B.I.G.O.T.S.

December 21, 2010
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B.I.G.O.T.S.

British Institute of Great Orators, Thinkers and Skeptics, according to Bruce on quackometer.

I am not that certain about the use of the terms “great”, “thinkers” or “skeptics” but the idea of denouncing bias as unbecoming is good.

I was asked a question by someone calling himself “badly shaved monkey” (rather reiterating his lack of elegance and his close intellectual relationship to cercopithecoid primates – ie. not hominoids, which is where-unlike monkeys- humans descended from) about what proof we have for the existence of a subluxation. I was stunned. The shear idiocy of that question left me completely flabbergasted.

So I decided to have a bit of fun. Then, after a few brief posts, I quickly realised that he, and some of the onanists who circumnavigate websites that aim to condescend to chiropractic theory, really did not understand the difference between a philosophy and a practise. That said, I have had to admit that some people who practise chiropractic also do not know the difference either…So I proceeded by making it as clear as I could that my interpretation of the theory was only ever my personal view point and understanding and held no representational value.

Anyway the point is this: in my opinion (I reiterate: in MY opinion) the term subluxation in the context of chiropractic philosophy is a theoretical umbrella term referring to ANY source of dysfunction, whether it be biomechanical, mental or nutritional/chemical. Much laughter ensued when I declared this position on my posts. Much laughter but zero counter-argument. To my colleagues who do have a sense of what they are meant to be doing as chiropractors, remember this: zero counter argument. And it is easy to see why: it is so blatently obvious that all things must have cause and that sometimes, particularly when the cause is not so apparant, it might be worthwhile looking at why the patient doesn’t seem to be able to heal themselves. Not laughing so much now… But here comes the crux of that debate: when the cause is not that apparent it might be worthwhile looking at why the patient doesn’t seem to be able to heal themselves.

The cause might not be that apparent because a clinician may not know how to look for it. In which case improving clinical ability and clearly deliniating scope of practice are paramount. Fair criticism may be levied against some clinicians in any field for failings in this context…and I feel that some of the bigoted opinions on chiropractic clinical practice are based on a vague and unsubstatiated sense that the quality of the education in chiropractic is substandard and that regulation of scope of practice is poor. But is that sense all that vague and unsubstatiated? On the one hand I think that a little introspection and acknowledgement  of the facts may actually lend some credence to the “sceptics” view point (inverted commas as most them really aren’t that sceptical of their own held beliefs and won’t do the research required to know the facts). Let’s have some clemency through the acknowledgement that the human mind is easily led by those who shout the loudest and let’s look at those who shout the loudest in the chiropractic field… ain’t all that pretty is it? Yes, they are a minority, yes they are maybe misguided idiots, but regardless of the facts, they are still shouting the loudest. Can you really blame poor wannabe sceptics to be guided by the impression created by the above shouting and idiotic minority? Remember, most of them are not used to accessing data-bases or well-versed at critical thinking and my conclusion is that the “bigoted and biased” behaviour is nothing more complex than wannabe-sceptic herd behaviour. Yes they are led by people who do the data-base accessing and the critical thinking, but isn’t it entertaining to see how little those actually state? Like true puppet masters they allow for the herd to infer from those minimal statements of fact whatever the herd’s bias predisposes it to think. Say a word and let the herd make sentence. It is really rather comical if you see it from this angle.

