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

chiropractic

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Absurd claims about spinal manipulative therapy (SMT) improving immune function have increased substantially during the COVID-19 pandemic. Is there any basis at all for such notions?

The objective of this systematic review was to identify, appraise, and synthesize the scientific literature on the efficacy and effectiveness of SMT in preventing the development of infectious disease or improving disease-specific outcomes in patients with infectious disease and to examine the association between SMT and selected immunological, endocrine, and other physiological biomarkers.

A literature search of MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, the Index to Chiropractic Literature, the Cochrane Central Register of Controlled Trials, and Embase was conducted. Randomized clinical trials and cohort studies were included. Eligible studies were critically appraised, and evidence with high and acceptable quality was synthesized using the Synthesis Without Meta-Analysis guideline.

A total of 2593 records were retrieved; after exclusions, 50 full-text articles were screened, and 16 articles reporting the findings of 13 studies comprising 795 participants were critically appraised. No clinical studies were located that investigated the efficacy or effectiveness of SMT in preventing the development of infectious disease or improving disease-specific outcomes among patients with infectious disease. Eight articles reporting the results of 6 high- and acceptable-quality RCTs comprising 529 participants investigated the effect of SMT on biomarkers. Spinal manipulative therapy was not associated with changes in lymphocyte levels or physiological markers among patients with low back pain or participants who were asymptomatic compared with sham manipulation, a lecture series, and venipuncture control groups. Spinal manipulative therapy was associated with short-term changes in selected immunological biomarkers among asymptomatic participants compared with sham manipulation, a lecture series, and venipuncture control groups.

The authors concluded that no clinical evidence was found to support or refute claims that SMT was efficacious or effective in changing immune system outcomes. Although there were limited preliminary data from basic scientific studies suggesting that SMT may be associated with short-term changes in immunological and endocrine biomarkers, the clinical relevance of these findings is unknown. Given the lack of evidence that SMT is associated with the prevention of infectious diseases or improvements in immune function, further studies should be completed before claims of efficacy or effectiveness are made.

I fully agree with the data as summarised in this paper. Yet, I find the conclusions a bit odd. The authors of this paper are chiropractors who declare the following conflicts of interest: Dr Côté reported receiving grants from the College of Chiropractors of British Columbia during the conduct of the study and grants from the Canadian Chiropractic Research Foundation, travel expenses from the World Federation of Chiropractic, and personal fees from the Canadian Chiropractic Protective Association outside the submitted work. Dr Cancelliere reported receiving grants from the Canadian Chiropractic Research Foundation outside the submitted work. Dr Mior reported receiving grants from the College of Chiropractors of British Columbia during the conduct of the study and grants from the Canadian Chiropractic Association and the Ontario Chiropractic Association outside the submitted work. Dr Hogg-Johnson reported receiving grants from the College of Chiropractors of British Columbia during the conduct of the study and grants from the Canadian Chiropractic Research Foundation outside the submitted work. No other disclosures were reported. The research was supported by funding from the College of Chiropractors of British Columbia to Ontario Tech University, the Canada Research Chairs program (Dr Côté), and the Canadian Chiropractic Research Foundation (Dr Cancelliere).

Would authors independent of chiropractic influence have drawn the same conclusions? I doubt it! While I do appreciate that chiropractors published these negative findings prominently, I feel the conclusions could easily be put much clearer:

There is no clinical evidence to support claims that SMT is efficacious or effective in changing immune system outcomes. Further studies in this area are not warranted.

Low back pain must be one of the most frequent reasons for patients to seek out some so-called alternative medicine (SCAM). It would therefore be important that the information they get is sound. But is it?

The present study sought to assess the quality of web-based consumer health information available at the intersection of LBP and CAM. The investigators searched Google using six unique search terms across four English-speaking countries. Eligible websites contained consumer health information in the context of CAM for LBP. They used the DISCERN instrument, which consists of a standardized scoring system with a Likert scale from one to five across 16 questions, to conduct a quality assessment of websites.

Across 480 websites identified, 32 were deemed eligible and assessed using the DISCERN instrument. The mean overall rating across all websites 3.47 (SD = 0.70); Summed DISCERN scores across all websites ranged from 25.5-68.0, with a mean of 53.25 (SD = 10.41); the mean overall rating across all websites 3.47 (SD = 0.70). Most websites reported the benefits of numerous CAM treatment options and provided relevant information for the target audience clearly, but did not adequately report the risks or adverse side-effects adequately.

