Chiropractors get their spine out of place over critique

A new audit reveals that Medicare funds millions and millions on chiropractic care. A Forbes author asserts patients would be better served by actual medical doctors. That rattled some bones in the chiropractic camp.

New Medicare Data Reveal Startling $496 Million Wasted On Chiropractors.

The 2012 Medicare data reveals that in 2012, Medicare paid $496 million for chiropractic treatments in all 50 states.

This is a stunning amount. It dwarfs the funding that NIH wastes on alternative medicine through NCCAM, which is itself an egregious waste of money.

Chiropractors are not medical doctors. They primarily treat back pain, but they claim to treat a wide range of other conditions, which some of them believe are related to mis-alignments of the spine, called subluxations. This belief has no scientific basis. Nevertheless, chiropractors have succeeded in convincing the government to cover their treatments through Medicare.

This is obviously not good press for chiropractors. This high-profile piece set their spine out of place.

The Foundation for Vertebral Subluxations (strange) issued a reply [PDF]

Forbes Article on Chiropractic Reveals Deep Seated Ignorance

In regards to vertebral subluxation the facts are that there is tremendous profession-wide
support that exists for the term, it is accepted by those outside the profession, there are peer-reviewed, scientific publications in support of the concept, internationally accepted guidelines, and books from major medical publishers. The notion that there is no scientific basis for it reveals such a deep level of ignorance that the only conclusion to be drawn is that it is simply an act of denialism. Denialism involves choosing to deny reality as a way to avoid an uncomfortable truth.

Where is the scientific basis for subluxations? They have been tested? Why does THIS research show that chiropractic foundations are baseless? I have a feeling the goalposts have been moved regarding the definition for “subluxations” as they have been roundly questioned as actually existing. There is a tremendous profession-wide support for astrology and psychic healing too. That does not make it valid or prove that it’s useful.

The International Chiropractic Association also took offense to the piece. They have taken a FAR MORE LITIGIOUS tone accusing the author of “highly prejudicial assertions about the risks associated with chiropractic care and the choice of outdated, misleading references”. 

These are people trying to save their livlihood. But, I am dumbfounded at their assertions nonetheless. All these decades, chiropractic has yet to be represented soundly as having a scientific basis while actual science-based medicine has greatly advanced. The inconvenient truth that they keep spinning is that chiropractic is “magical medicine” without basis in today’s medical knowledge. As noted in this piece, it was invented whole cloth without a foundation in physiology as we know it.

The FVS letter calls the Forbes piece this “a fit of logical fallacies, unsubstantiated conjecture, political rhetoric, and denialism.” Many would say exactly the same can be applied to chiropractic. The ICA asserts that the practice is safe and effective. I don’t find the evidence for chiropractic compelling (subluxations in particular) and there does seem to be an unaddressed risk when we consider the potentially nonexistant benefits.

Here is the other side of the coin – the conclusions from medical opinions Chiropractic « Science-Based Medicine.

Chiropractic fail.

The ICA is asking for an apology. Will we have another Simon Singh type lawsuit? How did that turn out for chiropractic in the U.K.? Not well.

  7 comments for “Chiropractors get their spine out of place over critique

  1. Indrid Cole
    April 25, 2014 at 2:36 PM

    I was working on a chiropractor’s home one time, when I noticed this agenda on his desk for a seminar he must have attended, titled “How to Create Patients for Life”. After seeing that I decided to steer clear of those guys.

  2. Someguy
    April 25, 2014 at 9:10 PM

    Sadly, my wife went in for chiro, but thankfully not to the extent that a lot of the quacks want you to (i.e. curing infertility, cancer, etc.). She has chronic back pain, and her options are chiropracty/massage (there’s a kind of weird placebo/pain relief effect from massage, or so I last read, and it didn’t really matter if the person was an actual masseuse or a spouse or whatever, human contact seemed to soothe a lot of pain, but anyway) or spinal fusion surgery.

    Let’s assume we had unlimited universal health care tomorrow. There are some people who will choose anything over going under the knife. My wife has thankfully stopped seeing Dr. Spinecracker, but she’s still scared to death of surgery, so she’s on spinal steroid injections to lessen the swelling.

