|
HOW TO CHOOSE A CHIROPRACTOR
(OR THE EIGHT WARNING SIGNS THAT MAY NEED A DIFFERENT CHIROPRACTOR)
My patients requested a list a pointers on how to find a good chiropractor when
they move and tips on how to inform their friends in cases when they suspect brainwashing.
1. Wellness or maintenance treatment. This is a good way for a
Chiropractor to make extra money, and a common reason many
medical doctors don't refer to chiropractors. There is no
scientific evidence that when you feel good chiropractic
treatment can prevent or maintain anything. If you feel good
and you chiropractor still wants to see you, get a second
opinion before continuing care.
2. Questionable diagnostics. If your chiropractor tests your
muscles and because they are weak diagnoses an internal
problem, he or she should refer you to an internist.
On the other hand, if you have weak muscles because you are out of shape,
a good Chiropractor will refer you to a therapist, a gym, or design a
strengthening program for you. If your muscles are weak due to a
serious disease, nerve problem, or serious structural problem your
DC should refer you for a second opinion with a neurologist or orthopedist.
Muscle testing alone should not be the reason your chiropractor wants
to continue to treat you if there is no pain.
3. Silly marketing gimmicks. Health fairs, swap meets, and
shopping malls often have chiropractors giving free spinal
examinations. There are a variety of gimmicks designed to
procure you as a patient. The most common one is a postural
analysis. If you have poor posture and no pain, a
chiropractor should not want to manipulate you, but instead
should design a workout or exercise program for you, or refer
you to a therapist or trainer for such a program.
4. Treating areas that don't hurt. When you receive treatment,
three things happen. You get better, you get worse, or you
stay the same. If you feel good, only two things can occur.
You either stay the same or you get worse. If you go to a
chiropractor with lower back pain, he or she should not
manipulate your neck unless you also have a neck problem.
There is no evidence that performing manipulation on a neck
can help your lower back or vice versa. If your chiropractor
insists on manipulating areas that don't hurt, get a second
opinion before continuing care.
5. Excessive supplementation. Chiropractors take many nutrition
classes in school. Beware of any chiropractor who says his or
her vitamins are the only ones that work. Beware of any
chiropractor who wants to sell you large amounts of
supplements without referring you to a retailer or health-
food store for comparable products at a considerably lower
cost.
6. Excessive x-rays. Beware of any chiropractor who uses x-rays
for any reason other than to rule out a fracture, dislocation
or bone disease. X-rays should only be taken if (1) you have
sustained a recent traumatic injury and are in considerable
pain and discomfort, or (2) a history and examination
indicate a possible bone disease such as arthritis. (3)You
have had long standing pain in an area that has not responded
or resolved with care. No person is perfectly symmetrical. No one's spine
is perfectly straight and balanced. If you have no pain and your chiropractor
wants to continue treatment because of what an x-ray shows, get a second
opinion before you continue care.
7. Excessive visits. When you get treated by a chiropractor,
you should feel better. It is not normal to be worse after
treatment. Depending on the nature and extent of your
problem, after a few visits you should notice considerable
improvement. A good way to measure is, after one to four
weeks, your pain should be reduced by 40-50%, depending
on how severe and how extensive your original problem was. Beware of
any chiropractor who recommends a 3, 6 or 12 month treatment plan
based on your first or second visit.
8. Unwillingness to work with other professionals. If you are
not getting relief, you should not have to ask for a
referral, your chiropractor should have already recommended
one for you.
A GOOD CHIROPRACTOR
A good chiropractor does everything he or she can to get you better as fast as
possible with as few treatments as necessary. A good chiropractor will give you
advice on how to avoid future problems without a costly maintenance treatment
plan. A good chiropractor will only x-ray when necessary and will not use
x-rays as a marketing tool to have you continue care. A good chiropractor
will give you sensible nutritional advice concerning supplementation and a
healthy diet without excessive pressure to purchase vitamins from the
chiropractor. A good chiropractor will have a strong working relationship
with allied professionals of all specialties, including family practice
physicians, orthopedists, neurologists, physiatrists, physical therapists,
athletic trainers and massage therapists.
The following letters are directed at Dr. G. Douglas Andersen's
"Food for Thought 2002: How to Choose a Chiropractor" in the January 28 issue.
This is the second issue we've included letters on this subject.
Space does not permit us to print all the letters on
Dr. Andersen's article, but these are representative.)
"I'm surprised DC printed it!"
Dear Editor,
Excellent article by Dr. Andersen, although I'm surprised DC printed it! I wish more
chiropractors took this viewpoint. After over two decades of practice,
I couldn't agree more!
