Angry Doctor

Saturday, September 16, 2006

Confidence Good 2

A letter to provide angry doc some weekend musing...

Beware chiropractors who mislead patients

IN MAY I came across a chiropractic road show in the basement of a shopping centre promoting 'free' back and neck computerised spinal assessment. There were two chiropractors on hand to explain the findings of the computer assessment and one of them diagnosed that I had a condition that needed to be treated.

I confirmed that I had been in a car accident and was in constant pain and undergoing physiotherapy. I also informed this person that my two infants had been in the accident as well and I was offered a discounted detailed assessment if I paid up that day. This would take place in their clinic over the course of two days. I paid for all three of us to be assessed.

After the first assessment, I received a telephone call informing me that the chiropractor was moving his clinic. At the second session in the new clinic, I was told I would need a total of 44 treatments over 18 weeks, at the rate of three a week. I was strongly encouraged to purchase a 'package' at $2,450 which would bring down the cost of each treatment from $70 to $54.

The chiropractor also examined my sons, aged 3½ and 1½, and told me that there were problems with them. In addition, one of my older boy's legs was shorter than the other. If not treated, these would cause serious problems.

After my third session, when I felt worse instead of better, I decided to stop the treatment as I was suspicious and alarmed at the constant 'reminders' by phone and SMS to keep my appointments. Sometimes I would receive two calls and an SMS reminder in a single day for an appointment that evening that was made two days earlier. A few weeks later, I received a call saying the chiropractor was moving again.

My children have since been examined by their paediatrician and another chiropractor who both confirmed they are fine.

I am concerned that these unscrupulous practitioners could be exaggerating conditions in an attempt to sell treatment packages and preying on the concern and sometimes paranoia of parents.

Michelle Tan (Ms)

Unlike the two other posts this week, this one is not about alternative medicine.


Afterall, Ms Tan did not decide from her adventure that chiropractry was quackery. In fact, she consulted another chiropractor for a second (third?) opinion.

So why did Ms Tan decide that the original chiropractors were 'exaggerating conditions in an attempt to sell treatment packages and preying on the concern and sometimes paranoia of parents'?

That they has a road show? Well, various 'medical' societies hold road shows and free health screenings too.

That they were selling their service in a package? Well, obstertrics departments sell antenatal packages too.

That they sent reminders for appointments? Well, hospital specialist outpatient clinics send reminders for appointments too, and as I recall this was well-received by some patients.

That she felt worse instead of better after her treatment? Well, maybe; but then again no other medical discipline can guarantee that a patient will feel better after the third session of a projected 44-session treatment. In any case, her physiotherapy must not have been too effective, or she would not have been in 'constant pain' and felt the need to give chiropractry a try.

That a paediatrician and another chiropractor both 'confirmed' that her children were fine? Interesting. What makes the 'confirmation' from the two more trustworthy than that from the original chiropractor? Was it a case of 'two against one'? If so, what if two chiropractors 'confirmed' that her children were fine, but one paediatrician said otherwise? Or one paediatrician versus one paediatrician and one chiropractor?

The constant clinic-moving was dodgy though, I'll admit.

I suspect it was a combination of all the above factors, and perhaps some others which Ms Tan chose not to express in her letter.

angry doc remains relatively clueless about how patients decide if their healthcare providers are quacks.

He would also like to know what the original chiropractor thought was the cause of Ms Tan's son's limb-length discrepancy was, and how he proposed to treat it though.

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  • This is why we have regulating bodies.

    For eg western medicine has the SMC.

    TCM has as similar body. TCM practitioners need to be registered and licensed.

    MOH helps in these 2 professions.

    Chiropracters? At the moment they are unregulated so anything goes.

    The question of course is how MOH decides which "professions" need to be regulated? How do they decide?

    I suspect all these are really driven by political and economic reasons MORE than any other reasons.

    There is no answer to this. Some people will be happy with their treatments.

    One example is my mother who had impingement syndrome of the shoulder, saw the orthopedic surgeon several times, had physiotherapy, had H&L injections to no avail). 6 months later with the pain still bad she went to visit a chiropracter who told her she should be treated with 6 sessions. She went for 2 sessions and never went back. She had been cured! Amazingly I keep asking her every few months if her problem has recurred and she says no each time!

    I have also met several patients who swear by Tui Na and chiropracters for conditions that indeed sounded like impingment syndrome.

    How does it work? I do not know cos I never studied chiropractice or Tui Na. Can I reject it? I cannot.

    Of course there are also patients who will curse the chiropracter and Tui Na physician for making their problems worse.

    The same could be said of western doctors too.

    Fundamentally I think that a therapy that works doesn't need to be proven and shown HOW it works to be given to patients. As long as it does not harm.

    As western doctors we take great pride in our "evidence-based" medicine etc. Rightfully so because we spend a lot of time and effort documenting it.

    However to patients they don't really care. All they care about is whether they get better.

    I always ask myself if I was a patient and had the same ailments what treatment would I undergo? I am sure if you ask other doctors on a personal level (not professional opinion) you might get rather interesting answers too.

    By Blogger Dr Oz bloke, At September 16, 2006 4:12 pm  

  • Chiropractic and osteopathy?

    What I call the "rubbing therapies". People like to lie on a couch, have soothing words spoken to them, and be rubbed. It cheers them up.

    Don't knock it!

    But don't pretend it is something it is not.


    By Anonymous Anonymous, At September 17, 2006 12:30 am  

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