July 2003

Chiropractic in Healthcare – The Need to Work Together for Maximum Therapeutic Effectiveness

By Chester Wilk, D.C.

What I propose is a National, State and Individual Success Program. If the general public truly understood and appreciated the benefits of chiropractic, there wouldn’t be enough chiropractors to handle the patient demand. Together we CAN make it happen at a negligible cost but we are not doing it. We find ourselves battling in the legal and legislative arenas, while many individual chiropractors are struggling to survive professionally. We can change this crisis if we do the right thing.

            Few people, including chiropractors, realize all of the significant clinical/scientific studies that exist from around the world providing an overwhelming case for the validity of chiropractic based on the five most important things we look for in health care. These are: 1) Therapeutic superiority, 2) Safety, 3) Cost effectiveness, 4) Clinical/scientific evidence, and 5) High quality of our training. If the public knew the following facts, our profession would be in a far different situation than we are in today. We’d be on the forefront of health care.

            Consider the following studies:

            1) A major U.S. Government study involving hundreds of multi-disciplinary researchers under the U.S. Office of Public Health researched tens of thousands of the finest scientific literature in the world, concluded that spinal adjusting is markedly superior to any other forms of treatment for most low back pain, recommended spinal manipulation and criticized excessive spinal disc surgery.1

            2) The University of Saskatchewan had a controlled study group of 171 patients suffering with chronically disabling low back pain for seven years who were unresponsive to orthodox medical treatments. The study group tried chiropractic adjustments and within three weeks, a remarkable 87% of these patients were totally free from pain for the first time in seven years, and remained pain free!2

            3) A professor from Northwestern University conducted a clinical outcome study of patients within two different Chicago area hospitals, one hospital orthopedic ward used chiropractic adjustments while the other ward only used medical care. The orthopedic ward using chiropractic care sent patients home well 7-9 days sooner than the other hospital not using chiropractic care.3

            4) AVMED, one of the largest health maintenance organization (HMO) in America sent 100 patients to a chiropractor for treatments to observe his results. Not only did the chiropractor get 86% results within three weeks on this test group, but all twelve patients diagnosed by a team of medical surgeons as needing disc surgery were corrected! None needed surgery.4

            5) The British Government financed and conducted an extensive ten-year study on chiropractic for low back pain, using randomized controlled trials and the scientifically accepted Oswestry Scale for pain measurement, and found chiropractic adjustments to be more effective by as much as a 2-1 advantage over physical therapy.5

            6) A study conducted at the University of Ottawa found that chiropractic care was markedly superior to medical care for safety, therapeutic effectiveness, cost efficiency, patient satisfaction, concluding chiropractic could save Ottawa hundreds of millions of dollars a year.6

            7) An Italian Government study surveyed 17,142 patients in 22 medical back pain clinics conducted over a two-year period showed chiropractic adjustments reduced hospitalization by 87.6% and work loss by 75.5%.7

            8) Workmen’s compensation records from the States of Oregon and California showed that patients under chiropractic care for the same disabilities returned to work at half the time and cost of medical care.8

            9) The worker’s compensation records from the State of Utah showed that patients under chiropractic adjustments had their low back ailments corrected at 1/10 the cost of medical care for similar back ailments.9

            10) The world renowned and respected RAND corporation found that spinal adjustments are not only appropriate treatments for low back pain but have considerably more randomized control trials supporting chiropractic validity than does medicine.10

            11) Medical physicians say the risk/benefit ratio of using NSAIDs for neck pain and headaches is reasonably safe and acceptable, while spinal adjustments are shown to be 400 times safer than taking NSAIDs!11

            If we combine the positive studies demonstrating the safety and effectiveness of chiropractic with the tragic results reported in the Journal of the AMA, of 106,000 deaths annually from non-error adverse effects of medications, including 80,000 from infections in hospitals, 12,000 from unnecessary surgery, 7,000 from medication errors in hospitals, estimated total of 225,000 deaths a year, iatrogenic causes is the third leading cause of death after heart disease and cancer (JAMA, July 26, 2000—Vol. 284. No.4). We need repetition of these facts to be repeated over and over again in the media and press to reinforce them as only official chiropractic spokespersons nation-wide can accomplish with credibility.

            1) The role of national organizations: 

            To urge the State chiropractic associations to start recruiting the most articulate, trustworthy and knowledgeable chiropractors in their State to become “Official State Chiropractic Spokespersons.”

            2) The role of the State associations:

            a) To recruit the best qualified spokespersons and give them the “Official Chiropractic Spokesperson” title and the responsibility to start contacting the media and press, not to replace the authority of elected officials, but to reinforce them. 

            b) To use the State chiropractic journals to inform its members of the spokesperson program and the book, “Chiropractic in Healthcare — The Need to Work Together for Maximum Therapeutic Effectiveness.”

            c) The State associations can send their spokespersons to Chicago to attend my special round table “conference type” meetings for spokespersons, where I will contribute my time sharing my 25 years experience and appearing on hundreds of talk shows.

            3) The role of the field practitioners:

            a) Read the book and understand chiropractic’s history and the solid clinical studies it contains supporting chiropractic. b) Become informed of the many advantages to better communicate these facts to patients. c) Place books in the offices for patients to read or purchase, and have copies available for anyone who may call as a result of hearing about the book in the media or press.

            Examples of provocative questions:

            1. How can a major respectable U.S. government study using hundreds of leading researchers and tens of thousands of the finest clinical/scientific literature from credible sources be ignored while chiropractic is isolated from 98% of our hospitals?

            2. Shortly after the scientifically based U.S. government guidelines were published advocating spinal manipulation as the best treatment option for low back pain, how can the AMA ignore the government study and guidelines, while claiming on the front cover of its own AMA Guidelines that “all treatment options for low back pain were inside,” yet exclude any reference to spinal manipulation? Is this not fraud by exclusion?

            3. How can any objective observer ignore the 87% results on a university-based test group of 171 medically unresponsive sufferers after seven years of incapacitating low back pain and suffering, be corrected within 3 weeks with spinal adjustments?

            4. A highly credible study in Canada showed that the chance of a stroke from cervical adjusting was one in 5.6 million, yet how can medical antagonists use dishonest, unscientific and worthless material misleading the public on the safety of chiropractic?

            5. If an independent clinical outcome study between two different hospitals in Chicago show that the hospital using chiropractic adjustments was sending patients home, well, 7-9 days sooner than the other hospital, why isolate chiropractic from hospitals?

            6. Can we morally or ethically ignore the ten-year scientifically based study conducted by the British Government showing chiropractic enjoyed a 2-1 therapeutic superiority over physical therapy? 

            7. What about chiropractic adjustments reducing hospitalization by 87.6% and work loss by 75.5% found in studying 22 back pain clinics in Italy on 17,142 patients?

            8. With 225,000 deaths attributed to medicine every year making it the third greatest cause of deaths after heart disease and cancer according to JAMA, wouldn’t it be more humane to embrace the best and most conservative treatment that each profession offers?

            I doubt that one person in a thousand, knows about the above positive chiropractic studies yet, a very large number will have heard of the spurious “stroke” study. Positive radio, TV and press exposure on chiropractic orchestrated by our profession is almost non-existent and so ten times “nothing” remains as almost nothing! The answer lies in changing our public relations priorities so that we can multiply our P-R a hundred-fold without necessarily increasing our membership.

            (For documentation of reference 1-11, see Appendix 1 in “Chiropractic in Healthcare—The Need to Work Together for Maximum Therapeutic Effectiveness.”)