Recent Controversies in Chiropractic and RMIT Courses/Clinic

by Mal Vickers

Hello all, this is the first post of a two-part series on my concerns about RMIT University and chiropractic. In this first post, I’ll mention some of the recent controversies in chiropractic. In the second post, I’ll write about my visit to RMIT Open Day and my attempt to ask an expert in chiropractic some questions about its practices.

For those that might be wondering – why do this? I’m a former RMIT student. RMIT’s association with pseudoscience, in my opinion, diminishes the greater and more worthwhile subjects such as engineering, arts, humanities and science-based academic courses offered in other departments of the University.

For a quick refresher on the sceptical and historical view of chiropractic you might try the Skeptics Dictionary entry.

RMIT claims the following:

RMIT is a leader in chiropractic tertiary education offering the world’s first government-supported chiropractic program.

RMIT offers undergraduate courses or you can go all the way and receive a PhD in Chiropractic. Indeed it does appear that RMIT is the leading institution educating chiropractors in the Australian.

Is chiropractic at RMIT really worthy of government (read: tax-payer’s dollars) support? Here is a list of recent concerns about chiropractic, some of which relate to RMIT’s involvement. There are many other worthy concerns about chiropractic but this is simply my current pick.

Recent Concern #1, The RMIT Chiropractic Paediatric Clinic

RMIT has been publicly criticised for opening a Chiropractic Paediatric Clinic, along with a public call from Loretta Marron for this clinic to be shut down. You may think that this doesn’t sound like much to complain about, the reason is:

There is zero scientific evidence that chiropractic is effective for any specific childhood condition.

It might otherwise be fine if RMIT were using the clinic 100% of the time for research studies.  However, this is a clinic within the university campus, offering chiropractic as treatment in exchange for a scheduled fee. RMIT claims the clinic is

staffed by registered and experienced chiropractors.

[April 2011, Letter from RMIT Chancellor Dr Ziggy Switkovski to Loretta Marron]

The UK’s 2010 Bronfort Report, which sought evidence in favour of chiropractic, stated the following:

In children, the evidence is inconclusive regarding the effectiveness for otitis media and enuresis, and it is not effective for infantile colic and asthma when compared to sham manipulation.’

(The definition of otitis media is inflammation of the middle ear and enuresis is the inability to control urination or bedwetting).

Chiropractic treatment is not without risks, thus children are being treated with chiropractic ‘therapy’, without any conclusive evidence that the treatment being performed is effective. From a totally objective, mathematical, non-emotional risk/benefit point of view, if there’s no benefit from treatment the child only gets the risks associated with the treatment.

Recent Concern #2, The Association between Chiropractic and the Anti-Vaccination Lobby

Reported in the mainstream press in July (2011) was an article about chiropractic and the deceptively named Australian Vaccination Network (AVN).

In my opinion, vaccines a stand out as one of medical science’s greatest achievements. I can’t think of another branch of health care that has more effectively and safely reduced preventable disease and death.

Fair enough, people have the freedom to do whatever they want and associate with whomever they want, however it’s puzzling that so many chiropractors support Australia’s largest anti-vaccination group. Of the AVN’s published list of 198 professional members, 128 are chiropractors.

The NSW based Health Care Complaints Commission (HCCC) issued a public warning about the AVN.

Why so many chiropractors are associated with a group that’s promoting the anti-vaccine message, thereby undermining public health and safety, I’m not sure. Does this say something about the education standards of chiropractors?

It would be nice to hear from RMIT that a Chiropractic education included critical thinking, along with an understanding of the methods of objectively measuring health outcomes.

Recent Concern #3, Chiropractors Failure to Inform Patients of Associated Risks

In Australia, it’s an accepted principal that medical doctors inform patients of the risks associated with any treatment. Patients are entitled to be properly informed so that they can make their own choices.

In July 2011 a survey was published in the UK which tried to answer the question; how well are chiropractic patients informed? The results show that many chiropractors do not routinely inform their patients of the significant risks associated with neck manipulation.

