When Richard Brown went begging for money to the international chiropractic organisations he spoke of the attack on chiropractic from the sceptics. When he is with his BCA colleagues he is talking prescribing and getting into the NHS. The “new” born again BCA (this will be their third reinvention in 15 years) is all about evidence based practice as described recently by David Byfield to the ECU. Aparently they represent “good” and presumably chiropractors like myself are bad and unethical. So convincing is the born again BCA, Simon Singh e-mailed me yesterday asking are these the same people who made the decision to sue him?
Yes they are the exact same people although Tony Metcalf has stepped back as president after his term ended in October and been replaced by his equally incompetent deputy Richard Brown. As immediate past president Tony remains part the BCA executive.
Today the BCA announced that they agreed with Skeptic Barista view of chiropractic, apparently there is no basis for chiropractors claims that the can help wellbeing by improving spinal joint dysfunction (vertebral Subluxation Complex). If this is true what is Chiropractic?
How could chiropractic have evolved over 100 years on the back of a bogus principal and now a minority of medipractors who spend more time on committees than correcting subluxations have announced its all bullshit in the hope that a few medical doctors will embrace them and make them the experts in managing back pain in the NHS? Dream on Richard.
This simply will not happen and the best analysis for the future of Richard Browns profession was done by chiropractic skeptic Blue Wode and some of his colleagues who said chiropractic will evolve into something like sports massagers. If one looks at the correct definition of quackery thats where Richard Brown will take the chiropractic profession if allowed.
Today the GCC education committee which is chaired by physiotherapist Graham Pope and his deputy the Medical Doctor Christopher Stephens have pronounced on the Veterbral Subluxation, the traditional name for the chiropractors “spinal joint dysfunction”. These two “chiropractic experts)have been assisted by chiropractic skeptics and BCA members Alan Breene and David Byfield and the token traditionalist Christina Cunliffe.
Personally I would prefer if the GCC came out and appointed Skeptic Barista and Simon Singh to their education committee. At least these guys are honest and open about their opinions of chiropractic and the “Vertebral Subluxation Complex” and will engage in discussion about it. Brown et al are not bright enough to do that as seen by their efforts to discredit Simon Singhs.
The BCA bottled making a decision on Subluxation in2001 after their rejection of the ACC paradigm and now the GCC have done it for them. The GCC will say it has been forced on them by, Skeptic Barista “The tea boy who dunked the GCCs Subluxation”.
The GCC have passed their advice onto the ASA making it virtually impossible for registered UK chiropractors to use the term in relation to people seeking chiropractic care in the UK, because the GCC say there is no clinical research evidence linking “health concerns” to spinal joint dysfunction (subluxation) a breach of the GCC code of practice. . This decision taken by the GCCs physio and medical doctor questions the entire theory chiropractic is based on.
In response the BCA is trying to cherry pick from their “plethora of evidence” and dismiss the rest as bogus. Simon Singh could not have written a better response for the BCA and its not surprising he is wondering if these BCA fools are the same fools that sued him. This is the GCC’s statement. http://www.gcc-uk.org/files/page_file/guidance_on_claims_for_VSC_May_2010.pdf
The GCC states: “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 or health concerns”.
The question chiropractors should be asking their regulator is; what does the GCC mean by a “ vertebral subluxation” and what does the GCC mean by health concerns. The GCC has avoiding defining them because to do so undermines the principles of spinal care and chiropractic and they would have to comment on the WHO understanding of chiropractic.
The GCC uses a 1999 World Federation of Chiropractic definition. The most recent definition of chiropractic (2005) is the World Health Organisations definition of chiropractic: Chiropractic as a “health care profession concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health. There is an emphasis on manual techniques, including joint adjustment with a particular focus on subluxations”.
Later the WHO explains the subluxation as; A lesion or dysfunction in a joint or motion segment in which alignment, movement integrity and/or physiological function are altered, although contact between joint surfaces remains intact. It is essentially a functional entity, which may influence biomechanical and neural integrity. And Subluxation theory as: A theoretical model and description of the motion segment dysfunction, which incorporates the interaction of pathological changes in nerve, muscle, ligamentous, vascular and connective tissue this has been taken from Meridel Gatterman’s excellent book Foundations of Chiropractic – Subluxation which puts subluxation theory into its historical and contemporary context and presents the evidence that the theory is based on.
The BCAs responses to the GCCs announcement was immediate so immediate I suspect Richard Brown was consulted on the GCC statement; Richard Browns response to the GCC statment was hardly a surprise in fact the only question one might ask was, why if the BCA believed this were they suing Simon Singh. This takes us back to the issue of the BCA’s “honesty” which became a key point in Simon Singhs case.
