33 Minutes Premiere
Welcome to the premiere of 33 Minutes, a regular feature of TCL with Drs. Gerry Clum and Jason Deitch, meant to fill you in on everything new, meaningful, factual and relevant to today’s chiropractic profession.
In this edition, the discussion revolves around the most exciting findings in recent subluxation research and how we should refer to them – factually – to best reflect what they say (and what they don’t).
Scroll down to hear the interview – or read the transcript – and learn how you can maximize your effectiveness in using this research to inform your patients and your practice.
Remember to be social – and even prosocial! Click, Like, Share. Let’s engage collegially with our leadership tribe.
Deitch: This is 33 Minutes. I’m Dr. Jason Deitch and of course, I’m here with the chiropractic profession’s… what did we call you the other day? We had a name for a grand icon we came up with the other day, Gerry.
Clum: Hi. My colleagues from New Zealand, particularly Phil McMaster, President of the New Zealand College. refers to me as the Kaumatua, and in Maori culture (and Phil is Maori), the Kaumatua was kind of a kind of an elder or senior statesman – kind of a judge or counselor kind of person. Phil dubbed me the Kaumatua a while back and it started to stick in certain circles. I think it’s kind of fun and now, frankly, I’m very flattered by it. I would be very happy to be thought of in that context.
Clum: Well, you know, you and I had been talking for a little bit and we were comparing notes, having watched 60 Minutes a couple of weeks in a row and remarking on the 50th anniversary of 60 Minutes, and thinking back to the year, many, many years ago when Life University (then Life Chiropractic College) and Dr. Williams were featured with Mike Wallace from 60 Minutes. I was a young faculty member back in those days and was part of that session that was taped. I can’t even remember when it was… maybe in the late seventies, that it aired. Out of that we talked about the format and the idea that nobody wants to hear somebody drone on for a half an hour on one subject in this kind of a setting. If you’re going to a seminar for a specific purpose, that’s one thing.
But this kind of a setting, everybody wants just a little snippet here, a little snippet there – something to think about, something to go look at, a something to check out when they’ve got a little bit more time. That’s the strategy that you and I talked about in the end – the approach that…
…what can we do for the chiropractor out there in practice, to maybe give them a little bit of insight into some of the opportunities that we have a because of our circumstances?
Dr. Gerry Clum
I haven’t been making my living over an adjusting table and decades, for better or worse. That’s the way it’s been. But for the man and the woman in the profession that is attached to that table, and they’ve got to be there on Monday morning and spend the week there, They don’t have the latitude sometimes, to do some of the things [or] have the opportunity to spend time looking at different areas, that their tasks and responsibility in the office compels them to provide. So, hopefully we can take a few minutes, make good use of it for them, and give them a little bit of insight. Again, if there’s something they want to dig a little bit deeper into, we’ll give him the direction on how to go there and how to get there.
Deitch: Right on. So, for those of you watching, this is intended to be a weekly program with Dr. Clum and myself. I have had for, I’ll say several years now, the honor of being able to hear the debriefs and the downloads of where you’ve been and who you’ve spoken to and what you’ve achieved and accomplished. I’ll also say, what your frustrations are and what the challenges are in the profession, the struggle, I know from the college’s side and even just about every chiropractic leader I’ve spoken to, is that there are just not enough people in the profession that are aware of the current circumstances and how to make sense or know what’s important, what to support, what not to support, and make sense of it all. So, I believe it’s true that there is an overwhelming majority of people that are part of no association, let alone any of the associations out there. We have yet to really develop a definitive place and space to appeal to the broad chiropractic profession with the news, the insights and updates to keep us all informed. That’s the spirit we hope to accomplish here.
Clum: You’re absolutely right.
