Dept. of Education to Council on Chiropractic Education: “Straighten Up!”

Our last look at the Council on Chiropractic Education (CCE), about 18 months ago, found the CCE deeply embroiled in a heated dispute among various chiropractic factions over new accreditation standards for chiropractic colleges. Today we offer an update on that situation.

Update: the CCE is deeply embroiled in a heated dispute among various chiropractic factions over new accreditation standards for chiropractic colleges.

As you may recall, the CCE, which accredits chiropractic colleges in the U.S., stood accused of removing the subluxation from its standards for accreditation, so that chiropractic students would no longer be required to learn how to “detect” and “correct” the putative vertebral subluxation. Of course, the chiropractic subluxation doesn’t exist, but we’ll get to that in a minute. This brouhaha was raised by the more traditional wing of the chiropractic community, called “straights,” whose practice (and livelihood) is based on convincing patients that their spines need “adjustments” to remove these subluxations under the threat of ill health should they be left unattended. The straights were also upset at the move by another faction of chiropractic seeking to rebrand chiropractors as primary care physicians who diagnose and treat a wide variety of diseases and conditions.

By way of background, the CCE’s standards for admission to chiropractic colleges are, to my knowledge, the lowest of any program awarding a doctoral degree. (See Policy No. 6 in link.) As you likely know, a student can’t get into graduate school in the standard American college or university (even to pursue a master’s degree, much less a Ph.D) without first obtaining an undergraduate degree and attaining an acceptable score on the Graduate Record Exam. Other graduate programs — such as law, veterinary and medical schools — have their own rigorous entrance exams. (You can find an outline of the topics covered by the Medical School Admissions Test here.) Not chiropractic college. A student need not have an acceptable exam score because there is no entrance exam for chiropractic college. In fact, the student doesn’t even need a college degree – only 90 undergraduate hours, including 24 hours of basic science courses, and a 2.5 (“C”) average. In other words, the entrance requirements for a D.C. degree are less selective than those for a master’s degree in one of the sciences.

Straighten up!

To redress their grievances, the straights organized a campaign to attack the CCE during its review by the U.S. Department of Education (DOE), which was required to retain its status as the sole national accrediting agency for American chiropractic colleges. Instead of evaluating higher education institutions itself, the DOE parcels this job out to private accreditation agencies but makes these agencies meet certain standards. Each accrediting agency is reviewed by the DOE every 5 years and it was CCE’s turn at bat. Reviews are conducted for the DOE by the National Committee on Institutional Quality and Integrity (NACIQI).

Accreditation is key to colleges and universities because it opens the door to taxpayer-funded loans for their students. States also use CCE accreditation in determining whether to accept a degree from a particular chiropractic college in licensing decisions.

A DOE staff analysis found that the CCE was not in compliance with 44 of the criteria for accrediting agencies outlined in the Code of Federal Regulations. This included failure to comply with regulations governing conflicts of interest, record keeping, processing of student complaints and the adequacy of its site review of accredited chiropractic colleges. (The DOE staff’s full report covers a number of accrediting agencies and is not numbered sequentially. You can find the section on CCE by scrolling down to page 61 of the PDF.)

The staff report noted that one chief concern of the dissenters was the elimination of the term “subluxation” from the CCE’s standards. In a response clearly demonstrating that a science-based education is of no concern to the DOE, the staff report stated:

This is a professional issue within the chiropractic community. Staff concludes that it is beyond the purview of the Department to dictate to any [accrediting] agency what its curriculum requirements and accreditation standards should be.

In other words, feel free to teach implausible and unproven concepts of human anatomy and physiology to students who will become licensed health care providers. That is not our job.

One particularly glaring omission in the CCE’s oversight of chiropractic education was in determining how many credit hours a college assigned to its courses. The DOE requires all accrediting agencies

to conduct an effective review and evaluation of the reliability and accuracy of the institution’s assignment of credit hours. . . . The agency is required to make a determination whether the institution’s assignment of credit hours conforms to commonly accepted practices.

It wasn’t that the CCE’s policies and procedures were insufficient. Rather, the CCE totally failed to address this criterion at all. This, it seems to me, is a crucial gap in the record, for it goes to the very heart of the quality of an institution’s education. Without this information we can’t know if schools are inflating the number of hours credited to coursework. Credit hours assigned to courses becomes a virtually meaningless figure.

