The chiropractor noted this in his records, but didn’t ask whether she was seeing an internist or oncologist, nor did he otherwise consider the patient’s history of cancer in his evaluation. She had a history of breast cancer with mastectomy. Some D.C.s consider diagnosis unnecessaryĪ middle-aged woman went to a chiropractor with pain in her lower back and pelvis. 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. We need to improve our image and patient care - by further documenting the efficacy of what we do and standardizing our services. But others don’t, and that hurts the profession. I also believe there are many good chiropractors: They practice rationally, attend postgraduate courses, and read medical and chiropractic journals. I believe spinal manipulation is an important, bona fide therapy for selected patients with back, muscle, and nerve problems. I don’t mean to paint a totally dismal picture. However, I’ve been outspoken about this issue for years, based on what I saw during a decade of private practice and three years as an instructor and clinician at a national chiropractic college. I’ve been doing utilization review for the past three years - helping businesses and health-care payers to determine the necessity of chiropractic services under the terms of their benefit plans. No doubt other chiropractors will call these opinions self-serving. s need to know to whom they refer patients. And as the barriers between the chiropractic and medical fields come down, I think M.D. Court of Appeals last February, when it upheld a lower court ruling that the American Medical Association, in violation of the antitrust laws, had conspired to boycott chiropractors.īut as I see it, despite my profession’s efforts to upgrade itself scientifically, we’re still well behind you.
Some of you are beginning to consider chiropractors your peers, like osteopaths, or at least part of a separate scientific discipline. I can only ascribe this to lack of knowledge about chiropractic education, training, and practice patterns.
I’m concerned because there seems to be a growing misunderstanding of my profession by M.D.s. With regard to the chiropractic profession, I suppose I’m a heretic. If you suspect that diagnostic shortcomings and therapeutic abuses still plague the profession, you’re right. Explanations of medical terms have been added in brackets. Copyright © 1990 by Medical Economics Publishing Reprinted with permission from the Sept 19, 1990, issue of Medical Economics, a magazine written for physicians.
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