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chiropracters using the title "Dr"
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26-01-2008 1:00am#1
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This thread is 'N8 bait.'
Tbh, it's not a cut and dry issue. Chiropractic degrees differ by institution. The big, recognized one in the US and Canada confers a doctoral degree. Technically, any graduates of this course are legally entitled to call themselves 'doctors.' AFAIK, certain elements/bodies of chiropractics are recognized as legitimate 'complementary' therapies by most medical organizations - certainly the AMA and WHO. No problems there.
The primary problem with chiropractics is the whole licensing and accreditation issue. Some awarding bodies are more reputable than others. Some are downright disreputable. Some practitioners are dangerously under-qualified, do not practice evidence-based medicine and may harm their patients - plenty of evidence of that, too.
Now, if they aren't legally entitled to use the title 'doctor', then it's fraud, plain and simple. Furthermore, deliberate conflation of chiropractic and conventional medicine to give an air of authority or authenticity is low. Reminds me of so many infomercials from 'nutritionalists' and other makey-uppy degree holders calling themselves doctors whilst hawking their detox pills to the highest bidder. :rolleyes:0 -
This thread is 'N8 bait.'
Tbh, it's not a cut and dry issue. Chiropractic degrees differ by institution. The big, recognized one in the US and Canada confers a doctoral degree. Technically, any graduates of this course and legally entitled to call themselves 'doctors.' AFAIK, certain elements/bodies of chiropractics are recognized as legitimate 'complementary' therapies by most medical organizations - certainly the AMA and WHO. No problems there.
The primary problem with chiropractics is the whole licensing and accreditation issue. Some awarding bodies are more reputable than others. Some are downright disreputable.
Now, if they aren't legally entitled to use the title 'doctor', then it's fraud, plain and simple. Deliberate conflation of chiropractic and conventional medicine to give an air of authority or authenticity is low. Reminds me of so many infomercials from 'nutritionalists' and other makey-uppy degree holders calling themselves doctors whilst hawking their detox pills to the highest bidder. :rolleyes:
Agreed, 2scoops. There's a huge problem with consistent quality of chiropracters.
Also agree that they are recognised by some bodies as complementary therapies.
Do you know what the legal situation is with calling yourself "Dr"? I've seen a few of them using the title who I don't think have been to any big uni stateside. I thought there was no legal barrier to calling yourself "Dr".
Gillian McKeith FTW!!
Can any awarding body award a "doctoral" degree?
I'm sure all the chiropractic "doctors" kicking about can't all have gone to this same uni?
Edit: I'm eagerly awaiting the wrath of N8's rage
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tallaght01 wrote: »Do you know what the legal situation is with calling yourself "Dr"? I've seen a few of them using the title who I don't think have been to any big uni stateside. I thought there was no legal barrier to calling yourself "Dr".
Hmm, maybe the legal forum would have a better idea of the legalities. Posing as a medical doctor when you aren't one is definitely illegal... but calling yourself 'doctor' may not be! I mean, there's nothing stopping anyone changing their name to 'Doctor John Murphy,' if they want really want to.Can any awarding body award a "doctoral" degree?
Diploma mills make a killing on it. They're just meaningless and not recognized by professional organizations. Not illegal, afaik.I'm sure all the chiropractic "doctors" kicking about can't all have gone to this same uni?
Highly unlikely. Most of the ones in Ireland (can't be that many, is there?!) are firmly on the spoofer/charlatan end of the chiropractic spectrum, I would imagine. 0 -
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Aha Scoops – sorry been away but had to ask a bit about this for you all.tallaght01 wrote: »I'm not posting this to have a go at chiropracters.
chiropractors (-:
I think this would be an uncommon mistake for someone to mistake a chiropractor for a medical doctor unless that chiropractor worked within a medical setting. It would be like confusing Big Ian as a medical doctor.tallaght01 wrote: »I only say it because I was talking to somebody tonight who thought a particular chiropracter was a qualified medical doctor.