Gary Polizzotto,DC
Atlanta, Georgia
"strongly personal opinionated mess"
Dear Editor,
That strongly personal opinionated mess should not have been approved for national
publication. Saying things like, "...there is no scientific evidence..." for this and for
that just opens the author up for "eating his words" when someone confronts him
with this or that study, which will eventually happen. Many DCs now do in-house
rehabilitation effectively and do not need to send patients with muscle weakness
due to disuse atrophy "out to a therapist or a gym." Motor paresis and/or sensory
paresthesia may be one of the few clinical signs in some neurological conditions.
With only a small percentage of the total nervous system capable of transmitting
primarily pain, yes, there can be cases where the area of pain is not the primary
area that requires conservative treat-ment. Most other points in his article sounded
reasonable. Please, editors, try to temper some of your "on-the-fringe"-type articles,
as some patients may end up reading these things and believing them as gospel!
S.W. Engen,DC
Kearney, Nebraska
Oppressed by the Mantra
Dear Editor,
It was right on and I am most thankful that others feel the same way I do. If I hear
one more DE guru chanting the mantra of what they like to call "principle-based" or
"subluxation-based" practice, I'll scream!
The trend in the profession for some is to try and convince us that symptoms mean
nothing, and that care must be based on when the doctor determines you're healthy.
Of course, this criterion is totally subjective and a mystery, usually based more on
the limits of insurance, rather than on true clinical presentation.
I decry the rationalization of "eternal" 3-2-1 plans, prepaid yearlong programs, and
so-called "subluxation-based" care that has become the cancer within our profession.
The article sets the record straight, and is very honest and forthright.
I am pretty sure (Dr. Andersen) will get some flack about it from the extreme
left of our profession, if they take the time to respond. Luckily for you, they will
quickly figure out that their abused and brainwashed patients are not likely to see
DC, so they're safe!
I would like your permission to download your article (unchanged) to my website,
which is under construction. I would like to provide a link where patients could
read this well-phrased advice.
Garth Aamodt,DC
Grand Rapids, Michigan
"Keep on swinging, Dr. Anderson"
Dear Editor,
Bravo to Dr. Andersen for stepping up to the plate and taking a swing at bad chiropractic!
Some of the pitches thrown by our colleagues should be "out of the park."
His "Eight Warning Signs that You May Need a New Chiropractor" were all
solid hits. My favorites were numbers one (wellness care), six (excessive x-rays)
and seven (excessive visits). We are now in an era requiring standards of care.
Each of his eight points highlights an area in which we have no backing, yet
continue to practice. I may have added more substance to point two
(questionable diagnostics). Certainly muscle testing falls into this category,
but so does static surface EMG, thermography, Activator and other "challenge" methods.
Keep on swinging, Dr. Andersen. You are a high-profile, well-respected chiropractor
who clearly values proof above superstition, belief systems, dogma and smoke
and mirrors. We need more of your kind on our team.
John McDaniel,DC
Mountain View, California
"...intra-professionally polarizing tripe..."
Dear Editor,
As a subluxation/posturally-based family chiropractor, I disagree with most of what
Dr. Andersen wrote. It is certainly Dr. Andersen's right to dispense pseudointellectual
bad advice to his own patients. However, I wonder why the editors at DC chose to
publish such intra-professionally polarizing tripe as a featured column, especially
in the absence of a juxtaposed "counterpoint" column.
Dissension has long existed in the chiropractic profession regarding the philosophy
and application of our discipline. I do not intend to waste time or space in an attempt
to change the views of Dr. Andersen or others of his ilk. However, a compelling case
can be made for posturally-based and radiographically-monitored chiropractic
intervention as a means to prevent degenerative processes and promote health
beyond pain relief. (Consider "Structural rehabilitation of the spine and posture:
rationale for treatment beyond the resolution of symptoms" by
Troyanovich, et al., January 1998 JMPT). Strong and well-referenced
arguments can be made in opposition to Dr. Andersen's limited vision of our
profession. It is pompous and intellectually dishonest for him to pretend otherwise.
Although Dr. Andersen's practice emphasis is obviously different from mine, I do
not assume him to be a bad doctor. And I do not begrudge Dr. Andersen his
personal opinions, despite how foolish they seem to me. Considering the DC
audience, though, his presentation of those opinions was arrogant and divisive.
Apparently, according to the column, chiropractors who differ with Dr. Andersen's
views are bad doctors with impure motives who brainwash their patients.
