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  #21  
Old 09 April 2014, 07:54 PM
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Originally Posted by Jahungo View Post
It may weaken the effectiveness of Mickey Blue's overall argument, but it doesn't affect the merit of other points.
No, it doesn't, and I didn't intend to suggest it did.

It is precisely because I consider those other points valid that I do not want to see the overall argument weakened by inaccurate claims.
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  #22  
Old 09 April 2014, 08:07 PM
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Originally Posted by UEL View Post
I'm going to clarify something.

In the US, will a MD make a referral for a patient to a chiropractor?

It does happen here. And it gets paid for.

In the US, will an insurer pay for a visit to a Naturopath?

It happens in half the provinces here.

In the US, is there strict regulation on the terms "Chiropractor" and "Naturopathic Doctor"?

There is here, after several years of university (such as the University of Alberta), and provincially controlled qualifying examinations, just as there is for dentists, surgeons, family doctors and optometrists.

In essence, the American version of Naturopath and Chiropractor is completely different than the Canadian version vis a vis regulation, qualification and management. Much less woo here.

If differing terminology were available, I'm certain that distancing from those terms would help.

**I have no idea why this annoyed me beyond just my perception of the "in the US, therefore the rest of the world" vibe I'm probably erroneously picking up.
The specifics of the regulation are irrelevant to my point. To suggest that a practice has merit because it is regulated by some authority is a fallacious "appeal to authority" argument and therefore logically invalid.

(Incidentally, although I'm not an expert on chiropractic practice in the US, some MDs do refer patients to chiropractors and it is, for example, covered by Medicare under some circumstances).

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Originally Posted by Lainie View Post
No, it doesn't, and I didn't intend to suggest it did.

It is precisely because I consider those other points valid that I do not want to see the overall argument weakened by inaccurate claims.
I think we are in agreement.

Last edited by Jahungo; 09 April 2014 at 08:13 PM.
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  #23  
Old 09 April 2014, 08:11 PM
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Originally Posted by Jahungo View Post
Homeopathy is also regulated in Canada, and it's as much bull-hockey there as it is here.
Did you read your link?

That is for the safety of products.

http://www.csoh.ca/A_Provincial_Issues.htm

Homeopaths themselves are unregulated. Ontario has initiated a transition to regulation. But as the society itself highlights, there is so much inconsistency in Homeopathy that they themselves recommend against regulation.l

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You're making a classic "appeal to authority" fallacy.
The definition being: the authority is not an expert in the field

If Health Canada is not an expert in the field, then I don't know how to respond.

I gotta bow out for right now. I've enjoyed the back and forth. I've got stuff to do. There is far too little banter like this where two reasoned people can debate a topic.
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  #24  
Old 09 April 2014, 08:16 PM
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My insurance covers chiropractic treatments, acupuncture, and probably some naturopath stuff too. There was a big push to get more "alternative" treatments covered a few years back. Chiropractors are licensed by the state, and have to have a degree from an accredited school, plus a certain amount of general college. Some doctors, I'm sure, refer patients to chiropractors. Canada's system doesn't sound different from the system here.

None of that proves that chiropractic is effective, used appropriately, and is not harmful. It can certainly still be full of woo.
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  #25  
Old 09 April 2014, 08:25 PM
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A few clarifications (apologies I wrote it quickly and it is clearly inaccurate):

-While I am aware there are chiropractic schools (of varying quality but that is a separate issue) I mean to imply that they are not trained to provide treatment of medical disorders (which, based on my quick scans appear to be the case) in the same way more regulated professions (such as physical therapists and of course MDs) and people who have specific medical disorders should seek professional medical health. I didn't mean to imply that anybody can hang out a shingle and call themselves a chiropractor (though again I take full responsibility for phrasing it extremely poorly) but their training is quite minimal for all the care they allegedly treat.

-There are many.. For lack of a better word 'groupings' of chiropractors; some have shed the 'magical treatments' in favor of more medical-science based treatments, some still hold on to the 'we'll use magic to fix your cancer!' and some are in the middle. The first is fine, but still not ideally trained (in my opinion) for spinal manipulation as a MD or even physical therapist would be. As for massage.. That is probably fine, given that anybody can generally safely figure out how to give a massage. The latter are, of course, a problem.

Chiropractic is not the ideal example (though it was the one from the case) because, as far as woo science goes it's on the 'ok' end for the most part (though one could argue how far can you move from what chiropractic peddles before you are no longer acting as a chiropractor and just an unlicensed physical/massage therapist, but that is neither here nor there).

As this thread shows, many people do not realize what chiropractic teaches, and even if the individual chiropractor abandons the woo teachings it's still a part of their training; all those accredited schools are ok with the idea of what amounts to magical healing of a variety of problems, and that to me discredits the scientific validity of their training, and worries me as some of their training involves the manipulation of the spine.