But, hang on! Isn’t the same true for chiropractors? Is it not true that 600 chiropractors find themselves under scrutiny because they have duplicated information they thought to be correct? Unthinkingly, unquestioningly duplicating whatever the GCC, their colleagues or the seminar guru said? Some, you may say, genuinly think that subluxations are vertebrae that out of line and impinge on nerves which causes the lung/thyroid/bladder dis-ease. They, I would argue, are muppets. A very (too) vocal, minority of muppets. A chiropractic Punch and Judy show if you wish. They are a liability that needs to be excised from the profession for no other reason that they bring what is in my opinion a fantastic profession with hughe and untapped potential in disrepute. But the regulators have no say on the matter and other than that a chiropractor cannot advertise in breach of ASA regulations (DUH) the GCC’s regulation of the profession has done none-other (sweeping statement-I am guessing that the GCC’s understanding of regulation has done more than that but it isn’t that obvious to me) than give the public a complaints process they could access. It has not “regulated” anything. It has not said what you should do, must do, shouldn’t do,… if it doesn’t involve a patient complaint. It can’t touch the scop of practice, it can’t tell you that seeing a patient three times a week for 6 weeks is unnecessary and that if it were to appear to be necessary it would mean the clinician missed something. It can’t tell you that if you have a need for prepayment schedules to acquire patient loyalty that it means you’re not a very good communicator and rather than relying on an admin-heavy negative karma process  you should invest in some communication classes. It can’t tell you many things that are very relevant to teh future of chiropractic in the UK… Why? Because there is no concensus and there is no true understanding of what best-practise is. There is no evidence to tell you that twice a week for 3 weeks is plenty to get very respectable results. There is no evidence to say that if Mrs. Smith presenting with this symptom which she’s had for 3.2 years that it will take 8 visits to achieve 65% improvement within 6 weeks and 90% improvement with 10 visits and a pair of orthotics at £350 a pair. There is no evidence to state categorically that one way is better than the other or that “route A” costs £400 and will achieve 85% improvement in 6 weeks and “route B” costs £200 and will achieve 75% improvement in 8 weeks-which would Mrs. Smith like to follow A (expensive but fast) or B (cheaper but slower and less complete)? There is no real understanding of “best practise”, there is no real “informed choice”. The whole exercise is a waste of breath until treatment formats are agreed upon, protocols are set and the results from the different formats and protocols are tested against one-another. What does this have to do with the GCC? As I stated the GCC is mainly a complaints vehicle (no disrespect, just an observation) and fact is that complaints (other than those malicisiously generated by certain people in and outside the profession-so I am referring to genuine complaints) are primarily due to poor communication, lack of clarity and false expectation, things that undermine whether a patient will like the clinician or not. In fact studies have shown that patients will not make complaint against clinicians whom they like, even if the action the clinician took was negligent. So, without the ability to make clinicians better communicators, without better predictors of therapeutic outcomes, without expectation and cost management procedures based on sound protocol assessment, … without any of these,… regulation is by and large never going to be any more than fire-fighting. Fire fighting with arguments and disagreements about what constitutes a fire to boot!

I have been told this is what Badly Shaved Monkey looks like when he's getting ready to go out on the pull

I have been told this is what Badly Shaved Monkey looks like when he goes out on the pull

So,… not so bigoted after all. In fact the puppet masters of the B.I.G.O.T. movement have plenty of reasonable grounds to make their comments and evaluation of the chiropractic profession in the way they have done. The puppets at the end of the strings are just that, puppets, but they, in all their puppetness are showing us a great many valuable things. Should we wish to see them.

So, Badly Shaved Monkey for all his being a narcissistic puppet, actually had a point in asking me what a proof we have of the existence of subluxations. And that point is that all I can give him, is my own and personal opinion. That point is that until we overcome the current political stale-mate, and until we decide on clearer, more directive and less opinion-bound positions on our protocols, methods and outcomes, until then, regulation has achieved nothing more than a cover the profession with a false veil of respectability, designed to protect the incapable and the clincally feeble, not the public.

Come to think of it, my calling myself a chiropractor has actually cost me more than it has earned me. My patients don’t come to me because I am a “chiropractor”. They come to me because I, like so many others out there, deliver the goods in a pleasant manner. In fact, come to think of it, there are people out there with successful clinics who have done phenomenal work whom the profession needs more than they need the profession. Let’s not delude ourselves, there are people out there who acquire respectability on your back. Because you are a good clinician you represent and heighten the public perception of the profession. All I can think now is that the formation of the GCC and the beast it has become was either a charitable attempt of those wonderful chiropractors that are and were out there to share in their success and help those who were struggling or an attempt for those who were struggling to make sure that the power did not come to lie with those who had the success,… or maybe it started as the former and got taken up by the latter.

A parasitic monster that has grown out of a seed of good…

Kind regards,

Stefaan Vossen

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  • http://spinaljoint.com Richard Lanigan

    The “real Doctors” I grew up with and the public came to expect were Dr Findlay, Dr Kildare, Marcus Welleby MD, Quincy and Cliff Huxtable, the kind who held a patients hand while the died and cared. These were not the modernist “evidenenced based” action men so loved by the bigots.

    The modernist TV doctor, constantly has a stethoscope draped casually around his neck, ready to enter a chest cavity, while banging a nurse in a closet. The CAM practitioner has taken the place of Marcus Welleby et el. But rather than hand it over amicable, the science nerds make a case that this approach is out of date and ineffective. There is a great opportunity for the chiropractic profession if they reach out and take it rather than trying to ape the modernist corporate medical types. I suspect in the UK it will be the Osteopaths who benefit most from the public disillusion with the scientific/statistical approach to their individual needs.
    The type of approach that said Concorde was the safest way to travel on 20th of July 2000, 24 hours later it became the most dangerous way to travel despite the fact the negligence involved was down to one of Concorde’s competitors. Those statistics were the begging of the end for concorde.

