The random thoughts of a sceptical activist

If it walks like a chiropractor and quacks like a chiropractor…

Way back in May, I wrote a blog post about some Advertising Standards Authority adjudications against chiropractors. It’s time we took a closer look at one of them. Well, two separate adjudications upheld against one company, Optimum Health Centres (OHC). (Be warned — it’s a horrible Flash website.)

The first was published on 19 December 2007:

Optimum Health Centres

One complainant challenged:

1. whether the ad feature made sufficiently clear it was advertising material;

2. whether Robert Delgados testimonial was genuine; and

3. the claim “There are many scientific studies that show that spinal adjustments can actually improve your immune system by up to 200%”.

4. Two complainants challenged whether the use of “Dr” and the claim that an osteomyologist had equal amounts of training as a regular medical doctor were misleading.

5. The ASA challenged the efficacy of the treatment for the listed conditions.

The testimonial appeared to be genuine, but all other complaints were upheld.

The second was less than a year later on 19 September 2008:

Optimum Health Centres

1. Both complainants thought the ad misleadingly implied that “Dr. Michael” held general medical qualifications.

2. One of the complainants challenged the efficacy of the treatment for the listed ailments, particularly migraine and whiplash, which were serious medical conditions.

3. The ASA challenged whether the ad was irresponsible, because it encouraged treatment of serious medical conditions without the supervision of a doctor or suitably qualified health professional, and discouraged the use of conventional medicine and medical supervision for such conditions.

4. The ASA challenged whether the claim “Dr. Michael Mathews, MAO … is a registered Osteomylogist [sic]” misleadingly suggested Michael Mathews was registered with a medical or statutory body.

All upheld, of course.

An osteo- what?

Of course, the practitioners at OHC are not chiropractors. Or osteopaths. They are osteomyologists. Osteomyologists are ‘spine specialists’, apparently. These ones style themselves as Dr Robert Delgado MAO and Dr Michael Matthews MAO.

It would be illegal for them to call themselves chiropractors because they are not registered with the General Chiropractic Council. It would be illegal to call themselves osteopaths because they are not registered with the General Osteopathy Council. Neither of them are on the General Medical Council‘s List of Registered Medical Practitioners, so they are not registered medical practitioners.

But they still call themselves doctors. The ASA had something to say about that in their adjudication against their adverts — that doesn’t stop them using the title on their website.

So, what’s those MAO initials after their name? They mean that they are members of an organisation called the Association of Osteomyologists. They have 207 members in England, 11 in Scotland, 14 in Wales, 2 in Ireland (North and Republic) and 4 abroad, giving 238 in total.

What’s an osteomyologist and what’s this all got to do with chiropractic?

OHC say:

Spinal specialists at the practice are specialised [sic] in the detection, correction and prevention of Vertebral Subluxations to assist individuals in attaining their ultimate health potential. Subluxations are spinal bone misalignments causing nerve irritation, which affect directly or indirectly the normal function of the nerve system and can subsequently cause a detrimental effect on health and optimal performance.

Spinal specialists correct subluxations by adjusting the spine. Adjustments are gentle, specific corrective procedures which help the body to realign the subluxations.

That’s the definition of what an osteomylogist does, not a chiropractor, apparently. Spot the difference: in the words of the British Chiropractic Association, describing chiropractic:

Like a telephone network, your spinal cord delivers messages from your brain to your body through the nervous system. The vertebrae – the bones of your spine – provide protection for this vital part of your body. As you go through life, a loss of proper function (movement) in the vertebrae, which some chiropractors call a subluxation, may interfere with the healthy working of your spine and the nerves that run through it. This may affect your body’s natural ability to recover from injury and you may find yourself increasingly unwell, unable to shake off apparently minor aches, pains and even some illnesses.

…chiropractors are trained and experienced in finding and correcting the loss of joint function which, undetected, may lead to pain or lower your ability to resist disease. They will use their hands to check the movement of your spine and joints before unlocking the problem areas (a process known as an ‘adjustment’).

Or, in the words of the ASA:

We noted osteomyology was not subject to statutory regulation. We understood that osteomyologists were therapists who had trained in osteopathy or chiropractic but were not regulated by the General Osteopathic Council or the General Chiropractic Council. That could be a result of personal choice or could be because they did not meet the professional or training standards required by those statutory bodies or had been suspended or struck off from them. Because there was no official requirement for osteomyologists to meet any training or professional standards and because they were unregulated, we considered they should not refer to themselves in their advertising as ‘Dr’

Not statutorily regulated? At least if they had been ‘proper’ chiropractors, they would have been under the control of the General Chiropractic Council and their Code of Practice, now wouldn’t they…

More claims…

However, as well as upholding the plethora of complaints against OHC on these two occasions, the ASA said something interesting. In the second advert that had been complained about, OHC had said:

People come to our clinic with their headaches, migraines, IBS, chronic pain, neck pain, shoulder/arm pain, whiplash from car accidents, backaches, ear infections, asthma, allergies, numbness in limbs, athletic injuries, or just a lowered state of health…

Do these claims ring any bells? And they way they have tried to make claims without really making claims?

The ASA ruled:

We noted the claim “People come to our clinic with their headaches, migraines, IBS, chronic pain, neck pain, shoulder/arm pain, whiplash from car accidents, backaches, ear infections, asthma, allergies, numbness in limbs, athletic injuries” had appeared in the ad which was the subject of the December 2007 adjudication.  In that case, the ASA Council decided the evidence provided by OHC did not prove that osteomyology could treat those conditions.

The osteomyologists couldn’t provide even one jot of robust evidence that osteomyology could treat those conditions. So the ASA ruled against them. They lost.