More than 90 percent of the profession does not belong or participate with the national association. It’s quite distressing realistically…
Dr. Gerry Clum
…and not so much for the profession, but for the consumer and the individual practitioner, if they don’t have that information flow that comes with the participation in different organizations. There are certain aspects of this that are a chiropractic thing, but there are other aspects of that are purely millennial things, that are time and circumstance things and we know, across all professions in all disciplines, that membership isn’t the order of the day. People aren’t belonging like they used to. So, hopefully we can fill some of that void with that information because there’s a lot of good stuff out there. There’s a lot of great stuff out there, and it’s accruing daily. When you’re in your office and you’re in that mode, sometimes it’s hard to look up from the table and to see it – and then to put it in context. So, maybe we can do that. And if we can, I’d be very happy to think that we could do that for, for some folks in practice, and maybe giving things a little bit more context and a little bit different perspective than they might have on, any given day [in the office].
Deitch: Many of you viewers who have been in practice for a few years may have remembered TLS, “The Latest Stuff,” from Gerry Clum. Thousands of us received it, I think weekly. And it was something I know that we learned to look forward to both because of your experience and your sense of humor, and your ability to cut to the core of the issue, to take away all the extraneous stuff and really help us understand what the issues are and help us better understand the impact they have on us practicing chiropractors and so on. So, I think of this as a hopefully a wonderful opportunity. If you’re watching, we’re going to ask you to engage; this program is only as good as the number of people that are able to see it, view it. We’re starting from scratch. So please feel free to say hello down in the comments below. Leave a like, comment, share; let us know where you’re from and if you feel so, kind to do so, please feel free to share this with other colleagues that might benefit.
Okay. Moving right along. So. a journey. We talked about a format. We’ll give this a try. Hopefully, we’ll get some positive feedback on it. We’ll adapt the program as we go, but we said let’s break the 33 minutes up, besides the intro and the conclusion, into three segments that we’ll generally right now refer to as head, heart and hands. A very common thing, within our profession. Let’s start with, what do we need to know?
There are some issues, intellectual ways of professional [interaction], so let’s get ready for our head segment. What are some of the things that are important, intellectually, for us as a profession to be aware of? You know, it’s Memorial Day; we’re now approaching the summer season. We just had the Rubicon Conference, a phenomenal success – the research that came together, the spirit of people coming together, beyond impressive. Great job. What do we want to talk about at our head segment this week?
Clum: Well, you know, the place I’d like to begin is to go back, thinking about Memorial Day and in the significance of the service, of over our service persons, over the years – what they’ve meant in our lives and continue to mean. We have an important interface with that. Less than ten days ago, there was an article published in the JAMA open journal.
It was authored by Christine Goertz and her colleagues at the Palmer College of Chiropractic, in the Palmer university system, their research center, and it was an analysis of the experiences of over 800 members of the military under chiropractic care and also under medical care simultaneously. You know, in the past we’ve evaluated how patients have fared under chiropractic care. And obviously medicine has evaluated how patients have done under what’s referred to as usual medical care. But, we’ve never had a crossover between the two. Dr. Goertz and her colleagues at Palmer have delivered to us through this article, a review of the experiences, as I said, of over 800 individuals who presented to military facilities.
There were three different facilities involved and subjects presented with low back pain of various intensities, various duration, and they received traditional medical care, usual medical care, and they also received chiropractic care. They were divided into all the groups you’d should expect for research purposes. They were followed by a numerical rating scale in terms of their progress. They were also followed by the Earl Morris questionnaire in terms of their responses to care.
It was fascinating to see the results in each of these areas. each of these geographic areas that were very similar across the country. There were differences in the numbers of people, in the average ages, in male/female balances, and those types of things at different locations. But overall, when you looked at each of the individual environments, there wasn’t a single environment where the patient population, the service members, did not do better under a combined offering of usual medical care and chiropractic care to the point that this was written up on May 20, first in Medscape in their orthopedic section, and it’s starting to get very significant traction within other areas of traditional medicine.
