July 2007

We're safe... but pretty much useless

by Dr. Terry A. Rondberg

In recent months, I've gotten so sick and tired of reading articles in the mainstream press about chiropractic and stroke that when the CNN Money.com article was published, saying that "risks are considered low" for chiropractic, I was relieved and pleased.

At least they didn't repeat the ridiculous claims about chiropractic "causing" strokes, the way Self magazine did.

Still, as I read the short blurb (the "article" consisted of just a few paragraphs for each of several "complementary" health care systems) I realized there was bad news along with the good news. True, the article didn't repeat the stroke myth, but it did repeat the "low‑back pain" myth. According to Money.com, chiropractic offers only "limited help for sore backs," and noted that "federal studies have found chiropractic ‑‑ that is, spinal manipulation ‑‑ about as effective as conventional medicine, which is to say, modestly effective."

The World Chiropractic Alliance immediately contacted the online editors and explained that chiropractic has actually shown chiropractic care to be superior to medical intervention for back pain, citing several scientific research papers as evidence.

More importantly, our letter emphasized that the benefits of chiropractic go far beyond mere relief of back pain. "Research is revealing strong evidence that chiropractic should not be limited to back pain," the WCA letter stated. "In fact, preliminary research has linked chiropractic care to a significant reduction in blood pressure and anxiety symptoms and reversal in the progression of both Multiple Sclerosis and Parkinson's disease. It has been shown to offer hope in addressing infertility, strengthening the immune system, reducing asthma and allergy symptoms, attention deficit disorders, otitis media (chronic ear infections in children), osteoarthritis, nocturnal enuresis (bedwetting) and other health issues."

Then ‑‑ as we do in ALL letters to the media ‑‑ we explained the role of subluxation correction in health care.

"Chiropractic is not a 'treatment' for any of these diseases or conditions, nor do most chiropractors claim to cure or treat them directly," we told Money.com. "The primary purpose of chiropractic is the detection and correction of vertebral subluxations, a misalignment of the bones of the spinal column that can interfere with nerve transmission and influence organ system function and general health. Sometimes, this interference results in pain or other obvious physical problems, yet often the damage being done remains invisible for months or even years. Doctors of chiropractic are the only health care professionals specifically trained in the detection and correction of vertebral subluxations."

Although we hope future articles will take this information into consideration, I can't really blame Money.com editors for placing chiropractic in that small box of back‑pain treatment and ignoring the entire basis of the profession... the detection and correction of vertebral subluxation. After all, far too many chiropractors, and chiropractic organizations, do the same thing.

Since chiropractic often is highly effective in relieving back pain, many DCs see treating this specific musculoskeletal complaint as a viable niche in the health care "market." Millions of people suffer from back pain and as our society becomes more and more sedentary, the prevalence will only increase. If things continue the way they're going, we might all be able to fill our offices with adults with back pain.

There are two things wrong with the scenario, though. The first is that once we've been labeled one‑trick ponies, we are dependent on that trick. What I see happening is a subtle but dangerous progression.

First, instill in the public mind the association between chiropractic and back pain. This is the "we're only good for treating back pain in adults" stage.

Then, convince the public that chiropractic is too dangerous, chiropractors are not qualified, or someone else (PTs, DOs, MDs) can do the same thing better. That's the "and they don't do that very well" stage.

Where does that leave all those DCs who thought they could make a living being an alternative to aspirin?

The second problem with the back‑pain only picture is that, when we limit chiropractic to back pain or other musculoskeletal complaints, we deprive the world of the real benefit of chiropractic ‑‑ correction of vertebral subluxation.

Whenever I can, I try to explain all this to reporters and editors, but, although attitudes are rapidly changing, we still live in a mechanistic world. All our first‑hand experiences are nothing more than "anecdotal" evidence unless we document them and have them published as research. If the evidence doesn't have the imprimatur of the scientific community, it's dismissed.

So, while I point to the preliminary research about chiropractic and blood pressure, anxiety symptoms, Multiple Sclerosis, Parkinson's disease, the immune system, asthma and allergy, attention deficit disorders, otitis media, nocturnal enuresis and other health issues, I know we'll never convince the media ‑‑ or the public ‑‑ until we produce a huge amount of research not just hinting at these connections, but proving them.

