November 2007

Following in BJ's footsteps

by Dr. Terry A. Rondberg

BJ Palmer is a hero to most chiropractors. Of course, he has his critics and detractors, including some within our profession who would like it if we all pretended he never existed. But for most of us, he's thought of as the person who developed chiropractic into a respectable and scientifically based health care field, and who fought with every ounce of his being to defend it from those who would destroy it.

Can you imagine what he'd say about the declaration from UnitedHealthcare that chiropractic for children and adolescents is "unproven," as is chiropractic for headaches?

First of all, it's a given that he wouldn't stop adjusting children or trying to help relieve people of chronic headaches by correcting their subluxations. He'd keep true to his vision of a subluxation‑free world, thumb his nose at the insurance industry and tell them where they could put their pronouncements and their claims reviewers.

But he wouldn't stop there. As a dedicated researcher, he'd get to work compiling the scientific evidence needed to show that chiropractic provides many significant benefits to children as well as their parents and grandparents, people with headaches and without headaches, with health issues and those who enjoy (and want to keep enjoying) good health.

BJ's dedication to research is evident from the exhaustive studies he conducted, and his founding, in 1930, of the B.J. Palmer Research Clinic. As stated in "Chiropractic in the United States: Training, Practice, and Research" (by Reed B. Phillips, DC, PhD; Alan H. Adams, DC; and Ruth Sandefur, DC, PhD, for the

Agency for Health Care Policy and Research, Chapter IX: Chiropractic Research):

The B.J. Palmer Research Clinic, located at the Palmer School of Chiropractic, accepted difficult cases and sought diligently to document patient care and progress as a means of investigating chiropractic. Chiropractors were anxious to develop methods and means to document clinical findings and patient response to care.

Much of that early chiropractic research wouldn't stand up to today's scientific scrutiny, just as much of the medical research from that period is considered inadequate. The difference is that today, medical research receives billions of dollars in funding from drug companies, medical institutions, and the federal government whereas chiropractic research goes unfunded except for specific studies of chiropractic "treatment" of low back pain in adults.

That's why insurance companies can state with impunity that chiropractic for children is "unproven." That's why they can deny your claims for helping patients with headaches or other health issues that we know, from clinical experience, can be addressed by subluxation correction.

BJ may be our hero, but most of us don't share his passion for proving chiropractic works. We go about our practice, seeing patients and filing insurance claims, and hope that the insurance company deems our care "worthy" of reimbursement or that patients will be willing to actually pay for our services on their own. We grumble and complain when we read statements like the one made by UnitedHealthcare, but we don't DO anything about it.

I hear many of you saying, "What can I do? I'm not a researcher." My answer? If you're a practitioner, you can be a researcher! You don't have to quality for an NIH grant or work in a university laboratory.

For example, have you ever had a patient come in complaining of frequent headaches? What did you do? What did your examination find? What was the program of care you provided? What was the outcome of that care? Did the patient report a cessation of headaches after four adjustments?

What about the last patient you had come into your office with a child suffering from asthma? What was the outcome of your care?

You already document all your cases (if you don't, you're a malpractice lawsuit waiting to happen) so half the work is already done. Now, all you have to do is write them up and submit them to a research journal. Case studies are valid research that helps add to our understanding of chiropractic and indicates areas worthy of more controlled trials.

If you're not sure how to write a case history, you can even get help from the peer‑reviewed Journal of Vertebral Subluxation Research (www.jvsr.com).

Or, you can become involved in Quixote's research and clinical science program, through which your objective and subjective patient findings are automatically added to the global research database for analysis by a highly qualified panel of scientists and researchers, including PhDs, MDs and DCs. This makes you part of the largest chiropractic research team in the world, standing side by side with more than 170 other DCs already contributing to the effort. (To learn more, call 619‑299‑2930 ext.1 or visit www.qchiro.com)

At the very least, you can subscribe to Journal of Vertebral Subluxation Research and keep current with the research that helps define and validate your mission as a doctor of chiropractic. (www.jvsr.com).

Actually, if you really want to follow in BJ's footsteps, you should do all three things.

If you don't do any of them, ask yourself why not? Are you just too busy? Do you assume somebody else will do it? Is chiropractic research just not important to you?

Picture yourself face‑to‑face with BJ and tell him your reasons. Explain why you don't think it's worth your time or effort to prove chiropractic works.

Then, picture yourself speaking with your grandchildren. Tell them that one of the reasons they can't receive chiropractic care is that you didn't want to get involved in the research that would have safeguarded their right to grow up subluxation free.

Finally, see yourself in front of a mirror. Look yourself in the eye and ask yourself if you're really doing everything you can to make your profession, and your world, better.