Separating the Circumspect from the Conjectural
Dear Editor:
Congratulations to you and your staff for continually striving to put out a quality periodical for the profession. In my view you have taken "DC" from a National Enquirer type of paper up to the level of, say, Time magazine, in a chiropractic news sense. Obviously your intention is to keep improving the quality of manuscripts published. Recent articles by Drs. Robert Anderson, Arthur Croft, Deborah Pate, Kurt Hegetschweiler, Marianne Gengenbach, to name a few, certainly come to mind.
What articles of this ilk have in common is credible research and/or objective reporting.
An incongruity lies in the placement of these circumspect articles amongst an array of pieces whose logic is supported only by hearsay, anecdote, conjecture and oftentimes flawed reasoning.
"DC" does not purport to be a peer-reviewed, scientific journal, but in my opinion it's always impressive to recognize that the views put forth in an article have been formed from valid research sources.
If we are to be taken seriously by not only ourselves, but the health care community as a whole, we're going to have to steer away from our traditional tendencies for fad and pseudoscience. Regardless of one's opinion of documents like the Mercy Guidelines, valid chiropractic research is thankfully here to stay, and we can't look back.
Perhaps you would consider a format in which the researched articles could be in some fashion separated from the opinion or anecdotal pieces -- in such a way that the "We Get Letters" or "California Forum" arrangements are featured.
I hope I'm not alone with this opinion, but in any case, good luck and keep up the good work.
Arthur Tripp, DC
McKinleyville, California
Blame It on Brazil Dear Editor:
I want to thank you for your assistance in publishing the article on "Chiropractic in Brazil," in the January 29, 1993 issue of Dynamic Chiropractic. As a result of your running that story, we have received over 120 inquiries from doctors, all over the world, interested in working in Brazil. It would never have been possible to generate this kind of interest without your help.
Thank you for being a critical part in making chiropractic services available in Brazil.
Brent R. McNabb, DC
Madison, Wisconsin
"Flirting with Disaster" Dear Editor:
I would like to call your attention to an article that was written in the February 26, 1993 issue of Dynamic Chiropractic, written by Stanley Greenfield. The title of the article was "High Volume Family Practice."
In it, Mr. Greenfield had asked his son Jeffrey who was a chiropractor, seeing over 100 patients a day, to give some thoughts on how to maintain a high volume practice. One of the things his son states is, "Do not spend a lot of time listening to their problems, just say, 'The best thing we can do is to give you an adjustment.'" If not listening to your patient is part of having a high volume practice, I suggest that Mr. Greenfield's son is flirting with disaster. In one scenario he states that "Little Johnny falls down the stairs and they call you first. Great! Fantastic! You have them come to your house and you put little Johnny's atlas back into place." Let's give another scenario. Little Johnny falls down the stairs and fractures his atlas. Little Johnny's parents call Dr. Greenfield. Dr. Greenfield states "Get to my house immediately." Dr. Greenfield tries to put little Johnny's fractured atlas back into place. Little Johnny has a cerebrovascular accident. Guess what? No more high volume practice for Dr. Jeffrey.
David P. Schmidt, DC, PT
Bellingham, Washington
"Are We Supposed to Live and Let Live?" Dear Editor:
I hear the whining of DCs unhappy with the Mercy Document and see the development of lesser guidelines and "conventions" with the slogan bantered about, "live and let live." The conventions are heralded by its proponents as a convention for both mixers and straights, and its sponsors claim to represent both.
It is my opinion that the sponsors represent the two extremes of our profession: The straight iconoclastic, B.J., dis-eased, cult oriented, innately dense, enuf said DCs, and the other extreme, the intuitive mixer, crystal therapy, chakra, and mind therapy gurus -- one group believing the subluxation to be the root of all evil and disease, (I guess jelly fish and other invertebrates must live forever), and the other pushing far out, unproven gobbledy-gook, with neither group adapting to current scientific data or providing acceptable research in an effort to support their claims. These "fringe chiropractors" are a danger to both patients and the chiropractic profession.
