Talk:Chiropractic

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A patient-centered approach?

Currently we have a list at the bottom of the Philosophy section that ends with a generic paragraph about "a patient-centered approach" that applies to all health care professions. So far so good:

• A patient-centered approach focuses on the patient rather than the disease, preventing unnecessary barriers in the doctor-patient encounter. The patient is considered to be indispensable in, and ultimately responsible for, the maintenance of health.

That statement has some truth to it, but it shouldn't stand alone. The section is referenced, but I have had some trouble finding the source in that reference, and have found something that backs it up, but not completely:

• Page 87: "Holism also involves the belief that the patient is a potent and indispensable factor in recovery from disease and the maintenance of health. A corollary is the notion that the patient is ultimately responsible for her or his own health and illness." [1]

The reason it shouldn't stand alone is that it lacks a significant factor that exists in chiropractic, in glaring contrast to mainstream health care. It is also a major chiropractic criticism of mainstream health care. In the mainstream health care system, the patient's responsibility is primary, with the patient being responsible for their own preventive maintenance, only bringing the MD into the picture when things go wrong further down the line. This is done by the patient keeping abreast of the latest knowledge published by scientists, MDs, and other allied health professionals, as reported in the media and public health materials. In chiropractic, the chiropractor is at the top of the line, with the patient being educated to seek the chiropractor, regardless of whether they have any objective health issues, since the fact that they exist means they have dangerous vertebral subluxations, and only a chiropractor can fix them. Thus chiropractic adjustments become a preventive treatment that is required on a regular basis. A good portion of the patient's responsibility is thus moved to the chiropractor, resulting in a chiropractor-centered approach.

To balance the current listing, we need to tweak the current wording with a slight addition:

• A patient-centered approach focuses on the patient rather than the disease, preventing unnecessary barriers in the doctor-patient encounter. The patient is considered to be indispensable in, and ultimately responsible for, the maintenance of health. This is an approach shared with the mainstream health care system.

and then add another paragraph that makes it all relevant and specific to chiropractic:

• A chiropractor-centered approach that incorporates the chiropractor as an important part of the patient's preventive health maintenance, since chiropractors educate their patients to believe that they all have dangerous vertebral subluxations, and that only a chiropractor can treat them through the regular use of chiropractic adjustments.

The reference for this approach is found here:

• Page 212: "Paternalism places authority in the hands of physicians to decide upon the needs for a patient, or to lead a patient substantively to a decision, as long as they place the needs of the patient above their own needs or the needs of others. Paternalism allows a physician to coerce a patient into making choices that serve the patient's best interests.... Paternalism does not alleviate the duty to relate truthfully and forthrightly with patients. A physician who feels strongly about a test or treatment might be tempted to "simplify" the decision variables to suit the physician's desired outcome, especially if the physician is concerned that the patient may not be entirely cooperative or clear about complicated information. The temptation to provide a simple lie instead of a complicated truth is a difficult position, ...." [2]

While the above applies to all physicians, it applies in a special manner to chiropractic, as it is there one finds the unique concept of adjustments as a necessary preventive measure. I have deliberately chosen the portions of the quote that apply to the reality of what is seen in chiropractic practice. The part about a "simple lie" would be recognized as true by skeptics and denied by chiropractors, since all but a very few believe it is true that subluxations are a major causative factor in disease. Chiropractic patient education is directed at convincing the patient of the truth of this historical chiropractic dogma, and the most glaring examples are found in the highly profitable practice building industry. Here patient education scripts are copyrighted and closely guarded tools that are sold for high prices to clinic owners. Here every word is weighed and designed to turn patients into customers for life, and any employee who deviates from the script can get fired. Complete patient compliance with the established treatment plan is the name of the game.

So what we need is a small tweak and an added paragraph. It can be sourced with appropriate chiropractic references (not necessarily the ones about scripts ;-).

-- Brangifer (talk) 22:41, 25 April 2009 (UTC)

Nice original research. --Hughgr (talk) 23:36, 25 April 2009 (UTC)

Not when it gets properly referenced. Right now this is a proposal on the talk page and before it can be used it needs sourcing. As a chiropractor, you of course recognize that what I've written is true, so the next step is to stop making accusations of OR and to help source it. That would be collaborative and make the entry more NPOV. BTW, the whole subject of practice building hasn't been touched.... -- Brangifer (talk) 00:32, 26 April 2009 (UTC)

I'm new here but this does not seem like a productive way to write an entry. BR has come up with an original premise and then expects others to find research which correlates with the supposition. That's ass backards. Or is that how it's done here? - MSchreiber —Preceding unsigned comment added by 32.174.185.155 (talk) 02:40, 26 April 2009 (UTC)

I agree with Hughgr and 32.174.185.155. Plus, this article is long enough. Plus.. I don't think that mainstream medicine is "patient-centered" in the way that BullRangifer has defined. If they were, they wouldn't be putting people with no evidence of heart disease on statins for the rest of their life. If you want to contrast mainstream medicine with chiropractic medicine, then contrast the risks of pain killers (which alleviate pain, but don't cure anything, and you have to keep going to the doctor to get painkillers if you have chronic pain), surgery [3] (time out of work, success rate, etc.). I'm sure there are statistics on that. Even with that... I'm not sure that really falls in the scope of this article. Perhaps the whole subject of contrasting mainstream medicine vs chiropractic for the conditions that chiropractic handles could be the base of another article. --stmrlbs|talk 07:32, 26 April 2009 (UTC)

I too agree with Hughgr and the IP editor. Further, Stmrlbs has a good point about mainstream medicine not necessarily being patient-centered. Certainly, chiropractic tends to be more pro-active (preventative), but it also is used to treat patients with complaints/existing symptoms. I'd even venture to guess that more patients come to chiropractors to treat existing conditions than those who come in as a preventative measure. -- Levine2112 ^discuss 01:36, 27 April 2009 (UTC)

Would it fix matters if we were to follow the cited source better? It presents the sea change in patient attitudes towards health care from practitioner-centered (old paternalistic model) topatient-centered as part of how our society is changing, with chiropractic poised to take advantage of the movement.

Failing that, rather than digress into a discussion of medicine, why not simply remove the termpatient-centered? It is really a non-term, meaningless fluff which does not increase reader understanding on any point, and will need to be nixed or fixed if we ever want this article to pass FA. Read the sentence replacing A patient-centered approach with The chiropractic approachto see what I mean. - 2/0 (formerly Eldereft) (cont.) 18:09, 28 April 2009 (UTC)

That would certainly be the simplest way to improve the paragraph, without dealing with the obvious lack as described. We could do that for now, and if we ever wish to really improve this, deal with the other as a separate matter later. It still has wording which I don't find in the source. -- Brangifer (talk) 01:40, 29 April 2009 (UTC)

Tagged as {{Not in source}} - Keating only mentions patient-centered in the context of why vitalism interferes with positive treatment outcomes. Checking the other references for that section to see if I can find where that language originates. - 2/0 (formerly Eldereft) (cont.) 18:30, 29 April 2009 (UTC)

It's in Mootz & Phillips 1997, which was cited at the start of that list and I guess needs to be cited for this list entry as well. I added a citation and removed the tag. Eubulides (talk) 19:38, 29 April 2009 (UTC)

Thanks for clearing up the source of the "patient-centered" wording. Now the OR needs fixing. It is placed in an order not in the source, and uses wording not there about in what manner it is patient-centered. The source should be followed, in lieu of OR.

That source also contains wording that backs up my "chiropractor-centered" approach. It is explicitly stated by the chiropractic authors in this section: "Table 2. Range of Belief Perspectives in Chiropractic".

The authors contrast "doctor/model-centered" with "patient/situation-centered". Both approaches are used in chiropractic, and both should be mentioned. The second is used by some, and is an ideal, not a description of the real state of affairs among all chiros.

There we have the straight model which I have described, and which is practiced by straights and many, if not most, mixers, and the mixer approach which is used by a few mixers who practice the ideal which is described. It's an ideal, not a description of real practice. The description of the straight method is a desription based on long historically proven methods used by most chiropractors, who have been straights until more recent times. So there is a good source for my description. That section needs to be added and ascribed to straights, while the existing "patient-centered" approach part should be ascribed to mixers. -- Brangifer (talk) 02:52, 30 April 2009 (UTC)

Sorry, I don't see a specific proposal here, and I'm having some trouble following the previous comment. Among other things, it's not necessarily WP:OR to discuss topics in a different order than the source. Eubulides (talk) 06:16, 30 April 2009 (UTC)

Sorry for causing confusion. I have tweaked my comment above.

My proposal is to tweak the original "patient-centered" point and to add another one about "chiropractor-centered", since the "patient-centered" one applies to mixers, and the "chiropractor-centered" one applies to straights, according to "Table 2...". Since both groups are part of chiropractic, we shouldn't only mention one as if they represent all of chiropractic. We know and have sources that confirm that straights have a far greater influence than their numbers would imply. The wording of my proposal above isn't final, and can be discussed and should probably be tweaked, but the general gist needs to be used. It would also need more sourcing for certain parts of it, but they are true and can be documented.

The OR is in the way things that are listed separately in the original source are here placed in a different order and connnected as if one was conditional and dependent on the other. There is no such connection made in the source, and that's synthesis/OR. -- Brangifer (talk) 14:40, 30 April 2009 (UTC)

Sorry if I'm slow, but I still don't see a specific wording proposal in the (adjusted) "Thanks for clearing up the source" comment, i.e., a proposal that says something like, "In Chiropractic #History, change the text 'a b c' to 'd e f'." Since Chiropractic reproduces all of the source's Table 2, I don't see how Chiropractic can be criticized as unfairly weighting part of Table 2. Also, other than Table 2 I don't see anything in the source that talks about a "doctor-centered" or "chiropractor-centered" approach, so if we add text about a doctor- or chiropractor-centered approach then we would be emphasizing that idea more than the source does, no? Eubulides (talk) 16:52, 30 April 2009 (UTC)

Straights and mixers

I wasn't making any criticism of our article here for "unfairly weighting" the table, which does happen to be reproduced in the article. When I look at the article as a whole (which I wasn't doing), rather than focusing on the four points immediately preceding the table, I think the solution would be to simply remove the last point about "patient-centered" since it doesn't say anything that's unique to chiropractic, and is simply promotional fluff, and an ideal which all health care professions aspire to reach. The table presents both approaches. I do wonder about why there are four bulleted points, when there are other points in the immediately preceding text that could just as well be bulleted. It seems the bulleted points are partial duplication of things mentioned above them. Why not just eliminate the bulleting and then combine like subjects?

My proposed addition would not be used at this time. It could still be useful if we decided to fill in the existing hole in the article, which exists because we are not dealing with the effect of a practice building mentality, which makes much of chiropractic practice more "chiropractor-centered" than "patient-centered".

The next section does need two subheadings to make the straight and mixer sections more noticeable. They are very important. On any other website we would simply make them bold, but here that isn't according to MoS, and italics just isn't clear enough. I suggest two simple headings. I'll try it and we can see how it looks. -- Brangifer (talk) 03:10, 1 May 2009 (UTC)

• I could certainly go along with the proposal for "patient-centered". As I understand it, you'd combine the 2nd and 3rd (bulleted) paragraphs of Chiropractic #Philosophy, eliminating the "patient-centered" bullet and combining the other bullets into paragraph text. Care to take a stab at a draft?
• The new "Straight chiropractic" and "Mixer chiropractic" subheads have problems. They repeat the article title (which is frowned upon by the MOS) and they nearly repeat the first words of the following paragraphs, which is offputting. I suggest eliminating them, and instead, replacing the subhead Schools of thought and practice styles with Straights and mixers. There are a lot of things to like about Straights and mixers: it's shorter, more informative, and more vivid than the subhead it would replace.