There is published evidence that some patients have become confined to a wheelchair or have died as a result of this form of chiropractic treatment.
Whilst I’m not suggesting that Australian medical doctors flawlessly inform patients of the risks of any treatment, that doesn’t logically prevent me from asking for the same high standards from chiropractic.

Are Australian chiropractors informing patients of the significant risks associated with manipulation of the neck? Does RMIT educate its up-and-coming chiropractors to inform patients of the risks? These are questions I’ll try to have answered.

Subluxations

I’m also interested in the current understanding of chiropractic subluxation theory. The subluxation idea dates back to the founder of chiropractic in 1895 by a former grocer and magnetic healer D.D. Palmer. A subluxation is said to be a place within the body where bones impinge on the nervous system, supposedly leading to all manner of diseases. Over the years, chiropractors have suggested that one day, medical science will discover the truth about subluxations. However, despite huge advances in medical imaging techniques, the subluxation idea appears to be less likely related to anything scientific or physical.

In May 2010, the UK’s General Chiropractic Council made the following statement based on the latest scientific evidence:

The chiropractic vertebral subluxation complex is an historical concept but it remains a theoretical model. It is not supported by any clinical research evidence that would allow claims to be made that it is the cause of disease.

[Note, this GCC quote and the link to it has been changed since this article was first posted, see the comments below]

Better Health Channel Website

The Victorian Government Health Department hosts a website informing the public of various health treatment choices. There seems to be no distinction made on this site between practices that are effective and those that aren’t.

On this site you’ll also find some extraordinary claims made about chiropractic. Put your critical thinking skills to the test? The page on chiropractic can be found here.

That’s all for now! Coming soon in part two, we’ll gain some fascinating insights from my recent visit to RMIT Open Day.

9 Responses to Recent Controversies in Chiropractic and RMIT Courses/Clinic

  1. keng2 says:

    Mal, as a fellow graduate of RMIT, I share your pain, and we’re not alone. Vic Skeptics has had several emails from RMIT graduates, wondering what happened to the integrity of their Alma Mater and what could be done to redress it. (The answer in my view is simple: the Bean Counters have taken over the shop and Money has replaced Science as the guiding principle – a bit like the Pharmacy Guild, really). Your investigations and article are a good start.

    I’d like to draw the reader’s attention to Loretta Marron’s excellent article on page 10 of the June 2011 Skeptic magazine, where she calls for the RMIT’s Chiropractic courses to be shut down.

    We’re also looking forward to Tim Mendham’s talk on “Woo Courses” at January’s Skeptics Café (See “EVENTS”). Tim assures us that while Victoria is not the only Australian state whose tertiary institutions run courses in pseudoscience, it is by far the worst offender.

  2. vanAdamme says:

    Which form of chiropractic do you think is worse? Gonstead or applied kinesiology? I have (shamefully) used both in my life. The gonstead guys go nuts with the cracking where the kinesiologists don’t appear to do anything dangerous. On the other hand, the kinesiologists seem way more wacky to me.

  3. Graeme Hanigan says:

    Phillip Ebrall – Professor of Chiropractic at Central Queensland University and who I understand is involved in the RMIT Research, made some interesting statements on Ken Harveys item about Blackmores here; http://theconversation.edu.au/pharmacies-to-push-supplements-as-fries-and-coke-to-prescriptions-3578

  4. Blue Wode says:

    Excellent piece. Looking forward to part 2.

    Just one correction. Unfortunately, in August 2010, the UK General Chiropractic Council removed the words “or health concerns” from its statement on the Vertebral Subluxation Complex following pressure from the four UK chiropractic assocations:
    http://www.gcc-uk.org/files/link_file/Guidance_on_claims_made_for_the_chiropractic_VSC_18August10.pdf

  5. Tremendous choice, Mal and I’m looking fwd to part 2.

    I too have real concerns about the fundamentalist, “Mystical Chiropractors” as I call them. Some points I’ve found myself discussing in just the last week….

    On August 21st, a video appeared on YouTube called “Homeopathic Evidence and Research”. Behind the camera is Simon Floreani national president of the Chiropractors’ Association of Australia. In front is Issac Golden pushing homeoprophylaxis, the Cuban hokus pokus and his own notably flawed PhD.

