Informed, engaged communities for health

Search
Generic filters
Filter by Categories
Aged care
Budgets
Federal Budget 2023-2024
Federal Budget October 2022
Federal Budget 2022-23
Federal Budget 2021-22
Budget2020Health
Federal Budget 2020-21
Federal Budget 2019-20
Climate and health
Climate emergency
Heatwaves
#CoveringClimateNow
#HealthyCOP27
#HealthyCOP26
COVID collection
Long COVID
COVID-19
COVIDwrap
COVID SNAPS
#JusticeCOVID
Caring for the Frontline
COVIDglobalMHseries
Croakey Conference News Service
#16nrhc
#GreenHealthForum22
#Heal2022
#ICEM22
#NAISA22
#NNF2022
#RANZCP2022
#RethinkAddiction
#RTP22
Choosing Wisely National Meeting 2022
Equally Well 2022 Symposium
GiantSteps22
Croakey Professional Services
NHLF series
#KidneyCareTogether
ACSQHC series
ACSQHC series 2022
ACSQHC series 2021
ACSQHC series 2020
ACSQHC series 2019
CATSINaM 25 Years
Croakey projects
The Health Wrap
ICYMI
@WePublicHealth
@WePublicHealth2023
#CroakeyVOICES
#SpeakingOurMinds
Croakey longreads
#CroakeyREAD
CroakeyEXPLORE
#PHAAThinkTank 2022
Summer reading 2022-2023
CroakeyGO
#CroakeyGO #NavigatingHealth
#GamblingHarms
#HeatwaveHealth
Mapping CroakeyGo
Determinants of health
Environmental determinants of health
Social determinants of health
Discrimination
Racism
Justice and policing
Poverty
Newstart/JobSeeker
Education
Housing
Internet access
Justice Reinvestment
Social policy
Commercial determinants of health
Alcohol
Digital platforms
Food and beverages
Sugar tax
Tobacco
Vaping
Plain packaging
Gambling
Pharmaceutical industry
Arms industry
Disasters and extreme weather events
Disasters
Extreme weather events
Bushfires
Bushfire-emergency 2019-2020
Floods 2023
Floods 2022
Floods 2021
Floods 2011
Donor-funded journalism
Donor-funded journalism – 2023
Donor-funded journalism – 2022
Donor-funded journalism – 2021
Donor-funded journalism – 2020
Elections
#NSWvotesHealth2023
Victorian election 2022
Federal Election 2022
The Election Wrap 2022
#QldVotesHealth
SA election 2022
WA election 2021
Tasmanian election 2021
First Nations
Indigenous health
Uluru Statement
The Voice
Community controlled sector
Cultural determinants of health
Cultural safety
Social and emotional wellbeing
Indigenous education
Lowitja Institute
NT Intervention
WA community closures
Acknowledgement
#CTG10
#NTRC
#RCIADIC30Years
General health matters
Consumer health matters
Cancer
Cardiovascular disease
Chronic conditions
Non communicable diseases
Diabetes
Oral health
Disabilities
Fetal Alcohol Spectrum Disorders (FASD)
Genetics
Medical marijuana
Mental health
Suicide
Trauma
LGBTQIA+
HIV/AIDS
Women's health
HRT
Abortion
Men's health
Youth health
Child health
Pregnancy and childbirth
Organ transplants
Pain
Sexual health
Infectious diseases
Influenza
Mpox
Swine flu
Death and dying
Euthanasia
Global health matters
Global health
WHO
Conflict and war
Asylum seeker and refugee health
#WorldInTurmoil
Ebola
NHS
Health policy and systems
Health reform
Workforce matters
Health financing and costs
Health regulation
Strengthening Medicare Taskforce 2022
Co-design
TGA
Royal Commissions
National Commission of Audit 2014
National Health Performance Authority
Pharmaceutical Benefits Scheme
Private health insurance
Healthcare
Primary healthcare
Social prescribing
Rural and remote health
General practice
International medical graduates
Primary Health Networks
NDIS
Nursing and midwifery
Australian Medical Association
Allied healthcare
Pharmacy
Paramedics
Pathology
Naturopathy
Hospitals
Emergency departments and care
Palliative care
Safety and quality of healthcare
Adverse events
Choosing Wisely
Co-payments
Out of pocket costs
Complementary medicines
Conflicts of interest
Health ethics
Digital technology
Telehealth
E-health
Equally Well
Health Care Homes
Medicare Locals
