Every so often I come across a post by quacks or supporters of quackery that make me wish that we as skeptics and supporters of science-based medicine actually had the abilities and powers attributed to us. I mean, what’s the good of being accused of running a conspiracy to crush any sort of “unconventional” or “alternative” medicine if we don’t actually have the power to crush unconventional and alternative medicine? Then, sometimes, there are posts that make me really wish that my bloggy skeptic friends and the skeptic organizations to which I belong actually had the power to do the things we’re accused of. Sadly, we don’t. But a guy can fantasize can’t he?

Certainly, that’s what I was thinking when I came across a hilariously paranoid post by a a chiropractor calling himself J. C. Smith (JCS), who runs a website called Chiropractors for Fair Journalism. The post is about a policy institute to which I belong, the Institute for Science in Medicine, and refers to ISM as The Medical GoodFellas. Before I respond, please take note of this disclaimer. In this post, I am not speaking for ISM in any capacity. I do not speak for ISM, nor am I authorized to speak on behalf of ISM. As a snarky blogger, I speak for no one but myself, and that is enough.

The article starts with the typical canards laid down by chiropractors about how horrible the American Medical Association is and how it supposedly tried to shut down chiropractic (as though that were a bad thing), referring to the AMA as a “medical mob” and to Morris Fishbein, MD, former director of the AMA as a “longtime medical godfather” and the “medical Mussolini.” JCS then equates opposition to the pseudoscience and quackery that underlie chiropractic with “bigotry”:

His intolerant quasi-KKK attitude about all non-allopathic CAM professions set the tone for the Jim Crow, MD, bias we see in many members in the medical profession today.

Without question, the medical bigotry fomented by Fishbein’s medical mob mindset remains steadfast in some quarters and is quite possibly the last bastion of acceptable prejudice in America. Clearly the “n-word” is unacceptable today in our general society, and the “b-word” is certainly an epithet offensive to women, but the “q-word” is still openly used by many biased MDs even though it was found to be a baseless charge back in the 1970s.

Because calling quackery quackery is exactly like using the n-word to describe African-Americans or calling a woman a “bitch.” Leave it to quacks to mistake criticism of what they have chosen to do for a living with criticism of what they inherently are because they were born that way and had no choice in the matter. There is a difference. African-Americans can’t help being an African-American, and women can’t help being women, which is a major part of the reason why slurs based on their being African-American or a woman are slurs constituting bigotry. In marked contrast, a chiropractor chooses to be a chiropractor. To become a chiropractor requires making a conscious decision to go to a school of chiropractic, to study the system of quackery that is so much of chiropractic, and then to put out a shingle and practice chiropractic. Let’s put it this way: If I decided to become a homeopath, would it be “bigotry” to say that I’ve become a quack? No! It would be a statement of fact, and, as we all know from the tagline of this blog, a statement of fact can’t be insolent. It also can’t really be bigotry, either, when it is a statement about a conscious personal career choice. None of this stops JCS from referring to valid scientific criticisms of chiropractic as the power of prejudice:

Although it is politically incorrect nowadays to be racist, sexist, anti-Semitic or homophobic, I have never heard any news pundit speak out against chiropractors being called “quacks” by chauvinistic medical professionals. While you may not read it in articles once seen in the era of the Committee on Quackery, their “everybody knows chiropractic is an unscientific cult” belief remains a wink-wink attitude among medical bigots although, ironically, research shows that chiropractic care is superior to medical care for most spine-related disorders, a fact untold by the media and unknown by the public.

Never mind that chiropractic is unscientific. Never mind that there is no such thing as a subluxation. Never mind that it’s nonsense that chiropractic is superior to medical care for spinal disorders. At best, it can be equal to standard physical therapy. Besides, it’s not really spinal manipulation that is the problem with chiropractic. As I’ve said so many times before, chiropractors are physical therapists with delusions of grandeur. The delusion comes from the claims of so many chiropractors that they can treat more than just back pain. I’m referring to conditions such as allergies, asthma, and all manner of other diseases not related to the spine or the musculoskeletal system that chiropractors claim they can treat. Therein lies the quackery, and limiting privileges of chiropractors in medical centers practicing science-based medicine is not a bad thing, particularly given the chance of stroke from neck manipulation.

