Spine ‘docs’ have a ghostly ori­gin

Los Angeles Times - - BUSINESS - DAVID LAZARUS

The Amer­i­can Chi­ro­prac­tic Assn. es­ti­mates that the na­tion’s roughly 77,000 chi­ro­prac­tors treat more than 35 mil­lion Amer­i­cans ev­ery year.

I sus­pect most if not all those pa­tients have no idea that the $15-bil­lion chi­ro­prac­tic in­dus­try owes its ex­is­tence to a ghost.

Daniel David Palmer, the “fa­ther” of chi­ro­prac­tic who per­formed the first chi­ro­prac­tic ad­just­ment in 1895, was an avid spir­i­tu­al­ist. He main­tained that the no­tion and ba­sic prin­ci­ples of chi­ro­prac­tic treat­ment were passed along to him dur­ing a seance by a long-dead doc­tor.

“The knowl­edge and phi­los­o­phy given me by Dr. Jim Atkin­son, an in­tel­li­gent spir­i­tual be­ing ... ap­pealed to my rea­son,” Palmer wrote in his mem­oir “The Chi­ro­prac­tor,” which was pub­lished in 1914 af­ter his death in Los An­ge­les. Atkin­son had died 50 years prior to Palmer’s epiphany.

Be­fore learn­ing of spinal ad­just­ments from a su­per­nat­u­ral en­tity, Palmer spent nine years as a prac­ti­tioner of what was known as “mag­netic heal­ing,” in which he would di­ag­nose and cure ail­ments by ma­nip­u­lat­ing a mag­netic field sur­round­ing the pa­tient’s body.

I bring all this up be­cause I saw a chi­ro­prac­tor the other day — my first visit as a pa­tient af­ter hav­ing writ­ten a num­ber of col­umns ques­tion­ing the qual­i­fi­ca­tion of chi­ro­prac­tors to treat di­a­betes, which is a grow­ing trend in the in­dus­try.

My wife in­sisted that I go af­ter my car was rear-ended while I was driv­ing on the 101 from Hol­ly­wood to down­town. My car’s in worse shape than I am. I came away from the ac­ci­dent with a stiff neck.

It was while I was ly­ing on my back in the chi­ro­prac­tor’s of­fice await­ing his heal­ing touch that two thoughts crossed my mind.

First: Why do chi­ro­prac­tors get to call them­selves doctors? They’re clearly not doctors, lack­ing both the ex­ten­sive train­ing and pre­scrip­tion-writ­ing abil­ity of a med­i­cal doc­tor. Yet to a layper­son, it may be hard to dis­tin­guish be­tween the two pro­fes­sions when they share a com­mon (and highly pres­ti­gious) ti­tle.

Sec­ond: While the ther­a­peu­tic ben­e­fits of a spinal ad­just­ment seem un­de­ni­able — you do come away from a ses­sion feel­ing re­freshed — why does what is ba­si­cally phys­i­cal ther­apy have to be wrapped up in so much pseu­do­science and pos­si­ble quack­ery?

Mod­ern chi­ro­prac­tors fo­cus pri­mar­ily on the spinal col­umn, seek­ing “mis­align­ments” that might af­fect joints, mus­cles, nerves and or­gans. The ba­sic idea is to re­store a sense of bal­ance to the body and help it heal nat­u­rally.

In re­cent years, some chi­ro­prac­tors have sought to ex­pand their prac­tices by claim­ing ex­per­tise in di­a­betes, neu­ropa­thy and other chronic con­di­tions.

My chi­ro­prac­tic ses­sion in­cluded an ex­am­i­na­tion us­ing what’s called a static sur­face elec­tromyo­g­ra­phy de­vice, a.k.a. sur­face EMG or static sEMG. What that means is that elec­trodes were held at spe­cific spots along my spine.

This pro­duced an im­pres­sive-look­ing read­out in which col­ored bars (green and blue good, red and black bad) were as­signed to dif­fer­ent parts of my neck and back.

That read­out, in turn, served as the ba­sis of sub­se­quent dis­cus­sions with the chi­ro­prac­tor and his as­sis­tant, the crux of which was that I’d need at least 12 more ses­sions at a cost of nearly $800, with a mod­est dis­count avail­able for pay­ing the en­tire amount up­front.

Sur­face EMG tech­nol­ogy has been around for a while. It’s used to mea­sure elec­tri­cal ac­tiv­ity. I was told at the chi­ro­prac­tor’s of­fice no fewer than three times that the tech­nol­ogy “is used by NASA,” which clearly was meant to al­lay any sus­pi­cions I might have.

“I don’t trust it,” said Fred Lerner, a Bev­erly Hills chi­ro­prac­tor and past chair­man of the Cal­i­for­nia Board of Chi­ro­prac­tic Ex­am­in­ers, the state reg­u­la­tory agency. He told me he doesn’t use a sur­face EMG ma­chine at his prac­tice and is wary of col­leagues who do.

