”The time has come for complementary medicine to turn away from the need to obtain legitimacy from orthodox medicine by adopting its paradigm and research methods”
David St George, Consultant/Senior Lecturer in. Clinical Epidemiology and Public Health Medicine at the Royal Free Hospital in London (2000).
There were many interesting responses in the “Rapid Response” section of the BMJ articles about libel and science. Unfortunately few of these responses were by chiropractors who seem to be taking the leaderships advice to keep heads down, which does little to the credibility of the chiropractic profession.
Last summer President of the BCA Tony Metcalfe advised chiropractors to “keep this issue in perspective”. He asked chiropractors; “how many of your patients are aware of what is going on? I can tell you that none of my patients have raised any issues of concern with me and are not in the slightest bit interested in the Singh legal action” . That must be how Tony justified doing nothing when I told him how the GCC was covering up the activities of the deputy registrar Greg Price and when more and more vexatious complaints were being made to the GCC about his members. Remember Tony is a former gamekeeper who was sacked by the voters and is hanging out and representing the poachers until he gets another chance to be on the gamekeepers council again. New BCA president Richard Brown wants to ape the biomedical model and get prescribing rights for his members.
I sent this into the BMJ “Rapid responses” in response to an Edzard Ernst article BMJ needless to say it was not published, they prefered Richard Browns “Plethora of evidence”
Tyranny of Evidence
If Professor Ernst wishes to devote his life to proving chiropractic helps children conditions that account for less than 5% of what I see in practise good luck to him. Much of today’s evidence on treatment will be dismissed in twenty years, what wont change is the activity is good for you and maintain spinal joint function is essential for spinal wellbeing.
In 1982 I ruptured my anterior crutiate ligament. The best evidence at the Rigshospital in Copenhagen where Peter Gotzche is a director required that my leg was put in plaster, from my toes up to the head of the femur for three months. Another two months before I could bend it and start the rehab. Knee extensions. The physiotherapists did not realise it was the hamstrings not the quadriceps that provided stability for the knee joint by then the hyaline cartilage in the joint had started to degenerate.
I developed terrible back pain and my GP told me I had a slipped disc and was told to lie in bed for a couple of weeks. On the way home the taxi driver said I should ring his chiropractor, he would sort me out. I choose bed, after three days and feeling a lot worse I dug out chiropractor Ole Wessungs number.
I crawled in and walked out, and have never taken pain medication since. He told me doctors always blame discs but the problem was the Sacra iliac joint. He explained the importance of movement in joints and the effect of stimulating mechano receptors in spinal joints and the effect on nociceptors. I remember him saying medical doctors say sacra illiac joints don’t move. Joe the chemists states “chiropractors cannot alter the relationships among bones in the spine” its nerve function that is altered Joe.
Everything I learned from this chiropractor I put it together and opened Copenhagen’s first Aerobic training and stretching centre “Sweat Shop”. Within a few years I was working with Team Danmark and any sports person worth his salt was doing his physical training with me. No on ever asked about “evidence” the results of my programmes were there for everyone to see. Even the Rigshospital was open to new ideas in 1984 I advised them on equipment for their new rehab unit. They also worked out around then that it was best not to immobilise knee joints as chiropractors had been saying for years. Perhaps I could contribute a chapter in the book for medical students on knee arthritis and why sometimes it is worth putting prejudice aside and listening to experienced practitioners.
In 1990 I decided to study chiropractic at The Anglo European College of Chiropractic and I am certain no junior doctor could access a patient with spinal joint dysfunction (subluxation) as well as a graduate from AECC. After 14 years in practice I would be delighted to compare my skills to any medical doctor or consultant.
If all I do for patients is get them off pain medication and I insist on it with all my patients I have done right by them. In 14 years I have practised in the same area and have never hurt anyone or had a complaint, not bad out of approx 5,000 patients.
How do I do it get patients off pain meds, I show them a picture of David Beckham with ice on his knee. Patient agrees Beckham has the best medical advice money can buy so why is he using Ice and Joe Bloggs is taking Cox 2s or whatever. Presumably because there are no reps going around to the doctors surgeries selling frozen water.
As a registered chiropractor I was forbidden from saying that. The General Chiropractic Council forbids criticising medical doctors so I resigned from the register. Working in the Cuban health care system you learn the patient is paramount, A few years ago the Department of Health was trying to discover how Cuba could provide such excellent health care for $10 per head a capita. I am sure their enlightened approach to what they call “Natural Medicine” is a major reason. Every Poli clinic in Cuba can offer acupuncture instead of drugs.
I was very fortunate to have a tutor like Professor Jenny Bolton teaching me about evidence based medicine. You see Jenny spends her time with her students not courting the hacks of fleet street and may not be so familiar with medical prejudice of Edzard Ernst. Professor Bolton explained why we had to do a research project in our final year “The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.” Sackett et al 2000. He wrote that four years after I graduated. What to these evidence based fascists think students do at the AECC.
Jenny Bolton also said the “Purpose of Clinical research into chiropractic is to improve chiropractic practice not prove it. The quote I remember from Sackett was “Without clinical expertise, practise risks becoming tyrannised by evidence”…. I know what my patients want, they want to be helped they could care less about evidence. That is most important as it is becoming apparent that the majority of the people involved in this debate are not clinicians.
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