Omnibus Complaint to the General Chiropractic Council
Various bloggers have been complaining to their local chiropractor, the British Chiropractic Association (BCA) or the General Chiropractic Council (GCC). These include jdc325, Tristan at Cargo Cult Science and APGaylard at A canna’ change the laws of physics.
These are all excellent and should make them realise that they are being watched – critically and under a very powerful (scientific) microscope. However, I don’t think this will bring about the seismic shift in the way chiropractors advertise their services that is badly required to properly protect the public. What is needed is the GCC to sit up and take note of what their charges are doing and ensure the rules governing chiropractors are followed – to the letter. After all, that’s what a regulator is supposed to do, isn’t it?
So, what are the rules? I’ve blogged about this previously:
Who are the British Chiropractic Association?
What the ASA have to say about chiroquacktic
What chiroquacktors are allowed to claim
These are the rules, nothing more, nothing less
Ok, so how many chiroquacktors claim to treat colic?
To summarise: the GCC has a statutory duty to regulate all UK chiropractors. Part of that duty is ensuring they abide by their Code of Practice (CoP). This clearly states that chiropractors should not make claims that would not stand up to the scrutiny of the Advertising Standards Authority (ASA). The ASA guidance is given mainly in their Code of Advertising Practice (CAP). This clearly requires scientific evidence for claims made by advertisers and not just anecdotal claims or testimonies. The CoP and CAP also require them not to use the title ‘Dr’ in any way that might lead the public to believe they are properly qualified medical practitioners.
It’s time to pull all this together and to make a complaint to the GCC – not just about my local chiropractor, but about all of those making claims for which there is no robust clinical evidence.
About 40% of entries in the BCA register give a website of a member’s clinic and I have used this to compile a list of the claims made on those 287 websites. According to the BCA’s register, there are 523 chiropractics working in these clinics. I have written an ‘omnibus’ complaint and I have submitted it to the GCC’s Chief Executive and Registrar, Margaret Coats.
My letter of complaint and the list of the 523 chiropractors concerned can be downloaded here.
The complaint is in three parts: complaints against the unsupported claims made; the use of the term ‘Dr’ misleading the public; and miscellaneous complaints about issues like chiropractors encouraging their patients into taking on continual chiropractic care for the sake of their ongoing health.
One thing I have found: the GCC do seem serious about complaints. It is one of their statutory duties to deal with all complaints in a thorough and professional manner.
I know what I want the GCC to do in response to my complaints, but I’ll save that for a later blog post and see what the GCC proposes.
106 Responses to “Omnibus Complaint to the General Chiropractic Council”
"chiropractors encouraging their patients into taking on continual chiropractic care for the sake of their ongoing health"
Surely you mean, "ongoing wealth".
Btw, good work.
Good work. Just remember to make sure you have a copy of the web sites in question. The Chiros' first reaction may be to just change the text and hope that the fuss goes away.
The best way is to print the site and then sign and date the back. Its not proof (and bugger all is in the digital age) but its a hell of a lot more convincing than 'well this is what it said a few months ago'.
If you save the pages and write them immediately to a CD (non-rewritable), the date of writing to the CD is there.
In fact these types of web sites are typically very small and can be downloaded in their entirety with an application SpiderZilla.
How long are you prepared to wait for them to respond effectively?
Excellent! I hope you get somewhere with this.
One of the clinics on your list, Amethyst Family Chiro Clinic) shows an interesting attitude on its 'prices' page.
'Initial visit:
Examination £24
Treatment £30
Therefore first visit £54'
So the default position is that you will need treatment, with no possibility of the chiro deciding s/he can't help or that you might not need any treatment anyway.
From there I found, via the Times Guide to CAM', a link to this:
http://freechirovideos.com which advises chiros on how to increase the numbers of 'patients' and tells how much money can be made using good salesmanship………….
Did anyone ever consider the possibility that Chiropractors may just be good people who are helping others in a medical systm that revolves around drugs and surgery and is manipulated by the big pharmaceutical companies with their huge budgets. Consider the possibility that Chiropractors may actually, after 6 years of tertiary education, have a skill and knowledge that can help a great many people.
