Terry A. Rondberg, DC | Wellness for Mind and Body

By Terry A. Rondberg

Being the target of a malpractice lawsuit doesn’t necessarily indicate incompetence or unprofessional behavior for any individual practitioner. Too many lawsuits are filed because of ignorance, lack of understanding, inaccurate expectations, unrelated personality conflicts, arguments over billing, and — sadly — greed.

Still, in general, the number of malpractice lawsuits filed against a profession or professional subsection can be roughly equated to the overall safety of that discipline. That’s why a riskier specialty like obstetrics or neurosurgery are associated with higher rates of malpractice lawsuits whereas lower risk approaches like chiropractic and acupuncture enjoy a far lower rate of legal actions.

It’s significant, therefore, to find that by late in their career, nearly two-thirds (61%) of all medical doctors have been sued, according to a study conducted by the American Medical Association.

The study analyzed data from 5,825 physicians who responded to the AMA’s Physician Practice Information survey, which examined costs of medical practice and associated factors from 2007 to 2008. The study revealed that, for the physicians surveyed, there were 95 medical liability claims filed for every 100 physicians — almost one per doctor. Highlights in the report include the following realities:

… Nearly 61% of physicians age 55 and over have been sued.

… Before they reach the age of 40, more than 50% of obstetricians/gynecologists have already been sued.

… 90% of general surgeons age 55 and over have been sued.

The study notes that 65% of the claims are dropped or dismissed, but doesn’t specify what percentage were settled out of court in the plaintiff’s favor. Average defense costs per claim range from a low of more than $22,000 among claims that are dropped or dismissed to a high of over $100,000 for cases that go to trial, the reported noted.

Although exact figures are not available for the chiropractic profession, it’s obviously far, far lower than those seen among even the “safest” of medical specialties. That’s reflected in the malpractice insurance rates as well as in the courts.

The information on the rate of lawsuits against MDs is good to keep on hand next time a patient or interested member of the public wonders about the safety of chiropractic!

SOURCE: Source: AMA Policy Research Perspectives, “Medical Liability Claim Frequency: A 2007-2008 Snapshot of Physicians,” August 2010 (www.ama-assn.org/ama1/pub/upload/mm/363/prp-201001-claim-freq.pdf)

About the Author – Terry A. Rondberg, DC
Dr. Terry A. Rondberg is founder of the World Chiropractic Alliance, as well as serving as its CEO. He is an staunch advocate for drug-free chiropractic care, not only for the spine for for the whole body. He traveled the world to speak on the issue of CAM in general — and chiropractice in particular –  and the shortcomings of our current healthcare system.

A recent report published in the Journal of the American Medical Association (JAMA) revealed that many medical doctors have direct, personal knowledge of an impaired or incompetent physician in their workplaces but won’t report them.

The researchers, led by Catherine DesRoches of Harvard Medical School, surveyed 1,891 practicing US doctors in order to “understand physicians’ beliefs, preparedness, and actual experiences related to colleagues who are impaired or incompetent to practice medicine.”

A majority of the doctors surveyed (64%) said they agreed that it was important to report other MDs who were “significantly impaired or otherwise incompetent to practice.” But just 69% said they were prepared to really do anything about the situation if it came up in their practice.

More shocking was the revelation that 17% of the doctors had direct personal knowledge of a physician colleague who was incompetent to practice medicine in their hospital, group, or practice. But of those, a full one third (33%) had not reported the colleague to the relevant authority.

The reasons they gave for their silence were the belief that someone else would take care of the problem (19%), the belief that nothing would happen as a result of the report (15%) and fear of retribution (12%).

The actual numbers might be even higher since, of the 2,938 physicians contacted, only 1,891 agreed to take the survey — the other 36% might have decided the questions were a bit too delicate to answer.

As bad as this sounds, I wonder how it differs from the chiropractic profession (or any health care profession). Granted, an incompetent chiropractor is far less of a threat to a patient’s well being than an incompetent MD, but what do we do when we realize a fellow DC is significantly impaired? If we know a colleague is drinking or using drugs during work, or is otherwise unfit to care for patients, do we report him or her to the board?

