Chiropractic, of late, has been no stranger to media coverage: Time magazine (see October 11, 1991 issue of "DC"); the New York Times (see August 2, 1991 issue); USA Today (see March 27, 1992 issue); as well as reports on CBS' "Good Morning" (see August 2, 1991 issue); ABC's "20/20" (see March 13, 1992 issue); and ABC's "Good Morning America" (see April 10, 1992 issue), among others. These reports have spanned the spectrum from favorable to less than flattering. The latest round of mention of chiropractic in the print media continues that pattern.
Good (Mostly Positive) Press
A positive piece for chiropractic appears in the newly-released book The Prevention How-To Dictionary of Healing Remedies and Techniques from the editors of Prevention magazine health books. The book defines chiropractors: "Doctors of chiropractic (DCs) treat disease and pain by manipulating the spinal column and joints, a technique commonly referred to as an 'adjustment.'" The section also quotes Milton Fried, M.D., D.C., who says, "Conventional doctors treat the disease; chiropractors treat the person. By restoring balance to the body, chiropractic allows the body to heal itself." Chiropractic's victory over the AMA in the Wilk et al. suit is included, as is information on the British Medical Journal study.
Louis Sportelli, D.C. comments on what kinds of sleeping positions and pillows are best for people who have lower back pain and disk problems. The article introduces Dr. Sportelli as a D.C. and notes that he is the former ACA board chairman.
"Ideally, a pillow should function as a means of support for the head and neck..." said Dr. Sportelli. "In many cases, the right pillow can actually help people with neck and shoulder pain." He adds: "People with lower back pain caused by disk problems should sleep in one of two positions: They should either sleep on their back with one pillow beneath their knees and one cradling their head, or they should sleep on their side with a pillow between their knees."
The negative aspect of the book comes when the editors of Prevention refer to the National Association of Chiropractic Medicine (NACM), and quote Dr. Kenneth Edington, a member of this small fringe organization (membership estimated at about 50). Normally NACM members "warn" consumers about the "dangers" of expecting too much out of chiropractic care, and make generally negative comments about chiropractors being primary care physicians. The book states that chiropractic "is ineffective in treating common ailments such as high blood pressure, heart disease, stroke, cancer, diabetes, and infectious disease."
McCall's
In the "Total Health" section of the September 1992 issue of McCall's appears "Should You Be Treated By a Chiropractor?" The article, for the most part, is positive. It quotes Scott Haldeman, D.C., M.D. (they omitted his Ph.D) and states that "Chiropractors, once dismissed by the medical establishment, have gained respectability in recent years." The article mentions that "New studies have demonstrated that chiropractic treatment can relieve certain kinds of back pain, and now some medical doctors refer patients to chiropractors (know officially as doctors of chiropractic, or DCs)."
Although the author writes that there is persisting "controversy" about "which problems should be treated by a chiropractor," he explains that manipulation tends to get patients back to their everyday activities faster and at half the cost than traditional treatment. Regarding the types of patients chiropractors treat, Dr. Haldeman comments, "The best candidates for manipulation are patients who have had back or neck pain for three weeks or less and who show no signs of nerve damage." Potential chiropractic patients are advised to choose a DC who graduated from an accredited chiropractic college.
Bad Press
The September issue of The University of California (UC) at Berkeley Wellness Letter, the "newsletter of nutrition, fitness, and stress management" published in association with the university's school of public health, printed the article "Evaluating Chiropractors."
One sign of trouble appears at the beginning of the article: "Yet many lay people and physicians think chiropractic is worthless, fanciful, or actually harmful. Indeed, chiropractors and the medical profession have waged verbal and economic war on one another for many years." This does not launch things off to a wonderful start.
The article stresses the wide range of practices and treatments in chiropractic: straights; mixers; old-line practitioners; those who look as themselves as primary health care providers; promoters of "health fads like iridology and hair analysis"; and those that prescribe and then sell "vitamin supplements and 'glandular' treatments of dubious value."
The "newer-minded" chiropractors are, according to the article, voicing criticisms of older theories and practices. "The most progressive new group, the National Association for Chiropractic Medicine has disavowed the subluxation theory."
The article also references the National Council Against Health Fraud.
The author mentions the RAND study, but comments that the findings were limited: "...in the RAND study, for example, only patients with acute low back pain did better with chiropractic treatment. Those with chronic low back pain, sciatica, or neurologic involvement did not do so well." As for the findings of the British Medical Journal, the author writes that between results from chiropractic care and results from traditional medical care for patients "the difference was slight."
Finally, the article warns patients of chiropractic: "Be wary of practitioners -- and there are many -- who claim to cure everything from bedwetting, chronic fatigue syndrome and migraines to menstrual cramps, cancer, and heart disease."
Looking Ahead
With the amount of media attention chiropractic has received in the last couple of years, the profession has had to "grow up" in a hurry. DCs must be aware not only of the image they are presenting to their patients, but also of the image the profession as a whole presents to the public. Part of this image depends upon chiropractic professionalism: DCs must meet the demanding responsibilities that go along with being primary care physicians.
With the upcoming chiropractic centennial, the profession is headed for even more media exposure. While the negative articles still surface, the positive article are outnumbering the negative.
Barbara Migliaccio
Second Assistant Editor
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