I had to ask but there is only chiropractor qualified as a medical doctor (or medical doctor qualified as a chiropractor) in Ireland.tallaght01 wrote: »The orthopaedic advice he was giving was pretty shaky, too.
Outdated and bad advice often is given by doctors chaps and orthopaedic surgeons generally do not give the most conservative of advice or choices but this is not the question of the OP just a comment of mine.tallaght01 wrote: »So, I was just wondering, they don't have a doctorate and they're not "doctors", so why do they use the title? Is it a common practise in Ireland?
Chiropractors in common with medical doctors do not have a doctorate. As with medical professionals, doctor is an honorary conference of title, and this is not only a common practice in Ireland but profession wide.AFAIK, certain elements/bodies of chiropractics are recognized as legitimate 'complementary' therapies by most medical organizations - certainly the AMA and WHO. No problems there.
Actually there was a problem with the AMA. In 1986 the AMA were found guilty of conspiring to destroy the profession of chiropractic. The 101-page opinion ruled that the AMA, along with the American College of Surgeons and the American College of Radiology, had violated the Sherman Antitrust laws by using an ethics ban on interprofessional cooperation to organize a national boycott of doctors of chiropractic by medical physicians and hospitals. The American Academy of Orthopedic Surgeons (AAOS) was also found guilty.
This is a common thread running through the medical profession worldwide, accusing chiropractors of quackery and such.
“Trial evidence showed that the defendants took active steps, often covert, to undermine chiropractic educational institutions, conceal evidence of the usefulness of chiropractic care, undercut insurance programs for patients of chiropractors, subvert government inquiries into the efficacy of chiropractic, engage in a massive misinformation campaign to discredit and de-stabilize the chiropractic profession, and engaged in numerous other activities to maintain a medical physician monopoly over health care in this country (US).”Chiropractic degrees differ by institution. The big, recognized one in the US and Canada confers a doctoral degree. Technically, any graduates of this course are legally entitled to call themselves 'doctors.' .......
The primary problem with chiropractics is the whole licensing and accreditation issue. Some awarding bodies are more reputable than others. Some are downright disreputable. Some practitioners are dangerously under-qualified, do not practice evidence-based medicine and may harm their patients - plenty of evidence of that, too.
No there is one worldwide body of accreditation – The Council on Chiropractic Education http://www.cce-usa.org/ of which they have a European arm so to speak http://www.cce-europe.com/. This is a pretty unique situation for a profession to have one world wide accreditation body.Some practitioners are dangerously under-qualified, do not practice evidence-based medicine and may harm their patients - plenty of evidence of that, too.
No there’s not - unless you can present some.Most of the ones in Ireland (can't be that many, is there?!) are firmly on the spoofer/charlatan end of the chiropractic spectrum, I would imagine.
As I said this is a common thread running through the medical profession (-:Posing as a medical doctor when you aren't one is definitely illegal... but calling yourself 'doctor' may not be! I mean, there's nothing stopping anyone changing their name to 'Doctor John Murphy,' if they want really want to.
It does appear there is no statutory registration of chiropractors in Ireland and this is why there are a number of unqualified practitioners describing themselves as chiropractors; unfortunately this includes some GPs. But remember the social workers, physios etc only got there statutory recognition with the Allied Health Prof bill of 2006.also, you will find a number of these chiropracters have qualified as doctors medical. i know whoever my friend goes to has a gp's surgery as well as chirpractoryness
chirpractoryness? (-: As I said above Tree I had to ask but there is only chiropractor qualified as a medical doctor (or medical doctor qualified as a chiropractor) in Ireland.tallaght01 wrote: »Edit: I'm eagerly awaiting the wrath of N8's rage
Aa- Ha! (-:0 -
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Barratt the unlicensed Pennsylvania psychiatrist... hasn’t that chap been hit with legal case after legal case all finding against him? Have you any evidence past this about chiropractors doing any harm on a day to day basis?
