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Oct 02 2013

Not the Ducks! – I Cannot Think of a Joke

Normally I have a decent grasp on headline titles but this post simply is not the place to make my usual references or jokes.

Warning!

TW – Just In General This Will Make You Mad

In New South Wales (Australia) it has come to public attention that Chiropractors have been entering hospitals to treat patients without permission.

In one particular case they have been entering paediatrics and neo-natal wards.

Subluxation is pure quackery. There is no benefit from it. You want to manipulate a nerve and see what it feels like? Bang your elbow on a table. Hurts doesn’t it? Why do you think your spinal cord is any different? The chiropractor stretches ligaments. You know what else stretches those ligaments? Stretching exercises.

And it’s cheaper too!

And safer. People are often terrified by the way doctors handle babies. I fear the idea is that doctors seem a bit “rough” around them. There is a “reason” for that. Some of the tests to determine a baby’s health are a tad rough. Like rocking the baby a bit to see how it’s eyes open. Or dropping the head of the baby a little to see it’s reflexes. Many of these are vital to determine the health of a child but at all times we know what we are doing.

IMHO you should be hit by an adult at only one time in your life. And by your mother’s obstetrician at that.

Many a patient is astonished by how robust an infant really is. Of course they are tougher than you think! They are tough enough to live! And our ancestors had none of the luxuries that we have.

But robust or not we still hold a child’s head when we pick it up. Because we know that it cannot hold it’s head up.

In NSW, a baby’s neck has been broken by a chiropractor.

The injury was reported to the Chiropractic Board of Australia, which closed the case without reporting it to the public and allowed the chiropractor to keep practising as long as they undertook education with an ”expert in the field of paediatric chiropractic”.

This is an outrage. No seriously. This is the fact an untrained quack walked into a hospital and severely injured a patient with no scientific oversight and his peers effectively gave him a slap on the wrist.

The 4 month old baby was injured after one of her vertebrae was fractured during a chiropractic treatment for congenital torticollis. This is a harmless condition that usually resolves itself by 8 months and can be treated when the child is older by physiotherapy. As the child’s neck muscles develop the condition ceases to become apparent.

As with any spinal cord injuries, the baby was extremely lucky to survive and make a full recovery. A few more mm of damage either way could have transected the spine and resulted in death or neurological impairment or even quadriplegia.

There is no scientific evidence for ANY chiropractic let alone to be applied to children and  neo-nates.

But the Chiros are fighting back.

ANGRY chiropractors are demanding a retraction of claims that a baby’s upper cervical vertebra was
fractured during an adjustment.

Because when your entire field is incapable of producing scientific research and instead spends it’s time treating using the placebo effect and unscientific and nonsensical claims then you are forced to worry about slander. Remember this is a group of people who  routinely encourage patients to not vaccinate and has lead to some pretty hefty tragedies where unvaccinated children have died from preventable causes on their advice. Advice they refuse to take responsibility for.

The Chiropractors’ Association of Australia (CAA) said it was “outraged” at Fairfax newspaper reports of an investigation into the case of a four-month-old Melbourne baby. The complaint was made to AHPRA by Dr Chris Pappas, a paediatrician at the Cabrini Medical Centre, who reportedly treated the baby following a chiropractic treatment for torticollis. “Another few millimetres and there would have been a devastating spinal cord injury and the baby would have either died or had severe neurological impairment with quadriplegia,” he was reported as saying.

Of course it’s outraged! Dr. Pappas is making them look like the quacks they are by telling people the damage caused by these idiots.

Dr Pappas received a response from AHPRA earlier this month indicating that the case, which was referred on to the Chiropractic Board of Australia, had been closed after the chiropractor committed to completing further education, Fairfax reported.

It’s not enough that Chiro’s are already quacks it’s that we have to watch them harm kids too with their nonsense. This was not harm by exclusion of genuine medical care this is something that I have been telling people for ages. You can hurt your back carrying weights so why is it impossible to understand that someone placing pressure on your back can damage it too.

And this is not education. One of the most amusing things was a Chiropractor demonstrating the “time” he spent learning. He said it took him 500 hours plus 300 hours to become what he called a Chiropractic Neurologist. Which to me sounds like “Tartan Paint Maker” and “Left Handed Screwdriver Manufacturer”.

So I sat down and worked it out. How many hours have I worked and studied in order to not know all the things I don’t know and to realise how little of Medicine I actually know.

I work around 2400 hours a year on a conservative estimate (40 weeks at 60 hours a week.). Even if I was in the UK it would be around 1600 hours a year. No matter what the entire course of Chiropractic can apparently be taught in under a year if we push the education system to be like Medicine.

Dr Pappas described the decision as an endorsement of “inappropriate” chiropractic treatment for infants without supporting scientific evidence.

I completely agree with Dr. Pappas. I would go so far as to use the word “Bullshit”.

The CAA, however, wants AHPRA to release full details of the investigation. CAA president Dr Laurie Tassell (Chiro) said there was no doubt the baby had a hangman’s fracture. “The official report made it quite clear that the chiropractor did not cause the injury but unless AHPRA releases the report we can’t use those findings,” he told Medical Observer, adding that no adverse events involving a qualified chiropractor treating a child had been recorded in medical literature since 1992.

Actually there are plenty of known cases. If we include the deaths caused by the anti-vax bullshit flogged the number of injuries skyrockets.

Oh and fracturewise? Children are harder to fracture. Children’s bones are not completely solid so flex and bend more. Any fractures caused can be silent but later on produce worse effects due to a lack of proper treatment at the time.

