Academy of Chiropractic Personal Injury & Primary Spine Care Program

Quickie Consult 202

From the Desk of Dr. Mark Studin
Academy of Chiropractic
Preamble: Many of the issues I bring to you are very small, yet each issue is just that, an issue. If you take care of the small issues, then you will be able to build and more importantly, focus on the bigger issues...a larger practice and more family time.

“RSD, Innate & Research”

Based on Quickie Consult #200 that was released yesterday, Dr. Thomas Dow, a chiropractor on Long Island in New York and a friend of mine for over 25 years, wrote a very pointed comment about an omission that I made in Quickie Consult #200 and a commentary on innate and research. The following is a string of e-mails that were exchanged as each of us “sparred” on our points. 

FROM: Dr. Dow
I have treated 4-5 RSD patients over the past 25 years and all have gotten relief from chiropractic treatment. Lately I had a patient with 5 year duration RSD in the left foot and she responded fantastically to manipulation under anesthesia.
Causes of RSD...Subluxation?
You forgot about innate?

FROM: Dr. Studin
I forget about nothing...chiropractic, after the disease has been stabilized to maximize the body’s ability is great...It’s like saying I am having a heart attack,...I am going to adjust you because innate will take over...I will choose the paddles and the drugs and then get adjusted after I am not dead so that I can function at my best...If I am dead, then I can’t get well...RSD as a disease is a “fast mover” and there has not been one doctor of chiropractic that I have spoken to nationally that has prevented the devastating sequella of RSD. If you have, then please write a research report so that we all can win. careful as this is not about your gut feeling, this is about following research protocols to prove effective outcomes as lives are at stake here...Mark
PS...this is a challenge to you to do the research.
FROM: Dr. Dow
You stated clearly in your email which I assume is read by hundreds if not thousands of chiropractors that “I personally would never treat an RSD patient". How many chiropractors will take your advice and be afraid to, and tell their patients that chiropractic care will not help them? 

How many patients will never have a chance to experience the release of their innate?

Under treatment, you didn't even list chiropractic as a treatment modality!

Mark, you were once someone that I looked up to in our profession. I can still remember the first health care class I heard you give. You were on fire with such passion and excitement!
That is what got me going and on my path. Yes it was you. Now, frankly I am sad and disappointed.
I could give a rat's ass about research and proving to the world that chiropractic works and that there is subluxation and innate. For decades, the patient's know it from the results and that's all that matters. That is what our pioneers believed, that is why offices were flooded with patients before insurance, and that is why subluxation based offices will be flooded after insurance.


FROM: Dr. Studin
Tom...I agree and disagree with you very much. The part I agree with is, although my intention was to ensure that patients get early intervention, chiropractic should be part of concurrent care if the patient can tolerate the care as many RSD/CRPS patients cannot even have you touch their skin. That has been my experience, but your experience dictated otherwise and I defer to what you have experienced.
The path we have taken has gotten us to 5% of the population under care based upon a belief system with no evidence. The technology now exists to prove what we have theorized over the last 100 years and although I passionately believe in the innate power to heal the body, I refuse to hide behind it. The 90% of the population left behind as a result of us not evolving deserve better from us...All of us!...Mark

FROM Dr. Dow
Dr.'s out here such as I practicing chiropractic and helping those who are sick get well, don't have time to do research. I commend you for doing the research and supplying the profession with great info like your stroke article, pediatric research article, etc. I read everything that you write and I'm sure that you have worked very hard to provide this important information. It is very crucial. Thank You. What I was disappointed with was your telling the profession that you would not treat a patient with RSD. Why? DO you know of any research that says that chiropractic care is contraindicated for persons with RSD, or that it can be dangerous? If so please provide me with that. You did not say that you would not treat a patient with RSD in the acute phase, chronic phase, or give any time frame at all. You simply stated that you would not treat a patient with RSD. You listed many treatments as modalities even psychotherapy and you did not list chiropractic.  I would have listed it first because of the 5 patients that I treated, none of the other modalities helped them. Why didn't you list it? You couldn't because earlier in your presentation you stated that you would NEVER treat a patient with RSD.
And by the way, I do not hide behind innate. There is plenty of research out there that verifies the validity of innate and chiropractic. Just ask Kent and Gentempo. I agree that we need people like you to provide important information so that more than 5% of the population can receive chiropractic; however I do not agree with misleading information or any information that would jeopardize even one patient's chance of getting helped with chiropractic care. Notice I didn't say cured, just like all the other treatments do not cure it but simply can help with the symptoms.
If you believe that innate might help these patients in any way, even if it is in the later phases, please consider making a correction to your article so that other DC's and patients know that chiropractic care is a treatment modality.
Sorry if this has gotten you upset, but this is my profession, that I love and cherish, and I am probably the only one that would have told you how it is. That's what real friends do.

FROM: Dr. Studin
Tom...This doesn’t upset me at all....Field doctors need to write “Case Reports,” a form of research that creates a formal forum so that I could have learned from your experience. If chiropractors nationally took 2 hours of their life to write cases like this, I could have gone beyond my 4 patients of experience, gotten beyond a theory and called you, the author to seek your counsel on how the care for my RSD patient. In addition, this type of material would be published for the world to see and other doctors (medical included) would be referring to you to care for these patients based upon your results.
This is the foundation for caring for 95% of the population and no one should be afraid of documenting for the world to see the results of what we do. As for innate, I don’t care if you call if God-like, voodoo, widgets, left handed smoke shifters of simply “what chiropractors do.” I only know that what we do works. Historically in our profession those words have created a dichotomy so powerful that we as a profession are splintered and has helped to prevent 90% of the rest of the population from being under chiropractic care.
As for research on innate; not only is there none, there is also no research on subluxation. It simply does not exist and is solely a theory to explain what we do. That is sad in 2011. Should I be wrong, please provide me with a copy of any; do not tell me who you “think” has done the research, but get me hard evidence because I have looked and cannot find any. I can find evidence of what we do, but not exactly what it is that we are affecting and certainly none of what subluxation really is.
My RSD experience; I have treated 4 RSD patients and every time I went to touch them, I created more pain, they weren’t able to tolerate it...I do agree that after the initial care and the pain level subsides, that chiropractic can play a very large role in helping the patient and I will amend my words to that affect.
As for being in my face, I have dozens nationally who do that regularly; it keeps me honest and helps put things in perspective while being part of my “checks and balances” to ensure accurate reporting. I Look forward to it and welcome all challenges.
I would like to share with the group our string of e-mails to get others to join the national debate and get people focused on research and case reports. I have really cool plans on resolving busy doctor’s ability to do the research through automating the process. Is that OK with you? I would not use your full name, only Tom...unless you want me to...Mark

FROM: Dr. Dow
I would love to help you in any way I can to help the doctors nationally or internationally and would not mind if you use my name in full as long as you use it in the right context and make your correction so that dc's, medical professionals and patients know that chiropractic care might help patients with RSD with their symptoms.
Someday with your work and others, I know that the public will realize the potential of what we do...Tom

A healthy debate is the only way for chiropractic to evolve. I appreciate the confrontation in a respectful manner and the end result is that our patients win.

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