“You’ll have two dif­fer­ent ex­am­in­ers and they’ll get two dif­fer­ent re­sults,” Lerner said. “The find­ings aren’t re­pro­d­u­ca­ble.”

I spoke with David Mar­car­ian, who helped de­velop sur­face EMG sys­tems while work­ing for NASA’s Ames Re­search Cen­ter and is now pres­i­dent of a Seat­tle com­pany called Pre­ci­sion Bio­met­rics. He said his pri­vately held firm’s My­oVi­sion de­vice dom­i­nates the mar­ket for sur­face EMG ma­chines in chi­ro­prac­tic of­fices.

Mar­car­ian ac­knowl­edged that, be­cause of his back­ground as a NASA re­searcher, some chi­ro­prac­tors claim that sur­face EMG ma­chines play a prom­i­nent role in the space pro­gram. In fact, he said, NASA uses the tech­nol­ogy only to test other di­ag­nos­tic equip­ment, not the well-be­ing of as­tro­nauts.

“The main rea­son static sur­face EMG has such a bad rep­u­ta­tion is be­cause so many chi­ro­prac­tors mis­use the data,” Mar­car­ian said. “Un­scrupu­lous chi­ro­prac­tors use it to scare peo­ple into be­com­ing pa­tients.”

As for chi­ro­prac­tors en­joy­ing the ti­t­u­lar ben­e­fits of “doc­tor,” Robert Puleo, ex­ec­u­tive of­fi­cer of the state Board of Chi­ro­prac­tic Ex­am­in­ers, told me the prac­tice dates back to 1922, when the state passed the Chi­ro­prac­tic Ini­tia­tive Act.

It laid the ground­work for reg­u­la­tion of the in­dus­try and has re­mained largely un­changed for nearly a cen­tury.

“It ex­plic­itly al­lows them to call them­selves doctors, as long as they don’t claim to be med­i­cal doctors,” Puleo said.

This ap­par­ently was very im­por­tant to early chi­ro­prac­tic prac­ti­tion­ers, whose be­liefs were some­what at odds with es­tab­lished medicine.

D.D. Palmer, the founder of chi­ro­prac­tic, de­scribed the prac­tice as “an ed­u­ca­tional, sci­en­tific, re­li­gious sys­tem” that “im­parts in­struc­tion re­lat­ing both to this world and the one to come.” In his 1914 mem­oir, he made the case that chi­ro­prac­tors should be per­mit­ted to treat pa­tients on re­li­gious-free­dom grounds.

“The Con­sti­tu­tion of the United States and the statutes per­sonal of Cal­i­for­nia con­fer upon me and all per­sons of chi­ro­prac­tic faith the in­alien­able right to prac­tice our re­li­gion with­out re­straint or hin­drance,” Palmer wrote.

Prior to pas­sage of the 1922 law, Puleo said, “Cal­i­for­nia chi­ro­prac­tors were be­ing thrown in jail. They were be­ing ac­cused of prac­tic­ing medicine with­out a li­cense.”

Be­ing granted the le­gal right to call them­selves doctors con­ferred upon chi­ro­prac­tors instant le­git­i­macy as med­i­cal pro­fes­sion­als.

Puleo said his of­fice is “largely com­plaint-driven,” mean­ing that it re­sponds to com­plaints filed by pa­tients but typ­i­cally isn’t out in the field look­ing for vi­o­la­tions of the law. “Un­less we get com­plaints, there’s not much we can do,” he said.

He ad­vised pa­tients to ap­proach chi­ro­prac­tors with their eyes open, watch­ful for any claims that may seem far-fetched. The board’s web­site al­lows peo­ple to search state records to make sure a chi­ro­prac­tor is li­censed and see if there have been any dis­ci­plinary ac­tions.

I men­tioned ear­lier that Palmer cred­ited a ghost with in­tro­duc­ing him to the basics of the call­ing. As such, it seemed only fair that I al­low the Amer­i­can Chi­ro­prac­tic Assn. to ad­dress the in­dus­try’s other­worldly ori­gins.

William Lau­retti, an as­so­ciate pro­fes­sor at New York Chi­ro­prac­tic Col­lege who serves as an as­so­ci­a­tion spokesman, ad­mit­ted that “D.D. Palmer was an ec­cen­tric.”

How­ever, Lau­retti as­sured me that con­sul­ta­tions with su­per­nat­u­ral be­ings “is not some­thing that’s part of the mod­ern chi­ro­prac­tic pro­fes­sion.”

Good to know. Still, when the chi­ro­prac­tor who ex­am­ined me called Wed­nes­day to book my next ses­sion, I de­clined. I said my neck’s feel­ing bet­ter.

I didn’t bother men­tion­ing that I’ve had the Casper the Friendly Ghost theme song play­ing in my head for days.

Palmer Col­lege of Chi­ro­prac­tic

D.D. PALMER, who per­formed the first chi­ro­prac­tic ad­just­ment in 1895, was an avid spir­i­tu­al­ist.

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