The straight’s attack on the CCE was prolific, if ultimately only partially successful. The NACIQI received approximately 4,000 comments regarding the CCE during its review, only 30 of which were supportive. Although many of the negative comments were simply copies of the same complaint, it does indicate some level of dissatisfaction among the approximately 50,000 practicing chiropractors in the U.S.

The NACIQI voted 12-0 to accept the DOE staff’s report on the CCE’s noncompliance. In light of the many complaints, the NACIQI told the CCE to demonstrate wide acceptance by chiropractors of its standards, policies, procedures and decisions “and to address how its standards advance quality in chiropractic education.” This, as well as the 44 shortcomings found by staff, must be remedied in 12 months.

The DOE’s final decision, in a letter to the CCE dated March 15th, accepted the NACIQI’s recommendation on all points except the added requirement that the CCE demonstrate wide acceptance. The recognition of CCE was continued provisionally for 12 months in order for the CCE to bring itself into compliance. It has 30 days after that to submit a full report on compliance, at which time the DOE will make a final decision regarding recognition. The DOE reminded the CCE that granting extensions of time to come into compliance were rare, and failure to achieve compliance in the additional time allotted would, in accordance with federal law, result in refusal to recognize CCE as an accrediting agency.

Interestingly, the Chair of CCE failed to mention the full extent of the DOE’s ruling in a March 20th memo to “Interested Parties and Stakeholders.” Rather, he opted to describe the DOE’s decision this way:

We would like to publicly acknowledge the U.S. Department of Education’s recent decision to renew its recognition of CCE. On March 15, 2012 CCE received written notification that the Secretary of Education, after performing a thorough review of our evidence, and following comprehensive and careful analysis of recommendations made by the Department Staff and National Advisory Committee on Institutional Quality and Integrity (NACIQI), decided to ‘continue CCE’s recognition as a nationally recognized accrediting agency.’

Looks like he left out a few important details.

The International Chiropractors Association, an organization representing straight chiropractors, was obviously unsatisfied with the DOE’s decision, as potentially devastating as it was. It is asking chiropractors to get in touch with their Congressmen to straighten this situation out. (I’m not sure what Congress can do, given that this decision is within the jurisdiction of the DOE.)

The subluxation stays

Right before its appearance before the NACIQI, the beleaguered CCE wrote “An open letter to the profession” trying to quell the controversy over its accreditation standards. It labeled a “myth” the assertion that it was trying to remove all mention of the subluxation from the standards and that students no longer have to know how to assess for subluxation. Not true, says the CCE: We didn’t eliminate it, we just moved it to the “meta-competencies” section of our policies, which describes what students of accredited programs must be able to do. And, true to the CCE’s claim, there it is, under “Meta-Competency 1 – Assessment and Diagnosis.”

C. Performing case-appropriate physical examinations that include evaluations of body regions and organ systems, including the spine and any subluxation/neuro-biomechanical dysfunction that assist the clinician in developing the clinical diagnosis(es).

Neuro-biomechnical dysfunction? What’s that? As the CCE explains in its letter,

Between the three drafts and the final 2012 Standards, subluxation received considerable attention by the Task Force and the Council. Despite its historical legacy in the profession, a number of educational programs and practitioners have opted to use other terms, such as joint fixation or joint dysfunction. [And, I might add, manipulable lesion, spinal lesion, etc., etc.] Even the Association of Chiropractic Colleges (ACC) has not reached a unified definition or specific criteria for subluxation, despite its own task force addressing this issue. The 2012 Standards opted to use a combination phrase, ‘subluxation/neuro-biomechnical dysfunction.’

So, in summary, although chiropractic’s two leading educational organizations devoted considerable attention to the issue, we don’t know what a subluxation is or how to define it. Nevertheless, we chiropractors give it a bunch of different names so, to add to the confusion, we invented another one. And, even though we don’t know what they are, we are going to make chiropractic students learn to detect and correct these subluxations/neuro-biomechanical dysfunctions or whatever you want to call them.

