vitalists

Impact Of Chiropractic Care on Opioid Use & Garbage Marketing In The Chiropractic Profession

CF 163: Impact Of Chiropractic Care on Opioid Use & Garbage Marketing In The Chiropractic Profession

Today we’re going to talk about the impact of chiropractic care on opioid use and then we’ll talk about garbage marketing in the chiropractic profession. I go off a bit. I can’t help it. They make me nuts.  But first, here’s that sweet sweet bumper music

Chiropractic evidence-based products

Integrating Chiropractors

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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.   If you haven’t yet I have a few things you should do. 

  • Like our Facebook page, 
  • Join our private Facebook group and interact, and then 
  • go review our podcast on iTunes and other podcast platforms. 
  • We also have an evidence-based brochure and poster store at chiropracticforward.com
  • While you’re there, join our weekly email newsletter. 

You have found yourself smack dab in the middle of Episode #163 Now if you missed last week’s episode , we had Dr. Bobby Maybee of the Forward Thinking Chiropractic Alliance and the Chiropractic Success Academy. It was Part Two of a two-part interview that I think you’ll all get plenty of excellent insight and inspiration from. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

I had the second Moderna vaccine shot on January 20th and all’s well. My experience is that, if you remember, I had zero symptoms with the first shot. Not even a sore arm. Nothing at all.  With this second one, I had a pretty sore arm. It felt like when I got the flu shot. Just a sore arm. It was red for a couple of days too. It was honestly about two days and that was it. I may have been hyperfocused on whether I was having symptoms or not but was maybe a touch tired that day.

I got the shot at 2:30 in the afternoon and then went back to work until 6pm so….I may have been a touch draggy but like I said, that could have just been me being hyperfocused. It wasn’t anything very noticeable.  My wife felt a little crummy for one day. Then she was back at it.  Overall, not a bad deal. They say the full protection is approximately 2 weeks after shot #2 so we’re looking pretty good and, outside of the first two weeks we took off in late March of 2020, I haven’t had to take any days off due to illness and if it all works out, I won’t have to in the future. As a result of COVID anyway.  As I’ve said here, I don’t think it’s unreasonable at all to wait to get yours until you’ve seen how everyone else reacts to it.

I really don’t. I’m not a ‘get your shot instantly’ type of guy. Especially if you have associates that will pick up your slack should you get COVID and be out sick. But when you’re a solo doc like me, the business depends on your presence. I can’t get sick and be out for 2-4 weeks. Some folks are out much longer than that. For me, there’s nothing that makes more sense than getting the vaccine as quickly as possible.  In addition, I have a wife that is 100% over this mess and is ready to go traveling. So, happy wife – happy life in full effect.  Also, I have a local surgeon running advertisements all over TV and it makes me want to punt baby bunnies into the stratosphere.  He says in thw commercial that we all deserve to live without pain and then he goes into his campaign in support of back and neck surgery. Who am I to try to keep someone from marketing their business?

But day-um. One word, two syllables. Day-um. 

Years ago it was illegal to run an ad for hard liquor. You don’t see any cigarette commercials do you?  Now, I’m not saying surgery is equal to cigarette smoking and hard liquor but I know several that have done worse through one surgery they they would ever do from a life of smoking and drinking.  I see that commercial come on TV and I start talking to the TV. I have a strongly worded conversation with the TV every time. It’s because I know that there’s little to no support for spinal surgeries in the research and there’s not better outcomes from them either. The problem is that the common, every day patient does not know that. 

They see the damn white coat and lose their damn minds and just say, “OK.” A pharma commercial could say that you butt could fall out of you walking across a room if you take this medicine and people would still line up for it.  You tell them we’re going to get you moving and exercise and they think you’re dangerous or crazy. It’s a conundrum.  Alright, let’s get to the good stuff shall we?

Item #1

This first item is called “Impact of Chiropractic Care on Use of Prescription Opioids in Patients with Spinal Pain” by Whedon et. al(Whedon JM 2020)….there’s that Whedon name again. It was published in Pain Medicine in December of 2020 and that a lot hot

Why They Did It

Utilization of nonpharmacological pain management may prevent unnecessary use of opioids. Our objective was to evaluate the impact of chiropractic utilization upon use of prescription opioids among patients with spinal pain.

How They Did It

  • The total number of subjects was 101,221.
  • It was a retrospective cohort design for analysis of health claims data from three contiguous states for the years 2012–2017.
  • included adults aged 18–84 years enrolled in a health plan and with office visits to a primary care physician or chiropractor for spinal pain.
  • We identified two cohorts of subjects: Recipients received both primary care and chiropractic care, and nonrecipients received primary care but not chiropractic care.
  • We performed adjusted time-to-event analyses to compare recipients and nonrecipients with regard to the risk of filling an opioid prescription. We stratified the recipient populations as: acute (first chiropractic encounter within 30 days of diagnosis) and nonacute (all other patients).

What They Found

Overall, between 1.55 and 2.03 times more non-recipients filled an opioid prescription, as compared with recipients.  Similar differences were observed for the acute groups.

Wrap It Up

Patients with spinal pain who saw a chiropractor had half the risk of filling an opioid prescription. Among those who saw a chiropractor within 30 days of diagnosis, the reduction in risk was greater as compared with those with their first visit after the acute phase. CHIROUP ADVERTISEMENT

Item #2

Alright, I’m going after vitalists a bit here today in item #1. I came across a script and I just can’t ignore this stuff anymore. If we’re not willing to call it out, then we are complicit. And I refuse to be that. In fact, if you have any of these scripts you’ve been given from vitalist gurus, please email them to me at dr.williams@chiropracticforward.com I would love to read them on future podcasts and discuss my disdain for the tom foolery within. 

This script is to be used when a patient hasn’t been in for a while. It’s basically used to scare the holy hell out them and force them back to your office because…..you know…..they depend on you to keep them healthy and there are no other means of keeping one healthy outside of the removal of the magical subluxation.  So, here is the script: Dear Patient I have been thinking about you! (with an exclamation mark because, you know….bilking and scaring people is super exciting and all). I realized I have not seen you in a while.

So, I reviewed your file and looked at your last x-ray.  I am concerned that based on your past history, you might be suffering the effects of spinal degeneration without being aware of it. The first effect of spinal degeneration is that the nerve that supplies the area stops performing its normal function.  This means that your nerve is unable to alert you to a problem that is potentially developing…. That’s not emotionally manipulative at all now, is it? It would be like cutting the wire to your fire alarm when your house is on fire!!! OMG!! Cutting….it sounds so awful!! 

The alarm can’t warn you of the fire in time to get out of the house, Holy s-word!!! That must mean I’m going to burn the hell up then. I better call this knucklehead’s office and be seen before I look like a crispy curly fry!! Gimme a damn break. I can’t believe professionals are sending out garbage like this.  It continues; Another sign of spinal degeneration is the loss of flexibility. You lose files without being aware of it. You begin to turn with your shoulders instead of using your neck.

You lift with your back instead of bending your knees. You should have enough flex to enjoy your life. This means you should be able to get out of bed in the morning without feeling stiff or sore. It means you can do the things you enjoy in life. You should be flexible enough to exercise and enjoy your hobbies and leisure time including sitting down to watch your favorite TV programs without being stiff when you get back up. 

