A Quick Overview of Chiropractic

Spinal manipulation is the favourite treatment (others;

actuator, atlas joint).

In Australia, chiropractors can‟t prescribe pharmaceuticals or

perform minor surgery. They can request X-rays.

An alternative medicine started with a claimed

cure of deafness in 1895. D.D. Palmer (US)

performed the first chiropractic spinal

manipulation.

There were 4845 registered chiropractors (30 June 2014).

“A subluxated vertebra ... is the cause of 95 percent of

all diseases ... The other five percent is caused by

displaced joints other than those of the vertebral

column.”Palmer D.D., The Science, Art and Philosophy of Chiropractic. Portland, Oregon: Portland Printing House Company, 1910

What About the Science?Q. How do you conduct a placebo controlled trial

investigating chiropractic? Placebo?

A. Sham spinal manipulation is the best placebo control.

Spinal manipulation: a systematic review of sham-controlled,

double-blind, randomized clinical trials.Ernst E & Harkness, J Pain Symptom Manage 2001, Oct; 22(4):879-89

http://www.jpsmjournal.com/article/S0885-3924%2801%2900337-2/abstract

•Searched for trials comparing SM with sham SM

•Eight studies found

•Only three did not have significant methodological flaws

•Two tested chiropractic and asthma

•One tested chiropractic and period pain.

“The results of the three most rigorous studies (two on asthma

and one on primary dysmenorrhea) do not suggest that spinal

manipulation leads to therapeutic responses which differ from

an inactive sham-treatment.”

What About the Science?Effectiveness of Manual Therapies: The UK Evidence Report

(The Bronfort Report 2010)http://chiromt.biomedcentral.com/articles/10.1186/1746-1340-18-3

There is some (weak) scientific

evidence for:

•Lower back pain

•Headache

•Neck pain

(In adults)

Prof Edzard Ernst on the Bronfort Report:

…it was hastily compiled by ardent believers of chiropractic…

…it is nothing short of a white-wash and not worth the paper it was

printed on.http://edzardernst.com/2013/08/evidence-based-chiropractic-is-an-oxymoron/

Chiropractic Regulation

in Australia

Industry Bodies

Pro Subluxation

Anti Subluxation

Government Regulator

(incl, CBA)

Appointments via

COAG

ACCC (via consumer

law)

DentalNursingRadiationMedical GPsChiropracticOsteopathy

TCM practitioners PharmacyPhysioOptometryetc,

How Regulators can Misinterpret

the Science

Medical/Scientific

Literature

Databases

Should chiropractors advertise that they can treat babies and children?

The Bronfort Report

(2010)Statement Paediatric

Care (2015)

NOThere are no childhood health

conditions chiropractors can

effectively treat

YESAnd practice in an

evidence-based manner

Science

Chiropractic Advertising,

What‟s the Problem?

“The conditions they claim to be able to treat include: colds, runny noses, ear infections (otitis

media), sinusitis, influenza, pneumonia, hypertension, dysmenorrhoea (painful menstrual cramps of uterine origin), asthma, allergies,

tinnitus, bad hearing, colic, hiatus hernia, irritable bowel,

diarrhoea, constipation, hormone imbalance, thyroid issues, cancer, heart disease, diabetes (and every other life threatening

condition), forgetfulness and even learning difficulties and behavioural problems.

Some chiropractor web sites assert that that everybody, from a newborn baby to the very elderly, can benefit from having their spine

checked and adjusted to ensure their body functions at its best; that intensive chiropractic care (more than 7 visits per year for more

than one year) increases resistance to winter bugs and common childhood diseases by “boosting” the immune system, and that

people who participate in a regular program of chiropractic care will suffer less from reoccurring symptoms like indigestion, sinus

problems and stress.

Others state that the benefits of regular chiropractic care in pregnancy include preventing caesarean delivery, a reduction in labour

time by up to 5 hours and a 50% decrease in the need for painkillers during delivery.

In addition, some chiropractors advertise Naturopathic services (including natural allergy testing)

and other non-evidenced based services such as Biomesotherapy, Homeopathy, Total Body

Modification, NAET (Energy Balancing Procedure) and Hair Tissue Mineral Analysis (HTMA) for which they appear to have neither

appropriate training nor recognised credentials.”

•A number of health conditions from colic to cancer

•Creating fear in people who are otherwise well with

“subluxations”

•Association with other pseudoscience; homeopathy, boosting

the immune system, hair analysis, kinesiology etc.

Letter to AHPRA, Dr Ken Harvey and Mal Vickers, 24 August 2015

Chiropractic Advertising,

What‟s the Problem?

10 reasons parents take their children to see a chiropractor:-To maximise their child’s neural plasticity (brain and nerve development).

- To enhance their child’s overall health and wellbeing.

- To strengthen immunity and reduce the incidence of colds, ear-aches and general illness.

- To help with colic and Irritable Baby Syndrome.

- To help with asthma, breathing difficulties and allergies.

- To improve spinal posture.

- To improve their child’s ability to concentrate.

- To assist with behavioural disorders and enhance emotional wellbeing.

- To help alleviate digestive problems.

