YouTube Video Promo for the On The Other Hand Podcast

I keep being told that in order to maximize our exposure with the podcast, we need to also have some video. I produced this video promo in order to let more people know about the project in which we help to uncover more scientific, ethical, intelligent people in chiropractic, alternative medicine and health care.

Edzard Ernst, CAM Critic, Talks with Dr. Brett Kinsler on Chiropractic and Bias

Book by Edzard Ernst complementary and alternative medicine

Professor Edzard Ernst, MD, PhD, FRCP, FRCP holds the Laing Chair in Complementary Medicine at the Peninsula Medical School, University of Exeter and is the Editor-in-Chief of two medical journals. He has also been seen as a major public opponent of chiropractic and alternative medicine. He has devoted most of his career to publishing articles that are critical of complementary and alternative medicine….an unbelievable number of papers. Like 1500 or so. He’s been especially critical of chiropractic and, in the opinion of many researchers, has glossed over important research and exaggerated results. To me, what’s most interesting about Ernst is that he claims objectivity and lack of agenda. This podcast asks some tough questions of Prof. Ernst.

You can get the podcast episode on iTunes by searching the podcast section for “On The Other Hand” or you can just click here.

Thanks to this episode’s sponsor: Audible.com, the audiobook company. Get a free audiobook download just by trying their service free for 14 days.

BMJ Writer Discovers Head Up Ass

photo of a kid on the beach with a clenched fist and the caption "I hate sandcastles."

John C. McLachlan is a professor of medical education who wrote an article in the British Medical Journal (BMJ 2010; 341:c6979) called “Integrative medicine and the point of credulity.”  McLachlan proposed that integrative medicine should not be used as a way of smuggling alternative practices into rational medicine by way of lowered standards of critical thinking. He worries that failure to detect an obvious hoax is not an encouraging sign.

The author, upon seeing a request for presenters at an integrative medicine conference in Jerusalem, submits a paper posing as an embryologist who discovered a new version of reflexology. He explains that he has identified a homunculus represented in the human body, over the area of the buttocks. The homunculus being inverted, such that the head is represented in the inferior position.  As with reflexology, the “map” responds to needling, as in acupuncture, and to gentle suction, such as cupping.

He stops short of telling the conference organizers he has discovered a system whereby the head is up the ass and responds to needles.  Funny, right?  Well, after submission of an abstract with some sciency sounding references, the proposal gets accepted for presentation.  The author declines to present and, instead, publishes the correspondence in the BMJ.

Now, I’m all for having a good laugh at the expense of wacko alternative medicine practices but my goal is clear — I want to help clean up the field in order to highlight the people who are actually doing some good, honest, logical research.  I actually have a problem with what Dr. McLachlan has done.  By poking fun from a distance and walking away without letting the conference organizers in on the joke, the author misses a huge opportunity to educate and possibly improve that which he criticizes. It would have been far better if he accepted a slot at the conference and awaited to see if people would point out the errors in his “research” or simply used the platform to show what bad science is.

The only thing that makes him not a 100 percent coward is that he published his story. Someone who asks difficult questions so that when you answer incorrectly you will learn is called a teacher.   To ask difficult questions and then tell your friends how stupid someone is without letting them in on where their error was is called by a different name entirely.

Remember Smith’s article about how parachutes aren’t evidence based? That one is funny and brilliantly illustrates its point. This article, while funny with its head-up-ones-ass ha ha I get it humor, is really only about as funny as watching your kids get their math homework wrong and, instead of helping them, you call all of your friends and laugh at your kids’ ignorance. Nothing was learned. Nothing was improved and we all feel a little bit sick for participating in the joke.

Yes, it was a hoax but science relies on some degree of honesty and trust.  It is impossible for one scientist to be at the apex of all fields and know all that is known from every discipline.  Isn’t that why we have specialists?  Could it be that the scientific committee accepted McLachlan’s proposal simply in order to learn whether or not this revolutionary discovery was plausible or bunk?  Unlikely, but possible.  Today, I would rather lend the benefit of the doubt to the conference organizers rather than the scientific playground bully.

 

Brett L. Kinsler is a chiropractor in Rochester, NY who writes the RochesterChiro blog and produces the podcast On The Other Hand.

 

Chiropractic and Stroke Podcast Interview Posted

The first real episode of the On The Other Hand podcast is now live.  In it, Dr. Stephen Perle discusses the topic of chiropractic and stroke with me.  You can get it through iTunes or from here. I’m interested to know what you think but for clarity I’m going to try to keep podcast comments on the podcast site or on iTunes.

Enjoy.

Our Podcast is Coming!

I just wanted to let you know that the podcast episodes are coming along nicely.  Today, I posted an introductory episode to make sure everything is working properly. It should be available in iTunes very soon.

