In early June, we began receiving phone calls from DCs who had just seen "A Different Way to Heal," and were appalled by the information presented in the "Adjusting the Spine" segment. What they were objecting to was the commentary of a former chiropractor/acupuncturist who is now a pharmacist. John Badanes told host Alan Alda that chiropractic has no basis in anatomy; that vertebrae changing position is an anatomical impossibility.
The program went from bad to worse with the inclusion of commentary from Robert Baratz,MD,PhD,DDS, executive director of the National Council Against Health Fraud. Baratz express concern about injury to the vertebral artery from cervical manipulation, and cited "a recent Canadian study estimated that 20 percent of all strokes caused by artery damage could be a result of neck manipulation. That figure translates into more than 1,300 strokes a year in the United States."
The ACA was quick to send a rebuttal letter to Scientific American Frontiers, the Chedd-Angier production company, and Pat Mitchell, president and CEO of the Public Broadcasting Service. In the letter, ACA President Daryl Wills,DC, pointed to the program's critical flaw: "The program did not offer any of your pro-chiropractic guests an opportunity to rebut the foolish statements made by the NCAHF group and former doctor of chiropractic John Badanes. This would be the legal equivalent to a jury trial in which the plaintiff's attorney is the only counsel permitted to make a closing statement to the jury."
To refute Baratz' claim that "hundreds of people" are paralyzed each year from chiropractic neck manipulation, Dr. Wills referenced a study done by the RAND Corp.1 that found the likelihood of a serious adverse reaction from cervical manipulation to be one in one million treatments, and a more recent study in the Canadian Medical Association Journal that calculated the occurrence of vertebral artery dissection at 1-in-5.85-million neck adjustments.2
Dr. Wills also pointed to a study that asserted the misuse of medical literature by researchers in discussing spinal manipulative therapy injury.3
Dr. Wills expressed his disappointment that the PBS segment was not balanced by an ACA representative and a member of the scientific community to discuss chiropractic research.
Dr. Wills listed a number of studies4,5,6,7,8 that the program could have cited to present a balance and fair appraisal of chiropractic from the research community's perspective.
Dr. Wills suggested that the program would have been more informative if it had, for instance, included segments on the first two DCs to practice in the attending physician's office on Capitol Hill, or extolled the new chiropractic internship program at the Naval Medical Center in Bethesda, Maryland, or perhaps mentioned the Complementary and Alternative Medicine (CAM) Center at the National Institutes of Health.
In short, Dr. Wills labeled the PBS report "biased, misleading and malicious." He said the report "severely and wrongfully damaged the reputation of the chiropractic profession and chiropractic colleges," a sentiment echoed by many of our callers. (See "We Get Letters".)
Editor's note: A synopsis of the "Adjusting the Spine" is on the PBS website at www.pbs.org/saf/1210/segments/1210-3.htm. On that page are links to Drs. Baratz and Badanes for your email questions or comments.
References
- Hurwitz EL, Aker PD, Adams AH, Meeker WC, Shekelle PG. Manipulation and mobilization of the cervical spine. A systematic review of the literature. Spine 1996;21:1746-59.
- Haldeman S, Carey P, Townsend M, Papadopoulous C. Arterial dissection following cervical manipulation: a chiropractic experience. Canadian Medical Association Journal 2001;165(7):905-06.
- Terrett AGJ. Misuse of the literature by medical authors in discussing spinal manipulative therapy injury. Journal of Manipulative and Physiological Therapeutics 1995;18(4):203-210.
- Bigos S, Bowyer O, Braen G, et al. Acute Low Back Problems in Adults. Clinical Practice Guidelines No. 14 AHCPR Pubilcation No. 95-0642. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services. December 1994.
- Shekelle, et al. The appropriateness of spinal manipulation for low back pain: project overview and literature review. RAND, R-4025/1-CCR, 1991.
- McCrory DC, Penzlan DB, Hasselbad V, Gray RN. Evidence report: Behavioral and physical treatments for tension-type and cervicogenic headache. Des Moines, IA: Foundation for Chiropractic Education and Research, 2001.
- Manga P, Angus D, Papadopolous C, Swan W. A study to examine the effectiveness and cost-effectiveness of chiropractic management of low back pain. Kenilworth Publishing, Richmond Hill, Ontario, 1993.
- Meade T, Dyer S, Browne W, Townsend J, Frank A. Randomized comparison of chiropractic and hospital outpatient management for low back pain: results from an extended follow up. British Medical Journal 1995; 311:349-351.
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