January 2005

An e‑mail dialogue

Who rules chiropractic in Europe?

In mid‑November, Dr. Hagan McQuaid, president of the Chiropractic Association of Ireland, wrote a letter to the General Chiropractic Council (GCC), a UK‑wide statutory body with regulatory powers, established by the Chiropractors Act 1994. In it, he expressed his concerns about recent decisions and actions of the GCC and the European Chiropractic Union (ECU).

Instead of a direct, professional response to his inquiry, he received a curt and disrespectful reprimand from Dr Barry J Lewis, president of the British Chiropractic Association (BCA), a member of the World Federation of Chiropractic (WFC).

The letters touched off a round of e‑mails between various chiropractic leaders in Europe and the U.S., which delved into issues of national chiropractic sovereignty, the role of the World Chiropractic Alliance (WCA) and the WFC in world affairs, and the right of individual practitioners to develop and follow their own practice purpose.

One important message emphasized by the exchange is that regulatory abuses must be brought to light not only by those affected, but by those national and international organizations committed to protecting the interests of subluxation‑centered, wellness chiropractors.

In addition, the dialogue made clear that unity can be realized only through tolerance and mutual respect. When organizations such as the WFC and ECU attempt to silence those who disagree with them, and respond to legitimate concerns with arrogance and evasion, they spawn divisiveness.

Musculoskeletal specialists and subluxation‑centered wellness practitioners must learn how to co‑exist. Attempts by one faction to coerce the profession as a whole into adopting one practice style will result in further infighting and division.

The chiropractic profession will grow and prosper only when its members and organizations welcome open dialogue, and exhibit respect for diversity. Ultimately, it is the patient/consumer who suffers when regulatory abuses threaten the availability of the full spectrum of chiropractic services.

Because of their importance, the e‑mails were circulated widely and spurred heated debate and discussion. They are reprinted here in order to inform all DCs of the various positions held and to maintain open communication on all levels.

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November 15, 2004 ‑‑ from Dr. Hagan McQuaid

Mrs. Margaret Coats GCC Chief Executive and Registrar m.coats@gcc‑uk.org

Dear Mrs. Coats,

I would like to introduce myself, my name is Hagan McQuaid and I am writing on behalf of our national professional association, the Chiropractic Association of Ireland.

Recently, our members had their professional indemnity insurance (i.e. costs paid in event of legal action and not just award) withdrawn. This is a crushing blow to the profession here and leaves any of us open to a spurious claim, which if fought and lost could end our livelihoods. We were informed this was as a direct result of the continued and relentless UK GCC prosecutions being brought against practitioners and the costs involved in defending such.

As you will know there has been increasing disquiet in regard to the GCC and its disciplinary proceedings and prosecutions, and as such we believed it to be an internal matter for the profession in the UK. Given the detrimental effects now felt for the profession in Ireland as a direct result, we no longer believe this to be so and wish to make a formal compliant.

The importance of such is that this email is being cc'ed to the executives of national professional associations Europe wide, the ECU and the three leading chiropractic associations worldwide, the WFC, WCA and ICA.

The bias shown in the decision to prosecute practitioners on the basis of their practice principles is apparent. It no longer has the appearance of either fairness or objectivity. There also should be no doubt that this will have such detrimental effects for the profession Europe wide. Compare this to the General Osteopathic Council (GOC) in the UK. They don't appear to have such a problem and nor does its profession. It is clear the GOC does not have an agenda. This is not so clear in the case of the GCC.

Recently a decision was challenged in the UK High Court, which the GCC claimed they had won in full. On closer examination, the high court findings were not so clear. The judge ruled that no suspension be served but because it was between two dates and not a term, the appellant had effectively and regretfully served the suspension.

One point of contention was the appointment of a lady involved heavily within the pharmaceutical industry as chairperson of the GCC professional Conduct committee. Whilst we would agree with the judge that a profession should be honoured to have such a prestigious individual sitting as a layperson on its governing council, we disagree as to the suitability and draw comparison to appointing a butcher chairperson to a board governing vegetarians.

