Calling All Evidence Based Chiropractors
If YOU are a chiropractor, or KNOW a chiropractor, who feels they use science and evidence based chiropractic, PLEASE pass this request along to them. If you know a chiropractor who DOESN’T practice evidence based chiropractic, pass this along to them as well!
I’ve spent the last month on general internal medicine in a rural community. Driving around this particular community what strikes me is just how many chiropractors there are! I’ve seen 4 offices for primary care doctors – either DO or MD, and 10 for chiropractors. Many people appear to be using chiropractors as their PCPs. Needless to say I have a problem with this. Below, I have some questions for these or any other chiropractors who would be willing to take some time to answer.
Over the course of the month, I’ve seen 3 patients who said their previous PCP was their chiropractor. In all 3 cases, the patients had blood pressures over 160/100 (that’s what we call “bad”). In all cases, the patient said their chiropractor suggested no medications, and did not recommend that the patient see an MD or DO for their blood pressure. None of the patients (2 men, 1 woman) had had the basic screening and health maintenance procedures or exams that we would call very important – pap smears, mammograms, digital rectal exams, colonoscopies, repeated blood pressure measurements for example.
One of the patients said they had been receiveing chiropractic manipulation for their allergic rhinitis. They claimed that the manipulation in question involved their low back and hips, and that the chiropractor said that their allergies were related to the curvature of their spine. I understand that patients often misunderstand explanations given to them, so I’m assuming something got lost in translation there.
If you are a chiropractor, can you explain your brethern’s clinical practice in these situations? Answer as many or as few as you feel comfortable doing so, this is not a trick and I will be VERY forgiving in my comments of any chiropractor who ventures into this potentially hostile territory. Below is a list of specific questions.
- Do you think chiropractors are prepared to be primary care providers? If so, why?
- What is the scope of practice of a chiropractor? That is, what conditions can you treat? What procedures and other actions are you comfortable, and licensed to provide? What special training do you require to provide these services?
- What kind of process does your profession use to decide if a new action or procedure is worthwhile, and discard those actions that are unacceptable, while promoting those that are good? That is to say, how do you separate the wheat from the chaff?
- Outside of treatment for low back pain, what conditions do you feel there is scientific evidence that chiropractic is useful?
- What is the chiropractic basis of spinal manipulation as a treatment for allergic rhinitis? If there is no such basis, is there a procedure to censure a chiropractor falsely claiming that there is such a basis, and charging patients for such manipulation.
6. What is the basis of chiropractic, is there still a vague belief in “innate intelligence”, or is there now a theory that is consistent with our knowledge of anatomy and physiology? If there is any such theory, is there any basic science study that backs this up?
I welcome your responses in the comments, or if you’re uncomfortable with that, via email, my email can be obtained from the contact page on the sidebar.
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