What's With the Chiropractors?

I have never had any strong feelings about chiropractors either way. Live and let live I have always said. I have a friend who is a chiropractor. He is a nice guy and fairly conservative. I know another chiropractor that got a mail-order MD from a Caribbean medical school and puts MD on his building although the state will only license him as a DC. He has sent some patients to the ED in the past. The most recent case in memory was a supposed cervical fracture. The patient arrived by ambulance with a backboard applied. The x-rays from the chiropractic clinic were very weird views. I could not tell squat from them. So, I scanned the patients neck with the spiral CT. I found nothing other than degenerative joint disease. The patient was most relieved. She had no history of trauma and was perplexed as to how shoe has "broken her neck" as the DC stated. But, in all professions there are good and bad practitioners. Live and let live.

Interestingly, not long ago I was talking with a physician friend. His son could not get into the medical school or osteopathic school. Thus, he went to chiropractic school. Upon graduation, his father gave him office space in his medical building and he started a practice. Supposedly, the chiropractic son was also trained in chiropractic neurology (whatever that is). Later I met the son. He was a great guy--but disappointed with his choice of chiropractic as a profession. I spoke with him at length. He lamented that all he could do was crack backs (called "adjustments"). He stated that the chiropractic concept of "subluxation" is pure baloney (this differs from real subluxation--which is a serious condition). His residency training in chiropractic neurology was some weekend courses. He said that his chiropractic education was almost evangelical in nature--heavy on faith and light in science. That surprised me as some states call chiropractors "physicians".

He went on to say that more than half his class (they evidently graduate 3 classes a year) did not enter practice after graduation. Furthermore, he said the average debt of a chiropractic graduate is in excess of $100,000. Also, almost half of the defaults for the federal Health Education Assistance Loans (HEAL) are chiropractors. What gives? Why spend all your time in school and incur the debt and not practice?

My friend's son recently learned that he had been finally accepted to an osteopathic school. He is closing his practice and becoming a physician. The osteopathic school would not give him credit for any of his chiropractic training so he has four more years of school to finance. But, he appears to be fulfilling his dreams.

I truly believe there is some role for physical therapies in musculoskeletal conditions (especially low back pain). But, does it take 3 years to learn to do nothing but pop backs? At least in osteopathic school, my chiropractor friend will master medicine and manipulation (he will soon learn the significant acadmic difference between medical school and chiropractic school). Interestingly, in Australia and New Zealand, physiotherapists (physical therapists) with 3-year bachelor's degrees do manipulations. But, live and let live. If chiropractic works for you and doesn't harm you, go for it. But, I am not sure that government programs should pay for it as the scientific evidence for the practice does not exist as best I can tell.