But they tried to get round this annoying little habit the ASA has of requiring robust substantiation for claims made by advertisers:

We noted that, since that adjudication was published, OHC had discussed revisions to the ad with the CAP Copy Advice team.  They were now relying on the argument that osteomyologists used the same techniques as chiropractors to justify that osteomyology could treat the ailments and medical conditions listed in the ad.

The osteomyologists tried to climb on the back of chiropractors by claiming that osteomyologists are really just chiropractors by any other name and pleading with the ASA to consider the evidence on that basis.

Hmmm…relying on the evidence for chiropractic? Smacks of a very large dose of ill-fated desperation! The ASA agreed:

However, we considered OHC could not rely on that argument, firstly because it was not established that chiropractic could treat all those ailments and conditions, and secondly because they had sent no evidence to demonstrate that the training, qualification and techniques of chiropractors and osteomyologists were identical.

The OHC didn’t bother to — or couldn’t — provide evidence that osteomyologists were, in fact, chiropractors. Or that chiropractic could treat those conditions. So the ASA ruled against them. They lost. Again.

…but not a jot of evidence

So, the ASA stated that they had not seen good evidence that chiropractic can treat:

  • headaches
  • migraines (although the ASA say elsewhere they will accept claims that chiropractic can treat migraines)
  • IBS
  • chronic pain
  • neck pain
  • shoulder pain
  • arm pain
  • whiplash from car accidents
  • backaches
  • ear infections
  • asthma
  • allergies
  • numbness in limbs
  • athletic injuries

…implying that claims to treat any of those conditions in an advert would need to be backed up by robust evidence — evidence that OHC could not provide.

The more observant among you will notice that all these claims have been made by the chiropractors I’ve complained about. Since the GCC’s CoP says that chiropractors have to abide by the ASA’s guidance, they could not make these claims (or for any other condition for that matter) without holding ASA-standard evidence to back up those claims.

The osteomyologists didn’t provide that evidence: I wonder if the real chiropractors have it secreted away somewhere? Given the total demolition of the British Chiropractic Association’s plethora of ‘evidence’, it doesn’t seem very likely.

9 Responses to If it walks like a chiropractor and quacks like a chiropractor…

  • Excellent post!

    Great research and sharp wit as usual, thank you. Looking forward to the next chapter, time these quacks were shown the door.

  • I was terribly disappointed to discover that Robert Delgado does not look like this.

  • Ah ha! Arch enemy of the good Doctor!

  • Great post; thanks. Such a shame ASA rulings aren’t binding on the High Court.

    (Tiny point, I think where you’ve said “..they could not make these claims (or for any other condition for that matter) with holding ASA-standard evidence to back up those claims” you may mean “withOUT holding ASA-standard evidence”.)

  • Thanks, Kate! Well spotted – now corrected.

  • Another very good post Zeno,
    I had never heard of osteomyologists; they must be the only lot we don’t have on this small Island I call home.

  • I just caught up with this string. I’m a chiropractor who has been in practise for over twenty years and throughout that time have had to put up with the idiosyncrasies of some of my colleagues. However, I remain proud of being a chiropractor and of the work that we do.

    That work is to improve and maintain the quality of life of our patients by helping them to recover from, and manage, disorders of the musculo-skeletal system. I’ve never been a subscriber to the concept of managing asthma or infantile colic and I’ve never seen a patient with a view to treating them for such ailments.

    I and my close colleagues have dedicated ourselves to treating mechanical pain syndromes. We incorporate every bit of evidence we can into our care programmes to ensure that we deliver safe, effective treatment to our patients.

    Don’t confuse good chiropractic practise with the offerings of these so-called Osteomyologists. This group of people didn’t exist before the creation of the General Chiropractic Council or General Osteopathic Council. In fact, they seem to exist precisely because of the creation of these bodies. These particular individuals may have chiropractic qualifications (apparently from South Africa), but they are not permitted to call themselves chiropractors in the UK, because the are not registered with the GCC. You’d have to ask them why they’re not on the register, but my experience is that it’s generally because they don’t wish to be bound by the Standards and Code that registrants are obliged to uphold. Responsible chiropractors respect these principles as part of their professional duty.

    No one is arguing that chiropractic should be immune from scrutiny, or that it shouldn’t continue to improve the quality and efectiveness of the services it offers. The Standards of Proficiency and Code of Practice are being constantly reviewed and updated and chiropractors will be obliged to adhere to them.

    This recent denigration of chiropractic is misdirected. It would be much better focused on the those who wish to do their thing with no regulation at all. The oteomyologists are a case in point.

  • David said:

    “No one is arguing that chiropractic should be immune from scrutiny, or that it shouldn’t continue to improve the quality and efectiveness of the services it offers. The Standards of Proficiency and Code of Practice are being constantly reviewed and updated and chiropractors will be obliged to adhere to them.”

    The BCA has drawn such criticism precisely because it attempted to exempt chiropractic from scrutiny by issuing legal precedings against Simon, thus frightening off all other critics, rather than engaging in scientific debate.

    With regard to the rest of your paragraph, you can’t be proficient in a therapy without benefit and under such circumstances a code of practice offers only the semblance of professionalism.

  • Derrik said:
    “The BCA has drawn such criticism precisely because it attempted to exempt chiropractic from scrutiny by issuing legal precedings against Simon, thus frightening off all other critics, rather than engaging in scientific debate.”

    No it didn’t. The BCA issued proceedings because Mr Singh made an untrue statement of fact that he refused to retract. It is absolutely untrue that the BCA have tried to stifle scientific debate.

    Derrik said:
    “With regard to the rest of your paragraph, you can’t be proficient in a therapy without benefit and under such circumstances a code of practice offers only the semblance of professionalism.”

    David says: Grow up, Derrik!

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