Eubulides (talk) 03:37, 1 May 2009 (UTC)

• I'll make a try of it here and we can work on it.

• Someone has already changed what I did, and it might be better. I did it the way I did to keep the TOC from getting too long, but it is actually rather short for such a large article. The main subheading provides context for why we mention straights and mixers, so it's important. A good TOC can actually summarize an article if it's made properly. This section used to be much more informative, but now it fails to mention some schools of thought, largely due to attempts to censor information and make the article read like a sales brochure. Notability and an abundance of RS were ignored and trashed. Too bad. The article is poorer for it.

-- Brangifer (talk) 05:11, 1 May 2009 (UTC)

• I'm afraid the change, while an improvement over the non-TOC section headers, is still not the best. The article shouldn't have single-paragraph sections, which is what the recently-introduced Straights and Mixers sections are; that's too stubby. And the article shouldn't have sub-sub-sections at all; it's not that big an article.
• If memory serves, the schools of thought you're thinking of no longer exist, or at least, we have no reliable source saying they currently exist. Coverage of these schools may be appropriate for History but they're not that appropriate for a Schools of thought section.
• The section's text is about straights and mixers; the title Schools of thought and practice styles is not only verbose, but a bit misleading (the phrase "school of thought" appears nowhere in the section's contents, for example).
• For now, I renamed the subsection to Straights and mixers and removed the subsubsection headers Straight and Mixer. This addresses the concerns mentioned above.

Eubulides (talk) 06:13, 1 May 2009 (UTC)

Proposed revision

From the Philosophy section:

Chiropractic philosophy includes the following perspectives:

• Holism assumes that health is affected by everything in people's complex environments; some sources also include a spiritual or existential dimension. In contrast, reductionism in chiropractic reduces causes and cures of health problems to a single factor, vertebral subluxation.

• Conservatism considers the risks of clinical interventions when balancing them against their benefits. It emphasizes noninvasive treatment to minimize risk, and avoids surgery and medication.

• Homeostasis emphasizes the body's inherent self-healing abilities. Chiropractic's early notion of innate intelligence can be thought of as a metaphor for homeostasis.

• A patient-centered approach focuses on the patient rather than the disease, preventing unnecessary barriers in the doctor-patient encounter. The patient is considered to be indispensable in, and ultimately responsible for, the maintenance of health.

I propose we delete the last bulleted point, but am uncertain as to whether it would be a good idea to combine the other three into a text version. Maybe we should just keep them. -- Brangifer (talk) 05:25, 1 May 2009 (UTC)

Keeping them would be OK. So, the only proposal on the table is to delete the last bullet. That's also OK with me. Eubulides (talk) 06:15, 1 May 2009 (UTC)

Fine. -- Brangifer (talk) 06:19, 1 May 2009 (UTC)

I made this change to match the proposed revision. QuackGuru (talk) 19:03, 6 May 2009 (UTC)

No specific objection to remove the questionable text was made. So I removed it. QuackGuru (talk) 21:10, 6 May 2009 (UTC)

I don't see any justification for the deletion of the last bullet. -- Levine2112 ^discuss 21:28, 6 May 2009 (UTC)

I don't see any reason being given to keep the last bullet. QuackGuru (talk) 21:29, 6 May 2009 (UTC)

It was clearly explained why we should remove it. QuackGuru (talk) 21:37, 6 May 2009 (UTC)

There was agreement for this edit. But editors only after the edit was made then it was disputed for no specific reason. No reason has been made to keep it. QuackGuru (talk) 00:30, 7 May 2009 (UTC)

For now I tagged the obsolete information. No reason has been given to keep the last bullet. QuackGuru (talk) 08:08, 7 May 2009 (UTC)

What is the specific objection to this text? -- Levine2112 ^discuss 15:40, 7 May 2009 (UTC)

It was previously explained the reason to remove it. What is the specific reason for keeping the text. QuackGuru (talk) 17:49, 7 May 2009 (UTC)

I disagree that it is original research. The sources quite clearly support the text. (i.e. "emphasizes a patient-centered, hands-on approach intent on influencing function through structure" from refname Chiro Beliefs and "Holism also involves the belief that the patient is a potent and indispensable factor in recovery from disease and the maintenance of health." from refname Keating05) -- Levine2112 ^discuss 18:12, 7 May 2009 (UTC)

That's your opinion. Anyhow, no specific reason has been made to keep it. QuackGuru (talk) 18:17, 7 May 2009 (UTC)

That's no opinion. It's a fact that the sources directly support the two statements. Do you really believe otherwise? -- Levine2112 ^discuss 18:38, 7 May 2009 (UTC)

It is a fact the text is not neutral in tone and promotional. Why keep it? QuackGuru (talk) 19:08, 7 May 2009 (UTC)

no specific reason has been made to keep it? how about the reason that we dont just go around deleting sourced information? what is the problem with this text? why is it questionable text? 70.71.22.45 (talk) 18:41, 7 May 2009 (UTC)

Villanueva-Russell Y (2008). "An ideal-typical development of chiropractic, 1895–1961: pursuing professional ends through entrepreneurial means". Soc Theory Health. 6 (3): 250–72. doi:10.1057/palgrave.sth.8700104.

Grod JP, Sikorski D, Keating JC (2001). "Unsubstantiated claims in patient brochures from the largest state, provincial, and national chiropractic associations and research agencies". J Manipulative Physiol Ther. 24 (8): 514–9. doi:10.1067/mmt.2001.118205. PMID 11677551.{{cite journal}}: CS1 maint: multiple names: authors list (link)

Singh S, Ernst E (2008). Trick or Treatment: The Undeniable Facts about Alternative Medicine. W.W. Norton. p. 170. ISBN 978-0-393-06661-6.

Other sources disagree chiropractic is a patient centered approach. The text is puffery. QuackGuru (talk) 19:08, 7 May 2009 (UTC)

So by your logic, we should leave out the material because is it disputed by other sources. So in essence, the sources for inclusion here are cancelled out by the sources for inclusion of the #Brochure information below. So if you truly believe that one refutes the other, then you must agree that the sentences proposed below in "Brochure" should be left out because it is refuted by the sources used for inclusion here. Agreed? -- Levine2112 ^discuss 19:19, 7 May 2009 (UTC)

The information seems dated. For example, The "Chiro Beliefs" cites: Palmer, DD. The Science, Art, and Philosophy of Chiropractic. Portland, OR: Portland Printing House, 1910. 1910 is very old. The text is promotional jargon. We have better sourcing available and proposed text which is not promotionally written. QuackGuru (talk) 19:33, 7 May 2009 (UTC)

You keep changing your argument everytime I refute your previous one. What is your objection truly? (BTW "Chiro Beliefs" is a source published in 1997. Not too old at all for the context of what it is sourcing, so please tell me that you are not objecting this text based on the age of the source.) -- Levine2112 ^discuss 19:50, 7 May 2009 (UTC)

The existing text is well-sourced, but there is a reasonable concern that it is one-sided. As mentioned previously, are also reliable sources saying that chiropractic is in part "chiropractor-centered" rather than "patient-centered". One way to fix the text (the better way, I think) is to present a balanced approach of both views. The other option is to remove the existing unbalanced text. Eubulides (talk) 19:49, 7 May 2009 (UTC)

The most reasonable option is to remove the puffery. We have better sourcing available. QuackGuru (talk) 20:34, 7 May 2009 (UTC)

I opposed this option based on arguments already given. No need to continue this circular argument. -- Levine2112 ^discuss 20:42, 7 May 2009 (UTC)

You have not given any good reason to keep the text. But editors have explained why it should be removed. QuackGuru (talk) 20:48, 7 May 2009 (UTC)

I removed the disputed text. QuackGuru (talk) 22:55, 10 May 2009 (UTC)

No explantion was given to restore the disputed text. QuackGuru (talk) 19:41, 11 May 2009 (UTC)

Explanations are given above. The text is well-sourced. There is a discussion to modify the text, but there certainly is no consensus to remove the text. -- Levine2112 ^discuss 19:47, 11 May 2009 (UTC)

Explanations was given to remove it. No specific proposal has been made to modify it and there is consensus to remove it. QuackGuru (talk) 19:50, 11 May 2009 (UTC)

Better sources for practice-building

I agree that better sources are needed, as the text and sources proposed above are far too much like original research to be acceptable for Wikipedia. I also agree that the topic of practice-building should be addressed in Chiropractic, as it's an important part of the profession. I suggest the following sources (most of which I currently lack access to and have not read):

• Baer HA (1996). "Practice-building seminars in chiropractic: a petit bourgeois response to biomedical domination". Med Anthropol Q. 10 (1): 29–44. PMID 8689442.
• Grod JP, Sikorski D, Keating JC (2001). "Unsubstantiated claims in patient brochures from the largest state, provincial, and national chiropractic associations and research agencies". J Manipulative Physiol Ther. 24 (8): 514–9. doi:10.1067/mmt.2001.118205. PMID 11677551.{{cite journal}}: CS1 maint: multiple names: authors list (link)
• Villanueva-Russell Y (2008). "An ideal-typical development of chiropractic, 1895–1961: pursuing professional ends through entrepreneurial means". Soc Theory Health. 6 (3): 250–72. doi:10.1057/palgrave.sth.8700104.
• Singh S, Ernst E (2008). Trick or Treatment: The Undeniable Facts about Alternative Medicine. W.W. Norton. ISBN 978-0-393-06661-6. On page 170 this book says "For example, chiropractors, particularly in America, have hearned a reputation for zealously recruiting and unnecessarily treating patients. Practice-building seminars are commonplace and there are numerous publications aimed at helping chiropractors find and retain patients. In many cases the emphasis seems to be placed on economics rather than healthcare .... Many chiropractors are embarrased by the zealous profiteering of their colleagues....

Eubulides (talk) 05:57, 26 April 2009 (UTC)

Treatment of patients

I made this change and this change to get the ball rolling. QuackGuru (talk) 20:10, 6 May 2009 (UTC)

As Schumpeter (1961) suggested, entrepreneurs should rightly pursue profit, however this was not the sole objective of the endeavor. Profit was not to be denied as a goal, but in the end, was only a fringe benefit of an underlying service ethos for chiropractors. Vedder (1924) asserted that chiropractor's training created a duty for chiropractors to disseminate their enlightened knowledge with others. 'Knowing that he has the ability to relieve distress and suffering and pain and sickness it becomes not only a privilege to do so, but an obligation and it likewise becomes an obligation for him to apprise the greatest number of people of that ability' (p. 78). If patients had to be 'sold' in order to agree to care, this commercial trickery was justified because chiropractors were obligated to convert all patients to their paradigm of health.

