We Don't Need More Anecdotes

The editor's recent call for more anecdotes about chiropractic care ("The Bigger Picture," Dynamic Chiropractic, November 6, 1992, p. 3) is a rather unfortunate step in the wrong direction: backward. There are several reasons why this is so:

Firstly, the "war," as Mr. Petersen describes the profession's scramble to offer hard data to government and third-party payers, cannot be won (or even waged) on the basis of anecdotes and testimonials. Private, uncritical, clinical "testaments" not only have no positive weight in the scientific arena, but their continued dissemination perpetuates an image of the chiropractor as an unsophisticated boob who cannot distinguish between credible information versus advertising fluff. The solicitation and publication of more anecdotes and testimonials undermines the hard won advances of our struggling research community.

Secondly, if you, the field doctor or clinical educator, have clinical information (e.g., a case study) that is worthy of publication, then it is worthy of publication in a chiropractic science journal. Such journals provide critical, blinded reviews of manuscripts (sophisticated feedback to authors by experts) and provide the widest available dissemination and retrievability through scientific sourceworks. We have a number of credible scientific periodicals in the profession, some of which go hungry for lack of enough good clinical material (see Table I). The editor of Dynamic Chiropractic knows this, or ought to know this, given his ex officio membership on the FCER's Chiropractic Research Journal Editors' Council. I am flabbergasted that he proposes Dynamic Chiropractic, a trade newspaper, as a vehicle for publishing worthy clinical data. Potential authors, please do yourselves and the profession a favor, don't waste quality clinical reports in Dynamic Chiropractic.

Thirdly, we don't need any more anecdotes and testimonials because we already have reams of them. Any cursory review of the historical record will verify this. Beginning with the Harvey Lillard case and continuing to the present (e.g., Dynamic Chiropractic, November 6, 1992, p. 33) chiropractors have turned out a steady stream of advertorials and infomercials involving patient testimonials and clinical anecdotes. Indeed, the profession is saturated with this sort of useless and embarrassing information. I am reminded of the 1937 joint venture by the National Chiropractic Association and the Burton-Shields Company, titled What Chiropractic Is Doing Right. If anyone needs inspiration from uncritical anecdotes and testimonials, check this book out at your chiropractic college library archives; it's chock full of irreproducible clinical reports and testimonials. For most recent examples, see the many current trade journals that publish this soft of stuff, such as the American Chiropractor, the Digest of Chiropractic Economics, and Today's Chiropractic. Enough is enough.

Fourthly, the continued promulgation of anecdotes among chiropractors by Dynamic Chiropractic and other noncritical chiropractic magazines only serve to maintain the generally uncritical and unscientific attitudes that have plagued our profession for nearly a century. If we mean now to become full participants in the health science community in this age of accountability, then it's time for us to get serious about our science and our scientific publications.

Joseph C. Keating Jr., Ph.D.
Sunnyvale, California