Another “myth” busted by the CCE was the contention that the standards no longer require students to learn to “adjust.” Again, not true. It’s right there in the meta-competencies that the student must “provide appropriate chiropractic adjustments and/or manipulation procedures.” But, the dissenters protested, that means that the college could teach only manipulation and not adjustments. What’s the difference, you ask? Well, manipulation is a plausible non-CAM manual therapy with some evidence of effectiveness employed by physical therapists, physiatrists, osteopaths, and chiropractors. It’s purpose is to reduce pain, increase joint range of motion, and address other physical manifestations of joint impairment. An adjustment is a means of correcting the non-existent subluxation. But, as the CCE notes, “many in our profession use the terms adjustment and manipulation interchangeably” so manipulation, to a chiropractor (but no one else), is also a “therapy” used to correct the subluxation. Got that?

The CCE also labeled as a “myth” the allegation that it was “forcing colleges to teach students how to prescribe. CCE is changing the profession into Medicine.”Once again, not true, says the CCE — there is no requirement that the DC curriculum include “prescriptive medications or pharmacology,” although it could if the college wanted it to. However, there is a requirement that the DC curriculum include “toxicology.” According to the CCE “many DCPs [Doctor of Chiropractic programs] see this as an opportunity to include instruction on the adverse health effects of medications.” So, although they need not have any training in pharmacology, DCs are presumably sufficiently educated by a course in “toxicology” to understand “the adverse health effect of medications.”

Bad Press

As if all this weren’t enough, a series of articles in The Chronicle of Higher Education appeared over the last few months which hung some dirty chiropractic laundry out to dry in plain sight of all of academia. First, not one, but two, articles in the Chronicle detailed the CCE’s fight with the straights as well as the drubbing it got from the DOE. The Chronicle summarized the DOE’s message to the CCE as a demand to “clean up its act within a year.”

Then came two more Chronicle articles exposing the high salaries and nepotism among chiropractic college presidents and their administrations. One article detailed how, in spite of declining chiropractic college enrollment, “the presidents of chiropractic colleges are taking in some of the biggest paychecks in higher education.” One example: In 2009, the president of Logan College of Chiropractic earned $791,418, an amount equal to 3 % of the college’s entire budget. This is about the same compensation paid to the president of the California Institute of Technology (yes, Cal Tech!) which has a $2.3 billion budget, or, as the Chronicle reporter calculated, 90 times the budget of Logan. The president of Parker University (formerly Parker Chiropractic College) earned about the same as the president of Brown University and the salary of Cleveland Chiropractic College’s president was comparable to that of Vassar’s. All of this raised eyebrows among several experts consulted by the Chronicle, who cited potential problems with the IRS and “governance weaknesses” indicated by the unusually high salaries.

Most recently, a piece appeared in Forbes questioning the use of taxpayer funds to subsidize chiropractic education through student loans. Author Steven Salzberg specifically noted chiropractic belief in subluxations, which, as he correctly points out, “have not even been shown to exist.” Referencing the recent controversy over college student loans, Salzberg asked:

But what about institutions that provide a substandard education? Or worse, what about institutions that educate people in quackery and pseudoscience? Subsidies to these institutions are worse than useless. These so-called colleges spread misinformation that will require much more investment to correct, if it is even possible. Why, to be specific, is the U.S. government subsidizing students to attend chiropractic colleges?

The answer: we shouldn’t.

Perhaps the CCE’s poor showing in front of the DOE and this spate of bad publicity will awaken policy makers to the deficiencies of an educational system that tolerates “CAM” education. At the least, the DOE should refuse to recognize credentialing agencies which fail to require science-based education for health care providers. This would stop the flow of student loans to these schools and eliminate wasting even more taxpayer dollars on pseudoscience. Without student loans these schools could not survive. That would go a long way in eliminating quackery in our health care system.

Posted in: Chiropractic, Legal, Politics and Regulation

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37 thoughts on “Dept. of Education to Council on Chiropractic Education: “Straighten Up!”

  1. mattyp says:

    re: Prescription/pharmacology:
    We are taught this at Macquarie University for one main reason: It is important for us to know what medications our patients are on. More importantly than that, it is important for us to understand exactly what the medication does. Certain medications may make manipulation, mobilisation or even soft tissue massage contra-indicated. Certain medications may produce neurological signs as a side effect that some practitioners may think is a “subluxation” if not fully aware.
    Why are colleges/universities teaching “adverse reactions to medicines” when they are not going to be prescribing these medicines? They’re better off understanding the mechanism of drugs and the effects of these drugs on their patients so as to not harm the patient. They might be better off also learning adverse reactions to their treatments and ways of minimising the risks associated with treatments delivered. The key to that – getting the diagnosis right.
    Does it mention how much of the program is dedicated to study of pathology, differential diagnosis, history taking, physical examination, understanding of blood and biochemistry testing?

