tag:blogger.com,1999:blog-4588205362847565197.post2373393890598857104..comments2024-03-09T10:14:07.193+00:00Comments on Dave Gorman: Chiro-BulliesDave Gormanhttp://www.blogger.com/profile/02260701102207639816noreply@blogger.comBlogger47125tag:blogger.com,1999:blog-4588205362847565197.post-44219769073757252322012-03-17T23:02:12.605+00:002012-03-17T23:02:12.605+00:00Hi Dave,
First point you dont manipulate an infant...Hi Dave,<br />First point you dont manipulate an infants spine the way you would an adult, the cervical spine of an infant is the size of my little finger, you use very little force. In paeds you are relying on the experience of the practitioner rather than "published evidence". Some people will have heard good things about me and bring their child, they see I have four very healthy children who have never had any kind of medication. They may decide to try it,they may not, its a matter of choice, which many skeptics dont want people to have, because of prejudices, not evidence. The evidence base for most child interventions is sparse for obvious reasons. Would you allow researchers to experiment on your child.When this happens you end up with the Bristol heart scenario. Do you think GPs are well trained in Paeds? Who messed up many childrens immunity by over prescribing antibiotics for conditions like otis media. Do you have evidence that chiropractic is harmful to children?I would not manipulate my children or anybody elses if thought I was likely to hurt them, would any parent.<br /><br />I am not a BCA member, however in 2007 I was elected on to the GCC to regulate the profession and was thrown off after 9 months, (wasnt because I refused to wear a suit and tie at meetings). Lets face it chiropractic politicians are as incompetent as any other politician. GCC spent over £100,000, High Court orders, and charges of defamation have been used in an effort to shut down my blog, and I did not have a book to sell, nevertheless I was very supportive of Simons right to express his opinion of chiropractic. <br /><br /> The irony in all this is both the BCA and GCC basically agreed with Simon Singh but were afraid of the loss of membership revenue for saying it, so being very litigious, what started as sabre rattling to please BCA members escalated out of their control. <br /><br />Research costs money and the chiropractic profession spends the little they have, where the money is in back pain, not paeds conditions.There are about 3,000 chiropractors practicing in the UK 80,000 in the US possibly 100,000 worldwide and we dont have a pharmceutical industry doing research for us<br /><br />What percentage of NHS interventions do you believe are supported by RCTs 100%, 50% 20%. Then you have the problems when an intervention looks good on the healthy research subjects used in the RCT and you dont get the same response when people have underlying problems as happened with Vioxx.A drug intervention does not have any variables that could confound results, Manipulation is very dificult to control for because its entirely dependent on the skill of the individual delivering the manipulation. Thats why Sackett attached importance to patient values and the role of experienced practitioners in his model of Evidenced Based Practice.richard Laniganhttp://www.chiropracticlive.comnoreply@blogger.comtag:blogger.com,1999:blog-4588205362847565197.post-42756772488193443592012-03-16T09:49:21.683+00:002012-03-16T09:49:21.683+00:00@Richard Lanigan: well, I would be a bit scared of...@Richard Lanigan: well, I would be a bit scared of letting someone manipulate my child's spine if there wasn't good evidence for both the efficacy of the treatment and their training in it. <br /><br />Your willingness to debate chiropractic with skeptics is great. If all chiropractors felt the same, maybe there'd be a willingness to do proper trials.<br /><br />Unfortunately the actions of the BCA suggested that they didn't want to have to justify their treatments, they just wanted to silence their critics. That's no way for anyone seeking authenticity in a medical field.<br /><br />Things are improved by scrutiny. What all fields of 'alternative medicine' should be doing is the research required to be, y'know, just medicine.