I recently met a chiropractor who stated that a particular technique was valid because the doctor using the technique had a waiting list practice and was turning patients away. My question was how many doctors using such a technique also had such a successful practice? In my own practice I have noticed that every time I learn a new method of treatment my results seem to improve. Is it due to my new enthusiasm? Dr. James Parker has always preached that FCB (faith, confidence, and belief) in your PSI (product, service, or idea) was important in getting sick people well.
Recently in the New York Times, the article "Placebo Effect is Shown to Be Twice as Powerful as Expected" was printed.1 It stated that it used to be thought that one third of patients would improve with a placebo, but in a study of more than 6,000 patients given experimental drugs for asthma, duodenal ulcer and herpes, two-thirds improved, at least temporarily, even though the treatments were later shown to be useless. Because the placebo effect is greater than previously thought, one group of scientists are calling for stricter standards in testing new medications while others are trying "to capitalize on the placebo effect in treating their patients in order to marshall the body's own healing powers."
Dr. Frederick Evans, a psychologist at the Robert Wood Johnson School of Medicine in New Brunswick, New Jersey says, "If a doctor believes in what he's doing and lets the patient know that, that's good medicine."
The "placebo effect" is now considered to be more than just a sugar pill. It is now defined as any improvement in a patient not specifically due to a particular drug or surgical procedure. How many times have you noticed in practice that a chronic patient will feel much better after the first few adjustments and then revert to their original complaint before they eventually improve. An anonymous doctor once said, "Hurry to give a new drug while it is still working."
Dr. Roberts from the Scripps Clinic and Research Foundation in La Jolla, California believes that the placebo effect will produce positive results in two-thirds of patients with mild medical problems but in condition such as AIDS and cancer, the placebo effects would be beneficial in only the patient's subjective complaints. Dr. Ronald Glaser, a virologist at Ohio State University Medical School, thinks that the psychological effect may have biological implications. For example, stress can effect the herpes virus; he found that an enthusiastic doctor can effect the emotional state of the patient and actually effect the virus.
Over the years, I have taken numerous technique courses and I know of several techniques being used in offices which are totally beyond my comprehension. As we often discuss in the MPI Soft Tissue course, we should attempt to find some functional test or tests that duplicates the patient's symptoms. The evaluation of the functional tests should also incriminate the particular tissue involved. And before we dismiss the patient, the patient should be able to pass the functional test that aggravated their condition. The statement by the patient that they are better must be functionally proven. Often, techniques are taught that are not related to the function of the lesioned tissue. If the technique used is not based on information that evaluates the function of the tissue, then I always ask myself, "How can this technique truly treat the dysfunction?"
Chiropractors have always had a belief system that has made great use of the new interpretation of the "placebo effect" in the treatment of the sick. It is also important that we treat the sick based on logical functional examinations and treatments.
Reference
1. Goleman D: Placebo effect is shown to be twice as powerful as expected. New York Times: p C3, August 17, 1993.
Warren Hammer, MS, DC, DABCO
Norwalk, Connecticut
Editor's Note:
Dr. Hammer will conduct his next Soft Tissue seminar October 16-17 in Oklahoma City, Oklahoma. He will also be conducting a Subluxation-Myopathology seminar November 13-14 in Boston, Massachusetts. You may call 1-800-359-2289 to register.
Dr. Hammer's book, Functional Soft Tissue Examination and Treatment by Manual Methods: The Extremities, is available. Please see the Preferred Reading and Viewing List on page XX, Part #T-126 to order your copy.
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