  2. The mere notion that a chiropractor could understand the pharmacology of a patient on 3+ medications is so remote that it is not worth considering. If any chiropractor thinks a drug side effect is a “subluxation” then they should be taken out backing shot just like the scum that they are.

    It’s always laughable reading how highly chiropractors value their education. I laugh at your suggestion that chiropractors can meaningfully interpret lab values, etc. Just stop. Chiropractors and their brethren don’t even know which diseases are fake (ileocecal valve syndrome, etc) and which are legitimate. The foundation of chiropractic is a fallacy. What more needs to be said? You sham pieces of garbage keep trying to expand your scope due to decreasing use and payments of your fraudulent services. . Stop pretending that you are a doctor, a PT, or whtever else and be thankful your country hasn’t de-licensed you damn quacks. Go get a real education and a real career.

  3. <- rough night. It just occurred to me that you may not be a quackropractor. My post is an open invitation for all chiropractors to "do the right thing" and quit practicing and pursue honorable income.

  4. Janet Camp says:

    Well, in spite of his bluntness and lack of civility, I have to agree with SkepticalHealth. It’s long past time to shut down chiros and their “colleges”. They have no more legitimacy than the now defunct Clayton College of Natural–whatever, can’t remember the full name.

    All of these licensing boards, and such, must be brought into the world of science. I think the problem is that to stop all the pseudoscience conflicts with our national commitment to religious freedom. A conundrum, no? The boards think that they are simply allowing people to make a “choice”, but what’s the point if the choice is totally uninformed? We have to separate the right to believe from the world of medicine. Kind of like church and state.

  5. mattyp says:

    Well in Australia chiropractors know how to read and interpret blood work and biochemistry. I had a long-winded post about how I’ve been taught that “subluxation”, “vertebral subluxation complex” or “VSC” as it is termed is actually bunkem, but my wireless connection died and it lost the text.
    I would like to think I’m not a “quackropractor”. I don’t believe in the aforementioned VSC. Whilst I believe that the body does a good job of healing itself and maintaining some sort of dynamic homestasis, I don’t believe in a mystic “innate intelligence” that can be blocked by the “subluxation”. I use “adjustments” or manipulations cautiously, and certainly don’t follow a “subluxation hunt” on the full spine.
    I’d much prefer to see chiropractic to lose the connection to it’s vitalistic origins and become a sub-grouping or sub-specialty (ego would see me call it sub-specialty) of physiotherapy (PT in the USA??) where we are experts in back pain management, are evidence based and scientific.

    Skeptical –> I’ll take your follow-up post to be almost an apology. If I’ve let you down by telling you I’m in my final year of chiropractic education in Australia, then I’ll wear that.

    Janet –> separation of medicine and state. Wow. Do you think that will ever take hold there? This is what can result where people’s rights to choose their medical care goes a little too far (apologies for the crude link):

  6. Scott says:

    @ mattyp:

    Unfortunately, I don’t see any credible path whereby chiropractic can become an evidence-based profession. The reasonable science-based chiropractors (in which category I will include you based on your comments) are a distinct minority. And laypeople can’t tell the difference – heck, not all MDs can. Which means that any individual can’t really risk going to ANY chiropractor because he can’t tell whether he’s going to get a quack or not (and the odds favor the former).

    What it would take to become a science-based profession would be a complete revamping of the educational and regulatory framework, the disqualification from practice of most current and upcoming chiropractors, and the establishment of rigorous enforcement of science-based standards. All of which will be vigorously resisted by the quacks who comprise the bulk of the profession, and would require new legislation. There’s just no way it’s ever going to happen.

    And no particular benefit from having it become a distinct subspeciality of physiotherapy, either. To the extent that there are science-based methods chiropractors use that normal PTs don’t, incorporating those into mainstream physiotherapy is far more plausible than reforming chiropractic.

    Kind of sucks for the few science-based chiropractors, saddled with a degree which doesn’t qualify them for a science-based profession. But I don’t see a way around that.

    P.S. I suppose it’s possible that chiropractors in Australia are less reliably quacks than those in the US, in which case some of these comments would not fully apply.

