Issue: BCMJ, vol. 50, No. 8, October 2008, Page 436 Letters

I’d like to relate an experience I recently had with a chiropractor in Kelowna. It was both educational and disturbing.

On account of recurring low back pain, my daughter was enthusiastically advised by one of her friends to visit a particular chiropractor who had “the greatest reputation in the world.”

The initial charge of $40 covered a brief consultation and an X-ray of the cervical spine (had she not been referred by a friend this initial visit would have cost $120). My daughter was then invited to return, with a friend, for an evening of group education, followed by a proposed personal care plan. With some considerable curiosity I agreed to accompany her.

Softening up
The panoramic view from his office was breathtaking. The ambience was congenial, refreshments and fruit were available, and Christmas carols played in the background (“Christmas in July”—proceeds from the initial consultation, we were told, would be used for an African charity).

Eight potential clients with “significant others” were present.

We were warmly welcomed, then for the next 40 minutes or so were lectured on the differences between “mechanistic and vitalistic” approaches to health. With evangelical enthusiasm and an occasional mention of God, a polished delivery of pseudoscience outlined convincingly why conventional medicine so often failed.

Build up
Having largely demolished any trust in conventional medicine, he then began to educate the audience on the so-called proven benefits of his brand of chiropractic, focusing particularly on the critical role of the cervical spine in everything from asthma in children to colitis in adults to arthritis in 75 year olds. In no short time he had taught the audience how to label an individual as healthy or sick from the appearance of the cervical spine.

The conversion from mistrust in conventional medicine (mechanistic) to a solid belief in his all-embracing “science” of chiropractic (vitalistic) was now consolidated by providing mul­tiple testimonials, all conveniently printed and contained in folders distributed to the audience.

Prior to the individual assessments he made it clear that to achieve maximum benefit a commitment to the entire program was strongly recommended. Likewise he stressed that clients should be very punctual since each “adjustment” took less than a minute and others were waiting their turn.

When my daughter and I went in for her personal assessment, her cervical spine X-ray indicated (as we had just been taught) that she really was in very serious trouble. However, she noted she had no neck pain whatsoever and that her problem was in her lower back. She was assured that his approach of concentrating on the neck would fix her problem. 

But it would take time—lots of time. A contract of sorts (“Investment Options”) was produced, indicating that the cost for a year’s treatment (three visits a week for 3 months, two visits for 3 months, and one visit a week for the remaining 6 months) would be $4301. Emphasizing that he was sure he could help her, he made it clear that she must now make the decision to be healthy or sick. 

Every effort would be made to accommodate her ability to pay. I remained silent as my daughter indicated she would have to think about it. The charming receptionist told her she would call the next morning to set up appointments. 

I too was asked when I would like to have an appointment for an initial assessment and X-ray. “I’ll call you,” I said politely.

By a remarkable coincidence, about a week later, as I was still mulling over these persuasion techniques reminiscent of religious conversions, one of my patients with MS came to ask my opinion on a recent offer she had been made by an individual who happened to see her struggling in a parking lot, and had offered his help and invited her to attend his chiropractic office. 

She had been exposed to the same persuasive performance by the same individual and wondered what I felt about the issue of spinal adjustments. It quickly was apparent she had already formed her own opinion and felt the only ingredient missing was snake oil. 

She also wondered if there had been a breach of confidentiality when told, on checking in at his office, that “Your doctor and his daughter were here last week.”

I invite comments and feedback!

—Andrew Farquhar, MD

Andrew Farquhar, MD. Chiropractors. BCMJ, Vol. 50, No. 8, October, 2008, Page(s) 436 - Letters.

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