The authors concluded that despite some high-quality resources identified, our findings highlight the varying quality of consumer health information available online at the intersection of LBP and CAM. Healthcare providers should be involved in the guidance of patients’ online information-seeking.

In the past, I have conducted several similar surveys, for instance, this one:

Background: Low back pain (LBP) is expected to globally affect up to 80% of individuals at some point during their lifetime. While conventional LBP therapies are effective, they may result in adverse side-effects. It is thus common for patients to seek information about complementary and alternative medicine (CAM) online to either supplement or even replace their conventional LBP care. The present study sought to assess the quality of web-based consumer health information available at the intersection of LBP and CAM.

Methods: We searched Google using six unique search terms across four English-speaking countries. Eligible websites contained consumer health information in the context of CAM for LBP. We used the DISCERN instrument, which consists of a standardized scoring system with a Likert scale from one to five across 16 questions, to conduct a quality assessment of websites.

Results: Across 480 websites identified, 32 were deemed eligible and assessed using the DISCERN instrument. The mean overall rating across all websites 3.47 (SD = 0.70); Summed DISCERN scores across all websites ranged from 25.5-68.0, with a mean of 53.25 (SD = 10.41); the mean overall rating across all websites 3.47 (SD = 0.70). Most websites reported the benefits of numerous CAM treatment options and provided relevant information for the target audience clearly, but did not adequately report the risks or adverse side-effects adequately.

Conclusion: Despite some high-quality resources identified, our findings highlight the varying quality of consumer health information available online at the intersection of LBP and CAM. Healthcare providers should be involved in the guidance of patients’ online information-seeking.

Or this one:

Background: Some chiropractors and their associations claim that chiropractic is effective for conditions that lack sound supporting evidence or scientific rationale. This study therefore sought to determine the frequency of World Wide Web claims of chiropractors and their associations to treat, asthma, headache/migraine, infant colic, colic, ear infection/earache/otitis media, neck pain, whiplash (not supported by sound evidence), and lower back pain (supported by some evidence).

Methods: A review of 200 chiropractor websites and 9 chiropractic associations’ World Wide Web claims in Australia, Canada, New Zealand, the United Kingdom, and the United States was conducted between 1 October 2008 and 26 November 2008. The outcome measure was claims (either direct or indirect) regarding the eight reviewed conditions, made in the context of chiropractic treatment.

Results: We found evidence that 190 (95%) chiropractor websites made unsubstantiated claims regarding at least one of the conditions. When colic and infant colic data were collapsed into one heading, there was evidence that 76 (38%) chiropractor websites made unsubstantiated claims about all the conditions not supported by sound evidence. Fifty-six (28%) websites and 4 of the 9 (44%) associations made claims about lower back pain, whereas 179 (90%) websites and all 9 associations made unsubstantiated claims about headache/migraine. Unsubstantiated claims were made about asthma, ear infection/earache/otitis media, neck pain,

Conclusions: The majority of chiropractors and their associations in the English-speaking world seem to make therapeutic claims that are not supported by sound evidence, whilst only 28% of chiropractor websites promote lower back pain, which is supported by some evidence. We suggest the ubiquity of the unsubstantiated claims constitutes an ethical and public health issue.

The findings were invariably disappointing and confirmed those of the above paper. As it is nearly impossible to do much about this lamentable situation, I can only think of two strategies for creating progress:

  1. Advise patients not to rely on Internet information about SCAM.
  2. Provide reliable information for the public.

Both describe the raison d’etre of my blog pretty well.

The General Chiropractic Council’s (GCC) Registrant Survey 2020 was conducted in September and October 2020. Its aim was to gain valuable insights into the chiropractic profession to improve the GCC’s understanding of chiropractic professionals’ work and settings, qualifications, job satisfaction, responsibilities, clinical practice, future plans, the impact of the COVID-19 pandemic on practice, and optimism and pessimism about the future of the profession.

The survey involved a census of chiropractors registered with the GCC. It was administered online, with an invitation email was sent to every GCC registrant, followed by three reminders for those that had not responded to the survey. An open-access online survey was also available for registrants to complete if they did not respond to the mailings. This was promoted using the GCC website and social media channels. In total, 3,384 GCC registrants were eligible to take part in the survey. A fairly miserable response rate of 28.6% was achieved.