Another issue was in regard to the efficacy of medication. Everybody knows that it is better to be “healthy” than “medicated.” Subluxation based care aimed at wellness helps provide this and is amply supported by individual evidence.

Now another pending prosecution has been brought to our attention with the deliberate intent of prosecution where what appeared to be a genuine client, (and who presented themselves as so) surreptitiously recorded both the practitioner's report of findings along with a further 30 minute phone call on a later date where it appears her only intention was to draw out lines of complaint on the philosophical basis of the practitioner's practice and proposed program of care. A forty‑page transcript was provided by the GCC to the practitioner. Whilst we would like to point out we are not saying this is GCC directed it is however, clearly entrapment, is repugnant and should not be acceptable.

The GCC should register and take onboard that a spread of opinions exist and not be prescriptive to exclude such differences in opinions. The profession, as a political entity, should be able to accept that differences of opinion are present, as in all professions, and accept that such is life. That some people will try to force their views on everybody else, or destroy the profession in trying, is another and much more serious matter.

Chiropractic legislation was put forth in the UK on the basis of public safety and the promotion of the profession. This is not happening. It would appear the GCC is attempting to limit access to a valid emergent consumer choice of healthcare in the UK, subluxation based chiropractic care.

The ripples of the GCC misdirection is now beginning to be felt external to the UK and it must stop and in the very least not be replicated anywhere else. It is time to examine the GCC from the bottom up and its aims.

This leads to our final question who is the GCC accountable to?

Yours sincerely,

Hagan McQuaid Chiropractic Association of Ireland

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November 16, 2004 ‑‑ from Dr. Barry J Lewis

Dear Hagan

I cannot see why you choose to pick a fight with our regulator in such a public fashion ‑‑ I think such an action is both unethical and unprofessional.

Considering that you have widened your mailing list beyond acceptability by including addresses outside ECU & WFC I will decline to comment further at this point. I would suggest, however, that you try and determine the exact role of a statutory regulator within the UK before we meet next week so that any discussion is based on fact rather than fancy.

B

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November 18, 2004 ‑‑ from Philippe Druart, President of the European Chiropractic Union

It seems logical to me to let you all know that I am supporting Dr B. Lewis' remarks on Hagan's letter in all their meanings. I was, in fact, going to write the same type of comment.

Sincerely Yours,

Philippe Druart ECU President

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November 21, 2004 ‑‑ from Terry A. Rondberg, DC

Dr. Lewis:

A regulatory agency, whose claimed purpose is to protect the public, is accountable to both the public and the members of the profession. When regulatory authority is abused to promote the philosophical agenda of one faction to the detriment of another, stakeholders have a duty to act.

It is clear that GCC has effectively declared war on chiropractors who offer lifetime, subluxation‑centered wellness care. They have interfered with free speech by preventing the publication of factual patient testimonials, based on their conjecture of how someone might interpret them. They have even resorted to surreptitious recording of telephone consultations and reports. Their prosecutorial mindset has resulted in the imposition of sanctions against chiropractors who dare to tell the truth, and offer quality, subluxation‑centered care.

Furthermore, the GCC has made this a public spectacle, with at least one news release.

Such outrageous behavior deserves a swift, public response. The profession worldwide should be apprised of these abuses, as should the health care consumer who may be unable to obtain lifetime, subluxation‑centered wellness care because of the actions of the GCC.

Hagan McQuaid should (be) commended for his very professional letter to Mrs. Coates. The withdrawal of professional indemnity insurance is a legitimate and serious concern. His decision to make the situation known to others in the profession is commendable.

It appears that you are more interested in keeping the issues invisible to the profession than you are addressing them. Losing professional indemnity issue, suspension of practitioners, and news releases flaunting one's authority are fact, not “fancy” as you suggest.

