"20/20" Examines Manipulation under Anesthesia (MUA)

On October 5, 1991, a crew from the ABC news magazine show, "20/20" came to Buena Park Doctors Hospital in Buena Park, California to film doctors of chiropractic performing in-hospital treatment (please see "Buena Park Doctors Hospital Leads The Way" in the February 1, 1991 issue). Specifically, their focus was on spinal manipulation under anesthesia (MUA), a technique originally performed by doctors of osteopathy intermittently in the 1950s and 1960s, but largely abandoned in the 1970s and early 1980s. It was resurrected by a group of progressive chiropractic doctors in Texas in the late 1980s.

By 1989, the Texas doctors had developed a specific adjusting protocol and had concluded that three consecutive MUA treatments yielded the greatest percentage of favorable results, not only for the patient's complaints, but for minimizing current and future medical expenses. The types of cases targeted were fallouts, that is, failed surgery syndrome, or patients who had many months, or even years, of a multi-disciplinary therapeutic approach (chiropractic care, physical therapy, exercise therapy, oral and injectable medications) and were not deemed surgical candidates based on at least one type of advanced diagnostic imaging.

In September of 1990, Dr. Steven Capps came to Buena Park Doctors Hospital and taught a small group of chiropractors with hospital privileges, a postgraduate manipulation under anesthesia course accredited by Texas Chiropractic College (TCC). This course included hospital procedures and practices as well as the specific techniques that were developed for the cervical, thoracic, and lumbar spines.

The filming began on the morning of October 5th with preprocedure patient interviews. This was followed by observation and filming in the operating room of the first of three consecutive daily treatments. The chiropractors observed and/or filmed included Cary Rothenburg, Barry O'Connor, Colleen Gillean, Manuel Da Motta, and Bea Heller. On October 7, 1991, the "20/20" team returned to film the third treatment of the patients previously filmed. "20/20" producer and journalist, Roger Sergel interviewed Drs. Rothenburg, O'Connor, and Gillean, and their respective patients.

Chiropractic and the Media

The 1990s have ushered in a new era for chiropractic. Our profession has made gains in previously unheard of areas. We have many fine doctors who have received excellent publicity treating athletes of all sports, including professional and Olympic athletes. Last year chiropractic was portrayed positively in a major motion picture for the first time in history. Last month, Time magazine ran a very favorable article on chiropractic. Doctors of chiropractic are beginning to apply and, for the first time, receive hospital privileges. Textbooks authored by doctors of chiropractic are no longer read only by chiropractors, but are read by other health professionals as well. In fact, there are now textbooks authored by chiropractors that are required reading in some medical schools.

With continued fair and positive media coverage, chiropractic's future is bright. Our chances of attracting an absolutely staggering number of new patients is excellent.

With increased exposure also comes increased responsibilities, both for the profession and the individual physician. As the spotlight shines more on our profession, not only will chiropractic's positive aspects receive press, but our areas where improvement is needed will be exposed to the media limelight. In addition to our basic science, diagnostic, and drugless healing knowledge, we must be aware of past and current research of conservative chiropractic therapy, and its cost effectiveness. Furthermore, as more and more chiropractors are interviewed by the media, we must be prepared to support and defend our profession. In addition, when the inevitable hard questions begin to be asked, we must have answers that will satisfy the public and the interviewer as well as provide a positive spin for our profession.

As we know, bad news sells; doctors must be prepared for questions like:

1. Why are there groups of chiropractors who hate each other?

    

2. Why do some chiropractors treat so long before they will refer?

    

3. Why do some chiropractors keep treating patients long after the pain subsides?

    

4. Tell me about the chiropractor who treats with a funny little hammer.

    

5. Why do some chiropractors say they can cure anything with vitamins?

    

6. Why do other chiropractors claim they can cure any disease by manipulating the spine?

    

7. How can one be a doctor and not diagnose?

    

8. Why does the guy across the street have bending and motorized tables, and you don't?

    

9. How come, when we send our investigative reporter to various chiropractic offices with the complaint of a gradual onset of three days of neck pain, one chiropractor takes full spine x-rays before doing an examination; the next chiropractor takes seven angles of neck x-rays before he does an examination; the third chiropractor does an examination first and then takes two x-rays of the neck; the fourth chiropractor immediately places him on a table and begins to "crack" his neck; the fifth chiropractor not only "cracks" his neck but also "cracks" his middle back and lower back even though our reporter says those areas did not hurt; the sixth chiropractor says that our reporter will need a minimum of 20 treatments; and the seventh chiropractor states that after examining the reporter, x-rays will not be required and one treatment should suffice.

    

10. Why was chiropractic the least expensive treatment for non-surgical back problems a few years ago, and is now the most expensive treatment for non-surgical back problems?*

As chiropractic continues to gain exposure, the profession must be prepared to comment on tough questions in a non-evasive yet diplomatic manner that will satisfy the public and media while minimizing our intraprofessional disagreements and emphasizing the many positive aspects of our profession.

We are proud of the DCs at Buena Park Doctors Hospital and hope that the segments on manipulation under anesthesia and chiropractic hospital care will receive fair coverage on "20/20."

References

* This issue was raised by Scott Haldeman, D.C., M.D., Ph.D., in an April 1990 seminar in which he stated that statistically chiropractic care is now the most costly health care for simple back pain. Dr. Haldeman went on to state, however, that when the top 20 percent of overtreating doctors were removed, the remaining 80 percent of our profession offered the most cost-effective treatment for simple back problems. Facts like this must be common knowledge to every chiropractor in America.

G. Douglas Andersen, D.C.
Brea, California