After all, chiropractors were simply being honest and forthcoming about their advertising and salesmanship. Orthodox medical practitioners also advertised, but attempted to obscure the practice. Medical doctors often had their pictures in the newspaper performing some service and this was no more than a subtle form of free advertising (Dye, 1939, p. 238). Gilmore (1960) asserted that osteopaths and medical doctors were 'openly and vigorously promoted by the various drug firms from which they obtained their prescribed medicines.' And surgeons also, utilized a form of salesmanship involving fear and the desperation of the client: 'Surgeons 'sell' their services, too – they say surgery is absolutely needed and people are willing to bear great expense, pain, and threat of death in pursuit of health'(Johnson and Johnson, 1928, p. 46–47). Chiropractors who repudiated medicine and rejected professionalization in favor of entrepreneurial means felt such practices were justified, honest and righteous, and therefore, deserving of the public's trust.

Villanueva-Russell Y (2008). "An ideal-typical development of chiropractic, 1895–1961: pursuing professional ends through entrepreneurial means". Soc Theory Health. 6 (3): 250–72. doi:10.1057/palgrave.sth.8700104.

Here is some information from the source. QuackGuru (talk) 20:32, 6 May 2009 (UTC)

A recent pair of edits added new text to the article. Any suggestions on where is the best place to put it and improve the text would be appreciated. This article may help improve this page too. QuackGuru (talk) 00:42, 7 May 2009 (UTC)

The largest chiropractic associations in the U.S. and Canada distributed patient brochures which contained unsubstantiated claims. Chiropractors, especially in America, have a reputation for unnecessarily treating patients. In many circumstances the focus seems to be put on economics instead of health care.

Here is the proposal. QuackGuru (talk) 03:41, 7 May 2009 (UTC)

I commented on this in #Brochures below; please follow up there. Eubulides (talk) 07:36, 7 May 2009 (UTC)

CONTINUED BELOW

Long run on sentence

There is a sentence that is longer than other similar sentences. For now I tagged the sentence. QuackGuru (talk) 00:12, 3 May 2009 (UTC)

When I look at the source, I (too?) question whether our wording is in harmony with the source. Can a better wording be formulated here and worked on until we have a consensus version? -- Brangifer (talk) 06:08, 3 May 2009 (UTC)

The best way to fix the problem is to shorten the sentence to about the same length as similar sentences. QuackGuru (talk) 06:54, 3 May 2009 (UTC)

Length alone isn't a legitimate argument. Relevance is more important. -- Brangifer (talk) 07:06, 3 May 2009 (UTC)

There are two problems with the long run on sentence. The first problem is the WP:WEIGHT issue. It is longer than other similar sentences. The other problem is that it gives a misleading conclusion that the spinal manipulation and mobilization had the benefit, but that is not accurate. The addition of exercise was the effect, not SM. It is not that important to go into such detail with the benefit of exercise. QuackGuru (talk) 07:30, 3 May 2009 (UTC)

(outdent) I reread the cited source (Ernst & Canter 2006, PMID 16574972) and found nothing in it that directly supports, or even indirectly supports, the claim "the benefits being pain relief, functional improvement, and global perceived effect for subacute/chronic mechanical neck disorder" that currently appears in Chiropractic. For now I tagged the claim with {{Fv}}. Eubulides (talk) 18:23, 3 May 2009 (UTC)

Agreed. If anything (which would be a reason to keep the source, but reword our presentation of it), it is an example of negative evidence, IOW it shows a lack of effect of SM, whereas it shows that the exercise was the significant factor in the improvement. The way it is worded (spun!) implies that the SM had some positive effect. The spin should be removed. -- Brangifer (talk) 19:09, 3 May 2009 (UTC)

I made this change to trim the long run on sentence. QuackGuru (talk) 19:09, 6 May 2009 (UTC)

No specific objection to shorten the long run on sentence has been made. QuackGuru (talk) 21:08, 6 May 2009 (UTC)

This edit has consensus. The edit was revert again without explanation. After editors discussed the change it was reverted. QuackGuru (talk) 00:26, 7 May 2009 (UTC)

Indeed, that edit had been discussed and there have been no objections here, so the reversion was obstructionism. -- Brangifer (talk) 03:43, 7 May 2009 (UTC)

This has been happening for a number of years now. But we must assume blind faith. QuackGuru (talk) 03:48, 7 May 2009 (UTC)

Since no source has been produced despite the {{Fv}} tag for several days, I removed the phrase in question. Eubulides (talk) 07:36, 7 May 2009 (UTC)

Consistency

The reference style for this article is to abbreviate. This edit contradicts that style. QuackGuru (talk) 00:19, 3 May 2009 (UTC)

That labels the source, but is not a reference in the style like the references in the reference section. I can understand the reason for the change, since using a redirect violates other standards here. To avoid that and still use what appears to be an abbreviation, we could use a piped link: OED That would be an acceptable solution. -- Brangifer (talk) 06:13, 3 May 2009 (UTC)

Why would using "[[OED]]" violate any standards? It is almost entirely equivalent in behavior to using the piped link "[[Oxford English Dictionary|OED]]", and the very slight differences don't matter here. Eubulides (talk) 18:24, 3 May 2009 (UTC)

Since our policies and guidelines have undergone lots of changes since I started here, I'm not sure about the exact policy wordings, but we try to avoid redirects, which cause a drain on servers. Using piped links solves that problem. -- Brangifer (talk) 19:10, 3 May 2009 (UTC)

This is a minor issue. I suggest we go back to the previous version when no preceived problems existed. QuackGuru (talk) 19:22, 3 May 2009 (UTC)

I don't care that much one way or another; it would be fine with me to go back to "[[OED]]". Current guideline is not to bother with pipes like "[[Oxford English Dictionary|OED]]" etc.; see WP:R2D. Eubulides (talk) 09:27, 4 May 2009 (UTC)

Thanks for that link. I wasn't aware of it. -- Brangifer (talk) 13:55, 4 May 2009 (UTC)

I made this change to the abbreviated version. QuackGuru (talk) 19:06, 6 May 2009 (UTC)

No specific objection to abbreviate it has been made. QuackGuru (talk) 21:07, 6 May 2009 (UTC)

There was consensus for this change. After the edit was made then editors reverted it. QuackGuru (talk) 00:23, 7 May 2009 (UTC)

I abbreviated the wikilink. QuackGuru (talk) 22:55, 10 May 2009 (UTC)

Wide gap

This edit added a wide gap between the text and the table. QuackGuru (talk) 00:27, 3 May 2009 (UTC)

I don't know what browser you use, but IE is the most widely used browser, and in it a small gap was made, and the result is as described in the edit summary, which is an improvement. -- Brangifer (talk) 06:18, 3 May 2009 (UTC)

The table in the Chiropractic#Straights and mixers section does not seem to have the wide gap. The tables in the article should be consistent. QuackGuru (talk) 06:54, 3 May 2009 (UTC)

Eubulides has just made it narrower and it works fine for me. As long as the letters don't touch the table (which they did before), it works. -- Brangifer (talk) 07:03, 3 May 2009 (UTC)

Yes, I changed the left margin from 10px to 0.4em. If that doesn't work, please feel free to change the margins to match the other table, for consistency. Eubulides (talk) 18:24, 3 May 2009 (UTC)

awww.. QuackGuru, me hurt. You didn't like my little effort to separate the table from the text? I could have done a lot more to make the table prettier and more consistent across browsers, but I thought I would wait to see if you would revert this one little change.. and you did! :)

I'm curious, QuackGuru. What browser are you using?

--stmrlbs|talk 21:07, 3 May 2009 (UTC)

I think it does not matter what browser is being used. What matters is that both tables in the article have the same margins. I still have a problem with the tables. The margins on both tables are not the same. For consistency I would like both tables to be the same margin. QuackGuru (talk) 04:44, 4 May 2009 (UTC)

What browser you use can make a difference. What version of what browser you have can make a difference. When I view your table with Firefox, it has a big black border around it. When I view it with IE, it has very pale gray border - I almost don't see the border on my laptop.

However, as far as the margin, they are defined differently for the different boxes.

--stmrlbs|talk 06:27, 4 May 2009 (UTC)

It may look different with different browsers but the margins continue to be different with each box. I only want each box to have the same margin. In others words, I want the spacing to be the same for the reader. When the boxes are defined differently for the each box then the margin will also be different. I suggest we make it the same margin for each box. QuackGuru (talk) 06:56, 4 May 2009 (UTC)

I changed the other table to use the same margin. Do things look more consistent now? Eubulides (talk) 09:27, 4 May 2009 (UTC)

Me thinks it is fine now. QuackGuru (talk) 18:36, 4 May 2009 (UTC)

QuackGuru, you don't think the gap by the quote box is too big (on top)? I would think that would look huge to QuackGuru, based on what he said about the 10px gap.

--stmrlbs|talk 20:30, 4 May 2009 (UTC)

Maybe we could work out a compromise. What other margins are good and what is the standard on Wikipedia. QuackGuru (talk) 20:32, 4 May 2009 (UTC)

QuackGuru, if you want the boxes/tables to be consistently presented, then you should have not only consistent gaps, but also consistent borders, and they should be consistently aligned (against the right margin for those right aligned articles). It doesn't matter to me. The only reason I added the gap to your table is that I couldn't read the text that was smack dab against it. QuackGuru's "Two chiropractic belief system constructs" table, before with no gap after my change, with gap If the group agrees to it -wants all the boxes/tables to look consistent, I will be glad to do. Let me know.

--stmrlbs|talk 22:58, 6 May 2009 (UTC)

Isn't the problem fixed now? I changed the margins to be the same for both wikitables. Eubulides (talk) 23:10, 6 May 2009 (UTC)

I think it is good enough, considering what it looked like before.

--stmrlbs|talk 00:11, 12 May 2009 (UTC)

What it looked like before was an abnormal wide gap. Now the gap is much less. QuackGuru (talk) 00:17, 12 May 2009 (UTC)

For everyone else, QuackGuru's "Two chiropractic belief system constructs" table before my change- no gap, text smacked right into the table so that it was hard to read, and after my change- with the "abnormal wide gap" that QuackGuru keeps talking about. Please notice the gap by the quote box and image at the top of the chiropractic article. This gap must look humongous to you, Quackguru.. but you've never said a word about that gap. Nor have you ever said what browser you are using.

If I was the suspicious sort (like thinking everyone was a sockpuppet or something like that), I would think that you just didn't like that change because I made it.

QuackGuru, if you are happy with the way the table is now that Eubulides put in the gap, that is fine with me.  :)

--stmrlbs|talk 01:51, 12 May 2009 (UTC)

You changed one table to a wider gap while leaving the second table with a different smaller gap. Both tables should have the same amount of spacing. Having different spacing for each table was abnormal. QuackGuru (talk) 03:42, 12 May 2009 (UTC)

Think about it for a minute, QuackGuru. You set up the table initially with NO GAP. Look at the the 2 tables. Is NO GAP EQUAL TO SMALL GAP? NO. Not in this universe. I'm surprised you didn't revert your change for that reason. "lack of gap consistency". I will have to remember that reason for future reverts.

(if you want to see inconsist tables, you should display the chiropractic page in firefox)

--stmrlbs|talk 04:38, 12 May 2009 (UTC)

I did not see a "no gap" in the first place. Now both have an equal small gap, not a wider gap with one table. Consistency is better. QuackGuru (talk) 04:50, 12 May 2009 (UTC)

what browser do you use, QuackGuru? Do you know? --stmrlbs|talk 05:34, 12 May 2009 (UTC)

Can't you two just drop this already? You're both satisfied with the result. The rest is just debate and violation of WP:TALK. If you both really wish to have a pissing contest, take it to your talk pages. -- Brangifer (talk) 05:51, 12 May 2009 (UTC)

Web presentation of a visual medium is somewhat important, imo. Half the work in designing any webpage is in trying to make it look presentable in the browsers most people use. I'm curious as to why this table looks different to QuackGuru than to everyone else. That is why I would like to know what browser he is using - and that is why I've asked.. 3 times now. For some reason, he doesn't want to tell me.