Here are 6 results that I found noteworthy:

  • Registrants who worked in clinical practice were asked if performance was monitored at any of the clinical practices they worked at. Just over half (55%) said that it was and a third (33%) said it was not. A further 6% said they did not know and 6% preferred not to say. Of those who had their performance monitored, only 37% said that audits of clinical care were conducted.
  • Registrants working in clinical practice were asked if any of their workplaces used a patient safety incident reporting system. Just under six in ten (58%) said at least one of them did, whilst 23% said none of their workplaces did. A further 12% did not know and 7% preferred not to say.
  • Of the 13% who said they had a membership of a Specialist Faculty, a third (33%) said it was in paediatric chiropractic, 25% in sports chiropractic, and 16% in animal chiropractic. A further 13% said it was in pain and the same proportion (13%) in orthopaedics.
  • Registrants who did not work in chiropractic research were asked if they intended to work in that setting in the next three years. Seven in ten (70%) said they did not intend to work in chiropractic research in the next three years, whilst 25% did not know or were undecided. Only 5% said they did intend to work in chiropractic research.
  • Registrants were also asked how easy it is to keep up to date with recommendations and advances in clinical practice. Overall, two-thirds (67%) felt it was easy and 30% felt it was not.
  • Registrants were asked in the survey whether they felt optimistic or pessimistic about the future of the profession over the next three years. Overall, half (50%) said they were optimistic and 23% were pessimistic. A further 27% said they were neither optimistic nor pessimistic.

Perhaps even more noteworthy are those survey questions and subject areas that might have provided interesting information but were not included in the survey. Here are some questions that spring into my mind:

  • Do you believe in the concept of subluxation?
  • Do you treat conditions other than spinal problems?
  • How frequently do you use spinal manipulations?
  • How often do you see adverse effects of spinal manipulation?
  • Do you obtain informed consent from all patients?
  • How often do you refer patients to medical doctors?
  • Do you advise in favour of vaccinations?
  • Do you follow the rules of evidence-based medicine?
  • Do you offer advice about prescribed medications?
  • Which supplements do you recommend?
  • Do you recommend maintenance treatment?

I wonder why they were not included.

 

After yesterday’s post entitled ‘What does a holistic doctor do that a traditional doctor doesn’t?‘, I thought it would only be fair to turn the question around and ask: What does a proper doctor do that a holistic healer doesn’t? The answers will upset a lot of practitioners of alternative medicine (SCAM), but so be it.

So, what does a proper doctor do that a holistic healer doesn’t?

I suggest several answers and hope that the readers of this blog will contribute to further points. Many of them center around safeguarding the public:

  • Proper doctors avoid confusing or misleading the public with titles they do not have.
  • They do have rigorous education and training.
  • They avoid making false therapeutic claims.
  • They adhere to the ethical standards of their profession.
  • They resist the temptation to advertise their services to the consumer.
  • They do their best to identify the cause of their patient’s symptoms.
  • They treat the causes of disease whenever possible.
  • They avoid pretending that they always have all the answers.
  • They abide by the rules of evidence-based medicine.
  • They are aware that almost any effective treatment comes with adverse effects.
  • They try to keep abreast with the rapid advances in medicine.
  • They know that a patient is more than a diagnostic label.
  • They try to treat patients holistically.

At this stage, I can hear some readers shout in anger:

  • Ahh, but that is rubbish!
  • I know doctors who are not at all like that!
  • You are idealizing your profession!
  • This is little more than wishful thinking!

Yes, I know that many patients are disappointed and have had a bad experience with conventional medicine. That is one of the reasons many try SCAM. I know that many doctors occasionally fail to live up to the ideal that I depicted above. And I fear that some do so more often than just occasionally.

This is regrettable and occasionally it is unacceptable. Medicine is populated not by perfect people; it is run by humans like you and me. Humans are fallible. Doctors have bad days just like you and me. If that happens regularly, we need to address the problems that may the cause of the deficit. If necessary, the case has to go before a disciplinary hearing. There are thousands of experts who are dedicated to improving healthcare in the hope of generating progress.

