Few Schools Outside US Teach Subluxation According to Curricular Review by Subluxation Deniers

Matthew McCoy DC, MPH
Few Schools Outside US Teach Subluxation According to Curricular Review by Subluxation Deniers

Should be Considered no More than Pseudoscientific Dogma

Just as their first paper on the prevelence of the word "subluxation" in the curricula of chiropractic schools served as a useful tool for teaching critical thinking to chiropractors and students who embrace the vertebral subluxation construct, the most recent paper by the pied pipers of subluxation deniers is simply another anti-subluxation rant by the usual suspects - Perle and Mirtz.

CLICK HERE for that history

Here is the new paper:

The prevalence of the term subluxation in chiropractic degree program curricula throughout the world. Matthew F. Funk, Aric J. Frisina-Deyo, Timothy A. Mirtz and Stephen M. Perle. Chiropractic & Manual Therapies 201826:24. 2 July 2018

This time they had a couple of (hopefully unsuspecting) students do their grunt work for them but in the end they trotted out the same old made up nonsense supplemented by references to their own publications or those of their subluxation denying friends. Both students are listed as enrolled at the University of Bridgeport where Perle teaches and Bridgeport has become a center for subluxation denier rhetoric. 

Published by the flagship journal of the subluxation denier community "Chiropractic and Manual Therapies" this paper is the greatest hits of the hate that lives in these people and is spewed by them.

Before pointing out some of the nonsense they came up with this time its important to remember where this was published and understand how this journal, their editors and publisher lead the attack on subluxation chiropractors.

Connect the dots with me.

Stephen M Perle, an instructor at the University of Bridgeport College of Chiropractic is a Member of the Editorial Board of the journal Chiropractic & Manual Therapies where their "study" was published.

Bruce F. Walker is Editor-in-Chief of the journal of Chiropractic & Manual Therapies and Head of the Council on Chiropractic Education Australasia (CCE-Australasia) accredited chiropractic program at Murdoch University in Perth, Western Australia, and a Board member of the CCEA.

Here is a partial list of some of Walkers concerns about chiropractic:

  • Adherence to a flawed chiropractic ideology centring on innate intelligence and vitalism
  • Claims of cures for visceral and other non-musculo-skeletal conditions
  • Anti-vaccination propaganda
  • Anti-drug and anti-medicine propaganda
  • Anti-physiotherapy sentiments
  • Misleading and deceptive advertising
  • Open plan clinics where multiple people are treated in the same room fully dressed
  • Unscrupulous contracts of care
  • Over-servicing
  • Obligatory full spine x-rays
  • Use of the term “subluxation” as a valid diagnosis
  • Unnecessary treatment of babies
  • Biologically implausible diagnostic tests and therapies
  • Unfounded claims of decreased immunity from “subluxation” and increased immunity from chiropractic treatment
  • Life time chiropractic care in the name of “wellness”
  • An unhealthy disregard of clinical research, evidence based practice, and non-specific treatment effects including natural history and the placebo effect.

The Journal that published this paper (Chiropractic & Manual Therapies) has several known subluxation deniers on its Editorial Board Including:

  • Bruce F Walker, Murdoch University, Australia
  • Charlotte Leboeuf-Yde, University of Southern Denmark, Denmark
  • Stephen M Perle, University of Bridgeport, USA
  • Mitchell Haas, Western States Chiropractic College, USA
  • Gregory N Kawchuk, University of Alberta, Canada 
  • Dave Newell, Anglo European College of Chiropractic , UK

Bruce Walker is the Editor of the Journal and an Associate Professor at Murdoch University.

Another Murdoch University Instructor Keith Simpson has stated that there is "no credible evidence for subluxation based care" CLICK HERE for that story.

While one should be aware of Fake News these days, chiropractors should be aware of Fake Research by the likes of Mirtz and Perle and anything published by this journal tool of the subluxation deniers club.

Its also worth noting that Perle was recently invited as the sole chiropractor presenting as the Keynote at the American Chiropractors Association's (ACA) 2018 National Chiropractic legislative Conference (NCLC) in Washington DC.

Perle is Professor of Clinical Sciences in the chiropractic department at the University of Bridgeport College of Chiropractic (UBCC) and has been a faculty member since 1991. He also serves as chairman of ACA's Research Advisory Board. Besides his role at UBCC Perle is also a consultant to the State of Connecticut, Department of Public Health, Division of Health Systems Regulation since 1996. The Connecticut Board of Chiropractic falls under this Division.

