Issue 14 / 28 April 2014

DO you remember dysphoric social attention consumption deficit anxiety disorder?

The condition first appeared in 2007 when it was said to affect millions of Australians, leaving them with the sense something was missing in their lives.

They felt empty after a full day of shopping and didn’t feel as young as they used to. They enjoyed new things more than old things.

Fortunately, a company called Future PHARM, with a commitment “to perfecting life through chemistry” came up with a cure for this debilitating condition — Havidol (avafynetyme).

The drug and the condition were the invention of New York-based Australian artist Justine Cooper, but the parody was so close to reality she found herself fielding calls from sales reps wanting to handle the exciting new product.

Cooper was deliberately mimicking the marketing techniques of the pharmaceutical industry. However, big pharma is not the only market sector to have realised the benefits of persuading people they have a medical problem so that they can be sold the solution.

A range of alternative medicine practitioners and manufacturers have also become enthusiastic proponents of such techniques, perhaps none more so than those chiropractors who aim to convince parents their perfectly health children need regular chiropractic check-ups.

One Sydney clinic recommends children attend up to six spinal examinations a year and says chiropractic treatment is proven to be safe and effective for children of all ages.

Significant benefits are achieved in conditions including scoliosis, colic, asthma, coordination problems, chronic ear infections and “growing pains”, the site says.

Would you like a subluxation with that?

And then there’s the Victorian chiropractic group that claims spinal misalignments may be behind “many newborn health complaints such as colic, reflux, breastfeeding difficulties, and sleep disturbances”.

So that’s why newborns keep their parents up at night.

The same group has promoted itself on Facebook with a picture of a baby in a nappy and the slogan: “It’s never too early … Get a chiropractic evaluation for your child today!”

The group’s website claims its chiropractors are “minimum 5-year trained doctors”.

I haven’t checked out all of the practitioners on the site — there are rather a lot — but the ones I looked at had Bachelors of Applied Science, not medical degrees or doctorates.

It may not be illegal for them to describe themselves as doctors, given that this is not a restricted term, but it certainly has the potential to mislead.

And what about the health claims these “doctors” make? The truth is there is remarkably little evidence to support chiropractic treatment in children, especially for indications beyond the musculoskeletal.

Cochrane reviews have, for example, found a lack of evidence of benefit in a number of conditions chiropractic is claimed to help, including asthma, bedwetting and colic.

An MJA editorial, criticising the teaching of non-evidence-based therapies by Australian universities, expressed unease about chiropractors extending their role in the health system beyond the treatment of back-related musculoskeletal problems.

“Alarmingly, some chiropractors now extend their manipulation of the spine to children, making claims that this can cure asthma, allergies, bedwetting, attention deficit hyperactivity disorder, colic, fever and numerous other problems, and serve as a substitute for vaccination”, the editorial said.

Manipulation indeed.
 

Jane McCredie is a Sydney-based science and medicine writer.

16 thoughts on “Jane McCredie: Truth manipulation

  1. Dr Andrew Kinsella says:

    Well you know, chiropractors do do a 5 year degree- and generally have far superior understanding of the functional aspects of anatomy, and questions of the moment to moment distortions of neurological input to the CNS caused by spinal malalignment than most “doctors” do.

    Strictly speaking the title “doctor” applies to a PhD- so all of us health practitioners who use it are pulling a fast one. This sily squabble has been going on for 30+ years now– and it is time that we recognised all this debate for what it is– jockeying for professional prestige and, in effect  the “monopoly rights over the placebo effect” that go with holding the position of prestige.

    My own experience as a medical practitioner is of having my own health care stuffed up by my profession for years. I even had the disturbing experience of having the one competent practitioner I had found in decades be hounded out of practice by AHPRA.

    I am very happy now to place my 2 chiropractors as my primary carers and more than happy to honor them with the title doctor. Very few of the medical practitioners who have treated me have come anywhere near to them in terms of knowledge or skill- and none have been able to come anywhere near the results that they produce without toxic drugs.

    I am about to get my hands ona paper that compares the health outcomes of children of chiropractors with those of children of allopathic doctors. I understand it does not make comfortable reading for us medical practitioners.

