CF 116: Chiropractic Scoundrels, Chiropractic Safety In Kids & What Is Chiropractic?
Today we’re going to talk about chiropractic safety for kids and then we’ll spend some time talking about a paper attempting to define what chiropractic is.
But first, here’s that sweet sweet bumper music
OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.
We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers.
I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.
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Do it do it do it.
You have found yourself smack dab in the middle of Episode #116
Now if you missed last week’s episode , we talked about epiduran steroid injections and why to give them the heave ho, asap, mi amigo. Make sure you don’t miss that info. Keep up with the class.
While we’re on the topic of being smart, did you know that you can use our website as a resource? Quick and easy, you can go to chiropracticforward.com, click on Episodes, and use the search function to find whatever you want quickly and easily. With over 100 episodes in the tank and an average of 2-3 papers covered per episode, we have somewhere between 250 and 300 papers that can be quickly referenced along with their talking points.
On the personal end of things…..
I’ve had some wah wah news to share with you guys since my Dad’s stroke in November and issues with my office getting broken into, and my bonus dad having his hospitalizations and all that. I’ll just get to it.
I lost two friends this week. One on Monday and one on Tuesday. While I can’t consider them my inner circle friends, they were friends over a course of many years and it’s never fun. More importantly, when they’re your age, it makes you consider your own mortality and honestly, who the hell wants to consider their own mortality?
Certainly not me so we’re going to keep trucking.
The week of recording this episode, my interview with Dr. Jerry Kennedy on RocketChiro’s podcast went live. Other than there being video where you can see my ugly face, I thought it was a lot of fun and we covered all kinds of topics most of you would probably find interesting. You can find that at rocketchiro.com and click on podcasts.
This week, I also spent an hour and a half on the witness stand testifying in court in regard to a car wreck patient of mine. I haven’t seen him in a couple of years. I haven’t had to testify in a few years.
The idea of testifying once mortified me. Absolutely petrifying. Lol. Some of you can relate because it probably scares the crap out of you too.
The thought of having your notes up on the big screen….ugh. You better be a good note-taker!! When you’re teaching staff to take good SOAP notes, tell them that their notes can be up on a big huge screen with your name underneath them!
Anyway, it was weird, the friendly attorney, the one that asked me to come testify, he asked me questions for roughly an hour and a half. When it was the bad guy’s turn, he asked me like 3 little simple, insignificant questions. Like, he had nothing. Nothing to ask me. Lol.
I don’t know if it’s because I was doing a good job throwing out research findings and whiplash injury factoids that he wanted me to shut up and get off of the stand……or…..if I was as insignificant as a fly and he had no use for me. Lol.
For my own sanity and mentality….I’m going with option #1. I’m sure you understand.
This podcast folks, it’s really started to take flight in the last few months. More and more people are starting to latch on and I couldn’t be more pleased to see that hard work does actually pay off with consistency.
And that’s what I’ve tried to provide you all consistent, high-level information tainted with a bit of personality and entertainment. Maybe….just maybe it’s an effective combination. I’m not where I’d like to be but we are certainly moving in the right direction. About 30,000 downloads for a nichey little podcast like this just isn’t bad, folks.
If you have helped me along the way, I want to tell you thank you. If I see you at an event, I hope you’ll come to introduce yourself and we can hug it out. I’m a friendly dude. What can I say?
All I can ask is, if you know someone that would be interested in the information you find here, please share us with them. Pump our tires a little bit and show them how to find us and connect. That’s all. That’s it. And thank you.
Before we dive into the reason we’re here, it’s good to support the people that support evidence-informed practitioners. Well, ChiroUp certainly does just that.
If you don’t take advantage of the deal I’m about to offer you, I think you just might be crazy.
Regular listeners know I’ve used ChiroUp since for well over a year now. I’m going to tell you want it is and then share a way to do a FREE TRIAL and, if you sign up, only pay $99/month for the first six months. So listen up!
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You can be confident that your patients are getting the best possible care because the reports and exercises are populated based on what the literature recommends and isn’t that reassuring? All of that work has been done FOR you by people that are deep into the research.
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This first one is called “The safety of spinal manipulative therapy in children under 10 years: a rapid review” by Corso, et. al(Corso M 2020). and published in Chiropractic & Manual Therapies in February – dammit that’s some hot fresh smart biscuits, people…
Why They Did It
“The safety of spinal manipulative therapy (SMT) in children is controversial. We were mandated by the College of Chiropractors of British Columbia to review the evidence on this issue.”
How They Did It
- They conducted a rapid review of the safety of SMT in children (< 10 years).