Why just chiropractors? Have you seen the British Osteopathic Website – the claims there are just the same. With cranial osteopathy it seems they can cure even more complaints.
Does cost effectiveness override efficacy? The research done on chiropractic that chiropractors seem to rely on have been well demolished on jdc325's Weblog, DC's Improbable Science, EBM-first and the adverse effects examined on Dr Harriet Hall's blog on Science-Based medicine.
m.coats@gcc-uk.org this is the registrar of the gcc, why not contact her directly?
I went to see my GP last month with a burning pain in my neck and shoulder. I work on building sites, and have put up with quite a bit in the past – but this was too much.
After my 8 minute consultation with my Doctor I got a prescription for painkillers. On my way to get them, I started to wonder if all the increases in medical research had really led us to this point. I decided not to get the pills.
I rang a local chiropractor, and saw them the next day. After 3 treatments I am back at work.
I'm not that bothered about research – I now have no pain and I've taken no drugs.
Answering some of the comments:
I'll obviously post any response from the GCC when I get it, but I don't expect a speedy response!
woodchopper, pvandck: I have copies of the relevant pages for their websites!
I think the osteopaths will be earning the sceptical gaze of many bloggers in the not too distant future!
I sent my complaint to Margaret Coats as Chief Executive & Registrar.
But not all comments?
Anonymous said: "Did anyone ever consider the possibility that Chiropractors may just be good people who are helping others in a medical systm that revolves around drugs and surgery and is manipulated by the big pharmaceutical companies with their huge budgets. Consider the possibility that Chiropractors may actually, after 6 years of tertiary education, have a skill and knowledge that can help a great many people."
I'm sure many chiropractors are 'good people who are helping others', but your characterisation of proper medicine is skewed. Of course there are drugs and surgery. Yes, pharmaceuticals have loads of money and yes, they do sometimes influence doctors and health policy when they should not. But thank goodness for drugs and surgery and proper doctors!
But none of this makes subluxations any more likely to exist; pressure on nerves more likely to be the cause of asthma, colic or the like; it does not make high velocity thrusts any more likely to affect a nerve in such a way as to alleviate any condition; it does not make any of the trials that have been done on chiropractic any more favourable to chiropractic being effective.
Making someone feel a bit better can be important, but we need proper doctors to cure the serious illnesses.
To the other anonymous commenter: I'm glad your neck and shoulder are better.
You say you are not bothered about research. Fine. But others are because if research isn't done, we'll never know what works and what doesn't work; what the correct doses are and whether they are safe.
Sorry – think we may have our wires crossed.
I am a fitter, and got forwarded a link from youtube about the court case from my mate as he knew I'd just been to see a Chiropractor.
My point really is that from my where I was sat, the GP was only interested in giving me something for the pain, and not for the problem. We didn't even talk about why I might have a problem.
At least the Chiropractor talked to me about why it might hurt, and where the pain might be coming from.
I didn't ask the GP for any evidence about why I was given pills, so why should I have asked the Chiropractor?
Had a quick google….
Cost Effectiveness of Physiotherapy, Manual Therapy, and General Practitioner Care for Neck Pain: Economic Evaluation Alongside a Randomised Controlled Trial
Available at :
http://www.chiro.org/research/ABSTRACTS/Cost_effectiveness_of_physiotherapy.shtml
I'll be honest and say I don't really get all of it, but there seems to be quite a lot on the site.
The conclusion states :
Manual therapy (spinal mobilisation) is more effective and less costly for treating neck pain than physiotherapy or care by a general practitioner
Only took me five minutes. Whats all the fuss?
Hi Zeno, In response to the time it is likely to take there are apparently several stages a complaint must go through. I guess you have read the documents on the GCC web site but for those that haven't the next stages seems to be:
What happens next?
