Chiropractors, etc.

[PrincessFiona]

I'm not a fan of naturopathy or chiropractic care either, but I don't have skin in the game since I don't use them. If someone feels differently than I do, I'm ok with that too. What bothers me personally is the lack of an evidence based approach to treatment. I also feel strongly about using an evidence based approach to treatment in traditional medicine, psychology, etc. Feelings are powerful things and unfortunately, medicine as it is now practiced often doesn't make room for this. People are diagnosed with diseases, treated with medications and are often left feeling like they haven't been listened to or not enough is being done. This creates a larger market for naturopaths/chiropractors I think. If doctors were still able to spend those extra few minutes explaining or talking to patients that might make a world of difference.

This is a timely topic, because the Montessori teacher here has been battling back pain for years. She has been seen for this by her chiropractor with adjustment after adjustment providing only short-term relief. Recently, she was in such pain that she was sobbing/crying/couldn't work for days. She saw her PCP (physician) who ordered an MRI and discovered that she has a bulging disk that is impinging her nerves... she has to turn to gentle physical therapy to try to avoid surgery ...

Also, there is a school of naturopathy here ... and they are responsible for some nasty misdiagnoses that end up becoming hospital admissions...also, there was the referral Thomas saw two weeks ago by the naturopath that diagnosed a systemic staph infection by looking in the patient's eyes. After being fit in as an emergency consult, the woman had no fever, there were no blood cultures drawn, and it was determined that she had a headache that was treated with tylenol.

[Vanquisher]

Kris, that is horrible, and something we see all the time. Another option before surgery could be an epidural steroid injection. I hope she gets the relief she needs soon.

[TulipsAndSunscreen]

I think all these things have their place. I had chronic knee pain when I trained for my first marathon. After an ortho work up, the MD suggested scoping my knee. After a visit to a chiro, he did active release on my knee and gave me some stretches. Clearly that was a case of inappropriate tx by an MD and I knew to seek a second opinion. Most MDs clearly would not have suggested a surgery so I'm not generalizing to all MDs but just saying that bad txs can go both ways.

I think there can be more quackery in alternative medicine but I do think it has a place. As long as they don't misrepresent their training or qualifications, I think we as intelligent consumers should be allowed to choose what we think will help us. I know not everyone wants to be an "intelligent" consumer (by doing this research) but I don't think that's a practitioners problem.

[MarissaNicole]

Just adding my two cents:

DH is HIGHLY skeptical of chiropractic care and says (not sure the accuracy of this) that one of the courses in their curriculum is "persuasion."

CONS: Just like any other profession, I think there are good chiros and bad chiros. Some I think offer care and send patients on their way; others have patients coming back to them forever in which case I'm not so sure they are really providing relief. I think some fail to refer patients to the proper healthcare provider and may try and provide alternative care when chiropractic care is not adequate/appropriate.

PROS: A good chiro knows his/her place in care and will send you to a massage therapist, physical therapist or orthopod when that's what you need. With my pregnancy I was in a lot of pain in my back, and tried massage, and even some physical therapy (my aunt and friend gave me exercises and tried working on me) with no relief. I figured I had nothing to lose and tried chiropractic. I think I was more open to it because my condition (pregnancy) is TEMPORARY so I didn't worry about them trying to get me come back forever. It has provided me so much relief.

Bottom line: Just as in any profession there are good ones and bad ones. I think they can be helpful in limited circumstances and just as any other specialty they need to understand where their expertise starts and ends. (Ex: the optometrists I've seen were great because they gave me eye exams, contacts and glasses, and they also knew to refer me to an optho when I had marks show up on the photos of my retina - so I go to both; they each have their place).

As far as calling them doctors - I think that if your degree says "doctor" there is no reason I won't try and respect the work you have done and address you by doctor. Whether that be a D.V.M., M.D., D.O., P.H.D, O.D., or D.C. I also understand the differences between the different "doctors" and realize that they all require different rigors of education but nonetheless they earned THAT degree. Every degree is DIFFERENT but I still think it should be acknowledged regardless of the level of prestige. You may not think that my juris doctor is worth crap, but I still earned it.

[niener]

I've seen a chiropractor since I was 13 and was discovered to have scoliosis. The ortho I saw naturally wanted to do surgery, put rods in my back, and put me in a back brace for months. My mom had been seeing a chiro for a couple of months for her TMJ and took me to him to see if he could provide a less traumatic treatment. Within a year of adjustments, my severe S-curve was straight as an arrow. No surgery, no scars, no piercing rods in my spine. I adore my chiro. He's become a family friend and even turned my dad, who it took years to convince him to even see a PCP, into a believer.

