Daniel David Palmer, creator of the nebulous subluxation and father of chiropractic.

Daniel David Palmer, creator of the nebulous subluxation and father of chiropractic.

Some time ago, I learned that a Seattle chiropractor, Johanna Hoeller, had been featured on a local TV newsmagazine show. She was so proud of the segment that she had it posted on her web page for all to see. Unfortunately it is no longer there, so I’ll have to tell you what it showed.

She demonstrated her techniques on-camera. She put one wrist on top of the other, held them about an inch away from the patient’s neck and proceeded to produce a cracking sound in her own wrists without touching the patient in any way. The patient claimed to have felt something and to have experienced relief of pain.

The funniest part was when the news crew showed her their video of her performance and pointed out that she had not touched the patient. She appeared to be surprised and responded, “My whole thing is that I’m touching.”

Hoeller practices a form of chiropractic called NUCCA (National Upper Cervical Chiropractic Association). It’s a variant of the hole-in-one idea first proposed by B.J. Palmer, the son of the inventor of chiropractic, D.D. Palmer. Supposedly if you adjust the top cervical vertebra, that will correct any problems in the entire spinal column. Fix one and you fix them all. There is no credible evidence for any of NUCCA’s claims.

So here’s a woman “pretending” to do something that doesn’t work even if you actually “do” it. A little knowledge of psychology easily explains why she has so many satisfied patients. It’s even easy to understand how her experiences may have genuinely convinced her she is doing something effective. What I have trouble imagining is how she first got the idea to try treating without touching in the first place!

I thought this was something the Washington State Chiropractic Quality Assurance Commission should know about, so I reported it to them. I pointed out that state law lists specific techniques approved for use by chiropractors: NUCCA is approved, but no-touch methods are not. If she claims to be treating with NUCCA, she is charging patients for a treatment she did not provide. If she claims to be treating with her own new method, she is using an unapproved method which is not allowed by state law. More importantly, she says she thinks she is touching when she isn’t, indicating that either (1) she is lying, or (2) she is delusional and should have a psychiatric evaluation.

The QAC evaluated my complaint by holding a telephone conference call and deciding not to investigate. They interpreted the video as a dry-run demonstration of what she would do by actually touching the patient.

I filed a second complaint, asking them to reopen the case, and they did. I asked them to view the video again because it clearly showed that she was demonstrating her actual technique, and that she said she thought she was touching when she clearly wasn’t. They still refused to act, because she hadn’t harmed any patients and they apparently thought what she was doing was OK.

I wrote some angry letters to state officials. I asked, if she can pretend to do chiropractic without touching, can I pretend to take out an appendix without touching? If so, there might be a lucrative career in my future. No one answered.

I contacted a professor of chiropractic who claims to be spearheading a reform movement within chiropractic. He was appalled, and brought the case to the attention of a national chiropractic QA organization, hoping they might put pressure on the Washington QAC. Nothing happened.

In September 2007, the Washington QAC finally took action against Hoeller for unprofessional conduct. Allegations include failing to keep adequate treatment and diagnostic records of patients, failing to re-examine a patient after treatment and failing to document a care plan for a patient. They said nothing about her no-touch techniques.

In other words, they didn’t care whether she deceived patients with imaginary hocus pocus as long as she followed them up and kept records of her deceptions.

I wonder… if I had a patient with abdominal pain and I pretended to fix something inside by waving my hands over him, followed him up to document that his pain resolved, and kept meticulous records, could I get away with it? I hope not, but now I’m beginning to wonder. It seems the state of Washington approves of voodoo medicine.


Posted by Harriet Hall

Harriet Hall, MD also known as The SkepDoc, is a retired family physician who writes about pseudoscience and questionable medical practices. She received her BA and MD from the University of Washington, did her internship in the Air Force (the second female ever to do so),  and was the first female graduate of the Air Force family practice residency at Eglin Air Force Base. During a long career as an Air Force physician, she held various positions from flight surgeon to DBMS (Director of Base Medical Services) and did everything from delivering babies to taking the controls of a B-52. She retired with the rank of Colonel.  In 2008 she published her memoirs, Women Aren't Supposed to Fly.