We Get Letters & E-Mail

The Window of Opportunity Is Open

Dear Editor:

Sometimes things are different from what one would think at first glance. When I was a young man growing up in the Alabama Bible Belt, we had something called "blue laws." These laws prohibited the sale of any alcoholic beverages whatsoever: no beer, no wine and forget anything else. However, there were ways to buy these alcoholic products. One only had to travel to the next county, where the voters had usurped the prohibitions. The other was your friendly moonshiner, although sometimes the product was potable and other times deadly.

The arguments for disallowing alcohol, also called," keeping a county dry," were many and compelling. Such arguments as preventing alcohol use, changing sinful ways or stopping drunk drivers,made sense until you realized that these laws did nothing; they simply meant that those who wanted the products had to cross the river into the dry county or visit the moonshiner.

To a young, idealistic man such as I, the reasons to keep dry were logical and reasonable until someone pointed out that the people who benefited most from these laws were the preachers and the moonshiners. This brings me to chiropractic and its prohibitive laws. First, as I have stated before, the lobbyists for the medical profession approach law with a permissive agenda. The laws for the medical profession permit the doctor to do anything. The don't even have to know how. They don't have to have training in a particular subject. They don't have to have experience.

The lobbyists for chiropractors take the prohibitive agenda. It doesn't matter if the chiropractor knows how, has training, has experience or is competent. They are a "chiropractor," and the law is designed to protect the public from their competence.

When I asked myself who benefits from such an agenda, the following groups came to mind: organized medicine including organized osteopathy; Stephen Barrett, MD, and Quackwatch seem to be obvious. I would never accuse, but it seems fair to ask: Are some chiropractors in bed with Dr. Barrett? How does it injure straight chiropractors if some of their peers want to monitor a patient's blood pressure?

New Mexico chiropractors have changed their laws to include injections of nutrients, prescribing hormone replacement therapy, etc. This does not seem to me to be a threat to society or to chiropractic. But to the ACA and the ICA, it obviously poses a threat and they have both made statements opposing such laws. Doesn't that make you wonder if our leaders are familiar with Dr. Barrett in the same way as the Alabama preachers and moonshiners? Now I am not accusing anyone of doing anything. I am just a simple chiropractor watching from a distance and asking the question: What if?

The question we should all be asking is, "Who will benefit from chiropractors expanding their laws and how should the laws be changed?" I believe that the society, the patients we serve, will benefit from a reasonable expansion similar to the one that New Mexico has pioneered. I also believe that the chiropractic profession and future chiropractors will benefit.

I believe we should not become the third medical doctor. Society has two of them, the MD and the DO. It is well-documented that they are the fourth-leading cause of death in this country. Society needs a good conservative physician, and we are in the best position to be that. If something is neither a drug nor surgery, it is, by my definition, chiropractic.

In Illinois, MDs and DOs are licensed to practice medicine in all of its branches. Chiropractors are licensed to do anything except drugs and/or surgery. I believe this is a good legal definition of chiropractic. That means if something is not drugs and is not surgery, then it is a tool a chiropractor may use. I want to be able to practice chiropractic in all of its branches.

We must keep vigilant for those forces that want us to perish. The easy way to prevent chiropractors from using nutrients is to make them by prescription only; to define it as a drug or surgery. That has been proposed numerous times and again recently by Senator John McCain. I propose that if something does not qualify as a drug by today's definition, then it is chiropractic. I say it that way because the rules can be changed to make water by prescription only. I believe the chiropractic laws should state that if a chiropractor can recommend something, such as vitamin B12, then they can administer it by any route: orally, intramuscularly, intravenously, etc.

Contrary to some – yes, even some of our leaders – chiropractors by and large are not stupid. Nurses, orderlies and untrained office help can learn to give injections. I will bet good money that more than a few chiropractors can learn it also. If I am recommending that a patient take a vitamin orally, why can't I use the injectable route if it will benefit the patient? Just as manipulation, by my definition, is not synonymous with chiropractic, injections are not the practice of medicine.

The window of opportunity is open for changes to take place. The health care industry is open to change as much as it will ever be. This window will close soon. I am thinking of changes that I want for future chiropractors: no more 12-visit limits, no more $1,000/year limits, no more confusion whereby the public thinks chiropractors are massage therapists, no more "they are not real doctors" and no more confusion with our medical peers thinking we only treat musculoskeletal problems.

