Self-proclaimed "quackbuster" Dr. Stephen Barrett is getting
media attention again and he wastes no time taking a stab at the
chiropractic profession:
"Chiropractors too have felt Barrett's sting. While he sees
benefits in chiropractic manipulation, he wonders about 'a whole
profession based on an idea--subluxations--that isn't true.'"
The article portrays Barrett as a hero, promotes his website: http://www.quackwatch.com
and contains this quote as well: "Twenty years ago, I had trouble
getting my ideas through to the media, today I am the media." We know
the extent of Barrett's ignorance from the statement regarding
subluxations and with the "I am the media" quote we now have
some insight into the size of Barrett's ego.
Keep in mind that Barrett is on the Editorial Board of The Scientific
Review of Alternative Medicine and is a long time collaborator of Sam
Homola.
Prometheus Books, which publishes the alternative medicine journal also
published Homola's and Barrett's books.
Following this Update you will find a letter I wrote to the Editor of
TIME Magazine regarding Barrett's statement. I encourage you to do the
same. Stick to the facts, keep your emotions out of it and let them know
that Barrett and his buddies are profoundly ignorant regarding this topic.
The Editorial addresses for TIME are:
Send a copy to both and forward a copy to me in case TIME does not
publish it and I will post it on the JVSR site.
For those of you who do not respond to TIME and who do not subscribe to
JVSR, I encourage you to make a simple contribution to the research that
supports what you do in your practice day in and day out by subscribing to
JVSR. Otherwise, as one episode after another like this occurs, who will
be the voice that answers them? As always, I look forward to your
feedback, comments and suggestions.
Dear Editor,
Leon Jaroff's article titled: The Man Who Loves to Bust Quacks in the
April 30, 2001 issue of TIME contains an absurd quote from self proclaimed
"quackbuster" Stephen Barrett regarding chiropractors. Barrett
contends that subluxations (what chiropractors treat) essentially do not
exist.
This statement is akin to saying that dental caries do not exist and
left unanswered poses a threat to public health since a person with a
subluxation may not get needed care. Readers of TIME should know that
state laws, the United States Federal Government, The World Chiropractic
Alliance, The Council on Chiropractic Practice, The International
Chiropractor's Association, The American Chiropractor's Association, The
Federation of Straight Chiropractic Organizations, and The Association of
Chiropractic Colleges all define the responsibility of chiropractors as
the detection and correction of vertebral subluxation and its resultant
neurological interference.
The chiropractic guideline document: Vertebral Subluxation in
Chiropractic Practice, produced by the Council on Chiropractic Practice
was reviewed by an independent research agency (ECRI) which is a
Collaborating Center of the World Health Organization. Based on this
review it was accepted for inclusion in the National Guideline
Clearinghouse of the Agency for Health Care Policy and Research of the
United States Federal Government.
The existence of subluxation is in accordance with the published
paradigm statement of The Association of Chiropractic Colleges, which was
accepted and signed by every Chiropractic College President in North
America. The ACC defines the purpose, principles and practice of
chiropractic as the finding and reduction of vertebral subluxations, which
will prevent and restore health by removing interference to the body's
inherent recuperative powers. This document, among other things, states
that chiropractic as a profession "focuses particular attention on
the subluxation."
The assessment and management of vertebral subluxation is either taught
as part of the regular curriculum of chiropractic colleges in North
America or as part of their post graduate programs. All of these programs,
including the general curriculum of the chiropractic colleges and the post
graduate programs, are approved and Accredited by the Council on
Chiropractic Education which is subject to the rules and authority of the
United States Federal Government's Department of Education. These schools
also hold accreditation through various local and regional accrediting
bodies.
The American Medical Association, in its Guides to the Evaluation of
Permanent Impairment, list the following as acceptable means to rate
impairment: Impairment due to loss of muscle power and motor function,
impairment due to abnormal motion of the spine, impairment due to loss of
motion segment integrity, impairment due to disc problems, impairment due
to pain or sensory deficit, and segmental instability. These are, in fact,
components of the Vertebral Subluxation Complex.
