Mike:
I have zero desire to trap you or play games. Our conversation began as a cordial one between colleagues in different stages of their careers. And I have strived to maintain that.
It is heartbreaking to be called naive, arrogant, or outrageous from a colleague in a position of authority in my profession. I am sorry to be experiencing this.
Be Well, Mike. I wish you and your family the best.
Rob
On Mar 27, 2020, at 6:10 PM, Michael Henze <michael.henze.dc@gmail.com> wrote:
Hey Rob,Sure, I'd love to see what you've come up with. I see. Yes, I'm familiar with the WFC and their 100 or so members. And yes, I've seen their review as well as others they have put out. I am not one bit surprised to learn that one of your mentors was one of the authors of the WFC review. Interesting how this new WFC can have such a different view and tone of the same research as the seasoned, well respected ICA has, no?It's easy to tell what many of the more recently graduating docs like you are being fed in your schooling. I feel sorry for you. Truly sorry for you. Your circumstance reminds me of a quote I have on my wall that I discovered a couple decades ago as I was struggling to come to grips with why so many in the medical and physical therapy fields seemed to simply not be able to free themselves from the philosophical a box they'd been put in with their training. It's from Bertrand Russell in 1953. And I have watched sadly, as I have witnessed it become more and more true over the past 2 decades from preparatory school to undergraduate school to now chiropractic school. It helped me then to realize that the large majority of these poor souls were likely trapped in their paradigms shrouded by the dogma that the were fed by their schoolmasters, no longer being able to think freely enough to consider the possibilities that are truly before them/us if they could only "have eyes to begin to see." Here's the quote: "Scientific societies are as yet in their infancy. It is to be expected that advances in physiology and psychology will give governments much more control over individual mentality than they now have even in totalitarian countries. Fitche laid it down that education should aim at destroying free will, so that, after pupils have left school, they shall be incapable, throughout the rest of their lives, of thinking or acting otherwise than as their schoolmasters would have wished....Diet, injections, and injunctions will combine, from a very early age, to produce the sort of character and the sort of beliefs that the authorities consider desirable, and any serious criticism of the powers that be will become psychologically impossible."I guess we will have to do that--you with your extremely limited experience and bias education and me with my 24 years and thousands and thousands of cases I've handled...along with the dozens and dozens of my colleagues that have done the same kind of thing. But you go ahead and stay convinced that you and your professor know best how to redefine words and alter what is said to mean what you want to think is being said or claimed, such as what is valuable or real enough or evidence enough. FWIW, I am operating on not only what I learned in chiropractic college, but what I've learned and continue to learn both in the research and my very valuable clinical experience. As for your question, in it you make assumptions that are absolutely stunning to me. It is even more clear with the posing of it that you have ideas and assumptions that not only are outrageous, they border on either idiocy or arrogance spawned from naivity. That's what you gathered from these discussions? Or was that your attempt at showing me your superior intellect in an attempt to trap me? Let's see your comments to the research. It will be telling I'm sure.Mike.
On Fri, Mar 27, 2020 at 4:02 PM Robert Sanders <sanders3@me.com> wrote:
Mike, Sorry for the delay! I thought this was sent yesterday!
Thank you for your handout. I went through each article, and wrote down my response if you would care to read it, just let me know. I feel in general you cite most of the papers included in the WFC review have you read it? I would say they are well-founded and I agree with their critique, and given your comments in your patient handout, you likely don't. We are just going to have to agree to disagree on what evidence is deemed clinically relevant. Most of the "studies" referenced are actually case reports, which are not actionable for knowing something works or does not at the population level. The few studies showed statistical significance but no clinical relevance (making a statistical difference to a control does not necessarily make that difference valuable). FWIW, I am operating on what were taught in chiropractic college on how to evaluate scientific literature, and in fact the former head of research at my school was one of the authors of the WFC review paper. While we are still on this topic, I'm curious how you manage immune system cases in your office. What dx codes do you use? What subjective or objective findings drive a treatment intended to improve immune function?Rob
On Mar 26, 2020, at 1:00 PM, Robert Sanders <sanders3@me.com> wrote:
Of course. I am going through each of those studies in your handout and applying what we were taught in school for interpreting literature. as best I am able (few of them have full text available publicly, and I am sad to say my college stopped giving alumni library access so I can't request them). Will report back!
On Mar 26, 2020, at 12:58 PM, Michael Henze <michael.henze.dc@gmail.com> wrote:
Deal. Please make sure and apply your judgements equally for all potential treatments and procedures.