The GCC will:
•Write to you within seven days to tell you it has received your complaint
•Tell you if it can take forward your complaint
•Tell you who is dealing with your complaint and how to contact them
•Give you detailed information about what will happen next
•Write to the chiropractor to tell them about your complaint. The GCC must pass them a copy of your complaint (and any other relevant documents) so that they know the details. If you are worried about this please tell the GCC
•Ask you to agree to the GCC obtaining your health records (if relevant to your complaint)
•Carry out an investigation into your complaint
•Explain what will happen at every stage of the process
The GCC may ask you if you are willing for a solicitor to visit or phone you to:
•Go over the details of your complaint
•Ask you to make a statement of evidence, set out in a legal way
If this happens, the GCC will pay the solicitor's fees.
THEN the chiro gets to respond:
A copy of any statement of evidence provided to the Committee under
paragraph (1) shall be sent to the chiropractor concerned with the notice given under
Rule 3(1), or as soon as practicable thereafter, and (if not sent with that notice) shall be accompanied by an invitation to submit observations within such period (expiring
not less than 14 days after the day on which the invitation was served) as may be
specified in the invitation.
After that the whole bundle of papers goes to the Investigating committee who may call for more evidence, throw it out or draft charges and refer it on to the Professional Conduct Committee. This seems to take a long time judging by dates on the charges for current cases due to be heard
We mostly trust our GPs. But there are good reasons for that trust. All medicines are regulated by the MHRA, any treatment has to be approved by NICE and doctors are well trained, qualified and regulated. So what your GP prescribes is very likely to be pretty safe and effective.
It's not that there have been no trials done for chiropractic, but that it has shown – in good quality trials – to essentially be ineffective. If there were no risks, then I'd be less opposed to it, but there are two categories of risk associated with chiropractic (other than the more common minor side effects): the risks of spine or artery damage, possibly leading to death, and the risk of delaying or dissuading people from getting proper medical advice for potentially serious medical conditions. You just have to read some chiropractic websites to see how scathing they can be of proper medicine.
Thanks dizzyblonde, but I can be patient as long as it is dealt with properly!
way to go Zeno – you've got the feckers running scared. you rule!
This is nothing more than a malicious witch hunt dressed up as a righteous crusade. "Let's get the chiropractors!" You obviously loath chiropractors. Now emboldened, you are possibly after the Osteopaths, so you hate them aswell. What about physiotherapsits who manipulate? Is that one just a too little tricky?
Why don't you just take the next stage and start beating them up in the street or have them thrown into camps for their wicked ways. You could also have them all arrested and put on trial for being enemies of the people, they'd never see that coming. Let's pin the recesssion on them aswell. I'm sure my house must be worth alot less because of them.
There you go, you've got alot more material to work with now. Put them all behind bars. Dress it up how you like, but don't pretend that is is anything other than your own personal unalterable dislike and prejudice.
So, Anonymous, you're not concerned about people making health claims they cannot substantiate and misleading the public? The GCC haven't been fulfilling their statutory duties, so someone's got to highlight it. It's now up to the GCC to put their house in order.
"Why don't you just take the next stage and start beating them up in the street or have them thrown into camps for their wicked ways. You could also have them all arrested and put on trial for being enemies of the people, they'd never see that coming. Let's pin the recesssion on them aswell. I'm sure my house must be worth alot less because of them."
Godwin.
"According to the groundbreaking 2003 medical report Death by Medicine, by Drs. Gary Null, Carolyn Dean, Martin Feldman, Debora Rasio and Dorothy Smith, 783,936 people in the United States die every year from conventional medicine mistakes. That's the equivalent of six jumbo jet crashes a day for an entire year. But where is the media attention for this tragedy? Where is the government support for stopping these medical mistakes before they happen?"
http://www.naturalnews.com/009278.html
Anyone can quote the negative side of any industry.
Yes, that's tragic and should be highlighted (assuming the figures are accurate). Does that site also have figures for the number of lives saved and vastly improved by conventional medicine?
Nice one anonymous…
So now I'm I bit confused.
Zeno quotes …"our PROPER medicine"
So year on year pharmaceutical companies produce more drugs, year on year GP's prescribe more drugs, year on year more and more people get ill and die.
I'm not entirely sure how this all fits together.
If the US are spending $95 billion (in 2005) on medical research then how come people are not now more healthy than they were say 10 or 20 years ago?
