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Significant issues and developments related to chiropractic.

 

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Chiropractic

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“Last Tuesday the Swedish Agency for Higher Education released a report regarding the education for chiropractors and naprapaths. Their conclusion is deeply concerning and unacceptable to Swedish chiropractors. If the recommendations in the report goes through, the chiropractic education and profession as we know it today will be removed with a stroke of the pen. In short, the group which made the recommendations propose that the Swedish government should make chiropractic a specialty of physiotherapy.” Øystein Ogre, European Chiropractors’ Union President (13th November 2010)

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The American Chiropractic Association has managed to persuade Kaiser Permanente Mid-Atlantic States and Mid-Atlantic Permanente Medical Group (Kaiser) to *suspend* its recent decision to exclude cervical Chiropractic Manipulative Treatment (CMT) from coverage, having claimed in a letter to Kaiser that there is a “large body of clinical research supporting the effectiveness and safety of cervical manipulation”. The ACA President, Rick McMichael, DC, has also claimed in a public statement that, if allowed to stand, the restriction would be “harmful to chiropractic patients and doctors”. Dynamic Chiropractic (11th November 2010)

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Legal clearance has been received for a class action lawsuit against the Life University College of Chiropractic in Marietta Georgia. The suit will be open to individuals who attended approximately between 1992-2001. If you attended Life University within or near this time period and notice the same deficit contact Allen Botnick DC at the given in the email below. An important cause of action will be breach of contract for failing to teach differential diagnosis in the core curriculum, a problem which has been verified by the CCE in an official US Department of Education investigation. Individuals will have to pay a reasonable retainer to participate. If you are a Life graduate from this time period or know someone who might be please contact Allen Botnick DC at aljbotnick @ yahoo dot com as soon as possible.  Chirotalk (30th September 2010)

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“A major HMO has taken a decisive action in support of science-based medicine. Kaiser Permanente Mid Atlantic States and Mid-Atlantic Permanente Group recently announced the elimination of neck manipulation from their chiropractic coverage. The revised policy states,

Given the paucity of data related to beneficial effects of chiropractic manipulation of the cervical spine and the real potential for catastrophic adverse events, it was decided to exclude chiropractic manipulation of the cervical spine from coverage.

Their decision was applauded by some but was predictably attacked by chiropractors.”  Harriet Hall, MD, Science Based Medicine (31st August 2010)

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Medical researchers Professor Shaun Holt and Andrew Gilbey have issued a strong warning against parents taking their children to see a chiropractor for any reason. Many chiropractic practices and organisations, in New Zealand and overseas, advocate routine spinal manipulation in infants and children, for conditions ranging from ear infections, colic and asthma to ADHD and even cancer…Holt and Gilbey's advice echoes similar warnings issued by paediatricians overseas. The Australian Medical Association has stated that chiropractic care for children is a waste of money and inappropriate. They advise parents who are worried about any aspect of their children's health to consult a medical doctor.   Infonews New Zealand (14th October 2010)

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A look at the possible consequences of the North American Spine Society [NASS] having now joined the American Medical Association's Scope of Practice Partnership. Dynamic Chiropractic (October 2010 issue)

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Judge rules that chiropractors can diagnose patients within limits, but can't perform two procedures medical doctors sued them over. The Statesman (9th September 2010)

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The vigorous spinal manipulations used by many chiropractors are an unnecessarily dangerous way to treat neck pain, an Australian researcher says. Dr Andrew Leaver, from the University of Sydney, said the practice should be reviewed after a study showed how a much milder therapy was just as effective at alleviating neck pain…"It makes us question why patients, or practitioners, would favour a treatment which possibly carries (the) risk of catastrophic outcome."… The frequently quoted estimate of serious injury following neck manipulation was one in a million, he said, though this was conservative and it could be as much as one in 15,000. "Whilst this appears to be a rare occurrence ... patients have a right to make an informed choice," Dr Leaver said. "We should also consider the severity of the risk and remember that the condition which people are initially seeking treatment for is a non life-threatening and mostly self-limiting condition." The research was carried out in collaboration with the University of Queensland, and the results are published in the journal Archives of Physical Medicine and Rehabilitation. Australian press report (8th September 2010)

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“We now have a reputable medical organization, Kaiser, which has acknowledged that there is a real potential for a catastrophic event caused by an upper neck manipulation, and that the risk outweighs the benefit,” says attorney Michael A. Abelson, a long-time advocate for victims of stroke. PRWEB (25th August 2010)
 [Michael A. Abelson of the Abelson Law Firm was named Lawyer of the Year by the Trial Lawyers Association of Washington, DC and has been listed in “The Cream of the Legal Establishment” by Washingtonian magazine. Mr. Abelson has more than 35 years of legal experience. He is a member of the American Board of Trial Advocates and a sustaining member of the American Association for Justice.] 

