Discover Chiropractic
No. I’ve not been converted and I’m not urging you all to realise that the future of humanity and an end to all pain, suffering and diseases known to man lies in the chiropractic way.
It’s the name of a chiropractic clinic in Edinburgh. They wanted to spread the word about the benefits of chiropractic and decided to advertise.
Oops! You’d have thought… No. I won’t say it again.
The advert
Discover Chiropractic placed an advert in the December 2009 Blackhall Bulletin, produced by Blackhall St Columba’s Church.
The advert made claims about:
- Low back pain/disc injuries/sciatica
- Neck pain/headaches/migraines
- Joint stiffness & some arthritis
- Shoulder/elbow/arm pain & numbness
- Breathing problems/digestive troubles/abdominal pain
- Childhood illness: colic/not sleeping/bedwetting/asthma
The magazine was passed to me and it was duly submitted to the ASA. The ASA decided to investigate the advert and one of their Investigation Executives contacted the advertiser.
The chiropractic clinic responded saying they would amend the ad. The ASA considered that:
…their assurance that they will amend the ad will resolve the complaint without referring the matter to the ASA Council.
No formal adjudication then, but they do get a mention in the list of informally resolved complaints this week.
So, is this just another chiropractor making blasé claims? Well, not quite. But it does seem that some chiropractors just are not aware of what they can and what they cannot claim.
Déjà vu
It’s as clear as it can be: the GCC’s Code of Practice clearly stipulates that they must abide by ASA guidance.
Take colic, for example. The ASA have published adjudications against chiropractors claiming they can help/treat/cure colic on three occasions:
- Dr Carl Irwin & Associates
- Larsen Health Care Ltd
- Koren Publications (see Skeptic Barista’s blog post for details)
Even the General Chiropractic Council had to agree to change two of their own leaflets as a result of separate complaints from Simon Perry. These didn’t get as far as a formal investigation, but, like Discover Chiropractic, they did get a mention in the list of informally resolved complaints. However, the GCC didn’t immediately take any action to resolve the problem with the misleading leaflets already issued.
Of course, just because these particular chiropractors didn’t — or couldn’t — supply good enough evidence to the ASA to substantiate the claims they were making doesn’t mean to say another chiropractor might not have the evidence to hand.
But you’d have thought that chiropractors who had been complained about would have tried their best to make sure the ASA didn’t uphold those complaints. Bad publicity is bad for business.
I have no idea why this particular chiropractor decided just to agree to withdraw the advert, but he was in a very good position to be able to supply that evidence — assuming it does, indeed, exist.
Although the advert only mentioned two chiropractors, there are four chiropractors at Discover Chiropractic: Glenn Caley, Torey Griswold, Rebecca Vickery and Ross McDonald. Of these, Ross McDonald is a member of the British Chiropractic Association, but they are all members of the Scottish Chiropractic Association. In fact, Ross McDonald is its President.
You’d have thought that he would have been far better placed than most to come up with the evidence to back the claims he made.
Apparently not.
No more claims
Top and left: 19 January 2010
Right: 26 January 2010
Discover Chiropractic have removed all the claims from their windows over this past week. I wonder how many other chiropractors will now remove all similar claims from their websites and advertising?
Doctor, Doctor
They were also told not to use the title Dr.
As well as featuring in the GCC’s CoP, the ASA’s guidance (which is binding on all chiropractors) on the use of the title ‘Dr’ makes it clear that chiropractors should not mislead the public by using the title:
In general, CAP advises that if they do not possess a general medical qualification advertisers should not call themselves “Dr”.
And:
…a chiropractor should not use the claim “Dr Smith (Doctor of Chiropractic)” but could claim “Mike Smith, who is a doctor of chiropractic” or similar.
Like the above claims — if the guidance wasn’t enough — there have been many ASA adjudications against chiropractors using the title ‘Dr’. For example:
But there’s more…
Much more.
As you can see from the advert, the chiropractors also made the claims that:
Chiropractic care improves the function of your spine and nervous system…
That is, of course, the main tenet of chiropractic. The GCC define chiropractic as:
Chiropractic is concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system and the effects of these disorders on the function of the nervous system and general health. There is an emphasis on manual treatments including spinal manipulation or adjustment (World Federation of Chiropractic, 1999).
