is outrageous! Where did they get their genecological training? Do they do OB/Gyn rotations in some chiropractic hospital? No. This sounds like, “my wife lets me look at hers so I must be an expert.”

    * * *

    Altogether a mixed scorecard for 2013. Here’s hoping for a better 2014!

    I am especially troubled by the continued role of NCCAM as apologist for frauds. This is an agency that spends $100 million per year “studying” quackery. This is money that is not being used to follow promising leads in medical reasearch, it is money used to count angels dancing on the head of a nitwit. As citizens and taxpayers we should expect no less than the simply honesty that, while nitwits abound, there is no evidence that angels exist or that any are dancing on the aforementioned heads.

  2. goodnightirene says:

    The description of that PRP procedure was very difficult to read through! What, exactly is the procedure meant to “treat” anyway–what causes the need to “regenerate vaginal tissue” for goodness’ sake?

    Happy Boxing Day!

    1. windriven says:

      Irene, a visit to the website suggests the purpose of the treatment is to help women get their freak on and themselves off. Hope that isn’t too graphic.

      1. Nashira says:

        I suspect it has more to do with pleasing the women’s partners than the women themselves. At least, that is the general drift of most “vaginal rejuvenation” procedures that I have seen advertised… as opposed to reconstructive procedures (such as labiaplasties) that can be done for the woman’s own comfort or functionality.

    2. Pmoran says:

      How creepy! — that of all the dubious potential uses of this supposed aid to tissue healing, a chiropractor chooses THIS!

  3. This is an example of free market unregulated capitalism, professional turf battles and desperate needy patient clashing into the a void of poor care.

    Patient need good quality healthcare that is readily available, inexpensive, fair and equitable.
    Alternative medicine like Acupuncture, dry needling, physical therapy, massage, myofascial release, active release and yes spinal manipulations would have to be apart of the new paradigm. There is validity in spinal manipulations but the reasons stated are flawed due to misunderstanding of trigger points, myofasical pain and dysfunction and the whole person.

    I’ve used PRP in joint injections and can see how it can be used for other purposes. These additional purposes are not valid as medical therapy but for cosmetic concerns. PRP injections work for incomplete and faulty reasons and need to be tested against the above disciplines. In a free market if someone wanted to pay out of there own pocket, fine by me, but not out of the true medical cost pool.

    If you guys want to know ways of saving dollars … taxpayers dollars … the above therapies will do that. Be aware orthopedic, vascular and neurosurgeons will scream bloody murder because the need for their procedures would drop like a rock, but we could save billions.

    I have no problem allowing Chiro to be physician extenders but not physicians. There training programs would have to be modified and upgraded.

    1. Sawyer says:

      We also could save taxpayer dollars (in the short term) by making all interstates out of cardboard. I wonder why more first-world countries haven’t integrated this “alternative road building” approach into their infrastructure planning? Must be a conspiracy by Big Concrete and Big Blacktop.

      It’s always nice to see that CAM fans’ knowledge of medicine is complemented by their understanding of economics.

      1. The problem we are having is with word definitions and meaning. My definition of pain is different than everyone here. so my thought process surrounding pain and all of the ways to treat it is foreign to you. Let’s begin by defining pain, “Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”[2] The most enigmatic pain is myofascial pain which is what the majority of patients have who complain about a sore back. MF pain can not be seen with any high tech equipment and it is very unique to that patient. Thus the therapy has to be unique to that patient.

        1. windriven says:

          “The problem we are having is with word definitions and meaning. ”

          Yes.

          “My definition of pain is different than everyone here.”

          No. Your definitions of science, proof, and evidence are different. Your theories about nociception are secondary.

          When the discussion moves to pain you first need to differentiate myofascial pain from bursitis, tendonitis, hypermobility syndromes, fibromyalgia and fasciitis. Then we can talk about myofascial pain and its treatment.

          “The most enigmatic pain is myofascial pain which is what the majority of patients have who complain about a sore back.”