Maybe we should be looking more closely at the so called evidence based, safe and effective medication that seems to be prescribed without thought or care in too many cases.
If a heathly person took drugs would it make them more healthly?
Thanks Zeno – my point exactly. What about the vast number of lives improved by alternative and complimentary medicine, including Chiropractic? Remember they don't have the research funding the medical world has especially if you seek to bankrupt their association.
"So year on year pharmaceutical companies produce more drugs, year on year GP's prescribe more drugs, year on year more and more people get ill and die."
Do you have evidence for any of that, or is it just speculation?
"how come people are not now more healthy than they were say 10 or 20 years ago?"
Again, why do you think that?
"Maybe we should be looking more closely at the so called evidence based, safe and effective medication that seems to be prescribed without thought or care in too many cases."
This is being done all the time. See NICE or the Cochrane Collaboration.
"If a heathly person took drugs would it make them more healthly?"
That doesn't exactly help your argument.
"…the vast number of lives improved by alternative and complimentary medicine"
You mean the one who feel a little nit better because someone listened to their worries and maybe gave them a nice massage or whatever?
There is certainly a place for that and GPs should be able to spend more time listening to their patients, but AltMed has no independent record of curing any major, non-self-limiting condition, so the comparison is flawed.
Jeeze, Louise!
The anonymous woo-woo-zombie cowards** have emerged from their mentally-impoverished slime-graves in order to give the most remarkable exposition of the
Gish-Gallop that I have seen in some time.
The lies are flying past at a rate with which not even an Olympic skeet-shooter could hope to cope!
Have these delusional liars NO sense of truth nor reality?
______________
** Assuming that your interlocutor is not a solitary fraud.
Just to counter the spurious claims about old wives tale never helping anyone.
Here's another, amongst many, story of how a widely used folk medicine, when put to the test by real open minded scientists proves the old stories are based on real experience.
This simple weed has definitely saved many people from skin cancer, amongst knowledgeable country people for decades at least (centuries if the truth was known/documented?), and eventually science has caught up. Phase 3 clinical trials complete an all.
http://www.brisbanetimes.com.au/queensland/old-wives-tale-to-fight-skin-cancer-20090518-bca6.html
Zeno,
Awesome. Glad you've seen fit to focus your energy on trying to bring down one of most helpful branches of medicine in existance today.
Research? Here's some: http://www.fcer.org
Let's see, unnatural drugs with oft disclosed multitude of side effects vs. the natural approach of enabling the body to do what it's intended to do – heal and take care of itself.
To the comment earlier about 'wealth'. Really, you have no issue with the pharma industry spending billions to make billions selling drugs to mask symptoms in a 'sick care' system that is little more than a profit machine (yes, Drs are good and do great things) but going to by Dr. to have him say "oh, I have a shot/pill/whatever" for that…which only masks the real issue…wow, that's advancement.
Sorry, you can keep your drugs. I'll keep going to my chiropractor (and stay healthy).
Shall we take blood pressure as a great example of medical care?
GP measures blood pressure
Gets a high reading
Prescribes a drug to lower it
Why? Because high blood pressure is seen to be a disease – which of course it's not – it's just simply the body expressing an intelligent adaptation to stress.
Any questions about what might be causing the elevated blood pressure? No. Questions about stress? No. Lifestyle advice? No.
So prescribe the drugs
Blood pressure goes down – victory for the GP, and result for the patient..
So has the patient got healthier?
Of course not.
The high blood pressure was an intelligent reaction, afterall the body is designed for health, and not sickness.
So the chemical toxins that artifically lower blood pressure stop correct and healthy cell function, and as the body recognises that the blood pressure is now inappropriatly low given the stressful situation its under, it responds by releasing more stress hormones to elevate the blood pressure to where it should be based on physiological demand.
So the blood pressure does come down, but the patient gets sicker from the diseases of adaptation that develop from the chronically increased stress hormone levels that have never been adressed – but in actual fact made worse by the use of drugs.
When another sign or symptom of their "disease of adaption" is discovered, another drug is prescribed and so the cycle of sickness continues.
Are we really then making great strides forward by using medication?
