A success with Victoria Chiropractic, a chap called Lanigan, and a paradigmatically relevant hypothesis...

Hurrah, time to chalk one up for the good guys! Following my complaint to Victoria Chiropractic Clinic in Woking I have finally had a response from Jeremy Spanton. As you may remember, I complained about his misleading use of the "Dr" title as well as his claims to be able to treat childhood illnesses such as colic.

He emailed me today to confirm that he had been

"in touch with my association, and on their recommendation... I have altered my name to Jeremy Spanton, Doctor of Chiropractic, and have removed mention of the specific childhood ailments for which Chiropractic can be helpful"

Sure enough, a quick visit to his site confirms that he now correctly identifies himself as a "Doctor of Chiropractic" and whilst he still refers to treating children he has removed references to colic, ADHD, IBS etc. The tone of this page has also been changed somewhat. I'm still not comfortable with his equating spinal exams with dental and hearing tests, but it's a big improvement.

Now, his reference to being in contact with his association interested me. Was he talking about the GCC (the industry regulator) or BCA? As you may know, the BCA are currently suing Simon Singh for claiming that treatments for conditions such as colic are "bogus". It struck me that if the BCA was now advising its members to remove references to such conditions then it might have some bearing on the case.

It turns out Spanton was referring to neither. He was in fact refering to the United Chiropractics Association (UCA), an organisation I had never heard of before.

I looked the UCA up, and what an odd bunch they are! The first thing that struck me was how unprofessional their website looked - kind of worrying for a "professional association". It looks like something straight out of the '90s.

It seems the UCA was set up in 2001 by a bunch of disgruntled chiropractors who were concerned that existing organisations just weren't wacky enough didn't adequately represent "the subluxation based wellness view of chiropractic". These are the people who won't only claim to help you with your sore lower back, posture etc. These are the ones that will claim to help with all sorts of conditions, for which there is no evidence chiropractic can help.

Their "Mission" page shows how bizarre they get. It's full of mumbo-jumbo cod philosophy that would make even a stoned sociology undergraduate blush. They base their mission around a "Philosophical Construct" that states:

Vitalism: We ascribe to the idea that all living organisms are sustained by an innate intelligence, which is both different from and greater than physical and chemical forces. Further we believe innate intelligence is an expression of universal intelligence.

Holism: The whole is greater than the sum of the parts.

Neural supremacy: We ascribe to the concept that the nervous system is the major co-ordinator and regulator of all bodily systems.

Conservative ethic: Our belief in the body's ability to heal itself logically implies that the best care is the least invasive care.

Humanism: We ascribe to the belief that individuals have immutable rights.

Indeed.

Looking further down the page we have the following gems:

In Relation To The Science Of Chiropractic

- Science should seek to answer paradigmatically relevant hypothesis, which by necessity, are borne out of our philosophical constructs
- Science itself is based on a metaphysical belief system built on a priori assumptions not amenable to proof.

This is classic "woo", and a clear attempt to change the rules of the game. Essentially, they're saying "science is what we say it is". That makes it nice and easy to later say that "science" says this stuff works. I call that bullshit.

The UCA currently have 250, 350 or 450 members, depending on which page you look at. Jeremy Spanton is one of them. I dare say the websites of a fair few others contain a few unjutifiable claims.

This isn't the end of the story though. What this demonstrates to me is that chiropractors don't really know what they are. The internal politics of the profession seem quite interesting, and mirrors some of the disputes between other alternative medicine groups such as that between the Alliance of Registered Homeopaths and the Society of Homeopaths:

SoH has sent out inaccurate and defamatory information to ARH members to coincide with ARH membership renewals. This communication has been accompanied by information and registering documents inviting ARH registered members to join SoH. This at the very least, constitutes unethical behaviour.

[T]he SoH’s recent actions suggest that they are more concerned about preserving their own position of power within the profession, than representing the actual needs of practising homeopaths.

I was made aware of the internal politics of chiropractic when a Richard Lanigan copied and entire earlier post of mine on his blog.

It seems Lanigan hopes that complaints from skeptics such as myself will bankrupt the GCC. Lanigan can't call himself a chiropractor, because he isn't one. He resigned from the GCC last year. Though he does offer chiropractic treatment at his clinic. in Kingston-upon-Thames. He is good enough to tell us on his website that:

This may affect your ability to claim from an insurance provider for chiropractic treatment from Richard

Buyer beware!

Not being a member of the GCC does have its benefits though. It means he is presumably not bound by their code of conduct and can therefore make whatever claims he likes on his website.

There's more to say on Lanigan, the BCA and the GCC, but I'll leave it there for now.