          Besides the grammar fail, wtf is this supposed to mean? Are you seriously suggesting that the majority of back pain is myofascial pain???

    2. Badly Shaved Monkey says:

      Alternative medicine like Acupuncture, dry needling, physical therapy, massage, myofascial release, active release and yes spinal manipulations would have to be apart of the new paradigm.

      I think you spoke more truth that you intended.

  4. cloudskimmer says:

    After going to the NCCAM website with the links provided, I was invited to complete a survey. This I happily did, telling them they should stop endorsing quackery and provide better information to consumers. Now I feel better, but they probably won’t listen.

  5. Marc says:

    No one is taking Ms. Bellamy, SBM or Ernst seriously. Perhaps it is because they hold fringe opinion that aren’t shared by the mainstream?

    1. Harriet Hall says:

      “No one is taking Ms. Bellamy, SBM or Ernst seriously.”

      Citation needed. :-)
      No, really – we have plenty of feedback to tell us that a lot of people are taking us very seriously. I think yours is the minority opinion.

  6. Marc says:

    If Ernst and Colqhoun were taken seriously, then don’t you think, if their opinion represented the mainstream, that the Royal Charter for Chiropractic wouldn’t have passed? You do realize that chiropractors provide 90+% of all manipulative therapy services, and that 9/10 of those manipulations of the axial and appendicular joints is for mechanical spinal and MSK disorders, right?

    1. tgobbi says:

      And if Marc is to be taken seriously, how might he counter the following extract from the NCAHF Fact sheet on chiropractic?

      “The National Council Against Health Fraud (NCAHF) finds it remarkable that the chiropractic profession has existed for a century without having made a single notable contribution to the world’s body of knowledge in the health sciences. The reason for this failure can be found in its origins and in the continued presence of antiscience attitudes. This includes the fields of the care and prevention of back pain and the value of spinal manipulative therapy (SMT), the areas in which chiropractic has dominated the health care services marketplace. Recent pronouncements on the value of manipulative therapy for back pain have involved medical research, not work done by doctors of chiropractic (DCs). DC publicists have been quick to grab the credit for these findings for marketing purposes, but deserve little credit. Some research projects are now under way, but chiropractic still does not play a significant role in researching the causes and treatment of the human ailments from which it derives most of its income.”

    2. Badly Shaved Monkey says:

      Marc, your semi-literate scrawl strongly suggests you don’t understand the significance of the charter that relates to the British back-crackers.

      Read this;

      http://www.quackometer.net/blog/2012/11/the-royal-college-of-vestigial-victorian-fairground-mystic-bone-setters.html

      Girl Guides would be a better source of primary healthcare advice. They may well have had a reasonable training in first aid.

      1. Blue Wode says:

        @ Marc

        I think you need to get up to speed on chiropractic, political lobbying, and friends in high places. See here:
        http://www.ebm-first.com/chiropractic/uk-chiropractic-issues/2190-jubilation-in-the-chiropractic-world-but-as-usual-all-is-not-what-it-might-seem-at-first.html

        Don’t forget to click on the ‘meddling’ link in the final sentence.

  7. Sawyer says:

    Let us know when the Brits have bastardized their language so much that “Royal” and “mainstream” mean the same thing. Or when either is equivalent to “science”. I don’t think these words mean what you think they mean.

    Please by all means hitch your wagon to the medical luminary Prince Charles. The United States is way behind other countries’ healthcare systems, and we look forward to these sorts of Royal decrees helping us narrow the gap.