The WFC and the ECU do not own the chiropractic profession. Other organizations, including the WCA, are duty‑bound to protect their constituents from unwarranted prosecution. The stated purpose of the WCA is clear and unambiguous:

“The World Chiropractic Alliance was founded in 1989 as a non‑profit organization dedicated to protecting and strengthening chiropractic around the world.

Serving as a 'watchdog' and advocacy organization, we place our emphasis on education and political action. With members throughout the United States and in numerous foreign countries, the WCA is constantly being alerted to situations and events which might affect the practice of chiropractic.

Unencumbered by a bloated bureaucracy, we're able to take swift and decisive action when threats to subluxation‑based chiropractors are detected, whether they come from forces outside of the profession, or within our own ranks.

We're (a) major chiropractic organization which passionately defends the rights of subluxation‑based doctors and will stand up against those who would corrupt chiropractic by denying its philosophical and vitalistic foundations.”

GCC's claim of “public protection” is not supported by evidence. I have seen no evidence that subluxation‑centered chiropractors pose any threat to public health. Here in the US, chiropractors who elect to limit their practices to the analysis and correction of vertebral subluxations enjoy lower malpractice insurance rates than their counterparts who engage in the diagnosis and treatment of diseases and conditions.

WCA strongly supports Dr. McQuaid's position relative to GCC. His points are cogent, logical, and demand action.

Political action masquerading as “public protection” is an outrage that demands vigorous action.

Sincerely, Terry A. Rondberg, DC President, World Chiropractic Alliance

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November 21, 2004 ‑‑ from Barry Lewis, DC

Dr Rondberg

Your interference is as unwarranted and unwelcome as Dr McQuaid's original letter.

Please go away and mind your own damned business ‑‑ the WCA has no role to play in European chiropractic

Goodbye

B J Lewis

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November 22 ‑‑ from Terry A. Rondberg, DC

Dr. Lewis:

The WCA has made some significant impact internationally and we are very involved in European chiropractic and will remain involved worldwide!

* WCA is the only chiropractic organization to be accredited as an NGO (non‑governmental organization) by the UN Department of Public Information.

* WCA gave the first presentation on chiropractic at the International NGO Conference in Seoul, Korea.

* WCA gave the first presentation on chiropractic at UN Headquarters.

* WCA established working relations with WHO in Geneva.

* WCA was had the first chiropractor chair the NGO Health Committee.

* WCA has and will continue to work with DCs in other countries, most recently Italy, Israel, and Ireland, regarding licensure issues.

* WCA has prepared a document on chiropractic laws worldwide for WHO, which has been sent to DCs in other countries.

* WCA is involved in the ongoing development of a model international chiropractic law.

* With the CCP, WCA was instrumental in developing the only Clinical Practice Guidelines peer‑reviewed, scientific evidence based including “best practices” by an international panel, and designed to be used worldwide.

Given our modest resources, I think this is a very impressive list of accomplishments.

Your hostility is similar to many leaders in the ACA and only serves to motivate our (members) and expand our international programs increasing our membership, with the active involvement of DCs outside the US.

Best wishes, Terry A. Rondberg, DC President, World Chiropractic Alliance

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November 25, 2004 ‑‑ from Dr. Hagan McQuaid

Dear All,

The original e‑mail to the GCC was circulated to all for information purposes only. The UK GCC is now perilously close to affecting the profession Europe wide, and circulating the e‑mail to each of you was as a courtesy. It was not meant to create an intraprofessional debate, one way or the other, nor create personal divide.

It is pertinent to point out; our national association has yet to receive a receipt of delivery from the GCC and will be sent again privately. Privately, to avoid further division and reach an answer to our legitimate enquiry. In doing so, I now agree with Barry, this could perhaps have been better dealt with.

Barry, your objectiveness has slipped. Whilst intrusion so close to home is unwanted and obviously annoying, it is no excuse to allow a personal attack on myself or upon us as an association be circulated.

