Monday, February 8, 2010

One Skeptic to Another

One Skeptic to Another

Note: the following blog is in response to an article that appeared in my local newspapers
Professor Pasachoff is a skeptic, as am I…to the extent that one of my guiding precepts is: ‘the quality of your life and your understanding of the world will be determined by the quality of the questions that you ask.’
I suspect that Professor Pasachoff and I would agree on many things, specifically that critical thinking seems to be underutilized, at best, and undermined, at worst, in our society.
But, he and I are at odds when he targets chiropractic in his skepticism. He crossed the line from skepticism/doubt into dogmatism with his label of pseudo-science. So, how do I, as a chiropractor and a skeptic, reconcile this? Quite simply, I welcome Professor Pasachoff’s skepticism, questions and scrutiny, as I do that of my patients. I would ask him what personal research he has done to make this broad denouncement? Or, in this instance, might he be wanting in critical thinking skills?
There is a plethora of scientific evidence supporting both the physiological effects and efficacy of chiropractic adjustments for the treatment of acute neck and low back pain of mechanical origin.
In fact, in 1989, the US government established the Agency for Health Care Policy and Researchto enhance the quality, appropriateness, and effectiveness of health care services and access to these services.” Because of the prevalence, the first guideline developed was for the treatment of acute low back pain. “This guideline was developed by an independent multidisciplinary panel of private-sector clinicians and other experts convened by the Agency for Health Care Policy and Research (AHCPR). The panel employed explicit, science-based methods and expert clinical judgment to develop specific statements on acute low back problems in adults.”
The panel concluded: “Surgery has been found to be helpful in only 1 in 100 cases of (all) low back problems. In some people, surgery can even cause more problems.” Furthermore, scientific, evidence-based research supported only three “Proven Treatments” for acute low back problems: NSAIDS (oral anti-inflammatories), the use of ice or heat and, remarkably…42 studies supported the use of (chiropractic) spinal manipulation of the low back.

Were these guidelines implemented? No! Why? Because citing the efficacy of conservative approaches and recommending non-surgical treatments for low back pain, drove back surgeons wild. They organized and lobbied congress and effectively stripped the AHCPR of its power, halting the development of all future guidelines. Incidentally, the number of spinal fusions continued to rise dramatically, over 127 percent between 1997 and 2004.

Perhaps Professor Pasachoff’s skepticism would be better directed at the machinations of the medical-pharmaceutical industrial complex. After all, in terms of risks verses benefits, the risks and deaths associated with medical/pharmaceutical care far exceed those of any he labeled as pseudo-science. Why aim so low?

It has been estimated that only 15% of what doctors do is backed by the type of hard scientific evidence Professor Pasachoff seeks: ie: that ‘there is little to no evidence that many widely used treatments and procedures actually work better than various cheaper alternatives.”

While there is significant evidence that corporate-backed science has infiltrated and undermined virtually all aspects of medical research for the purpose of marketing drugs.

In September of 2001 the editors of 12 of the world’s most prestigious medical journals issued an unprecedented and chilling alarm titled: Sponsorship, Authorship and Accountability. They wrote: “We are concerned that the current intellectual environment in which clinical research is conceived, study subjects are recruited and the data analyzed and reported (or, not reported) may threaten scientific objectivity…In light of that truth, the use of clinical trials primarily for marketing makes a mockery of clinical investigation and is a misuse of a powerful tool.”

In a world where medical journals have become an extension of pharmaceutical companys’ marketing strategies, skepticism, critical thinking and questioning are not only important, they can save your life.

1 comment:

yo bro said...

There is healthy skepticism, and there is gratuitous skepticism such as the entirely unsubstantiated reference by Pasachoff to chiropractic as "pseudoscience." It's not Pasachoff's job "as an educator" to fight what he arbitrarily decides to be pseudoscience. Rather, it is his job to teach his students to think critically for themselves, ask probing questions, and oppose dogmatic thought (such as his). Pasachoff sounds like one of those hoary, self-important professors, who has been around campus far too long, and probably couldn't exist outside it's ivy covered walls.