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'LGJ .... 0,

Chlfopracton c.rfOfttarle

COLLEGE OF CR!ROPRACTORS &.•arm. dn t$0 Bloor St Wat Chil"OIH'aticians Suite 902 de l'Ont.arlo Toronto, Onti,rio

M5S ms

COMPLAINTSCOMMITI'EE (Che c.Commlttee")

[4102 raJ 003

Tel; 416-922-635S Fax;416-925-96i 0

OF THE COLLEGE OF CHIROPRACTORS OF ONTARIO

BETWEEN:

Dr. Aatony Hammer

-and-Complainant

Dr. Brian .NaacaiB

·" Complaint

Dr. Hammer Wl'Qt~ in a letter dated Februazy 4, 200] that Dr. Nantais bas failed to maintain standards of practice by:

• Posting snislcad.ins infotmation on hi8 web site about medical conditions that can be helped through chiropractic care without credi'blc scientific ev.idenca to mpport such claims;

• Pract:ising outside his seopc of practice by ~ conditions which are unrda.ted to the spine or joints;

• Postm.r patients' testimonials on his web site hl contra\llmtiOzt of tho College's advertising standards.

In II lettcr dated June 12. 2002, Dr. Rammer stateS that his complaint '"relates to the very basis of '\straight"~ chiropmcty (sic). including the e.xiswlce of subluxatiom) the theoey tba:t -dley influence nerve conductiM and the. body's capacity to ~ itself cmd the role of the C.C.O. in pemritting chiropractors to make clwrns that cannot be substantiated by evidence-base.d scien.ce.,.

In an undated letter received by the College of Chiropractors of Ontario ("CCO'') on August 20. 2001. Dr_ Harnrner expands on bis origitial letteT of co~plaittt against the Member, starlni that:

• Dr. Nan1ai9 bas chose::n 46 "conditions" on bis website and mialcacl$ the general public into believing 1hat there is scientifi~ evidence-based proof of his tr,:aunc:uit's effectiveness. Dr. Hammer chooses epilepsy and asthma as ~ of the most obviow; examples of' conditiom on Dr. Nantais' list for which. " there is

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Co1r1plalot1 Committee Ded.sloD aad Reasom Nau1B.is-2798,.0J.F£-13

14103 Ill 004

0 • Dr. Nantais has chosen 46 ... corulitions 11 on his websim and mJsJC&tb the s«ll\fflll

public into believing that tbeR is scientifie~ evidence-based proof of his tLeatment) s eff'ecti~s. Or. Hammc::r c:hoo.ses-epi]ei,sy am.I uthma as two of the most obvious examples of conditions on Dr. Nantais' list for "Whi~ "" there is absolutely no credible scletttific evidence wmc:h ~sed in its ~ty. would 1~ any reasonable per-son, court of law or ~sting body to ccmch1.d.e that chiropracty (sic) plays any beneficial role iu treatment. Dr. N&aea:is' personal experience changes this not at all.'';

• Dr. Nanta,js' yellow pap ad~nisemen:r offers a ~e initial c011Sult8tion. 1ree consultative services if a patient is not "totally satisfied/' a. guar~ of success of ~ces provided and the c;,ffer of patient ~stimonials by calling a. toll free number;

• Dr. Hanunerurges the Committee to hlstigate ateviewofDr. Nauws' OIDP billings to cnswe that when a patient has been dissatisfic::d with the consultation service provided and this consultation has been funded by OHIP that OHIP bu been refunded its tee fur service, '

.J

Registrant'1 Relpou.se

Dr. Nan.ta.is responded to the initial letter of complaint on May 17,. 2001. He notes that. curn:ntly, there are no regulatiollll or policy conce~ the use of web sites within the profession and he considers his web site to be an in-office info.rmatiocal program for bis patients and himself. Dr. Nantais comments that thf'J co~nt is ienetal reprdmg chii-opractic and is not about himself and that the testitnonials acknow!edgc, the effectivciru::ss of chh'opractie and .not his penona] me~.