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A Texas district court judge has ruled that chiropractors must limit their diagnoses to biomechanical conditions of the spine and musculoskeletal system. The judge's reasoning is spelled out in the decision letter issued in August. The final order ended a four-year lower-court battle that pitted the Texas Medical Association (TMA) and Texas Medical Board against the Texas Board of Chiropractic Examiners (TBC) and Texas Chiropractic Association (TCA). The TMA initiated the suit in 2006 to block TBC rules that would permit chiropractors to perform clinical needle electromyography (EMG) and spinal manipulation under anesthesia (MUA), which the TMA charged were beyond the chiropractors' lawful scope of practice. The TMA also challenged whether chiropractors should have the right to "diagnose" medical conditions. MUA has some respectable use for treating frozen shoulder or knee problems, but spinal MUA has none. Aetna's Clinical Policy Guide provides a detailed discussion of MUA. In November 2009, the judge ruled that Texas law prevents chiropractors from performing EMG or MUA. The chiropractors have notified the court that they will file an appeal. The TCA Web site, which is seeking donations to help pay for the appeal, claims that the adverse ruling has the potential to wipe out the entire chiropractic profession.   Health Leaders Media (24th August 2010)

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An Auckland chiropractor has been found guilty of malpractice after telling a woman she had a degenerative spinal problem that needed expensive treatment when she visited him with a sore elbow. The chiropractor rang her at home after she decided against the treatment, warning her that she would be in a wheelchair within a year.   New Zealand press report (24th June 2010)

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“A Montgomery County jury reached a $5.6 million verdict after a nine day medical malpractice case against an osteopath for causing nerve and spinal injuries during a high velocity cervical manipulation performed upon his patient…In February 2005, Ms. Marquez presented to Dr. Rassael's office for purposes of receiving a very light, non-twisting osteopathic manipulation to her hip joint know as "muscle energy technique." Since her days as a Division One swimmer on the Michigan State swim team, and her participation in numerous trialthalons, many of which she won, she suffered from periodic hip pain which was resolved through use of the muscle energy technique. She presented to Defendant Rassael's office after specifically asking whether he was familiar with that technique and was told he was. After arriving at the office, however, the doctor laid Ms. Marquez on an exam table and proceeded to examine her back. When his hands got to the back of her head, he suddenly and without warning twisted her neck in both directions in a forceful manner, causing injury to the nerves in her neck and a rupture of one of her vertebral disks at C5-6. Ms. Marquez, now age 33, has never recovered from her injuries…Of significance, during the trial, the defendants intended to call a neuoradiologist, Charles Citrin, M.D., as an expert. Believing Dr. Citrin was a "professional witness" whose opinions were suspect, the plaintiffs sought discovery of Dr. Citrin's financial records to prove he was a "hired gun" expert. After three attempts to obtain this information to no avail, the presiding judge, The Honorable Marielsa Bernard, ordered Dr. Citrin to appear before her. After considering his testimony as to the whereabout of his financial records as "disingenuous" and his honestly questionable, she refused to allow Dr. Citrin to testify. This is one of the first reported cases of an expert being stricken for failing to produce financial information as to his/her income as an expert witness.”
Maryland Malpractice Lawyer (19th June 2010)
 

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“Chiropractors are making baseless claims about treating conditions such as asthma, ear infections and colic, new research reveals. The research, which appears in the latest New Zealand Medical Journal, reviewed the websites of 200 chiropractors and nine chiropractic associations in New Zealand, Australia, Canada, Britain and the United States. Ninety-five per cent of websites made unsubstantiated claims of being able to treat at least one condition including asthma, migraine, infant colic, ear infections and whiplash.” New Zealand Press (10th April 2010)

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A chiropractor disciplined for luring patients in with discounted initial consultations then selling them expensive long-term plans is now advertising an even cheaper deal. A 2008 Chiropractic and Osteopathy Board of South Australia inquiry into Dr Robert Marin was sparked by 10 "disturbingly similar" patient complaints. "The common thread seems to have been that patients felt Dr Marin provided them with an exaggerated diagnosis of the severity of their condition, with a view to persuading them to enter into a long-term treatment plan (of questionable benefit) at some expense." The inquiry found Dr Marin, who advertised an initial consultation for $27 or $37, then pressured patients to commit to a long-term plan that cost thousands, used testimonials purporting to be from his own patients - which were not….Australian Medical Association state president Dr Andrew Lavender said the practice of "loss leading" - where customers are drawn in by advertisements for unrealistically cheap deals - was concerning when it came to health. "The whole purpose is to sign people up for long and expensive courses of treatment with no scientific proven value," he said. "When someone promotes this to the general public, you know that they're doing it without any scientific basis and they're going to try to pander to the greatest fears of people. "There's very little evidence anywhere about any benefit of chiropractic treatment." Adelaide Now (22nd January 2010)

