How clean is your office?

By Terry A. Rondberg

Like many wellness practitioners, I don’t believe in the traditional “germ theory.” Of course I know germs exist, but I don’t think they “cause” illness. The true cause is the inability of the human body to deal with germs and counter their effects. After all, if germs were the actual root cause of illness, everyone who came into contact with them would be ill — that is, ALL of us!

Hand hygeineHaving said that, most of the people we see in our offices have impaired immune systems, to some degree or another. The existence of subluxations; the lack of proper diet or exercise; the overuse of antibiotics; and even physical, mental or emotional stress can all weaken the immune system to the point where the body is vulnerable to the impact of germs and viruses.

That’s why proper infection control procedures are critical in any wellness office. Unfortunately, this basic tenet of hygiene is often overlooked in medical settings. In fact, a report published in the June 9 issue of JAMA found that such lapses were common in many of the 70 ambulatory surgical centers studied. These centers are rapidly becoming the primary facility for a wide variety of medical and surgical procedures that don’t require hospitalization. In 2007, these facilities performed more than 6 million procedures including endoscopy, pain injections, and dental procedures.

The problem is, these places are often germ breeding environments where medical personnel don’t adhere to basic infection control procedures such as washing their hands.

Melissa K. Schaefer, MD, of the Centers for Disease Control and Prevention, Atlanta, and colleagues conducted the study and assessed procedures in five different categories: hand hygiene, injection safety and medication handling, equipment reprocessing, environmental cleaning, and handling of blood glucose monitoring equipment.

More than half of the facilities (67.6%) studied had at least one lapse in infection control noted by surveyors and 17.6% of the facilities had lapses identified in three or more categories.

Nearly one in five facilities (19.4%) didn’t properly apply “hand hygiene” (a euphemism for washing hands!) or use proper personal protective equipment such as gloves. More than one quarter of them (28.4%) had deficiencies related to injection practices or medication handling, primarily through use of single-dose vials for more than one patient.

Another 28.4% of these facilities failed to adhere to recommended practices regarding reprocessing of surgical equipment; and 18.8% didn’t properly clean high-touch surfaces in patient care areas.

Thankfully, chiropractors don’t have to be concerned with the high risk procedures involving injections and drugs, but tables and other high-touch surfaces need to be kept clean and disinfected.

The recommendations given by researchers from Parker Chiropractic College — published in Chiropractic & Osteopathy in 2007 — are excellent. They stated:

“Pathogenic microbes may be present on chiropractic treatment tables and can be effectively killed with proper disinfecting. Hand washing/sanitizing is an important measure in infection control as is table disinfecting. Rudimentary behavioral changes to improve chiropractic clinic infection control are needed. More comprehensive behavioral models are needed. All teaching clinics and private chiropractic offices should adopt infection control practices including routine table disinfecting and hand sanitizing. Effective measures can be put in place at minimal costs.”

References: JAMA. 2010;303[22]:2273-2279 — Abstract

“Assessment and risk reduction of infectious pathogens on chiropractic treatment tables,” Chiropractic & Osteopathy 2007

Research and Public Perception

by Terry A. Rondberg, DC

The media constantly communicates to its vast audience the recent medical breakthroughs. Traditional medicine dominates our society. The recent medical mishaps such as dangerous prescription painkillers, are associated with the failures of regulators who ignore the apparent loopholes of allopathic medicine.

However, alternative health care is gaining attention. It is commonly utilized by the general population. A recent study by Hong at Ohio State University found that nearly three out of four adults over age 50 use some type of alternative medicine. Hong noted, “The most commonly used…was chiropractic, which about 43% of respondents had used.” [1]

Research and Public Perception - by Dr. Terry RondbergUnfortunately, the general public is unaware of chiropractic’s potential contribution to overall wellness.

According to the results of the World Federation of Chiropractic (WFC) survey titled, “Identity of the Chiropractic Profession,” only five percent of participating DCs believed the public considers that chiropractors are doctors who correct subluxations, while 81% believe the public defines chiropractic as doctors who help treat back and neck pain.” [2]

Eighty‑five percent of the chiropractors said the nervous system is essential to the practice of chiropractic, and 65% indicated the public should define chiropractic as stress and  subluxation correction.