No, Barrett the retired Pennsylvania psychiatrist.
The legal cases against him are from highly litigious 'quacks' whose feathers he has ruffled. AFAIK, most cases have found for Barrett, not against. And don't forget he has a real live chiropractor co-editing his chirobase site!
Anyway, this is a merely collection of documented reports, why should I discount them as evidence simply because Barrett has brought them to my attention?Do you mean when its done within a medical paradigm and not according to the chiropractic paradigm of health?
Maybe - what's the 'chiropractic paradigm of health?'0 -
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dr.bollocko wrote: »I believe you failed to pick up, dear heart, upon my recursive wankery.
Clearly. Maybe I should hang out in AH more! 0 -
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dr.bollocko wrote: »Yeah I am completely fed up with random **** fraudulently calling themselves doctors with no qualifications to back it up.No, Barrett the retired Pennsylvania psychiatrist. The legal cases against him are from highly litigious 'quacks' whose feathers he has ruffled. AFAIK, most cases have found for Barrett, not against. And don't forget he has a real live chiropractor co-editing his chirobase site!
Anyway, this is a merely collection of documented reports, why should I discount them as evidence simply because Barrett has brought them to my attention? '
Did you get that information from Barratt’s site(s)? Quacks suing him… Like Ted Koren, Chiropractor?
During that trial in particular I understand that Barrett conceded that he was not a Medical Board Certified psychiatrist because he had failed the certification exam.This was a major revelation since Barrett had provided supposed expert testimony as a psychiatrist and had testified in numerous court cases. Barrett also had said that he was a legal expert even though he had no formal legal training.
The most damning testimony before the jury, under the intense cross-examination…, was that Barrett had filed similar defamation lawsuits against almost 40 people across the country within the past few years and had not won one single one at trial.
During the course of his examination, Barrett also had to concede his ties to the AMA, Federal Trade Commission (FTC) and Food & Drug Administration (FDA).
One of the most common questions now coming up about Barrat is his funding. Barrat testified that in a period of two years he made a TOTAL of $54,000, at a time when he was involved in fourteen (14) separate legal actions at one time? Legal actions which would have being costing $100,000 each?
We are definitely rolling off topic here but its being in the interest in putting things straight.what's the 'chiropractic paradigm of health?'
The chiropractic paradigm is that the principle focus of care is not the reduction of symptom per se but the increase in the function of a person being. Of course, in the vast majority of times these come together.0 -
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tallaght01 wrote: »N8, now that I have journal access again, can you tell me which david eddy paper you want me to read. He's pretty prolific in the BMJ.
This is the editorial:
British Medical Journal 1991 (Oct 5); 303: 798–799 [Editorial]
By RICHARD SMITH, Editor of BMJ
"Where is the wisdom we have lost in knowledge, and where," asked T. S. Eliot, "is the knowledge we have lost in information?" There are perhaps 30,000 biomedical jounals in the world, and they have grown steadily by 7% a year since the seventeenth century. [1, 2] Yet only about 15% of medical interventions are supported by, solid scientific evidence, David Eddy, professor, of health policy and management at Duke University, North Carolina, told a conference in Manchester last week.
This is partly because only 1% of the articles in medical journals are scientifically sound. [2, 3] and partly because many treatments have never been assessed at all. "If," said Professor Eddy, "it is true, as the total quality management gurus tell us, that ‘every defect is a treasure’ then we are sitting on King Solomon's mine."
What are the implications for those purchasing health care if the scientific base of medicine really is so fragile? Because, as Professor Eddy said, "it is not enough to do the thing right; it is also necessary to do the right thing." The implications for purchasers of the poverty of medical evidence were considered at the Manchester meeting, which was organised jointly by the, British Association of Medical Managers and the resource management unit of the NHS Management Executive.
