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The Council on Chiropractic Education Straightens Up?

Three years ago, we reported that the Council on Chiropractic Education (CCE) was deeply embroiled in a heated dispute among various chiropractic factions over its new accreditation standards for chiropractic colleges. In a June, 2012 update of that post, we found the CCE still deeply embroiled in a heated dispute among various chiropractic factions over new accreditation standards for chiropractic colleges. Current events, however, require that we now report that the CCE remains deeply embroiled in a heated dispute among various chiropractic factions over new accreditation standards for chiropractic colleges. And it has come to this:

CCE does not represent me

Ostensibly, the debate is about whether chiropractic students should be taught to detect and correct the putative subluxation and CCE’s commitment to chiropractic’s remaining a drug and surgery-free practice. As we have discussed several times here at SBM, a faction of chiropractors fancy themselves as primary care physicians who are competent to diagnose and treat patients with a wide variety of diseases and conditions, such as diabetes and cardiovascular disease, with various methods, such as “Functional Endocrinology.” This is, in fact, the position of the largest and most mainstream of the chiropractic trade associations, the American Chiropractic Association (ACA). (The ACA is actively promoting reimbursement of chiropractors for required primary care benefits under the Affordable Care Act.)

At the other end of the spectrum, the chiropractic purists (or “straights”) believe chiropractors should limit themselves to the detection and correction of the (non-existent) chiropractic subluxation. And they are adamant about chiropractic remaining “without drugs or surgery.”

Protestations to the contrary notwithstanding, chiropractic belief in the subluxation is widespread among chiropractors in North America and in Australia. And as far as I can tell, chiropractors who eschew belief in the subluxation have merely renamed it and redefined it in terms so vague as to be meaningless. Those who want to expand chiropractic to include a broader range of treatments do not exclude the subluxation as a relevant clinical entity. They’ve simply tarted it up in an attempt to obscure its lack of scientific viability. (more…)

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Chiropractic Abuse: An Insider’s Lament

chiropractic-abuse

There is a new book critical of chiropractic: Chiropractic Abuse: An Insider’s Lament. The author, Preston Long, DC, PhD, is a chiropractor who says he made a big mistake when he chose chiropractic as a career. He has written an intriguing book explaining his mistake and the experiences that resulted from it during 3 decades as a chiropractor and a critic of chiropractic.

Chiropractic encourages self-delusion, and those who break free of delusion have two choices: to fight or run. Preston Long chose to fight, to keep the baby and throw out the bathwater polluted with pseudoscience and quackery, to try to practice rationally and ethically, and to try to reform chiropractic from within. He soon learned that it was next to impossible for a chiropractor to make a living with a science-based, ethical practice. He eventually found his niche and put his knowledge of chiropractic to good use. He evaluates chiropractic cases for disability and fraud, has worked with the FBI, and has testified at over 200 trials. He has written two previous books, The Naked Chiropractor (2002) and The P.R.E.S.T.O.N. Protocol for Back Pain (2006). This new book tells the story of his life and exposes the delusions and misbehaviors of his chiropractic colleagues.

He reveals “20 things most chiropractors won’t tell you”: (more…)

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CAM Docket: Functional Endocrinology Update

Sometimes the media gets it right.

From time to time, SBM has reported on the disheartening credulity of reporters when they cover so-called “alternative” medicine. Denver’s Channel 7, an ABC affiliate, is a happy exception to the rule. Reporter Theresa Marchetta first broke the story of Brandon and Heather Credeur, chiropractors practicing “Functional Endocrinology.” And for three years Marchetta, with the assistance of reporter Phil Tenser, followed up, interviewing hundreds of patients who lost thousands of dollars paid to the Functional Endocrinology Center of Colorado for treatment of their diabetes and other endocrine disorders. They’ve reported regularly as the Credeurs legal travails progressed through various judicial and administrative forums. Channel 7 and its reporters deserve substantial credit for pursing this story. The Credeurs might have escaped further censure without their persistence.

Another recurring frustration at SBM is medicine’s embrace of alternative medicine, expressed repeatedly at SBM in posts on quackademic medicine and the branding device known as integrative medicine. We’ve also lamented the seeming complicity of the state medical societies in allowing quackery to be legalized in the form of complementary and alternative medicine provider practice acts.

But sometimes medicine gets it right.