And as for the pure and simple brainwashing and scare mongering of huge portions of society that CHD, cancer, obesity, ADHD, high blood pressure etc etc are genetic…. genetic??? don't think so.
"So, Anonymous, you're not concerned about people making health claims they cannot substantiate and misleading the public? The GCC haven't been fulfilling their statutory duties, so someone's got to highlight it. It's now up to the GCC to put their house in order."
So you don't deny this is a malicious witch hunt? You also don't deny that this is personal and based on your own prejudice? At least we all know that now. But it does seem, well, pretty obvious.
Frankly your other points are just lame. This is just all about you. Protecting the public is just your hobby horse, its what you're using to justify your actions. You're not really actually trying to make anything better are you? This is a consuming grudge for you isn't it? Actually, it could almost appear like a vendetta.
The most interesting thing is how do you expect the general chiropractic council to go about its other regulatory work? How can it regulate anything whilst investigating your ridiculous complaint. Or is that what you want aswell? You could have contacted them directly about your concerns, looked for clarification, made suggestions, etc. All the things people do to improve things. The public can't be aswell protected whilst the GCC is bogged down with this. Did you even reflect on that? Are you trying to have over 500 chiropractors struck off? Or are they just pawns to you?
Perhaps, thinking about it you get their bank accounts frozen aswell. Their clinics could be seized by the state and I think any staff would have to be fined and sent away for re-education. We could take away their homes aswell whilst we're at it. Everything must be their fault come to think of it.
You're a medical fascist, don't pretend otherwise.
It would be helpful if the various anonymousness would give themselves some name if only to distinguish themselves.
One of you makes an interesting point though when you say this is a vendetta. I think there may actually be some truth in this. The sceptical world view demands constant critical engagement with ideas in a process of creative destruction to arrive at better, though eternally imperfect understanding of the world around us. Singh, Ernst, Goldacre and the bad science bloggers have been pursuing this process in the belief that such open critical engagement of ideas and data takes us forward.
When the BCC sued Singh it threatened to use the fear of legal action to intimidate those engaged in such debate. It also promised to set a president by which other groups with even less legitimacy than the BCC might do the same. This must be prevented at all costs. Make no mistake, you are now in the fight of your lives.
Points of debate and facts should speak for themselves, names seem to be little more than grandstanding in this particular public fracas.
For the record and a long way away, the idea of using the law to crush people's (however ill-informed) opinion over some well humoured debate is a real problem. Though I'm also aware this has been used by the medical industry at times when it's to their apparent advantage going back a long way.
yours
Anonymously (again)
"Points of debate and facts should speak for themselves, names seem to be little more than grandstanding in this particular public fracas."
I totally agree, just pick some consistent moniker, even a random alphanumeric sequence, to permit your distinction from other anonymous posters.
"Though I'm also aware this has been used by the medical industry at times when it's to their apparent advantage going back a long way."
Totally agree, and worse is done, such as using threats to withdraw funding to secure favourable write ups from academics. Having papers ghost written for academics who have not been given access to full data. Sceptics do actually campaign against such things, we value clear unbiased evidence.
Chiros and homoeopaths are more of a warm up. Here the egregious abuses are so clear and unsophisticated they make good target practise.
Please check out the latest NICE guidlines relating to back pain. They recommend manipulation and acupunture. Yes those very same NICE guidlines you keep quoting are FOR chiropractors and acupuncture.
For excellent criticism of the NICE fiasco, see:
http://www.dcscience.net/?p=1516
http://www.dcscience.net/?p=1542
http://www.dcscience.net/?p=1593
"Chiros and homeopaths are more of a warm up"
"They make good target practice"
Yeah right, a bunch of rabid science freaks and physicists know everything about actually dealing with sick people, and justify a kind of cultural cleansing take place on that basis?
Healthcare of real humans is as much an art as a science… you might have something to contribute in regard to one aspect of that. Nothing here adds to the other aspects, in fact it seems completely dismissed and attacked.
yours
Anonymous (again)
The only rule is this:
If you presume to treat people, and particularly if you take money off them to do so, ensure you use treatments which you have good reason to believe will work.