In 2003, the Institute for Social Research at Ohio Northern University conducted a survey of  North American chiropractors.  The results showed that 89.8% of respondents felt adjustments should not be limited to musculoskeletal conditions and 88.1% felt that the term vertebral subluxation complex should be withheld. [3]

Some chiropractors have expressed that the public perception should identity the profession. Others wish to limit our role to musculoskeletal pain practitioners, justifying their position by claiming that only low back pain has sufficient research evidence and backing. Both sides are incorrect for reasons I have discussed elsewhere. [4,5]

A successful public relations approach should match the public’s interest with our vision of chiropractic. It is necessary for the public to be properly educated on how chiropractic meets their needs.

The success of this strategy came to light when Dr. Madeline Beherendt’s study on infertility was published in the Journal of Vertebral Subluxation Research, (JVSR) which resulted in positive and credible media coverage for chiropractic.

Among the television programs reporting the study’s results were: KBCI Boise, WCBS New York, KING Seattle, KYW Philadelphia, WTNH New Haven, KUTV Salt Lake City, WCPO Cincinnati, WOAI San Antonio, KOLD Tucson, and KPTM Omaha. On one of the specialized health news wire services, the press release was accessed by journalists more than 700 times by the end of March. [6]

Furthermore, Dr. Erin Elster, an upper cervical chiropractor in Boulder, Colo., gathered data from 44 MS patients and 37 PD patients treated during the span of five years. After treating upper neck injuries in 81 patients, 91% of MS patients and 92% of PD patients improved, suggesting that correction of neck injuries may reverse MS and PD.

The Chiropractic Journal reported, “The World Chiropractic Alliance (WCA), publisher of JVSR, distributed a press release on the research results, which was quickly picked up by major news media, including Reuter’s wire service. The news was relayed to newspapers and television stations around the world, and the story showed up in a wide array of media.

“Viewers watching CNN coverage of the Florida hurricanes saw the headline scroll by on the late breaking news crawl … readers saw all the details in The Washington Post … Internet browsers found the story on sites as varied as the National Institutes of Health’s MEDLINE and the Armenian Medical Network. Yahoo News featured the story and it even appeared on the Merck pharmaceutical company’s website.

“Within days, millions of people were exposed to information about chiropractic and how correction of subluxations might result in an improvement or reversal MS and PD. Although the research examined the two specific diseases, the press release emphasized that the role of chiropractic was not to diagnose or treat those diseases directly, but to correct subluxations and, in doing so, affect the progress of the diseases.” [7]

More recently, a collaborative study of chiropractic care, oxidative stress, and DNA repair has peeked the interests of medical news services and alternative health websites. [8, 9]

The public and journalists are not interested in “manipulation” for the treatment of low back pain. However, they are interested in learning about chiropractic as a focal point on wellness and quality‑of‑life issues often neglected by traditional medicine.

The answer is university-based research and not just a few studies focusing on small case histories. Although encouraging, a long‑term solution must be implemented. The university based research, should involve thousands of patients, and published in prestigious, medical journals. The group QOLR has embodied this challenge but your assistance is paramount.

References

1. Hong G‑S: “About 70 percent of older adults use alternative medicine.” News release. Ohio State University . April 9, 2005.
2. “Consultation on Identity: Quantitative Research Findings.” World Federation of Chiropractic, Dec. 7, 2004.
3. McDonald W, Durkin K, Iseman S, et al: “How Chiropractors Think and Practice.” Institute for Social Research. Ohio Northern University. Ada , OH . 2003.
4. Kent C: “A challenge and three myths.” The Chiropractic Journal. September 2004.
5. Kent C: “Where are we going?” The Chiropractic Journal. August 1997.
6. “Infertility research still a top news story in U.S.” The Chiropractic Journal. May 2004.
7. JVSR, WCA hit two more publicity home runs. The Chiropractic Journal. October 2004.
8. “Chiropractic Influence on Oxidative Stress and DNA Repair.” Medical News Today. March 7, 2005.
9. “Doctors crack code on chiropractic care.” Mercola.com. 4/27/05.