The Guidelines for Evaluation and Management Services published by the
Health Care Financing Administration of the United States Federal
Government and the American Medical Association (May 1997) outline what an
objective examination should consist of and these include commonly used
neuromusculoskeletal exam procedures within chiropractic such as: postural
analysis, palpation, assessment for subluxation, range of motion and
assessment of muscle tone. All of these are used to assess and manage
subluxation.
The Federal Government of the United States specifically defines what
chiropractors do as the detection and correction of subluxation under
Medicare and Federal worker's compensation laws. Common to all state
statutes is the adjustive process being utilized to reduce subluxations
and the resultant interference to nerve transmission. No less than 38
states employ the term adjustment in licensing laws in reference to the
procedures applied by chiropractors. 18 state statutes additionally
include the concept of manipulation, 34 states contain specific references
to responsibility for neurological complications of biomechanical origin (subluxation)
and over half the chiropractic profession practice in these states. In
addition, 11 states specifically discuss the concept of subluxation in
their statutes by using the term and for those that do not specifically
use the term there is an implied understanding of the concept in their
statutes.
The existence of subluxation and its acceptance is spelled out in
explicit detail by published policy statements of chiropractic
organizations as well as federal and state laws regulating the practice of
chiropractic. The epidemiology of subluxation has been researched since
the inception of chiropractic over 100 years ago with basic science and
clinical research to further elucidate the nature of it continuing to this
day. Dr. Barrett's comments regarding subluxation are irresponsible and
lack any scientific justification. I trust you will inform your readers of
the facts regarding this matter.
Best Regards,
Dr. Matthew McCoy
Editor - Journal of Vertebral Subluxation Research http://www.jvsr.com
Reader Responses
Short Note
A short note to convey my thanks for your brilliantly written letter. Thank you for continuing to guard our profession.
Yours, Dr Paul Finn, Chiropractor. Melbourne, Australia
Amazes Me
As a chiropractor, it amazes me that people like Stephen Barrett (April 30, 2001) can still find a voice in a reputable magazine such as yours. Please do your research and I think you will find that Dr. Barrett has a long history of a strong anti-chiropractic bias. In my opinion, it is clear that he is far more interested in promoting his agenda and himself than seeking out the truth. Both state and federal governments define chiropractic care as "the detection and correction of subluxation", yet Barrett seems to deny the existence of a spinal subluxation outright.
It seems odd to me that your magazine would publish Barrett's remarks about chiropractic as if he where an expert on chiropractic, while ignoring credible sources such as state and national chiropractic organizations and state and federal governments. In my opinion there are quacks out there...they are people like Barrett who wave their ignorance as a flag while turning their head to the fact that hundreds of thousands of people are killed each year by the medical field (JAMA July 2000). It will never cease to amaze me.
Yours in Health, Dr. Kenneth T. Hicks Historic Roswell Chiropractic Roswell, GA
Loved that Letter
I really loved that letter. I used some of your stuff. I appreciate your being there.
How Prophetic
How prophetic was B.J. ? He said that one day medicine would seek to take what we have, call it their own, and still call us quacks. And the sad thing is, that's the idiocy being propagated by the medical profession (still), the media, and yes, even other D.C.s. I believe B.J. also paraphrased another pundit who once said that if you don't stand for something, you'll fall for everything, and be good for nothing. It is true that for evil to triumph, all that is necessary is for a few good men to stand by and do nothing.
Stephanie R. Grenier, DC Mayor, City of Auburn, GA
Health Czar
Dear Editor,
Since when is Stephen Barrett, MD running for health czar? In reading Leon Jaroff's article titled: "The Man Who Loves to Bust Quacks" in your April 30th issue, Dr. Barrett is portrayed as a hero of public health, while his critics are painted as naive and reactionary.
