March 29, 2016

Re: DONALD TRUMP, CHIROPRACTORS AND THE AMERICAN VOTER

By Tristan Schaub In Chiropractic Pop Culture, Chiropractic Success

Our response to Dr. Bart Barrett’s post regarding Trump voters and Chiropractic

Want to be the Ultimate Chiropractor? Join us at the ChiroSushi Summit

On January 23rd, 2016 Dr. Bart Barrett, a family physician from Huntington Beach posted a blog that took a giant leap connecting Trump voters to Chiropractic care.

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“So how is he winning?

The answer can be found in an unexpected place- chiropractic care.”

He continues:

“There is no scientific evidence that chiropractic care is beneficial, nor is there any anatomic or physiologic basis for the theory upon which chiropractic is based. In spite of the lack of supportive evidence over 15 million Americans visit a chiropractor every year. “

Yet scientific research has been conducted for years proving the benefits of Chiropractic, including;

  1. Journal of the American Medical Association (JAMA) – Chiropractic and Low Back Pain
  2. Journal of Spine –Adding Chiropractic Manipulative Therapy to Standard Medical Care for Patients With Acute Low Back Pain
  3. Journal of  Manipulative and Physiological Therapy – Significant changes in systolic blood pressure post vectored upper cervical adjustment vs resting control groups
  4. Journal of Manual and Physiological Therapeutics Magnetic resonance imaging zygapophyseal joint space changes (gapping) in low back pain patients following spinal manipulation and side-posture positioning
  5. Journal of Manual and Physiological Therapeutics – effects of chiropractic spinal manipulative therapy (SMT) and epidural nerve root injections (NRI)
  6. Non-invasive physical treatments for chronic/recurrent headache
  7. Manipulation or mobilisation for neck pain

Even Harvard Medical School supports Chiropractic!

Dr. Barrett continues

“When I have asked patients why they seek chiropractic care in spite of the overwhelming evidence against it, their answers are eerily similar to the reasons given for voting for Trump.”

So let’s go down the rabbit hole Dr. Barrett presents:

The Establishment has failed them.

For patients with chronic back pain, the medical establishment seldom provides a cure. Desperate for an answer they turn to someone who promises he can make them great again. Voters who feel as if the political establishment has failed them are willing to look somewhere, anywhere, to anyone who will tell them what they want to hear.

We agree. The establishment has failed us.

Researchers reviewed records from 1,450 patients in the Ohio Bureau of Workers’ Compensation database who had diagnoses of disc degeneration, disc herniation or radiculopathy, a nerve condition that causes tingling and weakness of the limbs. Half of the patients had surgery to fuse two or more vertebrae in hopes of curing low back pain. The other half had no surgery, even though they had comparable diagnoses.

After two years, just 26 percent of those who had surgery returned to work. That’s compared to 67 percent of patients who didn’t have surgery. In what might be the most troubling study finding, researchers determined that there was a 41 percent increase in the use of painkillers, specifically opiates, in those who had surgery.

The study provides clear evidence that for many patients, fusion surgeries designed to alleviate pain from degenerating discs don’t work, says the study’s lead author Dr. Trang Nguyen, a researcher at the University of Cincinnati College of Medicine. – source 1 and source 2

2. They don’t trust Medical Professionals.

They do not trust medical research and feel that the system is corrupt and entirely motivated by money. They believe that big pharmaceutical companies and the AMA work together to find ways to make money, ignoring the needs of patients. They leave the system and seek care from an outsider who they believe is not beholden to these special interests. Voters who feel that the system is corrupt and that politicians can be bought are drawn to a billionaire who will not need to sell out.

While Dr. Barrett’s payouts from Big Pharma are relatively low and most likely coffee or lunches the reality is the pharmaceutical industry spends an awful lot of money on Doctors.

Dollars for Docs ProPublica

Also see:

Now There’s Proof: Docs Who Get Company Cash Tend to Prescribe More Brand-Name Meds

The more money doctors receive from drug and medical device companies, the more brand-name drugs they tend to prescribe, a new ProPublica analysis shows. Even a meal can make a difference.

3. Doctors didn’t understand them.

Their pain has been ignored and they concerns downplayed. They want someone who focuses on what matters to them. What matters to them is their pain. Voters who are suffering from lost jobs, who feel threatened and unsafe are drawn to someone who addresses these issues in a language they can understand.

With doctor’s compensation being tied to multiple variables from the ACA, patient time with a provider has decreased and options for care have been narrowed, which Dr. Barrett has admitted himself in a Yelp review response:

Barrett A Bart MD Huntington Beach CA 4 Reviews added this month Yelp

4. They feel better when they see a chiropractor.

It doesn’t matter that there is no reason for them to feel better or that the feeling may not last. It does not matter that the pain would have faded over time without treatment. It does not matter that the short term pain relief may be accompanied by longer term damage. They want to feel better now. Trump makes some people feel better about themselves. It may come at the expense of others and it may lead to long term harm to the country, but as long as they feel better now, they will overlook the risk.

