Respected and recognized among chiropractic professionals, Bruce F. Walker is the Head of the Chiropractic Program and Associate Dean (Research) within the School of Health Professions at Murdoch University. He is also the editor Chiropractic & Manual Therapies. He recently issued a global Open Access Commentary to the entire profession, admonishing many of its members for using antiquated, non-evidence based approaches in dealing with patients. Below are some highlights which expose many of the medical scams and frauds being perpetrated by chiropractors in the US, Canada, Australia, Europe and other parts of the world. For the full open letter click http://docplayer.net/20396779-The-new-chiropractic-bruce-f-walker.html
1)
Walker admits the profession’s reputation has suffered greatly due to
many of its member’s unsubstantiated practices:
“The
profession by and large graduates competent manual therapists who contribute
well to their communities and are good professional citizens, but there are
still aberrant elements with a profound retrograde ideology. These individual
and organised elements have caused the profession untold reputational damage
and continue to do so. As a consequence the professions reputation is commonly
poor among other health professions with whom it is compared and its approval
is variable within the community at large.”
2)
Walker exposes the lack of proper teaching and education in the
field, which inevitably leads to an embarrassment of phony treatments:
“Chiropractic
education should where possible be conducted at universities and this does not
mean small single purpose institutions that are deemed universities in name
only. Why is this recommended? Primarily because unlike some private colleges,
government funded universities insist on intellectual evidence based rigour in
their learning and teaching and importantly require staff to be research
active. Chiropractic courses need to have an underpinning pedagogy that insists
that content is taught in the context of the evidence and that students obtain
the necessary training to question and critically appraise.
“The
training of chiropractors as career researchers needs to be prioritised. All
chiropractic staff at Universities and Colleges need to be research active and
have or obtain research doctorates such as PhDs. While useful research outputs
are evident from many chiropractic colleges it is not enough to have undersized
and under resourced research departments within chiropractic programs. It is
worth stressing that research is a vital strategy in the advancement of the
chiropractic profession and the public it serves.”
3) Walker slams the common, endlessly debunked practice among
chiropractors of vitalistic subluxation,
which is the belief that adjusting the spinal column will cure a variety of
non-spinal diseases:
“Underpinning
chiropractic education is program accreditation and this is also in need of
review particularly where vitalistic
subluxation based courses have been legitimised by the accreditation
process. The question needing to be posed is ‘if colleges espouse to graduate
subluxation based chiropractors, how can they legitimately achieve accreditation?’
I postulate that it is self-evident that there must be something wrong with an
accreditation system that allows this to happen regardless of how worthy the
institution is in other ways.”
Just one
example of research done by four scrupulous chiropractors:
"No
supportive evidence is found for the chiropractic subluxation being associated
with any disease process or of creating suboptimal health conditions requiring
intervention. Regardless of popular appeal, this leaves the subluxation
construct in the realm of unsupported speculation. This lack of supportive
evidence suggests the subluxation construct has no valid clinical
applicability." https://en.wikipedia.org/wiki/Vertebral_subluxation
What’s
shocking is how prevalent these beliefs are:
“While some
chiropractors have rejected the subluxation paradigm, it is supported by the
major chiropractic organizations and schools and is considered essential by the
great majority of practicing chiropractors. In two recent studies cited in the
Mirtz et al. article, 98% of chiropractors believed that ‘most’ or ‘many’
diseases were caused by spinal misalignments and over 75% of chiropractors
believed that subluxation was a significant contributing factor to 50% or more
of visceral disorders (such as asthma and colic), an implausible idea that is
not supported by any evidence whatsoever.”
https://www.sciencebasedmedicine.org/the-end-of-chiropractic/
4)
Walker discloses how untrained and inexperienced many chiropractors
are:
“Chiropractic
education should also involve specifically relevant hospital access or work experience
such as hospital rounds so that students can observe patients that are truly
unwell and observe the signs and symptoms taught in their theory classes.
Hospital rounds would also allow chiropractic students to interact with other
health providers and increase the likelihood of legitimate partnership and
respect between health professions.”
5)
Walker unashamedly reveals the sad professional state and well-earned
reputation of much of this field, admitting its anti-science bias:
“Chiropractors
need to become solely musculoskeletal practitioners with a special emphasis on
spinal pain. If the profession becomes the world’s experts in this area it will
command the respect deserved. Importantly it will not be seen as a collective
of alternative medicine practitioners with a strange belief system and a large
minority displaying derision of science and medicine.”