I realize that there have been many (far too many) cases where chiropractors have “tattled” on their competition for the most trivial infractions of the rules, but that’s a far cry from accusing another practitioner of being incompetent.

This is one of those grey areas that require soul searching and total honesty. If we truly believe that a colleague might do any harm to patients or to the profession as a whole, we owe it to those patients and chiropractic to take a courageous stand. We might try approaching the doctor and discussing the situation with him or her, offering to assist in getting the person proper help overcoming the problem. If that doesn’t work, we may have no choice but to file a complaint with the state board.

SOURCE: “Physicians’ Perceptions, Preparedness for Reporting, and Experiences Related to Impaired and Incompetent Colleagues,” JAMA. 2010;304(2):187-193. doi:10.1001/jama.2010.921

Seemingly every day, science finds more evidence to prove that what we THINK is critical to how we FEEL, physically as well as emotionally. To a great degree, our thoughts can, and do, regulate our health. While intelligence is distributed throughout the entire body, the brain is the central processing location, the “Grand Central Station ” of the network of nerve impulses. We teach this to our patients when describing the benefits of chiropractic, acupuncture, or other neurologically based health care.

It would probably be a good idea, then, to make sure they have some basic information on how they can maintain and improve brain health at all stages of life.

John H. Byrne, Ph.D., professor and chairman of the Department of Neurobiology and Anatomy at the University of Texas Health Science Center (UTHealth) at Houston Medical School, studies the neuronal and molecular mechanisms underlying learning and memory. Here are three tips he offers for maintaining and improving brain health. Giving this list to your patients will be one more way you can help them live longer, healthier lives.

1) Exercise

“Everyone knows that exercise is good for the heart, but what they may not know is that exercise also appears to be good for the brain,” said Dr. Byrne, the June and Virgil Waggoner Chair. “There is a lot of recent evidence demonstrating that exercise itself promotes neurogenesis — the generation of new nerve cells in the brain. It had long been believed that once you lose nerve cells, they are gone for good and the brain cannot regenerate them, but exercise appears to inspire the brain’s ability to generate nerve cells.”

2) Diet

“There are certain ‘brain foods’ that seem to have a benefit on the brain,” Byrne said. “New research shows that Omega-3 fatty acids, such as those found in salmon and other fish, may build the brain’s gray matter. Foods and beverages that are rich in antioxidants may also help keep the brain sharp. For brain food, consider a glass of red wine, some salmon, blueberries, a little bit of chocolate or a cup of green tea. Foods, indeed, can play a role in brain health, but remember, everything in moderation. Research shows that those who are obese have a higher incidence of Alzheimer’s disease and other diseases that affect the brain. Staying slim appears to promote brain health, so exercise, watch your calories and eat the right types of food.”

Naturally, there are some “qualifications” to that advice. Taking the cue from Byrne’s counsel “everything in moderation,” a glass of red wine is good… a bottle isn’t. Dark or raw chocolate is good… milk chocolate isn’t. Salmon and selected other fish in small quantities is good… mercury-laden species or fried fish isn’t.

3) Brain activity

“You’ve heard the saying,’Use it or lose it.’ It’s true,” Byrne said. Those who are intellectually active have a lower incidence of Alzheimer’s. You must exercise your brain cells just as you exercise your muscles, so read a book or do a crossword puzzle. Those types of activities can protect your brain. There is also evidence that social activities help to promote brain health. Interacting with others stimulates the brain.”

SOURCE: University of Texas Health Science Center at Houston

One of the staff members of the newspaper I founded and publish, The Chiropractic Journal, gave birth to a healthy son last month. We all cheered the occasion, knowing that this child will grow up in a world that has discovered the true meaning of health and wellness.

It’s incredible to think that the work we do now, educating the public about the dangers and risks of drugs and invasive medical procedures, will improve the lives of generations to come. In that infant’s lifetime, we’ll make astounding advancements in what is now being called the “new biology,” and in the field of energy healing.