Professor Eddy began his medical life as a cardiothoracic surgeon in Stanford in California but became progressively concerned about the evidence to support what he and other doctors were doing. He decided to select an example of a common condition, with well established treatments and assess in detail the evidence supporting those treatments. Beginning with glaucoma, he searched published medical reports back to 1906 and could find not one randomised controlled trial of the standard treatment. Later he traced back the confident statements in textbooks and medical journals on treating glaucoma and found that they had simply been handed down from generation to generation. The same analysis was done for other treatments, including the treatment of blockages of the femoral and popliteal arteries; the findings were similar. That experience "changed his life," and after taking a degree in mathematics at Stanford University he became a professor at Duke University and one of the consultants most in demand in the United States.
Regularly he advises those producing consensus statements, and he is suspicious of the process. The best statements are based on scientifically sound evidence, but even when it is lacking (which is usual) the statements should make clear what evidence is available. Agreement of the experienced, without evidence, is a poor basis for producing advice, and as an illustration he told the story of the consensus reached by an international group that was expert in screening for colorectal cancer.
The group, including Professor Eddy, met all over the world for three days a year for five years. At the end the group recommended a protocol based on regular faecal occult blood tests and sigmoidoscopy. Professor Eddy asked each member of the group then to make a private estimate of how much mortality would be reduced by such a policy: the answers ranged from 0 to almost 100% and were randomly distributed within that range. Yet the consensus had been unanimous. As Hippocrates said, experience is fallacious.
Professor Eddy now runs courses for expert groups trying to achieve consensus. Each time he asks the members to list the outcomes they are seeking and to rank the scientific evidence for each outcome from excellent to none and then describe the best available evidence. For 21 problems tackled so far, the evidence has been judged— by the experts —to be between poor and none for 17, and usually the best available evidence was something less than a randomised controlled trial. Often the evidence that was available contradicted current practice; thus of 17 randomised trials on giving lidocaine prophylactically in patients with chest pain, 16 showed no effect, and one showed a positive result—yet practice in the United States was to give lidocaine.
The weakness of the scientific evidence underlying medical practice is one of the causes of the wide variations that are well recognised in medical practice. Dr Hugh Sanderson, director of the Wessex Cancer Intelligence Unit, illustrated the wide variations among observers and in referral rates, admission rates, investigations, and treatment. For example, among a sample of 172 radiotherapists 48% offered palliative treatment to patients with metastasised lung cancer only if they had symptoms, whereas 52% always offered treatment. Professor Eddy used this example to illustrate how doctors could be made not just to understand intellectually the variation in practice but also to feel it: radiotherapists could be asked to write down in secret what they would do for a particular patient and the results could then be pooled and discussed. The same process can be used with any specialty.
The evidence on effectiveness is poor, but the information needed— by purchasers, for instance— to choose among different treatments is almost never available. To choose, for example, among screening programmes you need, said Professor Eddy, data on how many people would need to be screened, how many deaths might be prevented, the cost of the screening program, and the savings. Turning to the "good news" in his presentation, he illustrated how mathematical modelling could be used to analyse limited data in order to make better decisions. He asked the audience to imagine that they had $400m to spend on screening for a population of a million adults and to choose between cholesterol screening as recommended by the national cholesterol education programme and breast screening as recommended by the American Cancer Society. These are two of the best studied screening methods, and much of the information needed for making policy decisions is available.
Cholesterol screening, according to the recommended protocol, could prevent 9620 events (including 340 sudden deaths, 2760 myocardial infarctions, and other conditions, some of them only poorly defined because of imprecise data) at a cost of $449m with a saving of $l01m (net cost $348m); breast screening would save 222 lives at a cost of $296m, but with a saving of only $5m (net cost $291m). A purchaser might thus opt for cholesterol screening, but Professor Eddy set his computer to adopt a more selective method of deciding who should be treated for hypercholesterolaemia— very much in the manner described in last week's BMJ by Professor Hugh Tunstall-Pedoe (28 September, p 744). The result is that you can prevent the same number of events with consequently the same saving (which is what Professor Eddy told his computer to do) at a cost of $192m, giving a net cost of $91m. The purchaser with $400m could then have both cholesterol and breast screening with $18m change. The computer could go further and be set to achieve higher benefits at lower costs.