<br /><br />Everyone wants people to be better. Everyone wants a child with colic to stop crying. Do proper RCTs. Get a proper body of evidence together. Demonstrate to people that it works.Dave Gormanhttps://www.blogger.com/profile/02260701102207639816noreply@blogger.comtag:blogger.com,1999:blog-4588205362847565197.post-28130027223029410102012-03-16T08:58:53.238+00:002012-03-16T08:58:53.238+00:00As luck would have it, I answered your first quest...As luck would have it, I answered your first question on colic in April 2010 as a challenge to Simon and skeptics generally. My question was what would they do if their child had properly diagnosed colic.This is a child who cries constantly every day and does not stop when picked up by the parents (the placebo) http://www.chiropracticlive.com/if-your-infant-has-colic-why-not-try-spinal-care-dare-i-say-chiropractic/<br /><br />Your choices are limited, let the child suffer, or find somebody who might help. Possibly the best evidence out there for helping colic is chiropractic, not a lot of money being invested into this kind of research and so students do much of it.<br /><br />Although the research evidence is not conclusive, most of whats out there out there is chiropractic. As a chiropractor I have supported Simons right to write his article from day one as I would anybody with a nose or an opinion. However one should keep in mind where Simon's expertise is, its not anatomy, physiology, or clinical science. I would be more than happy to go on a platform and debate clinical science and chiropractic with any skeptic. <br /><br />Most chiropractors are a bit scared of you lot and see skeptics as the bullies, however there are some of us would relish the opportunity of public debate rather than twitter debate, simply because skeptics( which I realise include some medical doctors) understanding of "evidence based medicine" is so limited, that it is laughable. Perhaps Dave you could outline your understanding of evidence in a clinical setting?richard laniganhttp://www.chiropracticlive.comnoreply@blogger.comtag:blogger.com,1999:blog-4588205362847565197.post-26856733955844477282009-06-30T18:05:20.462+01:002009-06-30T18:05:20.462+01:00Dr.H, the parachute RCT was not a joke, it was foo...Dr.H, the parachute RCT was not a joke, it was food for thought. Food for thought about the fact that as a clinician you are exposed to uncertainty, risk, a chronic lack of absolute knowledge and the fact that you have to make educated decisions regardless of all of the above. That you can't freeze in the face of lack of evidence based practice, but that you must let common sense prevail. Not so very funny really is it?<br />Some of the people here think that being a clinician is an easy job and although chiropractors don't save lives they regularly stop them from being lost (5 life-threatening, undiagnosed conditions last year in my case alone) something they have to be well-trained to do. I was trained first as a physiotherapist, then specialised in neurological rehab and then trained as a chiropractor. My cousin was a GP (7 years in Belgium) and retrained as a chiropractor. Trust me, if you are in any doubt that chiropractors are well-trained I would advise you look at the curriculum. My father is a GP and is in awe about what I know about backs. One of the main referrers to my practice is the neurosurgery department at a local hospital (testimonials to be read on my website). I am saddened by the fact that some people here seem to pick on one thing, then the next, then the next and at every angle we are supposed to prove ourselves worthy. You will find chiropractors who do bad things to good people as you will find in all professions, but that doesn't make the profession bad. And you will find chiropractors who do good things for people and that, in itself, does not make the profession good either, it just makes the care they received, from that particular person good. That they happen to be a chiropractor is really quite unexciting in itself. But obviously this lack of excitement won't shift books neither will it enable spitting of gall. Clinical practice is not about excitement it is about a special brand of stoicism, where humility and knowing that you don't know are interlaced with a sense of servitude to the patient. That some people make claims, behave unprofessionally and show poor ethos is really only testimony of their own standing, not that of a profession, or are all GP now to be considered serial murderers?<br />Stefaan VossenStefaan Vossenhttp://www.tcpn.co.uknoreply@blogger.comtag:blogger.com,1999:blog-4588205362847565197.post-7331140942523453932009-06-12T12:48:18.164+01:002009-06-12T12:48:18.164+01:00@Claire:
That parachute RCT you keep banging on a...@Claire:<br /><br />That parachute RCT you keep banging on about was in the well-know Christmas Edition of BMJ. It was a joke. Or meant to be, it's what passes for humour in medical circles. The entire Christmas edition is full of silly articles. Unfortunately, many CAM practitioners just don't get the joke and keep citing it seriously.DrHnoreply@blogger.comtag:blogger.com,1999:blog-4588205362847565197.post-44244098574811036972009-06-04T12:06:44.708+01:002009-06-04T12:06:44.708+01:00@Anonymous "For example, how do you run an RC...@Anonymous "For example, how do you run an RCT for the treatment of appendicitis. Who wants to be in the group that gets no treatment?"<br /><br />Controlled clinical trails can be and are conducted for surgery. The standard practice is, I believe, to compare two existing treatments or to compare a new treatment against an old treatment.<br /><br />You can also look at less rigorously controlled studies for evidence of effectiveness. For example, you can compare people who have not had surgery for some reason (e.g., no access to hospitals) to individuals who have (trying to match for possible confounding variables). Such studies are useful even if they aren't considered as good as RCTs.<br /><br />There are lots of treatments that haven't been evaluated in this way and should be. There are limited budgets to do the studies. This is why more research is needed and it is important that the research as high a quality as possible (to avoid wasting those resources).thomhttps://www.blogger.com/profile/00392478801981388165noreply@blogger.comtag:blogger.com,1999:blog-4588205362847565197.post-54866236886724991092009-06-02T11:37:59.066+01:002009-06-02T11:37:59.066+01:00For a very good understanding of the efforts peopl...For a very good understanding of the efforts people like Stephen Barrett and Edzard Ernst go to discredit the chiropractic profession, follow the following link.<br />http://www.chiro.org/LINKS/New_Zealand_Report.shtml<br />Under oath Dr. Murray Katz was found to be unrelaible, and Barrett's organisation was totally discredited.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4588205362847565197.post-3946411740506401262009-06-02T08:01:47.406+01:002009-06-02T08:01:47.406+01:00The consequences of this action will be that no He...The consequences of this action will be that no Health Care Provider, including pharmaceutical companies will be able to list the conditions that may benefit from treatments, unless peer review and randomised controlled trials have been done. There is a big problem with this, which is probably why at least 80% of allopathic medicine is essentially unproven. For example, how do you run an RCT for the treatment of appendicitis. Who wants to be in the group that gets no treatment?. Over the counter medications such as Paracetemol will be unable to list symptoms of PMT, migraine, etc. as those RCT's have not been done for these treatments. <br />Singh admits to having no expertise in chiropractic or complementary medicine, and Ernst, a former specialist in physical medicine and rehabilitation has long demonstrated extreme bias against chiropractic. His writings fall well short of peer-review. Writing in the BMJ in 1999, Dr Gordon Waddell, a leading UK orthopaedic surgeon and back pain auhority, described Ernst as offering “inter-professional confrontation under the guise of scientific objectivity.”<br />I wonder who really wrote the "bogus" article, It has the penmanship of Ernst, not Singh.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4588205362847565197.post-88441994611366046002009-06-01T16:59:18.361+01:002009-06-01T16:59:18.361+01:00Where is the BCA statement which they claim refute...Where is the BCA statement which they claim refutes Simon's statement.<br /><br />They claim to have presented 28 papers he "should have read", but they omit to mention which 28 they were. Cut and paste obviously challenging at the BCA.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4588205362847565197.post-7981618307990333572009-05-26T19:07:21.970+01:002009-05-26T19:07:21.970+01:00@Anonymous: the question should surely be why the ...