Chiroquackery! by Gert van der Walt

July 1, 2010
By

steve with BJ book The worst thing about being thrown off the General Chiropractic Council, was the indifference shown by the chiropractic profession. Apathy is what has allowed the GCC/BCA alliance to promote their biomedical agenda for chiropractic.  In recent months I have sensed that attitudes are changing but few were prepared to put their head above the parapet. A letter I received today from Gert Van der Walt DC a BCA chiropractor who practices in SW London suggests things may be about to change.

 

 

In the picture is Steve Carpenter DC holding an original Palmer book signed by BJ Palmer during his trip to the UK  in the 20s. Steve  found the book thrown in a skip outside the AECC library in the 70s, when UK chiropractors began embracing the biomedical agenda and clearing out the old.

Hopefully Gerts letter and Steffan’s postings on this blog may be the stones that start  ripples that give a few more chiropractors the courage to stand with them in support of chiropractic which is on its knees at the moment in the UK. While many would describe me as a “loose cannon”, (a badge I wear with honour), Gert has been part of the chiropractic establishment for most of his professional career and he is not convinced by the recent proclamations of the leadership of the UK chiropractic profession. 

In South Africa Gert served on a statutory equivalent of the GCC. He served as South Africa’s Representative on the WFC Council for 9 year, served three terms as President of the Chiropractic Association of South Africa – 3, Vice -President of CASA – 1 term, Secretary General of CASA – 1 term. Council member of the Associated Health Services Professions Board – appointment by the South African Minister of Health. Member of the Education Advisory Committee of Technikon Natal’s Chiropractic Faculties.

Gert has given me permission to post the content on my blog.

 

We, the undersigned, wish to strongly express our misgivings about the future of Chiropractic, when, at the merest sniff of controversy about the validity of care or the basis of Chiropractic, our profession’s leadership, in co-operation with the GCC (General Chiropractic Council), deems it necessary to issue a knee-jerk response “in the public interest”.

This begs the question – have we been lying to our millions of patients for over a century, by claiming that the VSC (Vertebral Subluxation Complex) interferes with nerve energy transmission and thereby prevents the body from restoring itself back to health? Are we just adjusting joints to hear audible releases and patients have improved by placebo?

The Vertebral Subluxation Complex (VSC) has been the mainstay of the profession for over a century – to now suddenly relegate it to the scrap heap is playing beautifully into the hands of our protractors (externally and internally) – just look at the orchestrated programme aimed at over 600 Chiropractors who dared to claim that they have seen patients overcome conditions like back ache, headaches, leg and arm pain, amongst many others. We are again facing the challenges that lead to the Wilk et al case in the 1970’s in the USA.

The word “subluxation” is synonymous with Chiropractic – it has been accepted by:

1. Most of the major Insurance Companies worldwide

2. Workmen’s Compensation Commissioners

3. World Health Organisation (WHO) – “WHO guidelines on basic training and safety in Chiropractic [2005]

4. The Council on Chiropractic practice [1998]

5. Mercy Guidelines

6. Major Chiropractic organisations who accept the ACC (Association of Chiropractic Colleges) paradigm on “subluxation” (May 23, 2001)

7. Most of the statutory bodies in countries that have legislated for Chiropractic around the world.

What has happened to all the Workmen’s Compensation facts and figures regarding the “Effectiveness and cost – effectiveness of Chiropractic care” – were we conning Governments about the VSC – you can bet your bottom dollar that all Government Departments of Health had their medical teams scrutinize all the Chiropractic submissions and we would not have impressed them with rhetorical facts and figures.

To render all research inadequate and flawed if it is not an RCT (Randomised Controlled Trial), is flawed in itself. Are case studies/series and subsequent similar studies, as well as individual practitioner’s clinical practice wrong then? With a combined practicing career of 40 years, is it wrong to assume nerve interference causes more than just pain? We all know about the complexities of the nervous system – the master controller of everything (posterior columns, spinothalamic tract, autonomic nervous system etc.), yet to say only pain is a subsequent of nerve interference is ridiculous. Without the basis of the VSC to explain these complexities and resultant dysfunctions, we are rendering ourselves inadequate. We understand with the onset of the mass GCC complaint, some Chiropractors were claiming cure for many conditions, but is it wrong to advertise one has noted improvements in patients suffering from epilepsy, asthma etc. when over 38 years of practice would suggest there is more to Chiropractic treatment than merely the relief of musculoskeletal complaints, and therefore, there should be more to spinal segmental dysfunction – viz: VSC. An interesting note is that in the recent Clinical Chiropractic Journal [1] (the official journal of the College of Chiropractors and a publication regarded as providing significant evidence-based research details), Martin Young – the editor, follows the same standpoint as us in his editorial: “Evidence-based balderdash” makes for interesting and thought-provoking reading.