Michael Henze, D.C.You bet, Rob.Good points. So, let's do some more studies! Consider taking a look at the 1975 study by Ronald Pero, PhD of long-term chiropractic care recipients showing a 200 percent greater average immune competence than the control group (people who had not received chiropractic care), and a 400 percent greater average immune competence than people with cancer or other serious disease processes present.Can we hold the medical community to the same standards though? Do we? If so, then why are there virtually no studies supporting flu vaccines and clear studies against them (search for the Cowling Study 2012 https://www.ncbi.nlm.nih.gov/pubmed/22423139)...one of the only true double blinded placebo studies on flu vaccine efficacy...showing no significant difference in the vaccinated group incidence of flu over the true placebo (saline only) shot receiving group, yet a 4 times greater incidence rate of Influenza Like Illness (ILI) (which you may know makes up at least 85% of all ILI) in the trivalent flu vaccinated group. I'll respond more but this is at least a little food for thought. Open your mind, brother. Be fair to your own profession on the evidence!
Michael Henze, D.C.
Henze Chiropractic Get Well. Stay Well. Age Well.
9211 W. Overland Rd.
Boise, Idaho 83709
Clinic: 208.377.8777 Mobile: 208-484-6105 HenzeChiropractic.comIMPORTANT NOTICE: This communication, including any attachment, contains information that may be confidential or privileged, and is intended solely for the entity or individual to whom it is addressed. If you are not the intended recipient, you should delete this message and are hereby notified that any disclosure, copying, or distribution of this message is strictly prohibited. Nothing in this email, including any attachment, is intended to be a legally binding signature.On Wed, Mar 25, 2020 at 8:32 AM Robert Sanders <sanders3@me.com> wrote:
Mike:
Thank you so much for taking so much time to correspond to me. I am truly touched!!
Going from the content of your email (will read the attachments and respond to!) we are at an important part of the QUALITY of evidence. You’re right: the ICA cites many studies. And a few of those studies show an increase in markers for substances involved in immune function in a small sample of healthy chiropractic students. But how meaningful is it? Specifically:
- how much of a change in these substances?
- what is the “clinically relevant” amount?
- does this happen in all age groups or just college kids?
- does this happen in sick people, or only healthy people?
AND THE MOST IMPORTANT PART:
- Does this change in these substances result in improved immune function?
Just having “evidence” does not make it clinically relevant. Imagine I could make a change to your vehicle that is shown to improve gas mileage! Awesome, right? But it costs $10,000 and only save you 0.25mpg. Now, technically this change IS SHOWN TO IMPROVE GAS MILEAGE. But it is not useful because that change is “insignificant”. In fact in research we literally say sometimes “statistically significant but not clinically relevant”.
Luckily for B12 we do have studies showing it has essentially the same levels of anti inflammatory effect as cortisone. And I don’t inject knees, in fact I don’t use it intra-articularly at all.
PS just to be fair to our osteopathic colleagues, they also operate from a healthy-body perspective. So BJ should have made some osteopathic friends back in the day, he might have enjoyed it!
Hey Rob,
Sorry for the delay in response! I felt I needed focus on and engage and respond promptly to Eri's comments/concerns since he went full group on them.
I'll address your questions now. Like with Eri's, I'll put yours in blue and my responses in red.
Are we willing and able to testify when sued for malpractice?
I am. I don't know about all DC's, but I know there are several that if push came to shove, they likely would. My personal goal is to inspire and encourage more DC's to take more courage in who and what they are and what we are about. We stand on the shoulders of some true giants and heroes. I feel we owe it to them and to our community members to have the courage to stand for the existential truths we know of.
Is this evidence cited by the ICA strong enough to hold up to scrutiny?
I believe so. But thankfully this is not even close to all of the (scientific) evidence in support of chiropractic adjustments and better said, chiropractic care in positively affecting the immune system of the recipients of this care.
I’d be careful encouraging docs to advertise this to patients.
Thank you for this observation. I completely agree. We should ALWAYS be careful in what any of us advertise or claim we can do for patients. BUT, I personally feel we should be careful to claim the entire truth on what we can and can't do for people. I believe that a big reason why most people have no idea about how chiropractic care can have a clear and substantial positive affect on overall health and well-being and not just the immune system.
To be clear, as a doc I am agnostic with regards to boosting immunity.
I rely on scientific evidence for benefits I stand by in practice. For example, I frequently inject B12 in inflammed areas to have a similar effect as cortisone.
This is hardly even heard of in health care, but we do have studies proving it.
We've talked about this a little. You admitted you don't know of any studies that directly support the joint you claim you have evidence it helps, but instead are inferring that other studies showing it appears to decrease inflammation is evidence enough to "stand by" this in practice. I feel you are being at the least hypocritical to not allow for at least the same inferring with evidence supporting chiropractic care boosting immune function. But alas, in our medicalized society it seems so much easier to move over to the medical-like side and be lenient in our requirements for scientific evidence when considering the well-accepted practice of "injections" when compared to something the medical community clearly does not seem to embrace like chiropractic adjustments. I will provide for you a great deal of scientific evidence below in support of chiropractic in care resulting in what appears to be boosted/strengthened/improved immune function...or even better said, boosted/strengthened/improved overall function.
