The random thoughts of a sceptical activist

Don’t panic, Mr Mainwaring!

“They don’t like it up ’em” also springs to mind from the excellent and much-loved seventies TV series Dad’s Army.

Dad’s Army were a comical bunch of misfits — a parody of the real everyday heroes of the Home Guard.

In a completely different world, it looks like my 523 complaints to the General Chiropractic Council (GCC) have had some effect already. I’ve not even received an acknowledgement from the GCC, but we all know they got it! Not only got it, but someone leaked it outside of the GCC. Or maybe they were stalking me in the Internet?

Anyhow, thanks to a disaffected chiropractor at www.chiropracticlive.com, we know that the McTimoney Chiropractic Association (MCA) know of my complaints. Not only that, but they have sent out a letter to all their members advising them to take down their websites immediately and to make sure they aren’t claiming anything there isn’t evidence for. Oh! And stop using the title ‘Dr’ where it might confuse the public into thinking they are real doctors.

Their letter is as interesting as it is entertaining:

Date: 8 June 2009 09:12:18 BDT

Subject: FURTHER URGENT ACTION REQUIRED!

Dear Member

If you are reading this, we assume you have also read the urgent email we sent you last Friday. If you did not read it, READ IT VERY CAREFULLY NOW and – this is most important – ACT ON IT. This is not scaremongering. We judge this to be a real threat to you and your practice.

Because of what we consider to be a witch hunt against chiropractors, we are now issuing the following advice:

The target of the campaigners is now any claims for treatment that cannot be substantiated with chiropractic research. The safest thing for everyone to do is as follows.

1. If you have a website, take it down NOW.

When you have done that, please let us know preferably by email or by phone. This will save our valuable time chasing you to see whether it has been done.

2. 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 or at any other site where they might be displayed with your contact details on them. DO NOT USE them until further notice. The MCA are working on an interim replacement leaflet which will be sent to you shortly.

3. If you have not done so already, enter your name followed by the word ‘chiropractor’ into a search engine such as Google (e.g. Joe Bloggs chiropractor) and you will be able to ascertain what information about you is in the public domain e.g. where you might be listed using the Doctor title or where you might be linked with a website which might implicate you. We have found that even if you do not have a website yourself you may still have been linked inadvertently to a website listing you or your services.

CHECK ALL ENTRIES CAREFULLY AND IF IN DOUBT, CONTACT THE RELEVANT PROVIDER TO REMOVE YOUR INFORMATION.

CHECK OUR PREVIOUS EMAILS FOR SPECIFIC ADVICE AND KEY WORDS TO AVOID.

KEEP A LOG OF YOUR ACTIONS.

4. 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.

5. 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 practice.

IF YOU DO NOT FOLLOW THIS ADVICE, YOU MAY BE AT RISK FROM PROSECUTION.

IF YOU DO NOT FOLLOW THIS ADVICE, THE MCA MAY NOT BE ABLE TO ASSIST YOU WITH ANY PROCEEDINGS.

Although this advice may seem extreme or alarmist, its purpose is to protect you. The campaigners have a target of making a complaint against every chiropractor in the UK who they perceive to be in breach of the GCC’s CoP, the Advertising Standards Code and/or Trading Standards. We have discovered that complaints against more than 500 individual chiropractors have been sent to the GCC in the last 24 hours.

Whatever you do, do not ignore this email and make yourself one of the victims. Some of our members have not followed our earlier advice and now have complaints made against them. We do not want that to happen to you.

Even if you do not have a website, you are still at risk. Our latest information suggests that this group are now going through Yellow Pages entries. Be in no doubt, their intention is to scrutinise every single chiropractor in the UK.

The MCA Executive has worked tirelessly over the last week keeping abreast of development and contacting at risk members. We have decided that this is our best course of action to protect you and the Association at this time of heightened tension. This advice is given to you solely to protect you from what we believe is a concerted campaign, and does not imply any wrongdoing on your part or the part of the Association. We believe that our best course of action is simply to withdraw from the battleground until this latest wave of targeting is over.

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.

Please be aware that the office phone lines are likely to be busy, so, if you need our help, please send an email to the office and we will get back to you as soon as we can.

Yours,

Berni Martin

MCA Chair.

Best wishes,

Nicki

Nicki Choules-Rowe
Administrative Officer – Executive Liaison
McTimoney Chiropractic Association
Crowmarsh Gifford
Wallingford OX10 8DJ
Tel : 01491 829494

www.mctimoney-chiropractic.org

Even the MCA were so unsure of what their website claimed that they took it down completely and replaced it with a single page.

I’m sure there will be much more on this amazing letter in various blogs shortly, but Skepticat, The Quackometer, The Lay Scientist and Gimpy have already blogged about it.

