MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

An article in the ‘Chronicle of Chiropractic’ defends the currently much debated chiropractic care for children. It is authored by ‘ChiroFuture‘, a Risk Purchasing Group founded by chiropractors. Here is the unabridged article (the references were added by me and refer to my comments below):

The chiropractic care of children has been the subject of increased media attention and scrutiny following decisions by chiropractic regulatory boards in Europe, Australia and Canada. These decisions were not based on science, research or data but rather a purposeful misrepresentation of the concept of evidence informed practice (1) and its application coupled with compelled speech.

As with the chiropractic care of adults, an evidence informed perspective (2) respects the needs and wants of parents for the care of their child, the published research evidence and the clinical expertise of chiropractors in the care of children.

ChiroFutures Malpractice Program does not base its malpractice insurance rates on the age of the patients a chiropractor sees.  In fact, we are not aware of any actuarial data showing an increase in adverse events from the tens of millions of pediatric chiropractic visits per year (3). The vast majority of claims or incidents alleging chiropractic negligence involve adult patients (4).

What chiropractors do is minimally invasive and typically nothing else but their hands are used to gently ease any obstruction to the functioning of the patient’s nervous system (5). Since the nervous system controls and coordinates all functions of the body it is important to be sure it is functioning as best it can with no obstructions and no matter the disease afflicting the patient.

State and provincial laws, federal governments, international, national and state chiropractic organizations and chiropractic educational institutions all support the role and responsibility of chiropractors in the management of children’s health (6). The rationale for chiropractic care of children is supported by published protocols that are safe, efficacious, and valid (7). The scientific literature is sufficiently supportive of the usefulness of these protocols in regard to the chiropractic care of children (8).

Those contending that there is no evidence supporting the safety and efficacy of the chiropractic care of children demonstrate a complete disregard for the evidence and scientific facts related to the chiropractic care of children (9).

ChiroFutures encourages and supports a shared decision making process between doctors (10) and patients regarding health needs. As a part of that process, patients have a right to be informed about the state of their health as well as the risks, benefits and alternatives related to care. Any restriction on that dialogue or compelled statements inconsistent with the doctrine of informed consent present a threat to public health (11).

__________________________________________________________

Here are my comments:

  1. Why ‘evidence informed’ and not evidence-based’? The term ‘evidence informed’ is popular with SCAM practitioners. Barratt and Hodson noted, “The evidence-informed practitioner carefully considers what research evidence tells them in the context of a particular child, family or service, and then weighs this up alongside knowledge drawn from professional experience and the views of service users to inform decisions about the way forward.”  This seems to imply that the two terms are synonymous. However, in reality they are not.
  2. Does that mean that ‘evidence-informed’ is defined as the practice wanted by patients, regardless of the evidence?
  3. There is no post-marketing surveillance in chiropractic. Therefore we do not have reliable data on adverse events.
  4. That might be true but it is unclear what it tells us. It might simply mean that chiropractors treat more adults than children.
  5. There is no good evidence to show that the function of the nervous system can be enhanced by manual therapy.
  6. Provincial laws and federal governments might tolerate but I don’t think they ‘support’ the role and responsibility of chiropractors. That chiropractic organisations support it surprises nobody.
  7. This sentence does not make sense to me. The facts, however, are clear: there is no sound rational for chiropractic manipulations and they are neither efficacious nor totally safe for children.
  8. The scientific evidence does not show that chiropractic care is effective for any paediatric condition.
  9. I think the complete disregard is shown not by critics but by the authors of these lines.
  10. Calling chiropractors ‘doctors’ gives the impression they have  been to medical school and is therefore misleading the public.
  11. The threat to public health are those chiropractors who advise parents not to immunise their children.

Perhaps ChiroFuture need to brush up on their knowledge of the evidence. Chiropractic has no place in the healthcare of children. Parents should be warned!

17 Responses to Chiropractic for kids: a ‘complete disregard for the evidence and scientific facts’

  • Ee…An article in the ‘Chronicle of Chiropractic’ defends the currently much debated chiropractic care for children. It is authored by ‘ChiroFuture‘, a Risk Purchasing Group founded by chiropractors…”

    For clarification, ChiroFutures was co-founded by Matthew McCoy. He most likely is the author of this article. McCoy was the researcher director at Life University for 17 years and was recently “let go”. He is now on the Board of Trustees for Sherman College of Chiropractic. He is/was the editor of several journals, which IMO are silly attempts to provide support of chiropractic dogma. I have engaged him in the past on social media, he has since blocked me from commenting on his posts. He considers those who wish to advance the chiropractic profession as the “Chiropractic Cartel” and that they are “subluxation-deniers”. He supports what they call a vitalistic, salutogenic model of chiropractic, even though it appears they don’t know what those words mean. Other than being an occasional thorn in the advancement of the chiropractic profession, no one takes him seriously, at least outside the small group he says he represents. Thus, IMO, it’s a waste of time to even discuss his ramblings and drivel. But I suppose it makes good fodder for Ernst’s blog.

