The random thoughts of a sceptical activist

British Chiropractic Association (BCA)

Beware the spinal spin

Finding a document on the website of the British Chiropractic Association titled  “CONFIDENTIAL FOR BCA MEMBERS ONLY” is an open invitation…

Perusing the BCA’s website usually finds extremely useful advice on schoolbagsgardeningbrasshopping, Bank Holidays, bakinggadgets, sitting and, of course, Christmas.

This time, however, I was bravely looking for what they said about the differences between chiropractic and osteopathy after a comment by a chiro on Prof Edzard Ernst’s blog:

Chiropractic and osteopathy have different origins. They are separate forms of spinal manip. Typically osteopaths use long level techniques, chiros use short lever. Both aim to achieve the same thing – spinal health.

This highlights a frequent question asked by skeptics: Are chiropractic and osteopathy substantially or even significantly different forms of healthcare?

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The Scottish Chiropractic Association: Attempting to ‘manipulate’ the entire Scottish population?

Guest post by Blue Wode. Originally published on The Twenty First Floor on 14 March 2012.

Introduction

In recent times, the two main UK chiropractic associations, the British Chiropractic Association (BCA) and the McTimoney Chiropractic Association (MCA), have come under intense scrutiny. The BCA was brought to its knees by the misconceived libel case it brought against the science writer and broadcaster, Simon Singh, and, as a direct result of it, the MCA suffered the humiliation of having a confidential email to its members leaked online which revealed that it had urged all of them to take down their websites as they were a real threat to both them and their practices. By comparison, the Scottish Chiropractic Association (SCA) has enjoyed a relatively uncontroversial existence. Until now.

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A right Royal chiro cock-up

Jubilation in the chiropractic world! But, as usual, all is not what it might first seem…

Chiropractors granted Royal Charter:

The College of Chiropractors will soon be given the honour of being named the Royal College of Chiropractors. In doing so, Chiropractors become the first complementary health specialty to be awarded a Royal Charter. It is great news for Chiropractors and the development of the chiropractic profession in general.

Royal Charters have traditionally been awarded to specialty areas of Medicine such as the Royal College of Surgeons or Royal College of Dentists. It recognises the value of the College of Chiropractors unique position as a leader in the profession. (Source)

College of Chiropractors receives Royal Charter. Feels great to now be part of The Royal College of Chiropractors (Source)

The College of Chiropractors have been granted Royal Charter. Congratulations to the Royal College of Chiropractors! (Source)

The College of Chiropractors will soon be given the honour of being named the Royal College of Chiropractors. (Source)

One chiro was quick to update their website (or maybe he always thought it was a Royal College?) with this new imprimatur:

 I am registered with the General Chiropractic Council…and a member of the British Chiropractic Association (BCA) and the Royal College of Chiropractors. (Source)

The British Chiropractic Association (BCA) published a press release (cached) that probably started this all off:

College of Chiropractors granted Royal Charter

Dated: 12 November 2012

At a meeting of the Privy Council on Wednesday, the Queen approved the grant of a Royal Charter to the College of Chiropractors, the first Royal Charter to be granted to a complementary medicine organisation in the UK.

The College is an academic, professional membership body, established along the lines of the Medical Royal Colleges, which over the past 13 years has sought to ensure quality, safety and excellence are at the forefront of chiropractic practice in the public interest.

Chiropractic is regulated by statute and although chiropractors provide their services largely within the private sector, NHS funding for chiropractic treatment is now emerging region by region under the Department of Health’s new commissioning arrangements. Chiropractors specialise in the diagnosis and treatment of problems affecting the joints, muscles and nerves and are probably best known for treating low back pain, a condition which costs the equivalent of between 1% and 2% of the UK GDP and has a significant impact on people’s lives.

Rarely granted, a Royal Charter signals permanence and stability and, in the College of Chiropractors’ case, a clear indication to others of the leadership value and innovative approach the College brings to the development of the chiropractic profession. The Royal Charter essentially formalises the College’s position as a unique, apolitical, consultative body, recognising its role in promoting high practice standards and certifying quality and thus securing public confidence.

Tim Jay, President of the College, said, “The College of Chiropractors’ Royal Charter emphasises to the public and other health bodies that chiropractic is a healthcare profession with parity in the field of musculoskeletal health, providing a viable and recognised option for patients.”

