Philosophy

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Leading the Way in Holistic Care

Dear Editor:

I am writing to tell you how much I enjoy the column called "The Country Doctor," by Willard Bertrand, D.C. Sure there are many of us out there that enjoy his column as well as many others, but rarely take the time to express our support. Dr. Bertrand demonstrates an extremely important concept for the future of our profession. That the concept of innate intelligence and proper diagnosis with holistic treatment are not mutually exclusive. In fact, the more one learns about diagnosis and the greater the detail with which one analyzes the human body, the more respect one gains for innate intelligence.

If we see ourselves as "neck and back specialists," surely we will lose the opportunity to be the premiere holistic physicians in our communities. We would be woefully out of step with the times if, while the public craves more and more natural health care, we choose to limit ourselves to musculoskeletal conditions while referring internal problems to medical specialists who could not care less about natural methods.

The ACA has a small but active council on diagnosis and internal disorders. There is a diplomate offered in this field and the quality of education is excellent. I would encourage all those who see chiropractic as more than musculoskeletal care to take advantage of the educational opportunities we have available in our own profession. We can be the best and we can lead the way in holistic care. The choice is ours, and the opportunity is open.

Peter W. Kfoury, D.C.
Charleston, South Carolina

 



More Discretion, Please

Dear Editor:

I enjoy receiving your publication and keeping abreast of political news in the world of chiropractic. However, with the noted exception of Dr. Hammer's column, and a few others, the clinical briefs could stand a bit more scrutiny. I realize that "DC" is not a refereed journal, but some criteria should be met before publication.

I refer specifically, in this case, to Dr. Arcadis' March 29, 1991 article on "Hyperemesis Gravidarum." It should be made known that hyperemesis gravidarum is not, as stated in Dr. Arcadis' article, an equivalent term for common morning sickness. According to the Merck Manual, hyperemesis gravidarum is "malignant nausea and vomiting to the extent that the pregnant woman becomes dehydrated and acidotic." This term "should be limited to women in whom starvation, dehydration, and acidosis are superimposed on the vomiting syndrome (of morning sickness)." It is, in fact, often life-threatening and requires hospitalization and IV therapy, and often adjunctive psychotherapy.

Beyond the confusion in terms, the majority of the listed treatment recommendations are anecdotal at best and should be indicated as such. I do feel that there is room for such information in your publication, however, it should be qualified and not preceded by statements such as: "The treatment is ..." Articles such as this are somewhat embarrassing and certainly not on par with many of your other well-documented clinical briefs. More discretion please.

Ronald G. Rogers, D.C.
Ocean Shores, Washington

 



Crossing the Line of Research into Avarice

Dear Editor:

The issue of Dynamic Chiropractic, March 29, 1991, contained a letter to the editor from Dr. Brian L Hatfield of Beverly Hills, california. In it, he expressed his support of the Vertebral Subluxation Research Institute (VSRI). Assuming that some readers may have found his remarks about the "sanctity of research" and purpose of VSRI convincing, I felt compelled to respond.

It is my opinion that it is the sanctity of our chiropractic oath at stake here, not the "sanctity of research." Those associated with the VSRI should honor the principles of their oath and discard the convoluted notion that would have VSRI devotees believe spinal screenings, mall shows, telemarketing programs, practice promotions, etc., "utilize the same concepts and principles as VSRI, but usually without the valuable benefit of contributing to the body of scientific knowledge."

VSRI has, with the exception of one highly controversial article, yet to contribute to the body of scientific knowledge within the profession. Dr. Hatfield mentions the JMPT and erroneously laments that most of the references and some of the articles in this journal are by MDs, omitting the fact that after all this time and controversy the VSRI has yet to add one iota of definitive scientific support to the body of knowledge pertaining to chiropractic. Spinal screenings, mall shows, etc., are at best a form of public service and at worst, a degrading method of recruiting patients. Few, if any, practitioners are claiming to advance scientific knowledge within the profession with a promise that their findings will eventually surface in a publication in accord with genuine research protocol.

It is not practice promotion, research designs or the origins of VSRI most chiropractors find "distasteful," as you have described, but the insatiable greed carefully cloaked behind a cleverly implied mention of service and science.

Constant regard for "converting" research volunteers into paying patients, as if it were incidental, is insulting to a trusting public and trustworthy practitioners.

As for your admitted amusement upon reading, seeing or hearing of MDs advertising for research volunteers and offering to pay for their cooperation; in every instance with which I am familiar, the subject does not pay for any additional care. This expense is undertaken as a burden of doing research. For example, patients volunteering for studies conducted at the National College of Chiropractic (NCC) are not "billed" when expensive MRI workups are performed, when indicated.

You close by observing that "To you, paying for patients seems to cross that line between ethical and unethical ..." and "... the public seems to think that it's an okay thing to have happen, and even think that research conducted under those conditions is a good thing." Indeed! I would speculate the public thinks that health care is expensive, research is a somewhat remote necessity, funded somehow by someone else. I also think that most of them know when the line is being crossed between the honest inquiry into research and the dishonest overreach of avarice.

Daniel R. Driscoll, D.C.
Lombard, Illinois

May 1991
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