by Mal Vickers
And so it was, I went along to RMIT’s Open Day on August 14, 2011, with my camera, voice recorder and some prepared questions. As any good skeptical researcher would do, I went searching for the evidence and for the experts that might help me find it.
Surely, if there is any up-to-date science behind chiropractic the leaders of chiropractic teaching in Australia would know? Would I be the one to eat humble pie and change my mind if the science had come of age?
As you would expect of any university open day, there were the usual information booths, people helping with directions and information, tours of the facilities etc. I took a tour of Building 213, the Chiropractic Clinic. On the outside, the sign said Building 213 was the School of Health Sciences, Teaching Clinics. Although once you’re inside, a different sign states RMIT, Complementary Medicine Clinics. (How does that song go? ‘things that make you go, hmmmmmm’) Interestingly, the building is also shared with RMIT’s Chinese Medicine Clinic.
Inside the many chiropractic treatment rooms, were ‘trigger points’ charts. They look like a cross between genuine science-based anatomical charts and reflexology charts. I don’t wish to get to side-tracked, so if the reader desires, you can side-track yourself and read about the chiropractic idea of ‘trigger points’ on Wikipedia.
It was rather confronting to observe pseudoscience being so openly displayed at a trusted, government-funded university, where anyone can come and pay for a ‘treatment’.
Additionally, this chart about spinal function in many of the treatment rooms. It purports to show a decline and then restoration in spinal health with frequent visits to a chiropractor.
Enrol Up, Enrol Up!
In Building 201, I sat in on a lecture given by the Chiropractic Head of Discipline, Dr Tom Molyneux. The talk was aimed at prospective chiropractic students and their parents. The list of units that the chiropractic students are expected to complete was enormous. The impression was that students would become highly-skilled and knowledgeable. Did you know that chiropractic students are given the opportunity to do cadaver study? It’s actually a rare privilege generally reserved for students studying a medical degree as I understand it. Did you know that a full-fee paying RMIT chiropractic student can expect to pay around $20,000 per year to study?
Much of the talk was about the VTAC score RMIT would like prospective students to achieve before attempting to enrol in RMIT Chiropractic. Some of the lecture was about the outreach activities of the Chiropractic Department. Apparently, there are four chiropractic clinics in total across RMIT’s campuses and there was talk of an outreach program at an aboriginal community. It was all quite positive stuff about health and helping people. A number of the staff and senior students of the Chiropractic Department also contributed to the discussion.
Of course, I was interested in what wasn’t said. No mention was made of the historical controversies and risks of chiropractic and not a hint that students may be enrolling in a course which combines outdated ideas with the placebo effect. It’s no surprise, I guess.
After the speech, and as people wandered away, I found a quiet moment to approach Tom and engage in polite conversation. I introduced myself as a blog writer from the Australian Skeptics and asked Tom if he’d be willing to be interviewed. Tom was polite but firm in his answer, which was “No”. I was told that I would have to go through another channel, that being RMIT University’s Communications Office. Tom politely gave me the contact details for the office.
I’m still a little surprised at being unable to get an interview with RMIT’s chiropractors/lecturers. Aren’t lecturers fervently supportive of the idea of academic freedom? Would every Head of a university science department decline to be interviewed by a skeptic like me?
Oh well…it’s their choice. I left RMIT Open Day without an interview (note the irony). But the story doesn’t end there…I’m a little more annoyingly persistent than that. I went ahead and contacted RMIT’s Communications Office. They said I’d have to write my questions in an email.
I’d prefer to have a friendly and civilised face to face discussion rather than an exchange of emails; it looks like I don’t have a choice.
As you’ll note from my questions, they’re very much about chiropractic. I doubted that RMIT’s Communications Officer would be able to offer expert advice. I suspected that they would need to forward my questions to the people in the Chiropractic Department anyway.
Nevertheless, on Monday August 22, I emailed my questions (see below), together with a polite preamble, to RMIT’s Communications Office.
My questions covered the five areas presented in my last blog post on this topic.
The 2010 RMIT position paper on subluxation says (in part):
‘…in that it emphasises the need for clinical evidence to support a diagnosis that leads to intervention by adjustment.’
The link to clinical evidence is made; however the statement does not actually reference any scientific evidence. Would you say Chiropractic subluxation (or VSC) idea is scientifically well established or not well established?
Chiropractic and Vaccination
Recently there was a news report that claimed many of the professional supporters of the Australian Vaccination Network are chiropractors. Note that the AVN is an anti-vaccination organisation. [Heraldsun news report.]
My questions are:
Are the principles of chiropractic inherently antagonistic to vaccination?
Do you have any ideas as to why so many chiropractors are supporters of an anti-vaccination group?
Does RMIT Chiropractic have a policy on vaccination?
Will this report lead to any changes with the teaching of chiropractic at RMIT?
Chiropractic to Treat Children
I have information that RMIT Chiropractic had opened a Paediatric Clinic. A brochure currently available at the Bundoora Chiropractic Clinic (Building 213) says that ‘a paediatric clinic has been established’ and I understand an RMIT newsletter made the same announcement. I’m sure you are also aware that campaigner for science-based medicine Loretta Marron ,wrote to the health minister Nicola Roxon asking for the RMIT Paediatric Clinic to be closed.
I recently did a quick tour of Building 213 as part of RMIT’s 2011 Open Day. I saw no direct evidence of a Paediatric Clinic, although I couldn’t get any direct answers from staff in relation to use of the facility to treat children.