This is not a witch-hunt, but it’s a pity that it has taken unpaid, but concerned bloggers to make happen what the GCC should never have allowed to happen in the first place.

MCA members should now be only making claims that can be substantiated and don’t mislead the public – and rightly so. All we need now is for the GCC to ensure ALL their members do the same and stick to their Code of Practice.

The analogy with Dad’s Army goes further. The chiropractors and their associations are like the the comical members of Walmington-on-Sea Home Guard, making fools of themselves at every turn: they mean well, but are ineffectual. Leave it to the real Doctors on the front line to provide the proper medical care.

I’ve stirred them up and no, they don’t like it up ’em, do they?

23 Responses to Don’t panic, Mr Mainwaring!

  • Incredible.

    Some McTimoney bods have taken down their websites but others haven't.

    But, there is lots of stuff that they can't get rid of. The ads in the Yellow Pages, etc. Taking down websites is probably not enough.

  • I offer my compliments on a job well done.

  • What do the websites of BCA members currently say?

    If they suffer a rash of mysterious disappearances then some ineluctable conclusions may need to be drawn that would begin to impinge on BCA vs Singh quite significantly.

    Have you checkmated them?

    Website makes dubious claims;

    1. Leave website alone. GCC should fulfill its statutory obligations and pursue them via their disciplinary process.
    2. Take website down. Prima facie evidence that claims are 'bogus' in the sense imputed by Mr Justice Eady.

  • This is fantastic news! A couple of weeks ago I wrote to two of the companies listed in your complaint. Thanks for taking the next step for me!

    You mention you haven't been able to find a couple of the chiropractors in the GCC register. This is interesting as practicing chiro without GCC registration is apparently illegal. Thankfully too; they've done such a good job protecting the public so far…

  • Gobsmacked! Just gobsmacked.

  • Shame on you

  • I am one of the chiropractors you have included in your complaint to the GCC.

    I practice in what I firmly believe is an evidence based manner treating only musculoskeletal complaints. So why have I been included in your complaint to the GCC?

    Your complaint refers to the list of only mechanical spinal problems, sciatica and a few types of sports injuries as conditions I treat.

    Chiropractic is not a treatment, but a profession. My website states that I use spinal manipulation (for spinal problems only, perhaps I should have said?), exercises, ice and heat and deep tissue massage as treatments.

    In practice I work alongside a medical Doctor and physiotherapist and many patients benefit from a combined approach.

    You would find the same treatments and conditions on any physio's or Sports Doctor's website. Are you going to complain about all of them too?

    Did you really want to target chiropractors like me who have all their career practised in an evidence based manner?

  • Chiro,

    I can't speak for Zeno but since this whole affair has resulted from a decision by the BCA to use their legal muscle against a writer based on the use of just one word in an article, I wouldn't be surprised if Zeno responds "Well you guys started it".

    You may well be a victim of collateral damage (I don't know since I don't know where you're from) but perhaps your consternation should be targeted closer to home.

  • "Did you really want to target chiropractors like me who have all their career practised in an evidence based manner?"

    What is your evidence for the existence of chiropractors' "subluxations"?

    Show that and you may be practising an evidence-based therapy.

    Fail to show that and I could only see the title chiropractor as providing you with a convenient marketing-brand for the type of physical therapy that you say you actually provide, but a marketing-brand that is utterly rotten at its core, which begs the question, why would an honest and ethical practitioner want to wrap themselves in such branding?

    This is more fundamental than the Singh case. I don't much care whether you have the proverbial "jot" of evidence that you can help backs. I want you to provide evidence for the central claim of chiropractic. The claims to treat medical conditions other than sore backs perch on that unsteady assumption.

  •  BSM said…

    Hear, hear, well spoken.
    I could not have put it better myself.

    It seems that "Chiro"** wants his/her cake, and to eat it as well.

    ___________
    ** I don't believe for a minute that this entirely anonymous poster is one of the Chiroquactors about whom legitimate complaints have been made.
    Why are they not robustly bursting with PRIDE to identify themselves, nor their particular "professional" practice, eh?

    I most certainly would, if it came to me professing the conviction that I had was in fact supported by solid evidence.

    Nay, his/her very guarded anonymity quacks as loud as any flock of ducks. Even one with homeopathic bird-flu.

  • Chiro says "Chiropractic is not a treatment, but a profession."

    Well, there's yer problem right there!

