December 16, 1981
Susskind: Many patients swear by chiropractors. Many physicians swear at them, claiming that chiropractors are unscientific and potentially very dangerous. My guests tonight represent both sides, and they’re here to discuss what chiropractors can and cannot do for you. Please meet them now.
- First, from Chicago, Dr. Chester Wilk, has been a chiropractor since 1955. And he has written two books, including Everything You Should Know About Chiropractic. In 1976, he and four colleagues brought a federal antitrust suit against the American Medical Association.
- Dr. Stephen Barrett is a psychiatrist, a consumer advocate and a medical writer. His books include Vitamins and Health Foods: The Great American Hustle and The Health Robbers.
- Dr. Louis Sportelli has been a chiropractor for 19 years in rural Pennsylvania. He is a member of the Board of Governors of the American Chiropractic Association, and he has written Introduction to Chiropractic.
- Dr. Reuben Hoppenstein is a neurosurgeon at the Orthopedic Institute of the Hospital for Joint Diseases in New York City, and he is co-chief of its Problem Back Service. His entire practice is devoted to microsurgery of the spine.
Now, as I understand it, the theory of chiropractic is that all disease flows from the spine.
Wilk: Well, that’s what our critics would have you believe but, basically, chiropractors do not . . .
Susskind: You don’t believe it.
Wilk: Absolutely not, and we have violently denied that; but our critics have consistently insisted that it does so that they can defame us by turning around and saying that we claim this. A ludicrous position.
Susskind: Why do you defame these nice chiropractors?
Barrett: Well, I’ve done a lot of research. I’ve been working on this for ten years. One of the things I did, for example, was to send volunteers into the offices of just about every chiropractor in our community to pick up literature; and this is one of the things that we picked up. [Displays “Chart of Effects of Spinal Misalignments”]
Susskind: If you hold it steady, the camera will get a picture of it.
Barrett: It’s a picture of a spine, and it says that the nervous system controls all the organs and structures of the body and that misalignments of vertebrae, meaning bones out of place, cause trouble — and then it lists the areas and the trouble. For example, the idea is that spinal difficulty and nerve difficulty cause such things as hearing loss, colds, pneumonia, jaundice, shingles, ulcers, hives, nephritis (that’s kidney trouble), and actually there are a hundred different conditions listed. Now this is what is in chiropractic offices. Dr. Wilk probably would say, “No, that’s not what chiropractors do,” but I can tell you that I’ve been there and this is what’s in their offices.
Sportelli: That’s what’s in their offices because it is for patient consumption, not technical consumption.
Susskind: Is it in your office?
Sportelli: Those are not in my office. My own book’s in my office because it happens to be a little more contemporary. But, the fact of the matter remains, the underlying promise of those health tracts does have as its basis some sound substance. Number one, that there is a controlling and coordinating mechanism of the nervous system to, which ultimately controls and coordinates most of the function of the body; and secondly, those conditions that are listed are for essentially for public consumption because people necessarily think of themselves as diseased organs or diseased processes. Chiropractors don’t treat any of those diseases at all, but they treat the body.
Susskind: Are chiropractors doctors? Do you have a medical degree?
Sportelli: No, and I don’t want a medical degree. If I did, I’d go to med school; but I have a Doctor of Chiropractic degree and certainly, we’re doctors within the sphere and scope of our own practice.
Susskind: Have you had a residency and internship?
Sportelli: We have not because, again, by our own election. Let me . . .
Susskind: Did you do anything more than go to a university?
Sportelli: I went to chiropractic college and I graduated with a Doctor of Chiropractic degree. By our own election, however.
Susskind: Is there such a degree?
Sportelli: Yes there is. It is a degree that’s recognized by the United States Office of Education and the government and all the states . . . .
Susskind: Would they have that at the University of Michigan, the University of Chicago, Harvard, Yale, Wellesley, Radcliffe . . .
Sportelli: No, absolutely not. They have it within the confines of our own chiropractic institutions. But let me say . . .
Susskind: Isn’t that a little bit suspicious, the idea that you are not medical doctors, you have a degree granted in four years which is not recognized as a real department of education at any of the great state universities or any of the private colleges . . .
Sportelli: I couldn’t have asked, or wished that you’d have asked, a better question because I think that from the start of this program, which is a chiropractic program, we need to develop — from a historical standpoint — why we’re at the stage we’re at in our evolution; and it has been because of the tremendous political pressure of the American Medical Association that has prevented chiropractic institutions from integrating into universities, from having universities participating with our profession. And let me also clarify something for the listening audience that may sometimes be used as a deterrent to chiropractic. They say, “Well, chiropractors do not prescribe drugs or do surgery.” That is absolutely correct. But that is by our choice.
Susskind: You crack . . .
Sportelli: We manipulate the spine very specifically and very delicately; and I would say, with the kind of skill that this gentleman right here, who is a neurosurgeon, utilizes in his surgical techniques. It is not by any chance a whimsical crack on the back.
Barrett: What do you manipulate it for, what kind of conditions do you treat?
Sportelli: We don’t treat conditions, I’ve just said that.
Barrett: You don’t treat any?
Sportelli: We treat the body.