This is not a manifesto for drugs and pills as sole treatment. This is just a demand for honesty and a rejection of fraud, because that is the issue here. Are chiropractors guilty of heath fraud?
Whilst living in Penang I visited an American Chiropractor for 6 months & had extensive treatment.
Prior to this my lower back would cause me so much pain that I was nearly immobile and even when the pain subsided my actual mobility was limited.
The manipulations were, in my opinion, the most effective treatment as he tried to correct the root of the problem, whilst my GP in the UK would just prescribe morphine based pain killers.
Pain killers do not address the problem, they simply mask the underlying cause. I don;t see what the issue is – if a mechanical machine has a misalignment then its pretty obvious that this will cause damage – so why not with bio mechanics too?
I think I might have some sort of illness. I don't think its an accident that there are chiropractors in my town. They obviously gave it to me. I'll report it to the medical authorities, police and to Simon Singh. This sort of this should be outlawed
"Are chiropractors guilty of health fraud?"
Are science freaks guilty of irrational generalisations about whole groups of people, events and places they have no direct experience and knowledge of?
People hand their money over for things they feel, understand or have good reason to believe assists them.
It's completely simplistic to ignore the fact that any relationship, financial or otherwise involves more than one side to participate. Unless of course every member of the human race, except science bloggers of course, is incapable of making any sort of reasonable and real decision for themselves. Based on their own real experience, good or bad.
''If there were no risks, then I'd be less opposed to it, but there are two categories of risk associated with chiropractic (other than the more common minor side effects): the risks of spine or artery damage, possibly leading to death, and the risk of delaying or dissuading people from getting proper medical advice for potentially serious medical conditions.''
I am a chiropractor and I agree there are risks for spinal manipulation which I inform every patient of before treatment. There are also 'red flags' in someones history ie. high blood pressure, previous strokes, and also tests that we can perform prior to spinal manipulation which can assess whether someone is in a high risk category for a bleed and no one deemed high risk receives spinal manipulation for their problem, there are other treatments available that would be offered instead.
Chiropractors are highly qualified in differential diagnosis (infact the first 3 years of my degree were very similar to what a GP would study at medical school), so if there are red flags for serious medical conditions then these patients in my office would be referred back to their GP (without treatment provided) along with a letter with the patients history and examination findings(in my experience the GP spends on average 10mins if you are lucky taking a history and if you are really lucky they may actually look at the problem; I spend approximately 1 hour taking a full medical history and performing a physical exam). I would like to repeat that any patient with a suspected serious medical condition would be referred back to the GP.
I would also like to state that I have had many patients who have come into my office and had the initial consultation – I have told them that I do not think chiropractic is not going to help them and I write them a letter to take back to their GP – they are very impressed by the examination that they receive in comparison to what the GP would provide. I do not make any money from doing this, aside from the initial consultation fee, which I think is fair as I have spent 1 hour of my time with the patient. Who would work for free?
As for lumping us all in one category, this is unfair. There are always rotten eggs in any profession and I believe you have highlighted a number of the problems including false advertising and overtreating of patients, but not all chiropractors are like this and certainly not me. And as for the GCC trying to protect the chiropractic profession I say 'rubbish', they just like to take our £1000 annual registration fees.
IS there any research for surgery?
Oaks: yes. But how does that change the lack of efficacy evidence for chiropractic?
It was more of a general question that I pondered halfway through the posts. Fund research for chiropractics and there will be evidence…based on the modern chiropractics not the slightly crazy ones of the olden days.
I heard someone say that its rare they say they can "cure" something like asthma or colic, but they can "treat", as in reduce the symptoms of. I used to suffer from asthma and my ribcage and muscles would get very tight, a couple of treatments with my chiro and I would be able to breathe a lot easier…thats just my experience though.
From my research, nearly 30% of chiropractors claim to have some influence on colic and one in five, asthma. Some of them use various obfuscating words around the claims, but the reader is left with the distinct impression that their condition can benefit from chiropractic. Now, if a chiropractic can substantiate that claim with robust evidence to the standard required by the GCC's CoP, then there is no problem.
What would be your suggestion to improve the research? As I read earlier there isn't much funding available.