  • http://www.chiropractorswarwick.co.uk Stefaan Vossen

    My step-daughter hurt herself the other day and my wife suggested that she tell me about it so I might help. She replied with “should I not go and see a doctor?” To which my wife replied; “but Stefaan is a doctor!” Predictably (in the context of these postings) my step-daughter replied: “No I mean a REAL doctor”!

  • http://spinaljoint.com Richard Lanigan

    @bilbo,it always amuses me the way these people cherry pick the “evidence” or images for the story they want to tell. I love Two and a Half Men and in the scheme of things Alan Harper is a “looser” by being a very upright boring person.

    The irony of this would seem to be lost on Andrew who wants to believe that Alan is a looser because he is a chiropractor, no doubt bigots will start wearing bowling shirts and shorts to be more like Charlie, the chiro basher.rather than the Dennis Nerdy look

  • Dr Bilbo Baggins

    @Andrew Gilbey

    awe, there there, as you compare a whole profession to one comedy character, who actually has more moral attributes than the main protagonist, Charlie Harper, does that mean that all geeks/nerds/it guys/ scientists fall into the portrayal of such an individual as Dennis Nedry (Jurassic Park);

    - obese
    - unkempt
    - dysfunctional
    - dishonest
    - socially inept
    - self interested
    - corrupt
    - liar
    - virgin
    - computer gamer
    - large chip on shoulder ( no pun intended).
    oh did I mention great dress sense?

    Yip Alan Harper or Nedry (of course the list of the latter type of character doesn’t stop there),  it would seem by your post that you see that as a difficult call. 

    You guys really aren’t very good at this and not shooting yourselves in the foot, is not an attribute you have, if previous posts are anything to go by?

    Hope Santa brings you lots if new games. Have a nice one.

  • Andrew Gilbey

    @Eugene

    You said, “Come to think of it, my calling myself a chiropractor has actually cost me more than it has earned me.”

    I’m not suprised! Look what it’s done for Alan Harper (Two and Half Men).

  • Paul

    Hippies I also can live with, bigotary based upon an inability to properly assess information and so providing the background to an IQ lower than my shoe size willing to dictate to me, I object in whole to.

  • http://spinaljoint.com Richard Lanigan

    @skepticat, I am severely dyslexic, I used get 25% extra time in exams. If that was my only spelling mistake I would be more than happy.

    As a parent governor I have to spend time observing classes. Last term, I was sitting in the class listening to a teacher talk about “alliteration” to six year olds. I dont think I had ever heard the word before. To crown it all I had to help the children with their work, I helped this child to spell “slivering snake” (slither) another “bizy bee” (busy) and the “Isle of wite”. The children’s face as I explained it was my mistake. I cleared the schools footpaths of snow last week as did many people in Thames Ditton so I am useful for something http://www.facebook.com/group.php?gid=321817783149 and have been walking around with a smug smile as the snow came in this week.

  • Dr Bilbo Baggins

    @ Stefaan

    Hippies I can live with bigots, I can’t.

  • http://www.chiropractorswarwick.co.uk Stefaan Vossen

    @Skepticat
    that only applies to you

  • http://www.chiropractorswarwick.co.uk Stefaan Vossen

    @Bilbo
    I agree that “they” are probably not motivated by the positive, but it is “our” choice to focus on the positive or the negative. “I” choose to focus on the positive. I have found it attracts lots of positive in my life and gives me the energy to build, rather than destroy. I know I sound like a hippie and that is because that is by and large what I am, even if my suits are tailor-made.
    There is nothing I can or want to do to punish “them”, but I do admit to have a quiet chuckle when “they” are getting their knickers in a twist. Now is the time to order to nachos and a six-pack of beers and watch the show…

  • http://www.skepticat.org Skepticat

    @Richard, @Eugene

    It’s Stefaan. One ‘f’ two a’s.

  • Dr Bilbo Baggins

    @Stefaan

    I agree, but you write someimes as if you agree with what they have done. I appreciate and concur that out of every negative comes a positive, but the cleaning up of the profession was not their intent nor will it ever be. I have to sympathise with those who accuse them of attempted genocide, based on their own petty and vindictive rationale. Therefore, any praise for their actions must also be tempered with an explanation of their intent.

