Chiropractic

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State Medical Boards should not recognize board certification in “Integrative Medicine”

The Integrative Medicine Wheel: False hope and lies

The Integrative Medicine Wheel: False hope and lies

There are a number of things about so-called “integrative medicine” (or, “IM”) we don’t know, such as

  • Whether IM really offers the best of conventional medicine and CAM.
  • Whether IM produces better outcomes.
  • Whether IM is effective in the area of prevention, including obesity and cardiovascular risk.
  • Whether IM has anything to offer preventive medicine.
  • Whether future IM research will yield beneficial results.
  • Whether IM has a positive impact on utilization clinical preventive services, smoking cessation, diet, and physical activity.
  • Whether IM is cost effective.

We don’t even have a working definition of “integrative medicine,” although experience tells us that incorporating diagnoses and treatments with insufficient evidence of safety and effectiveness is an acceptable element of integrative practice, as is rebranding “conventional” practices as “integrative.”

Normally, these substantial deficiencies would get in the way of declaring that IM is anything like a real specialty in medicine. Indeed, as David Gorski has pointed out, IM is more of a brand than a specialty. Yet, as we do know, integrative medicine considers itself exempt from the rules. Thus, a few years ago, Andrew Weil, MD, an early adopter in incorporating pseudoscience into medical practice, announced his desire to create of a board certification in integrative medicine. No doubt aware that IM couldn’t fulfill the requirements of the American Board of Medical Specialties (ABMS), he turned to the American Board of Physician Specialties (ABPS), whose requirements for Board recognition are more forgiving. For example, the ABPS is willing to credit work experience as a prerequisite to board certification, as opposed to residency and fellowship training. Sure enough, a few years ago, the ABPS formally accepted board-certification in IM via the ABPS’s recognition of the American Board of Integrative Medicine (ABOIM). (more…)

Posted in: Chiropractic, Energy Medicine, Herbs & Supplements, Homeopathy, Legal, Medical Academia, Naturopathy, Politics and Regulation

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Chiropractor Claims the CDC Is Trying to Get Nazi-like Unfettered Power in Violation of the Nuremburg Code

Heinrich Himmler, head of the Nazi gestapo. This is how chiropractor Koren sees the CDC.

Heinrich Himmler, head of the Nazi gestapo. This is how chiropractor Koren sees the CDC.

An email was recently circulated among chiropractors warning them about a proposed rulemaking by the CDC, saying that it will establish a public health gestapo. It originated from Ted Koren Seminars. A chiropractor who received the email brought it to my attention. He describes Koren as “a chiropractor who is a “leader” in the chiropractic community, lecturer, antivaxxer (he refers to the CDC as the “Centers for Disinformation Control” and states that the CDC “continues to spend taxpayers’ money spewing forth poorly written, biased, “junk science” studies that, through their connections, are placed in well-read medical journals for maximum media attention”. He is also the inventor of Koren Specific Technique, which he describes as a “system akin to muscle testing (applied kinesiology or AK) wherein a muscle will become weak when confronted with a negative impulse.” (Note: Applied kinesiology is bogus.)

The circulated email is a prime example of misinformation, conspiracy theory, and fear-mongering. (more…)

Posted in: Chiropractic, Public Health

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Chiropractic Gynecologist Offers Dangerous Treatments and Misinformation

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Yes, you can have a chiropractor for a gynecologist, but it’s not a good idea.

Over a year ago I wrote about escharotic treatments for cervical dysplasia. It is offered not by MD gynecologists but by chiropractors and naturopaths, along with inconsistent and unproven diet recommendations and supplements. A corrosive agent similar to “black salve” is applied repeatedly to the cervix; it works by destroying tissue. There are no controlled studies evaluating it for safety and effectiveness. One major drawback is that there is no surgical specimen to submit to pathology to determine if there is invasive cancer. I urge you to read my first article for further details. Escharotic treatment is decidedly not a good idea.

In that article I focused on the treatment itself. I recently revisited the website of the chiropractor I mentioned in that article, Nick LeRoy, and I want to comment on some other issues raised by this individual who is offering the treatment.

Who is Nick LeRoy?