The most serious effect of spinal degeneration is loss of vitality. Oh that sounds horrible. Not vitality!!  You should feel healthy!! Yes, you should but you can do that by making yourself move and exercise and eat better while getting a good amount of sleep. You don’t need a chiropractor to feel healthy.   You should have a sense of wellness and energy. You should be able to get out of bed ready to go. You don’t feel this way when your systems do not function properly. You feel that something is just not right but you can’t quite put your finger on it.

You feel stressed and tense. Yeah….like 100% of every other American on this planet.  Last paragraph of the garbage. 

I have set aside the next month for you as “Welcome back to Chiropractic month.” Damn, that’s so nice. They set aside a whole month for me. Sweet bastards. 

Do yourself a favor and call our office to schedule a visit. I will perform a ‘back to chiropractic adjustment and exam including x-rays if needed at no cost.’ Way to value you treatment, doc!! This visit has a normal valued of up to $175 and is yours absolutely FREE during the next month. It’s my way of encouraging you to get back on track and avoid the consequences of spinal degeneration. Please bring the enclosed ‘back to chiropractic’ coupon with you when you come to the office. I look forward to seeing you again soon! Now, if you can read through that without throwing up, congratulations. You have a stomach of iron.

Secondly, if you ever hear a vitalist claim they do not use scare tactics to take advantage of their patients, they’re simply not being honest. In essence, that’s exactly what the subluxation theory is in the first place. IT’s a scare tactic. The silent killer, right? You’ll get sick, you’ll be unhealthy. You’ll develop degeneration. Not because of the consequences of normal freaking aging but because you had all those subluxations all up in ya. 

Talking about the person and using the word ‘you’ is a sales tactic. They use the word ‘you’ or its variants 39 times in that mess of a sales letter.  Can I say that I’m not sure I’ve gotten a birthday card from my family MD much less a scare tactic-laden sales letter.  We can do better than this folks.

Crap like this make us all look like fools. Not to mention what it makes the ones sending their crap out look like. They look like bozo the clown in full makeup, y’all.  “I am concerned that based on your past history, you might be suffering the effects of spinal degeneration without being aware of it. The first effect of spinal degeneration is that the nerve that supplies the area stops performing its normal function.”

Come on man. Spinal degeneration is a normal part of aging. You quit building bone and then you start to regress over the years. This is natural. Stop making patients believe they have to depend on you. It’s not right and if the state boards have any teeth on this kind of garbage, they should start using it. That’s if chiropractic is ever going to step its game up.  We are better than this. When you and your heart and your business are built on things like, honestly, ethics, character, education, and love……you could never in your life send out something like that.  When you are built on selfishness, low-character, deceitfulness, and an anything to get ahead, then you’re more than happy to send it out and you won’t think twice when they come in because you scared them and then you scare them into treating every other week for the next year with upfront payment, blah blah blah. How do these types of practitioners live with themselves?  The absolute worst are the ones that claim it’s a God thing.

If they don’t come in and get their regular adjustment, they can’t allow God to express his true power in their body’s? Oh….is that right? The dude we Christians claim created the world and man in his own image……the dude controlling everything on Earth and beyond…..that dude needs a chiropractor to adjust their patients all of the time because he didn’t make quite perfect enough. The hell you say.

Remember, I’m a Christian. I can make fun. The hypocrisy in this type of practitioner is about as low as it gets for me.  All of these practitioners have big houses. No doubt. But at what cost personally and to our profession?  We’re better than that. Stop it dammit. Stop it now

Alright, that’s it. Y’all be safe. Keep changing our profession from your little corner of the world. Keep taking care of yourselves and everyone around you. Tough times are upon us but, the sun will shine again. Trust it, believe it, count on it. Let’s get to the message. Same as it is every week. 

Store Remember the evidence-informed brochures and posters at chiropracticforward.com. 

Chiropractic evidence-based products

Integrating Chiropractors

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The Message 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!

Key Point: 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…. That’s Chiropractic!

Contact 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.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  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. 

Connect 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.

Website http://www.chiropracticforward.com

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TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  

Bibliography Whedon JM, T. A., Kazal L, Bezdijian S, (2020). “Impact of Chiropractic Care on Use of Prescription Opioids in Patients with Spinal Pain.” Pain Med 21(12): 3567-3573.  

The Shake-Up With WFC’s Research Committee

CF 154: The Shake-Up With WFC’s Research Committee Today we’re going to talk about the research committee shake-up at the WFC. I’ve wondered for months now what exactly happened with shake-up and it hasn’t been easy to figure it out either. Who is to blame and what companies are to blame as well? We’ll get knee deep into it in this episode.  But first, here’s that sweet sweet bumper music

Chiropractic evidence-based products

Integrating Chiropractors

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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.   If you haven’t yet I have a few things you should do. 

  • Like our Facebook page, 
  • Join our private Facebook group and interact, and then 
  • go review our podcast on iTunes and other podcast platforms. 
  • We also have an evidence-based brochure and poster store at chiropracticforward.com
  • While you’re there, join our weekly email newsletter. No spam, just a reminder when the newest episodes go live. Nothing special so don’t worry about signing up. Just one a week friends. Check your JUNK folder!!

Do it do it do it.  You have found yourself smack dab in the middle of Episode #154 Now if you missed last week’s episode , we talked about how some chiropractors could be better and being careful which guru you’re going to place your faith in. Some are just absolute loons and only driven by profit, not results and not the patient.

The saying is, when you’re focused on the outcomes, you’ll never have to worry about the income. 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

On the personal end of things…..

Chugging along. Making friends and influencing people. That’s how we do it here. Actually, that’s not true. I’m sure I got the vitalists all fired up last week and probably will this week as well. I’ll probably get some companies fired up too.  We’ll see. It doesn’t have a thing to do with anything chiropractic but I’ve mentioned a time or two here that I’m branching out and, as a retirement plan, I’m working on a little side gig in the voice over / voice artist industry. This stuff is fascinating y’all. It really is. 

So I went through the steps you’re supposed to go through in getting yourself all set up and now, here I am, I got a commercial demo done. If you’re just feeling goofy and bored, go to jeffwilliamsvoice.com and there’s a demo there you can listen to. Turns out I have the John Deere, Ford truck, eat this burger type of voice and I’m totally OK with that.  Anyway, after you get a demo, you start submitting to talent agencies around the world. Well, hell….I don’t have all day to spend on doing this stuff so I can only get a few per day and there are tons of them.

But, in just the first round or so of submissions, I already got signed up with a talent agent out in San Francisco and Los Angeles as well as interest from a talent agency in Barcelona Spain and potentially a marketing firm down in Dallas/Ft. Worth. . So….how damn cool is that? Maybe, one of these days, my side gig takes over my day job. I’m not holding my breath though. But, seriously, my buddy has done it for about 7 years and he’s making six figures. Can you imagine making a good 6 figure salary but no employees, no overhead, you can make that money in your basement in your underwear (sorry for the visual there), and you can do it from anywhere in the world as long as you have an internet connection?

Well, it’s a cool idea and a lot of folks get to do it that way. Who knows? It’s a lot of luck and all that stuff but I’ve never been one that was afraid to take chances or afraid to fall on my face.  Either way, it’s exciting and isn’t that what it’s about? Keeping life interesting and exciting? That reminds me, if you need a voice over for a youtube video, your podcast intro, or any commercial you’re doing, remember ol Uncle Jeffro here. I got you covered!

