The random thoughts of a sceptical activist

Monthly Archives: April 2011

Is there a Doctor in the clinic?

There are a lot of doctors out there, but it can be difficult to know which are properly qualified and registered medical practitioners and who are, well, just quacks.

It’s not really that much of a problem for most of us. If we’re feeling unwell, we make an appointment with our GP. If there is any doubt about their status, you can always verify they are registered with the General Medical Council (GMC) by checking their List of Registered Medical Practitioners (LRMP).

But there are so many other ‘doctors’ out there. Ignoring The House Doctor®The Car Doctor and others who have obviously got nothing to do with health, there are many who certainly like to give the impression they are proper doctors — and I have no doubt some of them think they really are.

Take homeopaths, for example.

A simple search of the business directory yell.com shows a large number of homeopaths using the title Dr. Of course, some of them are also medically qualified and on the GMC’s LRMP, but you don’t have to look far to find examples of non-medically qualified homeopaths calling themselves Dr. Again, I have no doubt many of them think they really are doctors and some may well have qualification that entitles them to prefix their name with Dr, but no one should be in any doubt of what they are.

In the UK, Dr is not a protected title: anyone with a suitable qualification can call themselves Dr so-and-so. This is in stark contrast to, say, chiropractors, which is a protected term and its use by anyone not registered with the General Chiropractic Council is illegal under the Chiropractors Act 1994.

Things, thankfully, are a bit stricter when it comes to advertising services to the public.

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Taking the strain

The General Chiropractic Council‘s occasional News from the GCC publication rarely makes interesting reading. It’s usually a mish-mash of stuff only of interest to chiropractors.

But there is an occasional interesting item or two.

The latest issue discusses the apparent ongoing debate between the Advertising Standards Authority (ASA) and the GCC:

The ASA Committee of Advertising Practice (CAP) – the debate goes on

The latest issue we’ve flagged up to the team at CAP relates to claims to treat minor sports injuries.

Its AdviceOnline in respect of osteopathy and physiotherapy states that CAP has accepted that they may claim to help minor sports injuries, but there is no mention of this for chiropractic. In respect of physiotherapy, CAP goes on to state that

“At the present time, CAP is unlikely to ask to see evidence for the treatment of minor conditions.”

We’ve asked CAP to confirm that it would take the same approach to any claims made by chiropractors about minor sports injuries. As ever, we’ll keep the profession in touch with progress.

We have the situation where the GCC  — the statutory regulator for chiropractors, who frequently claim to be a primary health-care profession — is asking the ASA — the voluntary advertising regulator, funded through a levy on advertising spend — to add minor sports injuries back onto their list so their registered chiropractors can make claims about it!

Let’s see if we can help answer the GCC’s query.

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Out with the old…

When I submitted my complaints about claims made on chiropractic websites in June 2008, a fundamental requirement regulating what chiropractors could claim — firmly embedded in their Code of Practice — was that they only advertise consistent with guidance issued by the Advertising Standards Authority (ASA).

At that time, the General Chiropractic Council‘s Code of Practice that was in effect was the 8 December 2005 version and the relevant clause was C1.6. Let’s put it fully in context:

Chiropractors must justify public trust and confidence by being honest and trustworthy.

C1 Chiropractors must act with integrity and never abuse their professional standing.

Specifically chiropractors:

C1.6 may publicise their practices or permit another person to do so consistent with the law and the guidance issued by the Advertising Standards Authority. If chiropractors, or others on their behalf, do publicise, the information used must be factual and verifiable. The information must not be misleading or inaccurate in any way. It must not, in any way, abuse the trust of members of the public nor exploit their lack of experience or knowledge about either health or chiropractic matters. It must not put pressure on people to use chiropractic.29

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29 For example, by arousing ill-founded fear for their future health.

This clearly mandates chiropractors to ensure any advertising complies with ASA guidance, remembering that ASA guidance includes the CAP Code, other guidance and their adjudications.

In prosecuting my complaints, the GCC inexplicably forgot all about the requirement to be consistent with ASA guidance and came up with some arbitrary standard of evidence for compliance. The Professional Conduct Committee begged to differ even with that and effectively allowed any old evidence to be used to substantiate chiropractors’ claims. To understand the whole story, see Humpty Dumpty regulation.

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