On Saturday night, March 21, 1992, in the greater Los Angeles area, the local NBC news Medical Editor Bruce Hensel, M.D., presented a report on "MUST": Manipulation Under Sedation Treatment. (This is another acronym for MUA, Manipulation Under Anesthesia.) Even though the news segment was aired three days after the "World News Tonite" piece (please see page 8 of this issue), Dr. Hensel was not aware of the contents of the ABC segment prior to completing the final editing. This provided for a second independent look at MUA by a television news medical editor.
Dr. Hensel began by describing the procedure as controversial. A patient who had been the victim of an automobile accident told of having to live with pain so severe that she would "sneeze and (then) cry for half an hour." The patient had tried medication and physical therapy. But before surgery was attempted, her orthopedist suggested that she try MUST (MUA).
At this point in the program, Cary Rothenberg D.C., a local Southern California chiropractor was interviewed describing the procedure. It should be noted that the patient featured on "World News Tonite" was also a MUA patient of Dr. Rothenberg. A full diagnostic workup was conducted including x-ray, MRI and CAT scan. The medical editor was quick to point out that "You should realize that despite the claims of patients, orthopedists and other specialists that MUST can be helpful, some experts feel that there are limitations and dangers."
Next came the almost standard interview with the local neurosurgeon (or neurologist). He explained what Dr. Nachemson stated on "World News Tonite": that the loss of resistance left the patient unprotected and in a potentially dangerous situation.
Dr. Hensel proceeded right into the question of supporting research: "The fact is that there have been no completely controlled studies on the procedure's safety or efficiency, but some patients do report remarkable results."
The program closed with the patient giving a glowing report of her recovery: "I could do all kinds of things I could not do before, instantaneously."
In the final comments after the segment aired, Dr. Hensel reviewed that there were some dangers, no research studies, but that some patients swear by it (MUA). When asked about an orthopedist referring to a chiropractor, Dr. Hensel stated: "I think chiropractors have a great many uses. When they know their limitations, they can be very helpful. Many orthopedists work with chiropractors and other allied medical professionals."
The last question was asked by one of the news anchors: "Is there a great deal of pain when a patient comes out of the anesthesia due to stress on the spine?" Dr. Hensel stated that the patients say there is not.
This presentation by local NBC news covered much of the same ground as the ABC segment: potential dangers and lack of research. It didn't include an attack on the cost of the treatment. This did however include a "home video" of the patient receiving the MUA procedure. Overall, the most positive parts of this segment was the very positive testimony of the patient (iterated by Dr. Hensel), and the fact that this case had been referred from an orthopedist.
If the media continues to look at this profession and what we do, they will report on everything they see: good and bad. But as chiropractic comes out of the AMA closet, its acceptance by the public and consideration by potential patients can't help but be very positively affected.
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
On Feb. 1, 2024, two more legislators – John R. Carter (R-Texas) and Robert “Bob” Good (R-Va.) – co-sponsored the Chiropractic Medicare Coverage Modernization Act of 2023, bringing the co-sponsor total to 155, two more than the total achieved over the entire two-year congressional cycle in which identical legislation last appeared (2021-22).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