Quote:
Originally Posted by Mad Jay View Post
Would you have the same opinion if the woman had said that she got the mild injury from a massage session? or a workout session? Physical therapists tout physical exercise as a panacea against many ills, too, although Chiropracters are a lot more woo than physical therapists.

However, just one thing for you to think about: Are you driven by the welfare of them woman? or by your own distaste for the profession?
My issue is that her injury came from the manipulation workings of chiropractic, something I am not convinced they are adequately trained to do given what I have read/learned about them. A back problem that can actually benefit from spinal manipulation should only be performed by a doctor, in my opinion, and most of the other 'woo' types of spinal manipulation treatment by chiropractors should not be done at all since there is all risk and no reward.

I have had many patients using spiritual or otherwise 'woo' treatments (crystals, praying for cures, etc) and if it is not causing them direct or indirect harm it's totally fine by me. People can spend their money and time doing whatever they want, it's their business, but seeing a person who is untrained to deal with complex medical problems (which is the case for many chiropractors) or seeing a person who's spinal adjustment training was alongside being trained to use magic to heal asthma I worry.

Quote:
Originally Posted by UEL View Post
I'm going to clarify something.

In the US, will a MD make a referral for a patient to a chiropractor?

It does happen here. And it gets paid for.

In the US, will an insurer pay for a visit to a Naturopath?

It happens in half the provinces here.

In the US, is there strict regulation on the terms "Chiropractor" and "Naturopathic Doctor"?

There is here, after several years of university (such as the University of Alberta), and provincially controlled qualifying examinations, just as there is for dentists, surgeons, family doctors and optometrists.

In essence, the American version of Naturopath and Chiropractor is completely different than the Canadian version vis a vis regulation, qualification and management. Much less woo here.

If differing terminology were available, I'm certain that distancing from those terms would help.

**I have no idea why this annoyed me beyond just my perception of the "in the US, therefore the rest of the world" vibe I'm probably erroneously picking up.
Many insurance companies do cover such treatment, however that does not mean the treatments are 'real'. Homeopathy, for example, has no clinical value and no reliable evidence to support it; it is basically treatment with distilled water. Naturopathy is a bit more complex given that it's a blending of different concepts, many of them unsupported by science.

I apologize if there was any US-Centric tone, just that practicing here is the only experience I have.

Last edited by Mickey Blue; 09 April 2014 at 08:33 PM.
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  #26  
Old 09 April 2014, 08:59 PM
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TL/DR: While a Chiropractor may receive enough treatment to be able to give a decent massage, they receive unacceptable (obviously I can't evaluate every single school, but based on what I do know about their training) education and training to treat the various conditions that is incorporated with their teachings. Some may choose not to 'treat' those things, but they 'can' by law, and treat them in ways that are not supported by any science.
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  #27  
Old 09 April 2014, 09:10 PM
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For people who doubt that the spinal manipulation part of chiropractic can be dangerous:
http://www.smh.com.au/national/healt...928-2ul6e.html
http://www.quackwatch.com/01Quackery...irostroke.html
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  #28  
Old 09 April 2014, 09:48 PM
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What UEL said. Generally, government regulation of healthcare in Canada is not going to buckle under the weight of special interest groups, especially since that health care is almost exclusively paid for by extremely limited and precious tax dollars. So while I have heard of some wild claims of the chiropractic profession advocating their treatments to cure or relieve allergies, asthma, and digestive problems (mostly in US-based media), I've never heard of a person go to a chiropractor except with a physical issue - like joint pain or recovery from an injury. Nor have I heard of anyone claim to have been cured of their allergies, asthma, digestive disorders, otitis media (non-suppurative), by a chiropractor in Canada.
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  #29  
Old 09 April 2014, 10:19 PM
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They are still allowing payment for a medical profession who's contemporary training (in the US at least, I assume it's the same in Canada but it's possible it's not) includes obvious pseudoscience and is, at best, a better than average masseuse.

ETA: Ultimately though, my question relates to the American practice of chiropractic; I'm aware lots of individual practitioners shrug off the crazy, but the bottom line is they do not receive training in a science based curriculum (aside from the handful of entry level science courses) and there is real risk to their spinal adjustments which (IMO at least) they do not receive adequate training to do safely.

I have real concern (not just 'anti-chiropractic') for my patients who go to these practitioners, particularly when a patient suffers an injury; yes, injuries can happen in any situation, but in this case it's an injury from a person performing a procedure that they are not qualified (IMO again, I know they are legally qualified) to perform possibly for unnecessary reasons.

ETA: And really, though I appreciate I worded it poorly, it's more about the idea of the relationship between a caregiver and a patient and where intervention (if only discussion) should take place.