The series is called On The Other Hand and it will contain interviews, commentaries and rants with responsible, scientific people in chiropractic, alternative medicine and healthcare.  Most of the interviews will stem from West Hartford Group members (the chiropractic think tank) but there are others as well from within and in other professions.

I’m just getting started so there will be a learning curve; I will have to play with the audio settings until it all sounds right, but hopefully it is something you will enjoy.

Episodes can be found at iTunes soon but will also be posted, along with show notes and links, at:  http://ontheotherhand.podbean.com/

So far, only the test episode is there but I do have complete episodes on their way!  Let me know what you think and please vote for me on iTunes to ensure rational, scientific information predominates when someone searches for “chiropractic podcasts.”

Dr. Brett L. Kinsler is a fulltime chiropractor, a sometime blogger and a first time podcaster.

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Contract To Be Fooled

A few days ago, my ten year old forwarded an email to me containing one of those modern electronic chain letters. You know the sort: enter your favorite color, your pet’s name and the month you were born, forward it to 20 people and something magical will happen. Not wanting to miss a skeptical teaching moment, I replied to my daughter’s email asking if she thought there was any truth to this exercise. No, she wrote back, but it’s fun. Smart girl.

I recently wasted ninety minutes of my life watching a movie with no positive qualities whatsoever. Of course, my kids quickly declared it the second funniest movie ever. It was edged out by a YouTube video involving a cat and a magic marker. Well, the movie wasn’t entirely without merit. There was one of those scenes shot on a roller coaster from the perspective of a rider. The dips, the turns, the twists. I love those! Is it real? Of course not. But it’s fun.

But while enduring the mind numbing remainder of my kids’ second funniest film, that roller coaster scene got me thinking. Scenes like that in movies are fun because we have given our permission to be fooled. And simply by doing so, we can experience physiological effects like feeling our stomach drop and our bodies shift to balance on the turns of the coaster track.

Allowing our minds to be tricked can be entertaining and provide a physical manifestation. Just remember that you are doing it in fun. When you get carried away and believe the deception, there are problems.

Brett L. Kinsler, DC is a skeptical chiropractor in Rochester.

I’m With The Band

** SPOILER ALERT **

If you use Power Balance Bands and don’t want to know the truth behind them, do not read further. In fact, this warning goes if you use Power Bands, Balance Bands, Bionic Bands, Silly Bands or you’re just a singer in a rock and roll band. I don’t want to be blamed for bursting your balloon or adding strokes to your croquet game.

** SPOILER ALERT **

I have to tell you something.  I hate the expression I have to tell you something mainly because I know someone who says it all the time and it is usually something like “I’ve got to tell you, I like pens better than pencils” which may be entirely true but is not exactly the type information that was bursting to be brought forth. Had to tell me? HAD to? Okay. Anyhow, that’s not what I had  to tell you.

I do have to tell you that I am in something of a quandary. I have super secret information about Power Balance Bands that I want to tell you about but I am afraid it will be just too much for some people.  Like the fact that I am avoiding the whole Tooth Fairy conversation with my kids. I think it’ll be a bit much and it’s not really hurting them. Well, one kid I know who wanted a new video game and ripped a tooth out of her head so she could make a couple of extra dollars…she should probably be told about the Tooth Fairy and fast.  But I’m not doing it.  See, I’m not sure I want to be the one to lay this heavy news on people. Maybe they’re not ready to hear it. Maybe the Power Balance Strength Bands are giving them that perfect edge in their sport and anything that might spoil that edge isn’t worth it. Maybe I will single-handedly screw up the next world series or world cup or world wrestling federation cage match.

You’re probably thinking I’m going to tell you that these bands are worthless. That sticking a hologram on a piece of plastic and attaching that to your wrist couldn’t possibly affect athletic performance in any reproducible, measurable way. You’re thinking that the very idea that “Power Balance bands are designed to work with your body’s natural energy field” and “the hologram in Power Balance is designed to resonate with and respond to the natural energy field of the body” is downright silly.

And you’re thinking I’m going to tell you they don’t work.

You’re wrong. they do work.

Don’t misunderstand me, these plastic bracelets are the original silly band. They’re bullshit and there is nothing but junk hooey to back them up…along with a bunch of testimonials (insert your own joke about Ekolu Kalama famous stand up paddle surfer here).

But they do work.

How?

I asked my good friend, the world famous neurologist as seen on TV to explain in ten words or less how these plastic energy holographic bands work.

“Alex, I’ll take plastic placebos for 500.”

True. But placebos work.

