October 29, 2008 at 1:34 pm (ACA, Chiropractic Legislation, Current Events, Website Recommendations)
Tags: american chiropractic association, chiropractic, chiropractors, new york chiropractor, rochester chiropractor
I have just been informed that New York State chiropractors are about to lose something very important. If we do not reach the threshold of 500 members of the American Chiropractic Association by the close of business 10/31/08 NYS will lose a delegate. This would be more than unfortunate.
I believe in a few things in this world. I believe there is a general intelligence to the universe with the exception of certain parts of some states. I believe that personal freedom is usually better than it’s opposite. I believe it is easier to tell the truth than to remember a bunch of lies. And I believe in supporting my state and national chiropractic associations.
The ACA is the only real voice we have as a profession that serves the national forum and we need to support it. Five hundred members in NY is pathetic…falling below that mark is ridiculous. You may not always agree with your national organization but it is the only way we have to protect our rights in this country for the chiropractic profession.
You need to take action on this…..NOW!
If you are a chiropractor who practices in New York, please go to the ACA website http://www.aca.org
Click on Member Center and click on join ACA.
Thank you for being part of the solution, not the problem.
If you have comments about the ACA or other chiropractic associations, I would love to hear them.
Dr. Brett L. Kinsler is a member of the American Chiropractic Association and the New York State Chiropractic Association among other Associations.
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October 27, 2008 at 7:29 pm (Chiropractic Legislation, Current Events)
Tags: cato institute, chiropractic licensure, healthcare, medical licensing, states rights
I hate when I miss the policy studies from the Cato Institute. Did you miss it too? The one about medical licensing? See, in the United States, the authority to regulate medical professionals lies with the states. To practice within a state, doctors must obtain a license from that state’s government. State statutes dictate standards for licensing and disciplining medical professionals. They also list tasks clinicians are allowed to perform. This goes for chiropractors as well. I would dare say that the scope of practice for chiropractors from one state to the next can be dramatically different. A fact that caused one of my MD friends to exclaim that the human body doesn’t change when it crosses state lines.
The Cato Institute argues that state licensure not only fails to protect consumers from incompetent physicians, but, by raising barriers to entry, makes health care more expensive and less accessible. Institutional oversight and a sophisticated network of private accrediting and certification organizations, all motivated by the need to protect reputations and avoid legal liability, offer whatever consumer protections exist today.
Consumers would benefit if states to eliminate professional licensing in medicine and leave education, credentialing, and scope-of-practice decisions entirely to the private sector and the courts.
Good call, Cato! This is not a desire to reduce state’s rights but rather to standardize a system that would benefit all by being more nationally homogeneous. Let medicine police itself….and remind me to send a box of chocolates to the Cato Institute, I think they could use break.
Dr. Brett Kinsler is a chiropractor in Rochester, NY but his skills are the same when he crosses state lines. His office website is www.rochesterchiro.com
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October 24, 2008 at 9:58 pm (Current Events, Medical Ethics, Patient Information, Patient Resources)
Tags: chiropractic, Evidence Based Medicine, Medical Ethics, placebo effect, rochester chiropractor, scams
A person critical of chiropractic recently told me he believed the only reason chiropractic showed any effectiveness was entirely placebo effect. He was wrong. I’m not getting into that in this article. However, it looks like he could have made a similar statement about many medical practices and not been too far off the mark.
It turns out, according to a recent study published in the British Medical Journal (BMJ), almost half of U.S. medical doctors use placebos with their patients.
If your doctor has prescribed antibiotics for the flu or told you to try B-12 vitamins for fatigue, those treatments were just a placebo — an unproven therapy offered with the hope you would feel better if you took something…anything.
Treatment with placebos is far more common than you might think, according to the national survey about 58 percent of U.S. physicians admitted using placebos regularly. Only 5 percent said they tell patients explicitly that they are doing so. The survey was sent to 1,200 internists and rheumatologists with a response rate of about half of them.
Classic examples of placebos are sugar pills, saline injections and other treatments that seem to inspire confidence even though they are inert. But the physicians surveyed were far more likely to use active agents as placebos, including over-the-counter painkillers, vitamins, sedatives and antibiotics. What classified them as placebos was the context. If the recommended treatment hasn’t been shown, physiologically, to work for the condition in question, then it was a placebo.
Two years ago, the American Medical Association said it was wrong to use placebos without a person’s knowledge. But some make a case for what they call “benevolent deception” — letting a patient believe she’s getting a useful treatment because, paradoxically, it might work. I think that when placebos involve medications like antibiotics and sedatives there is a line that has been crossed. Furthermore, when the AMA code of Ethics states that “a physician shall … be honest in all professional interactions” I don’t see the wiggle room in there to tell Mrs. Smith that the garlic tablets you gave her will have a chance at curing her cancer.
So what’s to be done with patients who insist on a prescription for something they don’t need? I say, educate them, don’t lie to them. Tell them why they don’t need an antibiotic, give them a lollipop and send them home.
What do you think?
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October 22, 2008 at 10:53 pm (Evidence Informed Chiropractic, West Hartford Group)
Tags: chiropractic, EBM, Evidence Informed Chiropractic, think tank, West Hartford Group, WHG
Alright. There, I’ve said it. I’ve let the cat out of the bag. Some of you may already know about the West Hartford Group (WHG). Some of you may have just heard a rumor that it exists. Some people knew something was abuzz in the chiropractic profession but didn’t exactly know what it was. For the past couple of years, we weren’t allowed to talk about it.