Now, you and I may think, Man, c’mon; another low back study, just what we need.” Well, we may have seen them, we may be aware of them. We may understand the significance of how we can help that patient with low back pain. But, the bottom line is that many people in medicine don’t understand that. And now this study is giving them an opportunity to learn what chiropractic can do in almost in a nonthreatening environment – not in place of their care, but in teamwork with their care. And I’ll be frank with you and tell you, I don’t know the exact details in terms of where management in the in the case shifted from the chiropractors to the medical doctor or whether it was joint management throughout, but I do know what the result was. And the result was very clearly stated in the conclusions of this paper.
It said chiropractic care, when added to usual medical care. resulted in moderate short-term treatment benefits in both the low back pain intensity and disability. It also resulted in high patient satisfaction and perceived improvement in active duty military personnel. Now, the short term nature of this is simply the fact that they follow the people for 12 weeks. It was a short-term study. That isn’t to say there might not be the same result over the long-term. But. based upon what this study reveals to us, the bottom line is that, the statement can be made that these patients had had significant, moderate benefits both in pain intensity and disability. When you appreciate the fact that the significance of low back pain in the military environment and in particular, in the pilot environment, back pain takes a pilot off line and they can’t give a medication because they can’t fly the plane on the medication, so when they’re, when they’re out, when they’re off line because of low back pain, they’re out of the game, pure and simple.
So, having the opportunities to see how we perform in this environment is another significant addition to the literature that’s available for the professional around the country. I’d encourage everyone to get that. This is an open publication, so you don’t have to pay anybody to get a copy of the article; we will certainly provide the link to the article that you can go online and download it yourself.
Spend some time with it, look it over carefully and get into the detail of it because it’s very useful information, particularly this time of year when we’re thinking about Memorial Day. It’s a very nice thing for us to be able to do something in a real day in, day out sense for those people who put their lives and circumstance at risk for our benefit. So, I’m excited about it. Congratulations to Dr. Goertz. Congratulations to Palmer for their accomplishment relative to this study.
Deitch: I like where you’re going with that on so many levels. If nothing else, again, these are service people; they deserve the best. They deserve our support if no paper ever came out of it, but we continue to demonstrate that we were being of service to the people that are of service to our country. That’s a win. Number two, I love what you said about the fact that we as chiropractors might think, Oh, big deal; we already know that.
Let’s not forget that this no longer really is about us – or maybe it is – but it’s about other people being exposed to learning about us. And perhaps the military hasn’t had the opportunity, whether it’s decision makers or people on active duty. So, to be able to translate, again, we may think it’s as obvious as possible, but decision makers and administrators oftentimes do have to base decisions on some sort of data, on something they can refer to beyond just their opinion that says, See, here’s why I made my decision. This gives them another feather in their cap, or something that they can reference, to be able to make better decisions than without it. They just can’t do it, even though they may believe all day every day that it’s good for their troops and so on. So, that’s another phenomenal win and the more of these things that get out there, again, if we can get out of our own, “I already know that” consciousness and get into “How do we keep on, day after day, week after week, month after month, just sharing more and more of our positive results and data?” – the more people in the world are going to know it is a process. Just like adjusting the nervous system is a process. It does take some time for us to really make the impact we want to make in the long run. So, that’s A) very timely, and B) a very important study. I think that’s really the spirit of what hopefully this program is all about: How do we celebrate the wins, whether they’re ours or others? We are one profession that we should stay up to date on the winds that are going on in the profession.
Clum: You know, there’s another aspect of this relative to people in the military in medicine: they’ve got their hands full, they got their heads down, they’re working hard and they know their world. They don’t know our world. So, when we put a study on the table and say we do X, Y, and Z, or we were helpful in this environment, yeah, okay, fine. But, when this study is conducted in their environment, on their turf, with their patients and they see the results and the change that this data reflects, that has greater translational value, as you said. It provides greater ability for them to receive that information. A lot of times they don’t know us from Adam and maybe they don’t have a high perspective on the reliability of the chiropractor. When they’ve been in the same clinical environment with them [chiropractors], when they work side by side, when they’ve developed the data together, that changes things. And frankly, I think that’s why you see the uptake that you do for this kind of a study. So, congratulations.