Remember my post about placebos a while back? https://rochesterchiro.wordpress.com/2008/10/24/one-pill-makes-you-larger-and-one-pill-makes-you-lie/

We discussed the fact that placebos can be helpful to patients but there is no getting around act of lying. Well, the makers of Power Balance Bands are lying. They are telling people why the bands work using made up terms and junk pseudoscience instead of just telling people that they do work. The theory and pretend science is garbage and an embarrassment.

Here’s the bottom line: If you think these things will improve your athletic performance, your math skills or generally make you a better looking person, you are probably right.   But if you for one second believe that a 3-D picture like a hologram can balance out your energy fields, improve your strength or flexibility, or that Mylar material treated with energy waves at specific frequencies resonate and work with your body’s natural energy flow to help enable you to perform at the best of your ability, then please schedule some time with me because I think we need to have the Tooth Fairy conversation as well.

And remember, somewhere, someone has a warehouse full of copper bracelets all the athletes swore by ten years ago. If you are going to use one of those or the Power Bands, remember to wipe off the snake oil first. It interferes with the energy flow.

Dr. Brett L. Kinsler practices both chiropractic and skepticism in Rochester, NY.

Arrgh, Fake Number!

 song chart memes
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Do you remember that Seinfeld episode when Elaine admits to giving a fake telephone number to guys she meets but doesn’t want to date? The purpose, of course, is it allows her to avoid a confrontation either at the time of the initial meeting or on the phone later during which she would need to tell the prospective suitor she is not interested.  Instead of dealing with the real issue honestly and head on, she manufacturers a piece of false evidence so she can avoid dealing with the real problem.

The other day I received in the mail something that looked like a new chiropractic research journal. With a traditional medical journal type cover, there was no flash, no pictures, just a listing of the articles inside and their authors. The journal was entitled, “The Industry Compendium of Chiropractic Research” vol 56, no. 9.

Hell, I was impressed. How did I not hear that a new chiropractic journal was started, produced so slickly and mailed to chiropractors who hadn’t even paid for subscriptions? I have also been hearing how difficult and expensive it can be to keep a print journal afloat and how many medical journals are finding it necessary to move to electronic, on-line only versions.

Something wasn’t quite right.

The smaller print on the cover of this “journal” said, “Supplement to Chiropractic Economics,” a trade magazine known for glossy ads and fluffy articles. Everything changes once the Compendium is actually opened. Just about every article, some of which are lacking authors names, all of which are lacking statements of funding support, is followed by an advertisement for the very product discussed in the article.

A topical analgesic does well in a clinical trial, there follows an ad for that analgesic. Next, an article on the efficacy of a nutritional supplement followed by an ad for that nutritional supplement. In all, it was insulting that the word “research” was placed on the cover. Worse yet, there are a lot of people in chiropractic who will mistake this magazine for actual, high-quality research.

There is a significant body of research attributable to the chiropractic profession but there is much more that needs to be accomplished. Currently, there is a lack of financial resources and a shortage of qualified individuals necessary to carry forth the work. The fact that a trade publication, Chiropractic Economics, is interested in advancing the body of research within chiropractic is noble and welcomed. They could make a donation to private researchers, develop an award for research, support fellowships or one of a thousand other ways they could actually advance research within the profession. Like Elaine and her fake phone numbers, Chiro Eco’s fake journal avoids dealing with the problem head on and instead, they produced a fake research journal in the hopes of advancing their vendor’s agendas at the expense of intellectual honesty and impartiality.

Dr. Brett L. Kinsler is a chiropractor in Rochester, NY who had to look up the word compendium and finds it ludicrous it appears on the cover of this catalog.

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Yes Is The New No

There is a truth in science.  There is a right and a wrong answer even though we may not always find either one.  Science is not a belief system and scientists try to reject assumptions that cannot be tested in favor of facts.  It’s nothing personal.  There is just a difference in pedigree between science and faith.  Which is not to say I do not hold beliefs that I have not tested.  I do. 

For example, I believe you can catch more flies with honey than vinegar though I have never tried.  I also believe I don’t want to catch any flies. I also believe I don’t believe I want those little buzzy SOB’s barnstorming my ears.  But, having the vegan tendencies as I do, I believe I don’t want to kill the little buzzy SOB’s either.  Maybe vinegar is a better choice.  I don’t know.  At least I can feel like I am doing something without harming living things.

There was a point to this somewhere. Oh, yeah.  Negative attitudes. I’ve caught some flack lately for being a tad bit negative.  Moi? No! Okay, just a titch I suppose.  I admit I don’t usually play Susie Sunshine in the grade school play when I see the stupidity on the morning lineup that can be my profession — or healthcare in general for that matter.  I call it like I see it. I think that’s part of my job.  Calling it loud and obnoxiously is just a value-added service I offer.  As my wife likes to inform me, I might, occasionally, once in a while have a hard time not saying the exact thought that pops into my mind.  She says this like it’s a bad thing.