I have learned over the years that rational arguments have little effect on emotional positions. My scientific facts do not matter to people who want to be referred to a chiropractor, and political reasoning is unlikely to change the vote of a Trump supporter.

Let’s use an example of one of the largest pharmaceutical companies in the world and one of society’s favorite “feel good therapies” : Allergan and Botox

Botulinum toxin, a purified protein derived from the bacterium Clostridium botulinum, has been researched for ~100 years.  Ever since the bacterium was identified in 1895, researchers have been intrigued by its potential therapeutic uses.  

In 1989 The therapeutic value of Botulinum Toxin Type A to address an unmet medical need was recognized when Oculinum, Inc. received one of the first approvals by the U.S. Food and Drug Administration (FDA) under the newly established orphan drug status to market Oculinum in the United States for the treatment of strabismus and blepharospasm (uncontrollable eye blinking) in people 12 years and older.  Shortly after, Allergan acquired Oculinum, Inc. and received FDA approval to change the product’s name to BOTOX® (Botulinum Toxin Type A), which was recently changed to BOTOX® (onabotulinumtoxinA). 

In 2013 the U.S. Food and Drug Administration today approved a new use for Botox Cosmetic (onabotulinumtoxinA) for the temporary improvement in the appearance of moderate to severe lateral canthal lines, known as crow’s feet, in adults.

Yet, Cosmetic Surgeons and Dermatologists had been using Botox off-label and for unapproved indications for years.

It took time and most importantly money to get the FDA approval Allergan needed to promote for more indications. As of this writing, Allergan is trading at 273.91 USD on the stock market while Chiropractic is not traded.

What about studies on the preventive effects of chiropractic?

It is far easier to study chiropractic as a treatment than as an approach to wellness. When a patient has a specific complaint that can be measured by level of pain or certain limitations, different interventions can be compared in their ability to affect changes. But how does one measure wellness?

This is one of the elusive issues in research. What should the measures be and how does one control for the confounding effects of daily living? The currently accepted standard of sound clinical research is the randomized controlled trial, but in order to study wellness, other approaches will need to be devised and validated. Because of these issues, there is little research on the preventive effects of chiropractic. -source

If patients are feeling good, isn’t that the point? And science does support Chiropractic, which is underfunded yet privately researched every day in practice.

The proof is in the pudding they say and that pudding is visible from online reviews all over the web, where Chiropractor’s average 1 star ahead of medical doctors.

Source: Yelp; ProPublica analysis; NYU Polytechnic School of Engineering, Department of Computer Science and Engineering

Credit: Alyson Hurt/NPR

CATEGORY

REVIEWS

AVG. RATING

Doctors

286,033

3.6

Chiropractors

108,229

4.6

If Chiropractic didn’t work, don’t you think by now, in this day and age…it would be vanishing like AMA members? 

No, in fact the amount of Chiropractor’s are expected to grow at some of the highest rates.

13 Comments
  1. Kevin Smith, D.C. March 29, 2016

    I would love to debate Dr. Bart Barrett about the efficacy and safety of chiropractic care, and what has been published about this in the index medicus scientific literature. In fact, I would love to do this on nationally television with the whole world watching.

    In my book “Modern Chiropractic: The Way To A Pain-Free Lifestyle”, I have 25 pages of peer reviewed research citations proving chiropractic to be a safe and effective treatment for a variety of musculoskeletal problems.

    Reply
  2. Scott March 31, 2016

    Dr Barrett is clearly very ignorant. I thought it was common knowledge now that chiropractic is backed by research. He is the epitome of the Republican establishment! Clueless!

    Reply
  3. Dr Michael Breneman March 31, 2016

    Dr Barrett may need to be reminded that he is a by-product of the lingering effects of the American Medical Ass. conspiracy to contain and eliminate a more effective competitor, under the guise of protecting the public. WILK et. al vs. AMA 1974-1990.

    Reply
  4. Steven Becker, D.C. March 31, 2016

    Is there any relation to Stephen Barrett, M.D. the long known and disgraced anti-chiropractic psychiatrist?

    Reply
  5. Dr. Bart Wetherington, DC April 1, 2016

    I feel sorry for Bart Barrett and all of his patients. There is never an excuse for ignorance. Also, there is nothing more dangerous than an ignorant, ego driven Doctor. He screams to the top of his lungs about what he feels is dangerous in Chirooractic, but sticks his head in the sand about the dangers of immunizations. He chooses to ignore a scientifically proven treatment for his patients not to help them, but to help his own self. That, folks, is a dangerous Doctor.

