April 2007

The first letter to the BBC

TO THE BBC:

The World Chiropractic Alliance (WCA) has been informed that you are investigating several Spinal Specialists and plan to do an "expose" on them in a future broadcast. We are concerned that the information you obtained, upon which you based your conclusions, is erroneous and biased.

Unfortunately, most reporters rely on the General Chiropractic Council or the British Chiropractic Association for background on spinal health and chiropractic. However, neither of these organizations reflects the traditional non‑medical view of chiropractic and both have seriously distorted the basic premise of chiropractic as an alternative to medical treatment. This has lead to the current growing trend by chiropractors in the UK to divorce themselves from these increasingly medicalized groups and re‑define themselves as "Spinal Specialists" who focus on the detection and correction of vertebral subluxations.

According to the universally accepted Position Paper No. 1 developed by the Association of Chiropractic Colleges ‑‑ signed and endorsed by the presidents of all North American chiropractic colleges ‑‑ the basis of chiropractic practice is subluxation correction. The paper states, in part, that:

***  Chiropractic is concerned with the preservation and restoration of health, and focuses particular attention on the subluxation.

***  A subluxation is a complex of functional and/or structural and/or pathological articular changes that compromise neural integrity and may influence organ system function and general health.

***  A subluxation is evaluated, diagnosed, and managed through the use of chiropractic procedures based on the best available rational and empirical evidence.

This statement is also endorsed by the WCA, an international organization with members in Australia, Canada, France, Germany, Great Britain, Holland, Ireland, Israel, Italy, Japan, New Zealand, Peru, Portugal, South Africa, Spain, Switzerland, Taiwan Republic of China, Thailand and the United States. The WCA serves as an NGO (Non‑Governmental Organization) associated with the United Nations Department of Public Information and publishes the peer‑reviewed chiropractic research journal, Journal of Vertebral Subluxation Research. It also has an ongoing relationship with the World Health Organization (WHO) and has worked with that organization to develop an international model chiropractic licensing law.

It is with considerable dismay that the WCA and other international chiropractic organizations have witnessed the continual medicalization of the British "chiropractic" organizations. This deterioration in the chiropractic identify in the UK has reached such an extreme point that the word "subluxation" does not even appear on the websites of either group. Instead, they define chiropractic in medical terms as a treatment of ‑‑ as noted on the BCA site ‑‑ "conditions that are due to problems with the joints, ligaments, tendons and nerves of the body, particularly those of the spine."

This clearly puts the GCC and BCA outside the chiropractic sphere and presents chiropractic as a duplication of medical services already available to the people in the UK. By promoting that view of chiropractic, and displaying blatant animosity toward and bias against subluxation‑centered chiropractic, these groups have deprived the British people of a valuable alternative health system recognized throughout the rest of the world and supported by a large and growing body of scientific evidence.

It is no wonder, then, that a survey of doctors in Britain showed widespread dissatisfaction with the General Chiropractic Council. The survey, conducted by Electoral Reform Services in 2006, revealed that 71.1% of doctors of chiropractic in the UK did not have confidence in the GCC to regulate the chiropractic profession. Only 31.8% said they agreed that the actions of the GCC in disciplining chiropractors have improved the protection of the public. More than three‑quarters of the respondents (77.5%) did not think the diversity of the profession has been protected and encouraged under the GCC.

Many of the practices criticized by the GCC and BCA (the type of practices you are "investigating") are not only the norm throughout the rest of the world, but are supported and endorsed by various international organizations such as the World Chiropractic Alliance as well as chiropractic colleges and universities.

For instance, the accusation that there is something unethical about offering patients a "pre‑pay plan" is a totally unfounded claim and a blatant attempt to cloud the central issue. It is the position of the WCA that doctors of chiropractic may elect to charge a case fee for professional services, may permit patients to pay for professional services in advance and/or care may be offered and paid over fixed time periods, for example on a yearly basis. Fee structures and agreements are routinely negotiated on such bases between the chiropractor and the patient.

These may include family case fees where there are two or more members of a family under care. In such situations it is not uncommon for discounts to be provided for fees paid in advance and/or discounts for each additional family member under care. Such arrangements are common in other clinical specialties and professions, for example: orthodontics, obstetrics, and law.

Another outrageous claim is that the use of X‑rays is never required for a chiropractic examination. Even the Anglo‑European College of Chiropractic notes that its clinic "adheres to national and international guidelines regarding those patients for whom an X‑ray is necessary and students learn to make rational judgements in this important diagnostic area using accepted criteria."

We have been told that your investigators were told the mock "patients" sent to investigate the Spinal Specialist were found to be in "good health" by BCA chiropractors who did not use X‑rays in their examinations. Without such diagnostic tools, how could they make such determinations? Is a person necessarily in "good health" simply because a doctor failed to provide a thorough examination and did not detect a potentially serious condition?

It should be emphasized, too, that vertebral subluxation can, indeed, be a potentially serious condition, even in patients who do not exhibit physical symptoms. In fact, the percentage of people with impaired neurological function or organic damage who do not exhibit symptoms may be staggeringly high. Using MRI technology, one study of 98 asymptomatic people found that only 36% had normal discs at all levels, 52% had a minor disc herniation at each level and 27% had a significant disc herniation. In another, this time of 67 individuals who had never had low back pain or radicular pain, MRI showed that disc hernias were present in 20% of those under 60 years of age and 36% in the over‑60 year old group.

In a study published in the Journal of Vertebral Subluxation Research, chiropractors collaborating with researchers at the University of Lund found that chiropractic care could influence basic physiological processes affecting oxidative stress and DNA repair.