The British Chiropractic Association claims:
Chiropractors treat problems with joints, bones and muscles, and the effects they have on the nervous system. Working on all the joints of the body, concentrating particularly on the spine, they use their hands to make often gentle, specific adjustments (the chiropractic word for manipulation) to improve the efficiency of the nervous system and release the body’s natural healing ability.
The Scottish Chiropractic Association claims:
Chiropractic concerns itself with the relationship between structure (primarily the spine) and function (primarily coordinated by the nervous system) of the human body, and how that relationship affects the restoration and preservation of health.
The SCA go on to say:
The Focus of Chiropractic Care is on the Integrity of Your Nervous System
Sometimes vertebrae can become misaligned or fixated causing interference with the mental impulses that travel between the brain and the rest of the body. Chiropractors refer to this as a vertebral subluxation. A subluxation can cause pain, imbalance, fatigue, lowered resistance to disease and a general decline in health.
Doctors of Chiropractic specialise in locating and then correcting vertebral subluxations with a chiropractic spinal adjustment permitting normal nerve transmission, innate recuperative capability, and effective health and adaptation of the person.
That chiropractic can improve the spine and nervous system — whether or not they shun the dreaded ’subluxation’ word — is a universally held belief amongst chiropractors and central to their practice. Although there is no good independent evidence for the existence of subluxations — and some evidence that they don’t exist and do not have any effect on nerve function — there can be little doubt that, without such beliefs, chiropractic does not have a leg to stand on.
It is difficult to imagine how you could describe chiropractic without claiming it improves spine and nerve function.
So what would happen if these claims were undermined by, say, the ASA declaring that such claims have not been substantiated?
That is exactly what the ASA have said.
In my complaint, I doubted that the advertiser could justify the claims that chiropractic could improve the function of the spine and nervous system. The ASA have told me that they expect the advertiser to remove all the claims about conditions, serious or otherwise, not on their approved list and that:
This also applies to the claim that chiropractic is able to improve the function of the spine and nervous system, so we would expect the advertisers to also remove this claim.
A claim about improving the function of the spine or nervous system is treated just like a claim about colic or asthma: they are not on the list, therefore they are not allowed.
However, this is not something new or a new interpretation of their guidance:
…this has been the CAP/ASA position for some time. It is based on substantiation we have seen from the Chiropractic community, independent expert advice and previous adjudications.
A chiropractor making such a claim would be contrary to ASA guidance — and this has been the case for some time. And since ASA guidance forms an integral part of the GCC’s Code of Practice, it would seem that chiropractors are in a bit of a pickle.
Where do chiropractors go from here?
Well, they could try to persuade the ASA that they can, indeed, improve the function of the spine and nervous system. But the evidence for that is pretty thin on the ground and certainly currently not up to the ASA’s standard.
What they do meantime is for them to decide.
Discover Chiropractic
To find our more about chiropractic, visit the new Discover Chiropractic website, launched today. Although in its infancy, it will be built up as a resource of scientific and evidential information about chiropractic.
Prof. Edzard Ernst said this of the new website:
I think it is high time that the public learns the truth about chiropractic. Independent, impartial information was previously very hard to come by and the chiropractic profession has been shown over and over again to make unsubstantiated claims. This has the potential to cause serious harm and it is important that this stops.
Prof. Edzard Ernst, MD, PhD, FMed Sci, FSB, FRCP, FRCP (Edin.)
Complementary Medicine
Peninsula Medical School
Exeter
The respectable face of homeopathy?
The dichotomy must tear some homeopaths apart. They eschew conventional medicine — particularly the link to the ruthless and profit-mongering Big Pharma with all their toxic concoctions — yet they crave the respectability, fame and fortune of mainstream medicine. And in their quest, they seem to have no scruples and even mimic their enemies.
But then there’s the problem of homeopathy not being amenable to randomised controlled trials (apparently), yet they keep citing ‘trials’ published in their own comics. That might fool the layman into thinking there is a good evidence base for the efficacy of their sugar potions, but it fools no one who has even a jot of knowledge of science.