  7. @mattyp,

    The mere fact that you think you can appreciate lab values despite having zero clinical experience (ie, in a hospital, not manipulating your friends’ spines) is the exact reason you have no business even looking at them. Even newly graduated medical students, who are infinitely smarter, more experienced, and (infinitely) better trained really can’t appreciate the clinical implications of important lab values.

    I’m sorry, but the idea that less intelligent, worstly trained students with zero applicable experience being taught by equally unskilled “practitioners” can interpret something that is completely outside of their realm is just laughable. Thankfully chiropractors can’t really do anything important after supposedly appreciating an abnormal lab value.

    I’ ask @nybgrus to comment. He’s arguably an extremely intelligent medical student, and I’d wager that he wouldn’t feel comfortable interpreting the creatinine of a systolic heart failure patient and using his interpretation to adjust a Lasix dose. Not at this stage in his career. It’s something you learn with guidance and experience.

  8. @mattyp,

    “Certain medications may make manipulation, mobilisation or even soft tissue massage contra-indicated.”

    Well, it would be the responsibilities of the prescribing physician and dispensing pharmacist to make the patient aware of that information, since it would be rare to find any chiropractor or massage therapist that has a sufficient education in pharmacology and medicine to know when those contra-indications exist. Do chiropractors who get education in prescription/pharmacology as part of their chiropractic instruction take CEUs (or whatever chiropractors may have that is analogous to CMEs) to keep their pharmacology education up to date?

    “Certain medications may produce neurological signs as a side effect that some practitioners may think is a “subluxation” if not fully aware.”

    Of course, this statement only has any hope of not being complete nonsense if chiropractic subluxations actually exist. Even if chiropractic subluxations did actually exist, it’s still a laughable statement. Presumably certain non-subluxation medical conditions could also produce neurological signs that some practitioners may think is a “subluxation” if not fully aware. In what way are chiropractors qualified to be “fully aware” and make such a medical diagnosis to rule out non-subluxation medical issues?

  9. WilliamLawrenceUtridge says:

    mattyp, do you see any role for chiropractors beyond the treatment of musculoskeletal conditions? Do you think chiropractic can treat any diseases, infections, congenital disorders, syndromes etc. beyond those solely caused by mechanical forces and arrangements of the bones, joints and muscles?

    If so, what are they?

    Final question – assuming the answers to my first three questions are No, No, and None, how are chiropractors different from physiotherapists?

  10. Chiropractic is just hopeless. Every time it gets brought up they can at best claim to be substandard PTs, and it’s probably offensive to PTs to say that.

  11. WilliamLawrenceUtridge says:

    SH, this may or may not be true in both individual and aggregate cases, but I think we would agree the best outcome is to urge the next generation of potential chiropractors into physiotherapy instead, and dealing with the blatant nonsense quackery with whatever solution we come up with for the rest of all quackery.

    Any chance we can throw them into the ocean along with the lawyers?

    Um…no offence Ms. Bellamy?

  12. mattyp says:

    No, no, not applicable. Finally, very little. Did you see my comment re: chiropractic becoming a sub-grouping of physiotherapy? Throw out the vitalistic origins, stay within the scope of practice. I’m guessing the scepticism of this being a possibility comes from years and years of watching quack chiropractors steering just the opposite way.
    @ Karl: of course, I was being a tad facetious. Subluxations don’t exist. At my uni, a fair portion of our training is aimed at identifying potential non-msk causes of pain and dysfunction and refer immediately. This training comes from both MDs and chiropractors.

  13. @mattyp,

    Chiropractors should not be a subgroup of PT. Your training, education, and experience is subpar compared to that of a PT. You cannot treat at the same level of quality. If you want to consider yourself a PT, then go to PT school. I whole-heartedly agree with WLU that anybody considering chiropractic school needs a good shaking and be directed to PT school so that we (as a planet) stop minting these ridiculous quacks. Mattyp, even if you yourself do not believe in subluxations or other such garbage, you are still hindered by the stigma associated with calling yourself a chiropractor. It sucks, but it’s true.

    I do hope that you understand that you are unable to properly appreciate abnormal lab values. I sincerely hope that you never attempt to interpret a patient’s labs and counsel them in any way, shape, or form on them.

