The Jim and John Show
Dear Editor:
An interesting advertisement appeared in the July 4th issue of Dynamic Chiropractic on page 40. It was entitled "The Jim & John Show" which is being presented by "two of America's Most Successful Chiropractors -- together seeing over 3,000 patients per week, consistently, for over 16 years!"
Well, after reading this tidbit, I had to get out my calculator to see what this claim really meant. It seems reasonable to assume that an office may be open for 12 hours per day 7 days per week. Now if both of these chiropractors are working all the time their office is open, they will have worked 84 hours each, or 168 hours combined. When I divide the 3,000 patient visits per 168 hours, I find that there are about 18 patients seen per hour or 1 every 3 minutes and 30 seconds.
Well, of course this is quite reasonable when my original premise was that they both worked 12 hours non-stop per day, 7 days per week. What truly wonderful caring humanitarians we have here! I would bet the hole in a lifesaver that these chiropractors perform a much needed service, namely freeing the population from the "killer subluxation."
I am so pleased to find out that for only $495, they will allow me to "learn their secrets."
In short, this advertisement was a bunch of bovine excreta! I know you all have to pay the rent, but what trash!
John R. Carbon, M.S., D.C.
Norwalk, Connecticut
The Plague of Chiropractic Insurance ProstitutesDear Editor:
Since its inception in 1895 the chiropractic profession has survived prejudice and at times outright assault from the AMA, government, insurance carriers, and other outside forces. Despite these attacks, the profession has prospered and grown because above all else, correcting subluxations gets people well. While we have overcome many adversaries, it has been noted that our greatest threat comes from within. A recent experience with what I refer to as a chiropractic insurance prostitute (CIP) has made this observation painfully clear.
Several weeks ago I was asked to submit records and reports to Worldwide Auditing Service on a husband and wife who have been treated for chronic spinal problems. I had never heard of Worldwide but as is my usual custom I complied fully with their request, even though in one instance the case, as recently as October, had been reviewed by the better known National Chiropractic Review Service, as well as an IME which had authorized continued chiropractic care. In both cases, examination results, x-ray reports, positive CT scans, patient progress and treatment notes, letters of updates to the insurance carrier, full history, itemized bills, and full narrative reports were submitted for review.
This so called review took close to three months before a conclusion was reached and we received a letter from the carrier together with the consultant's conclusion. The CIP in this case was Dr. Charles Duvall,Jr., D.C., from Akron, Ohio. His report was nothing more than a form letter which included wording which was the most slanderous (and I might add false) information to both the chiropractic profession, as well as myself, that could possibly be put into the hands of an insurance representative. In order for you to judge for yourself, the following are direct quotes from Dr. Duvall's report. As you read them, remember that they are from a chiropractor and written to an insurance representative.
Among the quotes please consider: "Within the medical science literature, it is well noted that spinal manipulative therapy (SMT) is first diagnostic and then may be therapeutic in that if spinal manipulative therapy is going to be efficacious, it will do so in a relatively short period of time. Generally, it is felt that the physician should know whether SMT is in fact therapeutic in approximately 4-6 weeks or 9-12 treatments."
- It has been well written in medical science literature that SMT may cause patient dependence.
- Constant, continued and/or prolonged spinal manipulative therapy may subliminally reinforce a patient to believe that they may be more seriously injured than what they may be.
- This patient has a chronic low back problem. With such problems, she will always have some degree of discomfort depending upon her activities. Further, while spinal manipulative therapy may be efficacious in the therapeutic treatment of a patient with such conditions for specific re-injury or incident, constant, continued, and/or prolonged spinal manipulative therapy is contra-indicated and may aggravate the symptom expression.
Along with these comments, Dr. Duvall, of course, reported that there was an overwhelming paucity of medical data from the attending physician despite listing 11 separate items including narrative reports in his "inventory of records."
Aside from the obvious slander and personal damage that these remarks do to our profession and the individual chiropractor, let me advise you of the damage this does to our standing with the insurance representative. Upon receiving this report, the insurance representative wrote letters to my patients informing them that:
- My treatment was contra-indicated and was actually aggravating their conditions.
- Course of treatment unjustified.
- The carrier was not accepting liability for services rendered.
