The May 12, 2011 issue of the Arizona Republic reported the following: “Despite the results of a recent major clinical trial that demonstrated conclusively that good medical therapy is just as effective as balloon angioplasty or coronary artery bypass surgery for treating stable coronary disease, fewer than half of cardiologists use such therapy before subjecting their patients to the much more expensive surgical intervention, researchers said this week.”

The result is that scores of patients are being exposed to unnecessary, dangerous, and highly expensive surgeries when medical therapy would do the job.

Therefore, the Arizona Chiropractic Society (ACS) proposes informed consent. The ACS says that before a stable cardiac patient receives either an angioplasty or coronary bypass surgery, they should be required to sign an informed consent, which states that medical therapy would be equally successful without surgery.

ACS is also calling for informed consent before a patient receives an epidural injection for neck or back pain. They say these injections are an invasive and risky procedure given in a series of three at a cost of approximately $5,000 each. They are widely used in spite of the fact that the American Pain Society Clinical Practice Guideline from 2009 published in The Spine Journal reviewed 216 medical journal studies and issued this definitive finding: “Fair evidence that epidural steroid injection is moderately effective for short-term (but not long-term) symptom relief.” Research has also proven that epidurals do not decrease the rate of surgery.

According to the ACS, the informed consent would state that noninvasive chiropractic care provides at least as much short and long term pain relief. The North American Spine Society (NASS) reviewed 71 studies on spinal manipulation and low back pain and concluded: “Based on the RCTs (randomized controlled trials) reviewed, SMT (spinal manipulative therapy) appears to be effective for pain reduction in the short, intermediate, and long terms.”

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