Spin Doctors: The Chiropractic Industry Under Examination

David Bennett is the national director of the Department of Workplace Health, Safety and Environment at the Canadian Labour Congress in Ottawa.

Chiropractic medicine is a recognized, self-regulated profession that
claims to treat a very wide range of ailments suffered by people of all
ages. Spin Doctors is an exhaustive critique of the profession, from its
historical origins in the late 19th century to the present, by two
distinguished Canadian journalists. In their view, chiropractic medicine
is based on crackpot ideology and false theory, unsupported by
scientific fact. Despite widespread patient satisfaction, chiropractic
treatments are largely ineffectual, sometimes making things worse, and
in some clear, documented cases, cause fatal strokes. The best advice
the authors give or endorse is that patients should not rely on
chiropractors for diagnosis, they should seek chiropractic treatment
only for musculoskeletal conditions, and they should not undergo violent
neck manipulations as part of the cure.

The only criticism of this penetrating book is that it accepts
uncritically the validity of conventional medicine. In the authors’
view, medical intervention is based on science and correct theory. The
trouble is, however, that the science is sometimes merely speculative
hypothesis, one reason that treatments fail or are counterproductive.

Instead of seeing medicine as a science, we should see it as a craft, a
series of ploys and strategies that sometimes work in the absence of
sound theory. The attitudes and beliefs of patients are as important to
success as the quality of the craft. Viewed in this way, chiropractic
medicine would score higher on the success scale and conventional
medicine rather lower. Medicine is then to be viewed as one of the few
crafts in which the practitioners get paid irrespective of the success
of the intervention. Chiropractic medicine does not have a monopoly on
iatrogenesis—doctor-induced disease. The authors would have benefited
from a reading of Ivan Illich’s Medical Nemesis.