Chiropractic literature is resplendent with the word “subluxation”:

1. Gatterman – Foundations of Chiropractic: Subluxation

2. Faye and Lantz – VSC model

3. Petersen and Bergmann – Chiropractic technique: Principles and Procedures

4. Association of Chiropractic Colleges – “subluxation is a complex of functional and/or structural and/or pathological articular changes that compromise neural integrity and may influence organ, system function and general health”

5. Palmer College Post-graduate Preceptor program handbook (the Palmer Tenets No:2 — “The Subluxation Complex”—.

What we find most interesting is that in 1994, the US Government’s Agency for Health Care Policy and Research released a report that found that there were, at that time, only two scientifically validated treatments for low back pain (without red flags) – that is: analgesics and manipulation / adjustment. The medical establishment and its complementary therapies was found wanting in that a large percentage of their treatments / modalities were found to have no basis in science, yet they did not rush out to change names of treatments / modalities that were not “scientific”, or ban their use – in the “public interest”. Why are our powers that be kowtowing to “public and scientific opinion” that does not give a hoot what you call something, as long as it works and helps people regain their health. Is health merely the absence of disease?

We would strongly dispute the statement that there is no scientific basis for the VSC – what happened to all the work that Scott Haldeman et al did in the 1960’s to show that mechanical interference to the nerve root at the exit foramina interferes with nerve energy transmission, to name but one study.

The BCA has advised its members not to use the word “subluxation” and that their advice has no bearing on our Scope of Practice. What was the BCA defending when it took on the Singh case if all that we have been telling our patients for a century has not been “bogus”?

We are being encouraged to follow the so – called medical model, by looking at prescription rights – for decades now we have told our patients we do not prescribe drugs and that drugs are dangerous (look at the statistics for iatrogenic disease) – yet a large percentage of our BCA membership now calls for prescribing rights at their AGM. Are we so far gone that we now want to become pseudomedics?. What about the WFC Policy Statement (April 30, 2003) that “Chiropractic does not subscribe to the prescription of drugs in the interests of Chiropractic principle and patient welfare”? As a matter of interest, the BCA has been selling, as part of their marketing, postcards of a vial of painkillers with the phrase: “Avoid painkillers – Dosage: Visit your Chiropractor regularly” [2]. If the BCA is for prescription rights, why are the advertising materials they sell telling a different story? Following the Singh case, we as a profession were asked / instructed to remove a number of “unscientific” disorders from our websites – yet the word “whiplash” (a term said to be removed from all marketing materials by the ASA and subsequently GCC), appears on the AECC website [3] – the amount of discrepancies and double standards within the profession are staggering and bringing the profession into disrepute!

We as a profession need to stand up and be counted for providing natural healthcare care that helps the body to restore itself to health (without the use of drugs or surgery). Without the VSC as a basis for explaining what we are doing for patients, what do we really do?.

We believe that what is at issue really, is that some Chiropractors have been claiming cure –alls and that, instead of taking them to task, the leadership is burying it’s head in the sand and playing handsomely into the hands of people who would love to see our profession destroy itself from the inside. It is also interesting to note that the BCA leadership, on their own volition, decided they could speak on behalf of all their entire membership without any consultation whatsoever.

I am quite frankly appalled at the apparent direction being taken by the leadership of the profession in the UK. Did I spend half my professional career fighting for something that, according to our leadership, never existed?.

Dr G.T van der Walt D.C

Dr Xander van der Walt BSc (Hons), PGCert, MCC

References

1. Martin Young – Editorial; Clinical Chiropractic (2010) 13, 141-142

2. Painkiller vial postcard: Available from: <http://www.chiropractic-uk.co.uk/productdetails.aspx?ref=26&m=9&mi=18&ms=0> [Accessed 24 June 2010]

3. http://www.aecc.ac.uk/the-clinic/what-is-chiropractic.aspx [Accessed 26 June 2010]

· J Manipulative Physiol Ther. 1988 Apr;11(2):98-107.

