Chiropractic Part 2- Safety First

Next is safety.

So when I talk to my MD friends I always get the safety question. They have all heard stories of some brothers', cousins', aunts' roommate who had a horrible injury. Strange, that in a room full of MD's I have never hear anything more then an anecdotal story from a third party source.

Chiropractic is one of the most common procedures in the country. According to the ACA (American Chiropractic Association) over 20 million Americans visit a chiropractor every year. That is a lot of people and even I was surprised by their number. In a group that size if there are a high percentage of problems it would be impossible to hide.

This is the way I illustrate the safety of Chiropractic to my MD friends, and I normally get a few shocked expressions when I'm done.

All Doctors, MD's and Chiropractors etc..., we all pay for malpractice insurance. The amount any Doctor pays is a direct correlation to how much risk the insurance company is taking to insure the Doctor. In a nutshell the higher the insurance premium, the more chance the insurance company has calculated you might be sued, and the amount you might be sued for. Those are two of the main factors that go into the amount of premiums a doctor pays for malpractice insurance. More risk to the insurance company means higher premiums... That simple.

Let's look at insurance premium rates since the insurance companies already did the work for us.

So the best complied data that I found is from 2010. (source- www.mymedicalinsurance.com)

Specialty

Malpractice Cost Ave.

Internist

$ 13,541 (year – 2010) Georgia

General Surgeon

$ 49,889 (year – 2010) Georgia

OBGYN

$ 58,763 (year – 2010) Georgia

Chiropractor

$ 1,222 (Year 2015) My Personal (Georgia)

When I show this to my MD friends their jaws drop almost every time. I was presenting to a group of OBGYN's once and this came up. I showed them my actual insurance policy and one Doctor yelled from the back of the room that he paid more in malpractice insurance in a week than I pay all year. (In fairness he specializes in high risk maternity). I am not knocking my MD friends. They are great professionals who just happen to practice a riskier profession then I do. That's all.

After the malpractice insurance talk I normally get the “stroke” question. This one is also fairly common because it got some traction in the media many years ago. The story goes that there is a type of stroke called a Vertebro Basilar Artery Stroke (VBA) that was once theorized could be caused by Cervical manipulation. Like I said before there are 20 million patients each year in the USA, so if this was a common occurrence we would see it in the data. The data was collected by the Canadian government and found absolutely no correlation in the largest study of its kind to look into the matter.

The conclusion of the study was this: Quote- “VBA stroke is very rare event in the population. The increased risk of VBA stroke associated with Chiropractic care and PCP visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke. We found no evidence of excess risk of VBA stroke associated with chiropractic care compared to primary care.” -Eur Spine Journal 2008 Apr; 17 (Suppl 1): 176-183. Or http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2271108/

The study was almost 10 years long over a HUGE population of over 100 million people and found only 818 VBA strokes total over that time and population. A very small number. Only 4.4% had seen a Chiropractor in the month prior to the stroke and half of those patients had seen both a PCP and a Chiropractor in that same prior month. 51% had only seen their PCP in the month before and the rest were treated directly in the hospital system.

The study did find that a common early symptoms of a VBA stroke is headache and neck pain. Two symptoms that people commonly seek care from a Chiropractor, or their PCP for. That is the reason that the people who had VBA strokes where equally more likely to see their PCP or Chiropractor within a month before the major onset of symptoms. This means that the patient was already having the early onset of the stroke (dissection of the artery – is the more medical term) prior to seeking treatment.

I'm not one to sugar coat anything. Chiropractic like any medical procedure and like everything comes with some risks. In the case of Chiropractic care the most common injuries tend to be mild and self-limiting. Things like soreness, bruising, and increase in symptom, are the most common, and correctable with a change in treatment or referral. No type of care is successful 100% of the time and if you seek care from any Doctor and do not see improvement in a reasonable amount of time you should seek out other care. In my practice I typically look for a MINIMUM of 20% improvement in 2 weeks or less. If my patients don't meet that minimal standard I typically refer, or co-manage with, another specialty.

Thank you for reading

Dr. Judd Weinberg DC