 

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A patient advocacy group is suing sue two Connecticut chiropractic trade groups, accusing the chiropractors of violating patients' right to know about the health risks of neck manipulations and committing hundreds of violations. Victims of Chiropractic Abuse Inc. is suing the Connecticut Chiropractic Council and the Connecticut Chiropractic Association, two trade organizations that represent most of the chiropractors in the state…The complaint, filed in Hartford Superior Court and in the process of being served, claims members of the two organizations are leading patients to believe the procedure of neck manipulation is safe by failing or refusing to inform them about the risk of stroke from neck manipulations….If the chiropractic associations try to claim they don't represent individual chiropractors to avoid the lawsuit, the advocacy group has identified 453 chiropractors it believes have violated state laws…The group is seeking financial damages, an injunction forbidding what it considers "deceptive tactics" and other relief, such as an order requiring some chiropractors to pay fines. The lawsuit comes three months after the Connecticut Board of Chiropractic Examiners voted 4-1 to reject a proposed declaratory ruling that would have required chiropractors to warn their patients about the risks of neck manipulations. Associated Press (10th June 2010)

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“…rumors are that the state regulatory bodies in the US are working on defining chiropractic in a whole new light."  Matthew McCoy DC, Journal of Pediatric, Maternal and Family Health – Chiropractic (19th May 2010)
 

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For at least the next three years, Victims of Irresponsible Chiropractic Education & Standards (V.O.I.C.E.S.) will be alerting patients of chiropractic across the United States to the dangers of neck manipulation. It is now blanketing large markets throughout the United States with outdoor advertisements. "Healthy young people, mostly between 25-45 years of age, are having strokes just because a chiropractor refused to inform them of the risks so that they could make informed health care choices," said Susan Hoffman the Founder of V.O.I.C.E.S. "After more than 60 years of irrefutable evidence, it is time for Chiropractors to begin acting like responsible healthcare providers and tell patients, 'we know there is a possibility spinal adjustment can cause a stroke, but now you should know it too'." PR Web (12th May 2010)

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DAY 1 (5th January 2010)

Morning Session: Following a lengthy review of the exhibit list and attorney arguments on several motions to recuse a board member and exclude evidence, testimony begins with William Lauretti, Doctor of Chiropractic

(Length: 2 hr 51 min)
Afternoon Session: The cross examination of the Connecticut Chiropractic Association's witness William Lauretti, Doctor of Chiropractic, continues. He is followed by Doctors of Chiropractic James Lehman and Clay McDonald. (Length: 2 hr 58 min)

DAY 2 (6th January 2010)

Morning Session: After legal arguments on a motion to exclude proposed testimony on subluxation, intervenor Jann Bellamy of the Florida-based Campaign for Science-Based Health Care testifies for the remainder of the session (Length: 2 hr 44 min)
Afternoon Session: Gerald Clum, DC testifies for the CT Chiropractic Assoc. followed by intervenor Sharon Mathiason, a Canadian woman who testifies about the death of her 20-year-old daughter. Concludes with Gina Carucci, DC & President of the CT Chiropractic Assoc. (Length: 3 hr 13 min)

DAY 3 (19th January 2010)

Morning Session: Features the testimony of Dr. Douglas Fellows, representing the CT Medical Examining Board on its position on providing informed consent for patients and George Curry, Doctor of Chiropractic , representing the CT Chiropractic Council. (Length: 3 hr 14 min)
Afternoon Session: Includes the testimony of intervenor State Sen. Len Fasano and of stroke victims Janet Levy, Britt Harwe and Christa Heck. Susan Hoffman and Michael McCormick testify about their spouses' deaths following strokes. (Length: 2 hr 7 min)

DAY 4 (22nd January 2010)

Morning Session: (Length: 2 hr 51 min)
Afternoon Session: (Length: 3 hr 36 min) 

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“It is time for the [Connecticut] state legislature and scientific-minded chiropractors to act. Informed consent about the possibility of a stroke from neck manipulation is in everyone’s interest.” By Preston Long, forensic examiner, and J. William Kinsinger, M.D., New Haven Register (6th April 2010)