SECOND OPINION | Chiropractic critics being monitored by Ontario's College of Chiropractors
College registrar says 'it is important to know what people are saying'
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Is the College of Chiropractors of Ontario (CCO) keeping tabs on chiropractic critics? If they are, then Ryan Armstrong appears to be on that list.
The former biomedical researcher was surprised to see his and other critics' tweets listed on the February agenda for a regular meeting of the CCO under the subheading: "Blog/Social Media Comments by Individuals Opposed to Chiropractic Practices."
"I just thought it was strange that they were so interested in all of my work," said Armstrong, who has never even been to a chiropractor. His work is an admittedly "hyperbolic" blog posting titled Chiropractic: A Modern Threat to Canadian Health.
"His postings are not private postings. Those are public domain postings. They're on Twitter," college registrar Jo-Ann Willson told CBC News.
So why is Armstrong so concerned about a good back cracking?
"It's poorly regulated," said Armstrong, adding some chiropractors "mislead the public in matters of science and medicine. They tend to be opposed to conventional medicine and science-based medical procedures and techniques."
They believe they are literally channeling some kind of divine healing.— Ryan Armstrong, chiropractic critic
Armstrong said he's not criticizing all chiropractors. He's concerned about "radical" practitioners often referred to as "straight" or "principled" chiropractors (a reference to the century-old "33 Principles of Chiropractic") who claim to be able to treat a wide range of illnesses beyond back and neck pain.
"They believe they are literally channeling some kind of divine healing power through the spine that could heal almost any ailment."
Armstrong has filed specific complaints against two such chiropractors. He alleges one prominent chiropractor used "misleading and inappropriate advertising" via testimonials by various clients claiming to be cured of everything from diabetes, and ADD, to asthma, infertility and (in a particularly fiery speech) childhood speech disorders — all of that using only a few good spinal manipulations.
Understanding the history of chiropractic is crucial for understanding why there are so many Canadian chiropractors offering unsubstantiated and unethical procedures.<a href="https://twitter.com/TerryPolevoy?ref_src=twsrc%5Etfw">@TerryPolevoy</a> <a href="https://twitter.com/HealthWatch123?ref_src=twsrc%5Etfw">@HealthWatch123</a> <a href="https://twitter.com/DrHardick?ref_src=twsrc%5Etfw">@DrHardick</a> <a href="https://twitter.com/DrAricSudicky?ref_src=twsrc%5Etfw">@DrAricSudicky</a> <a href="https://twitter.com/gorskon?ref_src=twsrc%5Etfw">@gorskon</a> <a href="https://t.co/1TxaNzh5HR">https://t.co/1TxaNzh5HR</a>—@ryarmst
He's also tweeted about another well-known member of the chiropractic college who spoke about "healthy alternatives to vaccinations," as well as an Ontario chiropractor who performed an "adjustment" on the spine of a two-week-old baby.
These seemingly limitless health claims by chiropractors are endemic in the profession, said Armstrong. "If you Google 'chiropractor' and any disease, you'll probably get a hit."
'Important to know what people are saying'
Willson would not comment about Armstrong's formal complaints about individual chiropractors while the process is underway. But she insisted all 5,000 members of the college are peer-reviewed to ensure, in part, they're staying within the profession's "scope of practice" — which the college defines as "disorders arising from the structures or functions of the spine and the effects of those dysfunctions or disorders on the nervous system."
So is vaccination advice within a chiropractor's scope of practice? It wasn't — then they changed their minds. At first the college banned chiropractors from telling their patients whether they should get immunized, and required them to refer their clients to a physician or nurse. Then, in 2011, the ban was revoked. Today it's common to read about how chiropractic adjustments prevent influenza and supposedly helped contain the 1918 Spanish flu pandemic.
Whether it's nurses, dentists, doctors or laboratory technologists, professional colleges are regulatory bodies that have the arguably mundane job of ensuring their members are properly certified, acting ethically and occasionally disciplined if they've been found to be acting badly — all in the public interest.
So why is the CCO keeping tabs on critics like Armstrong?
"It's not just about the college. It's about the profession that the college regulates. So it is important to know what people are saying about that," said Willson.
Failing to protect public
There are questions about chiropractic claims all across Canada. A 2016 study of complementary health practitioners' websites in 10 major Canadian cities found 38 per cent of chiropractors claimed to diagnose and/or treat asthma.
The study's co-author, Timothy Caulfield, of the University of Alberta's Health Law Institute, said chiropractic colleges are failing to protect the public from these types of claims that aren't based in evidence.
"I think it's a very flawed approach to regulating alternative practitioners," he said.
Caulfield said he's met with government health officials and understands their motive for allowing professions like chiropractors to regulate themselves to create minimum standards to ensure patient safety, but "if they aren't science-based, be transparent about that, and then we can have a discussion about whether they should be a regulated health profession."
Instead, Caulfield suggested a more effective way to deal with dubious claims is by using other regulatory tools, such as the "truth in advertising" approach taken by the federal Competition Bureau.
He also said change can come within the profession. "There are chiropractors that are trying to nudge their profession to be more evidence-based, so one hopes that community will have sway over their colleagues."
Suspended over blood tests
Willson told CBC News a small number of chiropractors have violated the college's rules with their treatment claims or conduct. But she said they are dealt with. For example, last year the college suspended a London, Ont., chiropractor who continued to order blood tests for his patients after ignoring multiple "verbal cautions."
The same chiropractor authored The Cancer Killers: The Cause is the Cure, in which he discusses treating the disease exclusively with "holistic interventions."
As for Armstrong, seeing his posts flagged by the college doesn't fill him with hope. "After seeing them go after critics I'm a bit sceptical that complaints will be taken seriously."
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