DC editorials have frequently (and rightly) pleaded for peaceful coexistence, cooperation,
and unity among the various factions within the chiropractic profession. Dr. Andersen's
egotistical column does not serve that goal. I urge you to exercise better editorial
discretion in the future.
R. Todd Shaver,DC,DICCP
Wilmington, North Carolina
"Well said, brother!"
Dear Editor,
"Well said, brother!" I only hope that more would sing the same tune. Get ready for
some less-than-favorable feedback! You left off the sham technologies so currently popular.
You might have to concede a little bit on number four, i.e., an upper cervical adjust has
been proven to relax specific muscles in all four limbs, and restoration of joint play should
in most cases be beneficial. Yet the message is still brave and more accurate than most.
Nice - very nice.
Mack King,DC
Cornelius, North Carolina
"...I feel sorry for this individual..."
Dear Editor:
I understand that there are differing opinions on chiropractic, its scope, and its philosophy.
Rather than get into a debate about these issues, I would like to make one comment.
Frankly, I was extremely disappointed and truly concerned. Basically, his mantra was,
"If a patient doesn't hurt, he or she has no need for a chiropractor." I can't believe that
he doesn't check his children for subluxation (assuming he has children)! I can't fathom
that all chiropractors aren't checking their spouses and offspring, at least periodically,
for subluxation, whether they hurt or not! I can't believe that a competent chiropractor
wouldn't check the entire spine for subluxation, even if the patient's chief complaint
is low back pain. Isn't that just "chiropractic 101?"
On a personal note, I really feel sorry for this individual and his understanding of
chiropractic and subluxation. Whatever else he wants to add to chiropractic is up
to him and his state laws, but to take away the very core of what chiropractic stands
for seems unconscionable.
George Auger,DC
Greenville, South Carolina
"...one of the best ever read!"
Dear Editor,
"Food for Thought 2002" was one of the best I've ever read! You've captured everything I
believe in and value about our profession. I'm glad to see that I'm not the only one out
there that promotes your eight warning signs.
I would like your permission and doctor Andersen's permission to use the article for
promotion in the Phoenix, Arizona area. No part of the article would be altered in any
way. I'd like to get the word out there!
David Shipitofsky,DC
Scottsdale, Arizona
"Someone pinch me"
Dear Editor,
I simply cannot believe that someone as esteemed as Dr. Andersen would write an
article as thoughtless and full of holes. I'm still re-reading it to ascertain an
"April Fools' Day" statement hidden somewhere. Someone pinch me, unless
I missed a few core chiropractic ideas.
1. Wellness or maintenance treatment.
What about the five phases of subluxation, or treating the cause, not the symptoms?
Or are we to judge our treatment protocol based solely upon the "S" in SOAP and ignore
the motor nerve impingement scenario entirely? I'm speechless!
2. Questionable diagnostics.
How would the patient "diagnose" weak muscles due to a serious disease? Are we
not neuromusculoskeletal specialists? As Dr. Andersen states, if the patient has a nerve
problem (such as carpal tunnel, lumbar nerve impingement or radiculitis), don't trust the
expert in front of you if he doesn't refer you out. And how does the untrained patient
determine that the DC is not utilizing motion palpation, Derifield leg checks,
orthopedic/neurologic tests, or just plain intelligence to ascertain the problem in
addition to the infamous "muscle testing"?
3. Silly marketing gimmicks.
Are you really falling for this? Oh, and by the way, if the tooth doesn't hurt, there's no
reason to see the dentist; he just needs his next Lexus payment.
4. Treating areas that don't hurt.
Do the "Lovett Brothers" ring a bell? How about the various conditions caused by an
atlas subluxation? Or are we to ignore 100-plus years of clinical research and refer
only to double blind studies? Are we to completely ignore a preteen with
obvious scoliosis, "waiting in the wings," until the patient admits he or she hurts?
5. Excessive visits.
Dr. Andersen, you've never had an arthritic exacerbation then, have you? There are four
components of acute inflammation: pain, swelling, redness and heat. If you have an
acutely inflamed joint (your only criteria for seeing a chiropractor), when you direct
a high-velocity, low-force thrust into a zygapophyseal joint
(that's called "giving an adjustment") you run a considerable risk of exacerbating
inflamed tissue. How can you possibly stand behind your statement, "It is not
normal to feel worse after treatment"? Oh wait - you don't. Please refer
to item # 4: "When you receive treatment, three things happen: You get
better, you get worse, or you stay the same."