- They aimed to:
- describe adverse events;
- report the incidence of adverse events; and
- determine whether SMT increases the risk of adverse events compared to other interventions.
- They searched commonly used databases like MEDLINE, CINAHL, and Index to Chiropractic Literature
- They searched from 1990 to 2019 – That’s a pretty large search I think most would agree.
- They used rapid review methodology recommended by World Health Organization
What They Found
- Most adverse events are mild (e.g., increased crying, soreness).
- One case report describes a severe adverse event (rib fracture in a 21-day-old) and another an indirect harm in a 4-month-old
- Whether SMT increases the risk of adverse events in children is unknown.
Wrap It Up
The risk of moderate and severe adverse events is unknown in children treated with SMT. It is unclear whether SMT increases the risk of adverse events in children < 10 years.
OK – looky here. I may be a country bumpkin. I may just be a Texas Flatland dipstick but here’s my take. Even in politics…..it’s all about the kids, isn’t it? Haven’t you noticed that? If you can bring the kids into it, BAM!!! You have an instant impact statement, don’t you?
So, with the powers that have waged war on the profession of chiropractic for generations, don’t you think that if there were indeed any real, consistent, and common adverse effects from chiropractors working on kids, that we’d damn sure know about it by now?
Honestly, they searched almost 30 years of records. Are you stepping in what I’m tossing down? Let’s be honest, some goofy stuff happens here and there but this paper doesn’t ell me it’s unclear. Knowing this profession and the medical profession and the history of conflict there, this paper tells me there’s nothing to see here. Keep on trucking and getting the kiddos to feeling better if they need it.
Don’t work them over for no damn reason but if they have a complaint, by all means, help them. Please.
This second one is called “So, what is chiropractic? Summary and reflections on a series of papers in Chiropractic and Manual Therapies” by Jan Hartvigsen and Simon French(Hartvigsen J 2020). Published in Chiropractic & Manual Therapies on January 30, 2020
Nothing but steamy plates of fresh filets of brain food, folks!
The authors start the abstract by saying, “This commentary brings the 2017–2019 thematic series What is Chiropractic? to a close. The 18 papers published in the series contribute to a better understanding of what chiropractic is, where chiropractors practice and function, who seeks their care, what chiropractors do, and how they interact with other healthcare professionals. “
Several papers in the series highlighted deeply rooted disagreements within chiropractic about fundamental issues pertaining to ideology, acceptance of scientific evidence as the basis for clinical practice and the future of chiropractic.
If the chiropractic profession is to remain relevant in today’s evidence-based healthcare environment, there is an urgent for the profession to undertake further research to describe what chiropractic is, what chiropractors do, and provide evidence for the value of these activities to patients and healthcare decision-makers.”
Boy is that an understatement…..
They close out the body of the paper with what struck me as some powerful thoughts.
“Papers in this series have again revealed deeply rooted disagreements within the chiropractic profession about what chiropractic is, and what it should be, as a profession, as well as disagreements and variation in relation to the education of chiropractors and chiropractic clinical practice.”
In our opinion, it is ironic that while chiropractic has a strong presence in large parts of the world, is taking on increasingly important roles in disability prevention [6, 7, 17], in the military  and in interprofessional care  as well as growing research capacity , discussions about fundamental values and direction of the profession are unresolved.
This unresolved issue creates confusion for stakeholders and threatens to impede professionalization and cultural authority. If chiropractors are to remain relevant in today’s evidence-based healthcare environment, there is an urgent need to agree on, and further describe, what chiropractic is, what chiropractors do and importantly to provide evidence for the value of these activities to patients and societies.”
Dr. Hartvigsen and Dr. French are dead on target here but it’s 100% pointless. You will never unite this profession until the old guard changes or dies out. Some say, ‘what does it matter as long as we’re getting people better?”
Here’s why it matters. Many of us have worked our asses off raising our game and there are knuckleheads out there parading around as experts, scaring patients into long-term contracts, and making us all look like straight-up idiots and I don’t appreciate it. I don’t like to walk into a room of medical doctors and see the way they look at me when someone tells them I’m a chiropractor and know the reason is because of these knuckleheads.
So, if you’re a go along to get along type of person…..THAT’s why it matters
I happened to be on Reddit kicking around the Chiropractic subReddit and came across a girl who was a patient of a chiropractic clinic on the West side of St. Louis. Saint Charles to be specific.
The issue started out because this office was leaning HARD on her to market them to her friends and family and get her to get patients into their office.
OK let’s start there. I am not afraid to ask a patient every now and then if they have remembered to tell everyone they ever met about this amazing new office and the results they got here. I do it in a non-pushy, comical way but at the same time, I am encouraging some word of the mouth stuff to happen. Make sense? I hope so because it makes sense to me.