In another study involving 650 children, researchers found that vertebral subluxations may be associated with a variety of children's health complaints, including scoliosis (spinal curvatures) and spinal degeneration (arthritis), as well as a large number of common childhood conditions that science has been unable to find definitive causes for, including "growing pains," bed‑wetting, colic, etc.

For the GCC and BCA to continue to deny the severe health repercussions of vertebral subluxations and to go further by attempting to suppress any knowledge of the damaging effects of subluxations, is unacceptable to the global chiropractic community and should be unacceptable to the people of Britain who need and deserve access to traditional, non‑medical chiropractic care.

The World Chiropractic Alliance respectfully requests that you turn the investigative spotlight in another direction and look into the GCC and BCA instead. Find out why they have isolated themselves from the rest of the global chiropractic community, renouncing the very foundation of chiropractic and embracing the medical paradigm. Ask doctors of chiropractic throughout the UK why they have no confidence in their own governing board. Look into the research on the negative impact of vertebral subluxation and question why this research has not been given more media attention.

Examine, too, how the multi‑billion‑pound medical and pharmaceutical industries have stepped up their campaign to destroy all alternative health care approaches (start with Jeremy Laurance's article in the April 4, 2004 issue of The Independent, which concludes that "The multibillion‑pound global pharmaceutical industry is accused today of manipulating the results of drug trials for financial gain and withholding information that could expose patients to the risk of harm").

Or, start with the 1993 speech by Earl Baldwin of Bewdley to the House of Lords in which he stated: "The influence of drugs companies, with their multi‑billion pound turnover, now reaches into every corner of mainstream medicine. ...The majority of the members of the Committee on Safety of Medicines have links to the pharmaceutical industry. The Medicines Control Agency is wholly funded by fees from product licences. And then there is research. Without the drugs companies, whole areas of research would simply not be covered. But it is product‑orientated research: it has to be, because these companies are not in it for their health. And other kinds of research are being squeezed out."

You will no doubt find that the influence exerted by the medical and drug industries is having a devastating effect on the chiropractic profession in the UK (as it is around the world). Doctors such as those now calling themselves Spinal Specialists are the last bastion of true chiropractic in the UK. If they are hounded out of practice by the medically dominated GCC and BCA, the British people will lose the right to have access to a health care approach that is being embraced by millions of people around the world. They will be forced into a health care "monoculture" where choice, as well as research, is limited to the agenda of the profit‑driven drug companies.

The World Chiropractic Alliance offers its fullest help and cooperation in an unbiased investigation into the GCC and BCA, with the expectation that, as the British Broadcasting Corporation says in its statement of values: "Trust is the foundation of the BBC: we are independent, impartial and honest."

Yours truly,

Terry A. Rondberg, DC, President

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The second letter to the BBC

TO THE BBC:

The World Chiropractic Alliance (WCA) continues to have an interest in your investigative report on Dr. Farthing and chiropractic. I hope we can assist you in understanding some of the issues involved. In particular, there appears to be a misunderstanding about the meaning of "health."

In your questions to Dr. Farthing, you repeatedly noted that he saw "three perfectly healthy people." Your statement clearly indicates a misconception about what it means to be "healthy."

Most people think being "healthy" means a lack of symptoms. If you aren't in pain at the moment, or aren't exhibiting some outward sign of a disease, you are "healthy." But, according to the World Health Organization, health is "a state of complete physical, mental, and social well being and not merely the absence of disease or infirmity."

The practitioners who examined the three individuals did not conduct chiropractic examinations geared to detecting vertebral subluxations. How can they ‑‑ or you ‑‑ state categorically the three subjects were "perfectly healthy?"

The doctors who worked with you on this report also probably did not conduct examinations for such ailments as pre‑diabetes, ovarian cancer, heart disease or hepatitis C, all of which are commonly called "silent killers" and require specialized medical diagnostic procedures.

If one of these three people has any of these problems, would you still call them "perfectly healthy" simply because the doctors you hired to examine them failed to find anything?

The only thing that can be said decisively about the three people used in your investigative report is that the examinations they were given did not uncover any medical problems. However, until they went to Dr. Farthing, they had not been tested for vertebral subluxations.

There are thousands of chiropractors around the world who focus solely on detecting and correcting vertebral subluxations. The fact that the doctors you chose to aid in your BBC report did not find them speaks volumes about their position outside the mainstream of the global chiropractic community.

Throughout the world, wherever the practice of chiropractic exists, there is widespread acceptance of the fact vertebral subluxations are, in and of themselves, a physical entity that can have adverse affects on health and well‑being and that the correction of subluxation is applicable to any patient exhibiting evidence of its existence regardless of the presence or absence of symptoms and disease. The determination of the presence of subluxation may stand as the sole rationale for care.

The use of subluxation as a rationale for care or primary diagnosis is supported by protocols that are safe, efficacious, and valid. The literature is sufficiently supportive of the usefulness of these protocols in regard to chiropractic examination, analysis and diagnosis. In addition, subluxation as a primary diagnosis is consistent with the Council on Chiropractic Practice's, "Clinical Guideline # 1: Vertebral Subluxation in Chiropractic Practice," the Chiropractic Paradigm developed by the Association of Chiropractic Colleges, and the practice objective followed by thousands of doctors of chiropractic.

Perhaps you need to direct your next set of questions to the doctors who originally deemed the three people "perfectly healthy." Ask them why they didn't fulfill their professional obligation as doctors of chiropractic and examine these individuals for vertebral subluxation. Ask what examinations they do conduct, and what "conditions" are they looking for. Ask, too, what services they perform that could not be performed by a medical doctor and, if they are not offering a uniquely chiropractic service, why are they simply duplicating what M.D.s are licensed to do?

Again, the World Chiropractic Alliance stands ready to supply whatever background information you need to present a fair, unbiased and accurate report.

Yours truly,

Terry A. Rondberg, DC, President