So let’s move on to the ISM, given that I have more than a bit of a stake in the success of this particular organization. The ISM is a policy institute, newly formed—embryonic, even—dedicated to supporting science-based medicine and opposing bad science and pseudoscience in medicine. It’s as simple as that. In other words, it’s an institute dedicated to standing up for the sorts of issues that Orac has been standing up for right here on this very blog for seven years. What’s not to like? Well, if you’re JCS, apparently the mission statement of ISM is very offensive because it explicitly states that the purpose of ISM is to stand up for science and against quackery. JCS’s response to the statement that ISM “relies on the qualifications, expertise, and understanding of medicine and science of all our Fellows to reliably inform public policy with objective facts and sound judgment” is this:

This mission statement is troubling on many levels. First of all, it is not the role of any medical mob to police other healthcare professions. Keep in mind there are no federal or state agencies working in conjunction with ISM. It alone acts like a bully who brandishes this war of words to defame all CAM professions by fear-mongering and slander.

Because, obviously, to chiropractors like JCS, reliably informing public policy with objective facts, science, and sound judgment is slanderous. What drivel! What nonsense! How typical! Slander generally involves knowingly making statements about someone that are false and defamatory. Opinions offered in good faith are not slander. Opinions that are supportable with science, evidence, and facts are not slander. Nor is it “bullying” to state a scientific viewpoint. If anything, it’s practitioners of “complementary and alternative medicine” (CAM) modalities like chiropractic who tend to be the bullies. Remember the British Chiropractic Association sued Simon Singh for libel because he referred to chiropractors making “bogus” claims (which many of their claims arguably are). Fortunately, the BCA lost, and lost spectacularly. In any case, it’s usually the quacks who are the bullies, suing supporters of science-based medicine left and right who dare to criticize them too harshly. Examples are legion, and I’ve blogged about them many times before, including the case of Doctor’s Data suing Steve Barrett, Shayla McCallum and Dr. Thomas Lodi making legal threats against a blogging cancer patient, a quack named Andreas Moritz threatening to sue a blogger, Barbara Loe Fisher suing Paul Offit, Andrew Wakefield suing Brian Deer, Joseph Chikelue Obi legally threatening a blogger, and, of course, Marc Stephens threatening skeptical bloggers who criticized Dr. Stanislaw Burzynski.

The list goes on and on and on. In fact, it wouldn’t surprise me if JCS started making legal threats for my referring to chiropractic as quackery.

I must admit, I was a bit disappointed in JCS’s post. He mentions several skeptics, some of whom I know, such as Harriet Hall, Steve Salzberg, and Jann Bellamy. Hilariously, JCS gets something about Harriet Hall so completely wrong that I really do have to wonder where he got his information. First, he’s incensed that Harriet called the study of CAM “quackademia” on NPR on February 15, 2012. That’s not what’s wrong. I’m sure Harriet did do exactly that, and I heartily approve. I use the term “quackademic medicine” myself frequently, although I do try to give credit where credit is due and point out that I did not coin the term. Dr. R. W. Donnell did, as far as I have been able to tell. No, what JCS claimed was that Harriet was the spokesperson on Capital Hill during the “Obamacare” debate and demanded that only MDs be called doctors. I know Harriet. I also know that she has never testified before Congress (although I think it would be awesome if she were called to do so). I’d also disagree that only MDs should be called doctors. PhDs have every right to be called “doctor” as well.

In any case, what disappointed me is that I wasn’t mentioned at all in the post. Darn it, I spend seven and a half years discussing science, science-based medicine, and in general putting CAM, “integrative medicine,” and the antivaccine movement (as well as a lot of non-medical pseudoscience as well) into proper context, and I don’t even rate a mention?

Oh, well, JCS is promising part two. In the meantime, I can only wonder if maybe, just maybe, I should have resurrected the Hitler Zombie for JCS. Clearly his brain’s been chomped, given how he pulled a Godwin, quoting Adolf Hitler about the power of propaganda in the context of blaming the AMA for propaganda against chiropractors.

Maybe I should have done a Hitler Zombie piece, after all. Of course, on the other hand, JCS can’t seem to make up his mind whether ISM is a bunch of medical gangsters, Nazis, or just your run-of-the-mill bullies. He really is a very confused fellow. JCS’s confusion aside, I wish that we skeptics actually did have the power that people like JCS actually attribut to us. Alas, we do not. All we have is science, reason, facts, and our words. They will have to suffice.