MyHospitals website
Screening
Surgery
Tests
Media and health
Media-related issues
Public interest journalism
Misinformation and disinformation
Social media and healthcare
Health & medical marketing
The Conversation
Media Doctor Australia
News about Croakey
Public health and population health
Australian Centre for Disease Control
Public health
Prevention
Health inequalities
Health literacy
Health communications
Health in All Policies
Health impact assessment
Human rights
Vaccination
Air pollution
Physical activity
Sport
Obesity
Road safety
Transport
Gun control
Illicit drugs
Injuries
Legal issues
Marriage equality
Occupational health
Violence
Weight loss products
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
Government 2.0
Web 2.0
Nanny state
National Preventive Health Agency
Research matters
Health and medical research
#MRFFtransparency
Evidence-based issues
Cochrane Collaboration
Health and medical education
NHMRC
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2021
2021 conferences
#21OPCC
#BackToTheFire
#FoodGovernance2021
#GiantSteps21
#GreenHealthForum21
#HealthClimateSolutions21
#HearMe21
#IndigenousClimateJustice21
#NNF2021
#RANZCP2021
#ShiftingGearsSummit
#ValueBasedCare
#WCepi2021
#YHFSummit
2020 conferences
#2020ResearchExcellence
#Govern4Health
#HealthReImagined
#SAHeapsUnfair
2019 Conferences
#ACEM19
#CPHCE19
#EquallyWellAust
#GiantSteps19
#HealthAdvocacyWIM
#KTthatWorks
#LowitjaConf2019
#MHAgeing
#NNF2019
#OKtoAsk2019
#RANZCOG19
#RANZCP2019
#ruralhealthconf
#VMIAC2019
#WHOcollabAHPRA
2018 conferences
#6rrhss
#ACEM18
#AHPA2018
#ATSISPC18
#CPHCE
#MHED18
#NDISMentalHealth
#Nurseforce
#OKToAsk2018
#RANZCOG18
#ResearchIntoPolicy
#VHAawards
#VMIACAwards18
#WISPC18
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
#OKtoAskAu
#OTCC2017
#ResearchTranslation17
#TheMHS2017
#VMIACConf17
#WCPH2017
Australian Palliative Care Conference
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
Croakey Professional Services archive
#CommunityControl
#CommunityControl Twitter Festival
#COVIDthinktank21
Lowitja Indigenous knowledge translation series
Croakey projects archive
#CommunityMatters
#CroakeyFundingDrive 2022
#CroakeyLIVE #Budget2021Health
#CroakeyLIVE #USvotesHealth
#CroakeyLIVE Federal election 2022
#CroakeyYOUTH
#HousingJusticeAus
#IndigenousHealthSummit
#IndigenousNCDs
#JustClimate
#JustJustice
#LookingLocal
#OutOfPocket
#OutOfTheBox
#RuralHealthJustice
#TalkingTeeth
@WePublicHealth2022
@WePublicHealth2021
@WePublicHealth2020
AroundTheTraps
Croakey register of influence
Croakey Register of Influencers in Public Health
Croakey Register of Unreleased Documents
Gavin Mooney
Inside Story
Journal Watch
Naked Doctor
Poems of Public Health
Summer reading 2021-2022
Summer reading 2020-2021
Summer Reading 2019-2020
Summer Reading 2017-2018
Summer Reading 2016-2017
The Koori Woman
TOO MUCH of a Good Thing
Wonky Health
CroakeyGO archive 2017 – 2018
CroakeyGo 2018
#CroakeyGO #QuantumWords 2018
#CroakeyGO #VicVotes 2018
#CroakeyGO Albury 2018
#CroakeyGO Callan Park 2018
#CroakeyGO Carnarvon 2018
#CroakeyGO Marrickville 2018
#CroakeyGO Palm Island 2018
CroakeyGo 2017
#CroakeyGO Adelaide 2017
#CroakeyGO Melbourne 2017
#CroakeyGO Newcastle 2017
#CroakeyGO Sydney 2017
Elections and Budgets 2013 – 2019
#AusVotesHealth Twitter Festival 2019
#Health4NSW
Federal Election 2019
NSW Election 2019
Federal Budget 2018-19
Federal Budget 2017/18
NZ Election 2017
Federal Budget 2016-17
Federal Election 2016
#HealthElection16
NT Election 2016
Federal Budget 2015-16
Qld Election 2015
NSW Election 2015
Federal Budget 2014-15
Victorian Election 2014
Federal Budget 2013-14
Federal Election 2013
Federal Budget 2012-2013
Federal Budget 2011
Federal Budget 2010
Federal Election 2010
Federal Budget 2009-2010
