James Winterstein, D.C., president of the National University of Health Sciences, has objected to my judgment that a statement on his school’s Web site is misleading. On April 29, 2004, we had the following e-mail exchange. Note that he ignores the questions I raised in message #4.
Message #1: Winterstein to Barrett
To whom it may concern,
Quackwatch web site makes the following statement which quotes a portion of the National description of the practice of chiropractic medicine:
This is followed by your commentary quoted here:
It is clear to me that you are misinterpreting the conclusion of our comments because we, in our profile of chiropractic medicine do not say “chiropractic care has been demonstrated to promote optimal health.” What we said is that “Chiropractic practice (as we teach it) embodies the use of other conservative means in the promotion of optimal health, and we list several of those “means.” Certainly, nutritional counseling may “promote optimal health.” Certainly exercise may “promote optimal health.” Because the practice of chiropractic medicine embodies various “conservative means that have been demonstrated to promote optimal health,” our statement is accurate. We do not state that “every other conservative means promotes optimal health.” We simply state the truth. We use other conservative means to promote optimal health.
Message #2: Barrett to Winterstein
Hello Dr. Winterstein:
The convoluted nature of your published statement makes it difficult to respond optimally in a few words. However, I can see that the wording of my comment could be misinterpreted. I have changed it to:
I regard National as one of the better schools, but your embrace of homeopathy and meridian therapy is disgraceful. Regarding nutrition: although it can certainly contribute to optimal health, my data suggest that the vast majority of chiropractors know very little about it and recommend useless dietary supplements as part of their “counseling.” Reed Phillips [president of Los Angeles Chiropractic College] can tell you that although I am sharply critical of many chiropractic practices, my attitude toward chiropractic education is constructive. I would really like to see it improve. A few years ago I even applied to become a public member of CCE [the Council on Chiropractic Education], but my offer — which still stands — was turned down.
Stephen Barrett, M.D.
Messages #3 & #4: Winterstein to Barrett (yellow background) interspersed with Barrett’s responses (white background)
Thank you for your response. At least we apparently agree on one thing; we both want to see chiropractic education improve and I, for one would also like to see allopathic education improve.
|Medicine’s possible shortcomings have nothing to do with anything I have written about chiropractors.|
|You state that the ” vast majority of chiropractors know very little about it (nutrition) and recommend useless dietary supplements as part of their “counseling.”|
|During the past 25 years, I have collected and read 200 chiropractic books, several thousand chiropractic journals, and more than 20,000 miscellaneous chiropractic documents. I also have about 200 audio and videotapes. I have visited a chiropractor as a patient, attended classes at a chiropractic college, watched students at work in the college clinic, attended the Chiropractic Centennial Celebration, visited hundreds of chiropractic Web sites, and conversed with or received mail from thousands of chiropractors.|
|First of all, when you are writing about the web site of NUHS, you are not writing about “the vast majority of chiropractors.”|
|When you write about “Chiropractic practice embodies: . . . “, your words apply profession-wide. If your intent is to write about your school, I suggest that you change the wording.|
|Our graduates do know a lot about nutrition and are taught botanical medicine and pharmacology by a PhD Pharmacologist.|
I don’t know the contents of your nutrition courses so I can’t directly ,judge what is being taught. However, I am struck by the near-total absence of chiropractic textbooks or journal articles that discuss appropriate nutrition counseling. I suspect that a sizable percentage of your graduates don’t provide it. But the surveys (including one in your own journal ) that demonstrate inappropriate counseling (27% use hair analysis, for example), don’t indicate what percentage of National Graduates use it.
As for who teaches, so what? The important thing is what is taught. Do you believe that the prescription of herbal products should be part of ordinary chiropractic practice? Do you believe that the conditions that herbs might help are conditions that chiropractors can appropriately diagnose and treat? Do you believe that chiropractors are in a position to know whether herbal treatment is more appropriate for given conditions than is medical treatment? I don’t see how chiropractic education can provide a sound basis for herbal prescribing.
|Please do not presume to lump everyone into the same box when writing about National. Furthermore, ours is the only institution with a chiropractic degree program that requires matriculating students to have a baccalaureate something not even all allopathic schools require (though I recognize most allopathic matriculants have the baccalaureate for competitive purposes).|
|That’s nice, but irrelevant to my article. I realize that National is one of the better schools. I have been saying that for years to prospective chiropractors who call me for advice on what school to attend.|
|When it comes to acupuncture and homeopathic medicine, you take a very definite stand (they do not contribute to optimal health) which is purely an authoritative position, rather than a scientific one.|
Words, words, words. The real question is what the evidence shows. Homeopathy holds that products that contain no molecules of active ingredient are effective against the full range of disease. That is a delusion. Meridian therapy (Note carefully that I didn’t say acupuncture) is based on the notion that ill health is caused by imbalances and blockages of nonmaterial energy that can be corrected by skin needles in the skin. That is a delusion. If your school encourages either of these belief it is teaching delusion, not science.