Comments

  1. #1 AdamG
    July 20, 2012

    cortico-circuitry and neuroplasticity research, which are much too complex to explain here.

    I, personally, would love to read JCS’s explanations of these topics.

  2. #2 Mephistopheles O'Brien
    July 20, 2012

    JCS – even if we grant your indictment of the US medical system in all its particulars (something I do not do, but just for the same of argument):

    You have not to date provided evidence that chiropractic care provides any benefit for any condition other than back pain.

    You have not provided any data to indicate that chiropractors receive adequate training to act as primary care doctors.

    You have not provided any data to support any of the key topics in traditional Chiropractic (life force, subluxations, the linkage of spinal alignment to diseases other than back pain) .

    Frankly, sir, your posts appear to have the sole purpose of insulting others without providing useful data.

    Why, sir, should I not consider you a troll?

  3. #3 Mephistopheles O'Brien
    July 20, 2012

    Furthermore, where is the data that we need both physical therapists and chiropractors?

  4. #4 TBruce
    On a break from work which does not involve twisting backs.
    July 20, 2012

    For example, our health care system costs almost twice Canada’s, but we produce inferior results.

    of course, that is true. It must be due to the anti-chiropactic bigotry in the US system. Let’s look at some numbers to support this.

    Chiropractors in the USA: 100,000 (see above comment by Krebiozen)

    Chiropractors in Canada: 7000 (2012 figure from CCA)

    Since the population of Canada is approximately 1/10th of the USA, the numbers show a marked shortfall of chiropractors in…Canada!

    I’ll leave the obvious conclusion about health care costs and chiropractors in your chiropractical hands, JCG.

  5. #5 Redloh
    July 20, 2012

    My DH went to a local Chiro a couple years ago. He really only wanted the manipulations that Medicare would pay for. So first up, we need to watch some promotional video promoting all sorts of woo. Apparently the manipulations don’t work as well unless you also agree to be hooked up to some silly electrical pulse machine for 20 minutes or so. Then there are the PT exercises. oh and free X-rays for me and my son. Of course we should also submit to their therapy, though we have no pain to report.

    We never got out of there without melting the credit card for this crap.N I always felt that there was a hustle going on. My DH finally, alarmed at the effect on our budget said no more and he stopped going.

    He’s fine and we both agree, no more Chiro’s. They have all figured out that they can only grow their revenue by adding all sorts of ridiculous and useless “therapies”

    I agree with the PT comparison. We’ve both benefited and found them really effective. Best part, insurance covers it and they don’t try to run up the bill.

  6. #6 JCS
    July 21, 2012

    Obviously I am arguing with trolls who have not done any research on the effectiveness of SMT on Type O disorders. Instead, you simply repeat the medical propaganda that was disproved years ago at trial.

    On the other hand, there are some “flowers in the desert” who are not medical chauvinists like the ISM trolls. FYI: a similar discussion on the “pseudo-science” issue started by ISM has continued Down Under with its associates in the “Friends” of Science in Medicine.

    Fortunately, these flowers in the desert there have the backbone to refute their chauvinistic colleagues.

  7. #7 Krebiozen
    July 21, 2012

    Obviously I am arguing with trolls who have not done any research on the effectiveness of SMT on Type O disorders.

    Firstly, as the saying goes, you keep using that word, but I don’t think it means what you seem to think it means.
    Secondly, if you have some compelling evidence for the efficacy of chiropractic for nonmusculoskeletal disorders, do share it with us. The best evidence I have seen is an equivocal systematic review in an alternative medicine journal.

  8. #8 Krebiozen
    July 21, 2012

    This vanished first time I submitted it, apologies if it appears twice.

    Obviously I am arguing with trolls who have not done any research on the effectiveness of SMT on Type O disorders.

    Firstly, as the saying goes, you keep using that word, but I don’t think it means what you seem to think it means.
    Secondly, if you have some compelling evidence for the efficacy of chiropractic for nonmusculoskeletal disorders, do share it with us. The best evidence I have seen is an equivocal systematic review in an alternative medicine journal.