Last edited by Mickey Blue; 09 April 2014 at 10:47 PM.
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  #30  
Old 09 April 2014, 10:44 PM
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Mickey Blue,

I have a sister who has been getting into pseudoscience. I think where I have left it at with her, is that it is unproven scientifically or not covered by the FDA and that she really is proceeding at her own risk, but I wish her well. I also ask her to make sure that she's still getting primary medical treatment from a doctor for major issues.

However, issues that one of my sisters' has is that her husband has early onset Parkinson's that started in his 40s. She has felt that other issues that he has gets dismissed as being part of the Parkinsons instead of being investigated seriously as a potential separate issue. In the end, she has concerns about his quality of life and it encourages her to look into woo since the doctors aren't giving her the answer that she wants. I really don't know the details enough to determine how much of it is her not listening/not understanding or doctors brushing her off in an appointment slot that is usually 15 minutes.

As for chiropractic care, I have used it and compare it to cracking my knuckles. It doesn't cure cancer, but it can alleviate pain without medication (I do have an anecdote where the chiropractor helped me more than my PCP). A massage therapist will try to sell you on "reflexology" but it's just another massage where they poke your hands and feet more.

In the end, I think a lot of woo-seeking is about being listened to and empathized with by the practitioner. Aside from that, I don't think it would be out of line to emphasize that this injury was caused by the chiropractor and she may want to seek out different treatment. You may also ask her what she was trying to resolve with the chiropractor and what she may look into for addressing that issue within standard medical treatment.

Best of luck!

Khisanth
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  #31  
Old 09 April 2014, 10:53 PM
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Thanks so much for the response;

Yea, reflexology is another good example of allegedly magical treatment (in this case the idea that you can treat various diseases/disorders because of the nerve endings in your feet and hands).

As I said, I question whether chiropractors are truly qualified to do back realignments, but that is a debate that has two sides since they obviously receive at least a little education (between how to manipulate magical energy fields*) and I'm not the expert on how much education is needed, though other experts do express some concern.. Similarly some homeopath may say they can treat their premature balding with a solution of water and a molecule of copper or something, this is their call.

I worry when these things are done in place of real medical treatment, which is probably less common for chiropractors than other peddlers of woo, but they certainly do. In fact, a quick look at a bunch of random chiropractors in my city show nearly all of them (with detailed websites) offer 'magic' services such as 'energy manipulation' and similar things. Now maybe that's not why a specific person goes there, or how a specific practitioner practices, but that is still recognized as part of their treatment, this worries me particularly when they are treating one of my patients.

*In the effort to be more fair, a quick scan of some chiropractic school classes seem to suggest (aside from their pre-reqs which are pretty typical of low-end medical training like RN or Paramedic and legal medical classes like infection control) that a big chunk of their classes are business related, a big chunk are related to radiology (so they can probably read an x-ray better than your average person) and a big chunk are related to specific patient classes and disorders. This last chunk are where the issues may well be, given that (without a specific breakdown of the classes, which is more work than I'm willing to put in here) one cannot know whether this is real general training, magical 'woo' training, or somewhere in between.

Chiropractic is certainly better than most, maybe all, unsupported pseudoscientific medical treatment out there and seems to (these days) attract a large amount of providers who honestly try to provide science based medicine (despite choosing an unscientific speciality, I guess maybe it's easier than medical school). I picked this one not because I have a particular disdain for them, just that is what the patient in question was using, and even if it's better than average it's still potentially a problem, particularly given she already had one injury from an 'adjustment'.

A slap to the face may be better than a kick in the nuts, but neither is ideal.

Last edited by Mickey Blue; 09 April 2014 at 11:01 PM.
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  #32  
Old 10 April 2014, 02:31 PM
Elkhound Elkhound is offline
 
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Take a look at the curriculum of some chiropractic colleges. They require an undergraduate degree with the same sort of courses as pre-med (some will accept you with a pre-health-sciences associate's, but in that case the course is five years instead of three, and at the end of the second year one gets a B.S. in Human Anatomy and Physiology); the first two years of the D.C. degree are exactly the same as the first two years of medical school (I know someone with a D.C. who later decided to get an M.D.---she was able to do so in two years because she had taken all the first two year med. school courses in chiro. school). Chiropractors are also required to take nutrition--which is not part of the standard M.D. curriculum.

While some chiropractors do claim to treat non-neuromuscular conditions, the reputable ones consider such treatments to be adjunctive to medical. I've used chiros. in the past, and all have at one time or another said something like, "This is the sort of thing for a medical physician. I can give you some relief by manipulation and pressure points, but to really treat it, you need medicine."