Dr. Nantais responds to-the aJJegatio;c of posting n:ris1eading infoimatio.11 or practising outside his scope of practic:e by stating that he has sc.en in his own practice, the conditions be lists as being helped by chlropnwtic care a.ad that he knows personally and has met hundreds of clm:opractors who have bad the same successful results with these conditions. Dr. Nantais st&tc:$ that be belie'V\!!s there is soicntifiully sound · evidence lhat chu-opractic care and more specifi.call)', the restoration of normal nervous system function has helped these conditi.om. Dr. Nanta.is re-srates that it is through 1he '~oration of the normal necve ~tem function that the body can use it3 own reparative proces:s; to regain pwper fwlction. ••

Additional Information

In the letter received by CCO DD Au.g,ut 20, 2001, Dr. Hammel' di.sagrees that De. Nmtais' web site is an in-offiee infurmational proiP'.am for bis .Palie.nts becw1se the web site is referred to in Dr. Nantais' yellow page advertisement .md is open to public view. Dt. Hammer provides examples of how information contained in DY. Narrtm' web site conmwenes CCO Advertising Bmadards--

Co~ of C'.blropJUcon of Oncatfo -2-

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Compl1J11t, Co1Dlllftta Declaon hd Raton• N'tmaJl-27,tM)l-n.-U

14]04 li!IOO$

• On Octobt:r S, 2002, CCO received a 2~ da=d Sepccmber 30, 2002 tram Dr. Namais stating ttlat he had changed a paac on his web site to state, "Chiropractic M-.y Help ... from "Cbiroprat;tic Commonly Helps." On October 12. 20~ Ceo ~ved a fa.csimil1: from Or. "Hammer ctncbtag a copy of e page: of Dr. Nantais' web site indicating- tmrt Dr. Nrmtais had not changed !u web site completely and that be continues to wslead the publio. The ~b site page ~ ""Conditions Chiropractic Hcd_ps. '• The Commitree ~ewed a copy of" in.formation dowwollded from Dr. Nanwa• web site and noted tbat it stated, "Conditions Chiropractic lklpst contrary to the information provided by Dr. Nantais.

On January 11, 2002, the Committoe requested that Or. Nantais lisn an w,dutaking wiTh respect to i.$wes i-elated to his web site and yellow page advenisem.em. Dr. Nantais raised issue with one of the ~visions of the undertakmg.

On F cbrumy 18. 2002, CCO received a lethtt from Dr. Han:unc:r er,c;loai!JB " oopy of a tape recordmg he made at noon on February 14" 2002. The. recording ~umenwd Dr. N~tais :rcciring patient 1eltimonials an a lne(ilSQO l'elatcd to an infomuwatt line rcgarcling his chiropractic practi4;e. A1 the Pebruary 19, 2002 Commiuce meetingJ the Committee confumed that Dr. Nanws' phoo.e message still eontawed such patiG testimonials.

On March 23, 2002, Dr. Nantais signed an undertaking to the bgimv and Committee. a copy of whkJi is attached a.s Appe.odix HA" to this decision.

The Committes iirtlestipted Dl'. NtmWS' (;O~ianca with im prg-visi011S of the undertalc:mg. The Committee reviewed a downloaded c:opy of Dr. Nantais' web sin, infon:nation as of April 30, 200'2 and uoted that Dr. Nantais had complied wi1h tbe first provision of the lllldertaking. On May 7, 2002~ the Committlie contatted Ox. Nautais" office to request ma info:rma:tion line telepbono number. Dr. Nantai, stated that he could not recall or locate the number but would act back t0 tbc Committee promptly. ID. the ~ time .. the Co.mmittee located tJu, nwn~ and cmlcd it to oonfirm that it had been changed as per the signed~- It was noti:,ci 1bat 1m tesmrnonia\s continued to be played. Subsequently, Dr. Nazrtais t~ephoned CCO to say me mmsage WU chan&ed and t= Committee confirmed that t= testimonials had been temovc:d. The C-omm;u.ee uotcs that Dr. Nantai.! had nor octed '1D fwfillwg ctiis provision of 'the undertakina imtil he was prompted by the telephone call from the Committse.

No confirmation was n:cei,,ed from Dr. Nantais -with teSPM to cowpl..ianae with the second provision of the UD.dc:rtakinS regarding his yellow 1)8813 advertisement

con.ae of Chtrop~Qn of Ontario -3-

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Co1aplalDU CommlffN Detlsloo •sad R.a,on.