Item #1

Now, let’s get to spilling the tea shall we? I have to start by saying, I don’t love talking about this stuff. I don’t at all. It makes me uncomfortable. Mostly because some of my friends won’t like it. I work with a lot of chiropractors around the nation in different capacities and to be honest, while we work FOR the chiropractic profession, we don’t see eye to eye with each other on WHAT chiropractic is.  Still, they’re my friends. So what do I do? Do I just say nothing about things I know they won’t agree with? Or do I talk about it and give my view point on them?

Well, I have a podcast so I guess I talk about it. I could stay out of the messiness of our profession and avoid tough subjects all together I guess. But who ever changed anything by taking that sort of stance? That’s not really any kind of stance at all is it? You change things by standing up, somewhere, and supporting your convictions. So that’s where i’m at. I don’t like. I’m uncomfortable with it, honestly. But the show must go on.  Let’s start with what happened. Dr. Greg Kawchuk was the head of the World Federation of Chiropractic. I’m a fan of Dr. Kawchuk. so when I saw on Facebook or Twitter or somewhere that he resigned his post as head of the WFC research committee, it had me a bit miffed. Not only that but a lot of HUGE chiropractors on the committee left with him. Researchers on the level of Jan Hartvigsen for example. 

To be specific, those that resigned are

  • Greg Kawchuk DC PhD Canada – Chair
  • Simon French, PhD, MPH, BAppSc(Chiro) Australia
  • Iben Axén DC PhD Sweden
  • Jan Hartvigsen DC PhD Denmark
  • Martin Descarreaux DC, PhD Canada
  • Carolina Kolberg DC PhD Brazil

Every single one of these researchers has been in the episodes we have released. They are big time for our profession. The vitalists, unfortunately, have labeled them subluxation deniers. I label them scientists but….whatever.  I say tomato, they say dumb stuff. Their statement of resignation went like this, “Effective immediately, we (Greg Kawchuk (Chair), Iben Axen’, Martin Descarreaux, Simon French, Jan Hartvigsen, and Caroline Kolberg) resign from the World Federation of Chiropractic (WFC) Research Committee.

We no longer feel it is possible to function as independent academics in our roles on the committee. We urge the WFC to continue to promote the EPIC principles (Evidence-based, People-centered, Interprofessional and Collaborative), and to protect its core values from potential conflicts and outside influence. We wish the best for the WFC and our colleagues who serve on its Research Committee.” Now, it wasn’t all bad because they put Dr. Christine Goertz into the post as the head of the WFC committee and if you’re a listener here at the Chiropractic Forward evidence-based chiropractic podcast…..well then you know what a fan of Dr. Goertz we are. She’s a chiropractic treasure. 

But, when I first heard the news, as you can imagine, and as you probably felt when you heard, it was a bit concerning for our profession to lose so many high profile, top-level researchers at once. What’s that going to mean for our profession and why did this happen in the first place? I started paying attention. I started looking for information. What the heck happened? But nothing. Not only nothing on the story but nobody was talking about it either. Like….it was just another event that happened on just another day. No big deal. When, in reality, at least to research consumers such as myself, it was a huge deal! Why did this happen and what the hell is the story?

Well, I’m going to give away the ending here before we really dive in, I’m not 100% sure but at least now I have an idea. A generaly idea.  When I decided I was going to do this episode, I put it in our private Facebook group. We only have around 450 members approximately. Again, in case you don’t know, we have a public Chiropractic Forward page. That’s just to get the word out about the podcast and market the podcast.  Then we also have a Chiropractic Forward private group where we can share research papers, we can discuss amongst ourselves, and all that good stuff and we can do it privately. I encourage you all to join the private group.

Not if you’re a vitalist. That’s not the group for you. But if you’re evidence-based and patient-centered, then you’re a good fit.  Anyway, I posted in there that I wanted to do this episode and if anyone had the back story, please send me a private message about it. That I wanted to get it figured out and tell our audience. 

There was a lot of interest in the episode but nobody knew the story about what happened. I asked elsewhere. Nobody knew but everyone wanted to know. I even asked Dr. Kawchuk himself and he was tied up in a research project. Dangit.  Unfortunately, the research community’s lack of open communication on this matter has left this up to others to define the narrative. For example, when Googling up this story, I got an article by Matthew McCoy. The ever-so-nutsy vitalist out in Georgia. The townhall crier and huckster of woo. Yes, he’s one of them setting the narrative. 

Also, one of the top hits was by our global hater for the ages, Edzard Ernst. What a toolbag. Yes, our global hater sets the narrative on what is happening in the chiropractic world. But nothing from the evidence-based, patient-centered side of the profession. What in the hell is going on here, people? Why in the hell are you all sitting on your hands? Why are you not talking about this, writing about this, yelling about this, or at least pushing back on this? Are we spineless? No pun intended by the way. 

It’s just astonishing to me that so little is written about it and that the only information you can find on it is created by flat-earthers or by the apex of chiropractic haters.  Finally, one of my colleagues here in the U.S. contacted me through text and we set up a phone call. They gave me the story as well as they understood it and that’s what I’m going to give you. Thank you to this colleague for shedding as much light on this story as you could. I really do appreciate it and I’m pretty sure the rest of our audience does as well. 

If we are being fair, a small part of it appears to be Dr. Kawchuk’s fault, a very large part of it seems to fall on the vitalist, subluxation or nothing, rah rah rah crowd, and an even bigger aspect of the whole enchilada I believe can be directly pointed at the WFC’s corporate sponsors that backed the vitalist, subluxation is the only way crowd. I personally blame the companies. Without them bullying the WFC with sponsorship dollars, this wouldn’t have happened regardless of the rest of the dominoes that fell. 

Let’s back up a bit.  It sounds like it all begin in Berlin in 2019. Those of us paying attention know that it goes back much further than that though don’t we? Oh yeah, with the evidence-based, patient-centered model becoming more and more prevalent and moving the vitalists more and more to the fringe of the world, the louder the minority has become.  Still, it appears, Berlin 2019 at the WFC conference was the final straw. Dr. Greg Kawchuk, who again, I’m a fan of, was one of the speakers at the event. His presentation was not vitalist/subluxation friendly.

Word on the street is that his speech was met with cheers but was also met with water bottles being thrown up on the stage and antics like that. Because, you know….our profession is divided in two in case you’ve been hiding in a cave. So, cheers makes sense. I don’t know what makes the other side think it’s OK to throw stuff on the stage but who knows? Maybe that’s just a dumb little European quirk.  I had the opportunity to see almost the exact same speech at the Forward ’19 event in St. Louis a little over a year ago. I absolutely loved it. And, no….it was not subluxation friendly.  Here was the difference in the speech I saw in St. Louis and the one that was given in Berlin.

Dr. Kawchuk, it is suggested, made a quip during his speech that taking a child to a vitalistic chiropractor is similar to taking a child to a Catholic priest.  There are no recordings in existence of this version of the speech but I believe the basic gist of the comment was that if you’re willing to take your kid to a vitalist for 60+ visits, then you should leave your kids with a Catholic priest.  OK, let’s address this because this one comment is what the ICA hung their hat on so I think it’s a pivotal thing. I think it’s also why this part of the speech was dropped when I heard it in St. Louis.  It is my understanding, first of all, that Dr. Kawchuk wrote a letter of apology but it was perceived as having some “Yeah, but…” sentiment attached so maybe it didn’t come off as sincere as his detractors would want.