Is Dr. Barrett aware of how damaging his flippant comments can be? As a practicing subluxation-centered doctor of chiropractic, I am presented with the consequences of health illiteracy every day. The AMA Foundation says it effects nearly 90 million Americans.
A few quotes from their site illustrates the impact of health illiteracy: "Estimates show that more than 50% of all Americans experience difficulties in accessing the health care system, as well as obtaining accurate diagnosis and appropriate treatment because they cannot understand or utilize the information they are provided."
"This phenomenon costs us an estimated $73 billion year. The problem affects all age and economic groups and costs billions in potentially avoidable expenses, such as unnecessary doctor visits, hospitalizations, and longer hospital stays." For more detail see: AMA Article 3125-3307
In light of THAT reality, Dr. Barrett’s dismissive comments regarding subluxation’s validity riled my sensibility. Allow me to itemize some salient points in this matter.
Dr. Barrett made a statement about chiropractic manipulation having some benefits, which go unmentioned, while he still wondered about... "a whole profession based on an idea-- subluxations-- that isn't true". This can mistakenly lead the reader to conclude that subluxation, as a term, was invented by chiropractic. In fact, in a January 1997 article in The Chiropractic Journal, written by Christopher Kent, DC, a much different origin for subluxation was uncovered.
"The term "subluxation" has a long history in the healing arts literature. According to Haldeman [1] it was used at the time of Hippocrates [2], while the earliest English definition is attributed to Randall Holme in 1688. Holme [3] defined subluxation as "a dislocation or putting out of joynt." Watkins [4] and Terrett [5] refer to a 1746 definition of the term."
The problem surrounding the term concerns the ongoing lack of interdisciplinary continuity in defining it. Kent continued...
"The matter is further complicated by the diverse array of alternative terms used to describe subluxations. Rome listed 296 variations and synonyms used by medical, chiropractic, and other professions. Rome concluded the abstract of his paper by stating, "It is suggested that, with so many attempts to establish a term for such a clinical and biological finding, an entity of some significance must exist." [6]
Given the degree of health illiteracy out there, Dr. Barrett's comments are at the least unfounded, and at the extreme, inflammatory. The chiropractor's task to resolve subluxation is daunting enough, given the climate of the culture. The crux of my objections is that unless the reader recognizes chiropractic as a non-therapeutic discipline, they’d accept Dr. Barrett’s interpretation as suitable. In actuality, chiropractic doesn’t diagnose ANY disease or treat named conditions at all. To have your publication give credence to Dr. Barrett's limited viewpoint only perpetuates these misconceptions for everybody, on both sides of the issue.
Finally, does Dr. Barrett seriously consider himself an "investigative journalist"? If so, I'd rather see him articulate his misgivings about chiropractic in a manner that presented his whole view, referencing both perceived risks and benefits with facts, not his personal opinion or experience. However, I’m not hopeful. If any of your readers does some "investigating" about Dr. Barrett's background, the color of his particular brand of journalism, with respect to chiropractic, gets as plain as sunshine. I regret TIME did not do a similar job before this article was offered for public consumption.
Cordially Yours, Mark R. Filippi, DC WCA Director of Collaborative Education and Practice Associate Editor of the Journal of Vertebral Subluxation Research
Awesome
Awesome job responding to the article in time. I appreciate your powerful prose and argument. Very well said.
Blessings for vibrant health and prosperity, Karl R.O.S. Johnson, D.C., L.C.P. (hon.)
Well respected colleagues
Perhaps Dr. Barrett should read some of his well-respected colleagues' work; in particular, Dr. Barrett should refer to Drs. Kirkaldy-Willis and Burtons' book, "Managing Low Back Pain", in which they refer to "subluxation" and its effects on nerve function (specifically, lateral nerve entrapment). These MD's have text and schematics which represent the effects of subluxation on nerve function. On page 63 of their 3rd edition text, they offer a table showing that subluxations and disc resorption result in lesions involving lateral nerve entrapment. On page 65 of the same text, they show a diagram illustrating a subluxation which reduces the size of the foramen...can this result without concomitant nerve involvement? Chapter 16 is devoted to "Manipulation" and its positive effects on a number of "conditions" involving nerve function.