[4105 liloos

0 Nut.il-27'8-0l-J"E..13

Allepuona

In disposiug of 1his complaint. tho Committee considered the followm, possibl~ alleptions of professional miaconduct as defined in S. S l of the &alth Profusio-,,,,r Procedu1'tl/ C,,.;, &bedule 2 to thcRegulaledHealrhProfession;.Acl, 199/, (the "Code'') and in particular, a broach of the follow-in& sections ofOimrrio ~ation. 852193• Pro.fe.1atono/ Mi.sconduct-..

Alleptign 1.

• S. 2, Contravening• standard of practice of tbc profession or &Uicg 'O mamtain tha standard of pnw1ico expected of members of the profession. and in partieular,, 0011cmvemng Standard of Practice S - 003 Advertising (the "Advertising Standard of Practice 1 , and Guideline G-003 Advertising Code (the 11.Advenising Code");

Allcption2

·" • s. 28, Contravening the Chiropractic ...tct. the Regulated HIUl/0: Proftsnom Acl, J 991 (the ".RHPA.'j or the regulations under either of those acts, and in particular, practising outside tbe scope of chiropractic practice;

• S.3 l, Failmg to comply 'With an order o( or breacbiug 'ID uuderTJJking given to. the Complaints, Discipline or Fi11lcaS to Pnwtise Committee& ot to ~ R.eaisaar of the College;

Allcptjop4

• S.32 Failing to cany out an agreement entered into with the College; and

Allegation s

• S.33 Bnaagin& in oonduct or pcd'mmi.Dg an act that, baving regard to all the cucumstances, would reuooebly be tegarded by JDembers as disgracdbl. dishonourable or unprofeuu,nal. ,

ln detenniDing how to cxerci.e its ~on pursuant to S. 26 ofthe Cade, the Committee comidercd the followmg:

caneae nrc•1ropradon '1f O■mriu -4-

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ComplaJ.na Co111m~ Decllloo and Reaaoas Nantab-2'79&-ol .. Ji'E-13

14106 raJ 007

0 i) Whetbw the nature of the allegationB. if true. warranted a disciplmc hearing in

all of the ~ces; ii) If the alloptions did warrant a discipline hearing, was the information in

support of~ allega:tions of sufficient quality am quantity to l"equite a hom:iD& and;

ill) If 'the allegations were not re&,md to a ~aring. was some other action by the Cornm.itRie appropriate.

Iu.,..utiption

The investigation by the Committee included a .review of.

1. Letter to CCO from Dr. Hammer dated February 4. 200 l 2. Letter to Dr. Hammer from CCO dated March 13, 2001 3. Authoriz.auon of Dr. Hammer d~ April 5, 2001 4. Letter to'Dr. Hammer from CCO dated April 18, 2001 5. Letter to Dr. Na.ntais from CCO cla.ted April 18,. 2.001 6. Lc:tter to CCO .from Dr. Nantais dated May 17. 2001 7. L&tr::r to Dr. Nanta:is from CCO dated lv1ay 31, 2001 8. Letter to In. Hammer fi'om CCO dated May 31. 2001 9. Lc:tterT.o CCO 1i'om Dr. H&ornercfated June 12, 2001 10. Letter to Dr. Hammer from CCO dated JUDtJ 22. 2001 11. Letter to CCO tt0m Dr. Ra.miner dated A'U8U,St 18, 2001 12. Letter to Dr. Hammer from CCO dated August~ 200 l 13. Letter to Dr. N~ froru CCO dated August 22, 2001 14. Letter to CCO from Dr. Nentais dated Septi::mber 13, 2001 15. Letter to Dr. Nantais fi'<>m CCO dated September 27, 2001 16. Let'terlO Dr. Haminer from CCO dated Sc,ptcmber27~ 2001 17. L-ett=-to CCO from Dr. Hom.mer cta1Cd September 22, 2001 18. Facsimile to CCO from Dr. Hammer dated October 12, 2001 19. Letter to Dr. Hsrnrntt from CCO dated October 18, 2001 20. Wormation from Dr. Nan.ta.is' web site 21. :Facsimile to CCO from Dr. Hammer dated December 21. 2001 22. Letter to Dr. Hammer from CCO qatcd January 2, 2002 23. Fac$imile to CCO from Dr. Hammer dated Januazy 7$ 2002 24. Letter to Dr. Ni:lllWS from cco da.ted January 11, 2002 25. Letter to Dr. Hammer frOtn CCO datsd Janumy 14, 2002 26. Facsimile to CCO from Dr. Nautais dated January 24, 2002 27. Lett.er to Dr. Nmtais from CCO dated January 31, 2002 28. Letter to CCO from Dr. Hammet dated lBUuary 31, :2002 29. Letter to CCO from Dr. Hammu dated Febru.aq 14, 2002 30. Letter to Dr. 'HarmMT from. CCO dated February 28, 2002. 31. Letter to Dr. Nmrtais 1Toro CCO dated Fcbnwy 28, 2002