But here’s the thing, it wouldn’t have mattered how sincere the apology was, they found something to hang their hat on. They found an achilles heel and they weren’t going to let go of it. Regardless of what Greg said to them about it.  Can I just say that I’m a Christian and I’m used to getting made fun of by so many out there in the world. It almost doesn’t even affect me anymore. Notice I said ‘almost’.

Now, I’m not Catholic. But Catholics are Christians so, by association, I should be rather offended as well right? I suppose if I were of the easily offended mindset, I would be. But I’m not because I see it all for what it’s worth.  Number one: the Catholic church has had quite a well-chronicled issue in the past with priests and misconduct. I don’t know how you could argue with that and someone bringing it up has become VERY commonplace. That doesn’t make Greg’s comment any more out of place than the 100 other people I have seen mention or make fun of it on Facebook over the past 3-5 years. It’s become very common. Doesn’t make it right but it does make it common. 

Number Two: did that belong in this speech? Well, I wasn’t the speaker so how do I know. I know that I saw the same speech last year without the comment and it seemed very effective and very welcome to everyone that was in attendance. So, it appears it would have been just as good and ultimately less offensive to some.  Knowing what we now know, it doesn’t appear that it was a good choice to go with for that particular speech to that particular crowd. I would say that I enjoy a great and entertaining speech and the one I saw in St. Louis by Dr. Kawchuk was just that. It was actually pretty dang amazing.

I became an instant fan and hearing of the Catholic priest comment later on did nothing to dampen my fandom.  I suggest people lighten the hell up and quit being so damned dramatic. Water off a duck’s back. Oh my goodness, someone said something you didn’t like or agree with? Poor thing. Bless your heart.  So, Greg gave them something to hold onto and go on the attack with. OK. Do you think the ICA got irate over the priest comment? Or do you think they got irate because the speech was anti-vitalist, anti-subluxation?

Honestly….think about it. Let’s be smart. Which do you think it was? It should already be clear what I think it is.  So, the speech is made and the vitalists lose their damned minds and the ICA decides to deal with this travesty. Nobody but the higher ups over there know exactly how it all went down but, by all appearances, it looks like they started leaning on sponsors to pull support from the WFC until changes that the ICA deemed appropriate were made.  So, basically, the ICA decided to be a bully and start flexing on the playground.

They could read the tea leaves and with scientists like Kawchuk, Hartvigsen, and the others steering, the future wasn’t so bright for the ICA bullies so they started figuring out how to pull the purse strings. That’s what it looks like to me.  It looks like companies like ChiroHealth and Foot Levelers leaned on the WFC to remove Kawchuk. In advance of that, Greg just resigned. Then, the other top-level researchers resigned in solidarity and, I would imagine, in protest to what was happening. 

And I don’t blame them one bit.  Here’s the thing here; it is my opinion and the opinion of others that these vendors used our money that we paid them to bully the WFC at the urging of the ICA to oust Kawchuk. And it is my opinion that they used one sour comment to do it. When I feel pretty sure that they bullied the WFC simply because they didn’t like that the speech and the research committee seemed anti-subluxation. Here are the companies that pulled support simultaneously at this pivotal time for the WFC:

  • Standard Process
  • ChiroHealthUSA – USA
  • Chiro Diplomatic Corps
  • NCMIC – USA
  • National Chiropractic Council – USA
  • Koala Mattress – Australia
  • Life Chiropractic College West – USA
  • Life University – USA
  • Lloyd Table Inc – USA
  • Breakthrough Coaching – USA
  • Chiropractic Education Australia Ltd. – Australia
  • Da Vinci Labs – USA
  • Integrated Assessment Services Inc. – Canada
  • Japan Federation of Chiropractic Professionals – Japan
  • Mettler Electronics Corp. – USA
  • Tokyo College of Chiropractic (Formerly RMIT University) – Japan
  • Sidecar

It looks like vendors like ChiroHealth, Foot Levelers, and several others used the money we paid them, to then turn around and bully the WFC research committee because they gave a speech that was anti-subluxation. Used. Our. Money.  I repeated that for a reason. They use our money to get rid of the world’s biggest and best researchers because they didn’t like what they said.  On the other hand, these are the companies that continued to financially support and sponsor the WFC:

  • Palmer College of Chiropractic
  • Parker University
  • Logan Chiropractic College
  • New York Chiropractic College
  • Southern California University of Health Sciences
  • University of Bridgeport
  • University of Western States
  • National University of Health Sciences
  • Canadian Memorial Chiropractic College
  • Anglo European College of Chiropractic
  • Madrid College of Chiropractic
  • Nordisk Institute
  • Dynamic Chiropractic
  • The American Chiropractor
  • Chiropractic Economics

I would like to thank this group that chose to continue to support the WFC, thus continue to support research and science. Thank you for not being bullied by the ICA and the loud minority. Now, let’s be fair. Maybe it was just that times are tough. COVID has us all down. I know it’s got me down. Did they pull or reduce support for the WFC because of the ‘Rona? How are we to know? I don’t know. You don’t know either. But it seems pretty danged coordinated in conjunction with Dr. Kawchuk’s resignation doesn’t it? I mean….doesn’t it? It’s your choice to continue working with these companies but I’ll tell you this much, being evidence-based as I am….I will be second-guessing my commitment and participation with them going forward.

Honestly, how could you not? As my colleague so eloquently stated to me, “Their power is our power.” Again, nobody knows the exact motivation of these companies. I sure as hell don’t. I just know what it looks like.  What if enough of us contacted these companies and griped about this? We can collectively tell them we don’t approve of that sort of influence. We don’t approve of them using our money to bully our research community.

What if this were to serve as a rallying cry for activism over apathy? For a bunch of crappy stuff to take place, all it takes is for good people to just sit on their hands and do nothing.  This can be a rally cry for the WFC and Dr. Goertz, for the ACA, CARL, for the FTCA, and for this Chiropractic Forward Podcast. But, as my esteemed colleague said, there’s a cover charge to getting your voice heard and social media doesn’t quite cut it.  Now, how much of all of this was theater and how much was legitimate?

If Kawchuk was going to be let go because of the financial pressure by the ICA and these companies, was his resignation simply to keep the ICA from getting a win? It seems they reduce exposure by just going to their universities and doing their research there anyway. They’re not out front taking all of the heat and they’re still doing all of their research and all that anyway. Makes you wonder why anyone would want to be out front like that anyway, doesn’t it? I don’t think it was theater.

I think Greg got tired of dealing with the vitalist crap and said to hell with you people. I think the ICA bullied these companies and the WFC to push him out under the guise of a priest comment but really because they didn’t like the anti-subluxation sentiment of the research coming out of the WFC. And I think the companies did exactly what the ICA wanted them to do. So, I think the vitalists and subluxation people won at the end of the day.  It’s all looking like a bunch of stinky garbage on the part of the vitalists but, sometimes those unafraid to get down in the slop are the ones that win the battle. Doesn’t mean they win the war. Just the battle. 

Here’s what I believe. I believe right and truth win every single time. Eventually. So, let’s look at it from that perspective. There are mountains of papers supporting spinal manipulative therapy. There is a paucity as the researchers say….a paucity of solid, respectable research backing the vitalistic, subluxation theory that was generated in the late 1800’s. Here in 2020..it just hasn’t formulated into a solid, well-researched fact, folks. I’m sorry. Don’t punish the messenger.  Anecdotal evidence and charismatic gurus with guitars don’t make it true or make it right. 