@Anonymous: the question should surely be why the BCA didn't feel able to put this 'evidence' forward in a counter article, commentary on the original article or in some other public debate instead of filing a defamation case.<br /><br />The problem now is that the case has nothing to do with whether or not chiropractic is an appropriate treatment for colic etc. but all about whether or not they believed it to be so.<br /><br />I would have expected a responsible organisation to be more concerned with the search for truth than with the more trivial matter of whether they were <I>deliberately</I> misleading people.<br /><br />Whatever the outcome of the case it will do nothing to prove - or disprove their claims because it's simply not what the case is about. And surely - as a matter of public health - that would be the thing worth looking at.Dave Gormanhttps://www.blogger.com/profile/02260701102207639816noreply@blogger.comtag:blogger.com,1999:blog-4588205362847565197.post-45510425731390503912009-05-25T21:57:20.900+01:002009-05-25T21:57:20.900+01:00Why has no-one decided to comment on the BCA's rep...Why has no-one decided to comment on the BCA's reply which sets out a number of studies and papers in support of chiropractors claims?<br />Perhaps if SS had chosen his words more carefully or put his allegations to the BCA for comment prior publishing or even apologised for his article since, he might not staring down the barrel that he is now.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4588205362847565197.post-79474999597054346312009-05-22T11:23:36.455+01:002009-05-22T11:23:36.455+01:00It is so interesting that many people I know who h...It is so interesting that many people I know who have used chiropractice as a treatment and profess to its benefits are appalled and shocked at what the BCA are doing and some have even raised it with their own chiropractors who are equally astounded.<br /><br />The real problem is a deep defensiveness in the alternative medicine world against rational investigation of methods. They do themselves a real disservice by not opening themselves up to real scientific scrutiny. The reason for this is that the priority is not really about advancing scientific understanding of human biology, but about protecting commercial interests. As we discover more an more about the power of placebo - which the alternative therapists are well aware off - it shatters some of their so called unique techniques and with it their investment.Rob Shorrockhttp://www.robshorrock.me.uknoreply@blogger.comtag:blogger.com,1999:blog-4588205362847565197.post-67578294921628891652009-05-22T09:06:15.283+01:002009-05-22T09:06:15.283+01:00I have posted this email to the BCA:
Sirs,
Thank y...I have posted this email to the BCA:<br />Sirs,<br />Thank you very much for sueing Mr. Singh for libel. Your action has helped opening my eyelids at last: From believing that chiropractors were serious health professionals, I now see a behaviour that, sadly, reminds me more of a religious sect than of a scientific association. I realize that you most likely have no factual data to prove that Mr. Singh was wrong in whatever he may have said, because then you would have showed it. And whatever opinion he may have expressed, your own behaviour is the most revealing and the most defamatory to yourselves. So whether you win or lose the legal case, you have lost in the real world. Sincerely, Olle (etc. Full name, professional title and address, Sweden)Olle K.noreply@blogger.comtag:blogger.com,1999:blog-4588205362847565197.post-90124317034358801502009-05-22T01:24:44.208+01:002009-05-22T01:24:44.208+01:00John Braine said...
For all I could see it was not...John Braine said...<br /><I>For all I could see it was nothing more than a money making scam with no real care for the patient at all.</I>Don't you think that description fits much of the rest of CAM, particularly homeopathy, which is why some of us refer to it as sCAM (so-called Complementary and Alternative Medicine). And homeos have been pretty keen on the legal threats front in recent times too rather than reveal the evidence; with pretty disastrous results thankfully.<br />But the whole issue of resorting to legal process and abusing the libel laws does prompt the question that all sCAMmers should be required to answer - that is, if there is evidence why not produce it? Why resort to the law when the evidence would silence the critics for good?