The trouble with babies
When it comes to supplying the Advertising Standards Authority with evidence that backs up claims you’ve made in an advert, it’s a good idea to make sure it does actually back up the claims you’ve made. Common sense, really. Saves a lot of hassle. And an adverse adjudication. And adverse publicity.
It’s a fallacy of personal incredulity I know, but I’d have thought that Philips Electronics UK Ltd — part of giant Royal Philips Electronics of The Netherlands — would have been circumspect when it came to ensuring they have the appropriate evidence for claims they were making.
Boots the Alternative Chemist
Casting the runes II
In Casting the runes, I highlighted the abject failure of OfQuack to reach even their ever-so-slightly modified 2009 membership target. Remember, it started out at 10,000. Then it was downsized to 4,000 — just five months after they opened for business — by re-writing their press release from the previous December. Then, in September, The Lay Scientist announced that their July Committee meeting minutes said they were planning a celebration in the Autumn when their membership was expected to reach the dizzy heights of just 2,000.
Well, now it’s the last day of 2009, how have they fared? For those following the OfQuack Fail widget, it’ll come as no surprise to find that they have failed — spectacularly.
Washing dirty linen in public
The General Chiropractic Council publishes annual Fitness to Practice reports, which contain summaries of all complaints dealt with over the year and useful advice and guidance for chiropractors on topics like:
1. Professional boundaries
2. Abuse of trust or exploitation of lack of knowledge
3. Communication with patients and obtaining consent
4. Record keeping
5. Management and care: initial examination and review of treatment
6. Use of X-rays
7. Local complaints procedure
8. Treatment prescribed by another health professional
9. Protecting patients and colleagues from risk of harm
10. Honesty, integrity and trustworthiness
11. Politeness and consideration towards patients
12. Respecting confidentiality
Chiropractic evidence mashup
Some light relief.
Genius! Sheer genius.
And another one, found by Dr Aust: Chiropraktischer Untergang – updated with added Sturm und Drang. See his excellent blog for several more.
Shedding more light on acceptable evidence
Pharmacies are in the news again this week. Not Boots this time, but that other well-known high street chemist, Lloyds Pharmacy.
An ASA adjudication, published today, upheld a complaint against a TV advert about their ‘light therapy device‘. The advert claimed:
Hay fever seasons [sic] here again. But heres [sic] something you might not have tried before, the Lloyds Pharmacy hay fever reliever. Its [sic] been shown to help reduce symptoms like your runny nose and itchy eyes … Just pop it up your nose for a couple of minutes two or three times a day and start making the most of your summer.
Although I wouldn’t be entirely keen on sticking anything up my nose, I don’t suffer from hay fever. However, I do know it can be a miserable condition and anything that might help would be worth a try. But you’d want something for which there was good evidence for efficacy before you splashed out your hard-earned cash, wouldn’t you? And you’d want the seller to be able to provide that good evidence when asked?
What a week for quackery!
Phew! This has been a spectacular week or so for alternative medicine.
Firstly, we had the Landmark ASA ruling on asthma and colic. Then we have the spectacle of some of its major proponents being tortured and exposed before the House of Commons Science and Technology Sub-committee looking into the evidence (or lack of it) for homeopathy. Skepticat tells it far better than I could, but the admission by Boots of the absence of evidence for homeopathy and that they just sell the stuff ‘cos their customers want to buy it has been described as a Ratner moment.
That was Wednesday; but today was another significant day for the regulation of quackery.
Landmark ASA ruling on asthma and colic
The Code of Practice for chiropractors clearly states that claims made by chiropractors have to be:
…consistent with the law and the guidance issued by the Advertising Standards Authority.
There have been several cases where the ASA have found chiropractors to be in breach of this guidance by making claims for all sorts of medical conditions, some serious. Since the adjudications form part of the ASA guidance, you’d have thought that chiropractors would be somewhat cautious about making claims that the ASA either have already rejected or ones not on the list of conditions they will allow (providing the advertiser provides convincing evidence, of course). The only condition the ASA will allow without asking for evidence is migraines (not headaches). Not even lower back pain.
And now there’s another one.
