Stefaan Vossen Bio

Cripes – that picture makes you look much more of a mad-dog then ever I imagined!

Anyway – just a quick question about this guarantee you advertise: Is it just that you refund your charges if your therapy doesn’t work? Or do you pay out $500 if you fail to cure someone’s cancer?

Stefaan, why do you think it so difficult for many skeptics to ask a question without getting personal or is it they just lack a sense of humour.

Mind you “Mad Dog Vossen” does have a ring to it.

@Andy Gilbey
Welcome, I am glad to see you here. I am sad to note that even the straws you were clutching at have broken off now… may much wisdome ensue from it.
Anyway; the chiropractic profession, for your information, is the first healthcare profession in the history of healthcare to be able to offer patients who are eligible for treatment a money-back guarantee. This guarantee is underwritten by an international insurance company (as it would be illegal for me to refund treatments on a money-back guarantee basis as I would be acting as a de-facto health-insurance company which carries a minimum 5 year jail sentence in Britain, the FSA is harsh about things like that) and is calculated on the success rate on over 2500 cases assessed and treated. It covers the cost of care undertaken by patients as provided by myself and is under proviso that patients follow treatment protocol, advice and do not injure themselves during the treatment process. The £500 cap is due to the fact that all patients undertaking care should make significant symptomatic progress for less than that. If chiropractors wish to extend the cover beyond that, then they can but our feeling is that that would not be necessary.
On your cancer-cure statement; you have expressed very bad taste and I would like you to consider with courtesy the feelings of cancer-sufferers reading these postings.

It doesn’t even deserve stating but here goes: chiropractors in the UK do not seek to cure cancer as Mr Gilbey alludes. Chiropractors in the UK know their limitations and their scope of practice and although the philosophy of chiropractic is centred around optimising well-being and coping ability it is widely and totally recognised by the profession that cancer is a serious conditions requiring more than optimising well-being and coping-ability. Chiropractors regularly help undiagnosed cancer-sufferers by virtue of their expansive knowledge of back pain specifically and pain in general They are often the ones to help GP’s come to an early diagnosis and improved survival outcomes for many conditions, including cancer. The healthcare field is a complex and treacherous field where hypotheses are formulated according to the available knowledge and where cost of acquiring such knowledge is weighed up against potential value of such information. Sometimes these hypotheses are wrong but people like Mr.Gilbey choose to view such very occasional failings as inherent to the therapy rather than the humanity of the person providing it.
Many kind regards,
Stefaan

@Richard Lanigan
“Mad Dog Vossen” …. hmmmm I think I like it!
Stefaan

Mad dog wasn’t meant as a personal attack. Now I’m no image consultant, but, to be quite honest, your picture does make you look rather like an unemployed tyre fitter from Wrexham on a cheap holiday to Blackpool who has just quaffed 4 cans of special brew (No offence to unemployed tyre fitters from Wrexham on cheap holidays to Blackpool who have just ‘necked’ 4 cans of special brew). Just a suggestion: Why not a pose behind your desk, holding an activator and looking at an x-ray of some poor bugger’s spine?

Anyway, your reason against giving refunds is interesting – I hadn’t thought about it like that. I’m actually not convinced it would lead to you being viewed as a de facto insurance company, but an interesting point, nevertheless.

You say, “They [chiropractors]are often the ones to help GP’s come to an early diagnosis and improved survival outcomes for many conditions, including cancer”. What we need to know is the rate of correct diagnoses. For example, if you told everyone with lower back pain that they’ve got cancer, then every now and again, just by chance alone, you would be correct. However, if most of the time your diagnosis is actually a false positive, then you’d also be creating a lot of unecessary worry for people with simple lower back pain. Also of interest, but utterly forgivable because of your lack of training in the area, would be your rate of false. negatives.

Andrew, chiropractors are obliged by law to make a differential diagnosis. Our training includes clinical medicine and an understanding of referred pain syndromes. When symptoms do not fit the normal pattern of mechanical low back pain a chiro will consider prostate cancer in men, ovarian cancer in women, bowel cancer as options and refer the patient to their GP asap. We are not always right, but helping the patient find out what is actually wrong with them is definately in their best interest.