--stmrlbs|talk 05:59, 12 May 2009 (UTC)

When I look at the original gap, it sure looks small to me. I looked at the table with IE, Firefox and Chrome, and it looks about the same (small) to me. Which browser are you using, QG?

stmrlbs, I see what you mean about how the table looks in Firefox, but if that's the way the group wants it, fine by me. -- Levine2112 ^discuss 03:39, 13 May 2009 (UTC)

Splinter groups

A brief mention that chiropractic has had splinter groups would improve this article. This could be explained in the straights and mixers section. QuackGuru (talk) 01:11, 3 May 2009 (UTC)

That's one of the elephants in the room and a big hole in the article. It has to do with the controversial nature of the profession, and one of the many results of the controversies is that many splinter groups have and do exist. -- Brangifer (talk) 06:33, 3 May 2009 (UTC)

There was a book that mentioned the splinter groups. But I can't remember which book. QuackGuru (talk) 06:54, 3 May 2009 (UTC)

This seems to be to some extent duplicating the discussion in #Straights and mixers is too narrow above; I've followed up there. Eubulides (talk) 18:23, 3 May 2009 (UTC)

The lead says It has two main groups: "straights", now the minority, emphasize vitalism, innate intelligence and spinal adjustments, and consider subluxations to be the leading cause of all disease; "mixers" are more open to mainstream and alternative medical techniques such as exercise, massage, nutritional supplements, and acupuncture.[8]

The lead indicated there are two main groups. This can be explained in more detail in the body of the article.

Chiropractors have historically fallen into two main groups, "straights" and "mixers"; both have had splinter groups.<ref name=History-PPC/><ref name=Kaptchuk-Eisenberg/>

The WP:LEAD and body go together. QuackGuru (talk) 19:14, 3 May 2009 (UTC)

Something like that might be OK; but where exactly do those two sources say that both have had splinter groups? Eubulides (talk) 09:27, 4 May 2009 (UTC)

Page 94 of PPC is a good place to start. QuackGuru (talk) 18:34, 4 May 2009 (UTC)

I thought this was notable: "The diversity of beliefs among chiropractors defies comprehensive description. However, several clustering of these ideas may provide a useful mental shorthand, and seem to parallel some of the major political divisions within the profession. The practicial (clinical) and ethical implications of these groupings (e.g., evidence-based chiropractic, traditional straight chiropractic, purpose-straight chiropractic) deserve thougthful study by the profession." QuackGuru (talk) 20:30, 4 May 2009 (UTC)

I assume this is the Keating05 citation in Chiropractic? But Keating doesn't say that purpose-straight and evidence-based chiropractic groups are active now; on the contrary, he says the purpose-straight group is dead. See Talk:Chiropractic/Archive 15 #Elimination of reform chiro. So it would be misleading for us to imply that these groups are a significant factor now. Eubulides (talk) 22:01, 4 May 2009 (UTC)

This is from the PPC book. This verified the claim that chiropractic does have splinter groups. QuackGuru (talk) 23:26, 4 May 2009 (UTC)

It verifies the existence of some groups at some time in the past. It does not verify their current existence and importance. And other comments in the same source indicate that purpose-straight is dead. Eubulides (talk) 05:31, 5 May 2009 (UTC)

Chiropractors have historically fallen into two main groups, "straights" and "mixers"; both have had splinter groups.<ref name=History-PPC/><ref name=Kaptchuk-Eisenberg/>

The point is that it does verify the text being proposed for inclusion. I think it is important to briefly mention this in the article. According to the source it does "deserve thougthful study by the profession". This indicates it is important. The sentence explains which groups are the main groups and then ever so briefly states there has been splinter groups. Before there was two whole paragraphs about the splinter groups. A brief mention of the splinter groups satisfies WP:WEIGHT. QuackGuru (talk) 06:29, 5 May 2009 (UTC)

Sorry, I don't see how the quote verifies any claim about "splinter groups", as it doesn't mention anything splintering. Nor does the quote verify the claim that any of the groups is a descendant of any other. This brief quote is quite a slender reed on which to base any claim about the groups. If it's just one sentence in a long chapter, it suggests the topic of these groups isn't that important. Which would be understandable, since the NACM and the super-duper-extreme-straights don't exist any more as groups. Eubulides (talk) 07:15, 5 May 2009 (UTC)

I previously verified the text. The small quote was quoting the end of a sentence which indicates it is important.

Page 94 "The diversity of beliefs among chiropractors defies comprehensive description. However, several clustering of these ideas may provide a useful mental shorthand, and seem to parallel some of the major political divisions within the profession. The practicial (clinical) and ethical implications of these groupings (e.g., evidence-based chiropractic, traditional straight chiropractic, purpose-straight chiropractic) deserve thougthful study by the profession."

Since the source indciates it does "deserve thougthful study by the profession" it is important according to the source. QuackGuru (talk) 07:25, 5 May 2009 (UTC)

Please see #Differences among schools of thought and practice styles below. Eubulides (talk) 04:17, 6 May 2009 (UTC)

Schools of thought and practice styles

This proposal is to change === Straights and mixers === to === Schools of thought and practice styles === and to expand the intro paragraph to the section.

Chiropractic originated from mystical ideas which led to internal conflict within the profession. Chiropractors have historically fallen into two main groups, "straights" and "mixers"; both have had splinter groups. Chiropractic is often described as two professions masquerading as one. Unlike the distinction between podiatry (a science-based profession for foot disorders) and foot reflexology (an unscientific philosophy which posits that many disorders arise from the feet), in chiropractic the two professions attempt to live under one roof. Significant differences exist among the practice styles, claims and beliefs of various chiropractors.

Comments on Schools of thought and practice styles

Here is a proposal to expand the intro of the Straights and mixers section. You are free to edit the above proposal. Unlike the current version, this version tells a story. QuackGuru (talk) 06:50, 4 May 2009 (UTC)

The mystical origins should be specified. Palmer was a spiritualist who claimed to have gotten his ideas from the spirit of a Dr. Atkins, who had been dead for 50 years. That's where he claims to have gotten his "one cause, one cure" idea. In reality he most likely got his ideas from observing traveling medicine men and his education at A. T. Stills Osteopathy school. -- Brangifer (talk) 07:18, 4 May 2009 (UTC)

What would be the best way to clarify this if clarity is needed. A wikilink and/or changing it from "mystical ideas" to "spiritual ideas". QuackGuru (talk) 07:25, 4 May 2009 (UTC)

For now I added a wikilink. QuackGuru (talk) 07:45, 4 May 2009 (UTC)

This is atrocious. I most certainly hope this most biased claptrap never enters this article. —Preceding unsigned comment added by 32.154.164.246 (talk) 08:40, 4 May 2009 (UTC)

You have a nice sense of humor. I appreciate it. QuackGuru (talk) 08:52, 4 May 2009 (UTC)

• Now that I've restored the longstanding "vitalism" text, doesn't that lessen the need to mention mystical ideas?
• The cited source explains that the quasi-mystical concepts it is referring to were folk medicine, magnetic healing, innate intelligence; the article already talks about magnetic healing and innate intelligence, and it's not clear it's worth saying it again in this subsection. A stronger case could be made that folk medicine (bonesetting) should be mentioned in History, or that the quasi-mystical stuff should be mentioned at the start of Philosophy.
• The proposals to mention the NACM and to rename the section have problems, as discussed in #Straights and mixers is too narrow above.

Eubulides (talk) 09:27, 4 May 2009 (UTC)

There is a need to mention the mystical ideas. This explains why there is internal conflict, splits among different groups, and different schools of thought. I think on page 94 of the Chiropractic book is mentions the different schools of thought, internal conflict, and describes the splinter groups. See Talk:Chiropractic/Archive 16#Lead for past discussion. There is a need to explain the mainstream chriopractic opposition to evidence basis and the minorty view. This explains why there are different groups. The section needs to tell a story. This is accomplished with this proposal. The reference being used to verify the text is the best reference to verify and explain why there is opposition from the mainstream view to the minority view. There is internal conflict and this is part of the story. QuackGuru (talk) 17:50, 4 May 2009 (UTC)

By the way, in the book Health Beyond Medicine: A Chiropractic Miracle on page 166 it says "Today there are four main groups of chiropractors: traditional straights, objective straights, mixers, and reforms. All groups, except reforms, treat patients using a system based on the technique of subluxation." QuackGuru (talk) 18:21, 4 May 2009 (UTC)

In the book A Consumers Guide to Alternative Medicine: A Close Look at Homeopathy, Acupuncture, Faith-Healing, and Other Unconventional Treatments on page 70 it says:

The main chiropractic organizations are the American Chiropractic Association (ACA), the straighter International Chiropractors Assocation (ICA), and even straighter Federation of Straight Chiropractic Organizations (FSCO) and World Chiropractic Alliance (WCA). They all promote chiropractic mythology and self-serving propaganda to the public and to legislatures. The ACA is by far the largest of the groups. In a recent poll, 65 percent of WCA members who responded said that their patient education material referred to subluxation as the "silent killer". While most chiropractors continue to promote the dogma that their manipulations can help in systemic ailments, there is no credible research to support the claim. A reformist group, the National Association for Chiropractic Medicine (NACM), requires applicants to a pledge to "openly renounce the historical chiropractic philosophical concept that subluxation is the cause of disease." Its members limit their practice to musculoskeletal problems and have denounced unscientific methods used by their colleages.

I propose we inlcude information about chiropractic associations. QuackGuru (talk) 19:52, 4 May 2009 (UTC)

Neither of these sources are nearly as reliable as Keating 2005. The Chiropractic Miracle book is promotional fluff (are we going to cite its "five secrets to superior health and longevity"? or "why a chiropractor may become your family doctor"?), and the Consumers Guide is ancient (1992). Please, let's come up with reliable sources in this area, preferably review articles in refereed journals. Eubulides (talk) 22:01, 4 May 2009 (UTC)

Mainstream chiropractors tend to oppose the minority view of limiting the scope of practice to an evidence basis from using manipulation and physiotherapy methods to treat only musculoskeletal disorders.

For now I moved this out of the proposal. QuackGuru (talk) 23:47, 4 May 2009 (UTC)

Here is another book. On page 9 it has information on various chiropractic organizations. Educational Opportunities in Integrative Medicine: The A-to-Z Healing Arts Guide and Professional Resource Directory. Does this book meet RS? QuackGuru (talk) 00:08, 5 May 2009 (UTC)

I dunno: that's a job-hunter's book, written by an MBA, for job categories ranging from ayurveda to yoga training. That can't be all that good a source for this topic. Eubulides (talk) 05:31, 5 May 2009 (UTC)

Please see #Differences among schools of thought and practice styles below. QuackGuru (talk) 02:18, 6 May 2009 (UTC)

Differences among schools of thought and practice styles

This proposal is to change === Straights and mixers === to === Schools of thought and practice styles === and to expand the intro paragraph to the section.