Collcl• of Cbfropneton or Outarto -s--

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•

Complaiatl Committee Decil!on Hd Reaaoas Naata•379S..01-n-13

32. Facsimile to CCO from Dr. Hammer daled March 4. 2002 33. Facsimile to CCO from Dr. Hamnier daied Match 7, 2.002 34. FvsirniJe m CCO from Dr. Nanws dated on Marob 6, 2002 35. Letter to Dr. Nantau from CCO dated Me.rch 19 2002 36. Facsimile to CCO from Dr. H~er dare.ti M~h 18, 2002 3 7. Signed Undenalci.ng signed by Dr. Na®us dated March 23. 2002 38. Letw" to Dr. Han:uner .from CCO dated Mardi 28, 2002 39. Lettez to Dr. Nantais fi-om CCO dated April 10, 2002 40. Facwmlc to CCO from the Health Professions Appcw. and Review Board dated

April l o. 200.2 . 41. L~tter to Jmw Teny of h Health Professiona Appeal and Review Board dated

April 18. 2002 42. Letter to Dr. Nantaia froai CCO dated Aprll 30~ 2002 43. Copies oflnfonnatioa. from Dr. Nantais' website on April 30, 2002

Dccbion and Aeasom

The Committee decision end reasons with respect to the:: alle,ations js outJmod il;J ~ paragraphs below.

Allegation l

• S 2. CoTttrawming a standard of practice of the profu.rton or failing ta maintain rhe standard of practice ezpected of membe~.s of ths profassion. and in pantcular, contravening the Ad-.Jertising Standard of Prai:tictJ and A.~islr,,g Cods

The Committee cautions Dr. Nantais to comply with the Advc:rtising Standard of Practice and Advertising Code~ and in pattic:ular the provisions which prohihir advertiKmcuts from containini anything false or mi.~leading_ anything that, bocawle of its oature cannot be verifi~ a testimonial except within the µractitioner's offiQe. a gwmmtee as to the SUCCC$SI of the seN-ic:ca provided and any offer of free consullati.~, diagnostic or tre&tment services.

Dr. Nantais" underrak.ing. and compliemce with pamgraphs 1 and 4 of the widcrtaking, addresses to the Committee's satisfaction tho allegation ~lating to a~ of the Advertising Statldard of Practice and Advertising Code, in 1bat he amcadcd his web site to read "Conditions Chiropnwtic May Help,,, to comply with the Advertising Standard of Pracfic.e end Advcrt:is.in¥ Code which pro.bibiJ the inclusion of false or misleading infonnation in. advertisements, «ad fotkrwing prompting from the Complaints Committee bu chansed ms offi" photlB' greerjng to romo~ t.ntimamals. The Committee reminds Dr. Nantais that any adv~t includiug p\Wlic informa;tjon on a web .site must conform to the Advc:rtimlg Stauc:fatd of Pmctic= and

conese oi CJilropnaon of Otttario -6,,

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Conapl■inu Conullittee Dlclllon 1■d .Rauaas N•Dtt•2'7tl-01-FE-13

~08 fi&I009

• Advertising Code and that refenmces to supportive researob ahould be pro"Vfded to fully inform the public.

4U@vaff2t12

• S. 28, Conl1'enening tM Chlropro1;tic Act, lNI RHP A. or the regiila,to,u und,v either ofrhose acts, Qnd tn particu/a,-, practising outside the a~ope of chtroprm:nc praClice

The Committee decision is to take 110 further action with respect to alleption 2.