While this is not the ideal text for chiropractic, it does demonstrate the medical community acknowledgment of subluxation and its deleterious effects on nerve function. Chronological time (not the magazine) and subluxation research will prove Dr. Barrett wrong. We should not, however, discount the possibility that Dr. Barrett is THE media....as in the Enquirer or Mad Magazine.
Dr. Jack M. Bourla Providence Chiropractic Center
If you don't stand for something...
How prophetic was B.J.? He said that one day medicine would seek to take what we have, call it their own, and still call us quacks. And the sad thing is, that's the idiocy being propagated by the medical profession (still), the media, and yes, even other D.C.s. I believe B.J. also paraphrased another pundit who once said that if you don't stand for something, you'll fall for everything, and be good for nothing. It is true that for evil to triumph, all that is necessary is for a few good men to stand by and do nothing.
How can a publication of your stature write an article that is so one sided about chiropractic or any other profession? Especially without checking out the information from reliable sources within that profession to see if the information is true or misleading. Would you have the same courage to write an article about medicine with information supplied to you by a chiropractor who did not bother to research his information and based all of his information on his own personal opinions?
Chiropractic Naturally, Tracy L. Gabbert, D.C.
Disturbing
Letter Originally Sent to Time Magazine
Editor, Time Magazine
It is disturbing to see TIME stoop to irresponsible propaganda smacking of yellow journalism where public health is concerned. Leon Jaroff's article, "The Man Who Loves to Bust Quacks," (April 30, 2001), glorifies self-proclaimed "quackbuster" Stephen Barrett and seeks to discredit doctors of chiropractic. Barrett, long known for his anti-chiropractic stance and inaccurate criticisms of the chiropractic profession contends that the pathophysiological condition, vertebral subluxation, does not exist.
Chiropractic is the third largest doctoral level health care profession after medicine and dentistry. Approximately 28,000 Americans visit a doctor of chiropractic every year. Ten decades of research has demonstrated chiropractic to be a proven, safe, and effective health care science. Chiropractic is recognized as an integral part of the American health care system by the federal government and through most managed health care and insurance programs.
While many state licensing boards authorize the practice of spinal manipulation by physicians and other providers or therapists, doctors of chiropractic are the only health care providers educated and trained specifically to perform chiropractic adjustments to correct vertebral subluxation. According to the Association of Chiropractic Colleges, vertebral subluxation is a complex of functional, structural, or pathological spinal joint changes that compromise the integrity of the nervous system and may influence organ system function and general health.
The focal point of chiropractic practice is the detection and correction of vertebral subluxation for the purpose of reducing interference to nerve transmission. International research validates chiropractic's role in subluxation correction. The Manga Report from the University of Ottawa in Canada reviewed all available international evidence on the use of chiropractic and concluded, "Many medical therapies are of questionable validity or are clearly inadequate. Chiropractic care is greatly superior to medical treatment in terms of scientific validity, safety, cost-effectiveness, and patient satisfaction."
Similarly, a special commission appointed by the government of New Zealand reported, "Chiropractors should, in the public interest, be accepted as partners in the general health care system. No other health professional is as well qualified by his general training to carry out a diagnosis for spinal mechanical dysfunction or to perform spinal manual therapy."
Current venues of chiropractic research, such as those found in the Journal of Vertebral Subluxation Research, are increasing in areas other than the well-accepted effectiveness of chiropractic care for musculoskeletal conditions to include the benefits of chiropractic care on whole-body wellness. It is irresponsible and poor journalism to deny these facts to your readers.
Sincerely, Gerald Anzalone, D.C.
