Editor's Note: Dr. Fysh requested that we print his commentary on the "20/20" program in lieu of Part II in his three part series, "Spinal Problems in Children." Part II will reprise in the April 8th issue of "DC."
ABC's "20/20" television program February 4th on children and chiropractic purported to highlight a health care issue. What it really related to was an issue of market share and the medical profession's relentless competition for health care dollars.
It's no coincidence that this story was run at a time when various branches of the health care industry are jockeying for position in the new Clinton national health program. That the medical profession, through ABC, chose this time to launch yet another attack against the chiropractic profession, might have been predicted.
Both MDs and DCs are by legislation primary portal of entry health care providers, that is, they are the only branches of health care in which a patient may consult for any health problem without referral from another practitioner. The chiropractic and medical professions have comparable standards of education and training. They are both licensed and regulated by state government licensing authorities, so the two professions are really competing on the same playing field where the choice of provider is one to be made by the consumer. The medical profession is seeking to dictate to consumers what that choice should be, in the guise of a paternalistic concern for the outcome of that choice. In other words, the AMA does not trust your judgment where your children's health care is concerned.
The United States, as a country, has been built on the premise of freedom of choice, and yet by their scare tactics the medical profession is seeking to pre-empt that choice.
Well-educated and aware consumers are at liberty to choose whichever form of health care they deem appropriate and this choice will be based upon the track record, presentation, and ultimately, the skills of the health professionals themselves. While it is true that consumers should be protected from unscrupulous and incompetent health care providers, both the chiropractic profession and the medical profession have their own regulatory bodies to perform this function.
This debate therefore is not one of "science versus a belief system," as was suggested in the "20/20" program, but much more basic than that. This debate is one of, "Should parents as consumers be trusted to make an intelligent choice for their children's health care?"
In this "20/20" segment, ABC presented the views of a few practitioners and the cases of six young patients as being representative of the state of the art of current chiropractic knowledge and skill. The program particularly highlighted the cases of three patients where chiropractors had failed to correctly diagnose the child's problem. These cases are all well known and have been previously documented in the scientific literature. To my knowledge, these are the only cases in which children have suffered while being treated by a chiropractor. And while I don't wish to point the finger at any particular hospital, the four-month-old infant with the spinal cord tumor that was not detected by the chiropractor was also misdiagnosed by the hospital where he was born. According to the medical report from the Journal of Pediatrics, this child was born with a tilted neck (congenital torticollis) and the hospital apparently told the parents not to worry, that it would go away in its own time, and discharged the child. The point here is that this infant should have been x-rayed in the hospital shortly after birth and had that been done, the tumor would have been found before it had a chance to develop any further.
With the number of children being treated by chiropractors each week in the United States being in the hundreds of thousands, these three reported cases represent a safety standard which certainly cannot be matched by another other health care profession. Take for example the statistic that an estimated 1,600 people will die, this year alone, from aspirin and many more from drug reactions. By comparison, chiropractic treatment for children represents a very safe system of health care. In saying this however, I am not condoning poor diagnosis or inappropriate treatment methods. Where these problems exist in any regulated health profession, state licensing boards are well-equipped to handle such cases by investigation and suspension or cancellation of the offending practitioner's license.
I think the more important message for parents is that chiropractors can help with their children's health care for a number of the common childhood disorders, not just for back pain. It is a common misconception, that chiropractors are only back pain doctors. In the US, the major reason why parents bring their children to chiropractors is because their kids have chronic ear infection which have not responded to antibiotic therapy. This is a time when society is moving away from drugs and looking for more natural, healthy alternatives in live. Therefore, it is only natural that chiropractors are seeing an increasing number of parents bringing their children for care, especially when the traditional medical approaches have failed to help. This situation has been brought about not through marketing efforts by the chiropractic profession but rather, by parent's choice. It is worth noting that chiropractic spinal check-ups for children are not something new, they have been going on for nearly 100 years, almost as long as chiropractic has been around.
The vast majority of chiropractors who treat children do so very ethically and use great care in evaluating a child's problem before deciding if the child has an associated spinal condition. Many of the children being treated by chiropractors today are referred by the child's pediatrician, a point which was not brought out on the "20/20" program.
Peter Fysh, DC
San Jose, California
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