Here’s something else I believe strongly, when you have people like McCoy and Edzard Ernst setting the narrative for our profession because we’re not willing to discuss something openly, well, then we’re just asking for it, folks. You either want a well-respected profession or you don’t.  Or, do you want a split all together? The Primary Spine Practitioner program through the University of Pittsburgh may be a good first step for some of you that are bent on the separation.  Can’t we all just get along? I don’t see it happening. I really don’t. I don’t see how our profession can be unified.

Vitalists refuse to follow or even notice solid research that doesn’t confirm their bias. Outright refuse. They insist it’s appropriate to see regular healthy people once per week for life.  Evidence says that’s not appropriate so, therefore, evidence-based chiropractors say it’s inappropriate and it gives us a bad name. So, what do you do about that? You can’t fix it. Evidence based folks can’t continue in a profession where part of the crowd makes them appear illegitimate.

Vitalists refuse to conform to any appearances of being evidence-based.  So, what’s the answer? You tell me. I don’t see a clear answer. I think it lies with the middle group that is neither evidence-based or vitalistic. They’re just out there making a living and getting through their days but are pretty much apathetic to either. When something happens that activates that group, I think that’s what will be the deciding factor on where this profession goes. 

I disagree with 99.9% of everything Edzard Ernst says but I agree with this comment wholeheartedly when he says, “In my view, the problem of the chiropractic profession is unsolvable. Giving up Palmer’s obsolete nonsense of vitalism, innate intelligence, subluxation, etc. is an essential precondition for joining the 21st century. Yet, doing so would abandon any identity chiropractors will ever have and render them physiotherapists in all but name, Neither solution bodes well for the future of the profession.”

I would say that he left out the fact that many PTs are now adding spinal manipulative therapy to their arsenal so maybe PTs are rendering themselves chiropractors rather than the other way around? I would also add to Ernst’s comment that a recent nationwide poll showed that people go to chiropractors to get rid of their pain. They do not go for wellness, vitalism, weekly visits, or innate intelligence talk.  In the comments of Ernst’s post a chiropractor chimed in and said that in his opinion, the profession has a better chance of providing a valuable healthcare service without the ICA members which make up only about 5% of the profession tagging along and raising a stink whenever someone challenges their model or views. 

Researchers should have the freedom to speak thei truth without fear of reprisal of companies that we essentially fund. It goes a hell of a lot deeper than a bad joke folks. It’s an attack on evidence-based chiropractic and an attack on the research community. And we’d better all start seeing it that way because now, the ICA has a win and you can believe they’ll be back for more. If these companies reduced or withheld funding to pressure the WFC based on the ICA’s pressure, we should let these companies know how we feel about it.  I see chiropractors going forward in the world treating pain, following current research, and current widely accepted guidelines. Guidelines that are based in the research literature. I see a profession that accepts a certain standard and a profession that hopefully begins to take policing its own seriously. 

Otherwise, we’ll continue to be the pimple on healthcare’s butt. And that’s the way I see it. And before anyone says it, I’ll say it first…no, I do not want to be a medical doctor. No desire at all. But being a chiropractor doesn’t mean that I have to blindly accept and promote a philosophy from the late 1800’s. They are not mutually exclusive. In any way. The adjustment is the cornerstone of my personal practice and the way I treat patients. It’s just not the end-all-be-all of what I do.  And all of this mess when we are at the precipice of actually breaking through in the healthcare industry. I’ve said it so many times on this podcast but there is no better time to be a chiropractor.

Y’all, it’s a perfect storm. The opioid crisis. The research backs every freaking thing we do OUTSIDE of the subluxation theory. Literallly everything we do.  Spinal manipulative therapy, exercise/rehab, low level laser, massage, acupuncture, balance and proprioceptive training, and things like that. Research backs it all up. It just can’t back up the subluxation stuff.  But we are at a point that we can actually get more patients in our doors if we are a respectable, evidence-based, patient-centered profession.  Again, you can disagree with me. You can cuss me. But you’ll always know where I stand and according to me, I stand for what’s right, I stand for the truth, ethics, morality, and I stand for patients and their right to be treated like respected individuals and not targets that have to be closed.

IF we can’t agree on that, then maybe you can at least respect me and respect the fact that I’m willing to make a stand for what I believe in. Because honestly, I don’t see a lot of folks standing up on this deal.   Maybe it’s just me. I would assume these things would be common sense. Alright, that’s it. Y’all be safe. Keep changing our profession from your little corner of the world. Keep taking care of yourselves and everyone around you. Tough times are upon us but, the sun will shine again. Trust it, believe it, count on it. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.   

Chiropractic evidence-based products

Integrating Chiropractors

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The Message
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!
Key Point: 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…. That’s Chiropractic!
Contact 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.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  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. 
Connect 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.
Website http://www.chiropracticforward.com
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About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Some Chiropractors Could Be Better

CF 153: Some Chiropractors Could Be Better Today we’re going to talk about chiropractors, the subluxation – vitalistic group in our profession and we’ll probably make some grumpy vitalistic enemies out of these chiropractors in the process.  But first, here’s that sweet sweet bumper music

Chiropractic evidence-based products

Integrating Chiropractors

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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.   If you haven’t yet I have a few things you should do. 

  • Like our Facebook page, 
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  • go review our podcast on iTunes and other podcast platforms. 
  • We also have an evidence-based brochure and poster store at chiropracticforward.com
  • While you’re there, join our weekly email newsletter. No spam, just a reminder when the newest episodes go live. Nothing special so don’t worry about signing up. Just one a week friends. Check your JUNK folder!!

Do it do it do it. 

You have found yourself smack dab in the middle of Episode #153 Now if you missed last week’s episode , we talked about spinal instability clinical pearls and we tal ked about degeneration and the facets. That was some good stuff you need to to have in your back pocket. 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

On the personal end of things…..

I’m doing hte same stuff you’re doing for the most part. I’m just struggling through this second wave of COVID. Trying to stay smart and trying to stay healthy. I wish I could say the same for everyone around me.  For example, I just had a staff member start this week off by telling me she started working a part time job on the weekends because she got an apartment she thought she could afford but it’s not as easy as she thought.  Anyway, at this part time job, her buddy drank out of her drink. She’s like, oh well, it’s just my friend. No big deal. Yeah, no big deal friend called her today…..2 days after that…..and is feeling bad and going to get tested. Now, does that mean my girl has it? Of course not. The friend wasn’t even symptomatic so the chances are low she has it in the first place and if she does have it now, the chances she was shedding the virus then are low. 

Still…..come on man. Be smart. My daughter goes to school with 1000 plus kids every day and I don’t let her take a sip of my drink or anything like that. Much less a buddy at my part time job. Hell no. hell no.  So those are the things we get to battle with, right? We can control everything about what we personally do but we can’t control our kids at school with their friends. We can’t control my other kid at college and his behavior. We can’t control our staff when they’re not here at work.  We just do our best, keep our fingers crossed, and keep working diligently. And hopefully safely.  Not because I’m necessarily scared of getting it. Mostly because I don’t want to shut my practice down for 2 weeks minimum. Who can afford that? So let’s get on with pissing people off, shall we? 