• Chiropractors have historically fallen into two main groups, "straights" and "mixers"; both have had splinter groups.<ref name=History-PPC/><ref name=Kaptchuk-Eisenberg/>

Part of the conclusion of the chapter on page 94: "The diversity of ideas in the profession defies comprehensive, but several more or less distinct grouping of principles may be identied. Among the more prominent of there are evidence-based chiropractic, traditional straight chiropractic, purpose-straight chiropractic. Differences among these schools of thought form the basis for intraprofesional disputes, and failure to coalesce around a shared set of principles has hampered formation of a united front for a interprofesional activity."

Part of the summary of the chapter on page 94: "The diversity of beliefs among chiropractors defies comprehensive description. However, several clustering of these ideas may provide a useful mental shorthand, and seem to parallel some of the major political divisions within the profession. The practicial (clinical) and ethical implications of these groupings (e.g., evidence-based chiropractic, traditional straight chiropractic, purpose-straight chiropractic) deserve thougthful study by the profession."

Keating JC Jr (2005). "A brief history of the chiropractic profession". In Haldeman S, Dagenais S, Budgell B et al. (eds.) (ed.). Principles and Practice of Chiropractic (3rd ed.). McGraw-Hill. p. 94. ISBN 0-07-137534-1. {{cite book}}: |editor= has generic name (help)CS1 maint: multiple names: editors list (link)

The text from Principles and Practice of Chiropractic verifies chiropractic has had splinter groups and specifically states there are "Differences among these schools of thought". The title Schools of thought and practice styles would be a good fit for the section name.

• Chiropractic originated from mystical ideas which led to internal conflict within the profession.<ref name=Ernst-eval/>

From Ernst 2008: "Chiropractic is rooted in mystical concepts. This led to an internal conflict within the chiropractic profession, which continues today."

Ernst E (2008). "Chiropractic: a critical evaluation". J Pain Symptom Manage. 35 (5): 544–62. doi:10.1016/j.jpainsymman.2007.07.004. PMID 18280103.

It is reasonable to specifically state chiropractic is rooted in mystical ideas which explains why there is internal conflict, splits among different groups, and different schools of thought. It establishes the historical reason for why the split exists. QuackGuru (talk) 02:18, 6 May 2009 (UTC)

• That quote from PPC verifies nothing about "splinter groups". The quote talks about groupings of principles, not of people. And it contains no implication that any of these groupings are splinter.
• Furthermore, the PPC quote says that "implications ... deserve thoughtful study"; i.e., it is a call for more research. Lots of papers call for more research; this is hardly a notable point and if anything indicates that any conclusions in this area are speculative or tentative.
• In short, the PPC quote does not at all verify the proposed text: it's quite a different point than the point made by the text.
• The section header "Schools of thought and practice styles" is verbose and confusing. It does not summarize the section; the section does not mention schools of thought and it talks about "practice styles" just once. In contrast, it mentions straights and mixers multiple times each. "Straights and mixers" is a much better title: not only does it it summarize the section more accurately, it uses more-vivid wording.
• The proposed text "Chiropractic originated from mystical ideas which led to internal conflict within the profession." might be reasonable, with some questions.
  1. Where would it be placed?
  2. Shouldn't the surrounding text be altered to avoid duplication?
  3. "Mystical ideas" should wikilink to Mysticism, not to Spirituality.
  4. The source would better support "has led" than "led", as the conflict is continuing.

Eubulides (talk) 04:17, 6 May 2009 (UTC)

Chiropractic originated from mystical ideas which has led to internal conflict within the profession.<ref name=Ernst-eval/>

The reader is not going to understand why divisions among chiropractors exists without this sentence in the article. I'm not sure how to alter it to avoid any perceived duplication. I propose this new sentence be the first sentence of the "Straights and mixers" or somewhere in the intro paragraph. QuackGuru (talk) 05:55, 6 May 2009 (UTC)

Oppose. This article already suffers a WP:WEIGHT violation through it's over-sourcing of Ernst (13x!). The last thing this article needs is yet another opinion from Ernst. -- Levine2112 ^discuss 07:11, 6 May 2009 (UTC)

The reader has no idea what caused chiropractic to have internal conflicts. The best thing for the "Straights and mixers" section is to explain this in the intro. QuackGuru (talk) 07:19, 6 May 2009 (UTC)

That's your opinion. Per my comment above, I disagree that it is the best thing for the article. -- Levine2112 ^discuss 07:32, 6 May 2009 (UTC)

Your argument is a good reason to include the information because you did not say anything was wrong with the text. Hopefully we can work together on improving this page instead of others getting involved. QuackGuru (talk) 07:44, 6 May 2009 (UTC)

Levine2112, where in the article does it explain what caused internal conflicts. We should not let the reader be blind to the historical reason which led to internal differences. QuackGuru (talk) 18:08, 6 May 2009 (UTC)

Levine2112, can you explain where in the article the reader will understand why chiropractic had internal conflicts. QuackGuru (talk) 21:21, 6 May 2009 (UTC)

(outdent) The proposed sentence summarizes (and is therefore largely duplicative of) the 1st paragraph of Philosophy. That paragraph therefore seems to be a better location for the sentence. But the other sentences of that paragraph need to be adjusted slightly; merely prepending the sentence to the paragraph would be jarring. Come to think of it, the 1st paragraph of Philosophy is largely duplicative of Straights and mixers. Perhaps we should take this opportunity to merge the two; this should let us trim some of the duplication while we're at it. Eubulides (talk) 15:58, 6 May 2009 (UTC)

Chiropractic's early philosophy was rooted in vitalism, spiritual inspiration and rationalism;<ref name=Keating05/> the early mystical ideas has led to internal conflict within the profession.<ref name=Ernst-eval/>

I'm not sure the best way to merge these two sentences but I gave it a try. I don't know what else needs merging between the two sections. For now I would like to finish this sentence or you could start a new thread with the proposed merge of both sections along with the new proposed sentence. QuackGuru (talk) 18:08, 6 May 2009 (UTC)

Surely it would be better to merge the "internal conflict" bit with the "However" later in that paragraph, as the "However" introduces the idea of conflict. Also, I would change "the early" to "these", and "has led" to "have led". I'll see what I can do about a more-ambitious merge proposal, but there's no rush. Eubulides (talk) 23:10, 6 May 2009 (UTC)

Chiropractic's early philosophy was rooted in vitalism, spiritual inspiration and rationalism;<ref name=Keating05/> these mystical ideas have led to internal conflict within the profession.<ref name=Ernst-eval/>

I'm not sure where the best placement is for this sentence but what I do know is that it will greatly improve the page. QuackGuru (talk) 00:07, 7 May 2009 (UTC)

Again, it's better to integrate this into the "However" sentence rather than in the 1st sentence (which is what was done in the previous comment). Eubulides (talk) 07:36, 7 May 2009 (UTC)

However, these mystical ideas have led to internal conflict within the profession;<ref name=Ernst-eval/> most practitioners currently accept the importance of scientific research into chiropractic,[21]

I'm not sure about placement of the text. QuackGuru (talk) 07:49, 7 May 2009 (UTC)

That's better, but it still doesn't flow smoothly. The reader should clearly understand that the conflict between the straights and the mixers comes from the disputes over whether the mystical concepts should trump science. Admittedly it won't be trivial to word this. Eubulides (talk) 19:49, 7 May 2009 (UTC)

I added the "mystical ideas" to the chiropractic history page. QuackGuru (talk) 22:55, 10 May 2009 (UTC)

Revert mass edits

QuackGuru seems to have problems understanding WP:CON. Most of his edits have been rebuffed or challenged on this page yet he has continuously attempted to slowly edit-war them into place. Thoughts? -- Levine2112 ^discuss 20:57, 6 May 2009 (UTC)

Please read the above threads. All my edits were discussed and no specific objection to my edits were made. QuackGuru (talk) 21:00, 6 May 2009 (UTC)

WP:IDHT seems oddly appropriate all of a sudden. -- Levine2112 ^discuss 21:01, 6 May 2009 (UTC)

You have not provided any specific objection to the edits. QuackGuru (talk) 21:05, 6 May 2009 (UTC)

Here is evidence that Levine2112 has ignored previous discussion. QuackGuru (talk) 21:14, 6 May 2009 (UTC)

You made that edit 2 minutes ago declaring that no specific objections were made. You're being disruptive now by gaming the system. -- Levine2112 ^discuss 21:26, 6 May 2009 (UTC)

You still have not provided any specific objection to my edits. Please read the other threads. QuackGuru (talk) 21:27, 6 May 2009 (UTC)

Levine2112, you should be commenting in the appropriate sections above. Those threads will answer your questions. These edits have been discussed and there were no objections, so QG's edits were proper and your reversions are obstructive. Please discuss above, not here. -- Brangifer (talk) 03:50, 7 May 2009 (UTC)

It seems a bit much to call those recent edits "mass edits", as the total number of changes is fairly small. It also seems a bit much to call the reversion of these edits "disruptive"[4] in an edit summary. Please try to stay calm and discuss changes here in a reasonable way, before installing anything that's potentially controversial. (See #Brochures below for info on one such installation.) Eubulides (talk) 23:10, 6 May 2009 (UTC)

imo, since this Wikipedia is a public medium, the full name should be used instead of a Wikipedia acronym whenever possible. I think "Oxford English Dictionary" means much more to most people than OED.

Why did Quackguru remove this?: "A patient-centered approach focuses on the patient rather than the disease, preventing unnecessary barriers in the doctor-patient encounter.[20] The patient is considered to be indispensable in, and ultimately responsible for, the maintenance of health.[21]"

I also think to add something as vague as "Various chiropractic groups distributed patient brochures which contained unsubstantiated claims." What groups? what claims? too vague.

--stmrlbs|talk 00:18, 7 May 2009 (UTC)

Please read previous discussion for the OED bit and patient-centered approach bit. If you think the "Various chiropractic groups" bit is too vague then that what would you propose to make it not vague. QuackGuru (talk) 00:36, 7 May 2009 (UTC)

Stmrlbs, you should be commenting in the appropriate sections above. Those threads will answer your questions. These edits have been discussed and there were no objections, so QG's edits were proper and your reversions are obstructive. Please discuss above, not here. -- Brangifer (talk) 03:48, 7 May 2009 (UTC)

your kidding! that it is 'obstructive' for someone to revert an edit that they dont agree with? have you ever heard of WP:BRD? just because they didnt discuss it before they reverted it does not make it 'obstructive'. give me a break!

Not kidding. This subject has been beaten into the ground for several years now and no significant new proposals or RS have been brought forward that change the matter. Since you are new here, you are excused for not recognized this push by Levine2112 as obstructive, but he's been beating this dead horse for years, and that is considered obstructive/disruptive behavior here. If new information or RS of a different type had been found, this would be a very different discussion. Until then it's plain disruption. -- Brangifer (talk) 23:19, 7 May 2009 (UTC)

This article is on a controversial topic, and as such it makes sense to discuss potentially-controversial changes, preferably before they're made, but at least soon after. This includes reverts; they should be discussed as well. Eubulides (talk) 19:49, 7 May 2009 (UTC)

Mysterious IP reverts

http://en.wikipedia.org/wiki/Special:Contributions/166.191.172.116

http://en.wikipedia.org/wiki/Special:Contributions/166.191.166.100

http://en.wikipedia.org/wiki/Special:Contributions/166.191.225.235

http://en.wikipedia.org/wiki/Special:Contributions/166.190.79.69

This IP sock seems to be the same IP sock here.

