VOCA : New Haven Chiropractor Granted Form Of Probation

Chiropractors' Argument Falls On Deaf Ears

Rick Green | Hartford Courant

January 5, 2010

While a group of victims of chiropractic stroke listened intently at the state Capitol late Monday afternoon, Matthew N. Pagano stood in front of the cameras to declare that "there is no cause and effect relationship between chiropractic and stroke."

His problem was that cause and effect was all around him.

Pagano, a Winsted chiropractor talking on behalf of the Connecticut Chiropractic Association, spoke out against a proposal that would require chiropractors to tell their patients about the remote risk of a stroke from cervical manipulation.

The State Board of Chiropractic Examiners will open hearings on the proposal this morning at the Capitol. Pagano showed up after a Capitol news conference organized by chiropractic stroke victims who want Connecticut to become the first state to require specific "informed consent."

"What we do is substantiated by years of research," Pagano said, repeating his "cause and effect" argument.

David MacDonald sat watching from his wheelchair. A neck adjustment led to a stroke nine years ago for MacDonald, a former package store manager who lives in Windsor Locks. Now 62, he remains partially paralyzed.

Pagano's opposition didn't sit well with Christa Heck, who also looked on in amazement. Six years ago, the New York woman had a stroke after a neck manipulation at age 39. She thought she had an inner ear infection and waited too long to go to the hospital. No one told her about the risk of a stroke.

Then there was Britt Harwe, a Wethersfield woman who also stood listening to Pagano's embarrassing defense. If medical doctors had known Harwe had been to a chiropractor, it might not have taken them days to figure out what was wrong with her. It's taken her 16 years just to resume the ability to eat solid food.

Unfortunately, Pagano's desperate argument got worse.

I asked how informing patients — people such as MacDonald, Heck and Harwe — would be harmful? Wouldn't it actually benefit doctor and patient alike if everyone was more informed?

Pagano told me that the information patients get would actually be limited if the State Board of Chiropractic Examiners identified this specific procedure for informed consent.

Pagano said limiting informed consent to a single type of treatment would mean patients would actually learn less about their overall health care.

I just can't believe that chiropractors are against informing patients because they fear losing business. I also don't see how requiring more information about one procedure would stop a chiropractor from more discussion with a patient. So I asked again.

"This measure would be redundant," Pagano said, because it would be "singling out" chiropractors. Under state law, all doctors must inform patients about potentially risky treatment. The chiropractors don't feel that their neck manipulation is risky.

Not all chiropractors agree with Pagano and the trade associations. A number have e-mailed me to say that they have no problem with informing patients about the remote risk of stroke from chiropractic manipulation of the spine.

"We have warnings on a McDonald's cup of coffee. We have warnings on everything we ingest," state Sen. Leonard Fasano, R-North Haven, said at the earlier press conference organized by the stroke victims. "This one issue is being fought tooth and nail for reasons beyond my imagination."

I hope the chiropractors and their trade associations, who say this is merely about not wanting to be singled out, won't fight this to the end. But late Monday they filed paperwork seeking to disqualify one of the few members of the board of examiners who is not a chiropractor. What does that tell you?

"Why wouldn't they simply embrace this and let the patient have more information?" Heck asked me after she listened to Pagano. "It doesn't make sense to me."

The chiropractors say they "support a patient's right to be informed of the benefits and risks of any type of health care treatment."

Just not this kind of treatment.