The point I was trying to make is that there is such a thing as an ideal physician. It relies on:

  • rigorous training,
  • ethical codes,
  • post-graduate education,
  • supervision,
  • governance,
  • swift disciplinary procedures,
  • advances brought about through colossal research efforts,
  • etc., etc.

Do ‘holistic healers’ offer all of these safeguards?

The sad answer is no.

For those who disagree, let’s briefly look at a recent example.

John Lawler died in 2017 after being treated by a chiropractor (as discussed on this blog before).

  • Mr. Lawler died because of a tear and dislocation of the C4/C5 intervertebral disc caused by a considerable external force.
  • The pathologist’s report also showed that the deceased’s ligaments holding the vertebrae of the upper spine in place were ossified.
  • This is a common abnormality in elderly patients and limits the range of movement of the neck.
  • There was no adequately informed consent by Mr. Lawler.
  • Mr. Lawler seemed to have been under the impression that the chiropractor, who used the ‘Dr’ title, was a medical doctor.
  • There is no reason to assume that the treatment of Mr. Lawler’s neck would be effective for his pain located in his leg.
  • The chiropractor used an ‘activator’ that applies only little and well-controlled force. However, she also employed a ‘drop table’ which applies a larger and not well-controlled force.

As far as I can see, most of the safeguards and standards that apply to conventional medicine were not in place to safeguard Mr. Lawler. And that includes a timely disciplinary hearing of the case. Mr. Lawler died in 2017! The CCG has been dragging its feet ever since, and, as far as I know, the chiropractor was meanwhile allowed to practise. The HEARING BEFORE THE PROFESSIONAL CONDUCT COMMITTEE OF THE GENERAL CHIROPRACTIC COUNCIL has now been scheduled to commence on 19 April 2021.

I know, it’s just an example. But it should make us think.

This study compared the effectiveness of two osteopathic manipulative techniques on clinical low back symptoms and trunk neuromuscular postural control in male workers with chronic low back pain (CLBP).

Ten male workers with CLBP were randomly allocated to two groups: high-velocity low-amplitude (HVLA) manipulation or muscle energy techniques (MET). Each group received one therapy per week for both techniques during 7 weeks of treatment.

Pain and function were measured by using the Numeric Pain-Rating Scale, the McGill Pain Questionnaire, and the Roland Morris Disability Questionnaire. The lumbar flexibility was assessed by Modified Schober Test. Electromyography (EMG) and force platform measurements were used for evaluation of trunk muscular activation and postural balance, respectively at three different times: baseline, post-intervention, and 15 days later.

Both techniques were effective (p < 0.01) in reducing pain with large clinical differences (-1.8 to -2.8) across immediate and after 15 days. However, no significant effect between groups and times was found for other variables, namely neuromuscular activation, and postural balance measures.

The authors concluded that both techniques (HVLA thrust manipulation and MET) were effective in reducing back pain immediately and 15 days later. Neither technique changed the trunk neuromuscular activation patterns nor postural balance in male workers with LBP.

There is, of course, another conclusion that fits the data just as well: both techniques were equally ineffective.

A report just published by the UK GENERAL CHIROPRACTIC COUNCIL (the regulator of chiropractors in the UK) entitled Public perceptions research Enhancing professionalism, February 2021 makes interesting reading. It is based on a consumer survey for which the national online public survey was conducted by djs research in 2020 with a nationally representative sample of 1,002 UK adults (aged 16+). From this sample, 243 UK adults had received chiropractic treatment and were surveyed on their experiences of visiting a chiropractor.

Hidden amongst intensely boring stuff, we find a heading entitled Communicating potential risks. This caught my interest. Here is the unabbreviated section:

The findings show that patients want to understand the potential risks of treatment – alongside information on cost, this is the most important factor for patients considering chiropractic care. In fact, having any risks communicated before embarking on treatment scores 83 out of 100 on a scale of importance.

Many patients report receiving this information from their chiropractor. Seventy per cent of those who have received chiropractic treatment agree that risks were communicated before treatment commenced.

What does that suggest?

  1. Patients want to know about the risks of the treatments chiropractors administer.
  2. 30% of all patients are not being given this information.

This roughly confirms what has long been known:

MANY CHIROPRACTORS DO NOT OBTAIN INFORMED CONSENT FROM THEIR PATIENTS AND THUS VIOLATE MEDICAL ETHICS.

