Who will answer this question as objectively as possible? A Chiropractor? Possibly. But, we might encounter some bias in their response. What if we ask a medical doctor? That is a possibility. But again, there might be some bias in their response. How about a research scientist? Yes, another possibility but yet again, another chance of bias. So, who should we ask? The most objective person to ask is a malpractice insurance actuary. Let me explain.
Malpractice insurance is liability insurance purchased by health care professionals. Coverage protects healthcare providers against patients who file suit against them. Suits involve complaints of doctor negligence or intentional harm to a patient.
An actuary is a person who compiles and analyzes statistics to calculate malpractice premiums. A premium is the money paid to an insurance company to keep the policy active. Actuaries help insurance companies develop policies to minimize the cost of risk to the insurance company. It is in the best interest of an insurance company to design policies that contribute to their financial profitability.
By analyzing data, predicting future costs, helping set premiums and designing policies, actuaries determine risk associated with the insured. To put it another way, actuaries decide how safe or unsafe something or someone is.
Not all healthcare professionals pay the same premiums. Malpractice premiums are based on the risks associated with the intervention, the doctor's experience, prior claims and the state where you practice. The biggest factor involved in calculating premiums is risk. A 'risk' is the danger surrounding a given intervention and the potential for injury.
If Chiropractic is unsafe, you would imagine that a Chiropractor’s malpractice insurance would reflect that. Let's take a look.
As a practicing Chiropractor in Ohio, my malpractice premium averages at $1,600 per year. Is that a lot or a little? Let’s compare it to medicine. Depending on the specialty, a medical doctor in the state of Ohio can pay on average from $10,000 (dermatologist) to $69,000 (OBGYN) a year.
Based on malpractice insurance premiums, dermatology is more unsafe than Chiropractic. The dermatologist performs interventions that have a higher incidence of risk. A dermatologist needs to be insured more to pay out to a patient in the event of an adverse reaction or injury.
Chiropractors have one of the lowest malpractice insurance premiums in the United States. This is because Chiropractic's health intervention, the adjustment, is one of the safest. This information comes not just from internal sources, but external sources as well.
An external source such as a malpractice insurance actuary has an objective viewpoint on how safe Chiropractic is. This is because their allegiance is to the malpractice insurance company; not to Chiropractic, medicine or any pharmaceutical companies. Their bottom line is focused on the stability and profitability of the insurance company. Insurance companies aren't in the business of losing money.
Where does this idea come from that Chiropractic is unsafe? Like the majority of misconceptions, it comes from where you get your information. The majority of people who believe Chiropractic is unsafe get their information from certain healthcare “authorities.” In America, medicine is that authority. No authority though is without error. Any MD who makes the statement that Chiropractic is harmful, dangerous or downright quackery is ignoring the medical man or woman in their own office mirror. The most dangerous health care profession in America is medicine.
Now before you roll your eyes at the “hippie” Chiropractor who seems to have it out for medicine, I didn’t come to this conclusion. Medicine did. A 2016 study done at John Hopkins University Medical School found that medical intervention is the 3rd leading cause of death in America.
This study looked at 8 years of data and determined that over 250,000 deaths per year in the US are due to medical error. Using Dr. Stairfield’s calculation from the Journal of the American Medical Association (JAMA), the medical error deaths can be broken down as such: 106,000 due to non-error, negative effects of drugs, 80,000 due to infections in hospitals, 45,000 due to other errors in hospitals, 12,000 due to unnecessary surgery and 7,000 from medication errors in hospitals.
Other studies confirm the risks associated with medicine.
In 2013, John James, Ph.D. published an article in the Journal of Patient Safety. In the article, James examined the prevalence of iatrogenic deaths in America. Iatrogenic is a fancy word that means ‘illness caused by medical examination or treatment.” James concluded that more than 400,000 patients die in hospitals each year due to preventable harm.
These types of findings aren’t new. For example, way back in 1994, Harvard School of Medicine professor Dr. Lucian Leape noted in his article series “Error in Medicine” that American medicine kills 3 jumbo jets-worth of patients every 48 hours. In light of this information, would it be apt to Google “Is medical care safe?”
Facts might be on the side of Chiropractic, but belief systems don’t necessarily align with facts. If you are concerned about the safety of Chiropractic, all I ask is that you widen your perspective. Your focus will get pulled into the direction that follows the money. And money often makes sense.
- Jarek Esarco, DC, CACCP
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Jarek Esarco, DC, CACCP is a pediatric, family wellness and upper cervical specific Chiropractor. He is an active member of the International Chiropractic Pediatric Association (ICPA). Dr. Jarek has postgraduate certification in Pediatric Chiropractic through the ICPA. Dr. Jarek also has postgraduate certification in the HIO Specific Brain Stem technique through The TIC Institute. Dr. Jarek is happily married to his wife Regina. They live in Youngstown, Ohio with their daughter Ruby