  9. #9 Krebiozen
    July 21, 2012

    I have disappearing comment syndrome. I submit, it appears to process it, and the page refreshes with the updated comment number, but since the comment doesn’t exist it stays at the top of the page.

  10. #10 Krebiozen
    July 21, 2012

    Trying again.

    Obviously I am arguing with trolls who have not done any research on the effectiveness of SMT on Type O disorders.

    Firstly, as the saying goes, you keep using that word, but I don’t think it means what you seem to think it means.
    Secondly, if you have some compelling evidence for the efficacy of chiropractic for nonmusculoskeletal disorders, do share it with us. The best evidence I have seen is an equivocal systematic review in an alternative medicine journal.

  11. #11 Mrs Woo
    July 21, 2012

    @JCS – the whole thing in this forum is for YOU to provide the studies and evidence as to the “effectiveness of SMT on Type O disorders” – for that matter, which “type O disorders” (apparently, from what I read “type O disorders is a chiropractic term)? What were the trials and what were they tested/compared with? How well was the blinding done?

    The one group of studies you linked to long ago in this thread pretty much said that chiropractic had the best evidence for some types of back pain. When you got to other types of treatment either the evidence was sketchy or the study was (according to the summary table provided by the people who reviewed the studies). It really didn’t suggest that diabetes would be improved with chiropractic, at least not in a strong way.

    That was a review of studies that you provided. Yet you keep insisting that there’s evidence that chiropractic is effective treatment for “type O disorders.”

    Tell me – if you were insulin dependent would you rely on chiropractic to keep your blood sugar in check?

  12. #12 Krebiozen
    July 21, 2012

    Third time lucky?

    Obviously I am arguing with trolls who have not done any research on the effectiveness of SMT on Type O disorders.

    Firstly, as the saying goes, you keep using that word, but I don’t think it means what you seem to think it means.
    Secondly, if you have some compelling evidence for the efficacy of chiropractic for nonmusculoskeletal disorders, do share it with us. The best evidence I have seen is an equivocal systematic review in an alternative medicine journal.

  13. #13 Krebiozen
    July 21, 2012

    There’s something very odd going on, apologies if this ends up as multiple comments.

    Obviously I am arguing with trolls who have not done any research on the effectiveness of SMT on Type O disorders.

    Firstly, as the saying goes, you keep using that word, but I don’t think it means what you seem to think it means.
    Secondly, if you have some compelling evidence for the efficacy of chiropractic for nonmusculoskeletal disorders, do share it with us. The best evidence I have seen is an equivocal systematic review in an alternative medicine journal.

  14. #14 Johnny
    High and dry (we need rain)
    July 21, 2012

    A question for JCS –

    Can a chiropractor cure deafnes? Did Palmer tell the truth in case number 1, or was the whole thing made up? Or was it something else? What do you think really happened?

  15. #15 Denice Walter
    July 21, 2012

    I think that JCS should be made aware that our most esteemed and gracious host has indeed written another post about him… yesterday’s.

  16. #16 Mephistopheles O'Brien
    July 21, 2012

    So I did a quick Pubmed search for “effectiveness of SMT on Type O disorders”. What I found was 3 paperes:

    Spinal manipulative therapy for chronic low-back pain – “High quality evidence suggests that there is no clinically relevant difference between SMT and other interventions for reducing pain and improving function in patients with chronic low-back pain.”

    Efficacy of spinal manipulation for chronic headache: a systematic review. “SMT appears to have a better effect than massage for cervicogenic headache. It also appears that SMT has an effect comparable to commonly used first-line prophylactic prescription medications for tension-type headache and migraine headache.”

    Trunk exercise combined with spinal manipulative or NSAID therapy for chronic low back pain: a randomized, observer-blinded clinical trial. “For the management of CLBP, trunk exercise in combination with SMT or NSAID therapy seemed to be beneficial and worthwhile.”

    Are there other studies I should look at?

  17. #17 novalox
    July 21, 2012

    @jcs

    Nah, you’re not arguing with trolls. You’re just arguing with people who are truly knowledgeable in the sciences, and who likes to see a fool like you make a complete idiot of himself with his statements.

    At least your idiocy is entertaining. I’ve gotten a few chuckles out of your postings.

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