About the Author – Dr. Terry Rondberg
Terry A. Rondberg, DC, is a tireless advocate for drug-free chiropractic, chiropractic patients, wellness, and the mind-body connection for physical, mental, emotional and spiritual well-being. As CEO of the World Chiropractic Alliance, he is a global activist for the interests of doctors of chiropractic and their patients.

Chiropractic Research – Dr. Terry Rondberg

xray of human spineMillions of people around the globe have received chiropractic care and know its value. But the rest of the population dismisses the profession’s growth and patient testimonials as shoddy evidence.

Regrettably, scientists have only a few studies showing correlations between the quality-of-life changes and chiropractic care. Most scientific clinical studies suggest chiropractic as a treatment for adult low-back pain, thus limiting chiropractic care.

The public only hears: “…there is no evidence that any chiropractic treatment works for infants and/or kids.”  (Healthwatcher.net) – or – “I am not aware of any chiropractic research that has led to any significant improvement in patient care.” (Stephen Barrett, MD)

Supporters of chiropractic care are aware of this false perception and its negative affects on the general public.

“The dearth of defensible information about chiropractic and chiropractors is still hampering our external ability to integrate successfully with the rest of the so-called health industry…. Let’s face it. We have a massive fact deficit in chiropractic.” (William Meeker, DC, MPH, FICC, director of the Palmer Center for Chiropractic Research)

“Whether the practice of chiropractic is of any value to the patient cannot be known with certainty until a scientific base has been established. …It is clearly apparent that it would be beneficial to the public for the profession to systematically study the subluxation as it relates to the health of the patient. Chiropractic can be observed and measured.” (The National Upper Cervical Chiropractic Research Association)

“The Committee believes additional research is necessary to further quantify the already‑known benefits of chiropractic care.” (US Senate Appropriations Committee hearings on ‘Health Care Access and Cost Containment Strategies’)

“Evidence of the value of spinal manipulation for problems other than low-back pain is less extensive, and the role that subluxation (of other forms of joint dysfunction) may play in causing and/or providing relief through adjusting is uncertain.” (“In the Quest for Cultural Authority,” Joseph Keating, DC, et. a., Dynamic Chiropractic, December 16, 2004.)

“The claim that loss of neural integrity influences ‘organ system function and general health’ is also unsubstantiated by currently available experimental data. … assertions may be appropriate as hypotheses (tentative assertions) and proto-theories (from which testable propositions may be derived), and deserve our critical attention by means of research. However, to assert their validity in the absence of hard scientific data is to engage in dogmatism.” (Joseph Keating, Dynamic Chiropractic, Dec. 16, 2004)

The answer lies in thoroughly conducted scientific research and observing the mechanisms surrounding chiropractic care such as stress reduction on the autonomic nervous system and wellness. The results must then be reviewed by chiropractic experts and other professionals with the appropriate credentials to write and review research reports.  At that time, reports should be submitted to major health journals for publication.

It’s insufficient to research solely manual manipulation’s effectiveness as a resolution for musculoskeletal conditions such as low-back pain. Such technicalities only reemphasize the false belief that chiropractic is just physical therapy that can be provided by regular physician and physical therapists. Should this remain to be the only field of chiropractic research, it will be utilized as evidence to limit chiropractic care.

The chiropractic theory claims that stress on the nervous system negatively impacts overall wellness.  Such health-like components like immunity, vitality, and well-being must be measured.  It is essential to conduct research to confirm this supposal.

Research must compare and contrast the individual’s state of health before and after receiving chiropractic care. Our goal is to develop a standard rating system measuring the severity of stress on the nervous system and integrating it to measure the noteworthy result of chiropractic care. With this rating system, the next step is to create a formula connecting outcome results and the impact on a patient’s level of stress.