- To assist with bed-wetting and sleep issues.[My emphasis]

Chiropractic Advertising,

What‟s the Problem?

Chiropractic Advertising,

What‟s the Problem?

Why the recent media

flurry about chiropractic?

A Typical Complaint

Who?

Where?

Registration number?

Which laws may have been broken?

Which codes of conduct

may have been broken?

Numbered claims

URL

Screenshot

About five pages per complaint

Reaction in the media

What Happened?

7 Sep 2015

10 Sep 2015

AHPRA‟s Reaction

What Happened?

“False and misleading advertising is in

nobody‟s best interests.”“The Board‟s next newsletter to the

profession, which is due for

publication in coming weeks, is

entirely dedicated to issues about advertising.”

“Scientific information in advertisingChiropractors must take care not to mislead or create false impressions when using scientific information in advertising. Practitioners who choose to include scientific information in advertising must ensure that the information is presented in a manner that is accurate, balanced and not misleading and use terminology that is understood readily by the target audience. The advertising must clearly identify the relevant researchers, sponsors and the academic publication in which the results appear, and be from a reputable (e.g. peer reviewed) and verifiable source.”

AHPRA Chiropractic Newsletter Sept 2015http://www.chiropracticboard.gov.au/News/Newsletters/September-2015.aspx

10 Sep: ABC Statement

28 Sep: Newsletterhttp://www.chiropracticboard.gov.au/News/Newsletters/September-2015.aspx

14 Oct: Position Statement on Chiropractic Paediatric Care

20 Oct: Board Campaign on Professional Standards

AHPRA‟s Reaction

What Happened?

Position Statement on Chiropractic Paediatric Care

Clinic name Complaint number

Number of chiropractors

Number of claims

alleged non-compliant

Number that remain non-compliant

Comments

Referred?

Barham Chiropractic1 13 11 10 New claims ACCC

Newtown Chiropractic 2 1 5 1under review

Essential Health Chiropractic 3 3 8 6

under review

Haberfield Chiropractic 4 1 7 2 no further action

Blakehurst Chiropractic 5 2 4 1But new clinic / web site NC

no further action

Care Clinic 6 5 3 1 Also new claimsunder review

Champion Chiropractic 7 2 3 0no further action

Light Chiropractic and Wellness 8 1 3 1

under review

Back to Basics Chiropractic 9 7 3 3 Also new claims ACCC

KingsWilliamChiropractic 10 3 22 18 Also new claims ACCC

Total 10 38 69 43

Assessment of Compliance, Jan 2016

62% Non-compliance

Refusal to change

Barham Chiropractic

24 August 2015

Barham Chiropractic

Jan 2016

Back to Basics Chiropractic

24 August 2015

Back to Basics Chiropractic

Jan 2016

Editing Failures

Care Clinic 24 August 2015

Care Clinic Jan 2016

Added: Neuro Emotional Technique (NET)

Added: Nutrition

Added: …of injury and chronic conditions.

Website „Hide and Seek‟

(8 Aug 2013)

Blakehurst Chiropractic

Dr David Pham and Dr Eric Man Chung Poon

The Milan Centre,

637 Princes Highway,

Blakehurst, 2221

Phone: 9546 6033

(20 Jan 2016)

3-Ways Chiropractic

Dr David Pham (director)

The Milan Centre,

637 Princes Highway,

Blakehurst, 2221

Phone: 9546 6033

First Splash - MJA“… 62% currently remain non-compliant.”

“Given that track record, it’s not surprising there are now calls for the

Chiropractic Board of Australia to be sacked.”

18/01/2016

Second Wave 18 Jan 201618/01/2016

18/01/2016

18/01/2016

18/01/2016

18/01/2016

Second Wave 19 Jan 2016

19/01/2016

19/01/2016

Second Wave 20 Jan 2016

20/01/2016

20/01/2016

21/01/2016

25/02/2016

Here are

some

videos…

Interesting Responses

"I don't believe there is a widespread problem, and as I say, our

experience has been that in the vast majority of cases, when we

draw the attention of the chiropractor to something that may be in

breach of the advertising requirements, they take the steps to

amend that advertising.“Martin Fletcher AHPRA CEO , 18/01/2016 ABC PM

AHPRA

“We see a lot of kids with asthma and those types of things and

absolutely there’s next to no kids that don’t improve from

chiropractic.“

And

“But we never specifically treat someone for a specific condition,

we adjust the spinal nervous system so the body can heal itself”.Andrew Timbs, Chiropractor, 18/01/2016 Adelaide Advertiser

Chiropractor

Letters to COAG

„Sack the CBA‟

•Australian Skeptics (Victorian Branch) Inc

•Australian Skeptics (ASI)

•Choice Magazine

•SAVN

•Consumer Health Forum

•Friends of Science in Medicine

•(Others I don‟t know about)

The FSM letter included a list of 400 chiropractic business websites with

advertisements about childhood health conditions.

Jack Snelling, head of COAG

Review

Where are we at?There is still a LOT of shonky advertising online

Everyone at AHPRA still has a job

Ken & Mal are still cranky

Questions

?