Deadly quacks:

Neurologists have long protested the practice of 'highest neck manipulation,' which in some cases has resulted in lethal strokes

J. William Kinsinger, MD

National Post - Thursday, February 17, 2005

Ontario's decision to remove chiropractic care from its roster of publicly-funded health care services has been painted in the press as a purely budgetary choice. In fact, the government's decision was justified on both medical and ethical grounds. For the good of Canadians' health, one can only hope that other provinces follow suit.

Chiropractors are not "doctors," they do not train in any hospital and their medical teachings have been rejected by many universities. Chiropractic treatment is based on the philosophical -- not scientific -- idea that spinal manipulation can treat just about any illness, including asthma, hypertension in adults, autism in children and ear infections in babies.

The Ontario Chiropractic Association has marketed this idea well, instructing parents to bring newborn babies to chiropractors "as soon after birth as possible," and issuing alarming statements saying that "our children deserve to be treated naturally, not with dangerous chemical drugs and unproven surgeries." Such specious rhetoric has proven effective. Over the past 10 years, more than $100-million has been billed by Ontario chiropractors to treat infants and children, using spinal manipulation, for everything from newborn colic to bed-wetting. It has even been presented as an alternative to immunization. Thankfully, the medical community has moved to debunk such claims.

In 1994 and again in 1998, the Chiefs of Pediatrics of Canadian Hospitals rightly stated that spinal manipulation of infants and children is "ineffective and useless." Accordingly, they called on provincial governments to stop paying for the treatment.

Neurologists, meanwhile, have long protested the chiropractic practice of "highest neck manipulation," used frequently on people who have no neck pain whatsoever. Although coroner's inquests have found that highest neck manipulation can cause lethal strokes, chiropractors have persisted, claiming that strokes and death occur only rarely.

In fact, such outcomes are not rare, and case reports detailing strokes have been published in numerous respectable medical journals over the past 60 years. Two further reports appeared in 2004 alone. One can only wonder why Ontario waited so long to cut payment for such procedures.

Ontario chiropractors have also been marketing "maintenance care" as a means to sell their services, and have billed for hundreds of millions of dollars by performing spinal manipulation on people who are perfectly well. Wisely, the Center for Medicare and Medicaid Services in the United States recently delisted all such claims.

Ontario's decision to delist chiropractic services ought to be permanent. And Alberta, Manitoba and Saskatchewan, which still cover the cost of chiropractic treatment, should follow its lead. Unfortunately, some opposition politicians are making an issue of Ontario's decision.

The province's Conservative leader, John Tory, wrote in the Post last December that a "visit to a chiropractor costs less than one to a family doctor or an orthopedic surgeon." This is a narrow view: Whether a service is cheap or not matters little if the benefit is dubious and the attendant risks considerable.

Chiropractors misleadingly market themselves as mainstream health care professionals, offer help to those who do not need it and endanger patients by promising results they have neither the training nor the ability to deliver. Ontario has not only saved money by delisting chiropractic services -- it has saved lives as well.

J. William Kinsinger is an American physician, and a member of a professional group monitoring government support for alternative medicine.

National Post 2005

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