  14. ^ It’s like if a nurse said “Oh, I know everything a doctor does. I should be considered a nurse and given all applicable privileges.” That’s ludicrous. Nurses have completely different functions than doctors do and their education is directed towards those functions, and not towards the function of a doctor. The nurse in the situation is simply ignorant of what a superiorly educated practitioner is capable of. Similarly, the chiropractor is ignorant of what the superiorly educated PT is capable of. It’s almost like a professional Dunning-Kruger type thing. :)

    (Boy I come across as an arrogant prick on the internet.)

  15. WilliamLawrenceUtridge says:

    mattyp, the problem I see is that with that approach you are always going to run into problems given your choice of profession. Nutters looking for anti-doctor quacks are going to be disappointed because you aren’t trying to cure cancer through spinal manipulation. People looking for musculoskeletal adjustments are going to go to physiotherapists or massage therapists. Someone keeps making the point (perhaps SH) that once you graduate you’re caught between a rock and your student loans, forced to practice in a profession with a dubious evidence base and poor reimbursement for the conditions you can realistically claim an evidence base to treat. My sympathies!

    SkepticalHealth, that’s how you could have said it without sounding like (as much of an) arrogant prick :)

  16. Jann Bellamy says:


    No offense.

  17. lizditz says:

    Not totally off topic, but not totally on topic either.

    Yesterday, the California State Senate Health Committee heard and voted on AB 2109, which requires vaccine-refusing parents to get a certificate that they have heard reliable information on vaccine benefits, risks, and safety. Not surprisingly, the DCs were out in force opposing this bill. For example, Life Chiropractic College allowed students to use phone banks and faxes to flood the senators with the usual misinformation.

    The committee voted 7 to 1 to pass AB 2109 (Yay!)

    The anti-vaccine crowd are (predictably) waxing wroth. At the Oppose AB 2109 facebook page, the following comment was made:

    Paul Walton
    If PT’s want to have the same scope of practice as DC’s all they have to do is add the DDx education that DC’s have that matches MD’s. Then they can be MD’s who speacilize in physical medicine. Oh wait, there already is one Physiatrist (sp?)

    Now my question is, is there any truth to the claim that chiropractors have the same education in differential diagnosis as MDs?

  18. tgobbi says:

    Note to mattyp (who I believe is a chiropractic student): since you appear to be an ethical person and aware of the pitfalls of chiropractic: get out while you still can! Read what Sam Homola has said about how hard it is to buck the trend of the entire field of one’s colleagues.

    Chiropractic isn’t a healthcare profession. It’s an elaborate marketing scheme.

  19. @lizditz,

    No, there is absolutely no truth to the claim that chiropractors have even remotely the same skill in diagnosis as MDs.

    A chiropractor does not undergo any legitimate training whatsoever to allow them to diagnose the vast majority of medical conditions. Besides the obvious (on the average they are dumber students, they are poorly trained, and they have zero applicable clinical experience), they simply do not have any of the practical or educational basis to diagnose medical conditions beyond typical musculoskeletal ones. Any actual disease process and they are absolutely, without a doubt, 100% useless.

    An MD is capable of utilizing and interpreting a vast array of results and patient history in order to confidently arrive at a diagnosis. These are tests that chiropractors are incapable of performing and interpreting. They simply aren’t exposed to it and have no education on them. As I wrote above, a chiropractor could look at a lab value and tell if it’s low or high, because the normal limit is listed right next to it, but they are absolutely incapable of interpreting the meaning of that value in context of any meaningful disease process.

    Chiropractors can’t even distinguish between a real disease and a fake one, so how could we even entertain the idea that they could adequately distinguish between real diseases?

  20. @lizditz,

    The stupider chiropractors like to perpetuate an absolutely ridiculous myth that they are equally trained when compared to MDs. It’s completely false, but some believe it’s true. The just proves how scary their field of quackery is, and how bad the delusions their schools force on them are. These quacks are barely adequate at treating musculoskeletal pain, and yet they believe they can cure and diagnose any disease.

    I’d bet that even our resident chiros nwtk2007 and rwk or whomever would state that they have no business diagnosing any disease outside of msk conditions.

  21. mattyp says:

    @SH: how well versed are you into chiropractic education in Australia? You obviously have no clue how we are trained, the course content, who we are trained by, anything. So, stop making sweeping statements without a clue about what you are talking about. Your arrogance is dissembling your argument. With regards to what you have said with chiropractors being subpar to physios, on what measure do you use? How is our training not of the same quality?
    @WLU: I’m happy being in a limited scope of practice. I can rest easy in my own conscience that I am not bilking patients out of their hard earned funds unnecessarily by signing them up to adjustments to fight off disease. I may yet take on further study (DP, or MD) to allow me to achieve better patient outcomes.

