Peter Gott, M.D.
Newspaper Enterprise Association
200 Park Avenue
New York, New York 10166
Attn. Rebecca Shannonhouse
Dear Dr. Gott:
The American Chiropractic Association takes serious issue with your latest selective attacks on the profession of chiropractic.
No, the ACA does not maintain that the profession of chiropractic is the repository of all legitimate health care knowledge and it concedes that some individual chiropractors do overclaim, overtreat, mistreat, and otherwise behave poorly -- possibly in the same proportion as do medical physicians.
Rather, the American Chiropractic Association is puzzled by two of your most recent columns: "Does Reader Have Human Anthrax?" and "Chiropractic Care Can Lead to Nerve Problems."
The ACA's concern may be summarized as follows:
- You simply are legally incorrect when you make the totally uniformed statement that "chiropractors have no business diagnosing infectious disease." Simply stated, chiropractors are required by law, in most states, to be able to diagnose infectious diseases if for no other reason than to determine when a referral to a medical physician for care is needed. Because of this legal requirement, all chiropractic colleges accredited by the Council on Chiropractic Education teach diagnosis as a substantial portion of their curriculum. I am sorry, Dr. Gott, but a chiropractor who fails to properly diagnose exposes himself or herself to a possible charge of malpractice. Sometimes cooperation with other professionals is required -- just as it is for medical physicians -- and the illegal MD boycott of chiropractors did not help. You should, by the way, chastise your colleagues for their refusal to assist -- not damn the chiropractors for being unable to get such assistance. You did everyone a disservice by your uninformed statement in your "anthrax" article. You completely confused diagnosis and treatment. The "treatment" phase is discussed in paragraph #2 below.
- Most chiropractors would not even attempt to treat infectious diseases. That does not mean that a chiropractor would not, on occasion, care for a patient that had an infectious disease and who was simultaneously under the care of a medical physician. To clarify: Just because a patient is dying of cancer or some other dreadful malady does not mean they do not have a musculoskeletal system that requires care. Even a person with AIDS could utilize a barber without the barber being accused of taking care of AIDS. But there is something more disconcerting about your "anthrax" column. I have applied my suspicious lawyer's differential diagnosis to the language in the letter from the unidentified writer. I became very familiar with unidentified author letters used by the medical profession (see below) during the 15 years of the Wilk et al., vs. AMA et al., case in which I represented the four doctors of chiropractic. In the letter which you quote (paraphrase), the writer apparently knows how to refer to a "chiropractor" and also to a female "doctor." Please note that the writer states that a chiropractor "diagnosed" the anthrax. After that remarkable diagnosis the writer then switches to make the statement "since my doctor wasn't familiar with the disease, she did substantial research." We go from a rather astute diagnosis by a "chiropractor" to an uninformed "doctor" who has to do "substantial research." Since you refer to anthrax as a "medical rarity," I have more than a passing suspicion that it was a medical physician that ended up doing the prescribing and the treatment. Many of my medical physician friends tell me that chiropractors frequently diagnose rare conditions and refer them to medical doctors for treatment.
- The timing of your selective, scare tactic, anti-chiropractic columns is also suspicious. Is chiropractic the problem you see in the confused world of health care? It is strange that your anti-chiropractic articles are appearing just as a succession of favorable research articles involving chiropractic are being published. Dr. Gott, you are a medical physician and, apparently, a good medical physician. In that capacity, it is probably safe to say that you don't know the difference between a fireman's pole and an escalator when it comes to the dynamics of the musculoskeletal system. That comment is not intended as an insult; it is an hypothesis set forth to stimulate your curiosity. I am attaching hereto three items that might pique your curiosity about the basis for my challenge to your health care knowledge regarding 60 percent of the body systems:
- An article in JAMA written by the famed medical educator, Dr. John C. Wilson, M.D., regarding the lack of training and the lack of vision ("prejudice") of medical physicians regarding low back pain.
- Sworn testimony of Dr. John McMillan Mennell, M.D., who taught in eight American medical schools from 1950 to 1980. Dr. Mennell states under oath that the medical doctors encountered at the residency level of medical education had only approximately one to four clock hours of education in the musculoskeletal systems.
- An illustrative letter from Dr. Gary Gerard, M.D., a neurologist and professor of medicine at the Medical College of Ohio, regarding the effects of an upper cervical adjustment by a chiropractor.
Your "scare" article regarding the possible injuries that people might suffer from the use of chiropractors borders on bizarre since it totally lacks balance. Again, you attempt to obtain support for your uninformed assaults by referring to an unnamed former president of the ACA. Please name that former president so that the cleansing effect of debate (possibly involving the former president) might clarify the "scare" tactics used in your article.
You clearly represent a competitive profession to that of chiropractic. Your readers are prejudiced by your lack of knowledge, your lack of perspective, and your lack of balance. Since I choose to attribute altruistic motives to you, I am also enclosing an open letter that I wrote to two notorious chiropractic bashers requesting that they too bring balance to their commentaries. You may have already seen the essay, authored by me, that was reprinted in the January 13, 1992 issue of the American Medical News. Please read it if you have not already done so.
Dr. Gott, so that you will not think that the profession is beset by paranoia in its fundamental suspicion regarding columns such as yours, I enclose Exhibit 1407A from the Wilk et al., vs. AMA et al., lawsuit. It involves a columnist with a far greater audience than yours. I do not wish to open old wounds, nor do I want to continue to look under rocks and in dark caves for the source of what appears to be a sudden outburst of anti-chiropractic comments from competitive medical physicians. For that reason, I will not further describe the enclosed exhibit. I ask that you privately review it and see if the chiropractors' suspicions (the enclosed exhibit is only illustrative of numerous ones like it) might be justified.
Again, Dr. Gott, the American Chiropractic Association does not "hiss" (the disparaging description used in your article). It tries to stick to fact -- not fancy. Add balance and rational thought to your columns regarding the emerging profession of chiropractic. The decades of illegal boycott by your medical physician colleagues did damage to the chiropractic profession and to the public. Don't continue that pressure. It hurts real people -- patients of both medical physicians and chiropractic physicians. The chiropractic profession clearly helps people -- the extent of that help is now being actively researched and the research results to date are impressive.
Don't place yourself on the side of those who imprisoned Galileo. Open up your perspective -- don't be such a "homer" when you comment on professions that clearly have more skills than your own regarding certain afflictions of the human species.
The American Chiropractic Association would appreciate an opportunity to meet with you, at your convenience, to help bring factual balance to your articles. You occupy too sensitive a position to allow distorted, competitive, uninformed bias to influence your columns.
Finally, Dr. Gott, they caution individuals not to pick fights with those who buy printer's ink by the barrel. The ACA does not want to pick any fights -- it merely wants the debate and dialogue to be both fair and balanced.
George P. McAndrews, Esq.
Chicago, Illinois
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