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> if a doctor suggests that you have surgery and it's not an immediate need, you should seek the opinion of several other professionals to see if you really need the surgery or if the doctor just likes doing that one.

In France too, that is absolutely what I recommend. Never undergo a non-emergency potentially life-altering medical procedure without getting the opinion of at least another specialist. And also that if you go see a surgeon, their recommendation would almost always be a surgery, even if there are others, less invasive path of treatments.

As the beloved doctor Gregory House put it, "tell a surgeon it’s okay to cut a leg off and he’s going to spend the night polishing his good hacksaw" (instead of looking for other solutions).

> I know the doctors can't say "let's not save this one. we could keep them alive, but it's better for everyone to not do that".

They absolutely can, if they know that that's what you would want and someone from your family isn't actively trying to stop them. That's why it's important for people to have DNRs and/or make their wishes known to multiple family members.

>… quackery like … chiropractory(sic) is allowed…

There are indeed some Chiropractors who are quacks, and there are elements of the practice that are not understood well or even contravene our traditional understanding of science and medicine - however, if not for Chiropractors I’d have suffered needlessly. Visiting a Chiropractor and getting adjusted after Airborne operations has brought me back to full operational form. I woke up unable to turn my head on multiple occasions, getting adjusted was the only relief I got after my PCP’s only help was painkillers or the referral to the “quack” (as you put it).

Indeed, I have chronic back pain due to years of computer work with bad posture. I used to go to a chiropractor and I can understand the purpose. There are times where my spine seems to get really out of whack. Maybe I will sleep on my side and my neck will be really tight on one side. What I now do is yoga to stretch and loosen the muscles around the affected area, and then through regular circular motion of the affected joints I will usually, after sometimes a couple of days of stretching, get the joint to "pop" (again, just from slow movement that eventually loosens things up) and I will feel relief.

It may be better to do the slow yoga approach, but there are times where I am in a lot of pain for days in a row. Having a trained professional to look at my body, find the tense areas and apply heat to loosen things up before giving it a good push seems like a valid mode of treatment for what can be debilitating pain. Similar results could probably be achieved from massage, but a masseuse will never give the joint a push to try to reset things, and in my non medical opinion it seems like that could be a useful treatment at times.

It might sometimes work, but chiropractic is still quackery. Let's say I notice that kicking someone in the kneecap seems to cure the cold. If I go around offering to kick people in the kneecaps and don't claim to know why - or even if - it helps that's fine. But once I start saying it optimises your body's energy flow which enlists white blood cells to fight disease, that's quackery.

The whole basis of chiropractic is pseudoscience at best or actively rejecting the scientific method at worst. Part of what they do is likely effective for some. Studies suggest it's about as effective as massage, physical therapy or exercise.

Now, there are absolutely some "good" people in the industry that know and accept that chiropractic orthodoxy is pseudoscience, but nevertheless feel that spinal manipulation helps with some conditions and don't make grand claims or claim to be able to treat non-MSK conditions. It is probably unfair to describe those individuals as quacks. But textbook definition chiropractic as an industry is absolute nonsense.

Let’s draw a line then between chiropractic “can cure stuff beyond muscles, bones, joins, and related pains” and actually useful chiropractor/physiotherapist/remedial massage work… because I utterly despise the quackery yet routinely take advantage of an excellent physiotherapist who basically does “adjustments”, 95% of the time not to my spine but she’s an absolute wizard when it comes to fixing the back pain from occasionally being hunched over on a project in intensive concentration for too long and only noticing after I’ve hurt something and begin feeling pain the next day.

I have no doubt that some of the techniques can help - but "chiropractic" is still pseudoscientific nonsense. Even excluding the outlandish claims that it can cure other conditions, they make unscientific claims about how manipulations help with MSK pain. Chiropractic vertebral subluxations don't exist, joints don't need to be realigned - and even if they did - an activator device wouldn't do it.

As I said, studies do show it is as effective as other forms of manual therapy for MSK pain, which is to say it can be fairly effective.

I think it's probably the case in the USA that people call themselves chiropractors who, in other countries, would refer to themselves as physical therapists, because people know what chiropractors are. Sort of like branding. I've read about US having "evidence based chiropractors" who are, in effect, what in the UK would be called osteopaths - which is still alternative medicine but with far less woo than chiropractic.

I have been to chiropractors, osteopaths and others and did find it effective, but then I also found massage and physical therapy effective. I think just having someone really get in there to give your muscles a rub and crack your joints makes you feel good for some currently not known reason.