The questions that arise from this information are these:

  1. As the GCC has long known about this situation, why have they not adequately addressed it?
  2. Now that they are reminded of this flagrant ethical violation, what are they planning to do about it?
  3. What measures will they put in place to make sure that all chiropractors observe the elementary rules of medical ethics in the future?
  4. What reprimands do they plan for members who do not comply?

This recent article is truly remarkable:

There is a faction within the chiropractic profession passionately advocating against the routine use of X-rays in the diagnosis, treatment and management of patients with spinal disorders (aka subluxation). These activists reiterate common false statements such as “there is no evidence” for biomechanical spine assessment by X-ray, “there are no guidelines” supporting routine imaging, and also promulgate the reiterating narrative that “X-rays are dangerous.” These arguments come in the form of recycled allopathic “red flag only” medical guidelines for spine care, opinion pieces and consensus statements. Herein, we review these common arguments and present compelling data refuting such claims. It quickly becomes evident that these statements are false. They are based on cherry-picked medical references and, most importantly, expansive evidence against this narrative continues to be ignored. Factually, there is considerable evidential support for routine use of radiological imaging in chiropractic and manual therapies for 3 main purposes: 1. To assess spinopelvic biomechanical parameters; 2. To screen for relative and absolute contraindications; 3. To reassess a patient’s progress from some forms of spine altering treatments. Finally, and most importantly, we summarize why the long-held notion of carcinogenicity from X-rays is not a valid argument.

Not only is low dose radiation not detrimental, but it also protects us from cancer, according to the authors:

Exposures to low-dose radiation incites multiple and multi-hierarchical biopositive mechanisms that prevent, repair or remove damage caused mostly by endogenous reactive oxygen species (ROS) and H2O2 from aerobic metabolism. Indeed, non-radiogenic (i.e. naturally occurring) molecular damage occurs daily at rates many orders of magnitude greater than the rate of damage caused by low-dose radiation such as diagnostic X-rays. It is estimated that the endogenous genetic damage caused on a daily basis from simply breathing air is about one million times the damage initially resulting from an X-ray. We concur that “it is factually preposterous to have radiophobic cancer concerns from medical X-rays after considering the daily burden of endogenous DNA damage.”

And, of course, radiological imaging makes sense in cases of non-specific back pain due to ‘malalignment’ of the spine:

Pressures to restrict the use of “repeat” (i.e. follow-up) X-rays for assessing patient response to treatment shows a complete disregard for the evidence discussed that definitively illustrates how modern spine rehabilitation techniques and practices successfully re-align the spine and pelvis for a wide variety of presenting subluxation/deformity patterns. The continued anti-X-ray sentiment from “consensus” and opinion within chiropractic needs to stop; it is antithetical to scientific reality and to the practice of contemporary chiropractic practice. We reiterate a quote from the late Michael A. Persinger: “what is happening in recent years is that facts are being defined by consensus. If a group of people think that something is correct, therefore it’s true, and that’s contradictory to science.”

Thus, the authors feel entitled to conclude:

Routine and repeat X-rays in the nonsurgical treatment of patients with spine disorders is an evidence-based clinical practice that is warranted by those that practice spine-altering methods. The evidence supporting such practices is based on definitive evidence supporting the rationale to assess a patient’s spinopelvic parameters for biomechanical diagnosis, to screen for relative and absolute contraindications for specific spine care methods, and to re-assess the spine and postural response to treatment.

The traditional and underlying presumption of the carcinogenicity from X-rays is not a valid notion because the LNT is not valid for low-dose exposures. The ALARA radiation protection principle is obsolete, the threshold for harm is high, low-dose exposures prevent cancers by stimulating and upregulating the body’s innate adaptive protection mechanisms, the TCD concept in invalid, and aged cohort studies assumed to show cancers resulting from previous X-rays are not generalizable to the wider population because they represent populations predisposed to cancers.

Red flags, or suspected serious underlying disease is a valid consideration warranting screening imaging by all spine care providers. We contend, however, that as long as the treating physician or rehabilitation therapist is practicing evidence-based methods, proven to improve spine and postural parameters in order to provide relief for the myriad of spinal disorders, spinal X-rays are unequivocally justified. Non-surgical spine care guidelines need to account for proven and evolving non-surgical methods that are radiographically guided, patient-centered, and competently practiced by those specialty trained in such methods. This is over and above so-called “red flag only” guidelines. The efforts to universally dissuade chiropractors from routine and repeat X-ray imaging is neither scientifically justified nor ethical.