One of my chiros. told me that he has been called in by obstetricians to induce labor by manipulation and pressure points---far easier on both mother and baby than drugs.
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  #33  
Old 10 April 2014, 02:42 PM
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Quote:
Originally Posted by erwins View Post
My insurance covers chiropractic treatments, acupuncture, and probably some naturopath stuff too. There was a big push to get more "alternative" treatments covered a few years back. Chiropractors are licensed by the state, and have to have a degree from an accredited school, plus a certain amount of general college. Some doctors, I'm sure, refer patients to chiropractors. Canada's system doesn't sound different from the system here.
Fair enough.

Quote:
None of that proves that chiropractic is effective, used appropriately, and is not harmful. It can certainly still be full of woo.
Sure. But much of medicine cannot be proven to be effective and not harmful. Cancer treatment, for example.

It can also be full of woo. Woo pays well. (last sentence said tongue firmly planted in cheek)
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  #34  
Old 10 April 2014, 03:02 PM
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Originally Posted by erwins View Post
For people who doubt that the spinal manipulation part of chiropractic can be dangerous:
http://www.smh.com.au/national/healt...928-2ul6e.html
http://www.quackwatch.com/01Quackery...irostroke.html
Of course it can be dangerous. Any medical treatment can be. The question is, is the actual risk more than the benefit? How common is the risk, how great the benefit?

I have no dog in this fight. In fact, I am very resistent to chiropractors as well. But simply saying there is a risk means nothing; every effective treatment will have risks. The only thing the doesn't, AFAIK, is homeopathy. Well, ok , maybe you risk water toxicity.
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  #35  
Old 08 May 2014, 09:22 PM
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[QUOTE=Alarm;1814505
Where I have an issue is when you take something proven and push it into pure woo, like saying proper chiropractic realignment makes you nigh invulnerable to diseases. [/QUOTE]


That's my issue as well. IMO there is a place for DCs, but aligning your back is not going to prevent cancer and my non-medical advice to anyone would be to run not walk from any medical professional who makes that or similar claims. Several years ago my mother went to a chiropractor and it really helped her. He wasn't one of those that claimed the solution to the world's problems was spinal realignment though. Trust me a doctor of any specialty had to be pretty darn good for my mother to like him!
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  #36  
Old 08 May 2014, 11:18 PM
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Originally Posted by geminilee View Post
Of course it can be dangerous. Any medical treatment can be. The question is, is the actual risk more than the benefit? How common is the risk, how great the benefit?

I have no dog in this fight. In fact, I am very resistent to chiropractors as well. But simply saying there is a risk means nothing; every effective treatment will have risks. The only thing the doesn't, AFAIK, is homeopathy. Well, ok , maybe you risk water toxicity.
Fracturing a baby's neck vertebra while treating torticollis seems pretty cut and dried to me. Torticollis isn't about spinal misalignment, it's a muscular imbalance. It is normally treated with gental stretching and active head movement by positioning the child in such a way that he or she tilts the head to the opposite side voluntarily. There's no reason to manipulate the spine, and the benefit of doing so is clearly outweighed by the risk--however infrequent--of something as dire as a broken neck.
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  #37  
Old 09 May 2014, 02:23 AM
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I don't recall defending that, or any specific treatment.

It would have to be evaluated, like any other procedure, on a case by case basis, taking into account the amount of benefit expected from the treatment and the possible risks (and their frequencies). In this case the possible benefit is zero or nearly so, and the risk (wbile rare) is high. Conclusion: not justified in this case.
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  #38  
Old 09 May 2014, 03:17 AM
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Originally Posted by Elkhound View Post
One of my chiros. told me that he has been called in by obstetricians to induce labor by manipulation and pressure points---far easier on both mother and baby than drugs.
Police used to call in hypnotists to question witnesses and sometimes called in psychics to find victims. That doesn't prove that either one is effective. A single chiropractor being called in by a few obstetricians in a single area could just as easily indicate gullibility on the obstetricians' part as talent on his (if it's even true- remember, we only have his word for it).
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  #39  
Old 09 May 2014, 03:25 AM
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Originally Posted by UEL View Post
The definition being: the authority is not an expert in the field

If Health Canada is not an expert in the field, then I don't know how to respond.
Actually, an Appeal To Authority fallacy is stating that because someone says X, X must therefore be true without any independent evidence to back the statement up. For example, stating that Health Canada licenses chiropractors, therefore, chiropractors must be effective at treating illnesses.
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  #40  
Old 09 May 2014, 04:19 AM
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Originally Posted by geminilee View Post
I don't recall defending that, or any specific treatment.

It would have to be evaluated, like any other procedure, on a case by case basis, taking into account the amount of benefit expected from the treatment and the possible risks (and their frequencies). In this case the possible benefit is zero or nearly so, and the risk (wbile rare) is high. Conclusion: not justified in this case.
It was one of the two cites in the post of mine that you quoted.
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