The Colorado Medical Board has somewhat redeemed itself in ordering Brandon and Health Credeur to cease and desist the unlicensed practice of medicine. That’s right. A medical board has finally put its collective foot down and pushed back against chiropractic’s increasingly aggressive push to practice medicine.

And sometimes SBM appears to be making inroads into the hostile incursion of alternative medicine.

I recently discovered that if you google “functional endocrinology”, first up on the list is CAM Docket: Functional Endocrinology, the very post updated today. Admittedly, it appears at the head of a depressingly long list of chiropractic websites advertising the practice, but at least we get a first crack at anyone who might be considering paying thousands of dollars and wasting time, and perhaps their health, on this useless nonsense.

A trifecta in the war on quackery! Revel in this victory, supporters of science-based medicine, for it is small and the victory may be fleeting. Let’s see how the battle is going. (more…)

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Chiropractic Practice Building: A Doctor’s Confession and the Report of Findings

“I’ve got to get this off my chest!”

Dear chiropractic practitioner,

Confessions are tough…Real tough. They are painful, awful things. But, sometimes a confession can set the record straight, and I want to give credit where credit is due. Before I talk about my confession though, let me say a few other things first. You may want to sit down.

You know, when I meet people in town they usually say, “Oh, yeah, I know you, you’re Dr. Jones. I’ve seen your posts with that picture of you and the two cute little girls.” Well, I’m the guy on the left. Aren’t they cute? Now do you feel like you can trust me?

Years ago, something happened to me that changed my life forever. And I would love to tell you all about it, but first I need to give you my report of findings.

I’ve correlated the findings of your examination, and I’ve put it into a package that I’m going to review and send home with you, so you’ll know what we found and what we’re going to do to help you. In the next 10 minutes or so I’m going to review what we found, explain what these findings mean, recommend a course of action and discuss the results you can expect in the future. Feel free to ask any questions as we go along.

First a quick review. You’ve come to our website suffering from an inability to recognize your complete lack of effectiveness in the treatment of headaches, ear infections, asthma, or any other condition with the possible exception of acute musculoskeletal pain involving the back. You have difficulty accepting that any treatment you offer which is effective is provided by physical therapists, minus all the “baggage”, and that nothing you offer which is unique to chiropractic is effective. You are in denial over how the majority of your profession is woefully ignorant of, or exists in a state of denial of, so many of the advancements in modern medicine, like life-saving vaccines, made since chiropractic was invented by D.D. Palmer in 1895.
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Legislative Alchemy: Chiropractic 2013

Via the magic of legislative alchemy, chiropractors are already licensed health care providers in all 50 states. Thus their legislative efforts tend to focus on expanding their scope of practice and forcing public and private insurers to cover their services, in some cases at the same rate as medical doctors. Those efforts continue in 2013 with 65 bills impacting chiropractors introduced so far. Of those including substantive provisions (as opposed to, say, simply raising fees), only one is not to their advantage.

New Mexico chiropractors are once again attempting expansion of their scope of practice. In 2008 and 2009, the New Mexico legislature created a new iteration of chiropractor, called “the certified advanced practice chiropractic physician.” A certain faction of the chiropractic industry is attempting to rebrand chiropractors nationwide as primary care physicians and this was a signature event in those efforts. With 90 hours of additional education, these advanced practice chiropractors can administer a bevy of dubious remedies, such as bioidentical hormones.

The new law also permitted prescription of dangerous drugs and controlled substances and administration of drugs by injection, but only if on a formulary approved by the state pharmacy and medical boards. The chiropractic board didn’t like having to get approval from pharmacists and medical doctors, so they went ahead and added what they wanted to the formulary, ignoring the other boards despite their own attorney’s advice that they couldn’t do this. This got them into a couple of court battles with the pharmacy and medical boards. The International Association of Chiropractors (ICA), the traditional, subluxation-only chiropractic faction, jumped into the fray to oppose this power grab. The ICA believes chiropractic should remain drug and surgery free.

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The DC as PCP? The battle continues

Chiropractors are trying to rebrand themselves as primary care physicians, a topic both Harriet Hall and I have addressed (here and here) on SBM.  Toward this end, they are seeking the expansion of their scope of practice, via the magic of legislative alchemy, to include the prescription and administration of drugs.  Not drugs that any self-respecting M.D. would use, but drugs nonetheless.  That effort succeeded to an extent in New Mexico.  Recently Colorado got into the act.  Other states have followed suit.