    Reading Henesses latest blog, his anger and frustration is based on the fact that people are being found ‘not guilty’ that to many will show just how malicious their intent really is.

  • http://www.chiropractorswarwick.co.uk Stefaan Vossen

    @Eugene
    I have little doubt that there are substantial similarities in our practice views and even methods. One thing I do insist on though is that as a chiropractor I am primarily preoccupied with finding the reason(s) for the presenting patient’s dysfunctional movement pattern and if that reason resides in another expert field then I will collaborate with those people and case-manage as required to achieve the results. In consequence I have in my practice (and the organisational/geographical factors that define its functionality and patient demographic) no need or desire to include pharmacology. I can rationally understand the wish to include the ability to prescribe, but I feel that this is someone else’s job and expertise. In the same way (and in no way different) as I feel about involving a good podiatrist when gait dysfunction is present or a good dentist when significant occlusal dysfunction is present. But as it stands the facts are that I need prescriptions far less often than I do good orthotics….
    Regards,
    Stefaan

  • http://www.chiropractorswarwick.co.uk Stefaan Vossen

    @Bilbo:
    “This was never about standards, evidence nor public safety as Stefaan seems to have bought into, it was purely political, agenda driven and vindictive, always will be, always has been.”
    Just so you understand my point of view: I don’t care for agenda’s, politics or vindictive motivations. I won’t, to be quite frank, even acknowledge their existence (whilst aware that they are there), because I feel that the only relevant issues are standards, evidence and public safety. And if we can get that cleaned up, then politics won’t even be able to come into it. That might be idealist or even fantasist, but it is what I believe in and what I stand by.
    Regards,
    Stefaan

  • Dr Bilbo Baggins

    @Eugene

    See the latest whinge on zenos blog, simply because it isn’t all going their way. This was never about standards, evidence nor public safety as Stefaan seems to have bought into, it was purely political, agenda driven and vindictive, always will be, always has been.

  • Eugene Pearce

    Read Stephans article a little more carefully, we have more similarities than differences, particularly regarding muppets, perhaps not on prescribing, I think I like that dictatorship after all.

    Still at least the GCC has not found one person guilty of website contect yet. How much did Henness /Zeno waste in time paper and stamps. Being a bigot can be quite expensive dont you know.

  • Eugene Pearce

    @ Stephan

    Come to think of it, my calling myself a chiropractor has actually cost me more than it has earned me. My patients don’t come to me because I am a “chiropractor”.

    Couldnt agree more, and I wonder if we have similar styles of back pain musculoskeletal orientated practice.

    “All I can think now is that the formation of the GCC and the beast it has become was either a charitable attempt of those wonderful chiropractors that are and were out there to share in their success and help those who were struggling or an attempt for those who were struggling to make sure that the power did not come to lie with those who had the success,… or maybe it started as the former and got taken up by the latter.

    Dont be so cynical, we all know it was about not paying VAT, and the usual suspects craving for political power.

    @ Richard
    If the chiropractic profession gave Steffan and I £3,000,000 a year, and we continued in practice, administered the GCC in our spare time and rented a penthouse flat in Mayfair for when we had to be in London; do you think the chiropractic profession and the public would get better value from us or Dixon et al?

    What a sort of chiropractic dictatorship with someones whos opinions you share. That would be just as devisive as we have now, but Penthouse in Mayfair, like your style.

    Has there been a warnining from Coates employers regarding the interfereance in the PCC outcome, in the name of “Quality Assurance”? If not why not?

  • http://spinaljoint.com Richard Lanigan

    @Steffan is that an what the bigots call an “ad homine attack” or an attack for being ignorant.

  • http://www.chiropractorswarwick.co.uk Stefaan Vossen

    @Andrew,
    I hope you one day will actually be able to make a valuable contribution. Really. Just remember that I am here not writing for you and sometimes that means I will write about things you don’t understand.
    Stefaan

  • Andrew Gilbey

    Stefaan

    Looks like you’ve found a link to the “post modern essay generator”

  • Garland Glenn

    Sounds better than what we have.

  • http://spinaljoint.com Richard Lanigan

    This is a serious question for anyone to answer.

    If the chiropractic profession gave Steffan and I £3,000,000 a year, and we continued in practice, administered the GCC in our spare time and rented a penthouse flat in Mayfair for when we had to be in London; do you think the chiropractic profession and the public would get better value from us or Dixon et al?

    PS.
    G is for “Geek” CAM bigots are more than happy to identity with that image.

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