To further expound on the damage done to our profession in the minds of insurance carriers by statements such as Dr. Duvall's, allow me to relate a conversation with Geraldine Senack, the insurance representative involved here. During our conversation, I asked Ms. Senack why patients would continue seeing a doctor whose treatments were actually aggravating their condition. Her response was, "Most people feel that chiropractic is a religion and therefore they may be brainwashed into thinking they need the treatment." When I asked her where she could get such an obviously biased opinion of chiropractic, she replied, "Didn't you read Dr. Duvall's report? He is a chiropractor, isn't he?" When I told her I considered her letter slanderous and that I would contemplate legal action, her response was, "Fine, we have plenty of lawyers for that and I'm sure Dr. Duvall would testify for us."
I am sure that I am not the only chiropractor to have this unfortunate experience occur to him because of CIPs such as Dr. Duvall. The continuing damage done to our profession and our patients by such individuals is enormous. If men such as this are allowed to continue to sell themselves to insurance companies, our professional standing among insurance carriers, the government, and general public will diminish. The CIP is a plague within our profession and is potentially more damaging than any threat which we have dealt with before.
What can we do to fight back? Well, first let us expose these people to the general chiropractic population. Notify the ACA, ICA, major publications, and state associations. Secondly, speak with association lawyers and find legal ways to combat this type of slander. Paper reviews have been legally challenged before, successfully. This type, such as Dr. Duvall, should be an easier target since he slanders the profession using statements from so- called medical literature yet never names the sources. Perhaps because there are none. I would presume Dr. Duvall has never read the New Zealand report, the Australia reports, the findings from the commission on alternative medicine in Sweden, the study by Dr. Meade of Northwick Park Hospital, and many other documented studies which indicate the effectiveness of the chiropractic adjustment. I can name studies and their sources, can Dr. Duvall, a chiropractor who never uses the word, "adjustment?" Chiropractors treat with adjustments. We do not refer to SMT.
Finally, I suggest that we not cooperate with services which are biased, such as Worldwide. Companies who employ parasites such as Dr. Duvall should not be given a chiropractic host to feed on. CIPs are a plague on our profession, and as with our treatment of sick patients, we should remove the cause of the disease so that the host may become well and prosper.
Sincerely,
William J. Vendittelli, D.C.
Forest Hills, New York
"Mindless Mysticism?" -- A response. Dear Editor:
In the June 20, 1990 issue of Dynamic Chiropractic, Dr. Ralph Cinque writes that because the division between the different areas of the spine only exist in our mind, different homeopathic remedies should not be necessary to treat these different areas. This is the basis for his argument that homeopathy is "mindless mysticism."
Perhaps what he means is that the theory supporting it is mindless, since the theory is irrational. From the scientist's perspective, since favorable results are sometimes obtained due to the placebo effect, it could only be classified as "mindful mysticism." Since this is the only rational explanation of how homeopathy works, it stands to reason that because we make these spinal divisions in our mind/imagination, that's where the homeopathic remedy must work. For this reason, it is necessary to have different remedies for different areas of the spine, or at least make the patient believe there are.
With all the discussion about practice management companies lately, it should be pointed out that having more remedies to sell the patient, the more money the doctor can make.
Randall B. Lord, D.C.
Shreveport, Louisiana
The Anti-Chiropractic Paper TrailDear Editor:
Three points in regard to the Prevention Magazine article by Dr. John C. Lowe, June 20, 1990 issue of Dynamic Chiropractic:
- Every chiropractic college library and chiropractic office should have access to the book The Social Transformation of American Medicine, by Paul Starr. This was the 1984 Pulitzer Prize winner for general non-fiction. It is a historical account of the shocking rise of American medical doctors to the status of "dieties." The pathogenesis of the relationship between the AMA, their various publications, and the drug manufacturers is described. Since its beginning, the AMA has extracted enormous sums of money for advertising by drug firms, and that money has translated into enormous power.
- The name John Renner, M.D., should set off alarms for every DC in the country. Dr. Renner was the "medical writer" for the Kansas City, (Missouri) Star/Times newspaper. He wrote many anti-chiropractic articles for the Star, which to this day maintains an anti-chiropractic philosophy. Gary Null, author of the series Medical Genocide, The War On Chiropractic, has some less than complimentary information on Dr. Renner. Dr. Renner has one or more skeletons in his medical practice closet -- no pun intended. Dr. Renner is also affiliated with the new National Committee on Quackery. He also has some sort of information-sharing relationship with a Kansas City area DC who dislikes his own profession, is an insurance consultant, and was a chiropractic college faculty member.