Barrett: Here’s a pamphlet that says “Gallstones and Chiropractic” and it says that the best approach to permanent solution of gallstones or any other health problem is to see your chiropractor regularly. Now this pamphlet was picked up in a dozen offices in our community — the community that we live in.
Sportelli: That’s correct.
Barrett: And I don’t think that’s a true statement.
Sportelli: It is not a true statement. You’re absolutely correct because . . .
Susskind: You can’t cure gallstones.
Sportelli: We don’t cure or treat anything.
Susskind: It says: “Gallstones and Chiropractic.”
Sportelli: That’s correct. That particular pamphlet that is constantly utilized against chiropractors are merely because this profession has no alternative mechanism by which to educate the public as to what we do in terms of chiropractic.
Susskind: Dr. Hoppenstein, what say you about chiropractic?
Hoppenstein: Well, I, as a scientist, would like to believe there is some scientific basis for what chiropractic is all about. I cannot find anything that is a scientific basis that tells me that by manipulating the spine, other than treating pain coming from the spine — if that’s at all possible — that it can treat any other part of the body. I do not believe that anybody can manipulate the spine — and that includes physicians who claim to be able to do it — without it jumping right back because it takes several hundred pounds of pressure to manipulate the spine. You may move it temporarily, but it’s gonna go back to the same position. If there is a diseased joint, and you can move that part of the spine out of position, it’s gonna go right back very rapidly unless you can stabilize it. I do not know of one scientific study where they have put radiological markers on a spine in a living patient — just a few beads of a metal in the tips of the spine — and manipulate and take another x-ray and show there’s been any movement. I don’t believe that’s ever been done and that would be the prime research project to prove that anything is being done at all.
Barrett: Actually, it’s been disproven that you can influence the nerves by manipulating the spine. An anatomist at Yale took people within a few hours after death and hooked them up to a machine and found that the only way you can twist the spine to cause the nerve to be interfered with — like chiropractors say — is to rupture the ligaments, and that would kill a person.
Wilk: Okay, I’ve got to respond to that. You’re making reference to the Crelin Report from Yale, which no lesser authority than Dr. Scott Haldeman who is an eminent foremost . . .
Barrett: He’s a third-generation chiropractor. . . .
Wilk: Excuse me, I gave you the courtesy of not interrupting you. Please extend the same courtesy and let’s be gentlemen. The point I’m making out is that Dr. Crelin his report was severely criticized by Dr. Scott Haldeman who is a neurophysiologist, a Ph.D. in neurophysiology. He’s a chiropractor, and he’s a medical physician. The Crelin report, and I have a document, I believe it’s Exhibit 127 in our lawsuit with . . .
Susskind: You’re getting too technical for us, I mean, we haven’t read that document.
Wilk: Okay, it simply states this: Dr. Crelin said, “I am getting the material together and I am going to do a study to blow chiropractic.” Now how, pray tell, do you do a study when you have a preconceived notion that you’re going to do something to blow it.
Barrett: Well, the study was published . . .
Wilk: If a study is scientific, you don’t go in with the idea that I am going to do a study to blow it.
Barrett: Well, its . . .
Susskind: We have to pause, but as I understand the argument to this point, men of medicine — doctors — think that chiropractic is a fraud and a deception.
Barrett: That’s too simple.
Sportelli: Some of them. Some of them.
Susskind: Most of them.
Wilk: I would say. . .
Sportelli: Quite the contrary.
Susskind: And the men of chiropractic believe that they’re doing God’s work and helping people.
Barrett: Many of them do.
Susskind: Relieve pain.
Susskind: Is that the issue?
Wilk: Okay, back in August of 1980 . . .
Susskind: Well, just yes or no, because I have to . . . .
Barrett: No, the issue is far more complicated than that . . . .
Wilk: It is not that. I don’t think political medicine today is as hostile to chiropractic as is exhibited by the two gentlemen that are here. The reason they are — thank God they represent a dying breed — they are a minority group that is slowly fading away into the horizon but they do not represent the main thinking. . . .
Susskind: They look very healthy to me.
Sportelli: No lesser authority than the Chairman of the Board of Trustees of the American Medical Association back in August of 1980 made the statement that we’ve got to have closer cooperation in working with the chiropractors. Now these gentlemen do not speak for the American Medical Association or any organization.
Susskind: Hold it, we’re coming right back.
Susskind: Medical doctors and chiropractors for 85 years have been at each other’s throats, and the American Medical Association states that you are quacks.
Wilk: They do not.
Sportelli: Dr. Barrett states that we’re quacks.
Barrett: No, I try to avoid name-calling.
Susskind: And you say that you repair the failures of medical doctors.
Sportelli: To a degree we do. That’s how this profession was built — on medical failures virtually in the early 1900’s of this country when chiropractic was in its formative years. Had there been exaggerations of chiropractic claims? Certainly. Were there people who were evangelical in their fervor for chiropractic? Certainly. Did chiropractors themselves make overstatements? Certainly. But the fact of the matter remains that people sought out chiropractic as a viable alternative to medical care because they weren’t getting results under medical care. Chiropractic became then a threat to what has to be a monopolistic form of health care in this country dominated by the American Medical Association. Therefore, they were opposed to chiropractic.