  8. bonnie says:

    the discussion that is going seems to be bashing one another. The facts are for all your intellegents from Harvard Mal practice is a fact (live with spelling errors-you can figure this out). The other fact is that medical costs have gotten so high, people feel fortunate to have insurance but many can’t afford treatment. you can bash these people. Our system in the US is failing, as a result people are using the means available. The fact is the medical profession with all there research have used there skills for only the “upper class” who can afford there care. The care they receive is a license to scripts for very dangerous side effects that are known without any requirements to raise the raise the bar. What I ‘m impressed with in these discussions is not meaningful value to gain any improvement on treating anything. This is the war of ego’s, comic relief. While the system is crashing this is not relevant. Polarizing conflict will not bring better anything. Showing respect and even try to say what you mean without being condiscending would say this is meaningful and there is actually value in having the discussion for me. What I am getting out of this dialogue is that there are people who count and people who don’t count politically. How many ways can you say this. Have your drinks and fun and then look at this discussion as an opportunity to give something to the discussion (which is not ego based if you please)

    1. windriven says:

      “the discussion that is going seems to be bashing one another. ”

      Yes, well, disagreements sometimes end up that way. There are, unfortunately those who so lack connection with reality that normal polite discourse is meaningless.

      “The facts are for all your intellegents from Harvard”
      -ah, you are self identifying as a Luddite?

      “Mal practice is a fact (live with spelling errors-you can figure this out).”
      Yes, bad outcomes happen. Sometimes through actual malpractice as you suggest. But can you think of a profession that is more self-aware in this regard than medicine? Can you think of any other profession that invests the time, money, and energy in discovering its errors and preventing them in the future thanmedicine?

      “The other fact is that medical costs have gotten so high, people feel fortunate to have insurance but many can’t afford treatment. you can bash these people.”

      Yes, but this is more a political issue than a medical one. And I cannot recall anyone here “bashing” anyone who can’t afford medical treatment.

      “Our system in the US is failing, as a result people are using the means available.”

      Finally, we get to your point! As I translate – and do correct me if I’m wrong – quackery should be ignored, praised even perhaps, because it costs less than medical care. Do I have that about right? So using your logic we should also embrace the substitution of wood chips for food. Wood chips are cheaper than food and they are quite filling. Nutritious? Not so much. But some people can’t afford food so woodchips are therefore an appropriate substitute.

      The lack of universal availability of medical care in one of the wealthiest countries on earth is scandal. But the scandal is political rather than medical. If you think the solution is the embrace of shamans and quacks, well, I wouldn’t want to say anything polarizing…

      1. Dave says:

        Please don’t get the impression that doctors are unaware of the problems in poor people getting care. Many of us spend a great deal of time working with uninsured people and realize more than most people the tragedy of this system. The system is bad enough that many professional organizations have come out in favor of the ACA, and these are hardly left-wing organizations. The solution is not to bilk already poor patients out of money for worthless treatments. Finally, a lot of the costs are not due to doctors. You will probably pay more to an auto body shop to replace a dented car panel than to a surgeon to remove an appendix. However, the appendectomy requires an enormous support system in addition to a bloated administrative system, which inflates the total cost.

        The solution is political. A watered down attempt was made to fix this with the Affordable Care Act, which does little to limit the cost of care but at least is designed to assure that most peole will have insurance. However, the major goal of one political party has been to destroy this act, without having any other solution to the problem. It appears that a hugh number of votors in the country agree with them, though if you ask almost anyone if they favor certain aspects of the act ,they do so.

        The solution to the mess will lie in Congress. Currently the only thing the parties agree on is to give themselves annual pay raises, so I’m not holding my breath. However, you should gripe to your representatives and vote on solutions to this issue when the opportunity arises.

  9. Gary says:

    A psychologist once told me wistfully that she wished she had prescribing rights, and said that New Mexico is the only state that allows psychologists to prescribe drugs.

    Never mind “What’s the Matter With Kansas?”, what’s the matter with New Mexico???

  10. Marc says:

    SBM is fringe pushing with respect to chiropractic medicine. I’ve said it over the last 6 years, and as the profession progresses and integrates internationally, SBM becomes further radicalized as it maintains, ironically enough, the same dogmatic stance that it criticizes (straight) chiropracTIC for espousing.