Andy, I apologise you do have a sense of humour, and next time I meet Stefaan I will put a fag and can of larger in his hand for a picture.

If your only tool is a hammer I suppose a carpenter might think every problem could be solved with a nail. There is no doubt as in all professions there are evangelists out there but its unfair to generalise and assume all chiropractors are like that because you have encountered a few.

I dont claim to diagnose because I dont like to attach bio medical labels to conditions that may or my no respond to chiropractic care. When I am compelled to enter the biomedical area of diagnosis, I know I am good at it. That may be because I take the time needed to conduct a proper examination and take a good history, rather than because I am such a smart arse.

In the last two years I have picked up two cases of hip fractures, three compression fractures in the thoracic spine, two cases of trigeminal neuralgia and last week a case of leukaemia. All were missed by the GP either due to lack of time or incompetence. I would also add thousands of patients with “vertebral subluxation” in spinal joints which was not picked up by the GP.

I was invited to give a talk to a group of GPs last year and frankly they knew sweet FA about the anatomy or the mechanics of the spine so it is hardly surprising.

Accepting that your average medical doctor knows next to nothing about subluxation theory and chiropractic. I would be more than happy, in fact I would be delighted (and speaking as a graduate of the AECC, I can say with confidence most of their graduates would also love) to be given the opportunity to compare their level of knowledge of the biomedical model relating spinal disorders with your any general practitioner or medically trained “expert”. I dont even claim to be an expert in the biomedical model and Iam confident I know more than they do about the spine and related conditions.

I dont wish to go into what I would base my opinion on because I dont want to sound disrespectful to the GPs I have as patients or to Philipa who was kind enough to right an article about her experience of chiropractic “subluxation” care for a patients magazine. However if the sceptics have a few cocky GPs who think they could show me up in a public debate. To them I say bring it on, I have been saying that for a few years now and there have been no takers. I was told debating with quacks in public is beneath the dignity of your medically trained skeptic.

Why bother with debates? Why not just measure effectiveness? Never mind randomised controlled trials with their samples of populations and hand-picked practitioners, why not just measure patient outcomes and see which doctors create the most patient benefit for the least cost? That way we would answer the research question most patients want answering – “Which doctor is going to give me the best treatment” Fortunately, there is a service available to do this for free at http://www.recordyourresults.com. RCT’s give the right answers to the wrong questions, we need a better scientific paradigm, this is just the beginning.

Hi Simon,
I think the point of debate is contextualising what we should be doing and not just doing whatever we are doing just because we think to know what we think to know.
I have done the exercise you advise for the last 7 years and found that I can get things right (i.e. according to predictions, otherwise put delivering the predicted level of improvement in the predicted time/cost frame) 98% of the time. In the past 6 months it’s gone up to 99.2%. In consequence the reputation is good and my patients and the people whom they refer couldn’t care less about the debate. That said, there are reasons for the 99.2% and I, personally, wish that someone had told me about these reasons a long time ago. Ergo; entering in debate. I don’t know whether it is futile, but at least I personally feel like I have done and will continue to do my best to contribute, in my own small, and probably rather insignificant way.
I do understand your sentiment and scientific, objective, subjective or otherwise I think you very rightly say that the key-point will always be, the patient’s question “which doctor is going give me the best treatment?” The problem is that the patient needs to identify what they have before they can go and figure out what would indeed be the best, most cost-effective treatment for their condition…
By the way, I would really like to meet up some time, we have a mutual acquaintance who sends his regards. I am in Wimpole street tomorrow. Kind regards,
Stefaan

Could Andy Gibly please tell me, how he knows, how much training I have had in recognising atypical back pain, and the level of Radiological training I have had in determining whether a lesion on x-ray warrants further investigation. What does he base his assumption on that we are inadequately trained?

Also please give Mr Gibly the contempt he deserves when he suggests we tell every patient they have cancer and cause unecessary worry and stress. To simply say “your pain is not typical mechanical pain so I am going to suggest to your GP a blood test / investigation before deciding on the best course of treatment”.

I dont know if mr Gibly is in any way medically trained or just an interested skeptic, but does he not realise if someone has a past history of Breast / Prostate Ca. the idea it could have metastasised hasnt crossed their mind. Of course we have a duty to investigate this further even if this is a slight possibilty.