The scope of practic:e of cbhopractic and 1hc controlled aca at'lfborlzied :10 ehiloptactol"I are outlined in sections 3 and 4 of the Chiropra~tic ii.ct. l 991 (copii:s of,aduch are attached as Appcmda B). The scope of pra.ctice statement and autboria:d acts ref'or to the spine. nervous system and joints. Dr. Nantais has unmded his web si-te to read •'Conditions Chiropractic May Helpn and in tbe Committa's View~ this is an acceptable resolution.

There is evidence iD the chiropractic Utmaturctba.t improvc:memin.neuro-spiaal integrity 8t!d associated sbuctures may ha~e an e1fcct iu anisting with the expression of other illnesses. although the CommiUce emphasises thai the primary fuuc:tion of chiropractic is to evaluate the patient's ne\lJ:Omuscrular spma1 in=e,nty and. to QIN. for and improve :nero-mv.sculo-slceletal and biom~bani~ fuli.cmon. 1n ibe p«,eess of perfo.rming such care. there is cvidei1ee that improvc:mcnt can ~ in o1hcr m=n:, of patient health. Tms i• tbc case witb bath adults and c:hildm:n.. 1

' Bluks IQU, Scobuiler TL, Dobson M.; A reuospectiw UH111Qr.tlt of nctwark can, lllDll a mrvay of .self..,,..C,baalm. w1tl1r.lesa Qlld qual~of life . .1ounw ofVcr1Dbtal Subtwmdcm rc.lOlrCh.. !9971(◄):lS

O\WD\I Ef'. lfoltU& KT, Burdo.; Cl!.aocm ill emtl'll health mtus ciurma uppel' ocrvical dliropm,tic cin.. PBR propesi rw:port, CJ:dro RCMarc:.h Journal. t99S;6:'4

L.un> A, Mow:h B.., Clwopnctic: ~II of athlmc abilily. _Chiroprac~ Jo\U'Ul of Researah and CJ:il::dc:al Investigation. 1991; 6:84 .

Pcter.son KB. ?ff o1.1i,ct, of~ maipuZ.dan on tll'e intw.lSity of craarlcmal uvwial in pbob.to mbje¢.11 t1;pgnd 10 a lhn:at mmuhd; a nmdQau:a:ed. coazrollecl doubla \sliDd dmioll trial. Joumr.l of Mantpnlar.i\'e fllld Ph}'tloloaic:al Thc:rapcutica. IW7: 20:602

Selauo. JL. Hlgbrower ac. ~• B .. et al., The eff'oca of sped& uppc,r ~ adjuSUQcam on Ibo C04 c;ow:its of the HIV pmitivc paeicmts, Cbkoprw;:tic; Rollearc:h Journal 19i4; 3(1 )~32.

Ma,.nky CS IDd Todrm-Maank)' M.. Soma&ovilceral Alpcdl of Chiropnicdc: All evidmcc- bac:d approach. 2001 Cburcbj)l Lf.vmast=e ISBN: 0-443-06120-3

Collqp: ofClllropracton ofOaterto _,_

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Ccuap!aibtl Ca111m.ittee Declliou 1md lbasons Nantab■2798--0l-F£.J3

14109 Iii! 010

0 The Committee considered Dr. Ha.mluc:r's various submissions Md took note of the medical opinion of Dr. W. Rajkumar reprdmg chiropractic trea:trnent of asthma anci Dr. Allan Donner's revi~ of clinical studies resardill& the effects of chuopmctic manipulation. In the Committee ►s view, Dr~ Hsmm.er' s literature. teView was incomplete in that then is C'Yidcnce that 8PP10Priate chirop!'aetic ~ may help patieuts with asthma. particulerly since a component of a.stl1llw. m'Yolves the abctuwt movement of the thoracic spine and rib cage with associated muscles of breathing (diaphtagm, scalenses, inrscostals. etc.). Although chi~ton do not tteat asthma. accordmg to a medical ~igm, chiropractic care as dm:ct.ed to improvmg biomccm\Dlcal function oft.he spine and rib cage 8'5urts "\Vitb a pmie:nt's ability 10 'oreathe and reduction in asthma symptoms, aod the sssooi&tc:d imprc,wmenrin quality of life. 1

