Too early to say if disciplinary action needed for questionable ads: chiropractors association

The regulatory body for Manitoba's chiropractors can't say whether or not content flagged by a CBC investigation warrants disciplinary action against any of its members until it has performed a full review, according to the association's executive director.

Earlier this week, an investigation by CBC News found numerous examples of questionable or misleading online content on some professional chiropractors'websites, including anti-vaccination messaging andclaims of treating autism, cancer and Alzheimer's disease, along with other contentat odds with public health policy and medical research.

Afterdeclining an interview for the initial story, the executive director for the Manitoba ChiropractorsAssociation,Taras Luchak, agreed to a telephone interview with CBC I-Team reporter Katie Nicholson.

The following are excerpts from that conversation.

What is your reaction to the story we published?

"There is some information there that obviously we're going to have to take a look at and assess," saidLuchak, "and if at the end of the day if we find that any number of our members have acted improperly we will deal with them appropriately."

How is the scope of practice defined?

Luchak said under the new Regulated Health Professions Act, the scope of practice will be revised and will eventually replace the current Chiropractic Act.

"The current scope of practice as defined in the Chiropractic Act says: any professional serviceusually performed by a chiropractor, including the examination and treatment principally by hand and without use of drugs or surgery of the spinal column, pelvis and extremities and associated soft tissues," he said.

"In a roundabout fashion, when you improve issues related to your spine and nervous system, typically you will see other benefits."

What should happen to members who speak out against vaccinations?

"Speaking on the topic of vaccination in the province of Manitoba per se is not something that offends the [Chiropractic] Act, the regulations or our standards. It would become offensive if they presented the information in a manner that, again, was a form of recommendation or was unequivocal advice to a patient as to what options they should pursue,"Luchaksaid.

"We don't prevent chiropractors from speaking on the topic of vaccinations. We warn them of the potential consequences of doing so, but as a regulated health professional, they will exercise their judgement and we would hope that they would exercise their judgement appropriately."

Luchak says that if it's determined that a chiropractor has made a recommendation that falls outside his or her scope of practice, it will go through their disciplinary process.

What about the presentation of information regarding vaccines that is inconsistent with the views of people for whom vaccinations and immunization is within their scope of practice?

"A panel reviewing the comments would need to exercise some degree of interpretation and subjectivity to reach that conclusion. That is to say: does a statement, which of itself is inconsistent with a view of another health professional who conducts vaccination, become offensive for that reason alone? I cannot, on behalf of the MCA, suggest that is an obvious conclusion to be reached," Luchak said.

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"Our rules provide that a patient should be advised that the performance of vaccination is outside the chiropractic scope of practice and that the patient should consult with a health professional who has that act within his or her scope of practice."

Your code of conduct on advertising says ads must be truthful, verifiable andprotect the public from misleading statements. Based on what we found, do these not a first glance seem to contravene this code?

"I won't even comment or pre-judge it," Luchaksaid. "What you've described is the exact process that we will go through.

"Is it demonstrably true? Is it misleading? Is it dignified? Does it misrepresent facts? Is it subject to objective verification? We will go through that checklist and if it's determined that it's borderline or worthy of consideration then it will go up the chain, up to the next level."

What do you do to police your membership? Site visits, spot checks?

Luchak says while the association doesn't intend on conducting systematic reviews of websites, it does perform occasional audits.

"Every new member that comes into the profession receives a spot audit of their clinic, of their clinic setup. We do random reviews from time to time with members' clinics. Likewise we do, we obviously respond to specific complaints, and if we hear about information in some roundabout fashion, we absolutely will follow it up," Luchak said.

"Again our primary concern is we are a regulatory body, and like any regulatory body, our first concern is protection of the public and we take that very seriously."

Have you ever cautioned or sanctioned a member for making claims outside the scope of practice?

"I can't honestly say that Irecall one [case] where we have disciplined someone yet."

Can autism, Alzheimer's and cancer be treated with chiropractic treatments? What's a fair statement to make?

"The most reasonable statement I think would be that the symptoms of some of those diseases can be helped through chiropractic treatment, not the diseases themselves," he said.

When we presented these claims to medical experts, they expressed far more concern. Why do you think that is?

"I won't even speculate as to what motivated them to make those comments," Luchak said.

Are you concerned about losing your status as a provincially-covered health service in this upcoming budget?

"Our members are very concerned about the loss of access to the population, particularly to those who might be low-income families, working families, the marginalized, the financially disadvantaged. It is our contention, and we believe that we have the stats to back it up if need be, that the relative costs associated with chiropractic care actually lead to overall cost savings in terms of the health care system," Luchak said.

"We've received absolutely no direct contact or information from any government source suggesting that is currently high on their list of priorities."

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