<br /><br />One can only point to the obvious conclusion that there is precious little if any evidence.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4588205362847565197.post-58980472073948126872009-05-22T00:55:25.444+01:002009-05-22T00:55:25.444+01:00Thanks for the post Dave and for hopefully raising...Thanks for the post Dave and for hopefully raising public awareness of this issue. I like your approach here, you don't really need to engage in the debate of whether Chiropractic works or not to make the argument that they should not resort to intimidating legal action.<br />I've never really thought about the English libel laws much and was frankly shocked to read about this and discover that Simon was being put in the position of defending something he didn't actually say(depending on your interpretation). It's a ridiculous ruling.<br />Like you I used to view Chiropractic in a kind of physiotherapy/osteopathy way, though learned a while ago that's not so. I think this may be a fairly common gap in public knowledge, hopefully this trial will bring attention to both Chiropractic and the libel laws. You're doing your bit so thanks.Lewisnoreply@blogger.comtag:blogger.com,1999:blog-4588205362847565197.post-36809488677779912602009-05-21T23:11:09.613+01:002009-05-21T23:11:09.613+01:00Whatever the outcome of the libel action, I fear t...Whatever the outcome of the libel action, I fear the perception of chiropractic in the minds of the general public will be mostly unchanged. A few scientifically or skeptically minded people will follow Simon's case and curse and shout and blog amongst themselves but millions will ignore it unless it is thrust under their noses. <br />What can we do to make this story top of the news? Does anyone know why I can't find a single mention of this on the BBC's website?Aiken Drumhttps://www.blogger.com/profile/14234472601576444172noreply@blogger.comtag:blogger.com,1999:blog-4588205362847565197.post-34976760715253952252009-05-21T14:05:35.070+01:002009-05-21T14:05:35.070+01:00@Murrey
The difference between Osteopaths and Chir...@Murrey<br />The difference between Osteopaths and Chiropractors is that Osteopathy is actually more evidence based. Also an Osteopath uses gentle manipulation rather than violent cracking movements and Osteopaths don't do the Chiroprators neck twist (a movement very similiar to how a commando would break an enemy sentry's neck)Nashnoreply@blogger.comtag:blogger.com,1999:blog-4588205362847565197.post-82703960219280191432009-05-21T10:19:53.895+01:002009-05-21T10:19:53.895+01:00@Mojo: that link is fantastic. I had no idea. I re...@Mojo: that link is fantastic. I had no idea. I recommend you follow it, but for those too lazy to do so, it shows that a complaint against an individual chiropractor's advertisement was upheld by the Advertising Standards Authority.<br /><br /><I>"We considered that, whilst some of the studies indicated that further research was worth pursuing, in particular in relation to the chiropractic relief of colic, we had not seen robust clinical evidence to support the claim that chiropractic could treat IBS, colic and learning difficulties.<br /><br />On these points the ad breached CAP Code clauses 3.1 (Substantiation), 7.1 (Truthfulness) and 50.1 (Health and Beauty Products and Therapies).<br /><br />2. Upheld<br />We welcomed Dr. Carl's assurance that the practice would no longer refer to its chiropractors as doctors in their future advertising to avoid misleading readers.<br /><br />On this point the ad breached CAP Code clause 7.1 (Truthfulness).<br /><br />Action<br />The ad must not appear again in its current form. We told Dr. Carl not to refer to the treatment of IBS, colic and learning difficulties in future."</I>Dave Gormanhttps://www.blogger.com/profile/02260701102207639816noreply@blogger.comtag:blogger.com,1999:blog-4588205362847565197.post-9403787444159508762009-05-21T01:30:22.862+01:002009-05-21T01:30:22.862+01:00"If there is evidence for chiropractic being an ef..."If there is evidence for chiropractic being an effective treatment for colic and/or childhood asthma: Put the evidence forward..."