If you don’t understand by this point that there is a divide in our profession that simply cannot be healed, tied together, or unified, well….I don’t know what to do for you. You just need to pay more attention.  If at any point you have thought the two groups could come together, you are fooling yourself. This profession either needs to be split into two completely different degrees and entities or the vitalists need to practice their minimal practice and sit in the back seat and shut the hell up.  Yep….shots fired. I know. I’ll explain more as we go. Every now and then I get fired up and this is one of those times. I’m triggered. I’m the grumpy old ‘get the hell off of my lawn’ guy. More specifically, I’m ‘raise your damn game and quit actiing like fools’ guy. 

I should tell you why I’m triggered first. As our listeners are well-aware, I am a member of lots of Facebook groups but the most notable would be the Forward Thinking Chiropractic Alliance. Most friends and family would classify me as conservative in finances and life in general but when it comes to my profession, I’m all about progressive change and forward momentum. So this group fits me very well.  Anyway, one of the members posted a screenshot of a doctor  – trust me – I use that ‘doctor’ term extremely loosely here – it was a post of this guy claiming that with one table, by himself, he treated 99 chiropractic patients and 9 new patient exams all in 3 hours.  I did the math for you all. That’s right at 2 minutes per patient.

Well, for many of us, that’s not too far off of the mark for established patients. Some of you are boutique practices and spend 30 minutes to an hour with each patient and charge out the wazoo for that. But, for most of us, we are adjusting, passing off to our staff for therapy and rehab and moving on to the next patient.  I want to be fair here. My face to face time is typically 3-5 mintues with an established just depending on what questions I have to answer, if there’s a new complaint popping up that needs evaluated, new patient education, and things like that. Some slightly less than 3 mintues, some quite a bit longer than 5 minutes. 

Now, my patients’ whole visit will clock in on average around 20-30 minutes after therapy and/or rehab but that is delegated to the staff.  Here’s the real kicker for me on this joke. The new patients. I can not get past the new patients. Now I’ve seen 7 or 8 new patients in a day while juggling another 50 or more established patients. But damn man…that’s over the course of a 7 hour day. And, while I don’t think it makes me particulary any more special than anyone else, I have a Fellowship in neuromusculoskeletal medicine. I can come to a diagnosis somewhat quickly when compared to others.  Still, my exam, unless it’s a simple rib complaint or something easy like that, it’s going to take 30-45 mintues. Easy. And that’s with staff doing their history and intake part.

Them filling out OATS takes time on top of that. Plus, I recorded a 7 minute, ‘Welcome to our practice’ video they all watch.  Look, there’s no damn way on this damn planet anyone calling themselves doctor works that many new patients through in 3 hours while juggling 99 established patients and claims they’re doing a good job. No way now how. Nope, no, negatory, NO! Worst of all, he’s a vitalist, practice management guru so he’s offering to show other, impressionable knuckleheads how to mistreat patients all on their own.

Solo crappery if you will. Crappy treatment all by themselves. With his crappy guidance. What a crappy deal.  I have 34 mutual friends with this person and that’s just disappointing. It truly is. Many of you know who I’m referring to but I see no point in mentioning names because the last thing I want is to bring him even more attention. Especially when I don’t see the reason even one person would pay him any at all.  I have no way of knowing how long they’re spending with new patients but let’s just agree that it’s not 30-45 minutes.

There’s no way. I know this because if he spent 30 minutes with each of the 9 new patients, that would be about 4 and a half hours. Much more than the 3 hours he talked about in the post.  We are forced to assume it is much less than that. So let’s play with the math. Three hours is 180 minutes. I think we can all agree on that. A former attendee to one of his seminars said he bragged in the seminar that he could adjust a patient top to bottom in just 30 seconds. As a sidenote, he taught how to have the trash can right next to the door so that he could tear the face paper and grap the door knob in one smooth motion so as to have the door open and showing the person out before they’re even off of the table. That way, you don’t have to talk to them.  So you don’t have to talk to the patient……you get that?

Good Lord, can you imagine a doctor having to speak to their patient after treatment is provided? The horrors!!! Anyway, let’s say 30 seconds is his record but it actually takes one minute on average per patient. If 30 seconds is the fastest, can’t we assume there will at least be some greeting involved in the appointment? Some questions from time to time? There may be some 30 second appointments in there but there may be some minute and a half and some two minute appointments as well. I think that’s fair. 

So, if each of the 99 established takes an average of one minute, which is stillsubstandard care by the way, if they all average one minute, then that leaves 81 minutes to examine and evaluate 9 new patients. That means he has roughly 10-15 minutes for each new patient to do the following if he’s going to adequately assess the patient and have a specific diagnosis outside of subluxation slaying and spine whispering.  He’s got to:

  • Review the history taken by the staff before he came in
  • Review the range of motion if taken in advance by the staff
  • Review the vitals 
  • Meet the patient and listen to their story
  • Assess gait
  • Assess standing posture
  • Check yellow flags and discuss any that are present with the patient
  • Check for red flags – not everyone needs x-rays
  • Check reflexes
  • Check dermatomes
  • Check muscle strength (not freaking AK)
  • Check neurodynamic positions for radiculopathy
  • Assess for Ehler-Danlos and hypermobility
  • Check orthos
  • Check neuro testing
  • Check for extension/flexion bias positions in some cases
  • Come up with an accurate diagnosis
  • Educate the patient on their diagnosis
  • If chronic pain is part of the case, he has to educate on CNS upregulation and the biopsychosocial aspect of pain which is at least a 5 mintues conversation. 
  • Teach proper movement and biomechancis to remove the daily pain triggers
  • He has to answer questions the patient may have

Hell, I wonder if he’s ever had someone lay on their stomachs propped on their elbows for 3 minutes to see if they can identify a home self management strategy for their low back pain? Hell no. Three minutes wouldn’t fit into this doctor-centered model.  I have no way of knowing but I’m guessing the exam consists of ‘checking subluxation’ and telling them to lay down.

Pop, pop, pop, the ridiculous power is on, see you tomorrow for you next life-saving adjustment. It’s silly. And it’s insane. And it’s not evidence-based. And it’s not patient-centered. It’s not special. It doesn’t take talent other than being able to sell targets garbage. It’s the lowest common denominator and nothing more. 

The point being made here is that one cannot do an adequate, responsible, and appropriate exam in this amount of time. And assuming they average only one minute per patient face to face, that’s substandard as hell. Would you want your kid or brother or sister or mom or dad shuttled through an office like a bullet from a gun? Or would you want them to go to someone that cares, connects with them, slows down a tad and takes their time to listen and work with them? The answer is obvious and if you tell me you’d rather your family go to this guy or anyone like them, then you’re just being obstinate and disagreeable.

It’s obvious which style is superior in healthcare.  Maybe working on an assembly line you’d like to see fast, efficient, and little attention given to the specifics. But not in healthcare. This model, I’m sorry to be blunt here….this model is garbage when we are working with the breathing, ever-changing human body.  And….oh this guy loves him some of him. Oh my goodness. If someone likes to look in the mirror every morning, it’s probably this guy. Now, he’s selling his unique brand of BS to others. He’s doing a good job of it too. He’s got sycophants all over now learning how to shuttle them out of the office without having to speak to them. 

