Recent news of the UK McTimoney Association (MCA) for chiropractors letter to members, urging them to take down their websites has brought the reputation of the industry into question.

The story was broken by Andy Lewis from Quackometer, who published the letter in full on his website. An article, written by Chris French, detailing the events, was published today in the Guardian. You can read the full article here, but, briefly it says;

——

On May 20, 2009, the Advertising Standards Authority (ASA) published its adjudication on whether chiropractors Dr Carl Irwin and Associates “could substantiate the implied claim that their therapies could successfully treat some of the conditions mentioned, in particular IBS, colic and learning difficulties”. The relevant part of the adjudication reads as follows:

We considered that, whilst some of the studies indicated that further research was worth pursuing, in particular in relation to the chiropractic relief of colic, we had not seen robust clinical evidence to support the claim that chiropractic could treat IBS, colic and learning difficulties.

On these points the ad breached CAP Code clauses 3.1 (Substantiation), 7.1 (Truthfulness) and 50.1 (Health and Beauty Products and Therapies).

Simon Perry, the founder of Skeptics in the Pub, Leicester, was so incensed by the British Chiropractic Association’s libel case against Simon Singh, he decided to do something about making sure this legislation was enforced. He searched chiropractic websites, collating those that claimed to treat colic or else implied that chiropractic was an effective treatment for this condition and reported 174 for breaching the advertising standards code. In response, the MCA sent a letter to their members advising them to do the following;

——–

“If you have a website, take it down NOW. REMOVE all the blue MCA patient information leaflets, or any patient information leaflets of your own that state you treat whiplash, colic or other childhood problems in your clinic”

“If you use business cards or other stationery using the ‘doctor’ title and it does not clearly state that you are a doctor of chiropractic or that you are not a registered medical practitioner, STOP USING THEM immediately.

“Be wary of ‘mystery shopper’ phone calls and ‘drop ins’ to your practice, especially if they start asking about your care of children, or whiplash, or your evidence base for practices.

“Finally, we strongly suggest you do NOT discuss this with others, especially patients, Firstly it would not be ethical to burden patients with this, though if they ask we hope you now have information with which you can respond.

Most importantly, this email and all correspondence from the MCA is confidential advice to MCA members alone, and should not be shared with anyone else.”

—–

One would have thought it would be more responsible to advise members to simply not use therapies for which there is no evidence, particularly when it comes to treating children. But then quacks will be quacks…

And now it appears we have the same problem in Australia. The article below appeared in a regional newspaper this week and was sent to me by a reader;

chiro(emphasis is from reader).

The text says;
“Chiropractic treatment has also been shown to provide significant benefits for the treatment of colic. Research from the University of Southern Denmark found that spinal manipulation is effective in relieving infantile colic. Chiropractors use safe and gentle procedures to correct spinal misalignments affecting the nervous system. Chiropractors believe that trauma during the birth process can be a factor in the development of colic”.

I don’t know the laws in Australia regarding this, but given the smackdown the Arnica Montana website received this week from the Complaints Resolution Panel, this looks like a potential breach of the code.

In any case I plan to write a letter to the editior about this, citing the fact that there is no evidence for chiropractic being beneficial in colic. You should too; letters should be less than 250 words. Name, address, and phone number is required (can be withheld on request). Email editor@surfcoasttimes.com.au, snail mail, PO Box 714 Torquay VIC 3228, fax 5264 8413.

Thanks @eemyoo for the tip-off.

—-

UPDATE: Thanks to eemyoo for sourcing the CHIROPRACTORS REGISTRATION BOARD OF VICTORIA             STANDARDS OF PRACTICE GUIDELINES for ADVERTISING.

The sections this advertorial appear to breach appear below;

For the purpose of these Guidelines, advertising…..includes situations where practitioners make themselves available for, or provide information to, media reports, magazine articles or advertorials.

Advertising general guidelines; Chiropractors must be certain that they can substantiate any claims made in advertising material, particularly in relation to outcomes of treatment, whether implied or explicitly stated.

5.2 What is unacceptable advertising? a) create or be likely to create unwarranted and unrealistic expectations about the effectiveness of the chiropractic services to be provided


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  • Nancy

    Yes, chiropractors effectively treat colic in infants, better than Dimethicone too!
    The short-term effect of spinal manipulation in the treatment of infantile colic: A randomized controlled clinical trial with a blinded observer
    Jesper M.M. Wiberg, DC, Jan Nordsteen, DC, Niels Nilsson, DC, MD, Phd
    Received 7 January 1999; received in revised form 2 February 1999

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  • http://seantheblogonaut.com Sean the Blogonaut

    @M,

    So you think that chiropractors can treat colic?

  • http://thinkingisreal.blogspot.com AndyD

    In Australia, chiropractors in almost every state and ACT should qualify the title “doctor” by noting they are a chiropractor (eg Dr J Smith, Chiropractor). In NSW they must hold suitable university qualification. In NT I believe there’s no restriction. I sourced (almost all) this info from the various state chiropractic bodies.
    .
    On the issue of assessment – are you serious? I don’t need to be a financier to know some guy in Nigeria hasn’t really got a bag full of cash to share with me. Those drugs that get pulled are pulled after inexperienced people (patients) complain about side effects. Can you name any ailments chiropractors have changed their minds about treating – and why?
    .
    I think most writers have acknowledged that chiro might have some efficacy for bad backs – that isn’t what he Singh saga is about.

