Chiropractic abuse: An insider’s lament (Book review)

The Pediatric Insider

© 2013 Roy Benaroch, MD

This blog, The Pediatric Insider, is here to tell you the real deal. What the science of pediatrics really says– which, I know, isn’t always what’s told to parents at pediatric offices. I’ve been critical of medical doctors who put profits ahead of patients, or who are just going through the motions, following old habits that aren’t really helping anyone. I’ve been critical of pseudo-science and silly beliefs, whether they’re from medical doctors, anti-vaccine zealots, or alternative medicine practitioners. You want the truth? I think you can handle the truth.

Now you’ve got a chance to hear what an insider from another field has to say about their profession. You want the truth about chiropractic? Chiropractor Preston Long’s book, Chiropractic abuse: An insider’s lament, exposes his field for what it really is. This isn’t just some guy who’s read about chiropractic, or a sour-grapes chiropractic competitor looking to smear a profession. Long is a licensed chiropractor who has worked in his profession for many years, it’s clear that he really wants to help his patients. He puts that above any sort of blind loyalty to what he’s been taught, or his own self-interest in making a buck. And what he’s decided is that the practice of chiropractic is rife with fraud and quackery, and that chiropractors are far more trained in extracting dollars than in the diagnosis and management of any health condition.

Long’s book recounts his own decision to attend chiropractic school, and the odd, cultish setting that he soon encountered. He became disillusioned when he realized just how minimal the actual training was, even moreso when he found that most of what chiropractors rely on as “education” is centered on building a practice and retaining paying customers, rather than learning about the human body and how to prevent and treat illness. Their education, Long explains, is vastly different from that of medical doctors. In medical school and residency, a learning doctor will see thousands of patients across many settings, proctored and guided by experienced teacher-physicians, texts, and articles. In contrast, during chiropractic training Long was required to interact with only a few dozen patients, all in one place, most of whom were allowed to be his own friends and relatives. Has that changed since his training in the 1980s? Not really– in 2011, the chiropractic accreditation agency decided to set the requirement at 35 patient interactions to graduate. And only 10 of those had to be genuine, live patients rather than simulations or paper-based discussions. It is simply not possible for anyone to learn about the breath of variety in health and disease from so few patients.

The most striking chapter in the book is titled “Twenty Things Most Chiropractors Won’t Tell You.” Some of Long’s points include:

  • Chiropractic theory and knowledge aren’t based on anything close to what’s known by the scientific community. Their notions stem from a made-up theory from the 1800s which has no bearing on reality or how bodies actually work.
  • The legitimate scope of chiropractic practice is very narrow, limited to certain musculoskeletal conditions. Yet chiropractors often promise to be able to treat just about anything.
  • Chiropractors offer all sorts of unnecessary services, take too many x-rays, and sometimes do really strange things.
  • Chiropractic licensing boards won’t help protect patients from fraud or even sexual assault.
  • Chiropractors have no business treating children. (As I’ve said before, there is essentially zero evidence that anything chiropractors do can help kids.)

Long’s book does not set a hopeful tone. He’s spent his career trying to change the chiropractic profession by trying to bring it into the fold of legitimate, scientific medicine– and has been thwarted at every turn. Most chiropractic schools and practicing chiropractors, Long says, have no interest in improving care, advancing knowledge, or working with the medical community. There are good chiropractors out there, who genuinely try to help people, but they are hard to find, and are shunned and vilified by mainstream chiropractors. His chapter on “How to Protect Yourself” offers practical tips to help people find a good chiropractor, and protect themselves and their wallets from the bad one.

Dr. Long isn’t going to make many friends with this book—that’s not his point. But people who read this will understand what the field of chiropractic is, and what it is not. If you’re thinking of visiting a chiropractor, read this book first.

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