Most wellness practitioners, including chiropractors, fully understand that stress is the key factor in most — if not all — chronic illnesses, since it effectively shuts down the immune system. In a study appearing in the current online edition of the journal Proceedings of the National Academy of Sciences, researchers concluded (not for the first time) that stress increases the inflammatory activity that is part of our immune system’s natural response to potentially harmful situations. “Frequent or chronic activation of the system may increase risk for a variety of disorders, including asthma, rheumatoid arthritis, cardiovascular disease, and even depression,” stated lead researcher George Slavich, a postdoctoral fellow in the UCLA Cousins Center for Psychoneuroimmunology. Also included in the list of diseases that could be triggered by stress were certain types of cancer. (Abstract available online

What many people don’t know — including some doctors — is that the stress levels of pregnant women can affect the health of their unborn babies. In 2007, a study published in the journal Clinical Endocrinology, Stress revealed that high stress levels during pregnancy may affect the unborn baby as early as 17 weeks after conception, with potentially harmful effects on brain and development. Another research study linked stress during pregnancy to premature and low-weight births.

Obviously, stress reduction is critical for all people wanting to maintain a high level of health — but it’s even more important for pregnant women. After all, they’re pumping stress hormones for two!

On a lighter note, several research studies have found that eating some types of chocolate (dark and raw chocolate particularly) during pregnancy can be beneficial to the child, partially because it tends to alleviate some of the woman’s stress.

A Yale study published in Epidemiology, May 2008, claimed chocolate during pregnancy reduces the risk of preeclampsia, a major pregnancy complication. Another study — this one published in Early Human Development back in 2004 — found that babies born to women who ate chocolate every day while they were pregnant were more active and “positively reactive” (meaning they smiled and laughed more). They also showed less fear of new situations than babies of stressed women who didn’t indulge their sweet tooth in chocolate!

So, forget the meds … pass the chocolate!

By Terry A. Rondberg, DC

A commentary published in the July 28 issue of the Journal of the American Medical Association (JAMA) revealed that diagnostic errors are the single largest contributor to medical malpractice claims, accounting for about about 40% of all claims and costing approximately $300,000 per claim.

The authors — Mark Graber, MD, of Stony Brook University Medical Center; and Hardeep Singh, MD, MPH, of Baylor College of Medicine — pointed their fingers at everything BUT the practitioners themselves.

“The great majority of diagnostic errors have root causes that derive from the properties of the healthcare setting, organization and practice,” Dr. Graber said. “By working together, cognitive scientists, informaticians, clinicians, and human factors engineers have a unique opportunity to decrease the likelihood of diagnostic error to the extent that the five principles we outline in JAMA can be incorporated into every new medical home.”

The authors discussed a new model of primary care, called the patient-centered medical home, developed and endorsed by the American Academy of Family Physicians, the American Academy of Pediatrics, American College of Physicians, and the American Osteopathic Association.

The model facilitates partnerships between individual patients, their personal physician, and, when appropriate, the patient’s family. Care is assisted by physician “extenders,” nurse empowerment, information technology, and other means to assure that patients get care when and where they need and want it in a culturally and linguistically appropriate manner.

The medical home model places emphasis on team-based care, and primary care teams could include not only physicians but also nurses, allied health professionals and personnel, the authors explained.

In this model, the medical doctor would be the gatekeeper and decide what role the “allied” health professions would have. “The physician could take a leadership role, while the entire group collectively takes care of the patient,” explained Dr. Singh.

It’s always heartening to see the medical profession recognize and admit the problems inherent in the current disease-oriented system, such as misdiagnoses, prescription errors, unnecessary surgeries, etc.

Still, I’ll continue to work toward the time when we supplant the old paradigm of labeling and treating conditions and symptoms with the new holistic view of the human body as a complex system of energy patterns that responds to non-invasive care such as chiropractic and other “energy medicine” approaches. And I especially look forward to the time when we don’t label all wellness and healing modalities as “medicine!”

By Terry A. Rondberg

In recent years, researchers have piled up the proof that many of the prescription and OTC pills sold to “treat” colds and flu in kids are ineffective. Even worse, they all have potentially negative side effects. One study, conducted by researchers at Penn State, found that placebos were just as effective as OTC drugs in suppressing coughs due to colds.