There seems to be just one problem here: the broad consensus is against almost anything these authors claim.

Oh, I almost forgot: this paper was authored and sponsored by CBP NonProfit.

“The mission of Chiropractic BioPhysics® (CBP®) Non-Profit is to provide a research based response to these changing times that is clinically, technically, and philosophically sound. By joining together, we can participate in the redefinition and updating of the chiropractic profession through state of the art spine research efforts. This journey, all of us must take as a Chiropractic health care profession to become the best we can be for the sake of the betterment of patient care. CBP Non-Profit’s efforts focus on corrective Chiropractic care through structural rehabilitation of the spine and posture. Further, CBP Non-Profit, Inc. has in its purpose to fund Chiropractic student scholarships where appropriate as well as donate needed chiropractic equipment to chiropractic colleges; always trying to support chiropractic advancement and education.”

Osteopathy is hugely popular in France. Despite the fact that osteopathy has never been conclusively shown to generate more good than harm, French osteopaths have somehow managed to get a reputation as trustworthy, evidence-based healthcare practitioners. They tend to treat musculoskeletal and many other issues. Visceral manipulation is oddly popular amongst French osteopaths. Now the trust of the French in osteopathy seems to have received a serious setback.

‘LE PARISIEN‘ has just published an article about the alleged sexual misconduct of one of the most prominent French osteopaths and director of one of the foremost schools of osteopathy in France. Here are some excerpts from the article that I translated for readers who don’t speak French:

The public prosecutor’s office of Grasse (Alpes-Maritimes) has opened a judicial investigation against Marc Bozzetto, the director and founder of the school of osteopathy in Valbonne, accused of rape and sexual assault.

In total, “four victims are targeted by the introductory indictment,” said the prosecutor’s office, stating that Marc Bozzetto had already been placed in police custody since the beginning of the proceedings. The daily paper ‘Nice-Matin’ has listed six complaints and published the testimony of a seventh alleged victim.

This victim claims to have been sexually assaulted in 2013, alleging that, during a professional appointment, Bozzetto had massaged her breasts and her intimate area. “He told me that everything went through my vagina and clitoris, that I had to spread my legs and let the energy flow through my clitoris. That I had to learn how to give myself pleasure on my own,” she told Nice-Matin. The newspaper also recorded the testimonies of a former employee, a top-level sportswoman, an employee from the world of culture, and a former student.

“I take note that a judicial inquiry is open. To date, he has neither been summoned nor indicted,” said Karine Benadava, the Parisian lawyer of the 80-year-old Bozzetto. Her client had already responded following initial accusations from students: “This is a normal feeling for women, but if all the women who work on the pelvis complain, you can’t get away with it and you have to stop working as a pelvic osteopath,” replied Bozzetto. In another interview, he had declared himself “furious” and unable to understand the reaction of these two students.

The school of osteopathy trains about 300 students each five years and presents itself as the first holistic osteopathy campus in France.

______________________________

Such stories of sexual misconduct of practitioners of so-called alternative medicine (SCAM) are sadly no rarety, particularly those working in the area of manual therapy. They remind me of a case against a Devon SCAM practitioner in which I served as an expert witness many years ago. Numerous women gave witness that he ended up having his fingers in their vagina during therapy. He did not deny the fact but tried to defend himself by claiming that he was merely massaging lymph-nodes in this area. It was my task to elaborate on the plausibility of this claim. The SCAM practitioner in question was eventually sentenced to two years in prison.

It stands to reason that SCAM practitioners working in the pelvic area are at particularly high risk of going atray. The above case might be a good occasion to have a public debate in France and ask: IS VISCERAL OSTEOPATHY EVIDENCE-BASED? The answer is very clearly NO! Surely, this is a message worth noting in view of the current popularity of this ridiculous, costly, and dangerous charlatanry.

And how does one minimize the risk of sexual misconduct of SCAM professionals? The most obvious answer would be, by proper education during their training. In the case mentioned above, this might have been a problem: if the director is into sexual misconduct, what can you expect of the rest of the school? In many other cases, the problem is even greater: many SCAM practitioners have had no training at all, or no training in healthcare ethics to speak of.