They’re in the comments section of this post proclaiming him a rock star! BS. Rock on! I can’t wait to do this when I get out of school! You’re an inspiration. How awesome!!! Blahditty freaking blah. BS, BS, BS. I would comment, “What an embarrassment to our chiropractic community! What a fool! What about exercise and rehab? What about quality over quantity? You give our profession a bad name. You’re one of the reasons we have zero cultural authority and can’t pass a bill in the legislature because you and your followers are irresponsible!!!”  You know….things like that.  Now, I’ve been asked why I talk bad about other chiropractors.

Running them down and such. I don’t call it that at all. I call it policing our own and calling out BS when it’s right under your nose. I don’t know about you but I don’t want BS under my nose. It stinks. And not only can I smell it, but everyone else I come into contact with smells it as well. So, basically, these people’s actions reflect on me, my business, and my livelihood. And yours as well. So if you’ve been going along to get along thinking it doesn’t matter, it does matter. It matters to your bottom line. 

Can you imagine if we were to have more cultural authority and more integration into a regular healthcare protocol…..can you imagine how full our offices would be? Low back pain is the number one reason for disability globally folks. Yet we only see 10% of the damn population. It’s obvious why and the Palmer Gallup poll laid it out. The biggest reason people don’t go to chiropractors is because they don’t freaking trust us. Because of fools like this.  Lots of high volume clinics like this slay subluxations non-stop for weeks and weeks. Some see people every week for life. Think about a self-adjuster. The more they did it, the easier it got to the point they created instability in their neck, they have consistent chronic pain, and now they’re a mess.

Can we see this happen in patients that are adjusted too often for too long? Of course we can!!  These spine whipering TORs are many times creating instability and causing chronic pain. Which is the damn thing the knuckleheads are supposed to be treating in the first place. But they were too lazy to get educated beyond college and some continuing education each year about proper documentation and how to adjust an elbow.  What if they have a hypermobile EDS patient that really needs weight training but they just keep hammering away at what they call subluxations? This is low quality garbage for people that aren’t taking the time to properly evaluate their patients in the new patient exam.  In one of his videos he says, “The patient doesn’t care about anything other than does the doctor care and can he help me?” Again, I use that doctor term exceedingly loosely. I have to just say that he is 100% wrong. Yes, patients do care about those two things but you know what else they care about?

They also care that their doctor is smart. Is on top of his game. Is making decisions in the best interest of the patient and not the clinic or the doctor’s wallet. They care about proper biomechanics so they don’t re-injure their back. They care that if they’re hyper mobile, maybe they shouldn’t be adjusted and should focus on weight training instead. They care that a slight decrease in neck curvature isn’t really the harbinger of death and disease some chiros act like it is. They want to know their doctor is making decisions on their care based on accurate diagnoses. Is making decisions on their care based on research and not philosophy. Trust me, they care about a hell of a lot more than How incredibly arrogant of this supposed doctor to think he has the only answer to what patients care about. They’re not freaking sheep with little to no thought processes.

They’re smart as hell in many cases and they absolutely care about a whole lot of stuff is missing. Saying they don’t is selling them short and it’s unfortunate that he’s going around teaching that. One more example of him being doctor-centered rather than patient-centered. “I….the doctor….knows what the patient really wants and cares about. They can’t think for themselves.” Garbage.  Of course patients don’t care about the biopsychosocial aspects of pain. They don’t even know what the hell that is. But we as professionals should absolutely know and absolutely care and leverage it to our advantage. We should know about upregulated CNS and educate patients about it. Because it matters. The question might be, “Why would people keep going back?”

Well a lot don’t but, in general the ones that do have typically had the crap scared out of them based on x-rays that usually shouldn’t have even been taken in the first place. “Looky here, loss of curvature, that is so concerning. I’m really worried about this and what it means for your future if we don’t get that fixed. That’ll be 58 visits this year at a cost of $4800. That’ll be upfront and here’s the contract to hold you to it.”  Predatory, unbelievably unethical, astoundingly unprofessional, and embarrassing.  Fro every patient referred to a clinic like this, I’d guess they lose one that thinks they and every other chiropractor on the planet is insane.

Thank you vitalists. I really appreciate it. So much. thank you.  Clinics like this only see their successes. So they think they’re amazing. I’ll be honest, I see A LOT of patients coming to see me from practices like this because patients can’t stand being shuttled through like cattle, not being listened to, feeling that the care is substandard, being scared by the doctor into treatment, being scared into contracts, and things of that sor They feel taken advantage of and they don’t like it. And I don’t blame them. I just appreciate them for giving me a chance to show them that the majority of chiropractors don’t engage in foolish crap.

That we can play an integral part in resolving their pain. I have heard the most embarrassing stories about chiropractors from patients that escaped clinics like this. A chiropractor can still focus on subluxations but do it in an evidence based, patient-cantered way. Wanna help more people? Hire more docs to handle that patient load and be able to have the time it takes to spend with the patients to do a proper job. Serve more people.  Just hire more people to do it. I just want better from this guy and people like him. I want a standard in our profession. I want more from our profession. I want to have a conversation with someone in the medical field or someone that knows very little about chiropractic and not feel the need to apologize for guys like this.

He’s clearly a talented guy and a leader on some level. I just wish the talent was more focused on evidence-based, patient-centered endeavors. Basically, I don’t have a problem with people practicing under the subluxation model when they’re not advising against vaccines. We didn’t learn enough about them to be a damn authority on it. Stay out of the conversation either direction. It is not ours to have. Can you imagine telling a mother not to get a baby vaccinated and then the baby gets measles? Steer clear of that conversation.  Anyway, I don’t mind people practicing that model. At the end of the day, we are all moving bones. The adjustment is the cornerstone of my practice but it’s only a piece of my practice. IT’s not the end-all-be-all. IT’s a puzzle piece but the piece is the biggest piece of my puzzle and it’s right in the center of the puzzle. Nothing more nothing less.

It’s not spiritual. It’s just a really big, very effective tool I have.  My issue is the thought that a thorough and comprehensive exam is not necessary. That connecting with patients is not important. That talking with them, answering their silly questions, and educating them is not important.  It all is very important and all of it, like it or not, takes time. It just does and time is a constant we must all contend with and work within the contraints of.  So….that’s me, folks. Raw. And mostly censored because trust me, I cuss like a sailor when I’m not on this podcast. I could make this discussion so much more colorful and it’s deserving of the cuss words.  I know many of you know this guy and you think he’s the bees knees and you’ll probably tune out here and think I’m just an awful person because

I’m talking this way about him but here’s the deal, we cannot let quackery and foolishness not only permeat what should be an evidence-based, patient-centered healthcare discipline…..but it is pervasive. Not only is it permeating, but it’s pervasive. You don’t have to look far to find a sycophant.  I have 34 nutual friends with this knucklehead afterall. What more do I need to say? So, more akin to the medical field, we should recognize BS, we should call it out, and we should educate against it. And that’s what I’m doing. Every week.  It’s not the subluxation-based thing that gets me. I’m used to that. It’s the culture around it that is insane.

Don’t vaccinate, as long as you stay adjusted, don’t worry about COVID, or any other disease, I say a knucklehead guru in school telling me adjstements pushed cancer out of guy’s body. Come on, man. When New Mexico had a shortage of practitioners and allowed chirorpactors to go to two extra years of education to get an advanced practitioner certificate to help prescribe and help handle the patient load, you know who showed up to testify against their own colleagues? Vitalist, subluxation-based, crazy-eyed imbecile chiropractors holding on to green books, the words of BJ, and a philosophy created in the late 1800’s.