· BS Budgell – Journal of Manipulative and Physiological …, 2000 Volume 23, Issue 2, Pages 104-106 (February 2000)

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  • http://spinaljoint.com Richard Lanigan

    Dazed,
    No I have not. So I will ask you how has the McTimoney college and the association responded to the GCC statement regarding subluxation?

    John McTimoneys started the college because he felt the AECC was going to medicalise chiropractic and move chiropractic away from its traditions. Everything he predicted has come to pass. Question is what does McTimoney stand for and where does its future lie. Christina has played her hand very well on behalf of McTimoney, the divisions suit her agenda.

    The dynamics have change, McTimoney is no longer seems to be the BCA,s bogey man. Its traditional chiropractors who are without political influence, without a representitive on the GCC, the BCA or the ECU. Traditional chiropractors from the UCA endorsed Christina voted for her in the GCC elections and it would appear, that as soon as Christinal got her feet under Peter Dixons table, we never heard a word of complaint from the McTimoney Association regarding the GCCs view of traditional chiropractic.

    If that is not a fair assessment, please put me straight.

  • Paul

    I hate to state the obvious Dazed but the MCA / McT college will say what ever suits their current political agenda best just like when they became ‘chiropractic’ and then lately became ‘subluxation based…

    just as the AECC abandoned chiropractic and WIOC exploited the title to produce manual medicine graduates (no differet from physios who manipulate according [if I remember correctly] to D. Byfield).

  • dazed

    have you asked the MCA what they think?

  • http://spinaljoint.com Richard Lanigan

    Dazed in the latest Contact, Richard Brown states that AECC, WIC and McTimoney college have rejected subluxation theory.

  • dazed

    because we are chiropractors and subluxation based ones at that.

  • Paul

    Dazed

    Thanks – you will have noticed its nothing personal (I do believe both yourself and Fed up have integrity and are stand up) – however is McTimmoney therapy chiropractic anymore than manual medicine?

    Not saying it is not an effective therapy (past any holding on to chiropractic research and evidence) but why are you chaps not willing to stand as a therapy seperate and distinct from that push for maunual medicine in the UK?

  • dazed

    Paul, what a bee you have in your bonnet about McTimoney tkig over the world!

    FYI the full membership of the BSI group working on the UK part of the EU standards comrise representatives from:
    Anglo-European College of Chiropractic
    British Chiropractic Association
    College of Chiropractors
    Consumer & Public Interest Network
    McTimoney Chiropractic Association
    Scottish Chiropractic Association
    United Chiropractic Association
    Welsh Institute of Chiropractic

    you can verify this information at: https://ecommittees.bsi-global.com/bsi/controller/nomorg?livelinkDataID=28852517&XMLQUERY_commid=28852517

    All the UK chiro colleges, associations and the College of Chiros are representated. The BSI is only the UK arm of a wider network of committees across Europe working to standardise chiropractic education and legislation.

    Do keep up.

  • Paul

    @CDC

    ‘There are research indicating that an adjustment can effect the autonomous nervous system, brain function and even genes. Brain function! Genes!!’

    This is a gem illustrating your very point…

    Neurovertebral Influence on Visceral and ANS Function: Some of the Evidence To Date – Part II: Somotovisceral
    http://chiropractors.asn.au/Content/NavigationMenu/Publications/CJA/CurrentIssues2010/Volume40/Vol40Issue1/default.htm

    @Richard

    ‘CEN Project
    The European Centre for Normalisation,
    is the centre for standards across Europe.
    The UK delegation, under the banner of
    the British Standards Institute (BSI) consists
    of Tony Metcalfe, Christina Cunliffe and
    Richard Brown.’

    Does this then involve Christina Cunliffe with the ECU? Are we seeing the bedfellows of manual medicine and mctimmoney therapy setting European ‘Chiropractic’ Standards?

  • http://spinaljoint.com Richard Lanigan

    The ECU is run by the BCA, thats why the Danes left. Thats why they handed over £100,000 towards their legal costs of the Simon Sing case. Report in the latest Contact.

    Members of the ECU General Council
    met in London on 12th May ahead of
    the ECU Convention. BCA President,
    Richard Brown, attended on behalf of
    the Great Britain and reports here on
    a productive meeting and a new ECU
    President.