“Consumers spend billions of dollars each year on over-the-counter medications for cough,” said Ian Paul, assistant professor of pediatrics, Penn State Children’s Hospital, Penn State Milton S. Hershey Medical Center. “Our study showed that the two ingredients used in most over-the-counter medications were no better than a placebo, non-medicated syrup, in providing nighttime relief for children with cough and sleep difficulty as a result of upper respiratory infection… The desire to ease symptoms is strong for both parents and clinicians. This study, however, questions whether over-the-counter medications have a place in the treatment of these illnesses for children.” (“Effect of Dextromethorphan, Diphenhydramine and Placebo on Nocturnal Cough and Sleep Quality for Coughing Children and Their Parents,” July 2004 issue of Pediatrics.

Another study showed a significant percentage of children with attention-deficit-hyperactivity disorder improved when placebos replaced some of their daily meds.

“In ADHD, you can reduce the dose of the real medicine, substitute placebo pills and get the same effect on ADHD,” Walter Brown, MD, Clinical Professor of Psychiatry at Brown University and Tufts University School of Medicine, stated.

One theory is that the caring and hopeful attitude of the parents or caregivers has a powerful effect on the child. If the parent and child have a strong belief in the efficacy of the remedy, it will work. In the tests, participants had no more “faith” in one pill over another, so they all worked about the same. That’s the very definition of placebo effect.

You’d think that, given this evidence, parents — and their medical doctors — would be convinced that grabbing the pill bottle isn’t the best response to sniffles and sneezes.

But that’s not the way some people see it. Now, there’s a new pill being marketed to parents for use on their kids: a chewable, cherry-flavored tablet called Obecalp. You guessed it: that’s placebo spelled backwards, and the pill is nothing but sugar.

Giving a child a sugar pill is definitely an improvement to giving them chemical medications. But this still teaches the child that health can be delivered in pill form from outside. Why not skip the pill altogether and try activities such as yoga or meditation, both of which can be presented as a game or healing action? Health comes from INSIDE and the sooner we truly understand that, and share that understanding with our kids, the sooner they’ll take control of their health and wellness.

Allopathic medicine has a long history of “inventing” diseases and giving them fancy Latin names — all in order to come up with a pill or treatment to “cure” it.

But this one gets the absurdus maximus award — a Californian doctor, Steven Bratman, has “medicalized” a strong conscious desire to eat healthy, nutritional foods as a mental disorder! And, of course, he’s given it a name: orthorexia nervosa.

These poor demented souls are, as reported in The Guardian, “solely concerned with the quality of the food they put in their bodies, refining and restricting their diets according to their personal understanding of which foods are truly ‘pure’.”

They follow crazy behavior, like trying to eliminate refined sugar, salt, caffeine, alcohol, or other food groups from their diet. And they rebuff foods that have been in contact with pesticides, herbicides or contain artificial additives.

Granted, there are people who get a bit neurotic about food safety and base their dietary choices on fear rather than good sense. But the idea of turning food concerns into a mental health disease is just one more instance of medical manipulation.

While an anti-orthorexia drug hasn’t been developed — yet — Bratman quickly cashed in on his “disease” by writing a book called, “Health Food Junkies.”  I’m gratified to see it didn’t make much of a blip on the sales lists and got a dismal review score on Amazon.com (just 3 stars out of 5, with one person echoing my own feelings, saying, “So it is now a fixation to ‘obsess’ about healthy food? This is the most stupid, irresponsible drivel I have ever heard of. Ok, let’s NOT obsess about food, let’s keep eating meat, and dairy, and preservatives, and chemicals, let’s eat genetically modified food, let’s NOT read labels, let’s NOT think about what’s in our food, let’s keep getting diabetes, cancer and heart disease which NO DOCTOR has ANY CURE FOR!!! Just treatment, NO CURE. Let’s do that. Because doctors are so good at curing diseases. That’s why we are such a healthy nation! Mind-numbingly irresponsible, for a physician to write this.” I swear, I didn’t write that (but wish I had!). Here’s the Amazon page, just so you can read some of the other scathing reviews!

Not surprisingly, Bratman’s ideas have been picked up by the British medical community, which seems intent on destroying everything that isn’t totally aligned with the allopathic paradigm, be it homeopathy or, now, healthy eating!