Susskind: Mainly on the basis that you’re not doctors, right?
Sportelli: Well, you know, it reminds me of when I was home, you know, we had three brothers and two sisters and when my mom and dad used to go away we used to say, “Who died and left you boss?” And I think that we’re saying essentially the same thing to the American Medical Association. Who appointed them or anointed them as the saviors of health care or the protectors of health care in the United States of America? We’re saying that we have a right to exist as a viable health care delivery system that has been in existence for 85 years and has proven its worth on millions and millions of people. Why try to destroy us? Why try to boycott us? Why try to form a conspiracy against chiropractors?
Susskind: Why are you doing all these terrible things?
Hoppenstein: Well, I believe, David, that medicine is 5,000 years old. I know a little bit more than the people that taught me and my residents and students will know more than I do in the future. Chiropractic is 85 years old, was started by D. D. Palmer, a greengrocer who got the brilliant idea . . .
Wilk: That is absolutely wrong.
Hoppenstein: . . . of manipulating the spine and being able to cure everything from hemorrhoids to cancer. It has, obviously, evolved over the years. The medical profession has certainly accepted osteopathy into medicine because they certainly have the same medical curriculum today and they do what they do. They also manipulate the spine. What we as physicians don’t really know, what is the curriculum of a chiropractor? They talk about manipulations. I operate on the spine every day. You can not move the spine without cutting ligaments. It’s a very difficult thing. Also, as has been pointed out by Dr. Barrett, there’s a lot of clearance where the nerves come out of the spine and you’d literally have to do a lot of disruption of ligaments and exert 2,000 pounds of pressure in order to try and damage that nerve or relieve any pressure on that nerve. The other thing, I believe that most of the work done by chiropractors has to do with the spine and spinal pain. There is no way that a disk can be reduced. Once a disk comes out, it is always out. However, 90% of people get better — they don’t need surgery. . . . I believe that chiropractors actually do produce some alleviation of the spasms by their manipulation probably as a counter-puncture or acupuncture causing pain in the paraspinal muscles — which may break the pain cycle the same as physicians may use a deep intra-muscular injection into the myoneural junction . . .
Susskind: What is that?
Hoppenstein: Where the nerve goes into the muscle. I’m sorry. Now, I’m not saying that chiropractors never do anything. I have many patients who have been treated by chiropractors over the years. When asked why they went, it’s because they were treated by physicians and after getting some pain medication, they went off and got fed up because nothing was being done. We don’t manipulate patients usually, there are very few physicians who really manipulate patients. I personally do not believe that manipulation will do anything except if you produce enough pain that you can produce muscle relaxation. But as f ar as the disk going back, it never goes back. All that happens is that the nerve root looses its swelling over two to three weeks and the patient gets better. In short, whether you use acupuncture, a chiropractor, a physician, whether you use sphenopalatine ganglion injections . . . these people are going to get better. So what we are talking about is: if these are the people who’ve been treated, fine, that’s wonderful. What about the patients who have herniated disks that are already impinging on nerves where these patients are developing urological problems where they have an increase in frequency of urination, where their sex lives are disrupted because the same nerves are being pressed on, and they are being treated by manipulation two, three, four times a week for two years at a time? That disk is slipping out. Many of these nerve roots, despite the fact that that disk is removed in two or three years time, may never recover. So that deficit may remain permanent.
Wilk: Okay now, Dr. Hoppenstein is making reference to a great deal of structural type conditions which he calls subluxations, and there is a gross lack of communication between chiropractors and . . .
Susskind: He didn’t say subluxations — what is that?
Wilk: Well, disrelationships, subluxations — he talks about vertebral lesions or whatever, but when a chiropractor speaks of a vertebral lesion or a disrelationship, he’s speaking more in terms of a physiological term.
Barrett: Something you can’t see.
Wilk: Whereas when you’re dealing with structural, you’re dealing with anatomical disrelationship, which is a little bit different. In our subluxation, we’re talking about congestion, adhesions, swelling, pain, tenderness, possibly hypomobile or hypermobile vertebra. And this Crelin study was incredibly out in left field in that I would ask this Crelin: “If you slap a dead ham would it swell?” Or: “How many bottles of Ex-Lax would you feed a cadaver before it had a bowel movement?” I mean, it’s a ludicrous question and it’s equally ludicrous to take a cadaver and start talking about vertebral subluxations which are physiological.
Susskind: Wow! Can you give it to us in laymen terms?
Wilk: Well, yes, I . . .
Susskind: You mean manipulation, right?
Barrett: There’s a vertebra right over there.
Hoppenstein: You show me what a subluxation is.
Susskind: What is a subluxation? This is the spine. Right?
Wilk: Let me better explain it. A subluxation may be somewhere along these vertebrae, along here, maybe a disrelationship, but it could be a physiological, the amount of rotation of the vertebra maybe just millimicrons. It would be very, very slight.
Barrett: You can’t see it.
Wilk: And for a lack of a better word . . .
Susskind: Would it show up on an x-ray?
Wilk: It may or may not, but for lack of a better word, we term it a subluxation.
Barrett: All right, we say it doesn’t exist.
