Abstract
Medical iatrogenesis is at an all-time high with increasing deaths, disability, and costs compounded by unnecessary and ineffective surgeries despite the warnings from WHO, the US Public Health Service, and the Institute of Medicine. One area in particular, failed back surgeries, has drawn increasing attention by researchers due to disproved medical theories and surgical treatments. Paradoxically, while spinal manipulative therapy has been shown to achieve better results for this epidemic of low back pain in particular, medical and insurance programs often limit or boycott this inexpensive and effective treatment, indicating the solution to lowering medical costs and iatrogenesis now rests with political and economic factors primarily.
Key Words: Medical Iatrogenesis, Chiropractic, Joint Dysfunction, Distributive Justice
References
- 1.World Health Organization . The World Health Report 2000: Health SystemsImproving Performance. WHOP; Geneva: 2000. [Google Scholar]
- 2.Institute of Medicine . To err is human: Building a safer health system. National Academy Press; Washington, DC: 1999. [Google Scholar]
- 3.Schuster M, McGlynn E, Brook R. How good is the quality of health care in the United States? Milbank Quarterly. 1998;76:517–563. doi: 10.1111/1468-0009.00105. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Bigos S. Acute low back problems in adults, clinical practice guideline No. 14. AHCPR Pub. No. 95–0642. U.S. Public Health Service, U.S. Department of Health and Human Services; Rockville, MD: December 1994. [Google Scholar]
- 5.Leape LL. Unnecessary surgery. Ann Rev Public Health. 1992;13:363–383. doi: 10.1146/annurev.pu.13.050192.002051. [DOI] [PubMed] [Google Scholar]
- 6.Herman R. Back surgery. Washington Post (Health Section), April 18, 1995.
- 7.Widen M. Back specialists are discouraging the use of surgery. Miami Beach, FL: American Academy of Pain Medicine, 17th Annual Meeting; February 14–18, 2001.
- 8.Waddell G. Low back pain: A twenthieth century health care enigma. Spine. 1996;21:2820–2825. doi: 10.1097/00007632-199612150-00002. [DOI] [PubMed] [Google Scholar]
- 9.Meade TW. Letter to the Editor. BMJ. 1999;319:57. doi: 10.1136/bmj.319.7201.57b. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Berger E. Later postoperative results in 1000 work related lumbar spine conditions. Surg Neurol. 2000;54:101–106. doi: 10.1016/s0090-3019(00)00283-4. [DOI] [PubMed] [Google Scholar]
- 11.Rosomoff HL, Rosomoff RS. Low back pain. Evaluation and management in the primary care setting. Med Clin North Am. 1999;83:643–662. doi: 10.1016/s0025-7125(05)70128-0. [DOI] [PubMed] [Google Scholar]
- 12.Seaman D. Joint complex dysfunction, a novel term to replace subluxation/ subluxation complex. Etiological and treatment considerations. J Manipulative Physiol Ther. 1997;20:634–644. [PubMed] [Google Scholar]
- 13.Deyo RA, Weinstein JN. Low back pain. N Engl J Med. 2001;344:363–370. doi: 10.1056/NEJM200102013440508. [DOI] [PubMed] [Google Scholar]
- 14.Deyo RA. Low back pain. Scientific American. 1998:49–53. doi: 10.1038/scientificamerican0898-48. [DOI] [PubMed] [Google Scholar]
- 15.Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. Unconventional medicine in the United States. Prevalence, costs, and patterns of use. N Engl J Med. 1993;328:246–252. doi: 10.1056/NEJM199301283280406. [DOI] [PubMed] [Google Scholar]
- 16.Deyo RA, Psaty BM, Simon G, Wagner EH, Omenn GS. The messenger under attack-intimidation of researchers by special interest groups. N Engl J Med. 1997;336:1176–1179. doi: 10.1056/NEJM199704173361611. [DOI] [PubMed] [Google Scholar]
- 17.Meade TW, Dyer S, Browne W, Townsend J, Frank AO. Low back pain of mechanical origin: Randomized comparison of chiropractic and hospital outpatient treatment. BMJ. 1990;300:1431–1437. doi: 10.1136/bmj.300.6737.1431. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18.Manga P. The effectiveness and cost-effectiveness of chiropractic management of low-back pain. Ontario Ministry of Health. 1993 [Google Scholar]
- 19.Cary TS. The outcomes and costs of care for acute low back pain among patients seen by primary care practitioners, chiropractors and orthopedic surgeons. N Engl J Med. 1995;333:913–917. doi: 10.1056/NEJM199510053331406. [DOI] [PubMed] [Google Scholar]
- 20.Cherkin DC, Deyo RA, Battie M, Street J, Barlow W. A comparison of physical therapy, chiropractic manipulation, and provision of an educational booklet for the treatment of patients with low back pain. N Engl J Med. 1998;339:1021–1029. doi: 10.1056/NEJM199810083391502. [DOI] [PubMed] [Google Scholar]
- 21.Rosner AL. Flawed study in New England Journal could cause backlash for chiropractic. Advance. Foundation for Chiropractic Education and Research. November/December 1995, Volume 16—Number 4.
- 22.Bezold C. The future of chiropractic: Optimizing health gains. Institute for Alternative Futures; July 1998. [Google Scholar]
- 23.Manga P, Angus D. Enhanced chiropractic coverage under OHIP as a means of reducing health care costs, attaining better health outcomes and achieving equitable access to select health services. Working paper, Universityof Ottawa, 98–02.
- 24.Manga P. Economic case for the integration of chiropractic services into the health care system. J Manipulative Physiol Ther. 2000;23:118–122. doi: 10.1016/s0161-4754(00)90080-0. [DOI] [PubMed] [Google Scholar]
- 25.Chiro Wire. Eli Research, June 4, 2001.
- 26.Mootz R. Demand management: the next big thing? Dynamic Chiropractic, June 4, 2001.