I’ll add one more thing, which is that it wasn’t an either/or, right? The fact that…let’s just stay positive for a moment and let’s just assume for a moment that the military medical doctor actually really does have a sincere desire to help their people out, to help their patients, to help their colleagues. They absolutely want to do the right things to be able to say, here’s the data that says what I’m doing as a medical doctor, in conjunction with what you’re doing as a chiropractor, is so much easier for them to be able to just sort of accept and be open to that versus something that says what a medical doctor might be doing wrong and therefore what somebody else is doing right…it’s just not socially as acceptable as it needs to be. And this isn’t about pandering. So, those critics that want to go there, it’s human nature and the chiropractors aren’t trying to practice medicine in this environment and the physicians involved in the medical decision aren’t trying to practice chiropractic. We’re bringing…the best skills in each to the needs of the patient in an optimum setting…in an optimally integrated environment; let’s see what happens. And obviously the result here has been great.
Deitch: That’s phenomenal. And besides people getting well, this country could use some costs savings and I do believe that the long-term impact, if they hopefully continue to study, we’ll go from short term to long term and will continue to see the benefits of that. Great update. Next, let’s put [our listeners/readers] into dealer’s choice. Heart hands, head… what would you like to talk about next?
Clum: Well, let’s stay with the combination of the head and the hands this time. Obviously, I think everybody listening to us knows of Dr. Heidi Haavik and knows of her work at the New Zealand College of Chiropractic and her activity as a neuroscientist as well as a chiropractor around the world. She had an article published not too long ago in the journal, Neural Plasticity, which is a very prestigious journal. It began to talk about or…began to solidify the concepts that the adjustment might have an impact upon the central nervous system – and on the brain – in general. At…the [most recent, 2018] Rubicon Conference, we had the good fortune to have Dr. Haavik as the closing presenter on Sunday morning. What we asked her…was, “What can you put on the table for us that a chiropractor in practice can say, based upon the literature, with confidence, with integrity, with reliability, [again] based upon upon the evidence that’s there, about the effect of the adjustment as we know it in 2018?” Heidi was able to put forward a listing and I’d like to carefully go through them if I can, won’t take a lot of time, but it’s important.
The first is that the research is showing a that an adjustment causes neuroplastic changes in the brain, in the central nervous system. The second consideration is…that the research is demonstrating that adjustments enable muscles to contract more and stronger, both important elements: more and stronger. The third consideration is that…the research is demonstrating that adjustments are changing the cortical drive to the muscles from the brain. The next is a very important one in the broader context, is that the research is showing that adjustments allow your brain to be more accurately aware of where you are in space with your eyes closed – that body mapping, body scheme of phenomenon that, you know, when we get up in the middle of the night and we go to the bathroom in complete darkness and we know where we’re going.
We don’t fall over anything; we know how to get there. We need to know how to find the toilet. That whole process is that amplification of the ability of the brain to help us move accurately in space, particularly with our eyes closed. And then in addition, …the research has demonstrated that adjustments improved the proprioceptive appreciation and understanding of the movement of arms and legs in space. Now, if you think about whether you’re an athlete, whether you’re a line worker in a factory, whether you’re a air traffic controller looking at a screen, all of these types of things, these types of inputs, if you’re better at them, you’re more effective, you’re safer, you’re more competent, more capable, and you do a better job for everybody around you. Another consideration, according to Heidi, is that the research indicates that spinal adjustment improves your capacity to learn and/or perform movements.
