We Failed the Children

Matthew McCoy DC, MPH
We Failed the Children

Who Will Speak for Them?

Many of my close friends and colleagues have asked me why I decided to start a journal devoted to pediatric, maternal and family health as it relates to the chiropractic lifestyle.

September 2007 was one of those life-defining times for me. A chiropractor contacted me for help dealing with a complaint that had been filed against him by the parents of a child he had been caring for. What prompted the complaint was a letter the parents had received from Blue Cross & Blue Shield – a letter that many parents with Blues coverage and children undergoing chiropractic care had received. The letter informed parents that after considerable review of the scientific literature Blue Cross/Blue Shield had determined that research was so lacking for the chiropractic care of children that they now considered it experimental and investigational and would no longer provide coverage for it.

Focus for a moment on what they were really saying to the parents of children undergoing chiropractic care. The message was clear: besides informing these parents that they would not cover the cost of chiropractic care for children, the largest health care insurer in the entire world was warning them that subjecting their children to chiropractic was in effect allowing the chiropractor to perform investigational procedures on their children and in effect they were experimenting on them.

The news spread like wildfire through the chiropractic profession. Righteous indignation was everywhere. I had not seen chiropractors so worked up over an issue in some time. I admit I was caught up in the outrage as well. Along with my fellow colleagues I ranted and raved in lectures and print about the injustice of it all. When I calmed down a little I decided to take a closer look at the issues. First, I was able to run down the details of the process and criteria by which the Blues came to their conclusion. As it turned out it was all available on their website. The Blues have a very explicit process by which they determine if procedures are or are not experimental and investigational. Without going into details there are the usual criteria related to research evidence, levels of evidence and much if not all of the standard criteria we’ve all become familiar with in this age of evidence based health care.

Next I decided to have a look at what evidence related to chiropractic and pediatrics did exist. Over the next year and with the help of research assistants we were able to gather all of the scientific literature related to chiropractic for children that had been published. Let me state that again – we were
able to gather all of the literature. Hopefully that gives you pause as it did me. Not only were we able to gather all the literature that has ever existed on this topic but the accumulated research does not even fill a single copy paper box.

At this point I’m afraid my indignation took another turn. I grew up in and around chiropractic and was mostly exposed to the more charismatic, “principled” factions of the profession so this has always been the main crowd I ran with. Being in those circles one often hears about the importance of caring for children, the importance of allowing children to experience the world free from a subluxated nervous system. Long term benefits of children being under chiropractic and other assorted anecdotal stories were and are still told on a regular basis to students, practitioners, laypeople, and parents. I myself had seen my share of “miracles” in children following the introduction of chiropractic in my own practices. Besides seeing this in my own family practice I spent 2 years practicing in a Russian hospital for women and children and saw some of the sickest children get their lives back from chiropractic care. Of course, like all other chiropractors I was convinced of the benefits.

Unfortunately, our individual and collective beliefs about the benefits of chiropractic for children no longer matter. The same accountability that chiropractors scream for when it comes to every medical intervention is now being applied to our science, art and philosophy. While this accountability is of course being applied to all aspects of chiropractic care, for me the implications for children’s health is paramount and a serious, concerted, effort is necessary if we are going to meet this challenge and fulfill our responsibility to children, the mothers who bear them and the families that raise them.

I have always been outspoken about the desperate need for research in this profession and I’ve been critical of the leadership that came before me and the shameful lack of stewardship they have shown in regards to the research infrastructure of this profession. In my courses, students are utterly bewildered as they come to their own realization that most, if not all of the things they were taught to believe about the miracles of chiropractic have no scientific research to back them up. Just as I did - they assumed that no one was asleep at the switch.

As a result of that fateful day when I saw the letter from the Blues, I have now sharpened my focus and admonitions about chiropractic research and at this point I cannot think of a research agenda any more important than one directed at children, mothers and families. It is for this reason that I started this journal.

When I began editing the Journal of Vertebral Subluxation Research a decade ago the journal had not a single article or submission in the pipeline. Over the next ten years JVSR grew to hundreds of subscribers and more importantly hundreds of submissions. I believe that this was a result of dedicated chiropractors heeding the call for more subluxation based research. I fully expect the same response to this journal dedicated to children, mothers and families and to the call for action I am laying before you.

Please don’t think that I am simply asking you to subscribe and support this new journal – yes I am asking you to do that right away. But I am asking for a deeper commitment. I am asking that you engage in the process of research - even if it is a single case study. My greatest hope is that not only will you commit to compiling a case study and submit it to us but that you will become part of the International Chiropractic Pediatric Association’s (ICPA) Practice Based Research Network (PBRN).

It is my expectation that you understand the gravity of what is at stake here and that you will be thoughtful and serious about what role you can and will play in these efforts. This is a mission and the mission cannot be accomplished without you. To fulfill this mission we needed a place where this research can be published.

I have taken care of that piece with this journal.

To fulfill this mission we also need a mechanism to gather the data and produce the research that answers the fundamental questions we have about chiropractic, children and mothers.

The ICPA has taken care of that piece.

But the data does not get created or gathered on its own. This is where you, your friends and your colleagues come in. You must become part of that process by either doing your own research (case study) and/or becoming part of the ICPA’s PBRN.

Don’t wait. Take some action now. Children, including your children and your grandchildren are counting on you. Don’t let them down.

As always I look forward to your feedback, questions and concerns.

Matthew McCoy DC, MPH

Publisher - McCoy Press

McCoy Press