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Professor Edzard Ernst looks at a US health insurer’s decision to stop funding chiropractic upper spinal manipulation

A few days ago, Kaiser Permanente Mid Atlantic States and Mid Atlantic Permanente Medical Group announced that this major health insurer in the US intends to stop funding chiropractic upper spinal manipulation:

‘Given the paucity of data related to beneficial effects of chiropractic manipulation of the cervical spine and the real potential for catastrophic adverse events, it was decided to exclude chiropractic manipulation of the cervical spine from coverage,’ the insurer said in a statement.

The American Chiropractic Association (ACA) countered by stating that this treatment is both safe and effective. They also insisted that, in a statement from ACA president Dr Rick McMichael, that:

‘This restriction, if allowed to stand, will be harmful to chiropractic patients and doctors. We have contacted Kaiser to express our grave concern over this change, and we await its reply. ACA will expend every effort to encourage Kaiser to reverse this new restriction, and we will keep our members and the profession informed along the way.’

This quote is, in my view, remarkable, in at least two ways.

Firstly, it suggests that chiropractors have a very unorthodox understanding of the scientific evidence on this subject1. Secondly, it shows that US chiropractors now routinely use the term ‘doctor’ to describe themselves – a habit that seems to be increasingly popular in Britain as well. This might confuse patients and give them the impression that chiropractors have studied medical degrees.

Professor Edzard Ernst is professor of complementary medicine at the Peninsula Medical School, University of Exeter

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