Medicandus

Medicandus

Is the end near for the chiropractic profession as we know it?

There has been a rising tide of demands from governmental and other regulatory bodies targeting two related but distinct problems within the chiropractic profession.

The first is the push from COAG Health Ministers, the Australian Competition and Consumer Commission (ACCC) and (at a ponderous pace) the Chiropractic Board of Australia (CBA) to stop chiropractors from making unsupported statements to the general public. The CBA has issued press releases in January, March and April of this year, to go with their previous efforts including a detailed and specific newsletter in September last year and earlier mentions in the newsletters from March 2014, December 2013 June 2013, April 2012 and the very first newsletter it produced in November 2011. That means that in six out of the ten professional newsletters the CBA has produced, misleading advertising has been front and centre. Despite this hand-wringing from the Board, there remains a stubborn display of non-compliance with the advertising code from the profession.

I conclude that we will not see meaningful action from the CBA or the Australian Health Practitioner Regulation Agency (AHPRA) on this issue. I’d be very pleased to be proven wrong, and will immediately applaud loudly and publicly if it I am wrong about this.

One can only wonder at what the Chiropractic Association of Australia’s (CAA) lawyers said to them at this meeting. I can’t think how it came as a surprise to CAA that the Board was unhappy with the advertising practices of its members. Having the peak professional organisation at loggerheads with the statutory regulator over such a fundamental professional expectation as truth in advertising is just extraordinary.

Most of the problematic advertising relates to the second issue of interest, that of infants and children being subjected to pointless and potentially dangerous chiropractic treatment. The ABC RN Background Briefing program did an excellent job of covering these concerns. This page from a Victorian practice is typical of the genre. It’s a welter of mangled terminology and good old discredited vitalistic chiropractic. There is not a jot of evidence that suggests it should be offered to any child, yet the regulators and professional associations either dither on the sidelines or actively support it. The largest professional association, the CAA issued its own take on the ABC program which predictably enough failed to address any of the issues raised in the program. The CAA has previously doubled down in support of its many members who like the extra income stream that families provide. Most of the conditions they claim to treat are time-limited and not harmful, unlike the wholly imaginary chiropractic “care” they are subjected to.

This is essentially the reason why I believe the chiropractic profession in Australia must fracture and reform. The vitalistic chiropractors should have the integrity of their beliefs and leave AHPRA and the scrutiny of the CBA. They have seen the standards that a mature and successful profession must aspire to, and they don’t want to be held to them.

Reform-minded chiros should be taking over the professional organisations and forcing the quacks to the margins where they belong. They should be loudly demanding action from their Board. They should be writing articles like this. I don’t see any of that happening, despite the rise of Chiropractic Australia. It’s just more splintering, not reform in the end.

The chiropractors (if that’s what they still want to be called) who are left after the split will have an enormous amount of work to do to win back the trust of their health professional colleagues. The peak educational and professional standards organisation for GPs has already officially discouraged its Fellows from referring to chiropractors. For too long they have accepted the unacceptable, and treated the trivial by the application of the inane.

It means growing up as a profession and learning the hard lessons it takes to be accountable to the public and to a high standard of professional ethics. Espousing an ethical, scientific, truly evidence-based chiropractic profession means leaving no room for chiropractic “versions” of proper clinical disciplines such as neurology and paediatrics. It means researching treatments to be sure they work before selling them to colleagues or patients. Most importantly, it means not dismissing scientific findings they don’t like just because it proves their century-old fantasies wrong yet again.

They will have to make do with the same science as the rest of us use.

They shouldn’t be afraid. It’s working out well for us.