An interesting point a casualty GP told me whilst treating her and we discussed our radiology training, she was assessing x-rays in casualty with seriously less hours than I have had.

Stephan Good luck, nice to see a voice of reason when we are “resisting the medicalisation of chiropractic”, when really there shouldnt be the artifical boundaries, and a bit of medicalisation wouldnt hurt.

Actually you can do it yourself he frequents quackometer and skeptic Barista blogs I understand.

Go get the Eugene ;-)

@Eugene Pearce

Q. What does he base his assumption on that we are inadequately trained?

A. You’re a chiropractor! Quod erat demonstrandum!

@Andrew Gilbey
You display all the typical hallmarks of a denialist ignoramus with this under-powered solipsism, and as such I struggle to take you seriously. Not that that matters too much too you probably, but Eugene did ask you a ligitimate question.
Stefaan

@Andrew Gilbey

Without being presumptuous, maybe Eugene’s response should be;

You’re a ‘BIGOT’! Vescere bracis meis! But then again I am sure he is far too well educated and reasonable a man to consider such a banal response. 

I am saddened by your post above, as some may suggest,  it is as transparent as some of the ‘skeptics/BIGOTs’ arguments being posed. I thought you could have done better? Aren’t you the antipidean IT guy who used to work in a supermarket? Sorry if I got it wrong, but I seem to recall reading it somewhere.

 You see Andrew, your response to Eugene reminds me of a quote from my old Latin teacher, when asked what use is a dead language? Yes, I know its scary that the guys you are arguing with have an education, but its ok, I am sure everyone will be gentle. Anyway, I digress, his answer seems to have been pretty prophetic;  ’to look smart even when there is no real substance to your argument, use a Latin phrase, as normally, unless the people you are arguing with have both intellect and wit, merda taurorum animas conturbit’ eh Andrew? 

You guys throw in Latin terminology a lot on your blogs, so maybe an interesting hypothesis huh?

PS rumour has it that Blue Woad is Edzard Ernst’s own avatar. Interesting if true, but it would answer a lot of questions?

I suspect it’s EE’s wife. Before I had the thought, a blogger who seemed close to them called blue wode “she”. Could have been a red herring though.

Blue Wode is the editor of EBM first and he seems to be able to refference every word Ernst has written about chiropractic. So if its not Ernst, Blue Wode is Ernst biggest fan with way too much time on his hands. Personally I suspect it is Ernst because the only person who references Professor Ernst as much as Blue Wode is Edzard Ernst, see his latest article in Pulse 9 references seven of them “Ernst” himself. http://www.pulsetoday.co.uk/story.asp?sectioncode=20&storycode=4128048&c=2

How can anyone take an article on “Informing Patients” seriously that does not refer to the biggest study of its kind done in the UK by Coulter published by the Kings Fund in 1998 http://www.dh.gov.uk/en/Aboutus/Researchanddevelopment/AtoZ/Promotingimplementationresearchfindings/DH_4001844 which begs the question is Ernst intrested in information or propaganda.

Blue Wode is a UK registered GP and a medical journalist. I have narrowed it down to one of two names.

Oh, and of the male gender if that is relevant to anything.

@Carly Ann

Yip I heard that as well but I am inclined to go with Blue Woad being  Ernst. 

It is interesting, a friend of mine pointed out that Blue Woad uses more Ernst quotes and ‘imminent scientist’ than everyone else combined.  Their feeling is it reflects the mans writing styles of self quoting and therefore self perpetuation. If he was a GP, I think their code of practice may prohibit such forms of bigoted and obtuse comments and therefore, after a case is put together, a complaint could possibly be made to the GMC against them. Especially when one scrutinises Ernst work with the same degree of critique that the is done for chiropractic research.  Any regulated health care practitioner such as Mojo the physio, may also be able to receive the Henness approach to personal pleasure. Interesting thought but it may mean stooping so far down, the abdominal muscles would ache,

So until the evidence suggests otherwise, maybe all responses to BW should be headed @Edzard Ernst (Blue Woad). 

Does it actually matter who it is? Half you lot don’t use your real names anyway! Either way, Blue Wode seems to have some strong arguments and be well informed about quackery!

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