    Reply
  6. Natasha Deonarain, MD, MBA April 1, 2016

    My sister is a chiropractor. We worked together in a blended clinic with urgent care (my speciality) and chiropractic wellness. Not only did I change my paradigm, I feel embarrased at how close-minded my profession is about not just chiropractic, but all CAM modalities. It’ probably the reason Americans are flocking to CAM, leaving conventional medical doctors bewildered. They haven’t yet moved from myopic, convergent thinking to the bigger wellness and health picture! Perhaps check out my article: http://bit.ly/1SsdZeo

    Reply
    • Monte Hessler, DC, CCSP April 1, 2016

      Very good comments!

      Reply
    • Korey April 2, 2016

      To compare chiropractic and medicine is to compare apples and oranges. To me, a healthy spine and nervous system is a necessity, so I see a chiropractor. Good medical care is by definition, a necessity. They are not substitutes for each other.
      That being said, the main thing he’s complaining about here is that surveys seem to show people are dissatisfied with how much their doctor (M.D., D.C, or otherwise) “cares” about them.
      Even in the opinions of misinformed people, there is truth and lessons that can be learned.

      Reply
  7. bart barrett April 6, 2016

    The internet is an amazing thing, I took the blog post down, because I realized that the point that I was trying to make had not been well made, and that I was generating more anger than consideration. The internet is forever, so I cannot totally remove the post, but I did what I could.
    There are many other issues that I care about, and my hope and prayer is to focus on those
    I make it a point to not debate others in comment sections, and I will not engage in that practice here.
    While I am not yet a believer in chiropractic, I am willing to read and learn (I clicked on all of the references above). As with many caring physicians, I desperately long for an effective alternative to the traditional medical approach to back pain. The medical profession has failed to appropriately respond to the needs of all pain patients. We need to do better

    Reply
  8. bart barrett April 6, 2016

    I looked for the book on amazon and could not find it. Is there a place I can get it?

    Reply
  9. […] Another example of this was our own answer to a blog regarding Donald Trump and Chiropractic recent… […]

    Reply
  10. Chan, DC - California October 21, 2016

    As a chiropractor myself, I don’t claim that chiropractic can cure everyone’s low back pain. But science does show that chiropractic care and chiropractic manipulation help patients with low back pain. Humanity’s understanding of low back pain and the treatments we have available need to continue to be improved, just like most other diseases/conditions.

    It is important that someone like Dr. Barrett to not extrapolate his, assuming, few experiences with chiropractic as the entirety of the chiropractic profession. In chiropractic school all chiropractors are taught to a standard national board requirement, which in the diagnosis portion includes orthopedic and chiropractic examination and x-ray, and the treatment portion includes chiropractic manipulation and physiotherapy for neuromusculoskeletal conditions. In California, which I can confidently speak of, these forms of evaluation and treatment are accepted by most health insurances, worker’s compensation, and the Radiologic health board of California.

    In the field there are some chiropractors who integrate less mainstream forms of chiropractic into their practice, such as “Applied Kinesiology,” Sacro-occipital technique, among others, which at times reaches into the scope beyond neuromusculoskeletal conditions. These less mainstream forms of chiropractic can vary in their effectiveness and scientific basis. But do I abhor these treatments? No. I would equate the less mainstream forms of chiropractic to surgery techniques or cancer treatments that are also not mainstream. Most have not been proven to be effective in clinical research, but they may be helpful for many patients. They are pushing the limits and exploring, which we need if we are to further understand low back pain and other conditions.

    The other factor that those without much experience with chiropractic should realize is that chiropractic is an art and science as much as a surgery is. The quality of care is dependent on the dexterous skill of the professional – it is not as simple as taking a prescription drug. As a whole chiropractors, like surgeons, do cure diseases, but some chiropractors and surgeons are better at it than others.

    Lastly, some chiropractors do show overly confident and optimistic abilities to help patients. But so do some medical doctors. This needs to be discouraged, but recognize this is the reality of humankind.

    Reply
  11. Artiewhitfox January 20, 2017

    Use Upper Cervical Specific only. Don’t use neck twisting full spine manipulating kind that pops the spine. The head does not move when an adjustment takes place. X rays like Nasium, A – Open Mouth Lateral and Base Posterior need to be taken. People like Steven Duff in Windsor California does that. Richard Duff in San Francisco does that too. Use Upcspine, The Specific Chiropractic or Upper cervical heath centers to find a UCS Chiropractor in your area. The adjustment seems simple, but it does more than you think. Birth itself can shift that bone.

    Reply

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