Make what you will of all of this. Perhaps you could even make a "paradigmatically relevant hypothesis"!

Neal's Yard - who thought this would be a good idea?

The Guardian have a regular "You ask, they answer" column as part of their "Ethical Living" blog.

Today, the "they" in question is Neal's Yard, the well known spelling mistake and woo-remedy store. I can see the team meeting at Neal's Yard HQ, with everyone sat on bean bags drinking organic herbal tea (coffee and boardroom tables being too corporate!). Desperate to spread the message of holistic organic goodness, someone comes up with the idea of getting a piece into The Guardian. After all, surely only mung bean eating, sandal wearing beardy hippies read The Guardian.... don't they?

It obviously didn't occur to them that a fair few skeptics also read The Guardian, and regularly frequent thier Comment is Free website.

So far, around 25 questions have been asked. I don't think Neal's Yard will enjoy answering them. Here are a choice few:

Benulek : How do you validate the medical efficacy of your 'remedies'?

Saltycdogg : Do you see no problem with trying to be 'ethical' while at the same time selling snake oil for a living?

puzzlebobble : you sell a multitude of products for a wide variety of medical conditions, some of which are serious or life threatening.

Please could you explain what level of evidence of efficacy you require before stocking any product?

If, as I suspect, the level of evidence of efficacy is poor then will you tell us what, if any, studies are done to look for harmful side-effects? How are these studies conducted? Furthermore please show us the power calculations for these studies.

Surely you don't view it as ethical to sell products which are of unproven benefit and which you don't even know are safe?

takearisk : Your website states:

The correct homoeopathic remedy will stimulate a sick person's vitality to send healing energy where it is needed, thus rectifying mental, emotional and physical imbalances.

Could you please explain how the 'correct homoeopathic remedy' is decided on and describe the qualifications of the people who make these decisions?

I'd also be grateful for a biological definition of 'healing energy' and an indication of where I can find the scientific evidence for its existence.

I can't wait for the answers.

Complaint to Victoria Chiropractic submitted

Following my last post, I've now officially complained to Victoria Chiropractic, Woking, to give them an opportunity to get their website in order before a complaint to the GCC. Here's the complaint:

Dear Sir/Madam,

Following my previous emails I would now like to make a complaint about Victoria Chiropractic Clinic, which unless adequately resolved I will be forwarding on to the General Chiropractic Council.

I have two complaints to make, as I believe in each case you are breaching GCC regulations.

My first complaint relates to the use of the title "Dr" to describe Jeremy Spanton on your website. I believe the use of this term is misleading, as members of the public may be led to believe that Jeremy Spanton is a medical doctor. Whilst Nichola Worril states that she has a PhD, there is no such explanation of Jeremy Spanton's use of the title. I have searched the General Medical Council's register and find no Dr Spanton, and therefore assume he is not a registered medical practitioner.

I would like to refer you to GCC regulations which state that members:

"must not use any title or qualification in such a way that the public may be misled as to its meaning or significance. In particular, chiropractors who use the title of ‘doctor’ and who are not registered medical practitioners must ensure that they make it clear that they are registered chiropractors and not registered medical practitioners"

My second complaint relates to you page entitles "What we treat". On this page you claim that chiropractic is beneficial for children suffering from colic, amongst other conditions. However, you provide no evidence to back up these claims. I would like to refer you to a recent Advertising Standards Authority adjudication against a chiropractor named Carl Irwin, which stated that:

"We considered that, whilst some of the studies indicated that further research was worth pursuing, in particular in relation to the chiropractic relief of colic, we had not seen robust clinical evidence to support the claim that chiropractic could treat IBS, colic and learning difficulties."

The adjudication also instructed Irwin: " not to refer to the treatment of IBS, colic and learning difficulties in future."


I should remind you that GCC regulations state that members:

"may publicise their practices or permit another person to do so consistent with the law and the guidance issued by the Advertising Standards Authority."

Your claims are clearly not consistent with ASA guidance, and therefore are not permitted by the GCC.

I therefore request that you clarify Jeremy Spanton's qualifications on your website and remove any claims for which robust evidence is not available. I would also like you to acknowledge this complaint and confirm your intent to resolve these issues as soon as possible. Should I recieve no response, or not be satisfied with your response I will be submitting a complaint to the GCC and may also complain to Trading Standard.

Yours sincerely

Victoria Chiropractic Clinic, Woking, may break GCC rules

As shown before, the BCA's libel action against Simon Singh is causing a significant Streisand effect, drawing attention to dodgy claims made by chiropractors and their representative organisations in the UK.