It appears Dr. Andersen didn't think through his article for this edition, however,
it obviously wasn't proofread by any other practicing chiropractor either. He revisits
the valid point about working with other physician specialists frequently, but
bombs on the rest.
I am embarrassed by this article, and sincerely hope that my patients don't read it. I look
forward to a rewritten article that patients can use.
Bryan Born,BS,DC
Southfield, Michigan
Beware!
Dear Editor,
Your article is refreshing and accurate. Thanks for providing a voice of reason that our
profession desperately needs. Only when our profession eliminates these questionable
practices will we earn the respect that we deserve from the public and the medical
community.
I would like to add warning sign number nine: Beware of chiropractors who want you to
pay large sums of money up front, give you discounts if you do pay up front, and
aggressively encourage you to charge up your credit cards or borrow from relatives
to pay for the treatment plans they have recommended.
Well done.
Jeffrey Schneider,DC
Camp Pendleton Naval Hospital
Oceanside, California
Top
(Editor's note: "Food for Thought 2002: How to Choose a Chiropractor," by
Dr. G. Douglas Andersen in the January 28 issue had our phones ringing more than
usual. Many DCs were upset by his comments; some thought we should not have
printed it. Others felt Dr. Andersen's comments needed to be said. Here are some of your thoughts.)
"Dropped Ball"
Dear Editor:
Luckily, I had been warned about this article prior to reading it. Some of this appears to
be similar to websites such as the Quackwatch, NAHCF or the NACM websites. I've
seen them all too often. But at least I know how to respond to those statements, so I'll
take them one-by-one.
1. His comments on wellness or maintenance care are very common with
anti-chiropratic enthusiasts. While there may be no "scientific" evidence at this time
that this is warranted, let's get serious! Do I feel well or in peak shape when I neglect
to get adjusted for months or even years? Of course not. I prefer to be adjusted either
monthly or twice per month (if symptom-free). It would be hypocritical if I tell my
patients to rely on overt symptoms before being adjusted if I don't. It's also common
sense to get adjusted without symptoms and on a regular basis (would I neglect
taking basic vitamins if I feel good?). This point should be tossed out.
2. The only test he talks about is muscle testing. This could be a good point with a few
other tests, but the muscle testing is almost a non-point, except for deducing
supplementation through them (in my opinion). I don't use many outside of basic muscle
strength testing, so I can't comment further.
3. If chiropractic had the status of medical doctors, we wouldn't have to do any of these
things, but we do and should not be ashamed to do so (health fairs, etc). Again, he
misses an opportunity to go after truly ridiculous marketing schemes and blows it with
"postural analysis" and thinks we should rely on exercise to correct this, as if every
scoliosis patient just needs to be exercised to be perfect
(where could that have come from?). Terrible point. Degenerative changes take a
long time to become symptomatic, so why wait? Should we eat junk food until
we have heart attacks to eat right? I guess he missed that
along the way.
4. The human body never stays the same. You get better or worse. While I don't treat
areas outside of symptoms unless requested (which happens more often than not), I would
hardly condemn anyone who does. As far as the neck not affecting the lower back, the
Pierce; Pettibon; upper-cervical-specific; golf certification program; etc. may have
something to say about that. It's not wholly true.
5. Finally, a good point made well. (Big applause.)
6. Yes, taking a minimum amount of x-rays is good. Guess how osteoarthritis occurs? It is
caused by subluxation over time with reactive bone remodeling. If suspected, definitely
take an x-ray. Most horror stories I hear are from a DC not taking an x-ray and adjusting
into a spondylolysis. How easy that could have been avoided with a lateral lumbar!
7. Yes, true, unless they are going through corrective care via spinal biophysics or
Pettibon, and they know they are not just going through a program to get out of pain
(which they will be - long before correction).
8. Yes.
All in all, I really expected a lot more from a DACBSP. I used to look up to them. This
article I would consider to be a "dropped ball." He misses a chance to give a
good evaluation of how to look for a good chiropractor, and doesn't deliver.
Glen Peterson,DC,CCSP
La Salle, Illinois
--------------------------------------------------------------------------------
(Here is a sampling of three emails sent to Dr. Andersen):
"Needed to be said"
Great article, but you are going to take a bit of *!$# for it. I applaud your stance, although
it probably would have been best to say the good stuff first. Nice job; needed to be said.
I come from a different position then most chiropractors. I am a staff physician in
a large (90) multispecialty practice of doctors in NJ. I believe that if more DCs were
to follow your advice, they also could be doing what I am doing.
James McDaid,DC
Summit, New Jersey
"Refreshing"
What a refreshing article. I think I will distribute copies to all my patients!