Chiropractors have claimed from the very beginning they are primary care physicians. Chiropractic was born in 1895 with the notion that virtually all diseases could be resolved with chiropractic treatment.  This was Daniel David Palmer’s original contention, that the interruption of “nerve flow” by “subluxations” caused disease which could be remedied by spinal adjustment to restore the flow, thereby allowing the body to heal itself.

State chiropractic practice acts have always given chiropractors a broad scope of practice which allows them to diagnose and treat virtually any condition as long as they can squeeze the treatment into the “chiropractic paradigm.”  If they can pretend the condition is amenable to chiropractic treatment via the detection and correction of subluxations, they can diagnose and treat it legally.  This is how they are able to claim, falsely, that asthma, allergies, colic, and many other health problems can be resolved by chiropractic care.  This is how “straight” chiropractors still practice.

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Andrew Weil Flirts with Evidence Based Medicine

Andrew Weil, MD, pops up quite frequently on SBM, most recently in this entry by Harriet Hall, so I will not spend much space introducing him. An excellent biography and critique of Dr. Weil was written by Arnold Relman, former Editor of the New England Journal of Medicine. It is over a decade old, but contemporary to some of the events described in this post, and still quite relevant.

Suffice it to say that Dr. Weil is one of the most successful and well recognized popularizers of alternative medicine. He has authored or coauthored dozens of books. His website sells everything from baby pacifiers to vitamins to breakfast sausages, packaged bearing his name and/or visage. He is an altmed rockstar. He has been a key player in the branding of alternative medicine. In particular, been an advocate of “integration” of traditional and alternative medicine. He has created and exported residency training programs, and more recently proposed board certification in integrative medicine.

I recently read a book entitled On Being Certain: Believing you are right, even when you’re not, by Robert Burton, nicely-reviewed and recommended by Harriet Hall. In his book Dr. Burton excerpted an interview with Dr. Andrew Weil, pointing out Dr. Weil’s profound certainty about the effectiveness of a particular alternative treatment in spite of contradictory evidence. Dr. Hall also discussed this section of the book in her review. I found the excerpts fascinating and decided to delve more deeply into the interview. I also found another interview with Dr. Weil relevant to his ideas about evidence.

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CAM Docket: Functional Endocrinology

One of the signature abilities of CAM practitioners is the creation of new diagnostic methods and treatments which convincingly demonstrate they have only a superficial understanding of human physiology. Here at SBM, posts have addressed such sterling examples of this phenomenon as cranial sacral therapy, applied kinesiology and chiropractic neurology. Now we have a new one on the horizon: functional endocrinology.

I don’t know who thought up this idea, but a primary promoter appears to be a Colorado chiropractor, Brandon Credeur, a 2002 graduate of Parker Chiropractic College in Texas. In additional to operating the Functional Endocrinology Center of Colorado, in Denver (where he practices with his wife, Heather Credeur, D.C.), he sold (and may still be selling) practice-building courses on functional endocrinology to other chiropractors.

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The War Against Chiropractors

In 2011, chiropractor J.C. Smith published The Medical War Against Chiropractors: The Untold Story from Persecution to Vindication. He promises an exposé comparable to Harriet Beecher Stowe’s exposé of slavery in Uncle Tom’s Cabin. His thesis is that the AMA waged a shameless attack on competition, motivated only by money. I think the reality is closer to what he quoted from Dr. Thomas Ballantine, Harvard Medical School:

The confrontation between medicine and chiropractic is not a struggle between two professions. Rather it is more in the nature of an effort by an informed group of individuals to protect the public from fraudulent health claims and practices.

The book is self-published, long-winded, repetitive, and flawed. It is a vicious screed crammed with bias, half-truths, insulting language, and innumerable references to Nazis and racial prejudice. In my opinion, Smith not only fails to make his case but degrades chiropractic.

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The DC as PCP? Revisited

There is a disturbing effort afoot to rebrand chiropractors as primary care physicians, a subject both Harriet Hall and I have discussed in previous posts. Part of this effort includes convincing state legislatures to grant prescription privileges to chiropractors, an effort that succeeded in New Mexico, as reported in a post a couple of years ago. Let’s return to New Mexico and see how that is working out for everyone.

By way of background, in 2008, the New Mexico legislature created a new iteration of chiropractor called “certified advanced practice chiropractic physicians” with the authority to

prescribe, administer and dispense herbal medicine, homeopathic medicines, vitamins, minerals, enzymes, glandular products, naturally derived substances, 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.

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