June 2005

Research and public perception

by Dr. Christopher Kent

The media constantly bombard readers, viewers, and listeners with news of the latest medical breakthroughs. Conventional medicine enjoys the fruit of cultural authority. Problems with medicine, such as the recent debacles involving prescription painkillers, are attributed to shortcomings of regulators, not the tragically flawed and incomplete paradigm of allopathic medicine.

Thankfully, "alternative" health care is getting some press, too. The simple reason is that its utilization is too pervasive to be ignored. For example, a recent study by Hong at Ohio State University found that nearly three out of four adults over age 50 use some kind of "alternative medicine." Hong noted that "The most commonly used...was chiropractic, which about 43% of respondents had used." [1]

Unfortunately, there is a disconnect between the public perception of chiropractic, and its potential contribution to human health.

The World Federation of Chiropractic (WFC) published the results of a worldwide survey titled, "Identity of the Chiropractic Profession." The WFC reported that only five percent of DCs participating believe that the public perceives the profession as doctors who remove subluxations, while 81 % believe the public perception of chiropractic is that of doctors who manage back and neck pain.

Eighty‑five percent of the respondents viewed the nervous system as fundamental to the practice of chiropractic, and 65% indicated that the public should view the profession as the managers of vertebral subluxation with their impact on "general health." [2]

The results of a 2003 survey of North American chiropractors, conducted by the Institute for Social Research at Ohio Northern University, found that 89.8% of respondents felt the adjustment should not be limited to musculoskeletal conditions. Furthermore, 88.1% felt that the term vertebral subluxation complex should be retained. [3]

Some have opined that the identity of the profession should be determined by public perception. Others have suggested limiting our role to that of musculoskeletal pain practitioners, justifying their position with the claim that only such conditions as low back pain have sufficient research support to justify care. Both positions are dead wrong, for reasons that I have discussed elsewhere. [4,5]

The key to a successful public relations approach is one that matches the public's interests with our vision of chiropractic. Notice that I said public interests, not public perception. We must reposition public perception by making the public aware of how chiropractic fits their interests and serves their needs. Anything less is the tail wagging the dog.

The success of this strategy became obvious with the publicity obtained concerning Dr. Madeline Beherendt's work on infertility. Her small study, published in the Journal of Vertebral Subluxation Research, (JVSR) resulted in millions of dollars worth of positive, credible media exposure for chiropractic. Among the stations showing news spots on the research published in JVSR were: KBCI Boise, WCBS New York, KING Seattle, KYW Philadelphia, WTNH New Haven, KUTV Salt Lake City, WCPO Cincinnati, WOAI San Antonio, KOLD Tucson, and KPTM Omaha. On one specialized health news wire service, the press release was accessed by reporters 745 times by the end of March. [6]

In another media "home run," Dr. Erin Elster, an upper cervical chiropractor in Boulder, Colo., compiled data from 44 MS patients and 37 PD patients treated over the past five years. After treating upper neck injuries in 81 patients, 91% of MS patients and 92% of PD patients improved, suggesting that correction of neck injuries stimulated a reversal of MS and PD. The Chiropractic Journal reported: "The World Chiropractic Alliance (WCA), publisher of JVSR, distributed a press release on the research results, which was quickly picked up by major news media, including Reuters wire service. The news was relayed to newspapers and television stations around the world, and the story showed up in a wide array of media.

"Viewers watching CNN coverage of the Florida hurricanes saw the headline scroll by on the late breaking news crawl ... readers saw all the details in The Washington Post ... Internet browsers found the story on sites as varied as the National Institutes of Health's MEDLINE and the Armenian Medical Network. Yahoo News featured the story and it even appeared on the Merck pharmaceutical company's website.

"Within days, millions of people were exposed to information about chiropractic and how correction of subluxations might result in an improvement or reversal MS and PD. Although the research examined the two specific diseases, the press release emphasized that the role of chiropractic was not to diagnose or treat those diseases directly, but to correct subluxations and, in doing so, affect the progress of the diseases." [7]

More recently, a collaborative study of chiropractic care, oxidative stress, and DNA repair has attracted the attention of medical news services and alternative health websites. [8,9]

The message is clear. Journalists and the public have little interest in hearing about chiropractic "manipulation" in the treatment of low back pain. They are interested in a broader vision that places chiropractic in a position of addressing wellness, quality‑of‑life, and other health challenges traditionally neglected by mainstream medicine.

The key, however, is research. We need more than a handful of individuals doing small case series. Encouraging as these "baby steps" may be, a long‑term strategy must be implemented. We need top‑notch, university based research, involving many thousands of patients, published in prestigious, widely‑circulated journals. RCS is a group which has embraced the vision and the challenge. Have you?

References

1. Hong G‑S: "About 70 percent of older adults use alternative medicine." News release. Ohio State University. April 9, 2005. http://researchnews.osu.edu/archive/olaltmed.htm

2. "Consultation on Identity: Quantitative Research Findings." World Federation of Chiropractic, Dec. 7, 2004. http://www.wfc.org

3. McDonald W, Durkin K, Iseman S, et al: "How Chiropractors Think and Practice." Institute for Social Research. Ohio Northern University. Ada, OH. 2003.

4. Kent C: "A challenge and three myths." The Chiropractic Journal. September 2004. http://www.worldchiropracticalliance.org/tcj/2004/sep/kent.htm

5. Kent C: "Where are we going?" The Chiropractic Journal. August 1997. http://www.worldchiropracticalliance.org/tcj/1997/aug/aug1997kent.htm

6. "Infertility research still a top news story in U.S." The Chiropractic Journal. May 2004. http://www.worldchiropracticalliance.org/tcj/2004/may/d.htm

7. JVSR, WCA hit two more publicity home runs. The Chiropractic Journal. October 2004. http://www.worldchiropracticalliance.org/tcj/2004/oct/f.htm

8. "Chiropractic Influence on Oxidative Stress and DNA Repair." Medical News Today. March 7, 2005. http://www.medicalnewstoday.com/medicalnews.php?newsid=20809

9. "Doctors crack code on chiropractic care." Mercola.com. 4/27/05. http://www.mercola.com/2005/apr/27/chiropractic.htm

(Dr. Christopher Kent, president of the Council on Chiropractic Practice, is a 1973 graduate of Palmer College of Chiropractic. The WCA's "Chiropractic Researcher of the Year" in 1994, and recipient of that honor from the ICA in 1991, he was also named ICA "Chiropractor of the Year" in 1998. He is director of research and a co‑founder of Chiropractic Leadership Alliance. With Dr. Patrick Gentempo, Jr., Dr. Kent produces a monthly audio series, "On Purpose," covering current events in science, politics and philosophy of vital interest to the practicing chiropractor. For subscription information call 800/892‑6463.)