This is how important information can be, but one of the problems is that the information comes out of a mathematical model— and doctors feel uncomfortable with such models. The doctors who devised the national cholesterol education program responded to his computer manipulation by saying that the protocol he had devised was too complicated to use. Professor Eddy is sympathetic but points out that medicine is far too complex an activity to be conducted by human minds unaided by computers: "We've been trying that for two millennia and look where we've got to." Planes are landed better by computers than humans— especially in rough weather— and much of medicine is more complicated than landing a plane. Professor Eddy thus has a fantasy of a health room equivalent to the control room at an airport, and the health room would contain all the information needed to make decisions to improve health. Like all fantasies this must be treated with caution, and purchasers in the NHS and elsewhere are faced now with making difficult choices with grossly inadequate information.
The afternoon session of the conference tackled some of the hard questions faced by purchasers. Firstly, should they specify care processes or health gain in contracts? Whatever you go for, make your decision in an alliance with providers, said one group asked to answer the question. Professor Eddy thought that for now purchasers would have to specify processes rather than outcomes, because outcomes were delayed and probabilistic. Secondly, where should purchasers get their advice on clinical advances? They had to go to local providers, everybody agreed, but "get them to provide their evidence," said Professor Eddy. Go as well, the meeting agreed, to national and international bodies, set priorities, and look for sophisticated analyses that use the best data. And try to avoid duplication, said Professor Eddy: "In the United States we have 200 groups working on the same 15 problems." Finally, how can doctors be encouraged to use this information? There were mutterings about participation, ownership, alliances, quality assurance, education, and cultural change, but Professor Eddy concluded: "Get doctors to understand how much they need reliable information. What could be worse than two millennia spent making life and death decisions with inadequate information?"
REFERENCES:
1. de Solla Price D. The development and structure of the biomedical literature. In: Warren KS, ed. Coping with the biomedical literature. New York: Praegel, 1981
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2. Lock S. lntroduction. In: LockS,ed. The Future of Medical Journals. London: BMJ 1991: 1-8
3. Williamson, JW, Goldschmidt PG, Colton T. The quality of medical literature: an analysis of validalilon assessments. In: Bailar JC, Mosteller F. Medical use of statistics. Waltham. Massachutallaght01 wrote: »Also, can you tell me which one of the task force's papers you want us to read, and what it shows (for those who don;t have journal access).
cheers.
Not to be rude but I have not enough time to hunt this down. The post was at the end of January so it would have been the edition of that time.
http://www.spinejournal.com/pt/re/spine/searchresults.htm;jsessionid=Hxxcycq29qdYcL0pMyTdyVkhyynLsXF8nrRlCxsyPFNyCLmtRnH1!1469518537!181195628!8091!-1?&index=1&results=1&searchid=1
Here is the link to the search I began and in truth I don't see the connection or relevance to the original post besides the apparent need for you to seek out papers disputing the effectiveness and safety of chiropractic.
If someone here states chiropractic is unsafe they need no papers but if I say it is safe and even effective I must prove it?
My point was that presently there is not enough papers or evidence to back up the practice of medicine (as stated above and it hasn’t got much better).
However there is enough evidence to tell us that the practice of medicine is unsafe and possibly the third if not second largest killer of people in America, Canada and Europe, after only cancer and heart dis-ease.
http://www.bmj.com/cgi/content/full/320/7249/1561
http://www.bmj.com/cgi/eletters/320/7249/1561#11879
http://v.mercola.com/blogs/post.aspx?App=public_blog&PostID=18998&Subscribed=1
Death by Medicine - http://www.lef.org/magazine/mag2004/mar2004_awsi_death_01.htm0 -
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i predict a riot.............i predict a riot
tallaght01 is completely right. from a nursing pint of view, I'm not allowed to out someone on a feckingbedpan anymore unless the research backs up my methods!