     

  2. Dr Andrew Kinsella says:

    Further to my initial post:
    I would also draw our attention to the Victorian Legislative Assembly investigation into AHPRA. Within that report is contained the interesting statistic that Medical Practitioners (about 15% of AHPRA registered practitioners) attract about 54% of notifications to AHPRA– a rate of 42.1 notifications per 1000 practitioners per year, versus the rate for chiropractors of 20.6 notifications per thousand chiropractors per year (a rate that is close to the average across all professions registered with AHPRA.

    So- statistically speaking it appears that the figures are in favour of the safety of chiropractic as being superior to allopathic medicine, and, given that, I believe there is no place for the representatives of the more hazardous profession to be opining as to where parents should choose to take their own children.

    As for the claims of chiropractic re the conditions you mentioned– maybe if you spent more time reading their literature and the research tat is available from both chiropractic, osteopathic and European Allopathic medical sources, you might just be able to understand the mechanisms that are being proposed for these associations. They make perfect sense in terms of basic anatomy and physiology.

  3. Department of Health Victoria Clinicians Health Channel says:

    That’s excellent Rea(l)ity Check, I had a great laugh. Two points:

    1. You do realise that the term ‘allopathic’ actually refers to any health professional who is not a homeopath? Chiropractors, acupuncturists and other sectarian believers in mutually exclusive dogma are all “allopaths’ as well as medical practitioners.

     

    2. If you think time spent reading the chiropractic literature is well spent, I respectfully disagree. Chiropractors continue to demonstrate that they don’t, as a profession, deserve to be taken seriously because their parallel ‘science’ is really a cargo cult version of real science.

  4. Mari Morocz says:

    I was expecting to read your insight into how diseases are invented and marketed and how the medical profession and the drug industry collude in this process, instead I found a rather unexpected turn to chiropractic ‘bashing’. No insight though, just some repeated and regurgitated sentences. I thought the ‘truth manipulation’ was a good title – as I started reading – and see it as a wasted opportunity to pay attention to the phenomena. Sadly the article gave no insight into any of the subjects, did not add to it in a meaningful way and did not bring anything up in it’s “reasoning”. 

    I expect more – or rather, better from MJA contributors. 

  5. Dr Hasina Yeasmin says:

    The way mental health awareness is going I will not be surprised that if DSM for mental health adds DSACDAD in their 6th edition! Save us from DSACDAD! We have enough power to resist chiropractors but will be hard to fight psychiatrists if it gets to DSM manual.

  6. Max King says:

    Aha! Now I know why I suffer from a depressive illness – it is because the spinal misalignments arising from movements of my back cause moment to moment distortions of neurological input to the CNS (in particular the Papez Circuit / Limbic System?) such that the cacophony of changing spinal inputs to the “emotional brain” eventually causes a mental rebellion expressed as depression.

    Whacko – I must fire off a paper to an open access journal.

    As an aside, the term “doctor” derives from the Latin verb “doceo” (to teach), hence i can accept that allopaths should adopt this title because they have taught me that occult quackery and snake-oil merchants can fool a lot of the people a lot of the time. Panaceas are not cheap either.

    Bah and humbug.

     

     

     

  7. CKN Queensland Health says:

    Reality Check, saying that chiropracters have a “far superior understanding of…the moment to moment distortions of neurological input to the CNS caused by spinal malalignment” is a bit like saying acupuncturists understand acupuncture points better than doctors, or Rabbis understand the Torah better than atheists. It doesn’t actually add anything to the debate as to which paradigm is likely to be closer to reality.

    And saying you are about to get your hands on an unnamed new paper which will finally provide the required evidence is the same claim which could have been made prior to reading every pro-chiropractic paper ever examined by a Cochrane team. Extraordinary claims require extraordinarily solid evidence. So, like Mick Vagg (and Larry David), I prefer to curb my enthusiasm.

  8. Trevor Lowe says:

    When a chiropractic clinic runs a stall at a “health & fitness ” exposition; recruits new clients through loss leaders (free screening) and then tells fit, active pain free individuals that they have “serious spinal issues,” there certainly is something wrong. Either tha anatomy and physiology that many chiropracters learn/practice is bizarrely different from that learnt by medical practitioners or they are fundamentally dishonest or a mixture of the both. Whichever it is; the so called “classic chiropracters” should not be out there offering their “services.”

  9. Dr Hasina Yeasmin says:

    It’s like naturopath knows how world has been damaged by vaccination! So
    all who have been vaccinated need to go through cleansing process!