- This is my personal theory: The AMA is continuing their efforts to destroy chiropractic. They made mistakes, they are too open in their attacks, and they left a "paper trail" resulting in the Wilks victory. But that was only one battle; they have not lost the war. It is not coincidental that so many anti-chiropractic articles are appearing in so many and such diverse publications, from popular health magazines to company newspapers; and individual state medical boards filing suits and/or promoting anti-chiropractic legislation. Information favorable to chiropractic is suppressed. I have yet to read any stories about the DCs who treated the 49ers during Super Bowl. The current medical writer for the Kansas City Star newspaper just authored his fourth article in nine months on the same story about a Missouri chiropractor who plead nolo contendere to Medicare fraud charges.
We had better start collecting evidence now, in preparation for the next round of courtroom battles. I would suggest a computerized clearing house of media and legislative attacks on chiropractic. As has been said so many times before, chiropractors fighting their colleagues aids only the enemy, not this profession.
Gerald W. Howe, D.C.
Eldon, Missouri
It's Time to Adopt Stronger LawsDear Editor:
In response to Dr. Strasser's interview, July 4, 1990 issue of Dynamic Chiropractic concerning the recent workers' compensation changes in Oregon, I feel it is necessary to comment on several issues.
I disagree with Dr. Strasser's assessment that SAIF won "---because greed and incompetence fed the existing prejudice against chiropractic, and we ran out of friends---" When are we, as a group, going to start taking control of our profession and stop blaming others for what happens? If, as Dr. Strasser states, this had been brewing for 10 to 15 years, what did the Oregon State Board do to curtail these abuses? In Kentucky, we have established uniform fees for all workers' compensation claims with peer review by accredited reviewers to act on alleged fraud cases.
We also must establish a uniform scope of practice that is consistent from state to state. As a chiropractor, I treat vertebral subluxations only; I do not treat strains (not this straight vs. mixer stuff again) as does Dr. Strasser. I also use modalities where indicated. Until we establish a uniform scope, the profession will continually be compared to the medical profession with its short-term (5 to 10 visits?) crisis-oriented approach to health care.
For chiropractors to continue offering true health care through life-long adjustments to the public, we must adopt state laws with teeth to manage unethical practices, and we must become a united force capable of controlling our own destiny.
I agree with your assessment in "Report of My Findings" in the same issue that states "---until we can satisfactorily demonstrate competence in policing ourselves, the abusers creating these problems will continue to 'load the weapons' that kill off the profession. I suggest we include, as loaded weapons, weak state laws and/or board members, short-term pain relief advertising, and a lack of professional unity.
It's time to stop whining and start acting.
Larry R. Smith, D.C.
Lexingtron, Kentucky
Live and Let Die -- Then CryDear Editor:
Why have we waited so long to see the ACA, the ICA, etc., put its dollars to work in an all-out, twenty-four hour a day national education television campaign for chiropractic.
Isn't it about time that we, as an entire profession, treat 100 percent of the population instead of bickering over a mere small 20 percent. The simple truth is that we would rather spend our money in a very self-centered way. We would rather promote ourselves than educate the entire population and promote chiropractic.
Why are we foolishly spending our dollars to make marketing and management firms rich, while all they do is teach us to prostitute ourselves to 90 percent of the population in order to seduce 10 percent of the population? Why should our profession stoop to such tactics as knocking on doors? Does your internist or gynecologist knock on doors? "Excuse me, we are giving a special on Pap smears and breast palpations this week." If you don't respect yourselves or your profession, at least don't make it bad for the rest of us. We are all motivated by fear and desire and we all desire the finer things in life, however, enough is enough.
It is now time to get the ACA and ICA, together or separate, to promote us -- not the management firms.
At the last several state conventions I have attended, there were several practice management firms. Who is promoting them? We need to promote the profession on a much more dynamic scale before we lose our ground and respect through embarrassing tactics.
We must stand firm, become less self-centered, and demand the ACA and ICA to promote chiropractic. You are an important voice, so please be heard. If it costs us all an extra $25 a month, what is that? (It's less than the cost of one x-ray.) Would one new patient a month pay for it? Do not let this thought die.
Please sign and forward to both associations listed below:
Yes, I am interested in a national television campaign to promote chiropractic.
International Chiropractors Association
PO Box 10315
Arlington, Texas 22210-1315
American Chiropractic Association
1701 Clarendon Blvd.
Arlington, Virginia 22209
Signature ____________________________
Richard M. Powers, DC, PA, DNBCE
Palm Beach Gardens, Florida