Ursula Philpot, chair of the British Dietetic Association’s mental health group, told The Guardian: “The issues underlying orthorexia are often the same as anorexia and the two conditions can overlap but orthorexia is very definitely a distinct disorder. Those most susceptible are middle-class, well-educated people who read about food scares in the papers, research them on the internet, and have the time and money to source what they believe to be purer alternatives.”

(Interestingly, the main goal of the association appears to be acceptance by the medical profession, and, in the group’s words to “act as a specialist within a multi-disciplinary team … (and) act as a consultant to other health professionals advising on nutritional aspects of care.” Sounds much like those chiropractors and other alternative health providers who used to be willing to medicalize their professions in order to gain the approval of MDs. By now, most of them realize that’s not going to happen!)

Getting back to the dread “orthorexia nervosa” disease, Wikipedia further explains: “The subject may avoid certain unhealthy foods, such as those containing fats, preservatives, man-made food-additives, animal products, or other ingredients considered by the subject to be unhealthy; if the sufferer does not eat appropriately, malnutrition can ensue. Orthorexia sufferers have specific preferences about the foods they are eating and avoiding. Products that are preserved with additives can be considered dangerous. Industrial products can be seen as artificial, whereas biological fruits and vegetables can be seen as healthy.”

So, unless you relish an apple with a thick coating of pesticide residue, a fast food burger with 80 grams of saturated fat, or a TV dinner with a list of unpronounceable (and unidentifiable) ingredients, you may want to make an appointment with the nearest shrink. You could be a very sick mind (although chances are, you’ll have a heck of a lot healthier body than most!).

The friend who sent me this information — a guy who has a PhD in molecular biology and is finishing his last year interning as a psychiatrist — had a novel suggestion: “How about we come up with a term for a syndrome where certain sciences over-classify and are slaves of the pharmaceutical industry? Maybe inservio supervacuus (superfluous slave).”

When DD Palmer called our profession “chiropractic” — combining the Greek words cheir (hand) and praxis (action) — he couldn’t have chosen a better name. While there are a few doctors who substitute mechanical devices for their hands, even those practitioners have some hands-on work with patients — palpation, adjusting or just placing the hands on affected areas.

We, and our patients, have always known that the success of chiropractic has a great deal to do with the “personal touch” we provide (metaphorically as well as literally). Surveys on patient satisfaction almost always emphasize the influence of our personal involvement with those under our care, particularly when compared to the cold, impersonal treatment received from many medical providers.

A recent research study, sponsored by the National Cancer Institute and presented at the 6th International Conference of the Society for Integrative Oncology, reinforces our understanding of the importance of true “by hand” practice, whether it’s provided by a health care practitioner or a caretaker.

Researchers found that touch — particularly massage — administered by care partners significantly reduces the effects of cancer and the side-effects from its treatment while providing comfort and improvement in the quality of life.

In the study, 97 family caregivers learned touch and massage techniques from a 78-minute instructional DVD, called “Touch, Caring, and Cancer: Simple Instruction for Family and Friends.” They then used these touch techniques to safely care for people living with cancer. “The magnitude of the impact of family members was unexpected. Our research found significant reductions of pain, anxiety, fatigue, depression and nausea when massage was routinely administered at home by family and caregivers,” lead researcher William Collinge, PhD, revealed.

The study found massage by family members reduced stress/anxiety (44% reduction), pain (34%), fatigue (32%), depression (31%), and nausea (29%).

“The discovery that family members can learn and administer simple massage techniques that can consistently reduce stress is significant. Stress is a constant that negatively impacts the lives and wellbeing of cancer patients,” Collinge wrote. “Both cancer patients and caregivers benefit because massage appears to strengthen the relationship bond. Massage provides the caregiver a way to make a difference.”

This research not only reminds us of the significance of personal touch between doctor and patient, but might be a good incentive to bring a massage therapist into your practice. The synergistic effect of the two disciplines would no doubt benefit many patients and might increase patient volume.