  • I think that you people making this attack on the chiropractic profession should be ashamed of yourselves, most of your statements are absolute bolony and make no sense what so ever but you obviously have been gifted with 'spinning' and thwarting the truth. As for chiro not revealing their identity – what about the person responsible for the initial complaint letter to the GCC, as far as I can tell, you want to publish your unfounded claims on the internet but you also hide, you coward. As far as I know, at least the 500 or so chiropractors of whom you complained about will know who you are as they are entitled to know who has complained about them. As for your list – I have clicked on the first website for which you say the chiro has claimed they were a Dr and it specifically says 'Doctor of Chiropractic' which is in no way misleading to the public – so I think you should have done a little more research first before trying to make such a mockery of the profession. As for the professional associations giving advice to their members – what do you want them to do stand aside and let you unknowledgeable idiots ruin the good name of the profession – they are not saying that their chiropractors have done anything wrong, but only that they don't want them to get caught up in this mockery. Chiropractors are very hard working professionals who are trained in university settings for 5 years – not once during that 5 year period is there a course on 'chiroquacktics' or whattever sarcastic name you have given them. Show them a little respect and god help you when the day comes when you are in pain and no one including your GP is able to help you.

  • The complainant isn't hiding his identity, you idiot poster above me. You just need to look a bit further than this blog and the pdf.

  • I don't quite know where to start. There certainly has been a complaint been made against me. My reason for preferring anonymity is that there seems to be a lot of anger around, some of it I think justified, some of it not, and for a bunch of skeptics some of it a bit irrational. I fear personal attack through phone calls, letters and email. Can you guarantee that won't happen?

    There are a large group of chiropractors, myself included who have been trying to move the profession in this country from the inside to evidence based practice.
    Before coming to the UK I was in Denmark. Government registration there in 1994 meant inclusion into the their national health service. In Denmark the chiropractor's status is between a physio and GP. They can traige patients and refer on for further investigation or treat spinal problems using manipulation, exercises and massage. They do not treat anything else.

    I had hoped that in 1999 when the GCC came into being Chiropractors in the UK that still profess "subluxations" to help organic problems would be disallowed from doing so and the profession would move to a position similar to the Danish one.

    The original chiropractic premise is no longer taught at the chiropractic colleges in Bournemouth or the University of Glamorgan, apart from as a history lesson. The biomedical model is taught, and most graduates come out much like an extended scope physio (ie one who has done a post grad in spinal complaints and manipulation).
    It certainly does not form our core belief as suggested in a blog. You will find no mention of it on the GCC website, where you would surely find it if it did?

    More it's a minority who persist on believing it, despite the best efforts of people like myself.

    Unfortunately the GCC was unable to show it's teeth, as it seems a complaint is required before it can investigate a claim and not many are made. Until now of course!

    The hope I have is that there may be a silver lining as result of this storm stupidly cooked up by the BCA's action. I hope claims to treat, or treating, anything else than musculoskeletal problems in an evidence based manner, or chiropractors treating these conditions will be disallowed.

    That would leave me and the many chiropractors who don't and never have used the term subluxation, nor made any claims to treat anything other than musculoskeletal problems very happy.

    I hope this then will mean closer integration into mainstream medicine so that the treatments that are proven to help are made available to the wider community, rather than to those that can afford it.

  • For the record Chiro, I don't blame you for remaining anonymous. There certainly are irrational people on all sides of all issues – "skeptics" aren't immune.

    Have you, at any time, expressed your dismay to the BCA over the Singh libel action?

  • To clarify: I think the BCA's action against Singh was and is stupid and misconceived.

  • Chiro>
    1. You are perfectly within your right to remain anonymous and given the circumstances I too don't blame you for doing so.
    2. From your comments you do not seem like the kind of person that the complaint was targeted at. Perhaps Zeno will clarify but then how will he know which specific individual you are?
    3. I think the sentiment that 'well you started it' is a bit childish and unfair. Chiro whoever he/she is, did not start it and does not deserve criticism if he/she is really attempting to do what he can to reform chiropractic medicine and restrict it to treating ailments it may actually help.

    The fact that he/she is a chiropractor and not a physio could be for any number of reasons and while I agree that chiropractic has a lot of rubbish in it, it's also clear that it has practitioners who have much experience performing the same role as physio's and getting good results.

    I don't think it does any good to simply label all chiropractors as 'the enemy' because then you risk dismissing chiropractors who are genuinely attempting to promote reform in their profession.

    Just my thoughts…

    Chris

  • "The original chiropractic premise is no longer taught at the chiropractic colleges"

    I had an interesting conversation with a staff member of the AECC. He said they don't mention the "s-word".

    Without the s-word, what are you? If you are acting as a physiotherapist you should be trained and regulated as one.

    If you are a chiropractor then you are laden with a burden that includes denial of the germ theory of infectious disease, anti-vaccination campaigning and claims that chiro can treat every disease not just back back.

  • "not just bad backs"

    is what I meant to type.