Among other things, Perle believes the subluxation construct is "scientifically unsubstantiated" and that those focusing on subluxation are practicing a "pseudo-religion".

So what did Perle's students find out when he assigned them to do his dirty work?

Here are some highlights:

  • The US institutions with the greatest number of mentions of the term subluxation in courses and course titles were Life University with 25, Sherman College of Chiropractic with 17 and Palmer College of Chiropractic-Florida with 16.
  • National University of Health Sciences and Southern California University of Health Sciences did not mention the term subluxation at all.
  • Outside of the US, there are currently 28 educational institutions offering chiropractic degrees.
  • According to the subluxation deniers review, in the non-US chiropractic programs "subluxation was mentioned rarely", with a range of 0–4 times and a mean of 0.83 in course titles plus descriptions.

Only 47.4% of the non-US schools mentioned the term in their catalogs leading the subluxation deniers to assert that:

"This suggests to us that professional identity driven primarily by the concept of subluxation may be less important in countries outside the US."

and . . .

". . . fewer mentions of subluxation in public documents outside the US suggests that professional identity in non-US countries is not as dependent upon adherence to the subluxation construct as in the US."

Other than the basic facts about how little subluxation is used in course curricula both in the states and internationally the rest of the filler they came up with is a mix of straw man arguments, special pleading, appeals to authority, and statements presented as facts without substantiation.

It is another great case study in the use of logical fallacies - particularly the straw man fallacy, and the liberal use of unreferenced opinions presented as facts.

Keep in mind as you read their assertions below that over the past few years the chiropractic profession has shed its drugless character, subluxation has been removed from accreditation standards, philosophy of chiropractic has been removed from educational programs, chiropractic care of children has been attacked and the systematic marginalization of the traditional, conservative faction of chiropractic has been accomplished by the profession’s controlling cartel and the assistance of its crew of subluxation deniers.

Yet there is still the majority of subluxation centered, principled chiropractors who are sitting on the sidelines and watching while not doing anything.

Here are just a few of their assertions in the paper:

"The claim that a vertebral subluxation has any causal effect on health has been refuted."

"One must therefore question why this dogmatic philosophy is still maintained within chiropractic curricula."

"More than a decade ago, Wyatt el al proposed that all chiropractic colleges adopt an evidence-based curriculum – a goal which to date has not been attained, as demonstrated by the continued use of subluxation in courses found in this study."

"This raises an important question: will patients in an exclusively subluxation based model receive optimal diagnoses and treatments?"

"A practice that is exclusively subluxation based, thus driven by the doctor’s belief in the subluxation, cannot be evidence based."

"Rather than clinging to an outdated construct, providers should implement a more patient-centered model, which has been shown to yield better outcomes."

"Graduates of colleges that most often used the term subluxation in their curricula, as reported by Mirtz and Perle, were more likely to take early and inappropriate spinal radiographs."

"In addition, chiropractic educators and educational institutions have an obligation to provide non dogmatic, evidence based courses for future practitioners."

"The use of anecdotal evidence is used to demonstrate that such a construct exists. Many technique systems using either palpation and/or radiographic modalities have claimed to detect the subluxation. Many of these various systems of detection contend that their proscribed systems are superior forms of detecting and correcting the subluxation; however these methods lack reliability."

"The authors concluded detecting subluxation was not based on adequate evidence or reproducible; therefore, its detection should not be included in a graduate’s competency."

"Antagonists to the subluxation bring forth several rationales for critical questioning of the use of the subluxation terminology: the lack of scientific evidence, the inability for interdisciplinary function, and the cultural authority/professional credibility rationales."

"The lack of scientific evidence for the subluxation appears to be the main reason for discounting such an entity."

"The subluxation construct lacks sufficient evidence to even reach the level of a theoretical construct and should be considered no more than pseudoscientific dogma."

"Unscientific terms and concepts should have no place in modern health care education, except perhaps in discussions with historical context. Unless these outdated concepts are rejected, the chiropractic profession and individual chiropractors will likely continue to face difficulties integrating with established health care systems and attaining cultural authority as experts in conservative neuromusculoskeletal health care."

McCoy Press