Medical doctors as chiropractic patients

I saw a new patient this week in our chiropractic office in Rochester who is a medical professional. This is nothing novel as we have a lot of medical workers as patients. What was interesting however was this patient said she had asked her colleagues and none of them saw a chiropractor. Really? None of them? Surprising.

There was a time when the medical profession eschewed chiropractors but as the literature changed and (the better) chiropractors focused on science over superstition, those tables have turned. Still, when the occasional medical doctor or registered nurse questions the clinical veracity of what we do, I like to remind them of several important points:

First, these is no evidence of excess risk of vertebrobasilar artery (VBA) stroke from chiropractic care compared to medical treatment. None. This is not an opinion. We can point to the studies, back it up with research and factual evidence.

Second, recent studies show that patients with low back pain and neck pain do not add to overall medical spending seeing a chiropractor versus other types of medical care. This is based on a survey of 12,000 respondents. In fact, seeing a chiropractor results in a 20-40% decrease of costs in lower back pain compared to MD treatment.

Third, there are many clinical reviews of spinal manipulation for low back pain and it has been shown to be more effective in the short term for many cases and probably the most effective treatment for chronic low back pain patients.

Fourth, patients like seeing a chiropractor over most other health care treatments and isn’t having a compliant patient who is happy half the journey toward recovery?

I also remind my physician and medical worker patients that in our practice, we limit our focus to neuromusculoskeletal issues and treat with a biomechanical focus. That means no magic, no chanting, no candles. Just well evidenced, science based treatments that are worthy of their referrals.

The real question is why don’t more medical doctors, PAs and nurses refer appropriate patients to responsible chiropractors and see them for their own back and neck pain?

Dr. Brett Kinsler is a practicing chiropractor in Rochester, NY. Our practice is evidence based and spine focused.

 

 

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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.

Is Warren Hammer a Fasciaist?

Fascia is the newest focus in manual medicine. Those fibrous sheets that surround muscle are proving to be the link to all sorts of musculoskeletal problems. In this podcast episode, I interviewed one of the foremost experts on soft tissue manipulation who is bringing some groundbreaking techniques on fascial manipulation to the United States for the first time.

Excited about his recent work with well-known Italian physical therapist Luigi Stecco, Dr. Warren Hammer brings his 50 year experience in chiropractic and soft tissue procedures to his candid talk with me on our On The Other Hand podcast.

The episode can be found on iTunes or here.

Think you know all about chiropractors? Think again.

 

Interview published on the On The Other Hand podcast series by Rochester, NY chiropractor Dr. Brett L. Kinsler.

Hopsital Based Chiropractor Ian Paskowski on the Podcast!

Ian Paskowski, DC is the medical director of the medical spine care program at Jordan Hospital.  In this episode of On The Other Hand, he discusses delivering high quality spine care in a community based hospital and the future of this type of multi-disciplinary program.  He stresses that the program’s success hinges on patient centered care and in following the NCQA Back Pain Recognition Program guidelines as well as implementing best practices from the medical literature.  Practicing in an environment where medical specialties work together and chiropractors act in back pain triage has proven itself successful for Dr. Paskowski and his medical back pain program.

Find the podcast on iTunes or wherever fine evidence influenced podcasts are offered.  Direct link.

Podcast interview conducted by me, Dr. Brett L. Kinsler, skeptical Rochester chiropractor, blogger and one generally curious cat.

Podcast Episode: What Do Athletic Trainers and Physical Therapists Think About Chiropractors?

 

Timothy Mirtz, DC PhD from the University of South Dakota chatted with me about what athletic trainers and physical therapists think about chiropractors and what can be done to change the interprofessional relationships.

Find it on iTunes by searching for OnTheOtherHand or go here.

This is our first episode with our new sponsor. It’s very cool that a great business sees the value in our podcasts and wants to help us continue to make them.  I would appreciate if you would check out coldlasertherapy.us I’ve used them for years to buy all of my cold laser equipment. They have really fair prices and excellent customer service.  Complete cold laser setup with two pairs of safety goggles for under $1600.  For real!  Plus, listeners to the podcast get $50 off their order by using coupon code: PODCAST

Lowering the Chiropractic Doom and Gloom Meter

A colleague has a “meter” by which he predicts the current level of doom and gloom facing the chiropractic profession.  Whenever something untoward occurs, he bumps up the “meter” a bit. I think if the meter ever fully registers 100%, the entire profession will explode like the world’s largest bottle of Diet Coke enveloping the world’s biggest Mento.

I am pleased to report that the doom and gloom-o-meter can be reduced a titch. As of today, our podcast “On The Other Hand” has had over 1000 downloads in it’s first two weeks of existence!  There is proof that people are interested in hearing about evidence oriented chiropractic from a scientific perspective.

It’s either that or they want to hear if I sound weird pumped directly into their skull through ear buds.  I’m cool with whichever one it is.  Thanks for listening, downloading and subscribing.  If you are so inclined to rate the podcast and leave us a review on iTunes, that would also be great.

Brett L. Kinsler, DC is a Rochester chiropractor, blogger, podcaster and, with your help, is responsible for lowering the chiropractic doom and gloom meter just a little bit.

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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Arrgh, Fake Number!

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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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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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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.

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