Are we supposed to live and let live? These people attempt to pass themselves off as representing our profession, and on a world wide basis, no less. Well, they certainly don't represent me, and it is my guess the majority of chiropractors have similar sentiments. I believe most chiropractors, both straight and mixers, fall into a narrower, more rational band, somewhere between the two extremes. The "fringe chiropractors" flaunt current literature, research and rational, and present a danger to both patients and chiropractic. If we allow the attitude of "live and let live" with no responsibility to truth continue, we may kill both.
These irrational fringe chiropractors cry about "restrictive" Mercy Guidelines since adherence to rational chiropractic care as outlined by the Mercy document would put them out of business. Spinoza, one of philosophy's great rational thinkers said, "Those who wish to seek out the cause of miracles and to understand the things of nature as philosophers, and not stare at them in astonishment like fools, are soon considered heretical and impious, and proclaim as such by those whom the mob adores as the interpreters of nature and the gods. For these men know that once ignorance is put aside that wonderment would be taken away, which is the only means by which their authority is preserved." Perhaps chiropractic needs another division called "rational chiropractors."
Alas, I have begun to see a pattern. Every day and every week I see another brave chiropractor, both mixer and straight, take a bold stand by identifying the problem and asking the question: "Are we supposed to live and let live? Or should our doctors be required to provide rational thinking (Mercy Guidelines) before being allowed to practice?" Well, I add my voice to theirs and propose all "rational chiropractors," both mixer and straight, do so as well by supporting the ACA and the Mercy Guidelines. We must do all that is possible to discourage irrational thinkers and groups in our profession that detract from our integrity.
Jeffrey R. Cates, DC
Rockford, Illinois
"Only one percent of the articles in medical journals are scientifically sound."
Dear Editor:
Generally speaking, chiropractic science journal writers and readers are even-minded people studying good research. And more importantly, they do not disparage others who don't read or write for their science journals, nor do they criticize the "nonscientific" publications that others might read. I make the distinction here because there is another breed of chiropractic science journal writers and readers who seem to take pleasure at such arrogance. Recently, this condescending attitude was exemplified in a couple of articles: one in your "nonscientific" newspaper,1 and the other in a chiropractic science journal.2 They both basically took the position that true chiropractic science can be found most reliably in chiropractic science journals and all other publications should be read with a skeptical eye. This is not the first time these elitists have shown their heads. When an "unscientific" paper published Dr. Pero's preliminary research findings,3 we felt their wrath then too.4-6
My attempt here is not to criticize scientific research, rather to burst the nonscientific bubbles that need bursting, so those individuals can plant their feet back on terra firma just like the rest of we "ignoramuses." I am going to assume for the moment that these chiropractic science journal elitists1,2,4-6 would agree that the journals they advocate are at least as scientific as medical science journals such as the British Medical Journal. Now let's look at a peer-reviewed statement contained in that journal: "Only one percent of the articles in medical journals are scientifically sound."7 But let's give chiropractic science journals the benefit of the doubt and say that they are twice as scientific as medical journals. That brings the figure up to two percent. Still not very scientific.
Health care, be it chiropractic or medicine, is not a true science, as much as some try to make it so. It is nature that is scientific, not the doctor or his peer-reviewed publications.
References
- Keating JC: We don't need more anecdotes. Dynamic Chiropractic, 12-18-92, pp 40-41.
- McGregor M: Chiropractic magazines. Journal of Manipulative and Physiological Therapeutics, January 1993, pp 4-6.
- Pero RW: Medical researchers excited by CBSRF project results. The Chiropractic Journal, August 1989, pp 32.
- Keating JC: Not real research (letter). The Chiropractic Journal, September 1989, pp 8.
- Lawrence DJ: The editor dissembles. (letter). The Chiropractic Journal, October 1989, pp 5.
- Hildebrandt RW: He's sorry to say? (letter). The Chiropractic Journal, November 1989, pp 5,7.
- Smith R. Where is the wisdom? British Medical Journal, 10-5-91, pp 798-799.
John F. Hart, DC
West Des Moines, Iowa