It would now seem that the BCA agreed with Simon Singh all along but fearful of losing members to other associations they put claims on their website that they did not believe in (honesty??). Now having managed to create a situation where chiropractors are fearful of more complaints from skeptics and the GCC they have calculated they can push ahead with their aim to medicalise chiropractic, gain prescribing rights and few chiropractors will object.
The BCA anounced that it “welcomes today’s statement from the General Chiropractic Council (GCC) on Vertebral Subluxation Complex, which appears here http://www.gcc-uk.org/files/page_file/guidance_on_claims_for_VSC_May_2010.pdf
As a responsible organisation”, the BCA understands the need to ensure that the public is properly informed about the evidence base for chiropractic treatment so that it is able to make informed choices about the care it receives. For many years, the BCA has not supported the concept of the Vertebral Subluxation Complex in the light of the absence of evidence supporting claims made it can be the cause of disease and serious illness. It also notes that no provider of UK undergraduate chiropractic education teaches Vertebral Subluxation Complex theory in the context of modern healthcare delivery.
The BCA supports and encourages the inclusion of chiropractic in mainstream healthcare provision in the UK. To facilitate the integration of chiropractic, unsubstantiated historical concepts and ambiguous terminology must be discarded in favour of an emphasis on delivering an evidence-based care model that is easily understood by other members of the healthcare team.
The BCA reminds members of their obligations under the GCC Code of Practice and Standard of Proficiency. In ensuring compliance, they should refrain from making any reference to Vertebral Subluxation Complex in media to which their patients or the general public may have access. This advice has no bearing on scope of practice, which is not defined in the Chiropractors Act, but all chiropractors are required to adopt the practice of a reasonable and competent chiropractor.
Chiropractors are the leaders in non-surgical spinal healthcare. There is strong evidence to support the inclusion of chiropractic in musculoskeletal healthcare initiatives, most recently contained in the NICE Guidelines http://guidance.nice.org.uk/CG88 Chiropractors have specific expertise in the assessment, treatment and management of spinal and joint pain syndromes, and are well placed to deliver cost-effective services within the mainstream UK healthcare framework.
Notes to the above statement:
The issue from which this advice stems is that a member of the public has requested information from the GCC about its view on the strength of the research evidence supporting the contention that the VSC is the cause of disease, many health conditions and in some cases, premature death.
The enquiry was made in the context that outcome 4(a) in the current version of the GCC’s Criteria for Recognition of Degrees in Chiropractic, requires that students must “understand the history, theory and principles of chiropractic in a contemporary context” is accompanied by guidance that includes reference to “vertebral subluxation-centred models”.
The GCC’s Education Committee sought observations on the following from the three recognised UK providers of undergraduate chiropractic degree programmes (AECC, MCC and WIOC): –
- How the chiropractic vertebral subluxation complex is covered in the detailed curriculum; and
- What relevant research they draw from.
The detailed responses from each of the institutions can be read in the paper which was considered by the GCC at its meeting on 12 May 2010
The GCC’s Education Committee provided the following advice to the GCC which it accepted at its meeting on 12 May 2010 : –
- The chiropractic vertebral subluxation complex is taught only as an historical concept.
- There is no clinical research base to support the belief that it is the cause of disease or health concerns.
The GCC did consult all of the professional associations and the College of Chiropractors prior to its meeting, and has had further dialogue with representatives at the end of last week. This guidance relates to marketing materials and websites and is not an attempt to define the scope of chiropractic practice.
The GCC’s Guidance is as follows:-
The chiropractic Vertebral Subluxation Concept 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 or health concerns. Chiropractors are reminded that they must make sure their own beliefs and values do not prejudice the patient’s care – GCC Code of Practice Section 8.3. They must provide evidence based care which is clinical practice that incorporates the best available evidence from research, the preferences of the patient and the expertise of practitioners including the individual chiropractor her/himself – GCC Standard of Proficiency Section A2.3 and the Glossary refer. Any advertised claims for chiropractic care must be based only on best research of the highest standard – GCC Guidance on Advertising – issued March 2010 refers.
Any members referring to the VSC on their websites, are recommended to review the context of the wording used as a matter of urgency to ensure compliance with the GCC’s Code of Practice and Standard of Proficiency and thus prevent the possibility of a complaint being made to the GCC about the use of the terminology.
Please contact BCA Head Office if you require any clarification.
Richard Brown DC, LL.M, FCC, FBCA, FEAC
President, British Chiropractic Association 24th May 2010
You could not make this up.
To all chiropractors. I told you this would happen in 2002. What will UK chiropractors call
Spinal Joint Dysfunction now. A Zeno instead of a subluxation.