Support non-profit public interest journalism
Search
Generic filters
Filter by Categories
Aged care
Budgets
Federal Budget 2023-2024
Federal Budget October 2022
Federal Budget 2022-23
Federal Budget 2021-22
Budget2020Health
Federal Budget 2020-21
Federal Budget 2019-20
Climate and health
Climate emergency
Heatwaves
#CoveringClimateNow
#HealthyCOP27
#HealthyCOP26
COVID collection
Long COVID
COVID-19
COVIDwrap
COVID SNAPS
#JusticeCOVID
Caring for the Frontline
COVIDglobalMHseries
Croakey Conference News Service
#16nrhc
#GreenHealthForum22
#Heal2022
#ICEM22
#NAISA22
#NNF2022
#RANZCP2022
#RethinkAddiction
#RTP22
Choosing Wisely National Meeting 2022
Equally Well 2022 Symposium
GiantSteps22
Croakey Professional Services
NHLF series
#KidneyCareTogether
ACSQHC series
ACSQHC series 2022
ACSQHC series 2021
ACSQHC series 2020
ACSQHC series 2019
CATSINaM 25 Years
Croakey projects
The Health Wrap
ICYMI
@WePublicHealth
@WePublicHealth2023
#CroakeyVOICES
#SpeakingOurMinds
Croakey longreads
#CroakeyREAD
CroakeyEXPLORE
#PHAAThinkTank 2022
Summer reading 2022-2023
CroakeyGO
#CroakeyGO #NavigatingHealth
#GamblingHarms
#HeatwaveHealth
Mapping CroakeyGo
Determinants of health
Environmental determinants of health
Social determinants of health
Discrimination
Racism
Justice and policing
Poverty
Newstart/JobSeeker
Education
Housing
Internet access
Justice Reinvestment
Social policy
Commercial determinants of health
Alcohol
Digital platforms
Food and beverages
Sugar tax
Tobacco
Vaping
Plain packaging
Gambling
Pharmaceutical industry
Arms industry
Disasters and extreme weather events
Disasters
Extreme weather events
Bushfires
Bushfire-emergency 2019-2020
Floods 2023
Floods 2022
Floods 2021
Floods 2011
Donor-funded journalism
Donor-funded journalism – 2023
Donor-funded journalism – 2022
Donor-funded journalism – 2021
Donor-funded journalism – 2020
Elections
#NSWvotesHealth2023
Victorian election 2022
Federal Election 2022
The Election Wrap 2022
#QldVotesHealth
SA election 2022
WA election 2021
Tasmanian election 2021
First Nations
Indigenous health
Uluru Statement
The Voice
Community controlled sector
Cultural determinants of health
Cultural safety
Social and emotional wellbeing
Indigenous education
Lowitja Institute
NT Intervention
WA community closures
Acknowledgement
#CTG10
#NTRC
#RCIADIC30Years
General health matters
Consumer health matters
Cancer
Cardiovascular disease
Chronic conditions
Non communicable diseases
Diabetes
Oral health
Disabilities
Fetal Alcohol Spectrum Disorders (FASD)
Genetics
Medical marijuana
Mental health
Suicide
Trauma
LGBTQIA+
HIV/AIDS
Women's health
HRT
Abortion
Men's health
Youth health
Child health
Pregnancy and childbirth
Organ transplants
Pain
Sexual health
Infectious diseases
Influenza
Mpox
Swine flu
Death and dying
Euthanasia
Global health matters
Global health
WHO
Conflict and war
Asylum seeker and refugee health
#WorldInTurmoil
Ebola
NHS
Health policy and systems
Health reform
Workforce matters
Health financing and costs
Health regulation
Strengthening Medicare Taskforce 2022
Co-design
TGA
Royal Commissions
National Commission of Audit 2014
National Health Performance Authority
Pharmaceutical Benefits Scheme
Private health insurance
Healthcare
Primary healthcare
Social prescribing
Rural and remote health
General practice
International medical graduates
Primary Health Networks
NDIS
Nursing and midwifery
Australian Medical Association
Allied healthcare
Pharmacy
Paramedics
Pathology
Naturopathy
Hospitals
Emergency departments and care
Palliative care
Safety and quality of healthcare
Adverse events
Choosing Wisely
Co-payments
Out of pocket costs
Complementary medicines
Conflicts of interest
Health ethics
Digital technology
Telehealth
E-health
Equally Well
Health Care Homes
Medicare Locals