6)
Walker exposes the many chiropractors who practice with the full
knowledge that many of their “remedies” are not evidence-based:
“The
adoption of evidence based practice is critical to the future of chiropractic
and yet there is resistance by elements within the profession. Soft resistance
occurs with attempts to change the name of ‘Evidence-based practice’ (EBP) to ‘Evidence-informed
practice’ (EIP) … So why are some of our profession so keen to use this alternate
and weaker term?’ (EIP).”
7) Walker implores chiropractors worldwide take a leadership
role in exposing the fraudulent practices rampant within the profession, even
describing many of the ideas as illogical and dangerous:
“As
professionals chiropractors should not tolerate colleagues or leadership in the
profession who demonstrate aberrant ideas. If colleagues transgress the
boundaries or professionalism they should be reported to authorities and this
should be followed up with action by those authorities. It is important to
reject the notion of embracing the margins of diversity within the profession.
“If an idea
is nonsensical practitioners should express their opinion and make a stand,
otherwise their silence will be regarded as consent. Insist that professional chiropractic
organisations take a public stand against biologically implausible notions and
theories, illogical ideas, dangerous practices and be prepared to report even
likable but misguided individuals. It is not treason to seriously question
abnormal and implausible ideas within the chiropractic profession. In the short
term the consequences may be cathartic but they will ultimately lead to
positive change.”
8) Walker opposes the many chiropractors who
have anti- vaccination views and others who try to convince parents their baby
would benefit from their treatments, both which fall into the categories of
snake-oil and quack medicine:
“It is
important to speak up openly in favour of evidence-based public health measures
and to join public health associations and agencies. Chiropractic can and
should get involved in health promotion and disease prevention especially in
two main areas. First, where there is a synergy with musculoskeletal disorders
such as osteoporosis, falls prevention, the aging spine, ergonomic design of
furniture and work stations to name a few; and second to actively counter the
disinformation perpetrated by rogue elements within the profession. For
example, chiropractors promoting anti-vaccination views need to be countered
and also those in the profession who seek to medicalise infancy by ‘diagnosing’
infants with notional spinal manipulable lesions. In this way we will nullify
the destructive reputational damage caused by anti-public health advocates in
our profession and in turn bolster public health and indeed chiropractic ’s reputation
through advocacy in these areas.”
9) Walker boldly demands integrity, solid
evidence backing up claims, and a public apology from many chiropractors and
their representative bodies:
“Practitioners
should support and become involved in chiropractic organisations that are
clearly ethical and evidence based and add value to them. It is important not
to expect others to do this for you. Be wary of organisations that just pay lip
service to ethical evidence based practice (EBP). Ultimately these groups will
be judged by their deeds and not their words. As a way forward we should seek contrition
and apologies from organisations that have damaged the reputation of the
profession over decades. Indeed, unambiguous statements from chiropractic
organisations supporting science and evidence in practice are overdue.”
10)
Walker further demands a complete overhaul of standard practices:
“In the future more and more evidence will
inform our history taking, examination procedures, selection of diagnostic
tests, the therapies chosen and the advice given. It is very likely that the
future chiropractor will be more efficient, safer and more effective in
clinical practice for those with spinal pain than those of today. The profession
should not be afraid of the change demanded by new evidence. Indeed,
chiropractors should be prepared to alter how they as individual practitioners
communicate with patients, the diagnostic tests used or ordered, the prevention
strategies recommended and the therapies administered including the use of
medication and other interventions that are synergistic with musculoskeletal
disorders.”
11)
Walker’s summary of the problems and blatant scams that need to be
addressed in order for the profession to gain legitimacy and respectability:
----Adherence
to a flawed chiropractic ideology centering on "innate intelligence"
and vitalism
----Anti-vaccination
propaganda
----Anti-physiotherapy
sentiments
----Over-servicing,
including unnecessary treatment of babies
----Use of
the term "subluxation" as a valid diagnosis
----Biologically
implausible diagnostic tests and therapies without supporting evidence
----Lifetime
chiropractic care in the name of "wellness"
----Claims
of cures for visceral and other non-musculoskeletal conditions
----Anti-drug
and anti-medicine propaganda
----Misleading
and deceptive advertising
----Unscrupulous
contracts of care
----Obligatory
full-spine x-rays
----Unfounded
claims of decreased immunity from "subluxation" and increased
immunity from chiropractic treatment
----An
unhealthy disregard of clinical research, evidence based practice, and
non-specific treatment effects including natural history and the placebo effect
Photo: http://img.medscape.com/news/2014/dt_140422_back_pain_spine_800x600.jpg
Jerry De Luca is a Christian freelance writer who loves perusing dozens of interesting and informative publications. When he finds any useful info he summarizes it, taking the main points, and creates a (hopefully) helpful blog post.
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