I would LOVE to ethically state that chiropractic boosts immune function.
You virtually can. You simply need to put it slightly differently. Chiropractic care has been shown over and over to result in improved overall function of the body, with clear evidence of increases in immune system response and strength. This is a fact...proved over and over again. It has been demonstrated in case studies as well as double blinded control studies.
And all we need to do as a profession is do even a single study on sick people!
It sounds to me like you feel more studies need to be conducted. These need to be carefully constructed with clear controls for potential complicating and/or discrediting/disqualifying factors. It can be done. I would be more than willing to help. But these take time and effort to carry out properly. Then be prepared to bring the wrath of hell down on you in the form of discrediting scrutiny.
But until then, can we really say we have evidence? These ICA studies show NO direct connection between adjusting and reduction in illness. Dangerous!
I and many would respectfully but firmly disagree. What I would suggest is dangerous is the unwillingness of people like you in and out of chiropractic to open their minds and eyes and see what is before them in the form of scientific evidence.
As evidence of my sentiments directly above, I would first point you to what it is that the ICA calls for:
MORE CHIROPRACTIC RESEARCH (NOT LESS) IS URGENTLY NEEDED.
THE END OF CONTINUED DISCRIMINATION FROM THE MEDICAL MACHINE THAT REFUSES TO INDEX MANY CHIROPRACTIC PEER REVIEWED PUBLICATIONS ON PUBMED.
All of us that are clear on the power of chiropractic care in unleashing the body's innate ability to self-repair, self-heal, self-regulate, self-balance, and self-recuperate are anxious for more honest research on chiropractic.
Speaking on cures for ANY virus, there is NO CURE FOR ANY of them. As I hope you realize, once you contract a virus, it is with you til you die. So, NOTHING CURES people of them if we are being completely accurate. And ultimately, drugs or chemicals are not intelligent. They can make no decisions on their own. They don't know where to go or what to do, beyond their unintelligent chemical tendencies. But the human body is intelligent. Give the body what it needs without overloading it (poisoning it) in the way of chemical tools, and if there is a way within physical limits of matter it will self-heal and self-repair and self-re-establish homeostasis. And the more the brain can get and stay connected with the rest of the body through unencumbered neural pathways and undistorted neural signals, the easier and the quicker and the more completely this can occur. These are facts. A basic review of your Medical Physiology textbook will remind you of these.
Please note that in the first few pages of the ICA publication, they correctly assert that there is no credible scientific evidence to support any type of treatment for Covid 19. But should this stop any healthcare provider from trying a therapy or treatment to help the Covid 19 infected sufferer? How about any other sufferer?
Further the ICA quotes BJ Palmer who famously and precisely noted,
"While other [healthcare] professions are concerned with changing the environment to suit the weakened body, chiropractic is concerned with strengthening the body to suit the environment."
I completely agree.
Further,
The ICA publication includes 28 credible citations/publications.
The ICA publication notes a meta-analysis in 2017 of 1217 separate citations regarding spinal manipulations and biochemical markers. That's 1200+ studies, Rob. Sure they found "problems" with the reporting in those studies, but 1200! In the end, their conclusion was that spinal manipulation can result in the increase of Substance P (pain modulation), neurotensin (digestion), oxytocin (labor and delivery), interleukin levels (immune function) and may influence cortisol (inflammation, stress, insomnia, chronic fatigue syndrome, thyroid disorders, dementia, depression) levels.
*How does this stack up to your B12 injection evidence???
The ICA publication also cites solid evidence of near miraculous positive outcomes of care rendered by Doctors of Chiropractic that was far more successful than that of their contemporary medical counterparts during the 1917-1918 Spanish Flu epidemic. These statistics are irrefutable. They are etched in history. Claiming this is not strong evidence to support the likelihood that chiropractic care can help those seriously ill from virus-induced illnesses like the Spanish Influenza recover more easily than without chiropractic care, regardless of what else might have been tried as a treatment or remedy seems to me to border on dishonesty--if not near insanity.
One important note to make about the ICA publication: Nowhere in this publication does the ICA suggest or assert that chiropractic adjustments or chiropractic care cure any ailment, weakness, disease process, virus, etc. However, throughout the publication the ICA cites facts and quality research that suggest and support the likelihood of chiropractic adjustments and chiropractic care to lead to a circumstance where the body of the recipient of the chiropractic care is able to function better in likely several measurable ways.
I have several lists of research studies on health benefits from chiropractic treatment. I will include some of those in attachments to this article. Please carefully consider each of them as potential additional scientific evidence that chiropractic care is an effective way to help people function or return to function at levels closer to their innate potential, thereby arriving at a higher and more complete level of health and wellbeing.
I hope this helps you begin to see the true power of chiropractic care in helping people to get well, stay well, and age well.
Mike Henze