 

THE TELEGRAPH is not my favourite paper, but occasionally it does publish something worth reading – like, for instance, yesterday when it carried this article:

The head of NHS England warned homeopaths had “crossed the line” after a Sunday Telegraph investigation revealed some were peddling myths that taking duck extract was as effective as the coronavirus vaccines.

Sir Simon Stephens warned people taking their advice from homeopaths were putting themselves at greater risk, and warned they would slow down the nation’s vaccine efforts. His calls were echoed by Professor Stephen Powis, the NHS medical director, who said the findings were the “latest in a long line of disturbing and potentially dangerous online myths”…

Sir Simon told the Sunday Telegraph: “It’s one thing for homeopaths to peddle useless but harmless potions, but they cross a dangerous line when making ridiculous assertions about protecting people from Covid infection. “Anyone who took those seriously would be putting themselves at higher risk of coming to harm from Covid infection.” Prof Powis added: “Spouting claims on social media about Covid cures that are not backed by scientific evidence and accurate public health advice is the latest in a long line of disturbing and potentially dangerous online myths. We urge everyone to ignore misleading claims and get vital protection against Covid when they are invited for their vaccine.” …

Helen Earner, operations director at the Charity Commission, said the findings were being examined as “a matter of urgency”. She added: “Any claims that a charity may be providing misinformation during this time of national emergency is a matter of serious concern to the Commission.” She added that a regulatory compliance case had been opened into the matter and that the commission will be liaising with other agencies as part of the investigation…

These days, I read such articles with mixed feelings. On the one hand, I applaud the fact that UK officials do take note of dangerous quackery and promise to take action. On the other hand, I cannot help feeling a bit frustrated and ask myself: WHY HAS IT TAKEN THEM SO LONG?

I know, for instance, that the Charity Commission has long been dragging its feet to do something about charities that promote overtly dangerous quackery. I have discussed such charities three years ago, and others have done so even before me. As to the UK homeopaths’ (and other practitioners of so-called alternative medicine, SCAM) dangerously bizarre attitude towards vaccinations, I started providing evidence and warning the public as early as 1995.

Perhaps they did not know about it?

Yes, perhaps – I only published these warnings in the

BRITISH JOURNAL OF GENERAL PRACTICE

and in the

BRITISH MEDICAL JOURNAL!

This gets even more frustrating when I consider that the anti-vaccination attitude in SCAM is merely one facet of a much bigger and much more important subject. Starting also in 1995, I published dozens of papers, gave hundreds of lectures on it, and often called it the ‘indirect risks‘ of SCAM. They can be summarised in one single sentence:

EVEN IF A SCAM IS TOTALLY HARMLESS, THE SCAM PRACTITIONER OFTEN ISN’T.

It is therefore tempting to shout:

I TOLD YOU SO!

But that would hardly be helpful. Instead, I let me beg Sir Simon Stephens, Prof Powis, Helen Earner, and anyone else in a position of power to take a minute and consider the wider implications of tolerating SCAM practitioners impose their overtly dangerous health-related views on the unsuspecting public.

Guest post by Ken McLeod

On 31 March 2020, the Chiropractic Board of Australia issued a statement1 to all Australian chiropractors that they:

“should not make advertising claims on preventing or protecting patients and health consumers from contracting COVID-19 or accelerating recovery from COVID-19. To do so involves risk to public safety and may be unlawful advertising. For example, we are seeing some advertising claims that spinal adjustment/manipulation, acupuncture and some products confer or boost immunity or enhance recovery from COVID-19 when there is no acceptable evidence in support.

“Advertisers must be able to provide acceptable evidence of any claims made about treatments that benefit patients/health consumers. We will consider taking action against anyone found to be making false or misleading claims about COVID-19 in advertising. If the advertiser is a registered health practitioner, breaching advertising obligations is also a professional conduct matter which may result in disciplinary action, especially where advertising is clearly false, misleading or exploitative.”

What could be clearer than that?

So what was published by a registered chiropractor on 16 March 2020, two weeks before the Board’s warning, and is still on his website 10 months later? You guessed it, a video on the website of chiropractor Morgan Weber, a video ‘Coronavirus – Balancing the hysteria…’, 2 in which he says:

– the COVID-19 19 pandemic is all ‘hysteria’ and ‘what have we got to worry about’, because ‘Our body, (has) 51 trillion cells’ vs ‘A one single-cell virus,’ (sic.) ‘51 trillion cells that orchestrate our immune system, every function. Yet we seem to have more faith and trust in ‘medicine’ than we do in this amazing body we call home. Crazy, right? Crazy.’

