Respectful Insolence

In Petaluma, California (the Bay area), as reported by ABC 7:

June 14 – KGO – More former clients of a North Bay chiropractor are coming forward, echoing what we reported a month-and-a-half ago — that Daniel Marsh is making money off some bizarre treatments.

State investigators are looking into Dr. Marsh, his treatments and his billing practices. They’re checking out information uncovered by the I-Team. And now we’ve received new complaints about the Petaluma chiropractor.

Marianne Whitfield went to Petaluma chiropractor Daniel Marsh for her severe heartburn, or acid reflux. He had an unusual treatment plan that included mega doses of supplements costing hundreds of dollars, shoe lifts and repeated spine adjustments.

Yep, it’s yet another case of a chiropracter claiming to be able to use “spinal adjustments” to treat illnesses that have nothing to do with the spine, with a not-so-healthy dose of other altie woo thrown in for good measure.

This guy tried to get a patient to come back for 60 visits, after getting $2,000 up front to start for his “therapies”:

Marianne Whitfield, former patient of Dr. Marsh: “He said I had to go to 60 visits in six months, and I would have to go one time per week the rest of my life or I would get to be in the same symptoms as I have now.”

Wow. Now that‘s what I call guaranteeing a stable income stream! I keep saying time and time again that I must be in the wrong business. But there’s more, as, according to the story, Dr. Marsh apparently uses testimonials on his website from patients who are no longer happy with him:

Kendra Campbell saw her testimonial in our report and was surprised Marsh used it because she stopped going to the chiropractor a year-and-half ago. Her husband was unhappy with the mounting bills — $4,000 over a year — and with some questionable advice from Marsh.

Kendra Campbell: “Oh, you need to be careful of metals, you need to have your alarm clock at least five feet away from you. You shouldn’t be sleeping with that that close to you.”

Doug Campbell, husband of patient: “When it got to the alarm clock, then I said, wait a minute.”

Marsh defends his advice on the alarm clock — “we’re really only beginning to see the ill-effects of electromagnetic radiation which comes from things such as electronic radios.”

But the last straw was when Kendra says Marsh told her she shouldn’t wear the “live strong” bracelet she had in honor of a friend with brain cancer. The chiropractor claimed it was sapping Kendra’s strength.

Kendra Campbell: “I thought it was a little too far out, it just, you know?”

On the “live strong” bracelet, Marsh says “people react adversely to plastics or rubber … the reaction may be severe, or it can be more subtle, such as an overall weakness or ill feeling.”

No, not the Live Strong bracelet!

Apparently even some alties have their limit. Anything but that! I have to wonder if Dr. Marsh pulled a Hulda Clark and also suggested that Ms. Campbell also remove all of her metal dental fillings and whether that bothered her. Inquiring minds want to know! But wait, I notice that there’s one more treatment that Dr. Marsh offers that’s of interest to me as a surgeon:

Another one of Marsh’s former patients, 86-year-old John Valverde, has a hard time lifting his chin off his chest. When he went to the chiropractor’s office in a Petaluma strip mall, Marsh gave him a surprising diagnosis — the problem wasn’t his neck after all.

John Valverde, former patient: “He seemed to be more interested in my gall bladder and the heart muscles and this and that and the other, than he did my neck.”

Marsh claimed he had a cutting-edge treatment for the heart and gall bladder. He rested two boxes with lights on Mr. Valverde’s chest, apparently muscle stimulation devices. But Valverde didn’t feel anything from the treatment, except a pain in the wallet.

John Valverde: “$330 bucks for 90 minutes. Those two lights on there for 90 minutes, $330 bucks.”

Wow. The last time I checked, I found that Medicare reimburses less than twice that for a surgeon to do an uncomplicated laparoscopic cholecystectomy (CPT #47562), and that amount is for the global surgical package. (My private surgeon colleagues could tell me exactly what the reimbursement rate is these days for an uncomplicated laparoscopic cholecystectomy; one of the advantages of being in academia is being somewhat insulated from the nitty gritty of the finances of billing for our services, given that I receive a straight salary that doesn’t depend upon my billings.) This global fee includes all the post operative care. If the patient has complications from the surgery or requires more care, the surgeon doesn’t get any more than that unless the complication is not related to the surgery or persists beyond the global postoperative period (90 days for major surgeries; 10 days for minor surgeries). Again, when I see stuff like this, I can’t help but wonder if I’m in the wrong line of work. Why spend all that time learning to do laparoscopic cholecystectomies and deal with the potential complications when you can hook up two boxes with lights to the patient and pocket almost as much money for the same amount of time as the surgery takes but with no risk? Of course, there’s also no risk that your treatment will actually cure the patient’s gallbladder disease, but at least there are no medical risks other than delaying the patient’s definitive treatment.

As Wally Sampson says: “Eighty-percent of these kinds of symptoms are self-limited, they disappear with time, so the last person that you go to for help gets the credit for it.”

