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November 2004

• Chiropractic Care Lowers Health Care Costs, Study Shows
• New Bacteria Threaten Public Health
• Children Addicted to TV Run Higher Risk of Spinal Problems
• Medical Errors Still a Leading Killer
• ADHD Helped With Chiropractic, A Case Study
• Conflicts of Interest Affect Government Drug Recommendations

Chiropractic Care Lowers Health Care Costs, Study Shows

A study published in the October 11, 2004 issue of the Archives of Internal Medicine showed that including chiropractic care into health plans actually reduces the health care expenditures for those in the plan as well as reducing the overall cost to the insurance company for that plan.

This study was a retrospective claims data analysis, where the records of 700,000 people with chiropractic coverage in their plan were compared to another 1 million people who did not have chiropractic coverage. The utilization records were then compared for a 4-year period to see if there were any differences in usage and expenses.

The purpose of this study was to ascertain the effect access to chiropractic care would have on the overall usage of health care resources as well as neuromusculoskeletal-specific conditions, (such as back pain) within a large managed-care system. The study noted that back pain accounts for more than $100 billion in annual health care costs in the US and is the second leading cause of doctor visits and hospitalizations.

The results showed that chiropractic care reduced costs across the board. For instance, total health care expenditures for plan members with chiropractic insurance coverage, was on average $1463, compared to $1671 for those without chiropractic coverage. As expected, there were also savings for those with specific back pain problems. The study showed that less x-rays were needed, less MRIs taken, and considerably less hospitalizations were needed for the members in the plan that included chiropractic over those where chiropractic was not included.

Comparing the health plans that include chiropractic to the ones that do not, the study found that:

• Chiropractic care cut the cost of treating back pain by 28%.
• Chiropractic care reduced hospitalizations among back pain patients by 41%.
• Chiropractic care reduced back surgeries by 32%.
• Chiropractic care reduced the cost of medical imaging, such as X-rays or MRIs, by 37%.

Taking into account that this study was published in a medical journal, the stated conclusion was striking. The researchers concluded, “Access to managed chiropractic care may reduce overall health care expenditures through several effects, including (1) positive risk selection; (2) substitution of chiropractic for traditional medical care, particularly for spine conditions; (3) more conservative, less invasive treatment profiles; and (4) lower health service costs associated with managed chiropractic care. Systematic access to managed chiropractic care not only may prove to be clinically beneficial but also may reduce overall health care costs.”

New Bacteria Threaten Public Health

The above headline comes from a November 9, 2004 ABC News feature story. The feature describes a disturbing trend of new mutated bacteria that are resistant to medical attacks from antibiotics. The article focuses on one bacteria specifically known as “MRSA”. This bacterium is a mutated tough new strain of staph against which most of the antibiotics in the medical arsenal are useless.

David Geffen of the School of Medicine at UCLA and chief of infectious diseases at Harbor-UCLA Medical Center in Los Angeles notes, “The development of the MRSA problem is an example of what we're going to be facing on a regular basis.” The CDC does not presently have data on the spread of MRSA, though some officials estimate there are about 100,000 MRSA-related hospitalizations each year in the US alone.

The article notes that MRSA infections are causing illness and death among high school and college athletes, school children, prison inmates, military personnel, and hospital residents and employees — all groups who live in close quarters and are more likely to spread infections through physical contact or the sharing of towels, clothing, sports equipment, toys and other items.

The article notes that MRSA is not the only resistant bacteria that health officials are worried about. The National Institute of Allergy and Infectious Diseases reports that many common infectious agents have become resistant and represent an increasingly worrisome public health threat. They also note that other forms of staph and tuberculosis have also become resistant to even the strongest antibiotics and pose significant health threats.

Experts cite the rise of antibiotic-resistant bacteria to the casual use of antibiotics for everything including the flu and the common cold, against which antibiotics are useless. In addition to the overuse of antibiotics, even antibacterial soaps containing triclosan are being attributed to creating an environment where triclosan resistant bacteria can flourish. The ABC News Feature notes that even antibacterial soaps have been associated with an increase in bacteria on nurses' hands due to the skin damage these soaps can cause.

Joshua Lederberg, a Nobel Prize-winning geneticist concludes, “The future of humanity and microbes likely will unfold, as episodes of a suspense thriller that could be titled 'Our Wits Versus Their Genes.' "

Children Addicted to TV Run Higher Risk of Spinal Problems

An article in the November 8, 2004 edition of the “Daily Record” from Glasgow in the United Kingdom, reports on a study showing that children who watch TV for large amounts of time are more likely to suffer spinal problems and pain.

The study conducted by the British Chiropractic Association, looked at 200 secondary school aged children. They found that boys spent an average of 41 hours in front of the TV (or video game) per week while girls spent only 21 hours. The article notes that one quarter of them are lying down with their heads up placing extra tension on the neck and upper back areas. The article also notes that heavy backpacks seem to additionally contribute to the problem.

The article explains that the additional time in a non-active posture does not permit the spine to strengthen during the years of development, which last up till around age 18. Dr. Chris Turner, a chiropractor in West London, said: “The major factors in children’s back problems are a more sedentary way of life and lack of exercise.” He continued, “This means their muscles do not work very well and leads to strains when they are used, especially for carrying relatively heavy weights, including school bags.”