for example, the use of patient controlled epidural analgesia was rolled out across all surgical wards where i work a few years back. you wanna see the amount of articles and research I had to know before I was even allowed to sit the course. then there was a shedload more research during the course before i was deemed competant in the whole thing.
we're trying to get nurses in our urology units doing male catheterisation. I know in the UK nurses do this anyways, but I'm talking about specifically with urology patients,(enlarged prostates etc). its taken us a year to get to the stage were we can begin to put together an education programme never mind roll it out. why? everything has to be backed up by evidenece based practice and research.
sure.....as tallaght01 says, it can be a shot in the dark.....sometimes. But a lot of the time when that happens,someone writes about it and starts the research ball rolling. eventually what was once a shot in the dark, becomes practice.
while not trying to "put down" chiropractic as a discipline, i've yet to be convinced by it. this is coming from someone with a few back type issues that'd give a lot to get fixed0 -
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I'll have a read of your colic article later. I'll be interested in reading how chiropracters doagnosed colic in the firt place. One of the problems in trialling colic treatment is that is that paediatricians can't define colic. There are no diagnostic criteria for it. What one of us may diagnose as colic, another may not. We even argue about what it actually is, and even if it exists.
Your blood pressure treatment trial only has 50 patients in it!!!!! It was published a year ago, so i look forward to the proper follow up trial.
I say so many things about yor last post, but as you say you're finished posting on the forum then there's no point, I guess.
I guess that means there's no chance of getting a reference to that spine article you talked about earlier then?
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The body representing the medical profession in the US, the AMA, was found guilty of conspiring to destroy the profession of chiropractic, having ‘actively undermined its educational establishments, concealed evidence of its usefulness, subverted governmental inquiries into its efficacy, engaged in massive misinformation to discredit and de-stabilise the chiropractic profession and engaged in numerous other activities…’ added to this was an organised national boycott of doctors of chiropractic by medical doctors and hospitals and an ‘ethics’ ban on interprofessional co-operation.
The issue with the AMA has been largely resolved - the court case(s) you are referring to happened in the 1980s/90s and now the AMA has accepted the legitimacy of appropriate chiropractic consultation.Throughout the thread various claims were made and accepted without any evidence or reference. This included:
“Most chiropractors in Ireland” were “charlatans” and “spoofers.”
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Added to this it appears anyone is allowed ridicule the chiropractic profession here and despite that the fact that one Stephen Barrat, who has ties to the aforementioned AMA, has been found to be libellous, to have misrepresented himself and to have perjured himself in court, I am told that his anecdotal reports against chiropractic should not be discounted.
I made the charlatan comment and I withdraw it because it was an unfounded assumption on my part.
I hope I've come across as supportive of chiropractics, because I am - with the proviso that it is provided by qualified people. There are more chiropractic practitioners in Ireland than are registered with the CAI, who required the appropriate qualifications of their members. There is no legislation to stop people calling themselves chiropractors without having undergone the training and that's who the charlatan tag was directed at.
Also, your dislike of Stephen Barrett, which extends to a repeated, pejorative misspelling his name, has lead you to be quite biased against him, and your posts about him, although technically correct, have been misleading. His court cases are largely libel suits against his detractors who have called him names. His 'anecdotal' evidence against some, possibly not qualified chiropractors consists of several documented case reports. Why should these be ignored because you don't like Barrett? Also, Barrett works closely with real chiropractors, one of which co-edits his site, and they support him. I don't know what your problem with him is. 0 -
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Slightly off topic hunnymonster...but it seems a shame to have a world expert on a topic (however narrow it is) on the forum, without hearing about it
So why don't you start a thread, telling us all. Woud be good to get the perspective of a scientist in here. There's quite a few medical professionals posting, but it's a biology AND medicine forum.
So, give us the rundown. But keep it simple for those of us who are a bit slower 0 -
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