Sportelli: That’s cause you don’t know about it.
Wilk: Except there is only one situation: There are millions of people who go to chiropractors, have pains in their backs, have their backs manipulated, and they walk out of the office with the pain gone.
Barrett: That has nothing to do with whether your theory is correct.
Sportelli: No, that is absolutely incorrect. If we were to go on Dr. Barrett’s premise that we’d have to know exactly what was going on before we were able to utilize our particular therapy, that means that we shouldn’t have been able to use gravity until Newton discovered it. Well, that’s ridiculous. The law of gravity was there and it was there whether we discovered it or whether we didn’t. We’re saying the same thing in chiropractic. There is a lot of empirical evidence. This empirical evidence means that it is not scientifically validated to the point where we can demonstrate it in a laboratory. But then again, the body is a dynamic thing. It is not able to be placed in a laboratory.
Barrett: Yes, but if you had, say 10 chiropractors looking at the same x-ray, would they all see the same subluxations?
Sportelli: Probably not. Depending on what their emphasis was and where they were — I mean the location — they may not come up with the same thing. Absolutely not.
Susskind: Well, listen . . .
Wilk: And a similar position in medicine would be likewise. Medical physicians disagree. Right just today, I believe I heard during our gathering that one of the physicians made a comment relative to something about the spine and you took a strong opposition to his position and here you’re both M.D.s, you’re both from the area. So differences are bound to exist. When the differences exist in medicine, however, they’ll say, well, that’s growth, that’s a natural phenomenon. But two chiropractors, if they dare to disagree, they try to make a federal case out of it and make appear as well, chiropractors can’t agree; and it’s an unfair analogy. And I can see from the way this entire thrust of this meeting is going there is not even a remote understanding of what a chiropractor means by a vertebral subluxation.
Barrett: And I . . .
Wilk: You’re talking about lesions of anatomical displacement. We’re talking about physiological changes that take place and there is a world of difference.
Sportelli: Oddly enough, David, this gentleman is one of the few practitioners in medicine that we have no quarrel with. When a surgeon is necessary, it is necessary. There is no question in my mind that I refer every day to a member of the medical profession for cases that have gone outside the scope of chiropractic.
Barrett: Yes, but you’re very . . .
Sportelli: Outside the basis of what conservative chiropractic can do . . . Nowhere has chiropractic in today’s day and age, claimed to be a panacea, number one; claimed to have all the answers for the ills of mankind, number two; and thirdly, we refer to medical doctors. There was a recent survey of our own membership: 93% of them, I believe, if my figure is correct, referred to medical doctors on a regular basis. The figure coming back from the medical doctors to the chiropractors, however, is infinitesimal — and that shouldn’t be.
Barrett: I think it’s incredible that 7% never refer. In the Lehigh Valley where we interviewed 35 chiropractors, we found that that at least 10% never refer.
Wilk: Weren’t you under cross-examination for three days by the New Zealand Commission?
Wilk: I bear to differ with you. According to the New Zealand Report, they found your material as to be totally unreliable, unbalanced, and they could give no credence to it whatsoever. Your name is in the New Zealand Report.
Barrett: Well I was not . . .
Wilk: They viewed it as gross propaganda. . . .
Barrett: I presented nothing to the New Zealand Commission. The New Zealand Commission also said . . .
Wilk: Okay. Then they took your material.
Barrett: I don’t know where they got it, but the New Zealand Commission also said that chiropractors should not be primary care providers and if that were the case chiropractic would do very badly. But you changed the topic, let’s get back to what we were talking about.
Wilk: Let’s talk more about the New Zealand Report.
Barrett: You are one slick guy Dr. Wilk.
Susskind: Gentlemen, can we. . . .
Wilk: The bottom line of the New Zealand Report . . . .
Susskind: The bottom line is we better get back to America and I’ve got to pause.
Susskind: If I could interrupt your colloquy and just tell you that about ten years ago, I had a back pain, and at the time, it felt most uncomfortable. I went to a chiropractor on the advice of an athlete friend of mine. I should have known better. But he said “You know what you need, a chiropractor. He’ll get it out in just a couple of manipulations.” I asked him for the name of a good chiropractor. He gave me one who had a rather nice office in an expensive area of New York. I went in, got undressed, and got up on a table and then he cracked my neck in a way that I thought my neck would come off. Then he did something cracking my back, and then he cracked it again and I said: “It’s making awful sounds, but am I being cured?” He said, “Oh, yes. Don’t worry about the sound.” And after about 25 minutes of that, I was finished and got dressed, and while walking out of there felt pretty good. But about an hour later, the pain that brought me into the place was still present. So what had chiropractic done for me except take my check and crack a neck and a back?
Wilk: Well, when you go to a chiropractor, you don’t necessarily expect that you’re going to have one visit and get a miracle cure any more than you go to an M.D. and get one prescription of a pill and an hour later be cured. One has to consider the circumstances. Your circumstances may be such where you might have required several visits and so that wouldn’t be . . .
Susskind: Have you ever formulated an average number of visits to cure your average patient?