Tom Yankush,DC,FACO
Boardman, Ohio
"Would you mind my reproducing it?"
Good article, doc. Would you mind my reproducing it (crediting your authorship and DC)
for my patients and referring primary care medical/osteopathic physicians in the hospital
here at Scott Air Force Base?
David Ward,DC,DACBSP
375th Medical Group-SGCPC
Scott Air Force Base, Illinois
"The old chiropractic principle ... still works"
Dear Editor:
The article suggests that a "bad" chiropractor will continue to treat a patient when
symptoms are relieved. The author does not recognize the fact that symptoms are
the last thing to appear and the first to go away. The asymptomatic patient can
have underlying conditions, which is why the medical profession suggests
examinations and tests on people who "feel good" in order to detect conditions
they are unaware of. Relieving symptoms is a small part of correcting the conditions
that bring them to the office.
A "bad" chiropractor performs postural studies on people with no pain. I guess it's OK for
school nurses to check children for curvatures in the absence of pain, but not chiropractors.
Practically every chiropractic patient is a medical failure, in that he or she has to have been
to the family physician, orthopedist, neurologist, etc., who has said that because x-rays did
not show fractures, bone disease or dislocations, there is nothing wrong, or if there is a
thinning disc, the doctors recommend surgery or expensive prescriptions to kill the pain,
while the conditions get worse. And we are told to send these people back to the same
doctors who didn't help them in the first place!
The author left out the true test of a "bad" chiropractor: He's the one who uses words like "subluxation," "adjustment," and speaks of interference in nerve supply, or may even
mention "life-force." He may talk of correcting the basic underlying cause of the condition
that may be remote from the spine. Yes, the "bad" chiropractor may even have the audacity
to treat conditions other than back pain.
The old chiropractic principle of correcting subluxations to allow the body to restore itself to
health has worked for over 100 years, and guess what? It still works!
Arthur Kreiger,DC
Greenport, New York
"How to Pick a Chiropractor with a Weak Belief System"
Dear Editor:
Obviously, Dr. Douglas Andersen suffers from excessive letters following his DC degree.
I thank God that I didn't listen to a chiropractor using his guidelines when I ruptured two
discs in my neck. Two chiropractors that worked on me said I probably needed surgery
and suggested I see a neurosurgeon.
Fortunately, I found an elderly semi-retired chiropractor working out of his home who
believed he could help me, and adjusted me as much as three times a day initially.
(That's right - per day. There goes that treatment theory!) It took almost a month before
I could sleep lying down. It was almost four months before I was anywhere near feeling
normal. During that four months I went three times a week.
I was lucky to find a chiropractor that believed in the capabilities of his profession.
Since that time I have been more apt to treat patients for much longer periods of time;
especially those who have been to all the other "specialists." I have discovered absolute
reversals in declining health in patients, and believe strongly in the power of what we are
doing as chiropractors.
Dr. Andersen bases much of his treatment protocol in pain. I guess a patient whose leg
collapses while walking but doesn't after a spinal adjustment does not warrant care
because the person is not in pain. Poor muscle performance leads to injuries, bursitis,
tendinitis, and degeneration of joint space.
I guess if Dr. Andersen becomes a cardiologist, he'll tell his patients, "Since those
chest pains are gone, you're probably OK."
The title of his editorial should have been: "How to Pick a Chiropractor with a
Weak Belief System," or "How to Choose an Inept MD Wanna-Be."
J. Randall Short,DC
Newport News, Virginia
Food for Thought on Food for Thought
Dear Editor:
I would like to echo the sentiments of Dr. Andersen. It is refreshing to read a
voice of professionalism and reason. His stance, although regrettably
contested by many in our field, represents that component of our profession for
which I am proud to call colleagues. Frankly, I am embarrassed by the large
number of patients I have seen that seek second
opinions after experiencing outrageous sales tactics, or have been given
exceedingly bleak prognoses by chiropractors (unless they sign up for
expensive prepaid treatment plans).
A health care provider of any discipline should serve his or her patients
by encouraging and empowering them to practice a healthy lifestyle,
and not become dependant on any crutch,
be it protracted maintenance care or the overutilization of medication.
Scott Gilford,DC,CCSP
Poway, California
1001 E. Imperial Hwy.
Suite A-2, Brea, CA 92821
(714) 990-0824
Fax: (714) 256-0511
gdandersen@earthlink.net
www.andersenchiro.com
Copyright 2024, G. Douglas Andersen, DC, DACBSP, CCN
|