    Without blowing ones trumpet too much this vimeo clip waxes lyrical about certain CAA chiropractors and anti-vax sentiment – plus challenges much of Goldens message.

    http://www.vimeo.com/28707170

    This is a shorter version omitting the 1st third & focussing on Golden’s claims.

    (http://www.youtube.com/watch?v=b44XgR6hzcg)

    It’s worth noting that in the CRP’s finding that upheld Ken Harvey’s complaint against Fran Sheffield’s “homeopathic immunisation” advertisements they noted the NHMRC’s position. It in turn references the Council of the faculty of homeopathy London which strongly (and only) supports conventional vaccination. Something to think on as Golden is boasting about NHS support in the UK apropos his devotion to homeoprophylaxis.

    The NHMRC position goes on to quote from the ED of Aust’ Natural Therapies Ass’n that “no qualified natural therapist would recommend homeopathic immunisation as an alternative…”.

    The claims chiro’s make about vaccine risk takes on a bizarre face given that vaccine injuries pale alongside serious injuries from cervical manipulation. Eg; the World Chiropractic Alliance made much of narcolepsy from Pandermix vaccine for H1N1. Known to be genetically based it occurs at a rate of 0.003%.

    Last year health insurer, Kaiser Permanente withdrew coverage for cervical manipulation citing an upper rate of 0.005%. They wrote:

    “Chiropractic manipulation of the cervical spine is associated with vertebral artery dissection and stroke. The incidence is estimated at 1.3-5 events per 100,000 manipulations. Given the paucity of data related to beneficial effects of chiropractic manipulation of the cervical spine and the real potential for catastrophic adverse events, it was decided to exclude chiropractic manipulation of the cervical spine from coverage.”

    In a bizarre “press release” on August 30, 2010 countering this “widespread myth” (of links to stroke) the WCA said in part:

    “”In an attempt to discredit chiropractic and discourage people from seeking care from doctors of chiropractic, some proponents of allopathic medicine — and attorneys interested in filing spurious lawsuits — continue to disseminate misleading information about a supposed link between cervical adjustments and strokes.”

    On a Lateline segment that aired on July 6th 2009 Simon Floreani claimed injury from CM is approx 1 in 5.8 million. Which is aroundish 60 times less than Kaiser Permanente’s most conservative risk level.

    Finally, here’s the account from his wife Jennifer Floreani on managing pertussis in their baby:

    “This experience did indeed test our resolve and we were forced to draw on our support network of healthcare providers. We performed chiropractic checks on our baby daily and utilised a whooping cough homeopathic. I dosed myself with an array of vitamins to boost his immunity via breast milk and kept him hydrated with constant breastfeeding.
    Whooping cough is often slow to develop and may respond well to conservative management, including chiropractic, osteopathy, homeopathy, herbs, acupuncture or acupressure. Within two days, the severity of our baby’s symptoms cleared and within a two week period, each of our boys had a complete resolution of their symptoms.”

  6. Blue Wode says:

    @ Paul Gallagher

    Unfortunately, at the end of last year, Kaiser Permanente caved in to pressure from the chiropractic community and reinstated its coverage for neck manipulation:
    http://www.ebm-first.com/chiropractic/latest-news/1867-kaiser-permanente-reinstates-coverage-for-chiropractic-neck-manipulation.html

  7. A chiropractor employs several hands-on spinal moves, including a variety of replacement processes, to appropriately line up the musculoskeletal composition of the body system. The target is to let the body to recover without making use of medication or surgical treatment.

    • malvickers says:

      Hi waukesha wi chiropractors, thank you for your comment, however I think it would have been more helpful if you had more directly address the concerns raised in the post above.

      Chiropractors may use those methods, but are they effective for any health conditions? How do you know you’re not simply providing a placebo therapy, wasting the time and money of your patients and possibly distracting them from more effective treatments for their ailments?

      Are you also suggesting that chiropractic is a more effective treatment than surgery? If so, which conditions and what scientific evidence do you have?

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