Like the other day in a restaurant.  The waiter asked my friend, “You wanna box for that?” indicating his three leftover tortellinis.  I said, “Really? You’re going to kick his ass over a couple of tortellinis? Dude, if you want them that badly, you should just take them.”

Maybe that’s what my wife means.  Anyway, I am told this negative attitude could be bad for the profession.  I get it.  I need to have a more positive outlook and focus on the positive stuff. I need to waive the cheerleader pom-poms and rah-rah the pants off the chiropractic profession! Go00000 team!

I’d like to.  I really would. There is a lot to be positive about. At least things are moving in that direction. I need to see more greatness but there is some really good stuff going on.  I am just not sure I am the right guy to applaud mediocrity and fake cheerfulness.  I don’t think that’s what I signed on for.  Last I checked, the door I walked through said “Truth”.  At least that’s what I thought it said.   Maybe it just said “Push”.  I saw it as the same thing.

 

Dr. Brett L. Kinsler is a chiropractor in Rochester, NY who is working on his negative attitude problem.

Kill a Subluxation

When I had a back injury that first brought me to a chiropractor, my father asked me what the injury was. I told him the doctor said I had an L3-L4 subluxation. No, my father explained, that was just some nonsense the chiropractor made up. What was the real problem? Oh, well it turned out to be a herniated disc — but that was my welcome into the world of chiropractic subluxation.

It may not surprise you to know that for as long as I have been writing this blog, even though there is no topic that is more inherently chiropractic as the subluxation, I have hesitated to address it. Seemingly so integrated into chiropractic history the concept to me is antiquated and unnecessary to modern, evidence informed practices. I have avoided discussing this hotbed of chiropractic silliness due to the lack of good that usually accompanies such a can-opening of any similar collection of worms.

Now, however, thanks to recent statements on the vertebral subluxation complex from the General Chiropractic Council in the UK and the British Chiropractic Association, I have selected to be silent no more. Instead, I have chosen to be paraphrasic. The statement from the General Chiropractic Council (GCC), appears here:

http://www.gcc-uk.org/files/page_file/guidance_on_claims_for_VSC_May_2010.pdf

There is much in there with which to agree and also with the BCA‘s positive reaction to it. I am borrowing heavily from both as I develop my own affirmation:

The chiropractic vertebral subluxation complex is a historical concept but it remains a theoretical model. It is not supported by any clinical research evidence that would allow claims to be made that it is the cause of disease or health concerns. This is not to say that chiropractic treatment is not effective and important — but it is not lifesaving. Subluxations are not fatal.

Chiropractors must make sure their own beliefs and values do not prejudice their patients’ care. Furthermore, chiropractors must provide evidence based care, which is clinical practice that incorporates the best available evidence from research, the preferences of the patient and the expertise of the practitioner.

Any advertised claims for chiropractic care need to be based only on the best research of the highest standard. Think this is a no-brainer for everyone? I suggest you see what Bill Esteb over at Patient Media thinks about using evidence in advertising (http://www.patientmedia.com/blog/2010/05/rct_and_the_cult_of_scientism.html) Hint: he thinks it’s stupid.

In light of the absence of supporting evidence I do not support the concept of the vertebral subluxation complex as the cause of disease and serious illness nor am I in favor of teaching vertebral subluxation complex theory to chiropractic students in any other context than historical and theoretical.

I fully support and encourage the inclusion of chiropractic into mainstream healthcare and know that in order to facilitate this integration we need to discard ambiguous terminology and unsubstianted historical concepts. We need to emphasize an evidence-based care model that is easily understood by the other members of the healthcare delivery team.

I feel that chiropractors should refrain from making any reference to vertebral subluxation complex in any media to which their patients or the general public may have access.

Chiropractors are the leaders in non-surgical spine care and there is strong evidence to support the inclusion of chiropractic in musculoskeletal healthcare initiatives. Chiropractors have been shown to possess specific expertise in the assessment, treatment and management of spinal and joint pain and are well-placed to deliver cost-effective services within mainstream healthcare. Let’s not mess it up by speaking another language that other healthcare professionals don’t understand while waving the lunatic flag of our now dead forefathers. There was a reason for the reliance on subluxation dogma in this profession. We needed to prove ourselves separate and distinct from medicine in courts of law. That time is passed. We’ve also given up on that whole flat Earth thing. Get over it and move on.

The GCC and BCA statements are the best thing we’ve gotten from England since Hugh Laurie and perhaps we should all strive to be a little more British.

Dr. Brett L. Kinsler is a skeptical chiropractor in Rochester, NY who is 1/4 British — but is now working on increasing that ratio.

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