It appears to me that many of our leaders want us to only do what D.D. and B.J. Palmer did. This is not your grandfather's chiropractic; times have changed and we must change with them if we want to thrive. But on the other hand, the Palmers saw chiropractic as a complete health care system. They even recognized diet, nutrition and various other things besides manipulation of the spine. The Palmers were ahead of many of us; maybe it's time to catch up.

Forest Mapes, DC
Lyons, Ill.

New Car-Seat Safety Guidelines

Editor's note: The following two letters to the editor correct (rightfully so) Dr. Claudia Anrig's recent article on car-seat safety. While her article was submitted prior to release of the new guidelines, we apologize for this oversight and any confusion it may have caused our readers.

Dear Editor:

The June 3, 2011 issue of DC contains an article by Claudia Anrig, DC, titled "Must-Knows About Car-Seat Safety." Dr. Anrig cites the National Highway Traffic Safety Administration (NHTSA) guidelines and states, "Toddlers (over 1 year of age and weighing 20-40 pounds) need a forward-facing convertible seat."

However, the NHTSA guidelines, as quoted directly from the reference Dr. Anrig provides, states, "Ages 1-3: Keep your child rear-facing as long as possible. It's the best way to keep him or her safe. Your child should remain in a rear-facing car seat until he or she reaches the top height or weight limit allowed by your car seat's manufacturer. Once your child outgrows the rear-facing car seat, your child is ready to travel in a forward-facing car seat with a harness."

Given the importance of car-seat safety, Dr. Anrig's article should have been more clear with regard to recommendations for children ages 1-3. As currently printed, I feel that particular portion of the article is at best unclear and at worst incorrect.

Garry Silvesti, DC, MS
Hammonton, N.J.

Dear Editor:

I just read the article on car-seat safety and noted that the information given was outdated. The guidelines from NHTSA for car seats changed this year. For rear-facing vs. front-facing, they are now recommending that children stay in a rear-facing position for as long as possible, up to age 3 years old. NHTSA is also recommending that children stay in car seats until 4-7 years old, and in booster seats until they are 8-12 years old and can have the seat belt across them properly. Please see the specific recommendations at www.nhtsa.gov/Safety/CPS.

Meghan Van Loon, PT, DC, DICCP, FICPA
Ithaca, N.Y.

Overlooking a Major Finding?

Dear Editor:

I got a good chuckle while reading the piece, "Chiropractic Works – and So Can Your Patients" (May 20, 2011). While the author correctly stated the major premise of the study – that DC maintenance care is more cost-effective than care provided by MDs and/or PTs – he conveniently overlooked the significance of this piece of information: "with the only or mostly physical therapy group having the highest proportion of recurrent disability (16.9%) and the only or mostly chiropractor and the no health maintenance care groups having the lowest proportion of recurrent disability (6.5% and 5.5%, respectively)."

This says that providing no chiropractic maintenance care at all resulted in a slightly lower rate of recurrent disability than those who received that care. Sure, we do better than MDs and PTs (good news there), but does this study really support the need for ongoing maintenance care by DCs over this period of time? Answer: It doesn't. At best, we are providing a useless service and needlessly using up scarce health care resources. At worst, this study shows that chiropractic maintenance care in this circumstance contradicts the primary maxim of medical ethics: "First, do no harm."

Steven Hecht, DC
Acton, Mass.

Editor's note: Our article regarding the study in question actually did point out that rates of recurrent disability were slightly lower (5.5%) in patients receiving no maintenance care compared to those who received such care (6.5%). In fact, Dr. Hecht's quote is taken directly from our article. We chose to treat the study's findings as news and refrain from editorial commentary regarding any of the results, whether positive, negative or neutral toward chiropractic.

Dynamic Chiropractic encourages letters to the editor to discuss any issue relevant to the profession, including response to articles that appeared in a previous issue of the publication. All letters should be e-mailed to editorial@mpamedia.com with "Letter to the Editor" in the subject field. Please include your full name, degree(s), and the city and state in which you practice. Submission represents acknowledgement that your letter may appear in a future issue of DC, but does not guarantee publication. We receive considerable correspondence and endeavor to publish as many perspectives as possible.