COMMENTARY

Setting the Record Straight on Chiropractic Care

July 02, 2001

Introduction

As president of the American Chiropractic Association (ACA), I would like to comment on the article about chiropractic care by Dr. Samuel Homola, "Is the Chiropractic Subluxation Theory a Threat to Public Health?" which you published on your Web site, Medscape.com, and the articles published on your affiliate site, health.medscape.com, "How to Choose and Use a Chiropractor". It is unfortunate that you would choose to publish outdated and inaccurate information for public consumption.

From start to finish, the articles have a very negative tone, merely serving to scare patients away from consulting doctors of chiropractic. I would hope that this is not the goal of your otherwise informative Web site. By concealing the benefits of chiropractic care and exaggerating the archaic, clichéd notions about its shortcomings, you are not serving the good of the public.

There are so many problems with the articles that a simple letter could not possibly address all of the outrageous assertions made. However, I would like to address several points in particular that are of concern to the ACA, doctors of chiropractic, and chiropractic patients everywhere.

Homola's article states that, "Some chiropractic treatments involve significant risk," and, "Chiropractic neck manipulation can cause serious injuries." The fact is that chiropractic is one of the safest forms of treatment available today. According to a study by the Rand Corporation, a serious adverse reaction from cervical manipulation occurs once in 1 million manipulations. [1]

When compared to the number of illnesses and deaths that will occur this year from the appropriate and inappropriate use of prescription and over-the-counter drugs, the number of serious complications from chiropractic treatment is extremely low. A 1999 Institute of Medicine report concluded that medical mistakes kill anywhere from 44,000 to 98,000 hospitalized Americans each year. [2] In addition, a study published in the April 15, 1998 issue of JAMA found that more than 2 million Americans become seriously ill every year from reactions to correctly prescribed drugs and 106,000 die from those side effects. [3] Virtually all interventions by medical doctors have a complication rate higher than those associated with most commonly used chiropractic interventions.

Further, you imply that many chiropractors dismiss the role of infectious agents in causing disease and say rather that every medical disorder is attributed to spinal misalignment. The mainstream of the chiropractic profession, however, does not share that view. The ACA is not opposed to medical intervention when necessary and appropriate. Rather, the ACA is opposed to unnecessary and compulsory medication, unnecessary surgery, and any other treatments not in the best interests of the public's health and welfare.

I would also like to mention that the warning you give to patients to "Avoid chiropractors who use 'scare tactics'" is patently absurd. It would be wrong for any healthcare provider to use scare tactics with his or her patients. To single out doctors of chiropractic in that regard is deplorable. Would it be acceptable for a medical doctor to use scare tactics?

You recommend that patients should avoid those chiropractors who purport to diagnose or treat subluxations. This is a curious position for you to take, as even the federal government recognizes the term "subluxation" in Medicare regulations as a very real condition that doctors of chiropractic treat. [4]

Your article also warns the reader to "Avoid chiropractors who 'prescribe' dietary supplements, homeopathic products or herbal products or who sell these products in their offices. For dietary advice, the best sources are physicians and registered dieticians." The article does not mention, however, that there are specialists within the chiropractic profession who are not only qualified to practice nutritional therapeutics, but who have a postdoctorate academic degree in nutrition (as compared with a "registration" as an RD). In addition, chiropractic colleges teach overall wellness and healing to all students, with proper nutrition playing a significant part in that approach. The very nature of chiropractic education allows doctors of chiropractic to make informed nutritional assessments and recommendations to their patients.

An article with so many inaccuracies simply should not be written, much less released for the public to see. It provides 7 paragraphs of warnings and only part of 1 paragraph of potential benefits. Just as healthcare providers should not use scare tactics with patients, you should not use scare tactics with your readers. I urge you to remove Dr. Homola's article from your Web site, or at the very least provide a prominent link to this letter.

If you need help in obtaining more accurate information, please visit the ACA's Web site at http://www.acatoday.com or call the ACA's headquarters at 800-986-4636.

  1. Hurwitz EL, Aker PD, Adams AH, Meeker WC, Shekelle PG. Manipulation and mobilization of the cervical spine. A systematic review of the literature. Spine. 1996;21:1746-1759.

  2. Kohn LT, Corrigan JM, Donaldson M, eds. To Err Is Human: Building a Safer Health System. Washington, DC: Institute of Medicine; 1999.

  3. Lazarou JL, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients. A meta-analysis of prospective studies. JAMA. 1998;279:1200-1205.

  4. Social Security Act: Section 1861(r)(5).

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