The state of South Dakota has a peculiar law regarding chiropractic in that chiropractors are prohibited from being employed by corporations. In other words, a chiropractor can only work for himself or another chiropractor. They cannot work as an employee of a hospital, multidisciplinary clinic, or in an on-site clinic. After difficulty posting to the SDCA list-serve (since resolved), I wanted to publish this here as an alternate means of sharing my opinion.Read More
I've long had concerns with conflict of interest in medicine. It was a small factor directing me to chiropractic - this common complaint that medical doctors are in the pockets of the pharmaceutical companies, that they get treated to expensive dinners and luxurious weekend getaways for prioritizing a particular drug, or even prescribing it when not medically necessary.
The great secret is that chiropractors are just as subject to conflict of interest – perhaps to a lesser degree, or at least slightly lower earning potential.Read More
I'm applying to the chiropractic clerkship in the Tacoma, Washington Veteran's Affairs hospital. While writing my letter of intent, I was trying to think of how I, as the son of a Quaker-pacifist and grandson of a conscientious objector, have any connection to veterans of the military.Read More
This quarter I'm in a pediatrics class. I chose autism spectrum disorder for our written research project. Autism is controversial, especially with respects to the alternative medicine therapies. Many chiropractors, nutritionists, and medical doctors make fantastic claims about what can treat autism. I have been curious to know more about the research behind these claims and was glad to finally have a legitimate excuse to really read the journal articles more deeply. I wrote it pretty quickly (so it isn't as polished as I'd like) and I had to limit it to 4-5 pages even though there are many more topics I wanted to discuss. Here's the final paper in blog form.Read More
Just like the book of love, the road to evidence-based medicine is long and boring. The following is an excerpt from an article on the use of black cohosh as a botanical treatment for menopause and dysmenorrhea. It illustrates the tedious process of coming to a reliable conclusion on not only whether a drug works, but exactly how much is necessary.
In clinical studies before 1996, the dose was […] equivalent to 48–140 mg of black cohosh extract per day. A recent clinical trial comparing two different dosages of Remifemin® (40 mg vs. 127 mg daily), for six months, in 116 women with menopausal complaints, found similar safety and efficacy profiles for both doses (Liske et al., 2002). Based upon the results of this trial, a recommended dose equivalent to 40 mg of black cohosh (dried root) daily is currently recommended (Liske, 1998).
There was an older movie/TV show in which two unexperienced thieves inadvertently kidnapped a young girl. She experienced an asthma attack during the ordeal, and one of the robbers decided to give her a sip of coffee, which calmed her down. I brought this up during my Wilderness First Responder training as we were discussing asthma, and my instructor who is an experienced EMT, was skeptical, suggesting that it would take more coffee than was practical to have an effect. I set out to see whether he was right.Read More
Dr. Christopher Kent, chiropractor and subluxation activist, recently wrote an interesting post about Science vs. Scientism. His basic thesis was that Scientism is the habit of accepting scientific evidence as the only way to understand the world, excluding philosophy, aesthetics, etc. I don't disagree with this premise, but his conclusion - that anyone who fails to accept subluxation or innate intelligence as a valid construct must be adhering to Scientism, not science - seems to be a misconstrual of the scientific process.
[W]e cannot measure innate intelligence. Does this mean that it is not “real” and that we should abandon the concept merely because we have no technology to detect or quantitate it? I think not.
Straw man. Or red herring, I can't remember which.
Scientists do not suggest that we should abandon concepts merely because we don't yet have the technology for it, but rather that we should not blindly accept these hypotheses until we have evidence to support them. Kent mentions previously unproven concepts such as DNA and viruses, suggesting that we never would have benefited from understanding these ideas if it weren't for an open mind accepting ideas outside of what science can quantify. That isn't how science works, as I understand it. We would not have DNA technology if it weren't for the scientific process which has since substantiated it, not because of an acceptance of unproven hypotheses. DNA was accepted as the container of the code of life since Miescher first identified it in the 1860s long before it's structure was discovered circa 1953. But, read Watson's account of him and Crick stumbling upon The Double Helix and you clearly see that the process was one full of struggle, push-back, and incredulity among colleagues. Slowly the scientific community came to agree upon the structure we now accept – but only once the evidence was sufficient.
The concepts of subluxation and innate intelligence have been around for well over 100 years. There has yet to be convincing evidence of its validity as a construct other than anecdotal evidence which may or may not be explained by other well understood mechanisms.
Kent's argument that "doctors must not lose sight of the fact that science may not be the only valid method of inquiry" is accurate but not complete, because science is still the best method of inquiry.
As Carl Sagan shared in Demon Haunted World:
The difference between physics and metaphysics […] is not that the practitioners of one are smarter than the practitioners of the other. The difference is that the metaphysicist has no laboratory.
And so it is with chiropractic. The study of subluxation cannot be conducted in a laboratory, so cannot be considered a science and therefore is not a valid comparison by which to call others out for scientism.