Now DH, on the other hand, is a skeptic. He's more open-minded about it now that he's seen how it helped me, but just like you Heidi he's seen plenty of cases in his ortho rotations made worse by chiropractic care. But I want to echo here what ST said - the people who come into an ortho clinic with prior chiropractic care are an extremely self-selecting group. You would have never seen me in clinic. It reminds me of the c-section statistic with at-home births. Of course the rate is lower with at-home births; that's generally a lower risk cohort.

I think chiropractors make so many MDs uneasy because the standards of care vary widely and are less regulated, but that doesn't mean they're all "quacks". In my limited experience, I've met more "quack" MDs than "quack" chiros. For example, when I moved recently to a new state where rules are more lax regarding nurse-midwives (another class of heathcare providers some people consider "quacks") I decided to go see one for my gyn care instead of an MD. She was completely shocked at a certain regiment my previous Gynecologist put me on and thought it was very inappropriate for me. She changed it and within 2 weeks I felt 100% better.

I think all classes of heathcare providers have their place and the best ones in every field are the ones who can recognize when something is beyond their expertise.

[weeniegeniewife]

As far as calling them doctors - I think that if your degree says "doctor" there is no reason I won't try and respect the work you have done and address you by doctor. Whether that be a D.V.M., M.D., D.O., P.H.D, O.D., or D.C. I also understand the differences between the different "doctors" and realize that they all require different rigors of education but nonetheless they earned THAT degree. Every degree is DIFFERENT but I still think it should be acknowledged regardless of the level of prestige. You may not think that my juris doctor is worth crap, but I still earned it.

Absolutely, ITA!!!

[weeniegeniewife]

I think all classes of heathcare providers have their place and the best ones in every field are the ones who can recognize when something is beyond their expertise.

Yep.

[houseelf]

Funny, I laugh at the prospect of someone calling me doctor even though I have a JD. It feels uncomfortable and pretentious, but that's me. I don't look down at other people who refer to PhDs or JDs as doctors though. Come to think of it, the precise military hierarchy of titles weirded me out a little too. I'm far too entrenched in my American egalitarian views, probably. But I digress in a conversation that is highly entertaining and interesting only to me.....

I think this conversation has touched upon several fascinating subjects that are broader than the original question. I certainly am not a fan of chiropracters because of my parents' experience and my husband's views, but I'm open minded enough to know that I might be wrong in some cases.

Hell yeah there are quacks on all sides of the medical equation. One of the saliant points mentioned by the OP is the scope of what a practioner is willing to do. A popular refrain from the surgeon in residence here is that a good surgeon knows when not to cut. DH is the first to tell a patient's parents that while he could remove an angioma from someone's face, plastics would do a better job. Also, he frequently criticizes a few surgeons for their aggression to cut but I'm going to be circumspect about which particular surgeons in order to protect the guilty. I can get on board with lamenting the fact that some chiropracters, podiatrists, D.O., and MDs exceed the scope of their abilities which is far more dangerous than the effect of the underlying ailment. I don't know that I can cast the entire profession of chiropracter as quackery but I can agree that often many DC exceed their scope of abilities.

[weeniegeniewife]

I see two different discussions here: the medical profession that is dubious about chiropractors and other "alternative" practitioners, and lay people who may experience great benefits and help from those practitioners. I don't begrudge anyone who feels better after chiropractic, homeopathy, Reiki, and whatever else is out there. If it helps them (for whatever reason, including placebo), great!

[MarissaNicole]

I wouldn't want to be addressed as doctor either, I was merely trying to point out that all degrees should be acknowledged whether you respect the education/title or not.

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[DCJenn]

As long as everyone sticks to their scope (a constant battle in the Mental Health practitioners world, too) it's all fine. I think that often what some people want to seek medical care for would be better addressed by a gym membership and a nutritionist, just like NOT seeking medical care but going to your massage therapist isn't going to make your cancer go away, either. We've known plenty of people who head to Mexico for alternative treatments when the Western Medicine either doesn't work or has run it's course. Do I think it'll work? Not likely- but the power of positive thinking does often do amazing things so who knows what the real deal is.

I have gone to a chiropractor and an acupuncturist and a hypnotist (for quitting smoking- it worked for a while) and my regular NP and MD. I also love going for massages and my primary means of exercise and mental therapy is yoga.

Whatever works as long as it's not doing more damage.

J.