Wilk: There were some excellent studies by the Oregon Workmen’s Compensation Board showing that 41% of the people under medical care got back to work within a week whereas 84% got back to work within a week under chiropractic care. The California study was quite similar, showing under chiropractic care they got back to work — these are Workmen’s Compensation cases — within one-half the time. And the Florida Workmen’s Compensation study showed that under chiropractic care, one-third the cost and one-third the time. When we talk about chiropractic and medicine and the dispute that’s going on, I think, really, by far the most important thing we can leave this television studio with is the basic bottom line: Chiropractic works. The New Zealand Report said that it works, that it’s very effective, that it gets results with medical failures. In fact, the New Zealand Report went so far as to say that chiropractic must be in hospitals and if it isn’t, the government should intervene and force it. It said if there is any barrier between chiropractic and medicine, it is because of ignorance and prejudice on the part of the medical physician and it took Barrett’s report and referred to it as completely unreliable. . . .
Barrett: That’s not true. They did not take “my report” because I submitted nothing to them.
Wilk: Would you like to see a copy of the New Zealand Report . . . .
Barrett: I have a copy of the New Zealand Report. The fact of the matter is . . .
Wilk: I have it in my briefcase, I have it underlined and I can bring . . .
Barrett: I know, you’ve written about it too. You think it’s a big deal. I don’t. I’ll tell you why . . .
Wilk: Well, of course you don’t think it’s a big deal because they took you through the coals.
Barrett: No, you say that I made a submission. I made no submission.
Wilk: They made the statement that as far as they were concerned your material was not balanced, it was purely propaganda and they could place no reliability on your report.
Barrett: Who are they? Who are the New Zealand reporters?
Wilk: The New Zealand Report consisted of an eminent professor of chemistry from a university, a prominent attorney from New Zealand, and. . . .
Susskind: Do you think this is relevant?
Barrett: No, I don’t. I think it was a lousy report.
Wilk: Of course it’s a lousy report in your mind because they took you through the coals . . .
Sportelli: Let’s get to the point of Dr. Barrett. See, he’s a danger essentially to cooperation between the medical profession and the chiropractic profession because of his obsession essentially with the weak points in chiropractic. Now Dr. Barrett’s been.. . .
Susskind: Why can’t we establish some criteria? Are you compensable under medical plans?
Wilk: Yes, indeed.
Sportelli: Under insurance, every Workman’s Compensation insurance carrier in the United States of America pays for chiropractic.
Sportelli: Medicare pays for it . . .
Barrett: Did they decide to that voluntarily or did you ram laws through the state legislatures to get them to do it?
Sportelli: Well, when we, when we get to the political power and American Medical Association, we’ll talk about that . . .
Barrett: You didn’t answer the question, did they do it voluntarily?
Sportelli: Of course not, they don’t do anything voluntarily.
Barrett: Is that so?
Sportelli: Let me, let me just go on for just a moment and tell you . . .
Susskind: I just want to be clear, Medicare and Medicaid recognize . . . .
Sportelli: Medicare and Medicaid, Workers Compensation. . . I think 38 states in this country now have insurance quality laws which simply say that if you’re compensable under the care of a medical care, you’re compensable under a chiropractor. . . which I think is right because I think . . . Really, David, the bottom line issue in this whole deal is: Do the consumers of this country have a freedom to choose the health care provider of their choice?
Barrett: Sure they do!
Sportelli: I’m glad you said that.
Barrett: But the question is: Who should pay for it?
Sportelli: Without medical interference.
Barrett: If somebody chooses it, he should pay for it. Why should I pay for it?
Hoppenstein: I happen to agree with you. Especially if it doesn’t have any basis scientifically. I think you can’t keep doing things because they’ve been done for 85 years . . .
Wilk: Oh, you know you keep talking about the scientific basis as if the American Medical or the medical profession had a monopoly on science. To begin with, it is a scientific posture to put technology before science. In other words, if a particular method of healing works — even if you don’t know why it works — it is used. Case in point. Aspirin.
Millions and millions of pounds of aspirin are being used. They can’t explain how it works, but it’s all right and this is considered scientific medicine. Chiropractic works. It gets results.
Barrett: Where’s the evidence?
Hoppenstein: What conditions . . .
Wilk: Workmen’s Compensation studies from California . . .
Barrett: That’s not tenable . . .
Susskind: Dr. Wilk has written a book, Everything You Should Know About Chiropractic. It says that a chiropractor can be very helpful in a whole host of human problems. Nervous disorders, arthritis, sciatica, migraine headaches. Now let’s come to something interesting — emotional problems, hypertension, high blood pressure, cardiovascular conditions, heart trouble, trauma, the common cold, bursitis — almost everything.
Wilk: Fine, let me . . .
Susskind: What can you do, what can you do for cardiovascular conditions?
Wilk: Okay, let me explain this. This particular study there is based on 7,000 chiropractors that were . . .
Susskind: No, just tell me how your science — if it be a science — can contribute to the cardiovascular . . .
Wilk: Okay, very good. Let, I have to lay a foundation because so far we haven’t really laid a basic foundation. We’re off into the structural aspect, we’re off into the physiological aspect, we’re talking apples and oranges, we’re not even in communication . . .
Barrett: You’re not answering the question is what you’re doing.
Wilk: Well, I am going to.
