Doctor Barrett in his analysis, points out that while the notion of integrative health and wellness is a popular term today, that it’s meaning is very unclear, and has been used to cover many phony health care practices. I post it here more as FYI only. As long as this steers towards science based application rather than marketing of non scientifically based claims, I’m in favor of it.
Representatives Jared Polis (D-CO) and Mike Coffman (R-CO) have launched the Integrative Health and Wellness Congressional Caucus in the U.S. House of Representatives. The caucus’s stated purpose is to “serve as a non-partisan educational forum for legislators to receive up-to-date information from experts related to best practices and new research, and to discuss legislative and administrative opportunities for integrative health.” The press release announcing their move states:
Integrative health emphasizes prevention, health creation, health promotion and general well-being, and includes therapies like acupuncture, chiropractic, and mindfulness. At a time when the most expensive drains on our nation’s health dollars are chronic conditions like diabetes, heart disease, and high blood pressure, integrative approaches can offer improved outcomes with lower costs. While at least a third of Americans use complementary or alternative medicines, access is often inconsistent. This caucus will provide a platform for legislators to participate together and focus on the important opportunity that integrative health and wellness approaches offers across federally funded health programs, and find ways to make these solutions more available to the American people. [Polis, Coffman launch bipartisan Integrative Health and Wellness Caucus, citing successes of integrative health treatments. Office of Jared Polis. Press release, Oct 25, 2017]
“Integrative medicine” does not have a definable scope. It is a marketing slogan used by practitioners who claim to combine “alternative” and mainstream approaches to medicine to provide the best of both approaches. This may sound reasonable, but (a) the term is actually a smokescreen behind which enthusiasts routinely use dubious practices and (b) some of the preventive measures they embrace are part of standard care and others simply don’t work. [Barrett S. Be wary of “alternative,” “complementary,” and “integrative” health methods. Quackwatch, Oct 30, 2017] It remains to be seen whether caucus members will promote approaches that will improve health care in the U.S. or merely add to its cost.
I post this because there is some question as to whether this ruling will affect other states, including ours. Worth noting that it’s more about scope than ability. I agree with this ruling, by the way. A physical is a way of finding other conditions, such as high blood pressure, etc. Chiropractors are specialists. Physicals should be given by those trained to look for a much wider array of health problems.
Chiropractors in New York State are no longer authorized to determine whether commercial motor vehicle drivers meet the physical qualification standards of the Federal Motor Carrier Safety Administration (FMCSA). Last June, the FMCSA notified chiropractors that the New York State Education Department had determined that Department of Transportation physicals are outside the scope of practice defined by state law. [Schremmer M. New York chiropractors no longer allowed to give DOT physicals. Landline Magazine, June 2, 2016] In a letter to some of the affected chiropractors, The New York State Board of Chiropractic further explained the situation this way:
The basis for this decision is based solely on scope and not competency. The decision focuses around the exam itself. It has been interpreted, by the state, that any examination performed by a chiropractor in New York is predicated on finding and correcting subluxations. Although chiropractors in New York are trained to perform a complete physical examination, our ability to examine and diagnose in New York is limited to detecting and correcting subluxations. As there are many areas to a DOT exam, it is felt that the DOT exam goes beyond the scope of chiropractic in New York. Further, even if you have been credentialed through programs that teach the DOT exam process, this does not change the defined scope of practice in New York.
The Safe Drivers, Safe Roads Coalition, a group whose mission is “to protect, defend and expand the rights of chiropractors in their participation in the performance of DOT physicals and the supportive services associated with these examinations,” is mobilizing to fight the ruling. In a fundraising e-mail, the group indicated that similar “scope of practice” language might place chiropractors at risk in about 30 other states and that it hopes to file suit for an injunction in New York no later than January 22, 2017.
Since we have a journal in Port Townsend that has supported the anti-vaccine movement, it’s worth touching on this interesting article. I cannot understand why chiropractors, who work hard to legitimize their practice, are supporting the leading advocate of anti-vaccinations. One of our key goals in Jefferson County according to the Public Health Department is to raise the levels of vaccinations, which have fallen precipitously over the last decade as people like Wakefield have put forward ideas that have been discredited by science.
Forbes has reported that Andrew Wakefield, who lost his medical license for unprofessional conduct related to vaccine research, was a keynote speaker at the International Chiropractors Association’s Annual Conference on Chiropractic and Pediatrics in Maui. [Lee BY. Are chiropractors backing the anti-vaccine movement? Forbes, Dec 10, 2016] Noting that Wakefield was unable to provide scientific evidence to support his anti-vaccination claims, the report’s author asks whether having him as a speaker is the best way for a professional association and a conference to gain scientific legitimacy. The article is also skeptical about chiropractors in general.
There are chiropractors here in Port Townsend and elsewhere on the Peninsula advertising spinal decompression. I have no idea if they are using the Axiom DRX 9000. It does not appear in a search of any of the Olympic Peninsula chiropractors.
The Quebec Superior Court has authorized a class-action suit to proceed against 13 chiropractors and their insurers. The plaintiffs were treated for back pain at Zero Gravity clinics with a spinal decompression machine called the Axiom DRX 9000. The company went bankrupt in 2013, but the suit is directed against the individual chiropractors: Yves Bélanger, Marc Bureau, Amelie Jean, Bertrand Canuel, Patrick Fortier, Mario Amyot, Yoland Guimond, Catherine Morin-Noiseux, Valérie Bouthillier, Giovanni Ippolito, Caroline Huot, Jean Theroux, and Marie-Noelle Side. All of the case documents are in French. The complaint (in French) and Google’s English translation of the judge’s ruling are available online. The complaint states:
- In 2010, Health Canada banned sale of the device, saying that the manufacturer had failed to provide scientific evidence that the device is effective.
- The College of Quebec advised chiropractors to stop advertising and using the device and subsequently disciplined 9 of the 13 chiropractors.
The law firm handling the case is Ménard, Martin of Montreal. Press reports indicate that 650 people have signed up, but up to 8,000 people might be eligible. [650 people get permission to sue chiropractors. CTV News Montreal, Nov 23, 2016]
Spinal decompression is an expensive high-tech form of mechanical traction that can relieve some cases of back pain but has been widely promoted with unsubstantiated claims that it can correct degenerated and herniated discs without surgery. [Barrett S. Be wary of spinal decompression therapy with VAX-D or similar devices. Chirobase, Nov 25, 2016]