Indeed.

Unfortunately, as much as I admire Dr. Sampson’s skeptical work with regard to alternative medicine for the Center for Inquiry, I lack his faith in chiropractic boards:

Dr. Sampson is critical of chiropractors in general, but he’s especially disturbed by Daniel Marsh.

Dr. Sampson: “This is gross and I think it’s well within the purview of the chiropractic board to give him a little talking to.”

My guess is that the “talking to” that chiropractic board will give Dr. Marsh will simply to tell him to stick to spinal manipulation and not be so blatant about engaging in quackery next time–oh, and also to cut out the double billing while he’s at it. He can certainly make more than enough just billing for what he normally does without bilking Medicare to do it.

Comments

  1. #1 epador
    June 16, 2006

    It should be no surprise that California is a haven for this kind of mumbo jumbo. The place has been a breeding ground for gullible folks buying into all sorts of “alternate” lifestyles, entertainment, politics, economics and reality for decades. What is so sad is that even after the chumps realize they’ve been taken, they don’t seem to have a clue as to the enormity of the deception.

  2. #2 Dave S.
    June 16, 2006

    Well if the alarm clock is 5 feet away, then unless you have really long arms you can’t click the SNOOZE button, which forces you to get up to click it. Think of the exercise benefits!

    That’s how he should have answered that question.

    That’ll be $300 please.

  3. #3 Hyperion
    June 17, 2006

    Re: Epidor

    You think it’s a coincidence that Scientology has its headquarters in California? That state is the Mecca of Quackery. I wonder if it’s too late to void the treaty of Guadalupe Hidalgo?

  4. #4 EoR
    June 17, 2006

    “He said I had to go to 60 visits in six months, and I would have to go one time per week the rest of my life”. And these are the people that argue that doctors (and vets) are bad because you only see them in an emergency, whereas the woo brigade look after the “whole” person. They certainly look after the whole bank account.

  5. #5 Mrs. Coulter
    June 17, 2006

    This leads me to a question that I have been pondering for some time:

    Is all chiropractic care quackery? Or is there a kernel of something legit in the whole thing? Back in the 90s I was having severe headaches (probably stress related), and in desperation I went to a chiropractor for a while after they had one at the company’s “health fair”. I did feel better, but I often wonder if it had more to do with spending my lunch hour laying face down on a table while new agey music played in the background (I would often fall asleep) than anything the chiropractor actually did…

  6. #6 epador
    June 17, 2006

    IMHO, there is at least kernel of truth to spinal manipulation, be it osteopathic or chiropractic. However, the musculoskeletal dysfunctions and occasional systemic reflexes that respond to manipulative therapy are limited compared to the myriad of disorders that some practitioners claim they can treat. You’ll notice that these folks usually combine their manipulative therapies with expensive alternative treatments, and sometimes many radiographs. Folks that appropriately direct the use of their skills combined with physical therapy, mainstream medicine and counseling techniques are an asset to the health care system and should not be denigrated due to their abusive colleagues.

  7. #7 Nana
    June 17, 2006

    Chiropractic is based on the elusive “subluxation”, an imaginary condition that causes dis-ease. Chiros use this
    imaginary condition to sell supplements, chelation, and manipulation(in more than one way). It is all a hoax.

  8. #8 PlanetaryGear
    June 17, 2006

    save your money up for a really good spa day, a nice massage does wonders for stress and all the disorders that go with it. It will make your back feel better too.

  9. #9 misterbeans
    June 17, 2006

    Last I saw, the only thing literature supported chiropractic for was lumbar pain. Even neck pain doesn’t seem to respond (and it’s more dangerous, esp in the elderly because of atherosclerosis). I personally went to a chiro briefly awhile back because of a chronic back problem, I spent nearly $1000 in 2 months, wasted a lot of time, and now every time I sit up straight my back pops… I did gain some wisdom from the whole thing though! :P

    –misterbeans

  10. #10 Sid Schwab
    June 17, 2006

    An interesting question is what chiropracters themselves think about their “craft.” Are they so gullible that they believe it all? It seems unlikely but not impossible. When I practiced in Oregon one chiropracter ran ads with healthy children (about 2 – 8 years old, I’d guess) sitting on a couch, arguing that monthly manipulations were what made and kept them healthy. If he believed that, I’d say it says much about him and the whole concept of chiropractic. On the other hand I had a patient who presented with paraplegia, after her chiropracter husband had continued maniupulations for her back pain despite the obvious evidence of metastatic breast cancer.

  11. #11 J Bean
    June 18, 2006

    Here’s a story about “holistic dentistry” from the LA Times that will make you cringe. Ironically, the victim is a drug rep.

  12. #12 sandi
    June 19, 2006

    Shame on these patients, for falling for this scam! When presented with the cost, they should have asked a lot more questions, then walked away. A chiropractor can only scam someone if they are willing to be scammed.