MyHospitals website
Screening
Surgery
Tests
Media and health
Media-related issues
Public interest journalism
Misinformation and disinformation
Social media and healthcare
Health & medical marketing
The Conversation
Media Doctor Australia
News about Croakey
Public health and population health
Australian Centre for Disease Control
Public health
Prevention
Health inequalities
Health literacy
Health communications
Health in All Policies
Health impact assessment
Human rights
Vaccination
Air pollution
Physical activity
Sport
Obesity
Road safety
Transport
Gun control
Illicit drugs
Injuries
Legal issues
Marriage equality
Occupational health
Violence
Weight loss products
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
Government 2.0
Web 2.0
Nanny state
National Preventive Health Agency
Research matters
Health and medical research
#MRFFtransparency
Evidence-based issues
Cochrane Collaboration
Health and medical education
NHMRC
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2021
2021 conferences
#21OPCC
#BackToTheFire
#FoodGovernance2021
#GiantSteps21
#GreenHealthForum21
#HealthClimateSolutions21
#HearMe21
#IndigenousClimateJustice21
#NNF2021
#RANZCP2021
#ShiftingGearsSummit
#ValueBasedCare
#WCepi2021
#YHFSummit
2020 conferences
#2020ResearchExcellence
#Govern4Health
#HealthReImagined
#SAHeapsUnfair
2019 Conferences
#ACEM19
#CPHCE19
#EquallyWellAust
#GiantSteps19
#HealthAdvocacyWIM
#KTthatWorks
#LowitjaConf2019
#MHAgeing
#NNF2019
#OKtoAsk2019
#RANZCOG19
#RANZCP2019
#ruralhealthconf
#VMIAC2019
#WHOcollabAHPRA
2018 conferences
#6rrhss
#ACEM18
#AHPA2018
#ATSISPC18
#CPHCE
#MHED18
#NDISMentalHealth
#Nurseforce
#OKToAsk2018
#RANZCOG18
#ResearchIntoPolicy
#VHAawards
#VMIACAwards18
#WISPC18
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
#OKtoAskAu
#OTCC2017
#ResearchTranslation17
#TheMHS2017
#VMIACConf17
#WCPH2017
Australian Palliative Care Conference
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
Croakey Professional Services archive
#CommunityControl
#CommunityControl Twitter Festival
#COVIDthinktank21
Lowitja Indigenous knowledge translation series
Croakey projects archive
#CommunityMatters
#CroakeyFundingDrive 2022
#CroakeyLIVE #Budget2021Health
#CroakeyLIVE #USvotesHealth
#CroakeyLIVE Federal election 2022
#CroakeyYOUTH
#HousingJusticeAus
#IndigenousHealthSummit
#IndigenousNCDs
#JustClimate
#JustJustice
#LookingLocal
#OutOfPocket
#OutOfTheBox
#RuralHealthJustice
#TalkingTeeth
@WePublicHealth2022
@WePublicHealth2021
@WePublicHealth2020
AroundTheTraps
Croakey register of influence
Croakey Register of Influencers in Public Health
Croakey Register of Unreleased Documents
Gavin Mooney
Inside Story
Journal Watch
Naked Doctor
Poems of Public Health
Summer reading 2021-2022
Summer reading 2020-2021
Summer Reading 2019-2020
Summer Reading 2017-2018
Summer Reading 2016-2017
The Koori Woman
TOO MUCH of a Good Thing
Wonky Health
CroakeyGO archive 2017 – 2018
CroakeyGo 2018
#CroakeyGO #QuantumWords 2018
#CroakeyGO #VicVotes 2018
#CroakeyGO Albury 2018
#CroakeyGO Callan Park 2018
#CroakeyGO Carnarvon 2018
#CroakeyGO Marrickville 2018
#CroakeyGO Palm Island 2018
CroakeyGo 2017
#CroakeyGO Adelaide 2017
#CroakeyGO Melbourne 2017
#CroakeyGO Newcastle 2017
#CroakeyGO Sydney 2017
Elections and Budgets 2013 – 2019
#AusVotesHealth Twitter Festival 2019
#Health4NSW
Federal Election 2019
NSW Election 2019
Federal Budget 2018-19
Federal Budget 2017/18
NZ Election 2017
Federal Budget 2016-17
Federal Election 2016
#HealthElection16
NT Election 2016
Federal Budget 2015-16
Qld Election 2015
NSW Election 2015
Federal Budget 2014-15
Victorian Election 2014
Federal Budget 2013-14
Federal Election 2013
Federal Budget 2012-2013
Federal Budget 2011
Federal Budget 2010
Federal Election 2010
Federal Budget 2009-2010