    I’ve followed Mrs. Bellamy posts for awhile including the white paper which is essentially propaganda and shows how far the SBM authors will go to cherry pick and then ‘spin’ it. This is pseudo-research and it was done clearly by authors who don’t specialize in research nor have advanced credentials to do so. In short, SBM has no expertise in chiropractic, and uses a Sam Homala, who in all due respect, has been frozen in mental carbonite and whose views are inconsistent with current practice and clinical research occurring in chiropractic.

    From a scientific POV, what has the profession done? Contributed to spinal manipulative therapy research, spinal pain management, musculoskeletal medicine, and http://www.worldspinecare.com. Lastly, there are 41 international schools of chiropractic across the world. 35 of whom teach a model of chiropractic as spinal health experts (85%). Yet SBM falsely claims the minority (straights) are the majority. All not factual, all lies. Anytime Mrs. Hall, Mrs. Bellamy, Mr. Novella, etc. want to have a debate on the status of the chiropractic profession internationally, please do come forward. Otherwise, unless you modernize or evolve your stances are equally as dogmatic and ridiculous as those you critique.

    Respectfully,
    Marc.

    1. windriven says:

      @Marc

      Just a couple of questions-

      1. Presuming that chiropractic has disavowed vertebral subluxation as the one true cause of all disease, where does that leave chiropractic? What does chiropractic offer that, say, osteopathy does not?
      2. What skill set does chiropractic bring to spinal care that is not adequately handled by physical therapy?
      3. The ICA still embraces spinal subluxation. Does ICA not speak for chiropractors?
      4. The ACA never mentions subluxation so far as I can see. But it seems a little nebulous about the exact scope and limits of chiropractic. Does ACA better represent ‘new breed’ chiros? Does it have a clear position statement on scope?
      5. How are consumers and medical professionals supposed to differentiate between ‘straights’ and, what?, ‘newbies’?

      In short, if chiropractic is having an identity crisis, how is that SBM’s problem? I for one have seen little evidence that chiropractic has reestablished itself as a science based practice. There have been a couple of clearly serious chiropractors appear in the comments who want to see chiropractic follow that path. But they seem to recognize that they are a small minority.

      So I guess the final question should be, on what grounds do you speak for chiropractic? Why does your characterization of chiropractic deserve more respect than, for instance, the ICA?

    2. Sawyer says:

      Marc,

      You do not seem to understand the difference between “consensus of experts” and “majority of practitioners”. Understanding this difference is crucial to critiquing any treatment or specialty in modern medicine. At no point have authors here ever claimed that their viewpoints coincide perfectly with what the majority of doctors use, promote, or accept. Heck, that conflict is probably the primary motivation behind many of SBM’s best posts.

      You can’t call people liars by making up your own lie. Perhaps a course in the rules of formal logic is required before continuing to whine about chiropractors?

  11. Marc,

    All very good questions. When I was in chiropractic school i found myself asking very similar questions. I have been out of school for almost 5 years and just recently opened my own practice in Illinois. I have many friends in similar fields (athletic trainers, physical therapists, DO’s, and orthopedic surgeons). I believe there will always be some gray areas between these professions, however, it is my personal belief through experience in practice that chiropractic care is among one of the most cost effective, non-invasive, time efficient solutions out there for mechanical back pain. The reason I bring up friends and colleagues in similar fields is because i continue to hear the same thing from all of them. None of them either want to or know how to properly treat mechanical neck an back pain. In most cases its not that they don’t know how, its just not their particular expertise. Take a physical therapist for example. I know some amazing physical therapists that work in very large clinical atmospheres. I realize just like Chiropractic there are many specialties physical therapists can focus on. However, the care they administer is typically for post surgical patients working on deconditioning, or in a sports rehab atmosphere where they have to focus on many joint, muscle, tendon, and ligament ailments. As a chiropractor i get to focus on the thing that most people will have occur at some point in their life, chronic low back or neck pain.

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