hiropractors had always been considered a “fringe” providor (or worse) by conventional medicine. David M. Eisenberg's article, Unconventional Medicine in the United States: Prevalence, Costs, and Patterns of Use, published in the January 28, 1993 issue of the New England Journal of Medicine generated a shift in that opinion. This article was a rude awakening, and an genuine “eye–opener” for organized medicine, as it described an amazing shift in public opinion.
During the period that “Managed Care” was DRASTICALLY reducing medical incomes, Dr. Eisenberg observed that “in 1990 Americans made an estimated 425 million visits to providers of unconventional therapy. That number far exceeds the number of visits to all U.S. primary care physicians (only 388 million)”. And Chiropractic was one of the most–utilized of these “unconventional” treatments!
He went on to state that “expenditures associated with use of unconventional therapy in 1990 amounted to approximately $13.7 billion, three quarters of which ($10.3 billion) was paid out of pocket. This figure is comparable to the $12.8 billion spent out of pocket annually for all hospitalizations in the United States!”
A quick review of this article reveals that:
Unconventional therapy is clearly NOT on the “fringe”, and based on these numbers, it is actually the dominant form of “health care” in America!
and, Americans were paying prohibitive out–of–pocket costs when they make that choice. That's called voting with your pocketbook folks, and it's a point that conventional medicine could no longer ignore.
Dr. Eisenberg penned a follow–up piece, published in the Nov. 11, 1998 issue of the Journal of the American Medical Association, titled Trends in Alternative Medicine Use in the United States, from 1990 to 1997. This article revealed that there had been a 47.3% increase in total visits to alternative medicine practitioners during that period (guesstimated to be 629 million visits in 1997) and that the estimated $12.2 billion in costs now exceeded the 1997 out-of-pocket expenditures for all US hospitalizations!
Medicine's standard response has often been to go on the defensive (attack–mode). Hiding behind the old "pose" of protecting the public interest, medicine's reaction has been to publically demand that unconventional therapies demonstrate their efficacy through research. Doesn't that sound reasonable?
Yet, when the AHCPR reviewed the body research which supports spinal manipulation, they found that spinal adjusting was well supported and that many standard medical treatments for low back pain were either not effective, or were actually counter-productive! Organized medicine was so outraged by the AHCPR findings that they pressured Congress to shut that department down! More importantly, less than 15 percent of medical treatments have ever been tested by the same gold-standard of randomized research trials!
In an editorial in the British Medical Journal titled
Where is the Wisdom? The Poverty of Medical Evidence, BMJ editor Dr. Smith recounts a lecture he attended with renowned health policy consultant Dr. David Eddy. Eddy found, after doing significant research, that only about 15% of medical interventions are supported by, solid scientific evidence and that only 1% of the articles in medical journals are scientifically sound. Why is that? Because most of those articles reference other articles which made unfounded claims.
The Chiropractic Research Section details trials demonstrating the effectiveness of chiropractic for a wide variety of disorders. The Low Back Pain Guidelines Section provides access to scientific reviews which have taken place in other countries which make similar conclusions to the AHCPR review.
The Cost-Effectiveness Page details how increased access to chiropractic services are helping to lower annual total health care expenditures. Finally, the Safety of Chiropractic Page details how modern medicine has promulgated the illusion that chiropractic care is dangerous, and then details the astounding safety and efficacy of chiropractic care.
When the National Institute of Health (NIH) created the original “Office of Alternative Medicine” in 1994, the yearly budget was $1 million. The 2000 budget was over $70 million. Considering that the complete NIH budget was $17 Billion, one could ask why the dominant form of care (based on Eisenberg's figures) in this country was funded with a small fraction of 1% of the research budget? (less than a rounding-error!) Prince Charles has been a supporter of alt–med for years, and his comments in a London Times Editorial are compelling. These Health Mall comments are also of interest.
The purpose of this introduction and article collection is not to imflame concerns regarding the issues of imbalance or potential unfairness in research funding. My aim is to inform our readers, and bring them “up–to–speed” on what's being written and considered in the scientific (medical) literature. There have been hundreds of articles written on this topic, many of which are derivative and add nothing new to our knowledge and understanding. The Alt–Med Articles section is devoted to sharing those articles, both pro and con, which contain unique and interesting perspectives on the increased use of and/or research about alternative forms of care.
You may also find value in a review of our Chiropractic Research Section, where new projects and recently published research can be found which supports chiropractic care. I hope you find these sections of value, and that you draw them to the attention of your peers.