Hoppenstein: Our bodies are built differently. I don’t know any physiological basis for what you’re saying and that’s what I want to know.
Wilk: Okay, let me answer it this way. First of all, our basic concept is that good structure equals good function. If the spine has what we call a subluxation — it does indeed occur — and if by hand you can apply a certain type of manipulative technique to that spine and use a standardized technique and consistently produce predictable results and get it done over and over and over again, and if you can correlate the results to this manipulation of the spine. . . .
Hoppenstein: What can you do to a heart patient? What, how are you going . . .
Wilk: Well, I’m coming to that, I’m coming to that.
Hoppenstein: He’s got arteriosclerosis, I mean there’s the clogging of his . . .
Wilk: Okay, now keep in mind we are not treating the heart disease, we’re not treating arteriosclerosis. We treat the patients. . . . In the book I say that . . . we don’t treat conditions. And this is where a bone of great of confusion exists.
Barrett: They can’t express themselves.
Wilk: We treat the patient. We treat the patient and then the patient of its own natural ability.
Susskind: You don’t treat the problem, you.. . .
Wilk: We treat the whole patient. We help restore . . .
Barrett: Is that why you can’t measure anything?
Wilk: If you stop interrupting, maybe I . . .
Barrett: Well, you keep talking. You just talk and talk and talk and talk; and I don’t think it’s fair that you take up half of the program.
Susskind: I must stop in a second, but you can’t tell an audience of innocents out there that you can cure or allay, in an important way, heart trouble.
Sportelli: What kind of heart trouble?
Wilk: It’s a leading question in that it’s hard to know . . .
Hoppenstein: The clogging of the arteries.
Sportelli: Okay. You’re absolutely correct and no chiropractor. . . .
Susskind: But he says he can . . .
Sportelli: No. that’s not what he’s saying, I don’t believe that’s what he’s saying at all. I think again we need to break down what is being said.
Barrett: Here it is (showing pamphlet): “Heart Trouble and Chiropractors.”
Sportelli: What does it say, Dr. Barrett?
Barrett: “You can reduce the risk of developing heart trouble by eating sensibly, exercising and visiting your chiropractor regularly.” I presume to have your spine examined.
Sportelli: Because we feel that a properly functioning nervous system is the underlying fundamental basis for the good health of every individual.
Barrett: That’s the bottom line?
Sportelli: That is the bottom line.
Barrett: We feel that’s absolute nonsense . . .
Wilk: The adjustment of the spine . . .
Barrett: How often should you to have your spine examined?
Susskind: Gentlemen, on this note of sweet unanimity, we pause very briefly.
Susskind: A very important bone of contention between chiropractors and medical doctors is the use of the x-ray. Ninety percent of your patients are x-rayed and yet, the subluxations don’t show up on x-rays as . . . .
Wilk: They may or may not.
Susskind: They may or may not.
Wilk: May or may not.
Susskind: Yet you give very strong x-ray dosages, right?
Wilk: Wrong, wrong.
Barrett: How much of a dose does a full spine x-ray give?
Sportelli: I don’t know offhand.
Barrett: Oh come now.
Sportelli: The x-ray that a chiropractor utilizes is utilized not only for his determination of whether or not there is a biomechanical — and when we’re talking about biomechanical, we’re talking about these vertebrae and disks in the living human organism — whether or not these are involved. That’s one factor. The second factor that we’re as equally as concerned about David, is whether or not there are problems within that spine that would preclude the utilization of an adjustment. You take some 70-year-old woman with osteoporosis. That’s a condition that the viewers are familiar with. It’s where the bones have demineralized essentially and are very capable of breaking. You’ve heard about the old lady who walks off the curb and fractures her hip. Well that condition is not amenable to chiropractic manipulations of the kind of thrust that chiropractors would utilize; and therefore that would be one contraindication. There may be TB of the spine, there may be cancer of the spine. Those are conditions that the chiropractors are looking for to be able to rule out. Those conditions don’t belong in a chiropractic office and, therefore that’s another — probably as important as looking for the biomechanical disarrangements.
Hoppenstein: A man coming in your office with chest pain and some numbness of the left arm — what would you do with that man?
Sportelli: Well, the first thing I’d do is probably take his blood pressure and probably shove him off to the hospital for a cardiogram and have his cardiovascular system checked. Many of these people who have cardiograms; and you know, they’re kind of nebulous in their information. These people go to the hospital to have a cardiogram. They walk outside and keel over of a heart attack while the cardiogram says they’re normal. The fact of the matter remains, in my office, that’s the kind of a procedure I would utilize and that’s the kind of a procedure, incidentally, that most chiropractors would utilize. With chest pains that are predictably that which would indicate a heart attack — chiropractors would send them off to the emergency room or to a cardiologist to have their heart checked.
Barrett: That sounds terrific, and I would agree that Dr. Sportelli does it, but I don’t agree that most chiropractors do. I have in my hand an ad that says, “Chest pains can be caused by nerve disturbance at some point on the spine. ” And then it says, “It may vary from an intense fearful constricting pain to a dull throbbing pain.” The suggestion of the ad is to see a chiropractor. The fact of the matter is that when I arrested the chiropractor who placed this ad for false advertising, the Chairman of the State Board of Chiropractic Licensure came and testified that this ad represents chiropractic as it’s taught in the schools.