This IP sock made a strange statement "Undocumented claim" when the abstract clearly indicates the text is faithfully sourced. And then Levine2112 was quick to support the IP sock with a revert stating, actually I just read the source. It says nothing about Mysticism... see talk..

This mysterious revert was undiscussed on the talk page by the IP. All these edits made by the IP could not be an editor who forgot to log in. I think the edit by the IP should be completely reverted because no specific explanation on the talk page was given for the revert while other editors have given reasons for their edits. The last edit to the page restored most of the information the IP deleted. There is still a concern for the puffery in the philosophy section restored without discussion on the talk page by the IP. Finally, there is the missing wikilink spiritual inspiration, and a change from the word "among" to "between". QuackGuru (talk) 19:46, 12 May 2009 (UTC)

http://en.wikipedia.org/w/index.php?title=Chiropractic&diff=prev&oldid=289621649

http://en.wikipedia.org/w/index.php?title=Chiropractic_history&diff=289600392&oldid=289414602

Here are two more edits made by IPs. No comment on the talk page has been made by the mysterious IPs. QuackGuru (talk) 06:22, 13 May 2009 (UTC)

http://en.wikipedia.org/w/index.php?title=Chiropractic_history&diff=prev&oldid=289690250

Here is another IP that reverted an edit when the text is faithfully sourced. QuackGuru (talk) 16:19, 13 May 2009 (UTC)

IP addresses seem to have jumped out of the woodwork in the recent edit war, which would be a very strange thing if the IP addresses had been acting independently: the page had been quiet for some time. It would help everybody concerned if editors logged in before making potentially-controversial edits (see WP:LOGIN for details). Eubulides (talk) 23:12, 14 May 2009 (UTC)

Grammar issue

The source states "There are significant differences between straight chiropractic, conservative mixing chiropractic, and liberal mixing chiropractic." Healey JW (1990). "It's where you put the period". Dyn Chiropr. 8 (21). This is more than between two groups. This is among straight chiropractic, conservative mixing chiropractic, and liberal mixing chiropractic. This is a grammar issue. So is "between" correct or is "among". QuackGuru (talk) 20:21, 12 May 2009 (UTC)

I made the change without looking at the source because the grammar was simply bad. The source backs up my edit by also using the same word. Between can apply to differences between more than two. There is no reason to deviate from the source by using "among", which is poor grammar. The source uses proper grammar, and so should we. -- Brangifer (talk) 13:51, 13 May 2009 (UTC)

I thought when something is more than between two it would be "among" which means more than two. For example, this content dispute is between two editors. If a third editor commented, it would be among three editors. QuackGuru (talk) 15:27, 13 May 2009 (UTC)

Bigger issue. This source is really old and may not speak for the state of things currently. -- Levine2112 ^discuss 22:13, 13 May 2009 (UTC)

The source happens to use "between", and I think it's correct. "Among" just sounded wrong to me, and when the source also prefers "between", that clinched it for me.

As to the issue of the current state of things, it still applies. Some subluxation based chiropractors have softened their stance, so for them the differences wouldn't be quite as "significant", while others have strengthened their stance, so the diferences are even more significant. There are plenty of writings and websites that show these differences are alive and well. -- Brangifer (talk) 01:24, 14 May 2009 (UTC)

I know that and you know that. I'm just saying that perhaps we should find a source which isn't 20 years old stating this. -- Levine2112 ^discuss 01:49, 14 May 2009 (UTC)

You think chiropractic sources are reliable according to your editing pattern. QuackGuru (talk) 19:13, 14 May 2009 (UTC)

"find a source which isn't 20 years old". I agree. We have a more-recent source (Keating 2005) which says (p. 94) "The diversity of beliefs among chiropractors defies comprehensive description." Chiropractic is already citing that source in Philosophy, to support the claim "a wide diversity of ideas currently exists among chiropractors". With this in mind, it is repetitive and redundant for the article to also claim "Significant differences exist among the practice styles, claims and beliefs of various chiropractors." a couple of paragraphs later. I suggest that we remove the latter claim, which (as Levine2112 mentions) is poorly-sourced. Eubulides (talk) 23:12, 14 May 2009 (UTC)

I made this change to remove the duplication. QuackGuru (talk) 19:53, 17 May 2009 (UTC)

Brochures

A recent pair of edits added this text to Chiropractic #Scope of practice:

"Various chiropractic groups distributed patient brochures which contained unsubstantiated claims. Chiropractors, especially in America, have a reputation for unnecessarily treating patients. In many circumstances the focus seems to be put on economics instead of health care."

This text has little to do with scope of practice, and it contains potentially-controversial text that was added without discussion here. I suggest that it be reverted. It's better to discuss potentially-controversial changes here first, before installing them. Eubulides (talk) 23:10, 6 May 2009 (UTC)

Please see Talk:Chiropractic#Treatment of patients above. QuackGuru (talk) 00:38, 7 May 2009 (UTC)

I agree that this controversial (well, only because certain obstructive editors will dispute its inclusion, even though it is written by chiropractors and is undisputable fact) text should be discussed first and formulated better. It should be included, but the inclusion was poorly formulated and totally unattributed. It can be done better. -- Brangifer (talk) 03:30, 7 May 2009 (UTC)

I am following up here, rather than in #Treatment of patients above. (I suggest that further comments continue to be made here; it is confusing to have these discussions bifurcated all the time.) The revised proposal in that section doesn't address the comments I made above. In particular, the existing coverage of abuse, fraud, and quackery is in Chiropractic #Education, licensing, and regulation, which suggests that this new text needs to be added there too. However, a new paragraph should not be just plopped in there; the new text should be integrated with what's already there. Eubulides (talk) 07:36, 7 May 2009 (UTC)

The largest chiropractic associations in the U.S. and Canada distributed patient brochures which contained unsubstantiated claims. Chiropractors, especially in America, have a reputation for unnecessarily treating patients. In many circumstances the focus seems to be put on economics instead of health care.

I propose we add these two sentences to the article. QuackGuru (talk) 07:57, 7 May 2009 (UTC)

This seems like such a minor point in the grand scheme of the subject and I object to it being inserted per WP:WEIGHT and WP:NPOV in general. It seems that inserting this is an attempt to further push a negative spin on the subject rather a fair attempt at a neutral article. -- Levine2112 ^discuss 15:42, 7 May 2009 (UTC)

What is the specific objection? QuackGuru (talk) 17:46, 7 May 2009 (UTC)

WP:WEIGHT and WP:NPOV. -- Levine2112 ^discuss 18:38, 7 May 2009 (UTC)

You have not given a specific reason for excluding it. The text is sourced and neutral in tone. QuackGuru (talk) 19:10, 7 May 2009 (UTC)

Sure I have. Though this text is faithfully sourced, it is extremely POV yet presented as plainly factual. An article should not present opinions as facts. Furthermore, this opinion seems inconsequential in the grand scheme of the subject. We have limited space. Let's leave the petty POV minutia out. -- Levine2112 ^discuss 19:24, 7 May 2009 (UTC)

You have not explained what is not NPOV about it. You believe the text is "faithfully sourced". QuackGuru (talk) 19:33, 7 May 2009 (UTC)

The problem of unsubstantiated claims being made for chiropractic is a notable one, and it's definitely not a WP:WEIGHT violation to mention it. On the contrary, it'd be a WP:WEIGHT violation if the problem were omitted from the article. Similarly for the problem of unnecessary treatment. However, this proposal doesn't say exactly where the text should be added. Eubulides (talk) 19:49, 7 May 2009 (UTC)

I disagree that it is a notbale - certainly not as notable as the proposed text is making it out to be. What about the substantiated claims? Are those too just as notable in your mind? The POV comes in when we ask, "Who is saying that a claim in unsubstantiated? Who is saying that the same claim is substantiated? Who is right and who is wrong? Do we cite these positions as facts or attribute them as opinions?" Until we can honestly address these questions, then the proposed text (IMO) remains in violation of WEIGHT and NPOV. -- Levine2112 ^discuss 19:54, 7 May 2009 (UTC)

You previously stated the text is "faithfully sourced". Simon says attribution is unnecessary. QuackGuru (talk) 20:34, 7 May 2009 (UTC)

• The cited source (Grod et al. 2001, PMID 11677551) says that the claims in question are unsubstantiated. And this is not an isolated source on the topic of chiropractic and exaggerated claims. There is also Gilbey 2008 (PMID 18670471), Sikorski & Grod 2003, and others. For example, Cooper & McKee 2003 (PMID 12669653), writes that chiropractic 'risks damaging its legitimacy in both the public and political arenas by false and exaggerated claims that emanate not only from individual practitioners but also from its major organizations'; and Keating et al. 2005 (PMID 16092955) writes, 'Whether the ACC's subluxation claims have succeeded as a political statement is beyond our concern here. These assertions were published as a priori truths (what many chiropractors have traditionally referred to as "principle"), and are exemplary of scientifically unjustified assertions made in many corners of the profession.' There is no controversy among reliable sources that chiropractors make some claims that are false or exaggerated or scientifically unjustified, and that this is a significant problem.
• The substantiated claims of chiropractic are notable, and are covered quite extensively in Chiropractic #Effectiveness, which is a sizeable fraction of the article. I don't see how one could plausibly argue that substantiated claims are ill-covered in Chiropractic.

Eubulides (talk) 20:43, 7 May 2009 (UTC)

I see no problem with properly attributing these chiropractic opinions, based on chiropractic research of chiropractic literature. Make it clear this is a notable and uncontroverted opinion of major chiropractic researchers based on very clear and abundant evidence. -- Brangifer (talk) 23:37, 7 May 2009 (UTC)

i reverted the addition of such material because it is clearly not NPOV and there are issues with WEIGHT as well, i mean Ernst, a major CRITIC of chiropractic is already cited way too much and we shouldnt be giving more weight to his OPINIONS. You can tell from the edit history of the article too that there is no way there is consensus to add this to the article probably because of these reasons 70.71.22.45 (talk) 19:02, 11 May 2009 (UTC)

It was previously explained it would be a WEIGHT violation not to include the text. QuackGuru (talk) 19:16, 11 May 2009 (UTC)

It was previously explained why it would be a WEIGHT violation to keep it. I removed the whole section until some consensus on the matter can be reached. -- Levine2112 ^discuss 19:35, 11 May 2009 (UTC)

Without prior discussion the entire paragraph was completely removed. No specific reply was given to "Unsubstantiated claims are well-sourced and notable. Substantiated claims are already well-covered."[5] QuackGuru (talk) 19:53, 11 May 2009 (UTC)

Either you somehow missed the reams of prior discussion above your comment or you are ignoring the input of editors who disagree with you... lets get real. 70.71.22.45 (talk) 20:32, 11 May 2009 (UTC)

There was no prior discussion above to delete an entire paragraph for no valid reason. QuackGuru (talk) 20:50, 11 May 2009 (UTC)

A real discussion has taken place but an editor has continued to ignore the dicussion. QuackGuru (talk) 22:19, 11 May 2009 (UTC)

endlessly repeating urself doesnt make a discussion 70.71.22.45 (talk) 23:33, 11 May 2009 (UTC)

No specific objection was made to the real discussion. QuackGuru (talk) 23:43, 11 May 2009 (UTC)

NPOVing Education, licensing, and regulation

A 2008 commentary proposed that the chiropractic profession actively regulate itself to combat abuse, fraud, and quackery, which are more prevalent in chiropractic than in other health care professions, violating the social contract between patients and physicians. Unsubstantiated claims about the efficacy of chiropractic have continued to be made by individual chiropractors and chiropractic associations. The largest chiropractic associations in the U.S. and Canada distributed patient brochures which contained unsubstantiated claims. Chiropractors, especially in America, have a reputation for unnecessarily treating patients. In many circumstances the focus seems to be put on economics instead of health care. Sustained chiropractic care is promoted as a preventative tool but unnecessary manipulation could possibly present a risk to patients. A study of California disciplinary statistics during 1997–2000 reported 4.5 disciplinary actions per 1000 chiropractors per year, compared to 2.27 for MDs; the incident rate for fraud was 9 times greater among chiropractors (1.99 per 1000 chiropractors per year) than among MDs (0.20).