    Good God, maybe there’s just fewer quacks down here (or I haven’t been exposed to them through my course??).

  22. tgobbi says:

    Not that SH and WLU need me to come to their defense but I feel strongly enough about the subject and have enough knowledge about chiropractic to say that it doesn’t make any difference where you’re trained; Australia, Canada, US or anywhere else. It’s still chiropractic and it’s tantamount to being taught healthcare on the moon! You can have any sort of noble beliefs you want but, no matter how you slice it, you’re still being taught the equivalent of flat earth-ology. The foundation, whether it’s taught as such or not, is the non existent subluxation and when you finish your training and wind up in the real world of having customers walking into your office you’re going to be faced with the dilemma of ethics or economics. Obviously you’re young and have a very rosy picture of yourself as some kind of reformer but it isn’t as cut and dried as all that.

    Cynicism and the need to support a family have a tendency to make the noblest of us face the frightening world of reality. I’m an old man with more than 30 years experience of confronting DCs who, if they had ever had any scientific tendencies in the beginning, have turned their backs on science and the scientific method. If you want, I can cite example after example of the foolishness and vitriol I encounter when confronting chiros with requests that they back up the most preposterous and demonstrably false claims. Chiropractic per se is untenable and the only way to make a go of it is to espouse quackery – like it or not!

  23. tgobbi says:

    # mattypon 28 Jun 2012 at 3:05 am
    re: Prescription/pharmacology:
    We are taught this at Macquarie University for one main reason: It is important for us to know what medications our patients are on. More importantly than that, it is important for us to understand exactly what the medication does.

    OK, so I’m approaching MATTYP’s comments backwards but I keep re-reading Jann’s article and seeing things I missed before.

    I strongly disagree that the reason for “understanding” what medications do is related to chiropractic in any way other than to give DCs some (imaginary) ammunition to warn their customers of the dangers of any and all medications. Once again I draw on 30+ years of investigating chiropractic to reach the conclusion that the majority of them never pass up a chance to warn against the putative dangers of medication – prescription or OTC. And this includes immunization as well. Among the major differences chiropractors like to cite that keep them separate and distinct from science-based healthcare is their subluxation chimera and the “drug-free” approach to healthcare.

    Certainly drugs can harm. But they can also be of amazing benefit. The basic idea is for a well trained healthcare professional to monitor the drugs he/she prescribes to ensure that the benefit-to-risk ratio is taken into consideration. On the other hand there are no known benefits to subluxation adjustments because there’s no such thing as a (chiropractic) subluxation. And in this light, in the case of neck adjustments, any risk of stroke renders such adjustments criminally negligent!

  24. Costner says:

    Just to note… the Department of Education is not the “DOE”, but rather the “ED”. The DOE is actually the Department of Energy.

    The Department of Education website is while the Department of Energy has

    I know people often refer to the ED as the DOE and it can get confusing (even to people in the industry), but it is probably worth noting the proper acronym.

  25. DavidRLogan says:

    SkepticalHealth in classic form: I had to chuckle at “you sham pieces of garbage”. I dunno if it’s just flaming but I actually mentioned your thoughtful criticisms from this thread, SH, in a conversation last night.


  26. mattyp says:

    Well hopefully I can make enough noise to make a change. Immunisations work. Chiropractors have no business giving their patients advice on medication beyond “if you’re concerned, speak to your doctor”. Stick to MSK complaints, refer any organic/infectious conditions out immediately.

  27. marcus welby says:

    mattyp: Please make a lot of noise. The din is needed. Thanks for attempting to learn.

  28. @David,

    I’m glad to entertain :)

  29. BillyJoe says:

    In my admittedly limited experience, chiropractors in Australia tend to stick to treating musculoskeletal disorders. They also do not tend to rubbish mainstream medicine, vaccinations etc.
    Unfortunately, they do manipulate spines. And they do treat infants and children. The evidence is that they should do neither.

  30. BillyJoe says:

    Having said that, I just googled the chiropractor who has recently set up shop in my home town of Mooroolbark:
    It seems she believes in subluxations!