On one website he is listed as a Chicago holistic medicine physician and primary care physician for an HMO, Alternative Medicine Incorporated, which he says is underwritten by Blue Cross/Blue Shield. When I googled for Alternative Medicine Incorporated, I found a company in England, but none in America with that name. On his other website he claims to have “post-doctoral medical training in gynecology and internal medicine and to be a credentialed primary care physician (PCP) for Blue Cross of IL.” I phoned Blue Cross of Illinois, and they told me he was not listed as a provider in their records. They suggested I contact him directly to ask for clarification. I did, by email. He didn’t answer.

He has taken courses in acupuncture and Traditional Chinese Medicine, and got “private breast thermography training.” It’s not clear how much training he has in gynecology. On one page of his website he says his “integrative medicine training included gynecology, internal medicine, acupuncture, chiropractic, and nutrition.” In a video, he says he has been specializing in gastrointestinal disorders for twenty years, and he describes how he does unconventional food allergy testing for 154 different foods.

He lists himself as “DC, MS, AcT,” but he calls himself “doctor” and readers are likely to assume he is an MD. The testimonials all refer to “Dr. LeRoy.” He sells his books and supplements through his “doctor’s supplement store.” (more…)

Posted in: Cancer, Chiropractic, Obstetrics & gynecology

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A Credible Placebo Control for Chiropractic Research

D.D. Palmer, the father of chiropractic, died in 1913. Over a century later, his ideas have never been properly tested with placebo controls - until now.

D.D. Palmer, the father of chiropractic, died in 1913. Over a century later, his ideas have never been properly tested with placebo controls – until now.

The research on chiropractic has been far from rigorous. One of the problems is that studies of spinal manipulation therapy (SMT) can’t be double blinded, and it is very difficult to even do single blinding. So most studies resort to non-manipulation control groups like “usual care” or “wait list” or “pain medication.” Those studies are practically guaranteed to lead to false positive conclusions: they make SMT look more effective than it would look if you could provide a control that patients couldn’t distinguish from real SMT.

In a study just published in the European Journal of Neurology, Chaibi et al. successfully used a credible placebo manipulation on patients with migraine. It showed that SMT doesn’t work for migraine, but that’s not news. The news is that it showed how to improve the methodology of SMT studies to get more reliable results. (more…)

Posted in: Chiropractic, Clinical Trials

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Studying Chiropractic with Imaging: Another Dead Salmon?

The Activator: a spring-loaded thumper. Is this "chiropractic"? Does it really balance the alignment of the lumbar spine and sacrum?

The Activator: a spring-loaded thumper. Is this “chiropractic”? Does it really “balance the alignment of the lumbar spine and sacrum”?

Researchers in Japan have done a study evaluating the effects of chiropractic treatment using MRI and PET scans. It was published in the 2009 report of the Cyclotron and Radioisotope Center (CYRIC) of Tokohu University.

Their rationale for doing the study

Ray Hyman‘s categorical imperative is “Do not try to explain something until you are sure there is something to be explained.” These researchers believe there is something to be explained. They think chiropractic has proven clinical benefits and they are trying to find the underlying physiological mechanisms. They think they have found something with their advanced imaging procedures, but the dead salmon study and Satel and Lilienfeld’s book Brainwashed have taught us that neuroimaging studies can be misleading and must be interpreted with great caution.
(more…)

Posted in: Chiropractic

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Legislative Alchemy 2016 Update: Acupuncturists win; naturopaths and chiropractors don’t (so far)

Legislative Alchemy

Legislative Alchemy

Legislative Alchemy is the process by which state legislatures transform pseudoscience and quackery into licensed health care practices. By legislative fiat, chiropractors can detect and correct non-existent subluxations, naturopaths can diagnose (with bogus tests) and treat (with useless dietary supplements and homeopathy) fabricated diseases like “adrenal fatigue” and “chronic yeast overgrowth,” and acupuncturists can unblock mythical impediments to the equally mythical “qi” by sticking people with needles. In sum, by passing chiropractic, naturopathic, acupuncture, and Traditional Chinese Medicine (TCM) practice acts, states license what are essentially fraudulent health care practices and give them an undeserved imprimatur of legitimacy.

Only 6 of the 50 state legislatures are in regular session now. Many have ended two-year (2015-2016) consecutive sessions in which legislation from one year carries over into the next. The Texas, Montana, and North Dakota legislatures didn’t meet at all in 2016.

During 2015-2016, over a dozen naturopathic licensing or registration bills and at least 15 naturopathic practice expansion bills were introduced. (In some states, companion bills were introduced in each house. These were counted as one bill.) At least 19 chiropractic practice expansion bills were introduced in the same period. Four acupuncture/TCM practice acts were introduced, as were 14 practice expansion bills. This count does not include bills trying to force public and private insurers to cover CAM practitioner services.