So if you think about someone who’s in training for any type of activity, whether it be athletic, whether it be musical, whether it be anything you can think of, the ability and the capacity to learn and to perform movements repeatedly over time increases with the availability of spinal adjusting. And then finally, the adjustment alters the way your brain can accurately integrate sound and vision information. If you think about it – and I’ve got a little gray hair and I’m in my social security days and I’m glad to be collecting from Uncle Sam – but as you go along and you think about the capacities that you lose over time with age in terms of proprioception, in terms of sound, in terms of vision, and you talk about a procedure, in the form of the adjustment, that could increase the capacity and potential for these processes to remain strong, stronger and more viable over time.
These are huge developments. It’s a huge development and the perspective that was offered is that the evidence is there. These are solid statements. These are not wishy washy, could be. sort of, maybe, etc. We are able to make these as definitive statements. Now we’ve got to be careful that we don’t extrapolate them to other conditions, other circumstances, and give them far more meaning than I just gave to you, but the potential for your perspective of vision, your perspective of sound, your perspective of movement, your perspective of where you are in space, your ability to drive your muscles, your ability to contract stronger and longer with your musculature. All of those things are being derived out of the evidence associated with a spinal adjustment. So. as we said before, Jason, it is a remarkably exciting time. That litany that I gave you, those seven or eight things that I talked about, that was almost 20 years of work on the part of researchers all around the world to come up with that listing of things. So, when you’re looking for another, next week when we do the show, if you want to see another list of eight things, it ain’t going to happen. But, we need to understand these, appreciate these, not run any further or farther than the than the literature and the evidence allows us to, and be veryexcited about what we’ve got to work with here.
Deitch: That is awesome. Are there other names we should be acknowledging as part of this work or this is Heidi Haavik’s team out of New Zealand Chiropractic College?
Clum: No, no, over the 20 years, there’ve been all sorts of researchers. This is a series of statements that came from Heidi, so I’m going to quote her in this context, but there are all sorts of authors that went into this and, and I don’t want to be presumptuous naming them apart from their papers, but I did get this listing from Heidi and her authority to go ahead and relate them to everybody
Deitch: Right on. And we will put links to articles down below that you can share with others. Again, this is about getting the message to our colleagues and letting people know. We want to give you the resources to help you understand how to think about these resources. We’re here for questions. If you have questions, if you’re watching this on a replay, you can leave your questions below and we’ll answer in future episodes or join us live in a future episode. What can we say? I’ve spoken to Heidi many times. She’s like, “We can’t say that, we can’t say that, but how does the average chiropractor talk to the average person in a language they’re going to understand beyond telomeres and potential and things that just don’t connect for them? How would you simplify this into normal language and something that could be appropriate and exciting to normal people?
Clum: Well, I’ll go back to my age group. The number one circumstance is going to lead to the demise of a person in my age group and older is a fall. All of these things are going to help an individual stay away from that fall. If you know where you are in space, if you know where your arms and legs are, if your sight is a little bit better, if your sound responses a little bit better, your timing’s better – this is going to accrue to your wellbeing. Now, if people just sit and think a little bit about what would this mean to a consumer? We can’t say we’ve proven that chiropractic causes patients to fall less. We can’t say we’ve proven that chiropractic has increased life expectancy because people didn’t fall and therefore didn’t die, but what we can say is the information that I’ve just related, relative to the proprioception, relative to the sound, relative to the vision, and begin to interpret and extrapolate what that will mean to people in their day in and day out lives. I think there’s a ton there for the for the guy and gal in practice to begin to work with and like I said, don’t overstate the literature. Don’t make any promises you can’t back up; but the evidence is there for these statements. For sure.