You may even want to provide certain patients with the video used to train the participants in the study (it’s available from Amazon.com). I believe strongly that the “hands on” approach works for all people, regardless of the state of their health. Since it reduces stress — the primary cause of most health issues — it would be effective on most people, not just those with cancer.

By Terry A. Rondberg

A new study published by JAMA shows that among patients age 65 years and older, rosiglitazone (a medication for treating Type 2 diabetes) is associated with an increased risk of stroke, heart failure, and all-cause mortality (death) when compared with pioglitazone (another medication for diabetes).

In their conclusion, the authors wrote: “…in a population of more than 227,000 patients 65 years or older who initiated treatment with a thiazolidinedione, we found that, compared with pioglitazone, rosiglitazone was associated with an increased risk of stroke, heart failure, and death and the composite of AMI (heart attack), stroke, heart failure or death.” (JAMA.doi:10.1001/jama.2010.954)

Despite trying to put rosiglitazone in the most “favorable” light possible, researchers had to admit that “analysis showed no differences in the risk for heart attack between rosiglitazone and pioglitazone,” even though the study found that rosiglitazone was associated with a 1.25-fold increase in risk of heart failure compared with pioglitazone.

Obviously, BOTH medications have serious negative side effects, but the report’s wording seems somewhat biased to me so I delved a little deeper. Within the past five years, the study’s head researcher, Steven E. Nissen, MD, has received research support from numerous drug companies, including AstraZeneca, Atherogenics, Novartis, Pfizer, Resverlogix, Daiichi-Sankyo, Sanofi-Aventis and — most importantly — Eli Lilly and Takeda.

The drug that fared better in this study (branded name Actos) is manufactured by Eli Lilly and Takeda. Avandia, the branded version of rosiglitazone, is made by GlaxoSmithKline, a name curiously absent from the list of Nissen’s financial benefactors.

Probably just a coincidence, right? Yet, only this month, the BMJ (which used to be called British Medical Journal) published a report that explored a possible link between authors’ financial conflicts of interest and their position on the association of rosiglitazone with increased risk of myocardial infarction in patients with diabetes.

The research abstract noted: “Of the 202 included articles, 108 (53%) had a conflict of interest statement. Ninety authors (45%) had financial conflicts of interest. Authors who had a favourable view of the risk of myocardial infarction with rosiglitazone were more likely to have financial conflicts of interest with manufacturers of antihyperglycaemic agents in general, and with rosiglitazone manufacturers in particular, than authors who had an unfavourable view (rate ratio 3.38, 95% CI 2.26 to 5.06 and 4.29, 2.63 to 7.02, respectively). There was likewise a strong association between favourable recommendations on the use of rosiglitazone and financial conflicts of interest (3.36, 1.94 to 5.83)” (BMJ 2010;340:c1344)

In another, even more chilling report (also published in BMJ), the author writes: “Casually following the fortunes of the blockbuster diabetes drug rosiglitazone (Avandia), you can’t help but imagine a Hollywood thriller. There is the scene where a leading scientist secretly records a meeting with drug company executives, a high powered congressional investigation, and a bitter legal battle waiting in the wings. Yet when you look more closely, the facts are even stranger than fiction. An expensive new drug shown to raise the risk of heart failure and suspected of increasing the chance of heart attacks has been taken by millions of people around the world and is being kept on the market by an industry funded regulatory system, despite calls from senior safety experts to withdraw it.” (BMJ 2010;340:c1848)

I took a look at one other factor as well: pricing. The most common price I could find for Avandia — the drug touted as “safer” by the research paper — was $3.32 per pill (for 30 pills of 8mg, which is considered the normal dose). For Actos, the price was $1.34 per pill (for 30 pills of 30mg, again, considered the normal dose).

When it comes to this type of medical drug research, the saying “follow the money” seems to apply. Perhaps it’s also time to follow the advice of “X-Files” character Fox Mulder: TRUST NO ONE.

About Terry A. Rondberg, DC
Terry A. Rondberg is founder and CEO of the World Chiropractic Alliance. He is an ardent advocate for drug-free chiropractic care not just for back pain, but total body wellness. He has spoken globally on the issue of alternative care and the abuses of our current “health care” system.

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!

Having 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