There is also evidcmoe that patients with certain Rizurc diS<lrders may .r~ favourably to chiropractic care, which the Committee recognizes, may be approprian=ly delivered simultaneously with the care of othm-health profe.ssio:oah. i Finally, although in the Committee's view it would be~ to stato tl:w.cbiro~c can: cures epilepsy~ there are case studi~ citing i.mproVemeaJt aDJl/or ab«tttnMt of epileptic symptoms for patients '\lI1CW chiropractic care foz improvement in biomeehanical function. • The presence of a medical dis.ease does not preclude tmRtmcnt of the spine~

a Graham. R.L. and Pfstol$80 R.A.1 Ala impairment ratfng anaJym gf utbmmi~ chlldnrn undt.t chiro~ ~- .JO'lmW ofVcmebml Sublu,ga;ioa l\.osean:h; 1997; 1(4):41

Killinger-LZ., Chiropractic care in th$ -=meat of asthma, Pal.mer JoumeJ otR~b J 9~S; 2:14.

Balon J. et e.J., A comp~ of active and simulased dtlropnu.tic: i:naai-pulmion u adjunctive ~mt for chlldhood asthma.. New Eni!wd loumiu ofM~. 1998; 339: 101 '3

.Pailon J.M., Tbc role of the e)llropt1lctlc lldjul'Un=ut .in tbe ~ and tnamient of 332 cbilchn with otltis media.. Iocmal of Clmical Cbfropnlcm Pedillttic.s. 1997; 2(2): 167-

1 Pl&tolll!,jO R.A~ Epile~ and seimrc disardani: A nv,li,w of the li~ nlmivo to cblroprac:tic: care of c:hildrm. Jouma! ofM.111ipulative aud Physlolodcal 1'Mtepeutics 2001 March/April; 24(3): 1~20S

01;1lcxu L. M .. Yilll E.pload CA., Lo:u,i:tudinel ~linical cue ltUdy. niu!ti-dbdplimlry Cffl of a c:b11d with multiple funcdanal and developmental daonlcs, loumid c1f Mm:ilpulmw ud PhysiologlQ! Therapeutic, 1994; J?:279

' Hym1111 C..A., Ch.iropn.ctlc adjmtments and cbc redw:tiw of die Petita Mal Sefzlns in a ftve year old mlll.e; A ca.,e study. 1oWDal of Clb\ical Chlropraotic; ~~s. 1996; l(l):lS-32

Ho&pors LA., EEG and CEEO smdJes befon IIJd after uppet" ccrvu;w or SOT cabl2ar.Y D e.qjUJ1mCIDl8 in children. a&r bead tn\lml& iD ep.ilcpty and tn h~. Prowodmgs of lhc Ncfaoat Confcnmce Oft

Chiroprawc and Pediatrics. Arliqtan. V k 'hltemati(lml] ~ Anodadoo l m~84--139

Goodman R... Mosby J. Cesation ofueb;ure dilotder. comc.uon. of the 1111-sublmarion c;omplex. J. Chiro Res and CliD Iavesdg. 1990 !uly; 6(2): 43--46

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Coanplaiau Colllmltte. :D.:&ioq and .Reuoa, Naab.-l'798-0l•F&-13

14110 ~011

0 related JoiDts .nd nervous system by a chiropractor. as outlined in the scope of pmctico statement for chiropractic.

Fot1damental to Dr. Hatmner's c:omplaint appears to be either a Jack ofundorstaading or disagreement with the principles and paradipi. of ~pmcti.c care. tu the Committee's view. the dkposition of the complaim Wore it is not the appropdate forum to debate 1he medical versus chiroptactic paradigm, and Che Committee's role with respect to this complaint is to comlido.r t1H: aJ.legatiom apinst Dr. Nantais in the context of the existing legi.d.at:i.Qn, and the sumdard$ of pn.utioc e.nd pidelincs ar,provcd by CCO. whieb is the ~df-goveming body for chiropractic in Ontatio. with the same responsibilities as the otha self-gove:riuna boc:lie, for hea11h C8l'e

professionals tmOe7" the RHPA,

It is the CCO to whom Dr. Nantais ls ~colllltable. mid aceord.i.ogly~ the Comimttee does .not view Dr. Hammer'g rcforence to the Polley Statement on Complemcntuy Medicine ap_proved by the College of Physioi&M and Surgeows ("CPSOj to be relevant to-bis complaint. The CPSO of course~ repla,tes physicians in Ori.terio.