<br /><br />Actually, the ASA recently asked a chiropractor and member of the BCA to put forward their evidence that chiropractic is an effective treatment for colic (among other conditions). The result can be seen here:<br /><br />http://www.asa.org.uk/asa/adjudications/Public/TF_ADJ_46281.htmMojonoreply@blogger.comtag:blogger.com,1999:blog-4588205362847565197.post-87486165903699912802009-05-20T21:46:45.865+01:002009-05-20T21:46:45.865+01:00Thank you for an entertaining and informative spea...Thank you for an entertaining and informative speach on Monday. I will be blogging about this, as you suggested, as soon as I get the time.<br /><br />I've already taken the lazy option and facebook-posted it.<br /><br />Mind you, that will reach a larger audience than my blog will :)<br /><br />I didn't think the guys who spoke after you were as funny, but that short chap had a couple of good lines about politicians.Think Logichttps://www.blogger.com/profile/15841227968856151477noreply@blogger.comtag:blogger.com,1999:blog-4588205362847565197.post-34737502908325662192009-05-20T15:10:20.753+01:002009-05-20T15:10:20.753+01:00@Claire
Point taken about some CAM practitioners ...@Claire<br /><br />Point taken about some CAM practitioners offering cheap or free treatments, and good on you for aiming to do so. The 'cranial osteopathy' place that was in Cavendish Square, London (don't know if it's still there) also does so. I would also be interested to know which branch of complementary medicine helped with your chronic fatigue syndrome.<br /><br />Re complimentary/complementary, I appear to have touched a raw nerve and anything I say will probably inflame the situation (so I'm not about to become a physiotherapist - or a chiropractor). I am just a sad pedant.Angus Walkernoreply@blogger.comtag:blogger.com,1999:blog-4588205362847565197.post-69794679081764790392009-05-20T14:23:25.633+01:002009-05-20T14:23:25.633+01:00@Claire: don't worry, when I said it was "hastily ...@Claire: don't worry, when I said it was "hastily typed" I was referring to my own comment not yours. I assumed Angus's self styled facetious comment was aimed, kindly, at me.Dave Gormanhttps://www.blogger.com/profile/02260701102207639816noreply@blogger.comtag:blogger.com,1999:blog-4588205362847565197.post-16837372456614967922009-05-20T13:50:26.090+01:002009-05-20T13:50:26.090+01:00@ Dave @ Angus
It's wasn't hastily typed. I simp...@ Dave @ Angus<br /><br />It's wasn't hastily typed. I simply have dyslexic fingers (possibly not helped by missing four years of school due to CFS). But thanks for pointing that out. Immensely helpful. That said, I do and will continue to do complimentary medicine (for free) as well as complementary medicine. Just never alternative. <br /><br />@Angus You can't generalise to all CAM practitioners being at the other end of the scale. I'm not. I'm not in it for the money as I previously stated. I'll be lucky to break even. Or be out of debt anytime in the next 30 years.<br /><br />@ Dave The analogy with the parachute wasn’t mine it can be read in full here:<br /><br />http://www.bmj.com/cgi/content/abstract/327/7429/1459?<br /><br />I assumed that as it was peer reviewed it was valid? If that sounds facetious it honestly isn’t meant to be.<br /><br />Of course I agree that research helps rather than hinders. And bullying is abhorrent in any form.Clairenoreply@blogger.comtag:blogger.com,1999:blog-4588205362847565197.post-8223478492570177652009-05-20T13:27:56.126+01:002009-05-20T13:27:56.126+01:00It was a great evening, thanks for your contributi...It was a great evening, thanks for your contribution and your excellent post, Dave.<br /><br />My own review of the evening is here:<br /><br />http://skepticat.wordpress.com/2009/05/19/the-bca-v-simon-singh-pt-2-the-nerds-are-revoltingSkepticathttp://www.skepticat.orgnoreply@blogger.comtag:blogger.com,1999:blog-4588205362847565197.post-32563224983660771362009-05-20T12:48:45.706+01:002009-05-20T12:48:45.706+01:00Well Dave, what can I add to this? Nothing I don't...Well Dave, what can I add to this? Nothing I don't think though I've been trying to make sense of it (speech, freedoms, Web 2.0 in general) on my own blog<br /><br />http://singletrackroads.blogspot.com/2009/05/web-20-jedi-or-sith.html<br /><br />and it seems sometimes like the world can be a scary place. Like you said in your post "When a large crowd turns out for something like that, if nothing else, it confirms that you're not mad for thinking the way you do."<br /><br />Keep up the good work.Single Trackhttps://www.blogger.com/profile/12659569441973581784noreply@blogger.com