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[See related article: Harvard Health Letter Responds to Chiropractic Pressure]

When it comes to innovation and change in providing healthcare, the history of medicine is unfortunately replete with examples of resistance to change and discarded therapies that often appear ludicrous, even at the risk of the patient's health.¹ Thus it is no surprise that resistance to chiropractic has been widespread, dating back to 1924 with Morris Fishbein's crusades against chiropractic as editor of The Journal of the American Medical Association.² More recently, it has reared its head in several gross distortions of accuracy in the media.^3-8

In pursuing its mission to provide accurate information regarding chiropractic healthcare, FCER has taken on the task of disseminating as well as supporting the research and postgraduate study as a means to insure that best healthcare practices are recognized. This has included the writing of timely rebuttals to both flawed scientific studies and distorted and misleading reports that have appeared in the media.

Recently, a promotional mailing from the Harvard Medical School contained a misleading and biased statement about chiropractic care. It declared:

“Did you know that about half the people who seek spinal manipulation from a chiropractor experience problems caused by the treatment?”⁹

FCER's Director of Research and Education contacted the editorial staff of the newsletter in October 2004 to challenge the accuracy of this statement, which was apparently drawn out of context from a study by Edzard Ernst. Upon closer examination, Ernst indicated that the “problems” referred to were decidedly minor as well as transient, with estimates of serious complications ranging from 1 per 2 million manipulations to 1 per 400,000.¹⁰ In his letter to Harvard, Dr. Rosner indicated that spinal manipulation has actually been shown to be 37,000-148,000 times safer than the use of NSAIDs, 55,000-444,000 times safer than lumbar disc herniation surgeries, and 7400-37,000 less likely to yield cauda equina syndrome than surgery.¹¹

In response to Dr. Rosner's actions, Ed Coburn, Publishing Director of Harvard Health Publications, said:

“The brief item that appeared in our promotional mailing, while not incorrect, provides too little context to rule out your interpretation. That was not our intent. But I understand your interpretation and I do not want to leave the possibility for confusion. I have asked that we replace this item in our future promotional mailings.”¹²

Ed Coburn also indicated he had received similar complaints from the American Chiropractic Association.

But Dr. Rosner pressed the issue further:

“I bring up his (Ernst's) quotation to demonstrate the magnitude with which your quotation has deviated from any basis in the literature and the seriousness of its nature. Any rational mind reading your quotation in its present form...would assume that chiropractic healthcare is fraught with problems and thus should be avoided. Consequently, exposure of this egregiously misleading information in such a highly visible and respected publication as yours has the potential to cause extensive and justifiable harm to the entire chiropractic profession as well as the public.

“Accordingly, it is my belief that a simple revision of your quotation in future publications without calling the reader's attention to the fact that the original version was in error is not a viable option.... I would be available for meeting on short notice and would be pleased to try to arrive at a solution that would no longer be suspected of bias or even malice.”¹³

The most recent indication that Dr. Rosner's efforts are bearing fruit is the following conciliatory message from Harvard Health Publications' Ed Coburn:

“Regarding the use in the promotional mailing, if you have a simple revision that you think would adequately address the problem, I welcome your suggestion. I believe the copy writer wants to remove the item entirely and replace it with more current information... Thanks again for your time and interest. I truly appreciate it and regret the truncated item that appeared in our mailing and the misrepresentation it could leave.”¹⁴

The retelling of this success story is simply to alert you of the constant vigilance that FCER is under to insure that accurate information regarding chiropractic healthcare reaches the doctor, the healthcare insurer, the media, and—most importantly—the patient. YOUR CONTINUED SUPPORT OF FCER IN THIS ENDEAVOR IS ESSENTIAL TO INSURING THAT DISTORTIONS SUCH AS THE PRECEDING ARE NOT ALLOWED TO HINDER THE PUBLIC’S ACCESS TO QUALITY HEALTHCARE—CHIROPRACTIC OR OTHERWISE.

References:

1. Hyman M. Paradigm shift: The end of “normal science” in medicine: Understanding function in nutrition, health, and disease. Alternative Therapies in Health and Medicine 2004; 10(5): 10-15; 90-94.

2. Wardell W. Chiropractic: History and Evolution of a New Profession. St. Louis, MO: Mosby Year-Book,1992, p. 82.

3. Brody J. When simple actions ravage arteries. New York Times, April 30, 2001.

4. Bill Carroll Show, CFRB 1010 radio, February 6, 2002, posted on the internet.

5. Evenson B. National Post, February 7, 2002.

6. Hamburg J, Medical Minute, WOR AM 710 radio, February 22, 2002.

7. Jaroff L. Back off, chiropractors! TIME.com, February 27, 2002.

8. A different way to heal. Episode of Scientific American Frontiers Public Broadcasting System telecast, June 4, 2002.

9. 26 Health Revelations You Need to Know Now, Harvard Medical School Newsletter, September 2004, Statement #17.

10. Stevinson C, Ernst E. Risks associated with spinal manipulation. American Journal of Medicine 2002; 112: 566-570.

11. Oliphant D. Safety of spinal manipulation in the treatment of lumbar disk herniations: A systematic review and risk assessment. Journal of Manipulative and Physiological Therapeutics 2004; 27(3): 197-210.

12. Coburn E. e-mail of December 10, 2004.

13. Rosner A. e-mail of December 17, 2004.

14. Coburn E. e-mail of January 3, 2005.

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