How to Respond When the Media Criticizes Chiropractic: Do's and Don'ts
By Dana Lawrence, DC, M. Med. Ed., MA and Christine Goertz, DC, PhD
Editor's note: Drs. Goertz / Lawrence join fellow DC columnist Dr. Anthony Rosner in addressing the recent Forbes opinion piece by Steven Salzberg. Drs. Goertz / Lawrence provide tips on how DCs should (and should not) respond to the article; Dr. Rosner provides an evidence-based rebuttal (click here to read).
By now, most of you are aware of the article recently published by Forbes magazine in which the author, Steven Salzberg, argues that nearly $500 million per year is "wasted on chiropractors." We are sure you had as visceral a response to it as we did, wanting to get in there and defend our profession from the inaccuracies and slant the author built into his writing. And indeed, as of the time we write this, there are already hundreds of responses to that article, many from impassioned chiropractors who point out deficiencies in the article, as well as many that are emotional responses from those who feel hurt by what was written.
Some are thoughtful and will help us; others are less helpful because they fall prey to the same problems in the original article. So, our goal here is to discuss what you should and should not say in responding to articles like this.
The Internet thrives on controversy. Controversy drives Internet traffic (as "click-throughs"), which in turn, is how magazines have been able to monetize visits to their sites, given that fewer people now subscribe to magazines and journals.
While the anonymity of the Net allows people to "act" in ways they never could in public, which contributes to the overall coarsening of our culture, it also provides a means to reach people with important messages. Most news articles today now end with text that usually says something like, "Do you agree that chiropractors waste half a million dollars a year? Click here to post your comments!"
When you do, you had better make sure you have your facts straight. Reading over the comments to the Forbes article, as well as the author's response to some of them (and remember, he can pick and choose the ones he wishes to respond to, meaning he will likely pick the most egregious ones, or the ones that have their facts wrong), demonstrate both the risk and reward of responding.
But here is the rub: We live in an evidence-based world. That's what this column and our blog is all about. That is the language spoken by critics such as this one, and it is the language we need to use in return. In that sense, what you believe about chiropractic is moot; what we need here, to fight this battle, is evidence.
In the responses we read before writing this article, we noted lots of ad hominem attacks (Latin: attack the man). Feels good, but does not address the substance of the article. However, we were heartened because in many of the responses, the writers have provided links to scientific articles.
But a caution here. Linking to just a single trial, for example, may not be the best way to go. It might be better to find a systematic review or meta-analysis to offer, simply because one trial is often not sufficient to make the case. In the circumstances here, the author's argument is about cost; many responders wrote back about effectiveness, which is related, but not the same thing.
Some of the best responses came from the indefatigable J. C. Smith, a chiropractor and writer [search on the DC website for his recent articles, one of which (a two-part series) is a finalist in the ASBPE journalism awards], who supported his comments with extensive reference to scientific literature as well as news reports.
Dr. Smith argued that in comparison to other interventions for back pain, chiropractic is safer, more effective and less expensive – and he offered the citations to support those comments. This is precisely how we should be responding. Our national organizations, both the ACA and the ICA, did the same.
What You Should Not Say or Do
What You Should Say or Do
A well-cultivated response relies upon good habits of thought using intellectual standards. Here are some tips to help develop critical thinking habits to effectively evaluate a claim and construct a substantive response.
These tips will allow you to think more critically about the content of an article, and likewise assist you in formulating a response.
Keep in mind that critical thinking, logic and reason form the foundation of evidence-based practice. Therefore, appropriately applying the principles of critical thinking to evaluate an article and construct a counterargument is necessary for a well-reasoned debate within the scientific community.
Sadly, this approach is unlikely to make you feel as good (in the present moment) as it would to pen a scathing reply that is no more substantiated than the article which enraged you in the first place. However, in the long run, it will be of far more benefit to you, the chiropractic profession and the patients we serve.
Editor's note: This is the third article in a new column focused on evidence-based practice. Future articles will provide evidence-based answers to research-related questions. The column features an affiliated blog where DCs can post questions for the authors. For additional information about Drs. Lawrence and Goertz including a link to their columnist page, visit their blog.
Click here for more information about Dana Lawrence, DC, M. Med. Ed., MA.
Click here for more information about Christine Goertz, DC, PhD.