There are thousands of competent chiropractors in California helping people deal with back or neck pain.
And then there are some who run newspaper ads with bold claims about breakthrough treatments for diabetes and other chronic illnesses.
Robert Puleo, executive officer of the California Board of Chiropractic Examiners, the state's regulatory agency, can only shake his head when he sees these ads, which often include invitations to free dinners that are actually sales pitches.
"It reeks of snake oil," he said. "There are some chiropractors out there who want to make a buck any way they can."
Orange resident Wayne King attended "a free diabetic dinner event" in Irvine last month. The chiropractor holding the event, Candice McCowin, had run a newspaper ad saying that "stunning research now suggests Type 2 diabetes can begin to be reversed in as little as one week."
King, 75, said he has "a lot of belly fat" and has been told by his doctor that he's at risk of Type 2 diabetes.
He said he was eager to hear what McCowin had to say. King said, however, that he was instructed to leave the seminar after he refused to fill out forms asking for his name, address, phone number, age, birth date, Social Security number, insurance ID number and medical history.
"It seemed terribly unethical," he told me.
I tried to reach McCowin at her Irvine facility. A receptionist took my name and number and said she'd pass them along. McCowin never got back to me.
Puleo of the state board stressed that most chiropractors are honest practitioners who genuinely want to help people deal with spine-related issues.
But he said there are some who, because of their training in nutritional matters, have positioned themselves as experts in chronic ailments, particularly diabetes, one of the world's fastest-growing diseases.
Type 2 diabetes is frequently associated with obesity. It means the body isn't doing a good job of processing the insulin it produces to control blood sugar levels. Type 1 diabetes is often genetic and means the body is producing little or no insulin.
"Chiropractors probably have more knowledge than the average person about how diet and exercise can affect chronic conditions," Puleo said. "But they can't claim that they can cure these conditions. That's just false."
He said many ads for diabetes-related seminars obscure the fact that a chiropractor, not a medical doctor, is holding the event.
"They run these ads by attorneys to make sure they're staying just within the law," Puleo said, "even though they're misleading."
He noted that McCowin's ad referred to "stunning research" showing that diabetes can be reversed. But it didn't say such reversals would happen for seminar participants.
Typically, Puleo said, the chiropractor holding such seminars tries to sign people up for months of office visits that can cost thousands of dollars.
"It's a big sales pitch," he said. "Like a used car salesman."
It's impossible to say for sure what happened at McCowin's seminar, which was organized by her company, Next Advanced Medicine.
That's because seminar participants were required in advance to sign an agreement "not to record, by any manner whatsoever, any NAM doctor or staff member." Violation of this agreement, it said, would result in a fine of at least $50,000.
King shared with me documents from the seminar, including the "recording agreement."
McCowin was cited in March by the Board of Chiropractic Examiners for running misleading ads. In its decision at the time, the board also focused on a "free diabetic guide" distributed by McCowin.
It said McCowin claimed in an ad that the guide "explains in plain English how many diabetics have been able to reduce or eliminate their drugs and insulin injections, lose weight without exercise, reduce and eliminate the risk of diabetic complications, restore pancreatic function and even become non-diabetic."
The board ruled that the guide does not explain any of these things. McCowin paid a $500 fine and agreed to ensure that future ads "not be construed as misleading or deceiving to the public."
I wrote last month about a Southern California chiropractor, Philip Straw, who holds seminars throughout the region touting his knowledge of neuropathy, a form of nerve damage that can be a diabetic complication. He was cited by the Board of Chiropractic Examiners in 2012 for advertising his services in a potentially deceptive manner and for inappropriately portraying himself as a neuropathy expert. Straw didn't return a call for comment.
Puleo said the board tries to crack down on any chiropractor who "steps over the line." But the agency has only three investigators for the entire state, so it can be tough staying on top of California's 13,000 licensed chiropractors.
He said the board relies on members of the public to call its attention to questionable claims or practices.
"If someone doesn't forward these ads to us, it's likely we won't know about them," Puleo said. The board's address is 901 P St., Suite 142A, Sacramento, Calif., 95814.
As for McCowin, he said, "maybe we should send an investigator to one of her seminars."