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

It has been reported that B.C.’s chiropractors are deeply divided about the future of their profession, disagreeing on everything from false advertising to the use of routine X-rays.

Chiropractors attending an extraordinary general meeting of the College of Chiropractors of B.C. were split nearly down the middle on a series of non-binding resolutions addressing actions the College has taken in recent years. By the narrowest of margins, with at most 54% support, the members voted in favor of the college’s moves to limit the use of diagnostic X-rays and ban claims that aren’t supported by scientific evidence. The question that remains is who represents the bulk of the profession in B.C. — chiropractors advocating for what they describe as evidence-based practice targeting the musculoskeletal system, or “vitalists” who argue that chiropractic treatment can help with everything from immunity to brain function.

The modernizers see it as “a deliberate attempt to take over the college by a small group of chiropractors with no respect or knowledge of regulation … funded by organizations out of the province and out of the country,” Victoria chiropractor Clark Konczak told the virtual meeting.

At issue was a series of policies the college introduced in the wake of what Konczak called “the smoothie episode.” He was referring to a video posted on Facebook in 2017 by the then-vice chair of the college’s board, Avtar Jassal, in which he falsely suggested fruit smoothies are better than vaccines at preventing the flu.

Earlier this year, the college introduced amendments that bar chiropractors from performing routine and repeat X-rays, saying radiography is only scientifically supported when there are red flags that something is seriously wrong. The policy change on X-rays was the flashpoint in the long-simmering tension within the profession. A group of chiropractors has filed a petition in B.C. Supreme Court, alleging the college is preventing them from providing “safe, ethical, and effective care to their patients.” Their legal action has backing from national and international vitalistic organizations. During the recent meeting, a group of chiropractors argued unsuccessfully for the new X-ray policy to be tossed. Some suggested that chiropractors who don’t perform X-rays as a matter of routine are actually harming their patients. Another extraordinary general meeting has been called for July 20 to vote on resolutions calling for the removal of four college board members.

As I have often pointed out, chiropractic is all about money. The ‘chiro-wars’ have been going on for quite a while now, and they are by no means confined to B. C. or Canada. In a nutshell, they suggest to me that a significant proportion of chiropractors prefer money to progress.

5 Responses to ‘Chiro-wars’ in British Columbia

  • “The ‘chiro-wars’ have been going on for quite a while now, and they are by no means confined to B. C. or Canada. In a nutshell, they suggest to me that a significant proportion of chiropractors prefer money to progress.”

    Not only chiropractors – but the political representatives/administrations who allow vitalistic nonsense to hold sway.

    In respect of radiology – is there any paper published in a respectable journal which asserts: “But for a radiograph, the following important and significant pathological or morphological lesions or conditions would not have been identified, and the patients would have suffered.”?

    • Not sure where the quote comes from and if the author gave a list, but…

      “Most patients with thoracic aortic aneurysms are asymptomatic at the time of diagnosis, because the aneurysms are typically discovered incidentally on imaging studies (chest x-ray, CT scan, or echocardiogram) ordered for other indications.” https://www.ahajournals.org/doi/full/10.1161/01.cir.0000154569.08857.7a

      “Since most AAAs are asymptomatic unless they leak or rupture, they are commonly diagnosed incidentally during imaging for other indications. Uncommonly, unruptured aneurysms may present with abdominal or back pain.” https://radiopaedia.org/articles/abdominal-aortic-aneurysm?lang=us

      “But, although the prevalence of vertebral fractures is high, only one third of these fractures is clinically recognized.19,20 Spinal radiographs might therefore be helpful in deciding whether or not anti-osteoporotic medication should be initiated. The incidence of symptomatic vertebral fractures at our FO-Clinic is therefore 17.8% and the incidence of a-symptomatic vertebral fractures is 82.2%. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3598406/

      Certainly not a reason to x ray most patients as some chiropractors suggest.

      Also, the author should have wrote, “…potentially suffered…”

      • I am not sure what point you are making with these links to information about aneurysms? Are you suggesting that they should be screened for radiologically? The x-ray dose would be hard to justify except where there are risk factors present, such as Marfan’s syndrome, particularly if abdominal CT scans were used, which involve a much greater radiation dose than plain x-rays.

        Or are you justifying chiropractic x-rays on the grounds that they result in the diagnosis of aneuryms that would otherwise be missed? That would be a rather haphazard method of diagnosing a condition that is usually asymptomatic (at least until something dramatic happens, such as the aneuryms dissecting), particularly as I am not confident that chiropractors would be competant to recognise the radiological features of an aneurym, especially if they are looking for something else entirely (trained radiologists often miss things for that same reason). Furthermore, radiographs and especially CT scans are obtained using different techniques depending on the question that they are intended to answer.

  • EE “they suggest to me that a significant proportion of chiropractors prefer money to progress.”

    Significant: A significant amount or effect is large enough to be important or affect a situation to a noticeable degree.

    You have not provided evidence that this is “all about money” or that they are a significant proportion. In fact, they appear to be the minority and losing ground.

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