My questions are:
Could I get RMIT’s reaction to Loretta Marrons request?
Also, if the Paediatric Clinic is an ongoing entity, I’m interested in knowing how active it is and what conditions are being treated?
The Better Health Channel Website
The Victorian Government Department of Health has a website called The Better Health Channel. It has a page about chiropractic.
On this page the information stated the following:
‘….produced in consultation with and approved by RMIT University.’
The page also says:
‘Scientific studies have shown chiropractic can be helpful to assist with a range of disorders, including: Back injuries, headaches, lower back pain, migraines, period pain, problems with posture, sciatica (shooting pains in the leg), tinnitus (ringing in the ears).’
‘Chiropractic and Children.
Chiropractic care for pregnant women, nursing mothers, babies and children is offered by chiropractors with additional training in this field. Chiropractic care about the neck is not suitable in children with Down syndrome and some other conditions. Chiropractors typically work with very young patients in association with maternal health nurses and accept referrals from general medical practitioners (GPs).’
The UK’s General Chiropractic Council commissioned the Bronfort Report to look at the scientific evidence supporting chiropractic (2010). The Bronfort Report only used evidence from well-conducted, randomised, clinical trials.
The Bronfort Report contradicts what is stated on the Better Health Channel Website; sciatica was placed in the inconclusive category. Premenstrual syndrome is also mentioned in the inconclusive category and tinnitus is not mentioned at all.
The Bronford Report does not suggest the use of chiropractic to treat any conditions typically associated with pregnant women, babies and children.
I agree that the findings of the Bronfort Report also claims:
‘Spinal manipulation/mobilization is effective in adults for: acute, subacute, and chronic low back pain; migraine and cervicogenic headache; cervicogenic dizziness; manipulation/mobilization is effective for several extremity joint conditions; and thoracic manipulation/mobilization is effective for acute/subacute neck pain.’
My questions are:
Does RMIT Chiropractic stand behind the claims made on the Better Health Channel Website? In particular, I’m concerned with conditions for which there appears to be little evidence and the claim that ‘chiropractors typically work with very young patients’.
Informed Consent and Risk
A recent article in the UK’s Guardian Newspaper, noted that many chiropractors didn’t regularly inform patients of the risks associated with chiropractic manipulation of the neck.
My questions are:
Although the survey was done in the UK, do you think the same results would be found in Australia? I’m interested to know if the teaching of chiropractic has changed in relation to the survey’s findings?
Please note that by asking these questions I’m not suggesting that science-based medicine is perfect or beyond criticism. I’m also not suggesting that science has established all the facts. I also understand that chiropractors give practical, healthy, lifestyle advice to patients i.e. diet and exercise. Similar advice is also given by other healthcare professionals.
Skeptics are particularly interested in critical, unbiased evaluation of available evidence. That’s why I’m approaching RMIT. I seek the facts and to acquire the best information from one of Australia’s leading chiropractic educators.
I had a suspicion right from the start that RMIT wouldn’t like my questions and might find it easier to say nothing. Who would want to bother with questions from a skeptical amateur blog writer anyway? Thus, I added this to my preamble.
I don’t wish to sound rude or make this difficult, as it is you (and whomever you find) who would be helping me, however, I think a month would be a reasonable timeframe. Although, something sooner than that would be fantastic. If I don’t hear anything back in that time, I think it’s reasonable to assume no-one is willing to respond.
After a gentle reminder, I was surprised to see an email from RMIT in my inbox on the 15th of September. I’ve deleted names but other than that, the full text is shown.
In relation to RMIT’s chiropractic clinics, I can pass on the following:
RMIT operates four chiropractic teaching clinics. The largest, on our Bundoora campus, sees patients of all ages. The small number of paediatric patients are treated only by experienced registered chiropractors. The chiropractic treatment offered to patients is directed toward their musculoskeletal conditions.
I responded the next day:
I must say I’m a little dismayed and disappointed by the short answer. Perhaps one question where I asked if the Paediatric Clinic is an on-going concern was loosely answered. Although saying that treatment is only directed toward musculoskeletal conditions isn’t definitive.
The founder of Chiropractic, D.D. Palmer, said that:
“A subluxated vertebra… is the cause of 95 percent of all diseases. The other five percent is caused by displaced joints other than those of the vertebral column.”
That’s why I’d prefer a more detailed response as to the different types of conditions for which children are referred and given chiropractic treatment.
I also asked other important questions about; patients being properly informed of risks, the information provided to a government website and the association between chiropractors and the anti-vaccination lobby.
Is that the only response I’m likely to receive?
I appreciate the time you’ve taken so far and I am genuinely interested in getting RMIT’s views on recent concerns about chiropractic.’
Since then, there’s been no further communication from RMIT’s Communications Office (again, note the irony). I believe I’ve given them ample time to respond. I think that a month is a reasonable and generous amount of time. It’s disappointing because I thought my questions were worthy of a reply, well-researched and of public interest.
What do you think? Is the reply I got from RMIT satisfactory? Add your comments below if you wish.
Update: August 2012
Choice Magazine published an excellent article on Chiropractic titled: Can a chiropractor replace your GP?
Update: April 2013
Macquarie University in NSW announced it would be dropping its Chiropractic program from 2015. It appears that chiropractic is incompatible with Macquarie University’s new investments in teaching health sciences.
Update: May 2013
Australians spent $10M on chiropractic through the taxpayer funded Medicare system in 2012.
RMIT Open Day is the 11 August, 2013. I say go along, ask questions.