May 2006

Georgia association wants investigation of CCGPP

The Board of Directors of the Georgia Council of Chiropractic (GCC) addressed a growing concern regarding the potential impact of the new "Best Practice" guidelines being developed by the Council on Chiropractic Guidelines and Practice Parameters (CCGPP)

According to the organization, serious conflicts of interest appear to exist within the CCGPP Research Commission, chaired by John Triano, DC. It also questions CCGPP claims that its document will transcend the political and philosophical differences that have divided our profession for more than a hundred years.

To address their concerns, the GCC passed a resolution stating there is ample evidence that "the Chairman of the Commission of the CCGPP has formally expressed views which are contrary to the beliefs of the majority of practicing chiropractors," and that he "is collaborating with members of the managed care industry in order to promote a chiropractic identity that is in conflict with the majority of practicing chiropractors."

The resolution went on to emphasize that the organization "considers said collaboration with the managed care industry a direct conflict of interest with the duties of the Commission of the CCGPP" and called for his resignation.

Although not specifically referred to in the resolution, Triano ‑‑ who is praised as "one of chiropractic's most respected researchers" on the Quackwatch website run by arch‑chiropractic critic Stephen Barrett, MD ‑‑ has repeatedly and publicly dismissed the notion of vertebral subluxations. In one research paper, he presented a "new model of subluxation," which he calls the Functional Spinal Lesion.

In addition, contrary to the evidence presented in all major national surveys, Triano had stated that only 20% of the profession still "believes in the subluxation theory." His quotes frequently appear on Internet sites such as Quackwatch, quackfiles, and other anti‑chiropractic sites in support of their contention that chiropractic is "quackery." He was also a key member of the committee that developed the widely‑rejected Mercy Guidelines.

In its resolution, the GCC called for a "full and independent investigation by the Board of Directors of COCSA into any and all recent communications between members of the CCGPP Commission and members of the managed care industry" and noted that "if the outcome of this investigation does indeed reveal a collaboration between the CCGPP Commission and members of the managed care industry, the Georgia Council of Chiropractic publicly calls for the resignation of all members of the CCGPP Commission who have been involved in said collaboration."

In explaining its position the Georgia organization noted its own view of chiropractic as "a separate and distinct healing art that focuses on the detection and correction of the vertebral subluxation" and expressed dedication to the Palmer Postulates (that there is a fundamental and important relationship [mediated through the nervous system] between the spine and health; that mechanical and functional disorders of the spine [subluxation] can degrade health; and that correction of the spinal disorders [adjustments] may bring about a restoration of health).

The resolution pointed out that these postulates are "ubiquitous within the profession and are to be found in some form in the mission statements of every North American chiropractic college and in the curricula of those colleges and are further embodied in the ACC Paradigm" and that, according to the most recent and complete survey of the profession performed by the Institute for Social Research of Ohio Northern University, the majority of the profession accepts and practices according to these postulates.

This is not the first time the issue of conflict of interest has been raised in regards to the CCGPP members. Last year, Alan Immerman, DC, who often serves as a consultant to dispute the claims of chiropractic IMEs, reported in an article for The Chiropractic Journal that CCGPP chairman Eugene Lewis, DC, claimed all committee members had signed statements of non‑conflict of interest. However, Dr. Immerman noted, Triano, DC has performed IMEs for State Farm Insurance Company and other members might also have been paid by insurance companies to review chiropractic claims.