Sportelli: Dr. Barrett, fearful constricting chest pains are indicative of a heart attack. You know it. Chester knows it, Reuben know it, and I know it.
Barrett: Yes, and . . .
Sportelli: The fact of the matter remains is there are functional angina cases that go to their cardiologists, have had their cardiovascular system checked, have proven to be normal, they still retain their functional angina, which are fearful constricting chest pains. They go to a chiropractor, they have their dorsal spine manipulated and by God, you know what happens?
Sportelli: What happens is they lose their functional angina and that’s what . . .
Barrett: That’s what you say . . .
Sportelli: That’s what’s said by thousands of people. Incidentally, this is one of the problems, David. Somebody who has had a functional angina will leave the chiropractor’s office. Both the chiropractor at one time in our history would have believed he would have cured heart problems. The patient believes he’s had a heart problem cured because that’s where his pain was. Nothing could be further from the truth, yet that patient goes out and says to the world, “Chiropractors cure heart pains.” That is not what chiropractic is saying today, it is not what chiropractic has said for the last 20 years and that is not what that ad says. I disagree with that ad, but that does not negate the f act that it is, in fact, a valid ad taken in its proper context. And I don’t like the fact that Dr. Barrett utilizes advertising as a means to criticize the chiropractic profession. What I want to talk about, what I’d like to talk about here today from a chiropractic standpoint, is: Let’s forget about the esoteric problems of heart disease and cholesterol in your arteries and all this other business. Let’s talk about the 80 million people with back pain, let’s talk about the 40 million reputed people that have headaches — two conditions of which chiropractic has had astounding results in. We’ve got a 120 million Americans out there suffering from those conditions being kept from chiropractors.
Barrett: Well, why are all these pamphlets in chiropractic offices?
Sportelli: Simple because . . .
Barrett: They’re not advertisements. Pamphlets of this type are in most offices.
Sportelli: You’re absolutely correct.
Barrett: This has been studied all over the country.
Sportelli: You’re absolutely correct. We don’t like it either. That’s not . . .
Barrett: “We” is the majority.
Barrett: They’re in the majority of offices!
Sportelli: You see, one of the problems in chiropractic, David . . .
Barrett: There is a tremendous split . . .
Sportelli: . . . . has been the fact that this has been a singular, isolated profession kept from telling its story, kept from getting funds. Now let me just tell you something here, which is kind of interesting. . . . Let’s talk about the charge of chiropractic education. Dr. Barrett has utilized this charge before.
Barrett: I didn’t make it today, you want to go on?
Sportelli: You didn’t make it today.
Barrett: I didn’t make it today. You want to spend the next five minutes talking. I would like to have two minutes to speak sometime between now and the end of the program. Or maybe one minute to make two points.
Susskind: Well, take a minute now. How about that?
Barrett: Okay. I want to say two things. First of all, I think the audience has a right to feel confused. I think the confusion reflects the confusion within chiropractic not within the people here. Number two, Dr. Wilk’s case is very interesting. He spent seven weeks presenting his case to the jury where he sued the AMA and said, “You guys are trying to put us out of business. It’s a terrible thing to do, etc. etc. etc. ” The AMA spent a week saying, “Yes we did try, but we had a good reason.” The jury found with the AMA. The jury said, “Dr. Wilk, you lose.” And I would like to make one more suggestion: If anyone would like more information, they can write to me. . . . I will answer any letter that comes and send information about chiropractors. If you’re gonna go to see one, you better know what you’re getting into. [Note: This comment referred to a trial in which the AMA persuaded a jury that chiropractic was so outlandish that the AMA had a right to attempt to stop what chiropractors were doing. However, the verdict was overturned on appeal and the case was retried on narrower antitrust grounds in front of a judge, who concluded that the AMA had good reason to be concerned but had gone to far in its antichiropractic efforts.]
Wilk: And if they want information on chiropractic, let them contact the International Chiropractors Association in Washington, D.C.
Susskind: Don’t start writing all those letters because we’re coming right back.
Susskind: How much does an average visit to a chiropractor cost?
Wilk: It’l depend on what part of the country. In some areas it may be anywhere from 10 to 20 dollars a visit.
Barrett: Some can sock you for $75 or $100.
Sportelli: California’s a little bit heavier than the East Coast.
Barrett: But some have what they call “unit charges” where you go and they give you different modalities and can run up a bill of $125, $130, $150 dollars a day.
Wilk: In any event, it is a lot less money than you’d pay if you were hospitalized for similar conditions.
Susskind: One thing that disturbed me in the research we did was that at a Clinic Masters seminar for chiropractors in 1978, one topic on the agenda was “How to Achieve the Optimum Gettable with Every Patient.” That sort of suggests a kind of a how-can-you-rip-em-off . . .
Sportelli: David, I want to tell you that there’s no way that that can be defended, and no chiropractor in any position of authority or leadership would condone any of that nonsense in terms of the practice management people who have anything less than an ethical basis for their practice.
Barrett: Like Sid Williams?
