That's so Chiropractic

That's so Chiropractic

Some Chiropractors want to become primary care providers.  Bad idea.  Jann Bellamy and Harriet Hall have written about this at Science-Based Medicine. There are multiple issues with chiropractors taking care of people with real diseases.

The first is that their education in school is woefully inadequate to diagnose and treat common medical problems.

The second is that their practical training is equally inadequate. I have yet to meet a new medical school graduate who is even barely competent to take care of patients. It is why they have a residency. Most of the real meat of medical training occurs during the 3 to 7 years after medical school. Chiropractors do not have any meaningful post graduate training. 

Third is their raison d'etre, the correction of subluxations, has no basis in reality, and, as discussed a few days ago, chiropractors have no interest in altering practice in increase patient safety.

And finally, they do not want to participate in key principles of primary care. Part of primary care is diagnosis and treatment of acute and chronic medical problems and they have no training for this. But another part is health maintenance: doing the testing and treatments for the prevention of diseases. As an example, giving vaccines.

Vaccines are a key part of health maintenance and arguably the most important intervention to improve human health. Maybe fresh water and flush toilets were more important. I remain uncertain.  Part of health maintenance is making sure your patients are up to date in their vaccines.

And Chiropractors are often loudly and proudly against vaccines: Immunizations by Colorado DCs: Really?

Are You Prepared to Vaccinate?

Did no one in Colorado get the memo? Based on the feedback I've received from previous columns, not many doctors of chiropractic support prescriptive injectables2 and precious few would be willing to give immunizations to infants.

and

In my opinion, providing risky immunizations to Colorado babies for the purpose of accomplishing a pro-drug agenda is much like a betrayal of those infants for "30 pieces of silver."

Chiropractors do not subscribe to the reality that vaccines have been and are one of the key tools in the prevention of infections:

A greater than 92% decline in cases and a 99% or greater decline in deaths due to diseases prevented by vaccines recommended before 1980 were shown for diphtheria, mumps, pertussis, and tetanus. Endemic transmission of poliovirus and measles and rubella viruses has been eliminated in the United States; smallpox has been eradicated worldwide. Declines were 80% or greater for cases and deaths of most vaccine-preventable diseases targeted since 1980 including hepatitis A, acute hepatitis B, Hib, and varicella. Declines in cases and deaths of invasive S pneumoniae were 34% and 25%, respectively.

Chiropractors heck no antagonism is further evidence against their being responsible for primary care.

Are you willing to administer all of those vaccinations to your infant, adolescent and adult patients so you can meet the accepted standard of a primary care physician? I suspect the majority of you will not just say, "No," but will say, "Heck no!" So, if we are not willing to do that, then maybe it's time for us to stop trying to be something we don't want to be and trying to obtain authority to do things we don't want to do...However, I do not think the majority of the chiropractic profession believes that primary care – when it includes the medical "Holy Grail" of vaccinations – is the right course to follow.

For once I am in agreement with a chiropractor: they should stay out of primary care.

 

Points of Interest 8/12/2014
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