This proposal is to fix the WEIGHT and NPOV violations. The text is proposed to go in the last paragraph of Chiropractic #Education, licensing, and regulation. QuackGuru (talk) 20:34, 7 May 2009 (UTC)

Oppose per WEIGHT and NPOV objections stated above. -- Levine2112 ^discuss 20:41, 7 May 2009 (UTC)

Please be specific. Your previous comments was a good reason to include to text, especially when it is faithfully sourced. QuackGuru (talk) 20:45, 7 May 2009 (UTC)

More whitewashing from Levine2112. Is chiropractic controversial? Yes. Why? This is one of the most significant reasons. To leave it out would violate NPOV and WEIGHT. -- Brangifer (talk) 23:35, 7 May 2009 (UTC)

I added the proposal to the article. QuackGuru (talk) 22:55, 10 May 2009 (UTC)

Kusserow noted that, ‘‘overtly aggressive marketing [is]...deliberately aimed at misleading patients and the public regarding the efficacy of chiropractic care.’’135 In fact, unsubstantiated claims regarding the efficacy of chiropractic continue to be made, not merely by overenthusiastic individuals but also by official organizations. For instance, a patient brochure published by the UK General Chiropractic Council (the body that oversees chiropractic in Great Britain) stated that ‘‘chiropractors primarily treat: spine, neck and shoulder problems, joint, posture and muscle problems, sciatica, sports injuries, tension headaches and benefit may also be seen for some types of asthma, digestive disorders, migraine, infant colic, menstrual pains.’’136

This is from Chiropractic: A Critical Evaluation QuackGuru (talk) 18:53, 14 May 2009 (UTC)

I made this change to fix the WEIGHT violation. QuackGuru (talk) 19:05, 14 May 2009 (UTC)

Maintenance chiropractic care is promoted as a preventative measure for both musculoskeletal and visceral problems92 even though ‘‘such unnecessary manipulation might present a risk to patients.’’93

This is from Chiropractic: A Critical Evaluation QuackGuru (talk) 19:34, 14 May 2009 (UTC)

I made this change to fix the WEIGHT violation. QuackGuru (talk) 19:53, 14 May 2009 (UTC)

I made this change to fix the WEIGHT violation. No specific objection was made to the real discussion. QuackGuru (talk) 19:51, 17 May 2009 (UTC)

Doctor title

Some chiropractors appeared to have used the title 'Doctor' in a way that implied they are a registered medical practitioner, when no evidence was presented it was true.[6]

Here is another proposal for the section. QuackGuru (talk) 03:55, 8 May 2009 (UTC)

Um, that's New Zealand, so that should be clear. But this is a minor study and certainly not up to the level set here for sources. -- Levine2112 ^discuss 06:05, 8 May 2009 (UTC)

That's why it begins with the word "Some". Do you have any specific proposal for improving it. QuackGuru (talk) 06:07, 8 May 2009 (UTC)

"Some" is a vague term and frowned upon by Wikipedia GA standards. Try being more specific. Regardless, this is a weak source. -- Levine2112 ^discuss 06:32, 8 May 2009 (UTC)

Do you have any particular wording in mind. You believed a chiropractic promotional website is very reliable for Wikipedia standards. This ref is far more reliable. QuackGuru (talk) 06:45, 8 May 2009 (UTC)

Not for how you are (mis)using it. -- Levine2112 ^discuss 07:37, 8 May 2009 (UTC)

I don't understand what you mean. Please be specific. QuackGuru (talk) 07:40, 8 May 2009 (UTC)

I've been as specific as one can be. You use of "some" is vague and therefore misleading. Also, the source is weak as this article - by Eubulides' doing - relies on reviews of literature and not one-off studies. -- Levine2112 ^discuss 16:36, 8 May 2009 (UTC)

Directories

It is not uncommon for a Chiropractor to provide a no obligation and sometimes reduced fee consultation to prospective patients, to find out of Chiropractic may be beneficial to them. There are over 22 000 searches a month for the phrase "Chiropractor" so a directory may be the best first port of call. —Preceding unsigned comment added by Stevloc (talk • contribs) 08:10, 19 May 2009 (UTC)

It is not specifically meant for this article. I have added it to another article for now. The other article is about chiropractic education that covers doctor of chiropractic. You believed a chiropractic promotional website is reliable for Wikipedia. I'll do my best to fix the perceived vague. QuackGuru (talk) 17:55, 8 May 2009 (UTC)

Too many quotes in Vertebral subluxation

A recent edit to Vertebral subluxation added even some more quotes. This section is weaker than it should be, because it uses too many quotes rather than simply stating its points. We should not make things worse by inserting even more quotes. Wikipedia articles are not supposed to be quote farms, and there are currently so many quotes in that section that it detracts from what should be an encyclopedic feel. Eubulides (talk) 07:36, 7 May 2009 (UTC)

Agreed. (WTF?!) I think those quotes would be better suited at Vertebral subluxation. They are so specific to that subject and only tangential to this one. -- Levine2112 ^discuss 15:44, 7 May 2009 (UTC)

Come on Eubulides. I expect this type of obstructive and whitewashing behavior from Levine2112 (which he's doing above as well), but I'm beginning to wonder if you aren't acting more like a good hand sock of his. You make an effective tag team. The quotes happen to directly address the subject in the previous sentence, and are from one of the highest-placed leaders in the profession, hence they are a very significant opinion. Maybe they should be used instead of some other less significant quotes? -- Brangifer (talk) 23:33, 7 May 2009 (UTC)

The same paragraph seems to contradict itself. It says it is a "functional entity" then another sentence says that subluxation are "not structural entities". This is a bit confusing to a reader who is not familiar with vertebral subluxation. Are there more reliable sources on this. QuackGuru (talk) 03:40, 8 May 2009 (UTC)

being a functional entity is not a contradiction of being a structural entity... for example say someone has altered proprioception in their ankle they have a problem with function but not with structure 70.71.22.45 (talk) 04:37, 8 May 2009 (UTC)

Indeed. There is no contradiction. The section just happens to quote from different schools of thought in the profession, so they are naturally meaning different things when they use the word. This may be confusing to readers, and such wordings should be attributed to straights or reformers (mixers who deny subluxations, since most mixers ascribe to them). Straight chiropractors wish to retain the use of the term "subluxation", but they mean something different than when all other members of the medical community use the word. Some mixers (mixers who don't ascribe to subluxations are reformers) are attempting to get the profession to stop using the word as anything other than a historical word, but not as a description of a real, physical entity. They are using the word in its medical meaning - a structural entity. -- Brangifer (talk) 05:07, 8 May 2009 (UTC)

My objection to the section is not about its content, but about its style. Wikipedia articles should not be a collection of glued-together quotations; quotations are Wikiquote's job. For more on this subject please see When not to use quotations. As I understand it, the other editors who have commented on this topic agree that the section relies too heavily on quotes. Eubulides (talk) 23:12, 14 May 2009 (UTC)

Begin the rewrite of Vertebral subluxation

Change this: Attorney David Chapman-Smith, Secretary-General of the World Federation of Chiropractic, has stated that "subluxations are not structural entities and cannot be detected on x‑ray."

To this: Vertebral subluxation is not a structural entity and cannot be identified on a x‑ray.

This proposal is to begin removing the quotes in Vertebral subluxation. QuackGuru (talk) 05:25, 8 May 2009 (UTC)

Unfortunately that would remove the important attribution. We are writing about the different opinions on the subject, not about the "truth". Different opinions need attribution. That will make it NPOV. Without attribution, and just stating it as fact (which it is), we violate NPOV. It must be stated as the opinion of someone, unless it is an uncontroverted fact like the earth is round, one which 99% of the population agree is fact. This subject is not in that class. -- Brangifer (talk) 05:45, 8 May 2009 (UTC)

Per WP:ASF, attribution is unecessary. We can remove all the attribution and quotes in the section. QuackGuru (talk) 05:47, 8 May 2009 (UTC)

Actually you have ASF backwards. We are not supposed to assert facts as though they were opinions. Hence the call for attribution. -- Levine2112 ^discuss 07:38, 8 May 2009 (UTC)

Per WP:ASF, When No one seriously disputes any of these things, so we assert as many of them as possible.

By value or opinion, on the other hand, we mean "a matter which is subject to dispute."

No evidence has been presented there is any serious dispute from reliable references. Please show a dispute over the facts among reliable references. When the facts are not in dispute we assert it as fact without attribution. QuackGuru (talk) 19:49, 8 May 2009 (UTC)

Sure, for instance: The vertebral subluxation has a misalignment component that is measured with a very specific and repeatable x-ray analysis, and a neurological component that is detected as an imbalance in supine leg length, palpable tenderness in the suboccipital muscles, and asymmetric skin temperature in the paraspinal area. [7] -- Levine2112 ^discuss 20:51, 8 May 2009 (UTC)

There is no serious dispute among reliable references. The opinion of chiropractors does not qualify as a serious dispute. Chiropractors dispute the opinion of Ernst but we assert that opinion as fact. Please, let's stick to reliable references and not reach down into unreliable opinions. See WP:RS. QuackGuru (talk) 20:40, 8 May 2009 (UTC)

Um, chiropractic sources would probably be among the most reliable in documenting a chiropractic dispute. -- Levine2112 ^discuss 20:51, 8 May 2009 (UTC)

I understand you think chiropractic sources would probably be among the most reliable. But the most unreliable sources are chiropractic sources. Please see WP:MEDRS. QuackGuru (talk) 21:11, 8 May 2009 (UTC)

I understand that you think that this source is unreliable in this situation. I disagree. -- Levine2112 ^discuss 22:38, 8 May 2009 (UTC)

For now I formatted the two references. It does seem there is too many quotes. QuackGuru (talk) 22:55, 10 May 2009 (UTC)

Treatment techniques

After reviewing the article again, I still think the Chiropractic#Treatment techniques is the weakest section. Readers may want to know more about what techniques chiropractors employ. The section is a bit boring.