Finally, the Com.JDittee c~ns.idered Dr. Hmlrn-v;s commentary in his complaint that 04one of the principle points qf thtl Regulazed Heal.th P-,,,,.fen/01111 .Act, 1991, wa, to tneorporate common pro.fesstonal, ethtcal and scisntiflc standards throughout the medical professions bt Ontario. Surely, to B%flm/)t cm,-oprai:to'1's from these standards and allow the.m to base their pra~lias on scknl'ifical/y unYUbstanrlmed anecdotal evtdence and implausible, u11w!l'f/io.ble theorie$, bad.ed only by surveys of "pazumr satisfa,;tion, '' is to Teleya,e the. profe.uion to the .fltmJ.S cf ~trology and Pr,odqc,"

~

Dr. Hammer is entitled to a personal opinion. The Comrnittee ~es with Dr. Hammer's opinion and ~ instead with the fundamental putposes of pro-&Bsional regulation as articulated in the Recomrnenda:tio.m of th&! Health P.mfessfons Legialarlon Review in '"Striking a New BQiance: a Blueprtntfor the Regulation of Onzario 's

T.bmnaa MD md. J Wood., Upper cm-vical adj\lStmma may unprove m«Dml f\metiOA. Joumal Mamw M~ine. J992; 6:2l~216

Langley c_, Cil$0 tiudy. cpilaptle •~ Chin> hdwrics 1994: l (l):22

Ycnms o, Chiropractic su"css iD epi~ptic c;ondilialu. Journal Cblro. 1982; 19(4): 62--63

AndmsO!l c.D., Pmidp J.E.,~ plU-1 dentiw dafiQS hypcra(ltivity dbordar: A caso report International~ Aleoc:iation Int Rev Chiropr. l 993; 49:3S-31

Aleantara J. et al.., CbirotWcdc man.qement of a pm::i.ezl't with suhlww:iml,. low back J>IWl md cp~ :seiz:mes. JOUilUil Manipulative and Physiological TberapeuUc:s. 19511; 21: 410-418

College ot Cb.inJpntton of Oourio -9-

09/04/2002 15:30 FAX 9454462 08/28/2002 12:14 FAl 4169259810 COLLEGE OF CHIROPRACTORS

CQ1Dplal11ts Coaunlttea Deci•iou and lleaJom Na Qutls-,.79Hl-l'E-13

14Jll iaiou

0 Health Profossionr' which resulted in proclamation of tbe RHP A in l.993, and in particular. the ComIIlittee agrees with the following purposes of selfre,iulation.:

• Pt1,-mitting the public to exercise .fregdQm of choicll of hecuth ca:-e provi.du within a range af .s'!fi option,; and

• P,-omoting evolution In the rolds playe.d. by i.ndividual professions and flexi.blliry tn how Individual professionals can be Ulilis,d, so that 'health services are dfJliveP'ed with nu:aimum efjlciellC)I.

4.lluarton J..

• S.31, Fatli>ig to comply with an order of. or breoching an wvie~ gn,en to, the Complaints, Discipline or Fitness to Practise Commlttee.s or to the Regts-rror of the College

·" Allegation 4

• S.31 Failing to carry '1UI an agr«ment entered into wtrh rice College: @d

.A.llegarton i,

• S.3 3 Eng4ging in conduct or pe.eforming an act that Ji(zvirsg r,gard to all the ,. circvmsrance~. would reosonabl); be regarded by membe.rs as disgracejul, dtsht:>n()itrable or unprofessional.

The Committee refers alleptions 3, 4, and 5 to the Discipline Committee,. in that despite agreeing to do so, Dr. Nantais did not submit a revised y~llow page ad m the Adve:rt:imli Committc:-.e for pre-approval to ensure compliance with the Advertising Standard of Practice and Advertising Code and further he did not comply with removing the testimociws from his office phone greeting until prompted by the Complaints Committee.