    New Executive Council
    After six years as ECU President, Philippe
    Druart has stepped down and is been
    replaced by Norwegian, Øystein Ogre.
    Øystein was proposed by a number of
    ECU members, including Great Britain and
    has been on General Council for a number
    of years. The Executive Council now
    comprises:
    President: Øystein Ogre – Norway (Who has no objection to members seeking prescriping rights and has no comment to make on the WFCs position paper, which states prescribing is not part of the chiropractic scope of practice)
    First Vice President:Former BCA president 2003 – 2007 Barry Lewis –
    Great Britain.
    Second Vice President: Franz Schmid
    – (Switzerland who have had prescribing rights since 1995).

    The council discussed: European Guidelines on Back Pain, reinforcement of support for the educational institutions; discussion on prescribing rights; research;
    revalidation; and philosophy.

    Council members supported the idea and it was suggested that representatives of the educational institutions and researchers
    also be invited to attend. This event will take place on the 28th July.

    At the meeting, the ECU approved an
    assistance grant to the BCA of 115,000
    euros. This grant followed a proposal by
    the Executive Council to provide financial
    assistance in respect of the recent legal
    action against Simon Singh. While the costs
    of the affair have not yet been finalised,
    the BCA is most grateful for this grant and
    thanks the ECU for its support.
    ECU Remuneration Committee
    The ECU has now appointed a new
    remuneration committee to oversee the
    payment of honoraria and expenses to
    those undertaking ECU business. The
    committee will consist of two members of
    General Council (Gertjan van Koert and
    Richard Brown), the ECU Treasurer and the
    First Vice President.Richard has never looked a gift horse in the mouth and and received much honoraria from the GCC over the years. Yes GCC not BCA.http://www.chiropracticlive.com/?p=688

    Code of Good Practice
    ECU General Council approved the
    adoption of a new code of ethics. Now
    known as the Code of Good Practice, the
    code was principally authored by Richard
    of information would be appropriate
    were:-
    • A serious patient safety incident,
    where the root cause suggests that
    the fault lies principally with the
    individual healthcare worker;
    • Clinical indicators showing
    significantly poorer outcomes than
    would reasonably be expected given
    the case mix;
    • Allegations of poor clinical decision
    making or of a casual approach to
    managing clinical risks;
    • Allegations of communications (to
    colleagues or patients) sufficiently
    poor so as to put patients at risk;
    • Allegations of boundary violations or
    deliberate abuse of patients.
    Members noted the proposals and the
    need for compliance with the Code
    of Practice. At this stage it was not felt
    necessary to comment further, but BCA
    members would need to be informed
    of the new legislation and how it might
    affect them. ( Might be a good idea for BCA members to get insured against the risk for starters)

    Brown draws upon the current and
    past GCC Codes of Practice and Standard
    of Proficiency, General Medical Council
    guidance and advice from a leading
    specialist barrister.

    CEN Project
    The European Centre for Normalisation,
    is the centre for standards across Europe.
    The UK delegation, under the banner of
    the British Standards Institute (BSI) consists
    of Tony Metcalfe, Christina Cunliffe and
    Richard Brown.

    Is this what the French call a “menage et trois”?

  • CDC

    Brilliant, Richard!

    It is not only UK having these kind of problems. You are not alone! Other countries in Europe also face these problems with medipractors having too much time on their hands getting involved in the national Chiropractic Associations steering it away from traditional chiropractic towards something they think MDs and PTs might accept. I say they seek acceptance in the wrong place and it seems it will affect all of us! The apathy among the members is sad. I hope and believe the pendulum will swing back before other professions “find this” and claim it theirs. There are research indicating that an adjustment can effect the autonomous nervous system, brain function and even genes. Brain function! Genes!! And these morons want to limit us to do low back pain relief. Chiropractic is to them like finding an elixir of life and use it to do their morning toilet.

  • Paul

    Bravo – excellent letter and hopefully has some resonance within the BCA and GCC.

    However I would dispute what is at issue and state it is the hijacking of the chiropractic profession, its standing and inroads made by Manual Medicine and to a lesser degree and more recent past by McTimmoney therapy.

    Removing any reference to subluxation suits their agenda and its advance now having subdued the ECU toward WFC dominance.

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