The research also noted that 44% of children with school bags do not use both straps and instead carry the bags unevenly with only one strap. Dr. Scott Miller, the chiropractor who led the research, explained by saying: “Children’s bones are soft up to the age of 18. Discs in the spine are stronger than the bones and so deform if you keep carrying weight on one side.” He added, “Because many children lead sedentary lives, the bones aren’t getting the exercise they need to get strong. Then they are subjected to the horrendous weight of school bags, so the spine distorts.”

Medical Errors Still a Leading Killer

An article in the November 9, 2004 issue of the Boston Globe critically examines the rate of medical errors. The article starts off by recalling that five years ago a medical report titled, “To Err is Human” was published that exposed the large problem of medical errors.

The original report in 1999 called for a drastic reduction in medical mistakes. It revealed that accidental overdoses, infections and other care-giver errors had become a leading cause of death. Up to 98,000 US patients dying annually, the authors declared, "it would be irresponsible to expect anything less than a 50 percent reduction in errors over five years."

Dr. Lucian Leape of the Harvard School of Public Health and an original co-author of “To Err is Human”, notes that not much has improved in five years. “The evidence of improvement is indeed unimpressive. It's hard to get away from that.” He continues, “The problem of medical errors is immense.” In comparing medical mistakes to airline safety records, Dr Leape said hospital patients are at least 1,000 times more likely to die from mistakes than airline passengers.

The article noted that tracking medical errors has gotten more difficult instead of easier. This has occurred in part because Congress, under pressure from the hospital industry, rejected the Institute of Medicine's recommendation to create a mandatory national reporting system to track medical errors.

Janet Corrigan of the Institute of Medicine, study director for the original errors report stated her disappointment in the lack of progress. “Many of us who worked very closely on this project had hoped that we would have made more progress by now." She continued, "We do realize that what we're trying to change is one-seventh of the economy. The health-care sector is tough to turn around."

ADHD Helped With Chiropractic, A Case Study

In the October 2004 issue of the peer-reviewed research publication, the Journal of Manipulative and Physiological Therapeutics (JMPT), comes a case study of a child with ADHD (Attention-Deficit/Hyperactivity Disorder), who was helped with chiropractic.

The case was of a 5 year old boy who had been diagnosed with ADHD at age 2. The child’s pediatrician prescribed methylphenidate (Ritalin), Adderall, and Haldol for the next 3 years. The combination of drugs was unsuccessful in helping the child.

At age 5 the child was brought to a chiropractor to see if chiropractic care would help. The history taken at that time noted that during the child’s birth, there were complications during his delivery process. The results of this trauma and complications resulted in a 4-day stay in the neonatal intensive care unit. The child’s mother reported no other incidence of trauma.

The chiropractic examination and x-rays showed noticeable spinal distortion including a reversal of the normal neck curve indicative of subluxations. Chiropractic care was begun and the child’s progress was monitored.

According to his mother, positive changes in her son's general behavior were noticed around the twelfth visit. By the 27th visit the patient had experienced considerable improvement.

The child was brought by the mother to the medical doctor for a follow up visit and questioned the usage of the Ritalin. The medical doctor reviewed and examined the child and based on that assessment and his clinical experience, the MD felt that the young boy was no longer exhibiting symptoms associated with ADHD. He then took the boy off the medications that he had been taking for 3 years.

The conclusion of the author of the JMPT case study noted, “The patient experienced significant reduction in symptoms. Additionally, the medical doctor concluded that the reduction in symptoms was significant enough to discontinue the medication.”

Conflicts of Interest Affect Government Drug Recommendations

The October 16, 2004 edition of the USA Today carried a story that exposes the vast conflicts of interest many government doctors have in their capacity of making recommendations that affect the health of the public.

The story starts by exposing that a number of the famous doctors who advised the government recently on new cholesterol guidelines for the public, were also closely tied to the companies that make the cholesterol drugs. The USA Today article noted that eight of the nine doctors were making money from the very companies whose cholesterol-lowering drugs they were urging more Americans to take. Two of the doctors even owned stock in the companies. Two others went to work for drug companies shortly after working on the cholesterol guidelines. Another was a senior government scientist who moonlighted for 10 companies and even serves on one of their boards.

Dr. Scott Grundy, a University of Texas Southwestern Medical Center cardiologist who headed the cholesterol panel, noted, “The government is not producing drugs. All the big statin trials have been paid for by the companies.” This brings into question the motives behind recommendations where those recommendations could benefit the very doctors who work for the government and are making those recommendations.

The article notes that the drug industry spent $2 billion in 2001 on events for doctors. This figure was double the amount they spent just five years ago. Dr. Jerome Kassirer, former editor-in-chief of the New England Journal of Medicine, writes in his new book, "On the Take", “The time has come to ask whether all of the money floating around medicine has created a pattern of corruption.”

The USA Today article did interview a number of the doctors on the panel. They all admitted having ties to the drug companies but stated that it did not affect their recommendations and that the money they received was in most cases minimal.

The article also interviewed a number of other doctors who had no ties to the drug companies and said they would be more than willing to serve on the recommendation panels. Dr. Frank Gold, who in 30 years as a cardiologist has taken no consulting or lecture fees from industry stated, “I'm squeaky-clean," he says, and "would jump at the opportunity" to serve on a guidelines panel. "There are tons of people like me, and they're even in places like Des Moines."

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