F4CP Connects with Keith Overland, DC, to Discuss Past, Present and Future of Chiropractic
Dr. Overland Details Past Media Crises around Stroke and Chiropractic
This month, the Foundation for Chiropractic Progress (F4CP) had the pleasure of speaking with Keith Overland, DC, past president, American Chiropractic Association (ACA), who for the better half of the last decade has served as a spokesperson on the issue of stroke as it relates to cervical adjustments.
While no causation between the two has ever been documented, doctors of chiropractic (DCs) should stay up-to-date on the current research and literature that supports the safety and effectiveness of the services provided by doctors of chiropractic.
Throughout his time as a spokesperson, Dr. Overland recalls three major occurrences where the correlation between chiropractic care and stroke came into play publicly– with the recent and tragic death of Model and Social Media Icon Katie May being the most public.
Considering that Ms. May was a celebrity, her passing has put this controversial topic at the forefront of all major media platforms. In fact, Dr. Overland was called upon by The Today Show, NBC, CBS, Fox, Vice, U.S. News & World Report and more for commentary.
In 2007, Dr. Overland recalls a woman named Christa Heck suffering a stroke after allegedly visiting a DC in Connecticut.
Heck’s loved ones came together to form what is described as the “chiropractic stroke victims awareness group,‘’ and they started a ground swell. Aggressive resources including billboard, TV and newspaper advertisements began to surface in the public eye accusing chiropractors of causing strokes and untimely deaths.
Large green buses would drive outside chiropractic offices statewide, with the phrase, “Injured By A Chiropractor? Call 860-529-8826.”
Image Source: chirobase.org – Google Images
This was the first time the chiropractic profession had to deal with heightened media surrounding the accusation that doctors of chiropractic providing manipulation causes stroke.
At the same time, there were a 2-3 individuals who lobbied state legislature in an effort create a law to force DCs to inform the public that strokes were an adverse effect of chiropractic.
During four days of hearings by the Board of Examiners on this issue, individuals from all over the world spoke out to defend both sides. When the final verdict was reached, it was stated that the profession DID NOT have to recognize stroke as a side effect of chiropractic care because the evidence proved the frequency to be so insignificant.
In 2014, Dr. Overland recalls the second public incidence where the association between stroke and chiropractic care was questioned, when the American Heart Association released a guideline stating:
“Although a direct cause-and-effect link has not been established between neck manipulation and the risk of stroke, health care providers should inform patients of the association before they undergo neck manipulation.”
This statement triggered the formation of panel communication and research experts from the American Chiropractic Association, which resulted in the ACA’s statement on their own opinion of the AHA’s warning:
“The chiropractic profession shares the American Heart Association’s public health goal to reduce the number of strokes; however we have concerns about its statement on cervical manipulative therapy. The real message to all healthcare providers attending to patients with headaches or neck pain is to be vigilant for neurological problems that could be the early signs of stroke.
The largest and most credible study, Cassidy et al., found that a patient is as likely to have seen a primary care medical doctor as a doctor of chiropractic prior to experiencing a cervical arterial dissection (CD).”
It is important to note that if a patient seeks care for the neck pain and headache associated with a present dissection, the probability that they go on to develop emboli and stroke can happen essentially at the same rate regardless of the provider consulted.
Yet, despite the supporting evidence, as well as a previous Board of Examiners verdict declaring no cause for concern regarding the relationship between chiropractic care and stroke, here we are years later fighting the same battle.
By now we have all heard of the unfortunate and untimely passing of Katie May.
After the Coroner’s report was leaked in October 2016, the public learned that Ms. Katie May had suffered a ‘blunt force injury of the neck,’ causing bilateral vertebral artery dissections.
While the Coroner’s documentation states that the dissections occurred after chiropractic manipulation, neurologists who reflected on this case saw the origin of the dissection to be the position she was asked to hold for a long period of time during a photo shoot.
Regardless, the Coroner released a statement saying that he had never seen a case of this type in his career, confirming that this is indeed quite a unique circumstance.
The chiropractic profession has come together to express its deepest condolences to the family and friends of Katie May, and to present the public with the latest supporting evidence documenting the safety of chiropractic care.
Dr. Overland states:
“The silver lining of these tragic events is that it has allowed our profession to understand the importance of working closer together to create a more united response - one that provides the media and the public with information that is based on the best available science. As we saw in the Coroner’s report and from the occasional TV medical expert, we still see opinions that are not based on facts. The public deserves to hear the truth, and in this type of tragic event, we must continue to be fully prepared to provide it.”
With regards to the profession speaking with one voice, Dr Overland stated: “While the chiropractic profession still has a way to go, it is certainly making headway. Today, in addition to the ACA, there are one or two other organizations who understand the important role of a trained crisis communications team. What is needed now and into the future is that we all communicate quickly with each other and other stake holders so our message, regardless of the issue, will be professional, concise and focused on educating the public we serve.
The health care industry as a whole would be in much better shape if providers across all disciplines would come together and focus the conversation on one major tenet, which is: What is the safest, most conservative treatment option for a patient? It is unfortunate that at times, an extremely rare incident, can become so emotionally charged that the media creates a misplaced fear that may encourage a health care decision that would cause a patient to avoid an otherwise safe and effective approach-such as chiropractic.
And, of course there will continue to be obstacles that the chiropractic profession faces, Yet, I am confident that those stumbling blocks can be turned into stepping stones guiding us toward a future of improved patient centered care.”