Well, now I can tell you.
The West Hartford Group is a chiropractic think tank. It is a non-profit, non-political group formed to take strong stances on issues that our national and state chiropractic associations are unwilling to tackle. It has been kept quiet until recently though membership continues to be only by nomination. The goal of the WHG, essentially, is to advance the chiropractic profession in a responsible, patient-centered, evidence-informed way to create meaningful reform. Membership includes some of the best minds and researchers in our profession today. People on the cutting edge of integrative practice and non-surgical spine care. People who are responsible for many of the positive articles that are published and research that has been generated.
As the WHG becomes more public, much of what has been going on behind the scenes will become more apparant. There is some exciting stuff coming down the pike and I cannot wait! There’s lots I still can’t talk about but I will try to give you the scoop when I can.
The chiropractic profession is ready for a huge change and as a recently elected member of the board of directors, I am thrilled to be a part of driving this change! Got questions? Comments? Need to be a part of the change you know is coming? Let me know! Make your comments below or drop me a line at blog@rochesterchiro.com
Dr. Brett Kinsler is on the board of directors of the West Hartford Group, an international Chiropractic Think Tank.
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October 11, 2008 at 10:18 pm (Alternative Medicine Products, Evidence Informed Chiropractic, Patient Information, Patient Resources, Website Recommendations)
Tags: Alternative Medicine, myth, nasal spray, neti pot, rochester chiropractor, saline, sinus, skeptic, snot
Oh, thank you U.S. researchers, for your cleverness and sense of humor. Thank you for having the courage to shoot salt water up the noses of 121 adults with chronic nasal and sinus symptoms (stuffiness, congestion, or thick/ discolored nasal discharge). Thanks for referring to part of the procedure as a large volume nasal irrigation flowed into the nostril and drained out the mouth. Well, maybe not so many thanks for that as I am actually choking in the back of my throat a little just thinking about a large volume of anything being instilled into my nostril and drained out my mouth. Echh.
The patients in this study were evaluated using a previously validated instrument, a 20-item Sino-Nasal Outcome Test. Yes, this tool is called…are you ready…the SNOT-20. (Thanks for, without a doubt, my favorite named clinical measurement tool to date). Interestingly, this study showed SNOT scores improved approximately twice as much on average in the irrigation group versus the group that just had regular old saline spray. There were significant changes at both 4 and 8 weeks.
Bottom line: Nasal irrigation using a stream of normal saline, is more effective in decreasing general nasal or sinus symptoms than saline spray. The saline can be made at home, purchased as a kit, or administered using a neti pot (online videos in places like YouTube will have demos of this).
I know you’re excited but I feel it is my duty to warn you not to go randomly shooting large volumes of liquid up your nose and out your mouth at home without at least doing a smidge of research first.
Source: Arch Otolaryngol Head Neck Surg. 2007 Nov;133(11):1115-20
Dr. Brett Kinsler writes RochesterChiro, the skeptical chiropractor in Rochester, NY.
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October 4, 2008 at 12:11 pm (Alternative Medicine Products, Evidence Informed Chiropractic, Patient Information, Patient Resources)
Tags: chattanooga, Chiropractors & Chiropractic, DTS, non-surgical spinal decompression, rochesterchiro, skeptic, Spinal Decompression
A lawyer relative used to have a sign in his office that read “Honest Lawyer – One Flight Up”. The oxymoronic possibilities of the phrase ’honest lawyer’ struck me at a young age. I would have thought, with all of the hyperbole and dogma attached to non-surgical spinal decompression therapy, finding an honest spinal decompression representative would prove to be equally difficult. Not so fast. This week I met Chris Peetros from the Chattanooga Group.
I am not writing to endorse any product or company and my readers know that I will not hesitate to call someone on their bullcrap when I see it. That is why it was so refreshing to hear Mr. Peetros discuss the line of spinal decompression devices from Chatt. I asked him numerous questions about research and superiority and each time, he answered with honesty. There was no exaggeration, no dogma, no suggestions on how to squeeze more money out of patients. Here were some take home points:
(1) Chiropractors are getting ripped off by spinal decompression companies. In many cases, doctors are spending two to ten times more than a product is worth.
(2) Chiropractors in turn upcharge their patients in order to pay off these ridiculously overpriced machines.
(3) Spinal decompression is a result, not a procedure. These machines are mechanical traction guided by a computer for accuracy and repeatability. There is nothing magical, mystical or truly new about this therapy.
(4) Non-surgical spinal decompression is traction. Period. It is mechanical muscle and ligament stretching in the axial plane.
(5) There is no proof of superiority for spinal decompression to flexion-distraction or any other means of traction but some patients tolerate it better and with an acute patient, it might be easier to start slowly with a computerized traction device. Many traditional traction devices do not have the same control of depth and rate.
None of this is news. None of this is groundbreaking. All of it was honest and was spoken by someone whose company sells these units. The difference from what I can see is that Chattanooga sells theirs for a much more fair price (around 10k) and without all the hype and claims of the other companies.
Am I buying one? Probably not yet. I am still not convinced that I cannot achieve the same results and with better control manually. Most of our patients do extremely well without spinal decompression so I am not sure where the advantage would be. However, I have now located a device that I would consider using should the research so sway me.
Got an opinion or comment? Do you have any experience with these tables? I’d love to hear it.
Dr. Brett Kinsler is RochesterChiro, a skeptical chiropractor in Rochester, NY. www.RochesterChiro.com
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