• Cooperstein R, Gleberzon BJ (2004). Technique Systems in Chiropractic. Churchill Livingstone. ISBN 0-443-07413-5. (This source is already cited, but is hard for most editors to obtain.)
• Gleberzon BJ (2001). "Chiropractic 'Name Techniques': a review of the literature" (PDF). J Can Chiropr Assoc. 45 (2): 86–99.
• Hooper PD (2005). "Introduction to specific treatment methods". In Haldeman S, Dagenais S, Budgell B et al. (eds.) (ed.). Principles and Practice of Chiropractic (3rd ed.). McGraw-Hill. pp. 745–910. ISBN 0-07-137534-1. {{cite book}}: |editor= has generic name (help)CS1 maint: multiple names: editors list (link) (This is Section IV of the leading textbook on chiropractic. Hooper is the editor, and there are 10 chapters in the section, each with different authors, which should be cited separately as needed.)
• Mootz RD, Shekelle PG (1997). "Content of practice". In Cherkin DC, Mootz RD (eds.) (ed.). Chiropractic in the United States: Training, Practice, and Research. Rockville, MD: Agency for Health Care Policy and Research. pp. 67–91. OCLC 39856366. {{cite book}}: |access-date= requires |url= (help); |editor= has generic name (help); External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help) AHCPR Pub No. 98-N002. (This source is already cited by Chiropractic #Scope of practice.)
• Also, we have been using the NBCE job analysis survey to decide which techniques to mention, but I'd prefer a more-reliable source if we can find one.

After reviewing the archives and the article I determined what I think is left to improve. QuackGuru (talk) 07:45, 12 May 2009 (UTC)

[1][6][10][89][90]

There seems to be too many refs to verify the text. QuackGuru (talk) 19:57, 14 May 2009 (UTC)

To help a bit I combined the last two citations into one. The others can't be combined since they're cited elsewhere. This is a controversial point among many editors, and to some extent this justifies having several citations. Eubulides (talk) 23:12, 14 May 2009 (UTC)

I would comment out one of the refs such as number six. QuackGuru (talk) 02:18, 15 May 2009 (UTC)

Or remove one of the unnecessary refs. Three ref citations in a row is enough. Four is too much. QuackGuru (talk) 06:02, 15 May 2009 (UTC)

Or make them bulleted under one ref, as I have done some other places, like in the Quackwatch article. See refs 49, 51-53. It's not that hard to do. We need to be careful not to delete refs since they are valuable sources for readers who wish to study the subject of the article. Work has been exerted by editors, and we need to show good faith towards that effort. -- Brangifer (talk) 06:57, 15 May 2009 (UTC)

I already combined all the citations that can be bulleted under one ref. The other citations are used multiple places, and therefore cannot be combined in this way. Eubulides (talk) 23:53, 15 May 2009 (UTC)

Two models for practice

Continued from above.

MSchreiber/32.174.185.155 [8] and several other IPs and likely socks are supporting Levine2112 and Stmrlbs in their attempts to restore some one-sided fluff that we have previously discussed. To get this hammered out and stop the edit war, I'm resuming the discussion, even though it seemed settled before. For one thing the matter is covered in the next subsection, so it doesn't need mentioning where it currently is in the philosophy section. To balance it, we'd need to include the other part which is shown in the diagram in the next subsection:

• Two models for practice:

• Straights tend to use a doctor/model-centered approach which focuses on convincing the patient that the chiropractor is an important part of the patient's preventive health maintenance; that the patient has dangerous vertebral subluxations; and that only a chiropractor can treat them through the regular use of chiropractic adjustments.

• Mixers tend to use a patient/situation-centered approach which focuses on the patient rather than the disease, preventing unnecessary barriers in the doctor-patient encounter. The patient is considered to be indispensable in, and ultimately responsible for, the maintenance of health. (Needs other wording and sourcing, likely the same source as above: )

Maybe the best solution is to keep it, but balance it as proposed above, and move it to the "Straights and mixers" section. We can't continue to let a one-sided fluff comment stand alone. It would be a violation of NPOV and WEIGHT to leave it as is. -- Brangifer (talk) 05:26, 15 May 2009 (UTC)

Balancing it would be fine, but the proposed wording is not supported by the cited sources, and so would need to be reworded so that it reflects what the sources say. Nothing in the source supports the claim that straight approach "focuses on convincing the patient that the chiropractor is an important part of the patient's preventive health maintenance", or that it focuses on convincing the patient "that the patient has dangerous vertebral subluxations", or that it focuses on convincing the patient "that only a chiropractor can treat them through the regular use of chiropractic adjustments". Instead, how about replacing all 3 of the above bullets with the following 1 bullet?

• "Straights tend to use an approach that focuses on the chiropractor and the treatment model, whereas mixers tend to focus on the patient and the patient's situation."

This wording is better-supported, and is shorter. Eubulides (talk) 23:53, 15 May 2009 (UTC)

I totally agree that the proposed text is not currently supported by those refs. The proposed text is true, and could be supported using multiple V & RS, but your version would be a simple way to get both points included using the sources we already have. The "treatment model" happens to be the straight one, IOW a "subluxation-based treatment model", and that wording could be used, as it is implicit in any straight model. That's what defines it. Go for it. -- Brangifer (talk) 06:03, 16 May 2009 (UTC)

I made this change to add the new sentence. This replaces the previous disputed text. QuackGuru (talk) 19:55, 17 May 2009 (UTC)

The wording that was added is quite vague. How can a treatment approach focus on the Chiropractor? Will the reader understand this (even though I don't)? This should be expanded for clarity (with WP:RS of course). —Preceding unsigned comment added by 24.68.247.69 (talk) 20:13, 17 May 2009 (UTC)

Here is the ref for the sentence. If you have a suggestion to improve the sentence for clarity I would like read it. QuackGuru (talk) 06:19, 18 May 2009 (UTC)

That source fails verification. It says nothing about focusing on the chiropractor and the treatment model, and instead says that straight chiropractic focused on the patient's ability to self-heal. So we have a problem with vague, unsourced content. 24.68.247.69 (talk) 19:35, 18 May 2009 (UTC)

The "Practice attitude" line of Table 2 in the source does say something about focusing on the chiropractor and the treatment model: it contrasts the straight practice attitude, which is "doctor/model-centered", with the mixer practice attitude, which is "patient/situation-centered". In this context, "doctor" means "doctor of chiropractic", i.e., chiropractor. The patient's ability to self-heal is clearly a straight belief (it's part of the Innate Intelligence system of beliefs), but (a) this does not contradict Table 2, and (b) this is already summarized in Chiropractic #Philosophy in the "Homeostasis" bullet. Eubulides (talk) 22:51, 18 May 2009 (UTC)

As was pointed out by someone else, we are not being faithful to the source and thus we are violating WP:NPOV by using this source in this way. We are presenting it as if there is a dichotomy between straights and mixers, whereas the source makes the effort to say "Although there are still remnants of this dichotomy, the situation has changed with the advent of federally recognized accreditation, research consortia, and more collaborative political agendas. **Distinctions among current chiropractic perspectives are complex and can no longer be viewed as a simple dichotomy.**" 24.68.247.69 (talk) 17:22, 19 May 2009 (UTC)

OK, so if I understand you correctly, it's not a "fails verification" issue; it's really more of a weight issue. In that case, I agree: a bit more weight should be given to the diversity issue. The article currently does say "Although a wide diversity of ideas currently exists among chiropractors," which does give a nod to the notion that it's not a simple dichotomy; but the article emphasizes the dichotomy more than most reliable sources do. This goes along with the problem that the straight-mixer dichotomy is currently repeated, both in the 1st paragraph and last bullet of Philosophy, and in the Straights and mixers section. This repetition should be removed. But what's been lacking, so far, is an editor with the time and energy to propose a specific fix for the problem, a fix that is well-sourced. 19:27, 19 May 2009 (UTC)

[undent] Frankly, the piece of wording being discussed here looks like gobbledygook. The article already has an adequate description of the distinction between "straights" and "mixers" in the section headed "Straights and mixers". Brunton (talk) 22:40, 18 May 2009 (UTC)

Which piece of wording does the previous comment refer to? (Also, ideally, what would be a good way of rephrasing the confusing wording?) I agree that the straight-mixer stuff should be reorganized (the 1st paragraph of Chiropractic #Philosophy should be merged with the 1st paragraph of Chiropractic #Straights and mixers), but surely the model- vs. patient-oriented schism is worth mentioning one way or another. Eubulides (talk) 22:51, 18 May 2009 (UTC)

I think this edit fixed the sentence. QuackGuru (talk) 03:41, 19 May 2009 (UTC)

This edit added too much detail and is redundant. QuackGuru (talk) 06:18, 19 May 2009 (UTC)

I agree. It was better the old way. Also, the new way distracts from the central point of the sentence, which is the doctor-centered versus the patient-centered issue. Eubulides (talk) 06:41, 19 May 2009 (UTC)

Vaguely, not based on science"

WP:Words to avoid warns of words with multiple meanings.

For most of its existence, chiropractic has battled with mainstream medicine, sustained by ideas such as subluxation that are not based on solid science.

It is not clear whether it means a) not supported by empirical evidence, b) not accepted by scientists that know the evidence, c) not accepted by scientists that don't know the evidence or d) not supported by science organizations or e) supported by evidence but not in textbooks.--Ihaveabutt (talk) 01:44, 16 May 2009 (UTC)

When one reads the original content, with the refs, it seems to be clear that "ideas such as subluxation" is the part that is "not based on solid science", and the sources used bear out that interpretation:

For most of its existence, chiropractic has battled with mainstream medicine, sustained by ideas such as subluxation that are not based on solid science.

Could it be worded in a better way? BTW, lest anyone accuse editors of a SYNTH violation here, both quotes used are actually synthesized by the chiropractic authors in one of the sources used. It is the chiropractic authors who make it clear that it is subluxation that is "not based on solid science". We have just found the original sources and used direct links to each of them. -- Brangifer (talk) 06:17, 16 May 2009 (UTC)

If I recall correctly, the current version is a whitewashed version, IOW a pagt with the devil made with a certain editor who wishes this article to be written from a subluxation-based POV and including little or no criticism, even from chiropractic sources. We originally attempted to include more words (anti-scientific and pseudo-scientific ideas) from the quote:

A significant and continuing barrier to scientific progress within chiropractic are the anti-scientific and pseudo-scientific ideas (Keating 1997b) which have sustained the profession throughout a century of intense struggle with political medicine.... One example of this conundrum is the continuing controversy about the presumptive target of DCs' adjustive interventions: subluxation (Gatterman 1995; Leach 1994).[9]

For some reason we ended up with a whitewashed version, even though this is an extremely significant chiropractic source! Go figure. Some editors here go over to the dark side occasionally and cooperate with whitewashing attempts. -- Brangifer (talk) 06:32, 16 May 2009 (UTC)

This editor appears to have forgotten, or never read, WP:CIVIL and WP:AGF. 24.68.247.69 (talk) 18:18, 17 May 2009 (UTC)

CIVIL doesn't apply to my very civil comment, and there is no need to AGF when the history speaks for itself. Note that I haven't named anyone. Longtime editors here may recognize whom I'm referring to, but no one else will. -- Brangifer (talk) 07:47, 18 May 2009 (UTC)

When you state that people are attempting to whitewash the article, you are neither AGFing nor are you being CIVIL. The fact that you say "longtime editors here may recognize who I'm referring to" illustrates the problem. You are focusing on the editors, and not on the content, thus failing to follow WP:FOC. 24.68.247.69 (talk) 19:30, 18 May 2009 (UTC)

Here's another more recent example from a chiropractic source, describing the chiropractic subluxation as "an entity that is yet to be shown to exist". Brunton (talk) 11:59, 17 May 2009 (UTC)

References

Please keep this section at the bottom. TO ADD A NEW SECTION, just click the EDIT link at the right and add the new section ABOVE this one. Then copy the heading into the edit summary box.

(The following resolve otherwise-dangling references: )