  • And has been an ongoing criticism: no chiroquacker nor organization can actually define what “it” is, and what one of them is “educated” to do….excepting finding and eliminating/reducing (or pretending to), subluxation (something which they also refuse to delineate)? Which is a non-answer.
    The reason is clear; to define what, why and how of the practice of chiroquackery is to potentially reduce the number of worried-well that may get suckered into the trap. And of course an age restriction does the same. As innumerable Chiroquackery websites point out: chiroquackery is for ALL AGES AND ALL CONDITIONS, AKA; a religion.

    • Yes for some it has taken on a form that looks like a relgion.

      • Yes and the defense of a religious-proposition takes a form very similar to yours: “I’m different, and those old world dogmas are gone. I know more than my contemporaries. You can’t judge us by what we do…you need to judge us by what’s in our hearts…and our good intentions”. No real Scottish Chiroquacker.

      • @DC

        You told us several times that, for many, chiropractic is a philosophy. In this thread it now “looks like” a religion (for some), with dogma. The only thing you seem consistently to support is that chiropractic is a “profession”, i.e. a paid occupation. From there on, as MK points out, the only thing that ever seems to form your basis for debate is indeed the ‘No True Scotsman’ logical fallacy.

        • Frank. some call it a philosophy, some call it a religion, some call it a cult.

          But yes, by definition chiropractic is a profession.

          Profession: any type of work, esp. one that needs a high level of education or a particular skill: (Cambridge)

          • @DC

            So you don’t think that someone with a high level of education or a particular skill ought to be able to figure out whether chiropractic is a philosophy, a religion or a cult?

            Or even to know what a philosophy is?

          • Dogma: “An authoritative principle, belief or statement of opinion, especially one considered to be absolutely true regardless of evidence, or without evidence to support it. Dogma must be accepted as law”.
            Chiroquackery like all SCAM, abhors scrutiny, limitations and challenges to whether its underlying “opinion” is a universal imperative.

          • Frank…So you don’t think that someone with a high level of education or a particular skill ought to be able to figure out whether chiropractic is a philosophy, a religion or a cult?

            As with many things, this falls upon a continuum. It’s not black and white.

          • MK….Chiroquackery

            When you make up a word you can have it mean whatever you want.

  • HOW DOES CHIROPRACTOR CARE OF A CHILD WORK?
    (Found this among a myriad of similar postings) from a New York quack: “Dr._______ is very adamant about explaining to his patients that he is going to get to the root cause of your troubles. It is very common for an infant to benefit from the realignment of the spine because nerves can become shifted or pinched during pregnancy. In many instances the blocked nerve can interrupt the function between the brain and stomach, causing digestion and constipation problems”. INFANT CHIROPRACTIC CARE: “infant care in not normally covered by insurance. The cost is generally $40 per visit but this should and NEVER DOES hinder parents from seeking the proper care your child needs”.

  • At DC: funny how you decide my accurate, albeit poetic-wordplay ISN’T “your” CHIROPRACTIC. Yet you utilize the word CHIROPRACTIC, the License AND the moniker DC (and perhaps even answer your office phone as “Doctor”?) YET try to persuade ‘us’ and promulgate the idea that you are NOT a run-of-the-mill SCAMMER proselytizing people into the 125 year old vaudeville gag DCs are famous for: “we find the SOURCE” of your pain”, “only chiropractic can realign the spine”, “subluxation affects health”, “Chiropractic improves immune function and longevity”, “a chiropractor is highly trained in biomechanics, infants thru the elderly and can feel the spinal vertebrae that aren’t moving properly”, “chiropractors have as much education as an MD”, “Activators and adjusting guns can effectively reduce subluxation without cracking or twisting”, “we are experts in nutrition”, “chiropractic adjustments should be an important part of a heath wellness program…just like exercise”………….what would YOU call it? And IF this in no way describes anything you DO…you ought to also be making up your own name for it and QUIT USING DOCTOR OF CHIROPRACTIC.

    • MK…QUIT USING DOCTOR OF CHIROPRACTIC.

      We have discusses this option. The amount of changes that would need to occur make it an unrealistic option. But thanks for trying.

      • changes to chiro’s cash flow, I presume.

        • Yes. By seperating from the left we would expect to see increase utilization, increase collaboration, better insurance coverage, etc.

          But creating a new profession is not realistic. Splitting/tiering the profession is not realistic.

  • When you make up a word you can have it mean whatever you want

    Not if you want other people to understand what you are talking about.

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