In every case Chiropractors have had extremely mild punishments. In one case of a young woman who’s “adjustment” caused her carotid arteries to be damaged resulting in haemorrhage and death? The Chiro got a fine of $1000 and just 12 (TWELVE) hours of training to correct his lack of knowledge.

“The CAA is outraged that rather than clearing the chiropractor’s name, as appropriate, the newspapers have smeared the chiropractor and the profession with such an allegation,” a CAA statement read. “Chiropractic care can be remarkably gentle. Being a five-year, university-trained spinal health expert, a chiropractor will modify their adjustment techniques to suit the age and spine of each individual child,” Dr Tassell added.

To do so without an x-ray/CT-Scan or MRI is not just incredible but verging on magic.

I had a chiro case of a woman who had difficulty walking come into my orthopaedics OP (If you must know? I intend to qualify in Orthopaedic and Trauma surgery…). 5 years after a accident she has been getting regular subluxations.

For a broken tibia that had malunited causing osteoarthosis. If she had come in earlier we could have prevented all that. Instead she couldn’t tell the difference. Because Chiropractors call themselves Doctors when they don’t deserve that.

The Fairfax article also alleged there was evidence that chiropractors had been treating patients without the necessary permission at Sydney hospitals. “We will certainly find out what truth there is in that and if anyone has acted outside the rules or code of conduct then they deserve what they get,” Dr Tassell said.

A Slap On the Wrist and A Few Hours Of Training!

”I think they have put the chiropractor’s interests before the interests of the public,” Dr Pappas said. ”[Treating infants] is inappropriate and it carries a very small but real risk of causing damage, and in some cases, devastating damage.” A review published in the Pediatrics journal in 2007 also found serious adverse events relating to spinal manipulations in children, including a brain haemorrhage and paraplegia.

Remember that 1993 quote? There is a lot of stories about injuries caused by Chiropractic. The problem is many of those injuries are treated by the Chiropractors and blamed on other things.

The Chiropractic board has effectively meted out a paltry punishment to protect it’s reputation.

However, the president of the Chiropractors’ Association of Australia, Laurie Tassell, says chiropractic treatment is as safe for children as it is for adults, and chiropractors should be able to treat patients in hospital, if authorised.

No. They should not. We should not allow quacks to play with our patients. There is no evidence for Chiropractic treatments ever working beyond the placebo. And in many cases Chiropractors treat self resolving conditions.

My personal favourite is a proud Chiro telling me he treated a case of Serum Sickness over 5 years.

It takes 3 weeks to recover from Serum Sickness. In effect he either kept someone sick for 5 years or was bullshitting for 4 years and 49 weeks.

“Chiropractic care can be remarkably gentle,” he said. “Being a five-year, university-trained spinal health expert, a chiropractor will modify their adjustment techniques to suit the age and spine of each individual child.” President of the Australian Medical Association Steve Hambleton said the board needed to either produce evidence supporting chiropractic treatments for children or rule out paediatric care. ”The AMA is not aware of any evidence that chiropractic manipulative treatment of infants and children offers any benefit at all,” he said.

Well done AMA! It’s high time we stopped letting quacks call themselves doctors and offer up “sage medical advice” pretending to be them.

The Sun-Herald has seen Facebook conversations in which chiropractors discuss methods of sneaking into hospitals. Images, obtained by blogger Reasonable Hank, include one of a baby being adjusted in a hospital. AMA NSW head Brian Owler said it was “absolutely outrageous” for chiropractors to treat patients in hospital without permission. “None of us can go into an emergency department of a hospital and start treating patients without proper credentials and medico-legal coverage,” he said.

Which goes back to the reason of liability and responsibility.

A spokeswoman for NSW Health said treating patients without notifying the hospital may be improper conduct and it could be reported to the Health Care Complaints Commission.

That’s the thing. The medical profession has oversight. It is extremely well policed and not only is it in the interest of doctors to improve care but also to ensure sub-par and bad doctors are struck off.

There is no such thing with the Chiropractors.

And that’s the ultimate problem and the cost this time was nearly paid by gullible parents who let this untrained, uneducated fool (And let’s face it, any idiot who thinks playing with a 4 month old’s spine is sensible is a fool) with a faulty education in a quack field pretending to be a real doctor…. they let this man treat their child in trust.

And it was trust that was undeserved.

7 comments

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  1. 1
    billdaniels

    Why a duck?

  2. 2
    hapalochlaena

    *quack*

  3. 3
    ryangerber

    Just for reference, that 800 hours is less than the time I spent to become an EMT-Intermediate. About 5x the hours required to be an EMT-Basic.

  4. 4
    smrnda

    There’s lots of quackery out there, but how did chiropractors manage to go so mainstream?

  5. 5
    Kimpatsu

    Like rocking the baby a bit to see how it’s eyes open.
    Avi, please, please, please! Read this:
    http://theoatmeal.com/comics/apostrophe
    Grammar nerds everywhere will thank you for it.

  6. 6
    angharad

    I wish this had hit the news a bit harder here. Most people in this country seem to see chiropractors as pretty much interchangeable with physiotherapists, and the chiros themselves range from ‘I just crack backs’ to full on anti-vaxxer whackos.

  7. 7
    darahgna

    Melbourne paediatrician Chris Pappas did a misstake!!!

    Here are the facts, if you are intressted.:

    http://www.parliament.qld.gov.au/documents/tableOffice/TabledPapers/2013/5413T3781.pdf

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