It didn't take much googling to find a relatively local chiropractor making dodgy claims, and I now present to you... Victoria Chiropractic Clinic, Woking, Surrey, run by "Dr" Jeremy Spanton and Dr (PhD only) Nichola Worril.

So, what are the claims they are making, and how to they breach General Chiropractic Council regulations?

Use of the "Dr" title

It should be made clear that in the UK "Dr" is not a protected title. Anyone can call themselves a doctor if they wish, however certain organisations take a dim view of doing so misleadingly, including the GCC and the Advertising Standards Agency.

GCC guidelines, to which Spanton and Worril, as members, are bound, state that chiropractors:

must not use any title or qualification in such a way that the public may be misled as to its meaning or significance. In particular, chiropractors who use the title of ‘doctor’ and who are not registered medical practitioners must ensure that they make it clear that they are registered chiropractors and not registered medical practitioners

Whilst their website does indicate that Worril has a PhD (though it's not clear in what), there is no such explanation of Jeremy Spanton's title. Searching the General Medical Council's register brings up no results for a Dr Spanton. It is therefore likely that Spanton is using the term misleadingly. An email asking the clinic to confirm his qualifications has not been replied to in three days. The GCC will therefore be recieving a complaint about this claim.

Claims that chiropractic can help with conditions with no supporting evidence

Victoria Clinic's website has a page about what they can treat. Rather disturbingly they recommend chiropractic checks of children along the same lines as dental, hearing, eyesight checks etc. They seem to play the guilt card somewhat by claiming that:

Without Chiropractic care some children will live in continued sickness, condemned to a life of taking medicines and perhaps even surgery.

Whilst this is distasteful, the key part of this page which breaks GCC guidelines is the following:

Chiropractic care has been beneficial in a wide range of child-hood ailments, including:

ADHD, Asthma, Bedwetting, Colic, Poor posture, Allergies

The claim about Colic is one that cannot be justified. Again, I have emailed the clinic asking for evidence for this claim, but with no response. Victoria Chiropractic is not the only clinic to make such claims. In fact, a chiropractor named Carl Irwin recently made similar claims, which were investigated by the ASA. The full adjudication is available here, and the relevant extract quoted below:

We considered that, whilst some of the studies indicated that further research was worth pursuing, in particular in relation to the chiropractic relief of colic, we had not seen robust clinical evidence to support the claim that chiropractic could treat IBS, colic and learning difficulties.

This is important for all chiropractors, as the GCC require that chiropractors:

may publicise their practices or permit another person to do so consistent with the law and the guidance issued by the Advertising Standards Authority.

By claiming that chiropractic is beneficial for colic Victoria Chiropractic is not being consistent with ASA regulations and guidance, and as such may be breaking GCC guidelines.

A complaint will be made to the GCC about Victoria Chiropractic, who rather disappointingly have not responded to my concerns put to them by email.

Victoria Chiropractic certainly aren't the first to be making such claims. There are many more out there, and I, along with other bloggers, will be investigating these and making further complaints to the GCC until they start cleaning up their act and taking their own guidelines more seriously.

For more blogs on chiropractic claims, visit:
http://www.layscience.net
http://gimpyblog.wordpress.com/
http://www.quackometer.net
http://skepticat.wordpress.com/
http://jdc325.wordpress.com/

Chiropractors - a shot in the foot?

Have chiropractors shot themselves in the foot? Possibly. Following an article in the Guardian by Simon Singh, the scientist and co-author of Trick or Treatment?: Alternative Medicine on Trial, in which he was critical of chiropractors, the British Chiropractic Association (BCA) has decided to sue for libel.

Many people have already written about this case and rather than re-hash what has already been written I would recommend you peruse the following blogs to keep up to date here and here.

The reason I believe the BCA may have shot itself in the foot is because of the attention they have drawn to themselves and the glaring holes in the evidence base for chiropractic. This isn’t only attention from bloggers. A recent meeting in support for Simon Singh was attended by journalists, an MP, and various comedians. Interestingly, Dave Gorman spoke at this event, indicating that before this whole debacle he’d always assumed chiropractic was part of mainstream medicine. I wonder how many people out there thought the same thing.

Bloggers have already started taking on chiropractors and their dodgy claims, with the persistent Gimpy already chalking up one success following an Advertising Standards Agency ruling. Gimpy complained about “Dr” Carl Irwin’s use of the title (implying he’s a medical doctor) and his claims to be able to treat a range of conditions such as IBS, Colic, and Learning Difficulties.

Others are also starting to look out for claims made by other chiropractors. I have found a local chiropractor making similar claims to those of Carl Irwin. The chiropractor in question has been email, and I look forward to another blog post soon with details… and hopefully a response from them.

Watch this space.