The most favorable study of homeopathic research is a meta-analysis which concluded that homeopathy has not been demonstrated to alter the course of any disease but the data suggest that it is more effective than a placebo. Others looking at the same data judge it less favorably. But you want to claim that it contributes to optimal health? Where are the data? What study has ever demonstrated that or even tested for it?
|If these forms of care assist patients back toward optimal health, then they do help and there is at least some evidence for this probability|
|Not for homeopathy.|
|At the very least, you might say that they do not contribute to optimal health “in your opinion.” It is difficult to be so knowledgeable that you have all the answers at your finger tips.|
|Yes, it takes work, but I happen to have expert knowledge of homeopathy.|
|Chiropractic physicians cannot give “emotional support?” Since when? My mother did not graduate from high-school but she certainly gives emotional support and has done so for hundreds of people during her 92 years. I did not say our graduates are psychologists or psychiatrists – just that emotional support is part of the “conservative means” used in the practice of chiropractic medicine.|
|Again, where are the data showing that chiropractors provide appropriate emotional support. Your statement implies that emotional support is integral to chiropractic practice, that the support they give contributed to improved health outcome, and that you teach how to do this in your school. Has any published study ever shown that chiropractors improve health by giving emotional support. I know of hundreds of actual situations in which chiropractors did just the opposite. More important, I have a very large collection of materials (including scripts) from the huckster practice-builders which show how “supportive” comments are used to trick people into lifetime maintenance care. I plan to write about this during the next year. If you are unfamiliar with the subject, subscribe to my free newsletter and you’ll be notified as the articles are published.|
|It is one thing to offer constructive criticism, it is another to spend a career trying to “kill” a profession.|
I have not spent my career trying to kill the chiropractic profession. I have produced 49 book and over 2000 articles covering thousands of topics. Chiropractic is one of my favorites because it is the only profession that has actual textbooks and seminars on how to trick people.
Chirobase has posted practice standards and has a referral directory for those who say they follow them. Unlike the Mercy Conference Report (which was a good first step), I call a spade a spade. I press for an end to the practices we believe are worthless. Responsible chiropractic educators should be doing the same thing. You may think my guidelines are too harsh. I’d like to see a list of those you agree on and to see you unequivocally denounce and teach your students to avoid those that you believe are baseless. If you need help deciding, perhaps Alan Adams at LACC [Los Angeles Chiropractic College] can help you.
|If what I read in the professional journals about your profession is even partially true, you could spend a real career trying to end the useless surgeries, the massive misuse of antibiotics and the thousands of deaths caused by your colleagues.|
I discuss some of this in my college textbook and on Quackwatch. I also edited a book during the 1980s on unnecessary surgery, the only one I know ever published, but it is not my major focus. Lots of people are working on this, and I already have more than enough to do. Moreover, the situations are not parallel. No medical textbooks promote overprescribing or unnecessary surgery. But many chiropractic publications promote weekly or monthly spinal examinations. I collect them as a hobby. When I first got Sid Williams’s Blue Book, the New York Times thought it was so shocking that they assigned a reporter to write a series of two articles that began on page 1 of the paper.
I also speak out against what I believe are quack practices by medical doctors, dentists, and other health professionals. In fact, I have said in clear language, for example, that anyone routinely doing chelation therapy or unnecessaily removing amalgam fillings should be delicensed.
|We aren’t where [we] need to be, but our record of iatrogenic disease is miniscule comparatively speaking.|
|Once again, medicine’s possible shortcomings have nothing to do with anything I have written about chiropractors. The real question raised by my challenge to your quote on my Web site is whether you who have the power to do so should do more to clean up the teaching of pseudoscience in your own school. If that interests you, start with homeopathy and tell your students it is worthless.|
As I suspected, your motives are not pure in the least. You say “medicine’s possible shortcomings have nothing to do with anything I have written about chiropractors.” I suspected that would be your response, however, ostensibly, you write about the shortcomings of chiropractic physicians because you have some sense that by doing so you provide some kind of service to people who need health care, but who, according to you, are being fooled by the dirty chiropractors. What I am saying, is that instead of spending your life on a “pimple,” why don’t you consider the “systemic infection of allopathy?” Then you would be providing a real service to the public. After all, there is no evidence whatsoever that chiropractic care of any kind kills upwards of 100,000 people each year. I disagree with you. Medicine’s definite (not possible) shortcomings have far more to do with concern for the public than anything about which you have written. I am reminded of a comment from Jesus in the Bible – “don’t try to remove the splinter from your brother’s eye when you have a beam in your own!” Incidentally, I believe allopathic medicine is vital to the health of our people, but has massive faults and many of the same flaws of which you accuse the chiropractic profession.
- Barrett S. Improper claims on chiropractic college Web sites. Chirobase, April 29, 2004.
- Smith DL, Spillman DM. A survey of chiropractors’ use of nutrition in private practice. Journal of Chiropractic Humanities. Volume 9(1) © 2002.
From a Canadian Radiologist:
I just read the correspondence between you and Dr. Winterstein. It is absolutely shocking that the president of a supposed academic institution can employ so many logical fallacies over the course of a discussion. He can’t seem to understand that criticizing medicine’s shortcomings (based, of course, on a flawed interpretation of a series of important articles) has nothing to do with addressing the far more serious shortcomings of his profession. Shame on him.
This article was revised on May 2, 2004.