(more…)

Posted in: Acupuncture, Chiropractic, Legal, Naturopathy, Politics and Regulation

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The New Chiropractic. And I thought SBM had an uphill battle.

Sisyphus, our enervating mascot.  Join us!  We're tired.

Sisyphus, our enervating mascot. Join us, we’re tired!

Over at the Society for Science-Based Medicine we have Sisyphus as the logo on the website. Sisyphus, as you may know, is the Greek who had to push a boulder up a hill every day, the archetypal metaphor for futile labor. It was meant to be a bit tongue in cheek, but only a bit. As quackademia proudly expands I sometime feel we were overly optimistic. Perhaps it should have been Prometheus

But if SBM has it tough, it pales next to the work of Bruce Walker DC, an Australian chiropractor who is calling for The new chiropractic.

His goal is to remake chiropractic, turning it into an evidence-based spine specialty, abandoning all the pseudo-scientific baggage.

I wish him luck. He will need it. (more…)

Posted in: Chiropractic, Commentary, Humor

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Bye Bye Bravewell

Bravewell Collaborative

Exactly one year ago tomorrow, The Bravewell Collaborative shut down, an event so momentous that few seem to have noticed. It’s been a while since we at SBM devoted much attention to Bravewell, although, at one time, its doings were a regular feature of SBM posts.

For those of you not familiar with Bravewell, a brief history. The main mover and shaker behind The Bravewell Collaborative was Christy Mack, wife of former Morgan Stanley head John Mack and a financier of sorts in her own right. She and the widow of another Morgan Stanley bigwig, Susan Karches, neither of whom had any particular expertise in finance, managed to get about $220 million in bailout funds from the Federal Reserve, a boondoggle recounted in Matt Taibbi’s 2011 hilarious Rolling Stone article, “The Real Housewives of Wall St.” Ms. Mack had established the Bravewell Collaborative a few years earlier, with her own contributions and that of other philanthropists, as a private operating foundation, a further opportunity to benefit from government largesse in the form of tax deductions.

Here’s Bravewell’s definition of “integrative medicine”:

Integrative medicine is an approach to care that puts the patient at the center and addresses the full range of physical, emotional, mental, social, spiritual and environmental influences that affect a person’s health. Employing a personalized strategy that considers the patient’s unique conditions, needs and circumstances, integrative medicine uses the most appropriate interventions from an array of scientific disciplines to heal illness and disease and help people regain and maintain optimal health.

(more…)

Posted in: Acupuncture, Chiropractic, Energy Medicine, Homeopathy, Medical Academia, Naturopathy

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Chiropractic Moves into Transportation

Pictured: Not a justification for chiropractic care
I debated which of two topics to blog about this week that appeared in my feeds.

The first was “Graduate slams CQU for offering ‘pseudoscience degree’,” where an Australian is upset that her University is offering an undergraduate Bachelor of Science in Chiropractic and a postgraduate Master of Clinical Chiropractic degree because chiropractic is “complete pseudoscience”.

And the second was:
Foundation for Chiropractic Progress Publishes Landmark White Paper : Non-Pharmaceutical Pain Management is a Safer Strategy than Opioids.”

Why choose? Just keep in mind that chiropractic is “complete pseudoscience” as we look at the landmark white paper. (more…)

Posted in: Chiropractic, Humor

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Pushback on Chiropractic

Daniel David Palmer, creator of the nebulous subluxation and father of chiropractic.

Daniel David Palmer, creator of the nebulous subluxation and father of chiropractic.

From time to time we respond directly to reader comments or e-mails in an article, when it seems that doing so would be a useful teachable moment. One of the strengths of social media is that it is interactive, which can be didactic.

I feel it is very important to respond to what people actual believe and say, because otherwise we may tend to get lost in our own narrative, as legitimate as it might be. That is the essence of ivory tower syndrome, academics talking to themselves without a reasonable sense of what is happening in society. Part of our mission is to interact with society, not just our colleagues, and to engage in a serious conversation about the nature of science and medicine.

To that end, I recently received an e-mail responding to an interview I had done previously about chiropractic. The e-mail is full of pro-chiropractic propaganda and misconceptions, and so it provides an opportunity to address some of these claims. (more…)

Posted in: Chiropractic

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