Yeah, great look folks.  You know who is against the ACA’s push for Medicare parity? Yeah, not just the usual suspects like the AMA. Nope, hell, the AMA’s best teamates against chiropractic are the vitalists. Yeah, I’ve seen the sychophants of Matthew McCoy railing against us being treated equally under Medicare. Explain that for me….someone….please explain that.  Again, it’s not the subluxation. I don’t personally use or care for that word or philosophy but that’s not it. IT’s the insane leaders of that cult and the culture surrounding it that makes me want to punt baby bunnies into the damn stratosphere.  So, if you’re a subluxation person, my beef is not with you as long as you’re not scaring and taking advantage of your patients. As long as you’re not telling them to see you 80 times this year to keep them healthy and all that. I have no beef with you. 

Especially if you’re a Christian. Telling a patient that they were made imperfectly by a God you put every bit of your faith in makes no sense. at all. Y’all I’m a Christian. God makes no mistakes. He didn’t put us on Earth imperfect and in need of a chiropractor every week of our lives or be a miserable wreck of a person just waiting around on death’s doorstep. What a foolish concept for the faith-based models out there. The Body By God group. It’s silly. Sure be faitful, no problem there. But don’t tell people that they need you.

Otherwise, God can’t express himself fully without you. Yes, that is one of their talking points in case you were wondering. Insanity.  Current guides tell us to use spinal manipulative therapy for movement dysfunction, use exercise and rehabilitation, use low level laser, use heat, yoga, acupuncture, and soft tissue manual therapy, use balance and proprioceptive training as well. These are all ways of leveraging modalities to great effect in resolving pain. They also teach us to NOT create dependency in the patient upon us.

They shouldn’t depend on us. We should be teaching them ways to self manage ongoing pain at home and see them for periodic flare-ups.  That’s evidence-based and that’s patient-centered. 180 degrees opposite of what this practice I’m speaking about is doing.  There are so many amazing chiropractors in the world that have raised their games to such a level that they can command respect and money for their opinions and treatment. Then…..there just aren’t. They’re educationally lazy but they can sure talk a great game.  I’d like to see eveyrone raising the level. Raising the standard and taking this profession into an era of growth, progress, and respect. 

Item #1

It’s called “The disappearance of the primary care physical examination – losing touch” by Dr. Paul Hyman(Hyman P 2020), and MD and it was published in JAMA on August 24, 2020.  Damn the sizzle!!

It’s an article so high points we will hit upon He starts out by asking, “What is a physica examination worth?” He says he’s noticed that physical exams seem to be falling by the wayside in recent years and that fact has been highlighted for him since looking at the daily schedule and determining which will be see face to face in the days of COVID.  He says that an exam is clearly needed at times for a diagnosis but that he’s realizing other ways he commonly uses exams as well. He says it is a means through which he pauses and physically connects with patients. It’s a way to demonstrate his knowledge and authority to the patient.

He says it’s also a chance to persuade patients and reevaluate their narrative.  On the part about demostrating your knowledge, what are you demonstrating when you do a minimal, piss ant exam? Whether you know it or not, you may be demonstrating your lack of knowledge, right? Especially when that patient has had enough of your crap and goes to someone that knows what they’re doing. When the patients say, “This is awesome! The other chiropractor didn’t do any of this,” well, we have a pretty good idea of where you’ve been before getting to us.  He goes on to say, “When patients and I disagree on a plan, the physical examination not only provides data, it also acts as an arbiter.” 

He makes an excellent point here when he says, “In an admission of my own insecurity, the physical examination remains one of the few domains where I maintain a sense of professional skill and authority. I have never been much of a proceduralist. The mainstay of what I offer to patients is the ability to listen to them, to use critical thinking skills, and to offer my knowledge and experience. But those skills are sometimes challenged in a world where patients research their own health and develop their own medical narratives.

The physical examination remains a place where I offer something of distinct value that is appreciated.” You cannot make a difference in patients’ lives when you don’t know what the hell is wrong with them because you didn’t have the knowledge it takes to be accurate or because you only took 10 minutes to examine them.  CHIROUP ADVERTISEMENT

Item #2

This second item is called “Chiropractic, one big unhappy family: better together or apart?” by Leboeuf-Yde et. al. (Leboeuf-Yde C 2020) from February 2019 and published in Chirorpactic and Manual Therapies. 

Again, it’s an article so hittin the high spots.  They say that the profession has a long history of internal conflict. Today, the division is between the ‘evidence-friendly’ faction that focuses on musculoskeletal problems based on a contemporary and evidence-based paradigm, and the ‘traditional’ group that subscribes to concepts such as ‘subluxation’ and the spine as the centre of good health. This difference is becoming increasingly obvious and problematic from both within and outside of the profession in light of the general acceptance of evidence-based practice as the basis for health care. They argue here that the situation within the chiropractic profession corresponds very much to that of an unhappy couple that stays together for reasons that are unconnected with love or even mutual respect.  We also contend that the profession could be conceptualised as existing on a spectrum with the ‘evidence-friendly’ and the ‘traditional’ groups inhabiting the end points, with the majority of chiropractors in the middle. I personally call the ones in the middle agnostics.

They take a little subluxation/innate talk to heart but think evidence-based is the way to go but are not motivated about learning any of the evidence and research. Or just don’t know where to go to find it.  They say this middle group does not appear to be greatly concerned with either faction and seems comfortable taking an approach of ‘you never know who and what will respond to spinal manipulation’. We believe that this ‘silent majority’ makes it possible for groups of chiropractors to practice outside the logical framework of today’s scientific concepts. In their conclusion they say, “There is a need to pause and consider if the many reasons for disharmony within the chiropractic profession are, in fact, irreconcilable. It is time to openly debate the issue of a professional split by engaging in formal and courageous discussions.

This item should be prioritised on the agendas of national associations, conferences, teaching institutions, and licensing/registration as well as accreditation bodies. However, for this to happen, the middle group of chiropractors will have to become engaged and consider the benefits and risks of respectively staying together or breaking up.” No matter where you stand on it, it’s though-provoking and I’m sure to find email inbox filling. Lol.

I’m sure I get plenty of hate mail on this episode but I’ll get a lot of support as well. I cannot simply sit by and see BS and sweep it up under the rug. We have to meet it and stand boldly in front of it, and turn it away. For the betterment of ourselves, our profession, and our patients. 

 

Alright, that’s it.

Y’all be safe. Keep changing our profession from your little corner of the world. Keep taking care of yourselves and everyone around you. Tough times are upon us but, the sun will shine again. Trust it, believe it, count on it. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com. 

Chiropractic evidence-based products

Integrating Chiropractors

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The Message 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!

Key Point: 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…. That’s Chiropractic!

Contact 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.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  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. 

Connect 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 – Fellow of the International Academy of Neuromusculoskeletal Medicine – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

  • Hyman P (2020). “The Disappearance of the Primary Care Physical Examination—Losing Touch.” JAMA Internal Med 180(11): 1417-1418.
  • Leboeuf-Yde C, I. S., Young K, Kauchuk G, Hartvigsen J, (2020). “Chiropractic, one big unhappy family: better together or apart?” Chiropr Man Therap 27(4).