  10. Guy Hibbins says:

    DSACDAD is actually a hoax, as was Havidol which also never existed in the first place.  See http://en.wikipedia.org/wiki/DSACDAD

    Seriously though, a hundred years ago, only about half a dozen medicines in the pharmacopoeia were ones which are still in use today.  The rest were mostly a list of ineffective inorganic chemical mixed in various ratios which looked impressive when written down on a script.   In this context Western medicine competed with alternative medicine largely as a battle of the placebos.

    What happened then was that Western medicine went down the path of systematic scientific clinical trials which fundamentally changed its approach.  It is really only these trials which differentiate Western medicine in the 21st centrury from medicine in the days of Hippocrates.  

  11. David Lindholm says:

    It saddens me that this space can be hijacked by the likes of a clearly disturbed Reality Check to stifle a genuine debate. If we all practiced evidence based medicine there would be no chiropractors…..but we would have to tidy up our own backyards a bit too! First do no harm and then don’t spend public money on witchcraft. 

  12. Richard Gordon says:

    Thankyou Jane for another well expressed opinion and for taking on chiropractic. Thankyou also David Lindholm for a your comment which beautifully winds up this discussion of chiropractic/non-evidence-based treatment.

  13. Dr Judith Hamel says:

    Paradyms, paradyms, we all have them, and all of them have some truth in them and some falsehoods.  Is there really only one TRUTH?  Remember bleeding and leechs?  Paradyms change, and watching them do that gets easier with age!

  14. Dr Andrew Kinsella says:

    Justin and Mike,

    If you want a good review of some of the ample evidence that is available,I would suggest that firstly you sit down and read the book “Manual Therapy in Children” edited by the Gemran Orthopedic Surgeon Heiner Biedermann MD, then start work on the extensive research published by Alex Sato, and then work through the books

    “Upper Cervical Subluxation Complex” a review of the Chiropractic and Medical Literature by Kirk Eriksen and maybe finish with the book “The Naturopathic Basis of Physical Medicine” by the British Osteopath Leon Chaitow.

    Once you have covered those you will be in a better position to assess what evidence does and does not exist.

    I was highly sketical myself- but astonished when I started improving in my health (both back and neck pain, stress response and sleep) once chiropractic intervention commenced.

    Now – I am simply furious that my profession has such a pathetic and clearly self interested approach to looking at the evidence that is available. Unfortunately the chiropractic evidence base is rather piecemeal– and it needs work to go through it. Chiropractors do not have pharmaceutical money to help fund their research. It is to be hoped that their proper inclusion within universities will allow more funding to tidy up the research that has been done and fill in the many gaps that need work yet.

    The comment about “wasting time reading chiropractic literature” betrays a closed mind.

     

  15. Dr Andrew Kinsella says:

    David Lindholm:

    The comment “clearly disturbed” is an ad hominem attack that has no place in civilised discourse. The figures relating to notifications to AHPRA almost certainly reflect some underlying realitythat conventional medical doctors are harming their patients more often than chiropractors. Again- throwing around comments like witchcraft simply betrays ignorance on a grand scale.

    Finally David- please explain how my putting an alternative view, one based on direct experience as a patient, out there for discussion constitutes “hijacking” or suppressing debate. I would have thought that the whole point of having any comments section following an article was to promote a civilised exchange of ideas. I have put forward some ideas- and apart from a regrettable sloppiness about the use of the word allopathic– nobody has had the courage to examine any of them at all.

     

     

     

  16. Sue Ieraci says:

    ”Reality check” appears to be out of touch with the current reality of  chiropractic literature – a vast proportion of which consists of single case or small series case reports: the person had ”x”, we did ”y” (often many times over weeks to months) and the person’s symptoms improved.  There is a sub-group of chiropractors who have skill at musculoskeletal manipulative treatment, general fitness advice and sports injuries – these people do a lot of good for muscle and joint ailments. The large sector of the profession, however, that professes the model of ”subluxations” causing ”nerve interference” and organ dysfunction, allegedly from the time of birth, are letting the profession down. Those who are sceptical about Big Pharma profits should be equally critical of the business model of many chiropractic practices, where whole families are encouraged to be regularly ”adjusted” for life – symptomatic or not.

Leave a Reply

Your email address will not be published.