This method has gained popularity in epidemiology. It is also used for studying sleep apnea severities. (Journal of Subluxation Research, 3:24-30, 1999.) Upon completion, this formula will function as a universal standard for chiropractic care and wellness.

A detailed analysis of database findings of millions of chiropractic patients can disclose direct links between stress and wellness. The findings could lead to ground-breaking information regarding the impact of chiropractic on the human nervous system and overall health.

About the Author
Terry A. Rondberg, DC, is a leading proponent of research to demonstrate the benefits of chiropractic care on patients, not only for back pain but also for the brain, the heart, the nervous system and total body wellness. He is a sought-after public speaker, author and advocate for millions of chiropractic patients and practitioners.

Neurological Activity (Part Two) – By Terry A. Rondberg, DC

Part Two of three articles.

Understanding the brain is fascinating, but I must caution that despite stunning achievements, scientists know little about how we apply our knowledge to real-world settings. If we understood how the brain knows to pick up a glass of water to drink, that would be a major achievement. Non-scientists understand even less. I encourage everyone to be a bit skeptical about what they read in the popular press. Occasionally, I read an article that states the new brain science can improve business practice, and I’ll say, “Really?” We use our brains in business management, but it’s premature to predict how the revolution in neuroscience will affect the way executives manage their organizations.

Some things we’ve learned have great practical value. Let’s examine the impact of stress on the brain. Stress hurts the brain, which inevitably affects workplace productivity. The brain was created to survive jungles and grasslands and to endure acute stress. For instance, a saber-toothed tiger will either eat a human or force him to run away. In either case, the stress level decreases in less than a minute. One can have several of these spikes throughout the day and cope. In fact, stress is beneficial since it makes our muscles move. But man was created to handle stress for only 30 to 60 seconds. Today, our stress level is measured not in moments with mountain lions, but in hours, days, and months, as we experience hectic careers, screaming toddlers, marital issues, and financial problems. Our bodies aren’t built for this kind of ongoing stress. If you have the tiger at your doorstep for years, then various internal mechanisms break down, from sleep rhythms to specific parts of the immune system. Enduring chronic stress resembles taking an airplane and sticking it in water. Just like the airplane wasn’t built to be in water, the brain wasn’t built to endure chronic stress.

The biggest disgrace of modern medicine involves physicians prescribing unnecessary drugs that have not been thoroughly researched and performing unproven procedures on patients. This is one reason why more than 100,000 people die each year in the U.S. due to the medical care they are given.  Thank God for chiropractic.  But are we any different? We adjust patients on the premise that subluxations have a negative affect on their health, but do we have valid, scientific evidence to support this claim? We know this is true from our first hand clinical experience and we have some research for corroboration, but we do not yet have the necessary, indisputable evidence that accompanies large-scale clinical outcomes. We expect that someday we will prove to the world that the neuromusculoskeletal changes resulting from chiropractic adjustments can result in life-enhancing affect on all organic functions. Research will show that chiropractic strengthens the immune system, aids the body to defend against a variety of diseases and conditions, while improving the quality of life which we believe leads to a longer, healthier and happier life.

Too often chiropractic is viewed as a treatment for musculoskeletal disorders, disregarding the neurological aspect. When I first read The Chiropractic Journal’s commentary, “Do you want to re-define medical necessity?” by John Davila, DC, I found myself nodding vigorously in agreement, especially when he states, “The neurological component of the subluxation is our greatest weapon to expanding the definition of medical necessity.”

We will see in the next article how ignoring the neurological component of chiropractic is harmful to the profession.

About the Author – Terry A. Rondberg, DC.

As CEO of the World Chiropractic Alliance, Dr. Terry Rondberg is known globally as one of the chiropractic profession’s leading figures. For decades, he has shown tremendous commitment to the chiropractic profession. After receiving his Doctor of Chiropractic (DC) Dr. Rondberg began publishing The Chiropractic Journal, a professionally edited news source for chiropractic. In addition to publishing the Journal, Dr. Rondberg has written a number of best-selling books on the subject of chiropractic.