That's why I keep forcusing on the importance of Research & Clinical Science (RCS). It is the only major research program that is compiling data on thousands of people around the world and analyzing that data to determine the true impact of vertebral subluxation on human health and well‑being. It's the only project that is exploring chiropractic's usefulness in addressing a full range of health issues, not just back pain. It holds the promise of breaking chiropractic free of the confines of back pain treatment and positioning us as the premiere health care professionals. Instead of a few million back pain sufferers, we'll fill our offices with tens of millions of adults and children who know that chiropractors can offer what no one else can: a subluxation‑free life.

It's not always an easy sell. More than a hundred doctors have already signed up as RCS Authorized Clinical Investigators, earned their IRB (Institutional Review Board) approval, received their certificate for completing the National Institutes of Health "Human Participant Protections Education for Research Teams" training course, and begun recruiting volunteers to take the RCS Self‑Reported Quality of Life study.

The data allows RCS researchers and the International Scientific Advisory Panel (made up of PhDs, MDs and scientists from around the world) to compare health factors of people undergoing chiropractic care with those who have never received an adjustment. The preliminary results, soon to be published, are amazing. Subjects receiving chiropractic care experience an improvement of 16% in physical health, 16% in mental/emotional health, 29% in stress and 7% in life enjoyment.

But a couple hundred doctors out of a profession of 60,000 isn't as impressive as I had expected when I accepted the position of CEO for Research & Clinical Science. I've talked to thousands of DCs over the years and I know there are many, many more whose practice purpose is the correction of vertebral subluxation. They may not identify themselves as strictly subluxation‑based, but they don't want to be locked into the back pain paradigm. Where are all these doctors who say they want research to validate what we do?

Some, I realize, are hurting financially and can't justify paying to be part of a research program. It seems wrong somehow, particularly considering that, in the medical and drug industries, researchers get huge salaries and grants. But the NIH isn't doling out millions of dollars to do subluxation research. If we want that research, we have to pay for it ourselves.

Even some of those doctors made the commitment to research and budgeted their RCS membership as a necessary expense, just like rent or insurance. As it turned out, they were rewarded for their dedication in an unexpected way: many of the volunteers who came to their office for the RCS study ended up staying as paying patients!

In fact, one RCS member, Kevin Conners, DC, reported: "RCS has been a financial success to us. But more than that, I believe that it may be the one avenue in which we can save subluxation‑based chiropractic for our children, and that is the greater measure of success." Dr. Conners estimates his "return on investment" is about 20 to 1.

Jon Baker, DC, another RCS Authorized Clinical Investigator, said that "in a year's time we have introduced approximately 100 people to the study, our profession, and of course our office. Approximately 60% of those requested to become practice members after the study was complete!"

RCS member Kelly Kramp, DC, has similarly spectacular results: "I have been running with RCS now for just over 3 months and I have seen over 70 new people come into my office as a result of this. This is all from internal referral and no external advertising... I have found that about 70% of the new volunteers that come to my office become patients.... I have been in practice for 17 years and this is the first time I have seen patients actively tell me that they want to go and find new people to come into my clinic. My patients see the value in producing this research for their own benefit."

Obviously, the program can generate significant numbers of new patients as research volunteers learn more about chiropractic and your office!

But, as Dr. Conners said, "your ROI cannot always be measured monetarily... I've spoken to many doctors who seem to think that it is someone else's responsibility to 'save' chiropractic. Throughout history, it has always been the 'few' who stand for truth. I implore chiropractors to step up, catch the vision of chiropractic and join RCS. There is a 'what's in it for me' factor in RCS as well. You will increase your presence in your community and increase your new patients if you do it correctly."

No matter why they join RCS ‑‑ to help advance subluxation‑based chiropractic through research or to build their practices in an ethical and professional manner... or both ‑‑ these doctors are the ones who will change the way the media, and the world, views chiropractic. Thanks to them, in the near future, we won't be "back pain doctors" but health care providers in the truest sense of the word.

To learn more about RCS and how you can be an RCS Authorized Clinical Investigator, please call me at 800‑909‑1354 or 480‑303‑1694.