There are other rumors. At the third Chiropractic Research Agenda Conference (RAC3), there was talk of an effort by political medicine to put a spotlight on the dangers of cervical adjustments while underplaying the benefits.
With shrinking health care dollars, the human body is being "divided up" by practitioners engaged in turf wars. Chiropractic has established its "beachhead" (low-back care). The medical specialties also fear chiropractic securing a place in the care of headaches.
You can expect a new round of assaults against chiropractic. Little will be said about low-back care: that's a battle already lost by medicine. Look instead for new studies and case reports to surface to tell the world about the high risks and questionable benefits of cervical adjusting.
When patients present to the chiropractor, more than 68 percent of the time it's for low-back pain (see the front page graph of the June 15, 1998 issue). Only three percent of our patients come in for nonmusculoskeletal complaints. That should tell us a lot about how well our patients understand the full value of chiropractic.
Political medicine can't eliminate chiropractic, but they can contain it if they put fear in the public mind about the dangers of the cervical adjustment. All that is necessary is to present a few horror stories of patients who had cervical adjustments and subsequently became paralyzed; follow that up with some heartþrending interviews and video footage, then air in on "20/20."
If such a campaign is successful, most of your patient files will soon be stamped PATIENT REQUESTS NO CERVICAL MANIPULATION.
What can we do?
You'll recall the boost chiropractic received in Dec. 1994 when the Agency for Health Care Policy and Research published their clinical practice guideline Acute Low Back Problems in Adults. But the agency is no longer in the guideline business. Who will be generating guidelines to fill that loss? Guidelines with the credibility of the AHCPR reports would necessitate multidisciplinary panels and involve researchers from several countries: something on the order of the Quebec Task Force (please see "Quebec Task Force Rewrites Whiplash Protocols" in the June 5, 1995 issue).
A purely chiropractic effort to evaluate every possible ailment that the chiropractic adjustment might have an impact on, and the current level of research on each, should be seriously considered. This would help to broaden chiropractic beyond the low back musculoskeletal model.
But to fight the war to keep the cervical adjustment will take more than our own input. It will require assembling and funding a group of highly distinguished, internationally respected scientists from numerous related disciplines. Their job will be to examine and authoritatively determine the risk and value of the cervical adjustment. If we can establish a panel at this level, the battle will be over. There will be little point in political medicine's challenging a group that includes the most noted medical researchers.
The cost of winning will not be cheap. Efforts like this usually cost several million dollars. But if we ever hope to be more than just low-back specialists, we have no choice. To turn back now is to seal the outcome. The entire human body cries out for the renewal of life and vitality that the chiropractic adjustment brings. The public knows the value of chiropractic for low-back problems. It's now our job to move beyond that to the rest of the spine and, ultimately, the whole person.
Donald M. Petersen Jr.,BS,HCD(hc),FICC(h),
Editor/Publisher of Dynamic Chiropractic
Don-MPAmedia.com
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