Absurd Quote
Leon Jaroff's article titled: The Man Who Loves to Bust Quacks in the April 30, 2001 issue of TIME contains an absurd quote from self proclaimed "quackbuster" Stephen Barrett regarding chiropractors. Barrett contends that subluxations essentially do not exist. Dr. Barrett's comments are irresponsible and lack any scientific justification. The Vertebral Subluxation Complex is what chiropractors detect and correct every day in our offices. In fact, there is a peer-reviewed research journal, the Journal of Vertebral Subluxation Research, published each quarter with the latest research documenting the harmful effects of the subluxation on human health.
Readers of TIME should know that state laws, the United States Federal Government, The World Chiropractic Alliance, The Council on Chiropractic Practice, The International Chiropractor's Association, The American Chiropractor's Association, The Federation of Straight Chiropractic Organizations, and The Association of Chiropractic Colleges all define the responsibility of chiropractors as the detection and correction of vertebral subluxation and its resultant neurological interference. The chiropractic guideline document: Vertebral Subluxation in Chiropractic Practice, produced by the Council on Chiropractic Practice was reviewed by an independent research agency (ECRI) which is a Collaborating Center of the World Health Organization. Based on this review it was accepted for inclusion in the National Guideline Clearinghouse of the Agency for Health Care Policy and Research of the United States Federal Government. The assessment and management of vertebral subluxation is either taught as part of the regular curriculum of chiropractic colleges in North America or as part of their post graduate programs. All of these programs, including the general curriculum of the chiropractic colleges and the post graduate programs, are approved and Accredited by the Council on Chiropractic Education which is subject to the rules and authority of the United States Federal Government's Department of Education. These schools also hold accreditation through various local and regional accrediting bodies. Just because Dr. Barrett refuses to acknowledge the subluxation doesn't mean that they don't exist. The science and the patients show us otherwise.
Vince Campbell, D.C. Madison, Georgia
Ignorant and Archaic
I am writing regarding the article featuring Stephen Barrett. His comments regarding the authenticity of the vertebral subluxation complex are both ignorant and archaic. As a practicing chiropractor for 21 years, I have seen the human body recover from many conditions when the VSC was reduced or corrected. With technology such as surface emg, thermal scans, MRI, and x-ray, the various component parts of the VSC are objectively analyzed. Improvements are documented. Return to more normal function, resolution of subjective symptoms, and reported improvement in quality of life all attest to the validity of the art, science, and philosophy of chiropractic. Barrett needs to find a more constructive hobby. His axe has been ground beyond use.
Richard A. Crocetto, D.C.
...well off the mark.
(Reprint of letter to Time Magazine)
Dear Editor,
Leon Jaroff's article about Stephen Barrett regarding chiropractors is well off the mark. You portray Dr. Barrett as a hero and allow him to state "he is the media". Dr. Barrett denies an entire profession based on subluxation, because "there is no such animal" (my quote)
I am not going to defend chiropractic by stating all the federal agencies which allow us to practice in all fifty states, knowing all chiropractic schools define chiropractic care as the detection and correction of vertebral subluxation.
The scientific community has no problem with the term subluxation. There are many scientific researchers now accepting the term subluxation. I wish to mention just a few references to counter one man's crusade against windmills. Kenneth Blum Ph.d., a research professor at University of Texas in Houston is responsible for over 300 scientific articles in professional journals
and the discoverer of the first gene associated with addictive and compulsive behavior, has embraced the term subluxation. Candace Pert, a well-known neuroimmunology expert and the leading researcher on biochemistry of emotions, finds the term subluxation acceptable. "Reward Deficiency Syndrome-A Biogenic Model" contains 400 scientific references and presents a scientific model for the vertebral subluxation model. The Journal of Psychoactive Drugs and Molecular Psychiatry, both prestigious periodicals, have printed research containing the subluxation paradigm. These are just a few non-chiropractic
researchers validating our chiropractic premise. We don't receive federal grants, like medicine, to fund research. We depend on ourselves and friends of chiropractic.
Dr. Barrett has ridiculed my profession for years. Substance is not on his side, rhetoric, maybe. My personal opinion is he probably has a subluxation.