    There is also a link to the Australian Vaccination Network (AVN), more appropriately referred to by those in the know as the Anti Vaccination Network (AVN).

  31. rmgw says:

    “Your arrogance is dissembling your argument”……….subluxation of the dictionary.

  32. @BJ, oh my, that description of chiropractic written by that chiropractor is among the worst things I’ve rear. Isn’t it phenomenal she has four years of education and clearly does not understand anything about how the body works. It truly is a sin that any country licenses these morons.

  33. Also, to note, in the link BJ posted, the chiropractor is describing mythical subluxations and also notes that they “may cause no pain at all.” If any one sentence describes what filthy crooks they are, it’s that one. That’s what they will tell you to recruit you as a patient. “Oh, you better get evaluated and treated (and let me expose you to ionizing radiation!) before your subluxations start causing you pain!” – so called preventative care. It’s complete fraud. F-ing a-holes.

  34. Javeux says:

    I’m wondering if healthcare professionals can really appreciate how dangerous things like chiropractic are for the layman. Mainstream medicine doesn’t have a great record with certain chronic coniditions, and there are a lot of disillusioned patients looking to escape their daily hell by any means necessary.

    Everyone’s seen chiropractic clinics around town and websites are convincing enough to win over patients who don’t know any better. The fact that they have such a presence makes them seem “normal”; a viable alternative option. It’s just somewhere you go if you have back or posture problems, right? By the time patients read something like this blog, damage may already have been done, to their bank balance and spirit if nothing else.

    Personally, I never even considered the idea that chiropractic wasn’t a legitimate profession until I saw something in The Guardian about its history that reminded me of the South Park episode about Mormonism (maybe Scientology is more analogous). I’d actually looked at chiropractic sites in the past, but ended up going with physiotherapy because the prices were more reasonable. It horrifies me to think I could’ve paid some quack £60 to practise something closer to religion than medicine on me for 45-minutes. I just hope people don’t blame the patients and continue to spread awareness of what chiropractic is really about.

  35. mattyp says:

    @ Billy Joe:
    My apologies for not responding earlier – no internet while moving house.
    My head dropped when I read that. It really did.

    @ Skeptical Health:
    You’re 100% correct. The problem that doesn’t exist and isn’t causing pain and must be corrected. And 5 years of education…. I can only hope the chiropractor either wasn’t educated here or is from an era pre-dating science in how we’re taught (otherwise, my argument is blown out of the water eh).

    Sigh. I’ll keep on making a racket for science. Just don’t bring me down while I’m trying to do so!

  36. mattyp says:

    I encountered this, this morning: “Wouldn’t the best way to build effective “immune memory” be to ensure your immune system is healthy and then get the flu?”

  37. Locky says:


    I applaud your efforts in sticking towards the science-based side of chiropractic. Certainly I think the education here in Australia seems much more evidence-orientated than what seems to come out of the US. While we do have a large number of quack-chiro’s here, they (in my experience) tend to be non-university educated practitioners, largely an older school if you will.

    I have a few friends currently doing a chiropractic course at an Australian university and, on the whole, my interrogations of them seem to indicate that it is largely evidence based, with a definite effort to weed out the quackery. What worries me however, is that the attempt to legitimise chiropractic by taking an evidence based approach is a half-hearted one. Subluxion and associated theory are thoroughly debunked, but ‘dysfunction’ tends to take it’s place as a descriptor for any issue that cannot be well-defined. My friends routinely offer ‘adjustment’ (I think terminology might be an issue here – this ‘adjustment’ seems to be closer to what an American physiotherapist might term ‘manipulation’) for ailments other than MSK conditions associated with the back (persistent sinus pressure and an ankle sprain were the conditions in question – ones which I am not aware of any evidence supporting such treatment). More concerning is the advent of ‘chiropractic neurology’ as a serious pursuit, without any real evidence behind it.

    So while I certainly approve of the attempts to bring real scientific rigour and practices into chriopractic, I think there is currently something lacking in the effort. While the Australian university-based courses certainly seem more scientific than their American counterparts, they do not totally abandon the treatment approaches of traditional chiropractic. I don’t know whether this is because of the presence of some more ‘old-school’ chiropractors as educators; or simply that if you strip out the bullshit, what you have left is essentially physiotherapy with an extra manipulation (or ‘adjustment’) component.

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