Daniel, your reply, conclusion and call to arms at the next ECU GC was wrong, full stop. To create such a debate without GCC input and presence is not the way forward. I must also point out that his matter was not an internal matter for the BCA. They did not have their professional indemnity withdrawn; we did, nor was this as a result of the BCA.

If it is to be the case that the ECU does not agree with a national association's obligation to protect its members and the profession's interests, why would that national association retain it's membership?

It is neither unprofessional nor unethical, irresponsible or counterproductive to want answers as to the detrimental effect of a national association by a third party. Yes it is embarrassing when this detrimental effect is as a direct result of a particular states regulatory body. Yet, perhaps the email was too direct and to the point for some, we agree, but we have received much support from amongst you. It may also be that we know more of its dealings than others, being English speaking and mostly A.E.C.C. graduate driven. Our points of enquiry are cogent, logical and demand action. We expect an answer.

The CAI, and I individually, have always sought to protect our members and our profession. We have stood firm on matters of education on both sides of the philosophical debate, backing our colleagues in the U.K. and Germany. This was in the interest of maintaining professionalism. In this action (our email enquiry to the GCC Chief Executive), we again have aimed at professionalism, and the view taken by those parties outside the profession of such. We are beginning to look unprofessional to others outside of the profession. It required action.

We have no fear of open forum debate and are open to both sides of the philosophical divide in order to find encompassing benefit to us all. We do not all have to align ourselves to one side or the other. We are all encompassing, with strong standards of professionalism.

I would like to remind all of my personal and professional respect for Barry Lewis, and I count him as a friend. I myself, and our association, count Philippe Druart, our ECU president, and Daniel Muhlemann our professional colleagues and as such have our respect and support. We support the ECU.

We believe that Terry Rondberg and J.C. Smith have good and fulsome intentions. However, I would like to add that T.A.R.'s comparison, as a Jew, to a radical Muslim and saddamite is inciteful and overly personal.

We wish not to comment upon Dr. Smith's vendorship, his use of 'unsubstantiated testimonials,' or his lack of professionalism in his personal attacks. J.C. Smith has linked this issue of our loss of professional indemnity to CBS insurance in the US. This is not the issue. The issue relates to how others see us, as lacking professionalism as a result of the actions of the UK's regulatory body.

Personally, I think it is time we all woke up to the damage of our intraprofessional divide. Our executive in the interest of our continued professionalism would also support this attitude.

We would hope these personal attacks and professionally widening insulting confrontations would come to an end.

In withdrawing from public debate of this issue, it is not in the intention of cowardice, but our come to a resolution of the matter without causing any more arguments or ill feeling amongst us. We will continue to pursue the matter.

We hope any offence created by such an open e‑mail was not long lasting and forgivable ‑ this was not our intention.

Thank you,

Yours Sincerely, Dr. Hagan McQuaid Chiropractic Association of Ireland

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December 05, 2004 ‑‑ from Terry A. Rondberg, DC

Dear Dr. McQuaid:

You make many valid points, and I thank you for bringing the rhetoric back to a more reasoned and professional level. We all have difficulty keeping things on an even keel when debates ignite our passionate love for chiropractic. We need to keep in mind that, while there are a few individuals who are motivated simply by personal animosity or selfish gain, most have the best interests of chiropractic at heart, even if we don't agree with their goals.

I believe that, for the most part, it is important to keep these dialogues public. What chiropractic leaders around the world say and think shape the very essence of the profession and have an impact on all chiropractors. DC's have the right to know what is going on, and the obligation to be vigilant when it comes to protecting the sacred trust passed down to them from BJ Palmer.

All subluxation‑based chiropractors appreciate your dedication to chiropractic and your willingness to stand strong for chiropractic principles, while working to create a peaceful and cooperative environment so that all DCs can look forward to a vibrant and successful future.

As a global organization with members in many countries throughout Europe, Asia, Australia, North America and South America, the World Chiropractic Alliance will continue to seek partnerships with like‑minded organizations and individuals around the world.

Terry A. Rondberg, DC President, World Chiropractic Alliance