  • m

    Sensitivity or God Complex! Get off the whole Dr thing! We are given that title and YES clarification is not required! DRs come in many shapes & sizes. Vet, dentist, PHD, medical, osteopath. Naivety guys. Seems like you have a sensitivity to chiropractors claiming effectiveness with various visceral ailments! The clinical application of sound chiropractic techinques are intended to reduce locked spinal bones that may be responsible for nerve pressure. So are you an expert on chiropractic? If you cannot find a spinal problem and reduce it how can you maintain no validity in what we do? Medical acedemics like you spend your lives trying to disprove everything that doesn’t involve a study subject to the same standards as medical journals. Well Drugs come onto the market after proven safe with a big fanfare only to be pulled after sinister reactions! Touted as safe today, condemned as dangerous tommorrow! Happens all the time. You know it does. Respect the fact that studies are conducted by chiropractors and appear in chiropractic journals demonstrating the outcomes of clinical trials. So if you have a bad back will you refuse chiropractic because you disagree with our premise? Some may equate that to throwing the baby out with the bathwater. Food for thought. Open your eyes, experiential learning. Some of my patients are in fact MD’s

  • GerryC

    This whole UK thing piqued my interest in the topic of Chiropractic and how insidious it is here in Adelaide.
    A local chiropractic (who calls himself a doctor but doesn’t indicate that he is a doctor of chiropractic) has this page on his website:

    http://www.paradechiropractic.com.au/research/safety.htm

    On it, he talks about a New Zealand Royal Commission of Inquiry into Chiropractic in 1978 which said that chiropractic was “remarkably safe”. Has anyone got any other information about this commission – it is a little hard to pin down.

  • Alan

    My local paper in Sydney had Homeopathy and Astrology in the news section … The Journalist was “treated” and reccommends it to readers.
    … oh look the Newsagent has “New Age” magazines in the Science section…
    It’s going to be one hard slog for eternity.

  • Mick

    Goddam it, that’s my local paper ! I saw this article and was going to write a letter to editor. Been too distracted by the recent fluoridation debate to do it though….

  • http://thinkingisreal.blogspot.com AndyD

    Not alone…
    .
    A search for “chiropractor colic” limited to Australia, turns up quite a few Aussie results on page one.

  • http://cafe-grendel.blogspot.com Grendel

    It suddenly occurred to me while reading this post that chiropracters probably get most of their information from industry journals and thus it is the editorial standards of these journals that are critical. if they do not hold to the same standard as a medical journal then they will be passing on ‘clinical’ information to chiropracters that is quite probably only good as passing comment or anecdote.

    The ‘chiropracter-on-the-street’ with no real training in discernment of such information or critical evaluation of research is therefore likely to take it as chiropractic gospel and try to treat conditions that they are totally unqualified to diagnose let alone treat.

    This does not absolve the individual practitioner but it does indicate that standards for the quality and veracity of informations must start at the top of any industry and remain consistent all the way through.

    And with that, there is no way you’ll find me receiving chiropractic treatment for any reason!

  • @eemyoo

    Oops, I meant to add that according to the Chiropractors definition of “Advertising” (including “advertorials”), the claims may be in breach of section 94(1d) of the Victorian Health Professions Registration Act 2005 Act No. 97/2005 http://bit.ly/PVLUf:
    “94. Advertising
    (1) A person must not advertise a regulated health
    service or a business providing regulated health
    services in a manner which—
    (d) creates an unreasonable expectation of
    beneficial treatment;”

    But then again, is “equivalent to placebo” considered unreasonable?

  • @eemyoo

    I’ve done a little research that suggests the article might have crossed the line, especially if you use the Board’s own Advertising guidelines:

    CHIROPRACTORS REGISTRATION BOARD OF VICTORIA – STANDARDS OF PRACTICE GUIDELINES (ADVERTISING) MARCH 2008
    http://www.chiroreg.vic.gov.au/docs/gl_advertising.pdf

    Of note:
    Section 2, Paragraph 3:
    “Advertising also includes situations where practitioners make themselves available for, or provide information to, media reports, magazine articles or advertorials.”

    Section 5, Paragraph 2:
    Practitioners should … be mindful that some consumers may have particular vulnerabilities in relation to the advertising of, and the provision of chiropractic services.

    Section 5, Paragraph 4:
    In determining whether an advertisement is misleading, or whether it creates an unreasonable expectation of beneficial treatment or directly, or indirectly, encourages the indiscriminate or
    unnecessary use of chiropractic services, the Board will consider the overall impression of the advertisement and the likely impact the advertisement may have on a member of the public, Specifically, the Board will consider what conclusions a member of the public can reasonable infer from material contained within an advertisement and whether the material is likely to mislead or deceive either directly or by omission.

    Section 6.3, Paragraph 2:
    Scientific information in an advertisement should:
    .. Be presented in a manner that is accurate, balanced and not misleading,
    .. Use terminology that is readily understood by the audience to whom it is directed,
    .. Identify the relevant researchers, sponsors and the academic publication in which the data appears.”

    Also for reference:
    Victorian Health Professions Registration Act 2005
    Act No. 97/2005 http://bit.ly/PVLUf