Last week a friend of mine was given a flyer from a local chiropractor, which she forwarded to me.  The flyer, photocopied onto fluorescent pink paper, carried a banner "Optimal Health University™" and proclaimed the top ten ways that chiropractic can improve your life. It was liberally sprinkled with the chiropractor's name, address, and phone number, and included such gems as "Chiropractic Prevents Other Conditions" (high blood pressure, colic, ear infections, and Parkinson's diseases), "Chiropractic Boosts Immunity", and "Chiropractic May Make You Smarter" by improved cortical processing, as measured by testing volunteers' response time to various stimulations  The chiropractor flyer states:

Many people find that they actually save money on their health care expenses by seeing a chiropractor. Another way to save. Studies show that chiropractic can double your immune capacity, naturally and without drugs. The immune system fights colds, the flu, and other sicknesses. So you may not be running off to the doctor as much.

The flyer also claimed that Tiger Woods and Lance Armstrong rely on chiropractic to "reach optimal performance capacity."  A brief search on Google seems to confirm this claim, although I don't recommend anyone take health advice from celebrity endorsements, no matter how many testimonials they give.

The only evidence cited in support of its claims, probably banking on the fact that most patients would not research it, is the Journal of Manipulative Physiology Therapy. A review of the journal online indicates a publication with a nearly unbiased view of chiropractic as a legitimate medical field.

The bottom of the flyer contained small print with a copyright symbol. It referred to Preventicare Publishing.   Preventicare is a company that publishes weekly flyers for chiropractics to use in marketing their services.  For a year's subscription, one will receive 52 issues, each written around a specific health theme, and each in the form of a single master copy that the practice can then photocopy onto its own paper, inserting the name and contact information of the chiropractor. The chiropractor is advised to remove all other publications from their waiting rooms.  Sample issues can be viewed by visiting their web site.

The promotional material on Preventicare explains how chiropractics can build their practices by using the flyers as ‘theme-a-week' resources that will encourage customers to drop in and pick them up.  One endorsement on the site claimed that the flyer "opened their eyes to different things, and then they would actually make an appointment to go and see the chiropractor!  It's a practice builder!"  In other words, like marketing a new-generation iPod or potato chips, you create a perceived need and then sell the remedy.  A strong current running through all of the literature is how to encourage patients to maintain regular chiropractic care.  For example, one flyer advises pregnant women to visit their chiropractor throughout pregnancy to diminish lower back pain, and another suggests ongoing treatments will improve the immune system by boosting levels of polymorphonuclear  neutrophils and monocytes - white blood cells.

In a related website, practitioners are directed to various companies that provide chiropractic marketing lectures.  Note, these are not medical conferences a chiropractor attends to learn the latest science and techniques, but rather on how to boost new patient volume, how to get referrals from patients or get patients to bring in friends and family at a next visit, or how to hold weekly seminars for patients that might get them to seek additional treatments.  Two of the sites, which readers may investigate, are www.learningcurves.us and www.perfectpracticeweb.wordpress.com

Anyone with a business needs to market and promote their business.  Medical doctors operating a private practice want to increase the number of patients they have in order to cover their costs, pay their employees, and make an income for themselves, and there is nothing unethical in this.  However, so many chiropractors believe in pseudoscientific subluxation and must create a perception of need in the public in order to stay in business.  When a chiropractor tells me that he began ‘adjusting' his own children shortly after their births and they remained cold-free, I understand that he truly believes in what he is doing.  But the proliferation of marketing counselors indicates that they are struggling to be accepted as a legitimate medical field.