  • Chiro, I posted this at Quackometer. You may not have read it, but this is what I think you need to address;

    "The time has come for the chiros to decide what they want to be. Chiropractic is a brand with a lie at its heart. Honest chiropractors need a new brand or they need to admit that lie and redefine the brand as something more akin to physiotherapy. How they would then be regulated and who would do it are then questions that need to be answered. First, they have to show the courage and integrity necessary to make that change."

    You may be the honest MP. Your colleagues were taking money for moat-clearance and duck-houses.

  • You are right BSM. The chiropractic profession in this country needs take the long overdue action of disallowing the (vocal) minority from continuing to make claims to treat anything but musculoskeletal problems.

    This would leave us different from physios in that we have a 4 or 5 year training specialising in the diagnosis and treatment of spinal problems, as well as associated advanced skeletal radiology skills.

    There is no identity problem in Denmark or Norway where chiropractors practice this way, within their national health systems, and is the model this country's chiropractic leadership should aspire too.

    I know that some of my colleagues were taking money for moat-clearance and duck-houses. Those that were need to be deselected!

    In answer to an earlier query, I have expressed my dismay to the BCA regarding their action against Singh. I know many others who have too.

  • This issue has its roots buried in Singh's financially motivated decision to co-author ‘Trick or Treatment? Alternative Medicine on Trial’ with the crypto-denialist Ernst. Ernst is a poor scientist; his papers seem to refer to a lot of his own work or to other selected cases and ignore the substantial body of evidence that is robust enough to convince NICE that chiropractic is safe.

    Singh wrote a series of great bestselling popular science books ("Fermat's Last Theorem", "The Code Book" and "Big Bang") and, as he freely admits, made a fair bit of money. And why would Ernst want to co-author with Singh? because, I suspect, he could provide the reputation to get the book sold (Kerching” for Singh). This is done with the ill-considered article in the Guardian, which you will notice has as its last line:

    ”• Simon Singh is the co-author of Trick or Treatment? Alternative Medicine on Trial “

    (more Kerching for Singh)

    Now, he’s a journalist and should know that if in the article he libels a profession then he’s in the clear (i.e.: all doctors are in the thrall of the drug companies) but if he libels an individual or an organization he is not (i.e.: Dr Smith is in the thrall of the drug companies). So now he’s scared as all the financial gain from the previous three books (triple Kerching for Singh) look like being sucked up by the law case.

    But why the suit? As a summary in the Guardian article Singh says:

    “ – if spinal manipulation were a drug with such serious adverse effects and so little demonstrable benefit, then it would almost certainly have been taken off the market.” (unlike paracetamol, celebrex and any one of the COX-2 inhibitors then)

    which is based on the piss-poor ‘evidence’ delivered up by Ernst rather than the solid evidence produced such as the BEAM report which said:
    “Conclusions: Spinal manipulation is a cost effective addition to "best care" for back pain in general practice. Manipulation alone probably gives better value for money than manipulation followed by exercise. “
    UK Back pain Exercise And Manipulation (UK BEAM) Trial
    A randomised trial of physical treatments for back pain in primary care.

    As well as the MEADE report and the all evidence that convinced NICE to issue its pro-manipulation clinical guidelines only in May this year.

    So with this ill-informed, unscientific, drubbing ringing in the profession’s ears the BCA notice that not only have they been kicked in the book and kicked in the article they have been libelled in the article, and all for Singh’s financial gain based on discredited science. What would you do?

    So, where does Singh go before he goes bankrupt? He creates a media storm, because that’s what he can do, and he spins it to look like this (taken from the online petition):

    “The British Chiropractic Association has sued Simon Singh for libel. The scientific community would have preferred that it had defended its position about chiropractic for various children's ailments through an open discussion of the peer reviewed medical literature or through debate in the mainstream media.
    Singh holds that chiropractic treatments for asthma, ear infections and other infant conditions are not evidence-based. Where medical claims to cure or treat do not appear to be supported by evidence, we should be able to criticise assertions robustly and the public should have access to these views.”

    So Singh has managed to move the issue away from the utter damnation of all chiropractic set out in his article to a freedom of speech issue based about chiropractic care claimed by some chiropractors to treat colic and other fringe activity. Neatly done.

    And then he got his media friends and science colleagues and you and me to see this side of the story and I think we may have been misled.

    If Singh had spent a bit of time reading round the subject and using his judgement rather than just seeing the £ and listening to the loon Ernst than none of this would be happening.

  • Chiro:
    All this complaint will do is force the GCC to enforce its own remit to ensure the rules are being followed. If you are not making claims that are unsubstantiated, or misleading the public then you have nothing to fear from this complaint. Go about your business normally and a thorough investigation (and all these investigations should be thorough) should find you entirely blameless.

    As for the campaign in general, I think it would have been prudent to note the google cache/wayback machine addresses of these websites before they were taken down, or at least to take screenshots to present as evidence.

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