Chiropractic Abuse: An Insider’s Lament

There is a new book critical of chiropractic: Chiropractic Abuse: An Insider’s Lament. The author, Preston Long, DC, PhD, is a chiropractor who says he made a big mistake when he chose chiropractic as a career. He has written an intriguing book explaining his mistake and the experiences that resulted from it during 3 decades as a chiropractor and a critic of chiropractic.

Chiropractic encourages self-delusion, and those who break free of delusion have two choices: to fight or run. Preston Long chose to fight, to keep the baby and throw out the bathwater polluted with pseudoscience and quackery, to try to practice rationally and ethically, and to try to reform chiropractic from within. He soon learned that it was next to impossible for a chiropractor to make a living with a science-based, ethical practice. He eventually found his niche and put his knowledge of chiropractic to good use. He evaluates chiropractic cases for disability and fraud, has worked with the FBI, and has testified at over 200 trials. He has written two previous books, The Naked Chiropractor (2002) and The P.R.E.S.T.O.N. Protocol for Back Pain (2006). This new book tells the story of his life and exposes the delusions and misbehaviors of his chiropractic colleagues.

He reveals “20 things most chiropractors won’t tell you”:

1. Chiropractic is not based on science
2. Chiropractors promise too much
3. Their education is vastly inferior to that of medical doctors
4. Their legitimate scope is very narrow
5. Little of what they do has been studied
6. It’s best to get diagnosed elsewhere
7. They offer lots of unnecessary services
8. “Cracking” the back doesn’t mean much
9. If the first few visits don’t help, more treatment probably won’t help
10. They take too many x-rays
11. Research on spinal manipulation doesn’t reflect what happens in chiropractic offices
12. Neck manipulation is potentially dangerous
13. Most chiropractors don’t know much about nutrition
14. If they sell vitamins, they charge too much for them
15. They have no business treating young children
16. The fact that patients swear by them doesn’t mean they are actually being helped
17. Insurance companies don’t want to pay for chiropractic care
18. Lots of chiropractors do really strange things
19. Don’t expect chiropractic licensing boards to protect you
20. The media rarely look at what they do wrong.

The first time I read this list, there was no number 19. I wondered if 19 was the one thing no chiropractor will tell you, not even Preston Long. Turns out it was just an inadvertent omission that was corrected in subsequent copies.

He started to realize his mistake during his first classes in chiropractic school. He wondered why he hadn’t learned about those displaced bones and all the devastating health problems they cause during his undergraduate studies in anatomy, physiology, and biology. He noticed that his teachers never mentioned how hormones help regulate the human body. Despite glaring doubts about this profession, he stayed, simply because he had no other place to go. He has lots of stories to tell about his first adjustment, the cheating he observed, and the inconsistencies in what he was taught.

He covers the history of chiropractic, the imaginary subluxation, the studies evaluating the efficacy of spinal manipulation, the economic abuse of patients, the reasons you should never sign a contract for chiropractic care, the risk of stroke with neck manipulation (with tragic patient stories), insurance frauds and injury mills, upcoding visits, regulatory abuses, and unethical practices of chiropractic boards.

As a practicing chiropractor, he observed many kinds of misconduct among his peers, from cynical marketing techniques to defrauding insurance companies. I got a kick out of the idiotic behavior of chiropractors in several of the cases of sexual misconduct he encountered during his career. One chiropractor

…did rectal exams on all of his female patients and videotaped them. When women complained, investigators found tapes in and near a VCR in a bedroom in his home. He claimed to have done the taping to document the procedures so that insurance companies would pay for them. But he could not explain why they were in his bedroom.

Another chiropractor

…suckled a woman’s breast while doing a breast exam. The woman ran out of his office in her gown only. She contacted police, who asked her to call the chiropractor and record the call. He admitted to it and even asked her to return later that same day. Somehow the chiropractor got wind of the taped call, walked past his receptionist (his wife), locked the clinic door with her still inside, and flew to Colorado where he remains today.

One chapter covers how to protect yourself and what red flags to look for. Another chapter reproduces the Institute for Science in Medicine’s Chiropractic White Paper, authored by our own Jann Bellamy. A final chapter asks if chiropractic can reform. He is not optimistic:

I believe that in order to survive as a profession, chiropractic must adopt the substance of a scientific health discipline and not merely a veneer. This would require abandoning subluxation theory, adopting ethical standards, and clamping down on the wide range of practices that are unproven and lack a scientifically plausible rationale. Unfortunately, having seen little progress in this direction during the past 25 years, I do not believe chiropractic has the ability to reform from the inside.

This book is a very valuable addition to the literature on chiropractic, combining Long’s personal story with everything you never wanted to know about chiropractic. It’s fun to read and packed with information. Even if you think you’ve heard it all before, there are revelations here that will be new to you, that will elicit surprise, indignation, and laughter.

^{This article was originally published in the Science- Based Medicine Blog.}