Deitch: I like where you’re going with that and we are going to come up a little bit on time, but just to complete this, and we’ll pick this up in future conversations and future episodes, but there’s a way to speak about science that I’ve noticed in the medical profession and scientists, researchers that is slightly different than what journalists do. Journalists want to sell papers, they want to create hysteria, they want to create drama so that they can basically click bait you into buying or clicking, They just have a different responsibility. I think we, as practicing doctors, have to fall more on the research side and what that means, is that there’s a responsibility in how we present these things that has everything to do wIth potential. There’s nobody anywhere, whether you are a staunch supporter of a particular procedure or a particular medication or something that you believe is very effective, there’s still nobody who can say, 100 percent of the time, this is going to happen. There’s always the exception. I think that there’s an art of communication that I hear you use. I hear other teachers that keep to the way in which they present things, that actually adds more credibility to what you say than thinking if you could say it definitively, that it’s more effective. I hope I’m being effective.
Clum: Sometimes less is more. That’s exactly right. And, I’ve done it. I’ve been guilty of it. I’ve gone one bridge too far with extrapolating what the meanings were and so on. I’ve had my head handed to me and I had my butt kicked before and I’ve gotten a little bit more cautious over time about it. But, in the long run, it has been better for me to understate rather than to overstate. I would suggest that’s a strategy that we could use more effectively in and around the profession now that we don’t appreciate, that we don’t value what we do in the applications. But, thinking beyond just your office, and in the broader marketplace, and in this world where anything that’s said at any given moment can be global in a second, we need to be careful.
Deitch: So would it be fair to say something along the lines of, “Here’s what the research is showing us; let’s see what’s possible for you. [Clum: That’s right.] Here’s what we know, but nobody knows how this is going to affect you. You look forward to finding out. I look forward to the impact and the benefits you will experience,” and I think we as doctors have to remember a really important part of this equation, which is what we do to people is one thing, but everybody comes to us differently. So doing what you do at adjustment, correcting a subluxation, whatever technique you’re using, to a 20 year old, to a 40 year old, to a 60 year old, and an eight year old male, might be very similar in terms of our application, but certainly very different in terms of how it’s received. And I think that’s an important part for us to keep in mind when we’re making claims, which I think is sort of what we’re dancing around
Clum: Right. Before we wrap up, one area I wanted to get to is a bit of a heart discussion. We kind of touched on that relative to the veteran and the guy and the gal in the military and so on, but I had the chance to see, in the last couple of days, a very interesting YouTube video and I’d encourage everybody to just go to YouTube and type in the search, enter “beautiful minds” and the name Stephen Wiltshire. It’s a five minute, 22 second clip. Steven Wiltshire is a gentleman who just has lived in London. He’s autistic. He has significant communication challenges, but he has the ability to see things and then be able to create images of them like nothing I’ve ever seen before. And Steven was taken on a 45-minute helicopter tour over Rome and then given three days, in a space of three and a half yards wide, to draw what he saw going over Rome and, with the accuracy of those that built the buildings, he drew the number of portals in the coliseum, the columns in the pantheon, the accuracy over this over three days of artwork from the memory of that one flight. And the reason I bring that up is that Steven is autistic. He didn’t speak until he was five. He didn’t pick up a pencil until he was 10 and he created his first artwork, which was a map of the city of London with a similar consideration when he was 11 years old.
The reports just came out recently that the ratio of persons that are being born, children that are being born with autism in the United States is in some areas now down to as low as one in 59 children.
We don’t know much about what’s going on. We need to learn more. We need to understand more. We need to have more compassion, we need to have more kindness. We need more appreciation for the circumstances of those people who are varied in their abilities, in genius, and in their insights. So as we close today, or at least from my perspective on this discussion, I’d ask everybody to take five minutes, sit back, listen to Steven Wiltshire’s story, marvel at what this man can do, and think about the capacity of the human mind and the ability of the body to heal. Thanks, Jason. I appreciate this opportunity
Deitch: Look for the links down below. Hey listen, thank you for joining us on our first edition of 33 Minutes. We hope you’ll join us each and every week. Your feedback inspires us. Please like, comment, and share below. if you have questions, please leave them. If you’ve got suggestions for future topics for us to cover, please let us know. Thanks for joining us. We’ll see you next time.