Donald M. Petersen Jr., BS, HCD(hc), FICC(h), Publisher
In the September 17, 1990 issue of Medical Economics, there appeared an article concerning chiropractic. This article had in fact been written by a chiropractor named Mark Sanders, D.C. The article is titled: "Take It From A D.C.: A Lot Of Chiropractic Is A Sham."
In case you have never heard of Dr. Sanders, you are not alone. Still, in his introduction, the author states: "However, I've been outspoken about this issue for years, based on what I saw during a decade of private practice ..."
As part of his opening statements, Dr. Sanders contends: "We need to improve our image -- and patient care -- by further documenting the efficacy of what we do and standardizing our services. Until then, I'd have to reluctantly agree that organized medicine's perception of the diagnostic shortcomings and therapeutic abuses of chiropractic has generally been accurate."
The author then continues to anecdotally discuss several issues:
"SOME D.C.s CONSIDER DIAGNOSIS UNNECESSARY"
"D.C.s employ a variety of elaborate x-ray marking systems and techniques to determine misalignments and make therapeutic choices. I know of no documentation supporting the validity of these systems ..."
"PRACTICE BUILDERS" TO D.C.s: PUMP UP THE VOLUME"
"It is not especially unusual for a chiropractor to recommend up to 100 manipulations for a simple back strain. Sometimes that's based on practice habit or on what a colleague told them. Recently, however, a new trend has surfaced: The chiropractor may be following a 'practice builder.'"
"STILL, M.D.s AND D.C.s SHOULD COOPERATE"
"Having said all that, I'd encourage you to establish a rapport with at least one good chiropractor."
This display of the chiropractic profession's so-called "dirty laundry" was very similar to the presentation made by Charles DuVall Jr., D.C. entitled "Chiropractic Nonsense" which he presented twice at the National Council Against Health Fraud's (NCAHF) annual convention (please see "National Council Against Health Fraud" article beginning on the front page). Both are a case of discussing chiropractic issues outside instead of inside the profession.
In reviewing the actions of both Dr. Sanders and Dr. DuVall, there are some very striking similarities:
Both decided that they preferred to present their "concerns" to persons outside of the chiropractic profession. Why?
Dr. DuVall is and Dr. Sanders was a member of the National Association of Chiropractic Medicine.
Both doctors are greatly involved in reviewing the services of other chiropractors for third party payers.
Both presentations direct themselves not at the abuses, but at chiropractic with titles of: "Chiropractic Nonsense" and "...Chiropractic Is A Sham".
Are these really the expressions of concerned chiropractors? If so, why weren't these concerns presented to one of the chiropractic publications where they could be printed for the potential edification of the chiropractic profession, instead of its damnation?
Why is chiropractic attacked, instead of the abuses? Why was it necessary to present issues that are currently being addressed within the chiropractic profession as if they were being totally disregarded?
In asking all of these questions, one ultimately comes back to the fact that Drs. DuVall and Sanders both receive much of their income from performing reviews for insurance companies. Could these presentations be a form of advertising?
Perhaps these presentations are the equivalent of "a mating call of claims reviewers." Any DC willing to expose their profession to the ridicule of MDs, RNs, insurance companies and law enforcement agencies will surely be willing to serve the needs of third party payers.
There will never be a perfect chiropractic profession. All health care professions have problems. We are no worse than any other (please see "Health Fraud - How Is The Chiropractic Profession Involved?" on page XX). But there are avenues to address the problems within the chiropractic profession:
Bring the problems to the attention of the state boards
Encourage state and national associations to address the problems
Submit articles or "letters to the editor" to various publications
Both Dr. DuVall and Dr. Sanders suggest that they have been trying to alert the chiropractic profession to these problems. Where? When?
In what publications have they published? To my knowledge, the total published efforts of these two individuals amount to one co-published case report in JMPT by Dr. Sanders.
Where were the voices of Drs. Sanders and DuVall when the issues of practice management were being discussed (articles addressing this subject occurred in seven issues of "DC" in 1990)?
Where were they when Dr. James Healey, President of SCASA, presented his thoughts on diagnosis and non-diagnosis (please see his article on page 25 of the July 18, 1990 issue of "DC")?
There are ways to address the issues in an effort to make chiropractic a better profession. But, subjecting the chiropractic profession to public ridicule will never accomplish anything. All issues must be resolved from within.