All the usual spin, of course.

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Chiro regulator admits systemic failures

I have never been 100%  sure of the exact numbers of complaints of mine the General Chiropractic Council had to deal with.

I certainly submitted a list of 524 names, but the number changed as the complaints were processed. Quite a few chiros were added to my initial list because they were at the same clinic as another I had complained about and some have been removed for various reasons. Then there were more than a few issues of chiros changing their names, moving clinics, moving abroad and other things that made it difficult to keep track, so I didn’t bother to keep my list absolutely up to date. There didn’t really seem any point in fretting over the minutiæ. After all, the GCC are a statutory regulator and they could be trusted to keep track because it was their statutory duty to deal with these things, couldn’t they?

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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

______________________

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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Humpty Dumpty regulation

The phrase Humpty Dumpty chiropractic cropped up in a Google Alert a few days ago. It was the fitting title of an editorial (cached) in the December 2010 issue of Clinical Chiropractic, which discussed the slippery and nebulous meaning of vertebral subluxation complex (VSC).

For those who don’t remember their childhood, in Lewis Carroll’s Through the Looking Glass, Humpty Dumpty is discussing the meaning of words with Alice. HD remonstrates:

‘When I use a word,’ Humpty Dumpty said in rather a scornful tone, ‘it means just what I choose it to mean — neither more nor less.’

Such equivocation is typical of on-line conversations with chiropractic supporters discussing the VSC, but it applies elsewhere as well.

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Where the evidence leads

Google Alerts is a very useful tool for skeptics. It sends you an email whenever the word or phrase you’ve asked for crops up in their searches of news, blogs or other websites. They are excellent for keeping tabs on what’s going on by helping you track new stories and hits.

Naturally, I have one set up for the General Chiropractic Council (GCC), just to see where they crop up on web sites and in the news.

A few days ago, I received a Google Alert about a page that had been recently updated, although the mention of the GCC was from some time ago. It linked to a decision by the Press Complaints Commission (PCC) about complaints made by the GCC against the Daily Telegraph, the Daily Mail and the Guardian about articles published on 9 November 2007.

According to the GCC, the articles said:

  • Chiropractors ‘are waste [sic] of money’, Daily Telegraph, Rebecca Smith
  • Chiropractors ‘are a waste of time’, Daily Mail, Jenny Hope
  • ‘Chiropractors may be no use in treating back pain, study says’, The Guardian, Alok Jha

Nothing new there, then.

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The Mass Libel Reform Blog – Fight for Free Speech!

This week is the first anniversary of the report Free Speech is Not for Sale, which highlighted the oppressive nature of English libel law. In short, the law is extremely hostile to writers, while being unreasonably friendly towards powerful corporations and individuals who want to silence critics.

The English libel law is particularly dangerous for bloggers, who are generally not backed by publishers, and who can end up being sued in London regardless of where the blog was posted. The internet allows bloggers to reach a global audience, but it also allows the High Court in London to have a global reach.

You can read more about the peculiar and grossly unfair nature of English libel law at the website of the Libel Reform Campaign. You will see that the campaign is not calling for the removal of libel law, but for a libel law that is fair and which would allow writers a reasonable opportunity to express their opinion and then defend it.

The good news is that the British Government has made a commitment to draft a bill that will reform libel, but it is essential that bloggers and their readers send a strong signal to politicians so that they follow through on this promise. You can do this by joining me and over 50,000 others who have signed the libel reform petition.

Remember, you can sign the petition whatever your nationality and wherever you live. Indeed, signatories from overseas remind British politicians that the English libel law is out of step with the rest of the free world.

If you have already signed the petition, then please encourage friends, family and colleagues to sign up. Moreover, if you have your own blog, you can join hundreds of other bloggers by posting this blog on your own site. There is a real chance that bloggers could help change the most censorious libel law in the democratic world.

We must speak out to defend free speech. Please sign the petition for libel reform.

Getting their nappies in a twist

It had never occurred to me that one of the important design parameters of a nappy would be how little noise it makes when flexed.

However, this seems to be a USP for some manufacturers and they want to tell prospective customers all about it.

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