ABC RN Interview: Does the evidence behind chiropractics stack up?

ABC RN Afternoon Program “Chiropractors under test” presented by Michael Mackenzie

Guests:

  • Dr Ken Harvey, Adjunct Associate Professor, School of Public Health and Preventive Medicine, Monash University
  • Dr Bryce Conrad, Board Member, Chiropractor’s Association of Australia
  • Professor Rodney Bonello, President, Chiropractic Australia.

There was some misinformation provided by Bryce regarding notifications to AHPRA about chiropractors and doctors. Our topic was advertising offences (not total notifications) and the following facts come from AHPRA’s 2013/14 Annual Report.

During 2013/14, AHPRA received a total of 547 advertising related complaints. Of these, 4,845 registered chiropractors accounted for 34% and 99,379 registered medical practitioners accounted for 9% of complaints. That is per 1000 chiropractors, 38.4 had an advertising complaint made against them in 2013/14 while per 1000 medical practitioners, half of one (0.5) had an advertising complaint made against them.

A total of 290 (98%) complaints were resolved when the individual or organisation complied with AHPRA’s demand to amend or remove the advertising, and required no further action. AHPRA referred six practitioners to the relevant National Board for disciplinary action.

The number of advertising complaints received about chiropractors in 2013/14 was the highest since complaints were first recorded in 2011/12.

The Board statement posted on the RN web site notes, “Managing advertising breaches is primarily complaints-driven”. Also, “The vast majority of advertisers respond to the first warning letter and amend their advertising accordingly. Any advertisers who fail to comply with the law after a second warning are considered for prosecution by AHPRA and/ or disciplinary action by the Board. This approach has proven to be a low cost and effective way of managing breaches of the National Law in relation to advertising”.

It may be low cost to AHPRA but it’s certainly not effective!

As I stated in the RN interview, working up an detailed and effective complaint is both time-consuming and unrewarding for the complainant. In my experience, a number of complaints (sent to various Boards) have been acknowledged but have then disappeared. Upon following these up I was told that an educative process was being pursued. For others, 12-24 months will elapse and then one receives a bland statement that “the matter has been resolved”. Unlike the TGACRP process, there is no public record of the complaint and its determination, no correction of misinformation by the imposition of retractions and no education of the profession about problems identified.

While this process may improve the advertising of individual chiropractors it has clearly failed to change the advertising of many others as shown by our current list of over 200 complaints (from which we have submitted a representative 10) and many more collated by Friends of Science in Medicine:

These problems continue despite, “The Board has reminded practitioners about its advertising and evidence based practice requirements in more than six publications in the past three years, including communiqués, newsletters (which are emailed to every registered chiropractor in Australia), guidelines and FAQ’s. The Board’s next newsletter to the profession, which is due for publication in coming weeks, is entirely dedicated to issues about advertising”.

The Board’s statement concludes, “We are always interested in ways to increase transparency within the requirements of the National Law and welcome suggestions to help achieve this”.

I have reiterated the need for the Board to increase its transparency (and better protect the public) by publishing the determinations made about advertising complaints and ordering chiropractors to place retractions of claims found to breach the National Law on their web sites in order to correct the misinformation promulgated.

It remains to be seen if this will happen.

 

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About Dr Ken Harvey

Public Health Physician, Medical activitist
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