Sportelli: Now. . . Let me . . .
Barrett: Did you see this one?
Sportelli: I saw that.
Barrett: He’s an ICA board member.
Sportelli: Let me also say to you that from a historical standpoint . . . Okay, let me go, I have to go back . . . . Do you notice I utilize a historical basis for some of my answers only because you have to know where you came from before you know where you’re going. One of the problems in chiropractic that had been early-on in chiropractic history was that we were virtually cut-off, we were prosecuted, we were persecuted, we were. . . . Everything was done to a chiropractor. He couldn’t virtually survive. The entrepreneurs within the chiropractic framework saw a means (practice building techniques) by which to make these chiropractors survive financially; and at a time it served its useful purpose. It is no longer valid today.
Barrett: It’s still going on.
Sportelli: It’s no longer needed today.
Barrett: Isn’t it still going on?
Sportelli: Yes, Dr. Barrett, it is still going on, and I want to tell you something. That’s the only thing that you have done that I applaud. You’ve called attention to a weakness in chiropractic that the national associations do. As a matter of fact, I might add to you — you read all of our journals — you know there have been two recent blatant editorials denouncing the entrepreneurs in practice. . .
Barrett: Yes, but one of them is on the Board of the very organization the president spoke out on. . .
Sportelli: You do not change administrations overnight, you know that.
Barrett: Nothing’s going to change.
Sportelli: But, let me tell you, David, that was a basis for survival at a time. There is nothing stronger than the instinct of survival. Chiropractors needed practice management people to tell them how to survive.
Barrett: Yes, but what they’re doing is conning people into coming once a month for life.
Sportelli: No, and there’s nothing wrong with that. You know, this is interesting. This was in The Wall Street Journal, I often get it sometimes. Doctors turn to. . . Let’s talk about real doctors, medical doctors. . .
Barrett: You’re changing the topic.
Sportelli: No, I’m not changing the topic. I want to tell you that practice-building is not a dirty word. It is a dirty word in the context of when it is unethical., when it is unscrupulous, when it involves bilking the public out of money. Yes it is, absolutely. Nobody will stand for that. But I’m going to tell you that the techniques that chiropractors have utilized in those seminars that Dr. Barrett talks about are being talked about and told to medical doctors today. It costs them $350. What are doctors doing? Just, doctors aren’t handing out two-for-one bonuses but they’re sending flowers to their patients, then calling to chat about it. What we have done with those practice-building courses is create an awareness that there needs to be a personal relationship between you, the patient, and me, the doctor.
Susskind: Dr. Hoppenstein, you’ve been very quiet. Have they convinced you at all.
Hoppenstein: They haven’t convinced me, and I’m still waiting for one shred of scientific evidence that manipulation — no matter how you spell it. . . . There is no way that that spine can be manipulated to cure all sorts problems . . . .
Wilk: Read the New Zealand Report, it’ll tell you that there is . . .
Hoppenstein: What is possible — and I will hand this to my colleagues here — is that in acute pain in the spine, manipulation or . . . . by producing pain in the neighborhood can break the pain cycle for x number of hours or days. It does not treat the condition. it’s not making you healthy and you’re making your spine crack.
Sportelli: I only disagree with that because . . . Perhaps I asked you earlier in the show if you did any manipulation. You said no you did not do it.
Hoppenstein: I do not.
Sportelli: David, several years ago, the federal government of the United States — not New Zealand now — convened probably one of the most historic conferences of its kind in the world. It was at the National Institute of Neurological and Communicable Diseases and Stroke in Bethesda, Maryland. I happened to be in attendance at that conference, not as a participant. I don’t have those kinds of credentials. I was in the audience listening. I was proud to be in that audience. Why? Because what it did was convene from all over the world the authorities in manipulation from chiropractic, from medicine and from osteopathy. Now, this gentleman claims to be a scientist. I will get him a copy of the NINDS Report. It was called “The Conference on SMV because the medics didn’t want to use the word “adjustment” and the chiropractors didn’t want to use the word “manipulation” so they finally came to a compromise and said let’s call it “spinal manipulative therapy. ” The world-renowned people came to the conclusion that there is much benefit, but we don’t know why. Let’s do some further research. And I think that any conference of its kind dealing with the specifics of manipulation is going to come to that same conclusion.
Susskind: We’re almost out of time. Can you conceive of any condition in yourself that would bring you to a chiropractor for relief?
Barrett: Well, I have some chiropractors that I trust. I would say that if you’ve been diagnosed by a medical doctor, there might be certain kinds of aches and pains that a chiropractor can relieve. However, I’ve sent people for check-ups to 16 chiropractors and 15 of them recommended treatment for perfectly healthy people. And no two agreed as to what was the matter with any patient.
Susskind: What do you say to that?
Wilk: Well, I think my feeling is that in the limited time, I know we’re running out in a few seconds, I, may I suggest that the people get Everything You Should Know About Chiropractic from your local chiropractor. It’ll put things in a proper perspective.
Susskind: I’m sorry, we are out of time. Get that book Everything You Should Know About Chiropractic
Barrett: Get my book (The Health Robbers) too.
Susskind (to the audience): Again, I want to thank you for inviting us into your home.