    It sucks, but that’s how a lot of people are. Just look at Steve Jobs. He chose non-surgical quackery over actual surgical medicine and it cost him his life.

  3. Adam
    April 28, 2014 at 5:05 AM

    Chiropractors / naturopaths exist in such number because insurers offer cover for them. I assume it’s cheaper to underwrite quacks than have people with minor conditions visiting doctors and specialists.

    I think that governments should levy health insurers to fund a network of health centres. These would be run by qualified staff and offer advice on minor ailments, weight, diet, exercise, vaccination etc. without incurring the same cost as a doctor. They would also be qualified to make referrals if necessary.

    If insurers were whacked with such a levy they would probably just dump the quackery because it no longer serves a purpose and the overall cost is probably no different to the end user.

  4. Adam
    April 28, 2014 at 5:09 AM

    I know someone who got a Groupon for a chiropractor for a few session. Unsurprisingly, “free” turned into a x-ray, and a dubious diagnosis recommending a whole course of back manipulations. All this was justified because the patient could claim it back on health insurance. It’s a scam, and what’s worse, this one chiro with his groupon was indirectly causing MY health premiums to rise with his bogus treatments.

  5. Jim
    May 2, 2014 at 11:31 AM

    Hi Adam:

    One reason the insurers cover “alternative medicine” is because of consumer demand (it has very little to do with evidence at all). I build clinical care pathways and policy for the musculoskeletal medicine division for the largest specialties healthcare management company in the US. If consumer demand for these services drops, they would be dropped. Period. But the fact is (whether one likes it or not) the touchy-feely fields have higher patient satisfaction, perceived attentive listening and validation of the illness, perceived reassurance, etc. Does one “need” an x, y or z practitioner to get it? No. It makes people “feel good” and thus they perceive it as beneficial (this is not the same as curative or therapeutic; those are evaluated separately).

    We must look at the situation dispassionately to understand its mechanisms. As a quick note to your first comment, from the private insurer’s standpoint (not talking about Medicare here), it is not chiro reimbursement that costs the companies the kind of money that makes them stay up at night. It is, as of 2014, more about unnecessary epidural steroid injections (ESIs) and back fusions for NONspecific diagnoses. We know what these procedures do well, and what their boundaries are. But proceduralists push the boundaries of good clinical applications because of our perverted reimbursement system where docs are rewarded for the number of procedures they do and NOT patient outcomes. JE

  6. Jim
    May 3, 2014 at 12:17 AM

    Dear Moderator: my computer/browser had a glitch earlier and it appeared my requested response for meditation had been deleted. In fact, it was just a connection or fresh issue on my part so THANK YOU for supporting my comment. Much appreciated and apologies for the confusion on my end. Best, Jim Eubanks

  7. Peta
    May 5, 2014 at 6:53 AM

    I live in Australia, which has its own problems with Science Denial & an upsurge in people choosing unproven “therapies” – usually funded by Private Insurers rather than our Medicare (mind you, I’m told that public Chronic Pain Units don’t exactly shy away from Woo either…).

    I agree with all previous comments: but would like to mention something incredibly unethical which has come to my attention recently. I used to be of the belief that “alternative” therapies were primarily sought by worried well/hypochondriac types OR those with chronic physical problems for which there is little respite currently offered by SBM.

    Over the last year or so I’ve discovered that at least three people I know (friends of friends) with differing untreated psychiatric illnesses have been duped by various practitioners – for example, a woman I know who has Schizophrenia has been conned into believing that if she doesn’t attend her Chiropractor at least once per week, her non-existent “scoliosis” will have her in a wheelchair within 12 months! I’m pretty certain that if the individuals being defrauded in this fashion lodged complaints to the appropriate departments etc, action against such unscrupulous individuals would be taken – however, the complaint has to be made by the person aggrieved. Clearly – if an individual lacks insight this isn’t going to happen. It certainly says something about the credibility of many “complementary” therapists that many of them are willing to exploit obvious cognitive deficits (such as paranoia) to their own ends.

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