Weber further downplays the crisis by saying ‘Enough of this nonsense about the big bad bug and all the worry about washing your hands.’

Weber, after denigrating evidence-based medicine, recommends instead:

– ‘Keep up with your chiropractic adjustments….’

Weber is a registered chiropractor practicing at Wave Chiropractic, Maroochydore, Queensland, Australia. His AHPRA registration is CHI0001601286. Weber’s webpage home site is at https://www.wavechiropractic.com.au/index.php

WEBER’S VIDEO:

Since 16 March 2020 Weber has posted a video on his website a video ‘Coronavirus – Balancing the hysteria…’. 3

Weber says:

BEGINS TRANSCRIPT

00:00. Hi everyone. Hasn’t it been fascinating lately? The news, the hysteria. Everything has gone almost upside-down. Crazy. I found it so fascinating.

00:12. So today we thought we would have a bit of a chat and sort of balance the scales and the story getting told out there in the mass media. I hope you’ve got your toilet paper stockpiled and sorted ha ha ha ha. It’s hilarious to see people coming and going with huge amounts under their arms as they come out of the grocery store. Crazy isn’t it, crazy times.

00:42. So let’s think about if for a second, and if we bypass all that hysteria and noise and just think a little bit about this. Our body, 51 trillion cells. A one single-cell virus. My gosh. What have we got to worry about? We have this amazing system. 51 trillion cells that orchestrate our immune system, every function. Yet we seem to have more faith and trust in ‘medicine’ than we do in this amazing body we call home. Crazy, right? Crazy.

01:20 ‘The other story, the other sort of facts behind what we do, and I (unintelligible) told a fair few of you of this already, how the immune system works. So, across the road from Waves, we have a really kind of bare patch of grass, just before you go onto the beach. Now if I took a handful of seeds. Now this is an analogy for how our system works, and how amazing our body’s immune system is. If I took a bunch of seeds and dropped them onto the ground, some grass seeds, not all of those seeds would take. There needs to be a hospitable environment, a moist warm sunlit area for those seeds to take, then root and grow into a fully mature grass and perpetuate on and on and on. However that area across the road is barren rocky sandy and yuck. You drop those seeds, most of those are going to blow off and away because that area is a no-go, it’s got a strong resistance, a barrier, a non-hospitable environment.

02:18. Now that is how our immune system works. Now the story I feel that should be out there, is what are you doing to nurture your body to do the best it can be, to have the strongest barrier it can be.

02: 30. Enough of this nonsense about the big bad bug and all the worry about washing your hands. ‘Cause I tell you what, if you are neglecting to nurture your body and the 51 trillion cells to be the best they can be, watch out, that may not be enough, washing your hands.

02:47. So let’s talk about that. How do we orchestrate a healthy system that has a strong immune barrier to anything that’s out there? And really guys, this should be a day-to-day forte (?) for everyone who just wants to be their best.

03:00. So let’s go through it. Boosting your barriers. You need to trust your body. First and foremost, the 51 trillion cells are remarkable. Trust in that.

03: 12. You’ve gotta eat well. Eat well with nutrient-dense, mineral-dense foods. Stay well hydrated. Move. You’ve gotta move well. Exercise your body regularly, moving all parts in all directions. Enjoy healthy sunlight exposure. You’ve gotta think well. Follow your passions and purpose. Think positively. Perhaps switch off the TV.

03:41. Keep up with your chiropractic adjustments. An optimal brain and body communication via the nervous system is vital so ensuring your body is in a surviving state. Do all these things guys. Up the ante of them. Go in harder with your (unintelligible) exercises, your hydration etcetera, and trust in your body. It’s amazing. It’s built with this in-built protective mechanism. Foster it. Help to balance that story out there, and help people to take on a more useful interpretation of this current crisis out there.

04:19. I hope this was of value and you guys enjoy.

END TRANSCRIPT

The regulator has been informed. As the world’s death toll rockets past 2 million, we wait to see if they really meant what they said about disciplinary action.

 

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