Now, that’s OK. But what she was describing was the doctors on her at every visit and coming close to harassing her about it.
OK, not cool but not a deal-breaker but then she started to go into more of her story with these knuckleheads. Here’s what she said.
I signed a one year contract with what they call a “wellness center.”
Two chiropractors run it. I have already received 5 months of treatment and have 7 to go.
The payments are due over a 10 month period of time, but I will receive 12 months of treatment in total when it’s done.
Anyways, my chiropractor every day pushes his clients to refer to other clients. I am new to the area and I’ve told him that I’m new.
Also, I’m not his marketing team. Like sheesh. Well, today he said to me “you’ve lived here long enough, you have someone by now you can send in here and save their life with chiropractic.” I’m started to feel harassed.
Save their life with chiropractic. Look folks…..I’m all about valuing chiropractic and what we do for our patients but ‘Save their life?” That and turn the power on type stuff makes me want to throw up in my mouth a bit. I’d rather run a cheese grader on my legs than hear that crap.
Anyway – she continued
But here’s my main issue:
When I signed the contract, they said the RETAIL for 12 months of care is over $5k. Since you will be signing a contract it will be taken down to $3,350
So I pay $335 every month for ten months. I’ve already paid 5 months. They said if this contract is broken early, you will then owe the difference for each visit you have received of what the “retail fee” would have been since you are being discounted for having a long term contract.
I believe their “retail fee” is $55/visit and my “discounted fee” is $36 per visit. I’ve probably had close to 40-50 visits so I’d back owe close to $1,000.
She concluded by saying, “Please help me! I was snaked by these people because I just wanted pain relief!”
If you agree with the tactics this clinic is using against this woman, just stop listening to me. Put your phone down now. I can’t with you or anyone like you. It’s shameful and it pisses me off.
To scare them into a contract, to make them feel they’re locked into the contract and they’ll owe a fortune if they try to get out, and to carry on as a healthcare practitioner or to carry on as anything other than a snake oil salesman out on the street corner…..I just can’t.
So here’s what she’s going to do. Or what I hope she’s going to do. I hope and am encouraging her to contact the state board of examiners for Missouri and tell them her story. If there is an issue there, they’ll open a complaint. If there is not an issue, I’m going to open up a complaint with the Board of Chiropractic Examiners in Missouri. Lol
I’m fortunate enough to be in Texas. Texas chiropractors can’t pull this crap anymore. Thank God.
I’ll repeat what I’ve said countless times on this podcast
- There is no place for contracts for your healthcare. Ever.
- It is a profession with A LOT of room in the scope. Chiropractic is not a modality. It’s a profession.
- It is not a church. It’s not a faith-based system. It is a scientifically validated profession but only when you’re using evidence-based research. Not piddly case studies that fit your bias or studies performed by the stakeholder of the system they’re selling.
- Professions have a birth. Then they have learning and progress into the current state and construct you see. They do not have a birth and then remain in the same place with the same amount of information and techniques for over 100 years. The medical field doesn’t do that. Physical Therapy doesn’t do that. Chiropractic shouldn’t do that.
- Be a doctor. Don’t be a salesperson. It’s gross and, even if nobody says it to your face, it’s embarrassing to you and to the rest of us.
Well, how many enemies have I made right there? Lol. Honestly, I don’t care at this point. Let’s be honest with each other can’t we? We’re all mostly grownups I hope.
Be an a-hole, take advantage of people, scare people, bully people, and screw people and you’ll find that maybe you make a lot of money but that doesn’t come without consequence. Whether it’s turning your soul a shade of blackish/gray or whether it’s the snickers, sneers, and giggles behind your back as you walk by, or maybe whether it’s the eventual realization of what you’ve done to the reputations of not only your family and friends but also to your colleagues. Whatever forms it takes, there are consequences to living and behaving like that.
On the other hand, be a good person. Be smart. Be ethical and have a moral compass. Then good things happen. You can walk upright and proud.
Remember the evidence-informed brochures and posters at chiropracticforward.com.
I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.
When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few.
It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient.
And, if the patient treats preventativly after initial recovery, we can usually keep it that way while raising the overall level of health!
At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints….
Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.
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We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.
We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.
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About the Author & Host
Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger
- Corso M, C. C., Mior S, Taylor-Vaisey A, Cote P, (2020). “The safety of spinal manipulative therapy in children under 10 years: a rapid review.” Chiropr Man Therap 28(12).
- Hartvigsen J, F. S. (2020). “So, what is chiropractic? Summary and reflections on a series of papers in Chiropractic and Manual Therapies.” Chiropr Man Therap 28(4).