Finally. the Committee considered the issue raised by Dr. Hmnmer> that the Committee imtigate a revi,:w of Dr. Nantafa' OHIP billings to ensure that when a pati=t has been dissatisfied with the consultation servioc provided 8lld. this COll5lllbmon hu been funded by OHIP mat OmP has been retunded its fee for service. The Gen=ral. Manager of OHIP ~es peiceived billini ~gwarities by health professionals entitled to bill OlnP through the review committees under the Health Insurance Act. The Committee does 110t have 1he jurisdiction to im:tigatt a~~ of .Dr. Nantais" OH1P billings.

CoUcp of Cbtropnccon of Oatarto -10.

09/04/2002 15·30 FAX 9454462 uor~or~uu~ Ll:l~ ~il 41U8Z~9610 COLLEGE OF CHIROPRACTORS

Complaints Committee Detltton and Reason, Natttail-2198-0l•FE•l3

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• The Committee re.odcri.ng this decision is composed ofprofcssicml m=nbers, Dr . Keith Thoms,on, Committee Chair, Dr. Gilles Lamaiche, and Dr. Eliza.bc:th Anderson­Peacock and public member, Ms Regina wmrnann

2002

Cotlqe of Cblropna:ton of Ontario •ll•

09/ 04 12002 15:30 FAX 9454462 OS/2612002 12:1~ F.U 41G9ZS9610

~ c /(r 1'sf>'1ttt M"" I~ I<.,. RECEIVED

MAil 2 5 2002

COLLEGE Of CHIROPRACTORS

APPENDIX A

cou.Eoe OP CH11•c0,-,vcr0M COLLEGE or CBIR.OPJU.croa oJP ONT ABio .OF ~ .

VNDERTAXIN0

U: Complaint bf Dr. ADtbolQ1 Rammer, Nutall J798 01-n,..13

To: Til4 Coq,Wnu Col'Dlm1CN amt the, bgistrar

Bnm: Dr. Briaa NantBis

1, Dr. Brian N~t. a mmnbc:r of the CtJl'9 of Cluropncwl of Ontario (MCCO-, tlndencand and agree ti:> the followini; ,

l, l will cbmp my website whhlo 30 dqa of ldgniog tb.b ~ in tb, fb11owmg \\'I.Y! ·"

• coneot1he menu sectlon whm'e is tNds, UConditiom Chlropraotic Help&.• to~ ~May~" md rancm, EM s«tioa• l'O.lmd to. M(Jr,aumtee, .. ""Tesmnnnfal, .. and "Offer to New Patients;"

• temo-A paint 7 ad 9 in 1hc "l O PtUOftt to OlooN Our Clime fat you Healch Needs,"~ to~ of Satis:fitd Patrons ~se We~ .. and ~ ~ou; ..

2. I wW submit a IC'Vixd yd!Dw psse ad to tM Adnrdslng Ca1lUDfftee for~ SM pnwide coidiana:doD that I hav• done so tg the Complainla Ccuamtueo w&h1n 30 days ot sipins thit undeltaldng and,~~. l will reviae ~ yellow J)Ogo advc:tuement ia accord.mtJC with tru, AdvCJ'tisina Commlttee•.s ~ .fbribe ~ a'\'Ulahlo _priming;

3. · With J'C9pecl many rutute &dvertisina, I will mmnh my adYc:rti.semcms ro the Advmuing CommiUeo far teView before priirting or postina for a period of 1 year from~ date of sigui.Dg dtls ~

4. l will exclude 1tom my oai(;o phone at~ Ill padmtt ~

$_ l ~ that in 1he ewmi that tha ~e ofCb:hopraotco of Omario mw:sffgats ~ matler$ whlah mc lrimilarto the matter~ bl ibis «mplal'fft tbis undcrtakma cmd oaw ie1mnt fnfonnadoD wru, ai • cco1

, opaon. l,e provided fD ~ Complehm Commiuee 8lldlor to #IC ~vc °"'1mb1De;

[4113 llJOH

0910412002 15:30 FAX 9454462 08/26/2002 12;15 FAX 4169299810

Dr,BrlaNlldlll Ile: ~1,-2798-GJJl'B-Jl Febnaary 28, 2002 Paae2

coll.EGE OF caIROPRActORS

[4! 14 ral Olli