Can you hear me at the back?
I’m sure we all know the story of the birth of chiropractic by now. Shopkeeper, spiritualist and magnetic healing advocate, D D Palmer invented it in 1895. Harvey Lillard goes down in history as being the catalyst that made Palmer realise where his fortune and fame lay. Palmer himself tells the story (Palmer DD: “The Chiropractor’s Adjuster.” Portland Printing House Company. 1910. P. 18.), recounted on Stephen Barrett’s excellent Chirobase website:
Harvey Lillard, a janitor, in the Ryan Block, where I had my office, had been so deaf for 17 years that he could not hear the racket of a wagon on the street or the ticking of a watch. I made inquiry as to the cause of his deafness and was informed that when he was exerting himself in a cramped, stooping position, he felt something give way in his back and immediately became deaf. An examination showed a vertebra racked from its normal position. I reasoned that if that vertebra was replaced. the man’s hearing should be restored. With this object in view, a half-hour’s talk persuaded Mr. Lillard to allow me to replace it. I racked it into position by using the spinous process as a lever and soon the man could hear as before. There was nothing “accidental” about this, as it was accomplished with an object in view, and the result expected was obtained. There was nothing “crude” about this adjustment; it was specific, so much so that no Chiropractor has equaled it.
Lilliard gave a slightly different account, but so convinced of the money-making possibilities, Palmer set up the Palmer School of Chiropractic the following year.
So, with this marvellous success, you’d have thought that curing deafness — or even just partial deafness — would be on every chiropractors list of conditions he/she could treat? (Unless, of course, it was so specific that none have been able to match it since.)
But curiously, I haven’t found a single reference to deafness or hearing loss on the websites of any of the 500 chiropractors I complained about. Perhaps Palmer was mistaken? Perhaps despite 110 years of painstaking chiropractic research, no one has been able to replicate Plamer’s fantastic first success? Or perhaps they have eschewed all the research that has been done or maybe they are just not aware of this plethora?
In 2007, the GCC instigated a complaint against Cashley. The allegations, given in the GCC’s Fitness to Practise Report 2007 were:
- Failure to ensure that the content of a website that promoted the practitioner’s practice and for which he was responsible, was factual, verifiable and compliant with the GCC’s Code of Practice and the Advertising Standards Authority’s Code of Advertising Practice
- Exploitation of the public’s lack of experience or knowledge about health or chiropractic matters
This is obviously very similar to the allegations I have made in my complaint and it’s good to see that the GCC do actually monitor and pursue their members.
So, what were the complaints against Cashley?
1 failed to scrutinise the content of his practice’s website, either during its construction or afterwards; and
2 the website made reference to chiropractic being able to relieve a number of serious ailments such as deafness, blindness and inability to conceive. It made further claims, which could not be verified, about improved hearing, eye function, sexual function, improved function of reproductive organs, easier childbirth and reduced labour; and
3 the website contained a number of statements that might abuse the trust of members of the public, or exploit their lack of experience or knowledge about either health or chiropractic matters, in that it used the words “the silent killer”
Note the references to blindness and improved hearing. (It’s not clear to me whether the phrase ‘which could not be verified’ refers to their inability to verify that those further claims were actually made by Cashley (did they bother to ask him if he had made those claims?) or whether they were saying that those further claims could not be substantiated. I suspect the former is intended.)
Surely, since the foundation of chiropractic was curing deafness, they could hardly object to that claim?
It appears they held a hearing into this case on 26 January 2007. However, it’s not so easy to see exactly what happened because:
The named Chiropractor has been subject to a PCC [Professional Conduct Committee] hearing and action by the PCC has concluded. In accordance with our disclosure policy, information relating to this matter is no longer available on our website. This information can be obtained by contacting the Regulation Section on 020 7713 5155 or at email@example.com
However, the Fitness to Practise Report, gives some information about the hearing:
At the outset of the one-day hearing, Dr Cashley admitted all of the allegations. The Committee duly found the matters and facts proved.
(Dr Cashley? Dr? I thought they were supposed to make it clear they only have a doctorate in chiropractic and are not registered medical practitioners — I can’t find a Mark Cashley on the General Medical Council’s List of Registered Medical Practitioners.)
Anyway, guilty as charged, m’lud. Did they throw the book at him for making these absurd and unsubstantiated claims? Or for alarming the public?
Well, not quite.
The finding of unacceptable professional conduct
The Committee found that the proven facts amounted to unacceptable professional conduct. In reaching this decision, the Committee considered that Dr Cashley’s conduct fell short of the standard required for a registered chiropractor by
* failing to ensure that the content of the website was appropriate and in accordance with the GCC’s Code of Practice
* failing to properly scrutinise the content of the website during, and after, its construction
The Committee emphasised that “as a professional, a chiropractor has the responsibility for all the information disseminated about his services; this includes ensuring that it is factual and verifiable. Nonverifiable claims are not permitted because members of the public might be misled. People with problems such as infertility, deafness and loss of sight may look for anything that could help to relieve their condition. The use of non-verifiable claims may misinform the public and may undermine confidence in the profession. The public need to have confidence that what they read accurately reflects what is clinically achievable.
Further, publicity about chiropractic practices on websites is readily accessible to members of the public. Information on the internet reaches very wide audiences and may exploit their lack of experience or knowledge about health or chiropractic matters, in particular by the use of terminology such as “silent killer”.
Failure to exercise professional responsibility and comply with the Code of Practice in these respects undermines public confidence in the profession”.
Extract from the Committee’s final decision
“The Committee was impressed by your evidence and accepts that the failings you have admitted in this case were errors of omission, rather than ones of commission. It accepts that you have an exemplary record as a chiropractor and the Unacceptable Professional Conduct it has found is not based on any question of your honesty, integrity or clinical competence. It takes account of the fact that you admitted all the allegations at the earliest opportunity and that they amounted to Unacceptable Professional Conduct. It accepts that as soon as you were notified about the problem relating to the website you caused it to be withdrawn immediately. Further, the Committee accepts that your prompt apology, which you repeated in this hearing, was a sincere expression of regret, and in the view of the Committee is a clear manifestation of your insight into these failings…
However, a registered health professional…cannot abrogate their responsibility for any publicity put out in their name”.
After all this, they finally decide on appropriate punishment…
Imposing a proportionate sanction
The Committee decided that an admonishment was an appropriate sanction to impose upon Dr Cashley and concluded the case.
He was admonished because he apologised for making those absurd claims and quickly removed them once he was found out.
Palmer’s second case was someone with ‘heart trouble‘. There weren’t any claims for heart troubles in my list, but there are plenty in the US who make such claims. It looks like they have very lax regulation over there as well.