Bad Advice

Not so long ago, my office manager asked me to take a phone call.  Someone was asking if we do a certain technique. This was not an uncommon scenario — people call all the time wanting to know if we can do what their doctor in Peoria did.  Many times we can, sometimes we don’t but it never hurts to ask.

This particular person was asking about a chiropractic technique my assistant had not heard of so she punted it to me. My feeling, and the research generally agrees, that most chiropractic techniques get you to the same place.  The old-timers used to say it didn’t matter if you took a bus, car or train — they all get you to about the same place eventually. So, whether someone adjusts your spine with the push of a hand or the thump of an instrument, whether the table moves with the adjustment or lights up like a winning slot machine, most chiropractic techniques can eventually help patients in pain.

However…the techique this person was asking about is, well, bull. Plain and simple. If you saw it done, you would laugh your ass off.  Seriously. Right off. Gone. It’s disproven, silly and so far from the realm of scientific reality it would make Stephen Barrett squeal like a little girl. Of course I took the call.

“Hello Ma’am. Yes, I heard that’s what you were looking for. Oh, I’ve heard of it alright. Oh boy. Well, you do know there is absolutely no scientific evidence supporting that technique, right? No, none. It’s garbage. Huh? Right, so you know it’s a complete waste of your time and money? Okay, well I certainly don’t use that procedure in my office and I really don’t respect anyone who does. I couldn’t possibly. Why?!? Because they are basically criminals; lying to patients and tricking them with pseudoscientific jargon and useless tests that are light years beyond ridiculous.  In fact, anyone who uses that technique would have to be the worst chiropractor in town. What’s that now? Really? You’re kidding me?”

“Ma’am, are you actually asking me to refer you to the crappiest, most dishonest, clinically incompetent doctor I know? Please hold for the number…”

And so it went. Clearly there was a huge disconnect between what this woman wanted to hear and what she needed to hear. I thought I was doing her a favor by smoking her beeline to quackville. Instead, she just wanted the information she wanted in the way she wanted it.

I have a friend who told me he stopped going to his primary care physician since she always gives the same advice.  He once went in for an ankle sprain and he swears she told him to diet and exercise.  He’s the same wiseguy who when she questioned how he was working on his type 2 diabetes, he responded “Positive thinking?”  The problem is that patients frequently don’t want to heed lifestyle changing advice even if that’s what they need to hear the most.

Recently, I was asked for advice on how someone could lower her cholesterol without medications. I told her to try a low-fat, whole foods, plant-based diet. She tried it — for one meal. Then she gave up, citing it as too difficult, and reverted right back to what she was already doing. Six months later she had her blood retested. Shocked! Shocked! that her cholesterol was even higher that it had previously been!  I was again asked for advice on how to lower this skyrocketing cholesterol.

“I am not going to answer this question since you already know my advice,” I said. “If you want some new advice, you really should be asking someone else.”
“Oh, not the vegan thing again,” she sighed, “I was hoping you would tell me something different.”
“Yeah,” I said, “but that is the absolute best advice I have for you. I can give you bad advice. Is that basically what you’d like? Some bad advice? Okay. You should be performing the Mexican Hat Dance during all lunar eclipses in months with a R in their names. That will shoot down those triglycerides like a cartoon anvil falling out of a helicopter. And while you’re at it, smear peanut butter between your toes every night before bed. That will ward off the evil aliens from the planet Cholesterak that inject cholesterol into your blood while you are sleeping.”

I can be chock full o’ bad advice.  Piece of cake. But it’s a metaphor, isn’t it? It’s always a freaking metaphor. I’m chock full of those too.  We know the answers to so many questions in our lives but choose to look the other way. Often, we have the solutions to our health problems but we simply do not want to hear the answers that will actually help. 

How about you? Are you just looking for the advice you want and ignoring what you need?

Is there something you haven’t heard lately?

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  1. July 1, 2010 at 5:53 pm

    Doc this reminds me so much of how most chiropractors think about their practice as well. It’s why you also see so many chiropractic consultants getting rich. Chiropractors are notorious for gravitating to that which they are most comfortable and not doing the other things that are necessary to run a successful practice.

    Most consultants are getting rich by telling chiropractors exactly what they want to hear…you don’t need to do that…just simply do this…no need to invest any money on that…you can use this and get exactly the same thing…you don’t need to put any effort into that…it can be done for you without any work….I’ll show you exactly what to do and the rest will take care of itself! It’s a shame so much of this is B.S.

    But most chiropractors know better, but what do they do? They invest in something knowing full well that it’s a long shot and they beat themselves up when things don’t work out especially when their coach or consultant blames the doctor for it not working.

    Kind of how many chiropractors place blame on a patient for not producing certain results that were promised because they didn’t do what the doctor told them. What’s easy to do is also easy not to do. I’m all about underpromising and overdelivering. My clients get that from me and appreciate it. I’m also not afraid to tell someone exactly as it is, but tactful with my communication. The words we choose to use, the speed and tone in which we communicate those words is the difference between opening up someone to do that which is necessary to impact their life, health or practice or creating a barrier that can subconciously sabotage all the same.

  2. July 1, 2010 at 9:11 pm

    Looks like you’re master of analogies today. Good comparison. Thanks for your thoughts.

  3. John said,

    July 11, 2010 at 8:43 am

    I am sure you have been waiting for this but what “Technique” was it that they asked for?

    If the patient asked simply if you do it and you go off on a skeptics mission did you help the patient? Was she benefiting from this before? Did you ask if it had helped her and what condition she was dealing with? Maybe if something emotional that it was helping with and she liked it or pain caused from stress and this tech relieved stress. I am sure the chiropractor would be competent enough to refer is she was not getting better or thought something else was going on.

    Also, are you licensed in the sate to tell patients what techniques are good to use and which ones are bad. Unless it was a technique that has truly been classified as fraud by the FDA or state of your practice I would be cautious of a board violation.

  4. July 11, 2010 at 10:29 am

    I would love to see the NYS board hit me with a violation for telling a patient that a placebo was a placebo! Awesome comment, Doc!

  5. chiromed06 said,

    August 11, 2010 at 10:45 pm

    Thanks for these brilliant insights.


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