A cautionary note about calls to crack down on chiropractic

A few weeks ago, Health Minister Nicola Roxon received a submission calling on the Government to close a chiropractic paediatric clinic run by RMIT University in Melbourne, and raising concerns about the use of chiropractic in babies and children.

The submission was from Loretta Marron, a regular contributor to Crikey/Croakey, cancer survivor and a former Australian Skeptic of the Year who advocates against unproven and disproven alternative therapies.

As I reported in the BMJ at the time, the science writer Simon Singh and the complementary medicines expert Professor Edzard Enrst have lent their weight to Marron’s campaign, as have several prominent Australian medical and scientific experts.

However, another Croakey contributor, Jon Wardle, argues below that there are many benefits to keeping chiropractic training within the university sector. Rather than tarring the entire field with one brush, critics would do better to pursue the minority who are charlatans, he says.

***

Will taking chiropractic training out of universities really protect patients?

Jon Wardle writes:

Recently a submission to the health minister recommending the closure has made news both nationally and internationally in an effort to force RMIT University to close down its paediatric chiropractic training clinic.

Although the submission initially suggests it is a request to only close down the paediatric clinic at RMIT University, as it promotes the use of unproven and harmful remedies targeting pregnant women and children, it goes further to suggest removal of chiropractic training from the university sector altogether.

The submission says “[i]t is high time that universities returned to their core principles and dropped pseudoscientific courses which lead to attacks on vaccination and the promotion of expensive, useless and potentially harmful treatments”.

In addition to RMIT University, the submission also suggests courses at Macquarie University and Murdoch University should also be investigated.

But would removing these courses and clinics from the university sector really be in the public interest?

A university chiropractic course is comprehensive, usually lasting five years. The RMIT course has twice the amount of conventional anatomy, physiology and health sciences units as it does units specific to chiropractic practice.

But even the chiropractic units have a substantial conventional health science element to them as well.

That’s a lot of ‘real’ science for what the submission calls a ‘pseudoscientific’ course. Students are even taught clinical research skills to evaluate evidence.

The reason for this is because although chiropractors may have their own philosophy on healing, they must also work within the conventional health model.

This high level of conventional training also means that practitioners can recognise the limitations of their therapies, be made aware of serious conditions that require referral, can recognise ‘red flag’ situations, and of course can also better assess treatment risk – and therefore minimise these risks – when delivering their treatments.

What’s more, this increase in standards has been a direct result of moving chiropractic training into the university sector. In fact the federal government’s 1977 Webb report recommended regulation of the profession and inclusion in the university sector specifically to increase these standards.

This is important because the simple fact is Australian’s have a right to choose their health provider as they wish. To deny patients this right would be construed as anti-competitive.

The fact is one in six Australians do choose a chiropractor – and they will continue to see them regardless of where their clinical training comes from.

Having this training in a university setting rather than the private sector (or from within the profession itself) provides for better and safer practitioners.

Whilst the evidence base for chiropractic in children is low, this does not necessarily mean that such treatments should be automatically denied.

Some children may respond well to chiropractic – whether it is due to specific or non-specific effects.

Some of these may be children who have not responded to more ‘evidence-based’ medicine (which, after all, does not actually work for everyone). Where should these children go then?

And of course whilst the submission primarily made reference to the inappropriateness of chiropractors treating non-musculoskeletal conditions in these populations, some children will require musculo-skeletal treatment, though admittedly the evidence for this area is also lacking (for both positive and negative trials).

Even if the practitioner does refer, it may be their duty of care to provide an attempted treatment within the initial consultation if it does not pose undue risk. To do nothing may simply not be appropriate. After all, it could be weeks before the referral appointment can be made.

Although it shouldn’t be first-line treatment, there is a case for chiropractic to at least be another option for child treatment.

Chiropractic has come a long way since the days of ‘vertebral subluxation’ being seen as the only source of illness. Not every modern chiropractic treatment focuses on manipulation.

Chiropractors learn far more gross anatomy and as much physiology as most health professions. Most chiropractors work in conjunction with other health professions, and often expand their treatments to include massage, physical therapy, dietary and lifestyle advice and some medicines.

They generally focus on musculoskeletal conditions, though like any other health profession in Australia are not limited to these conditions.

Nor is spinal manipulation a therapy that is limited to chiropractors. It is also taught to and practised by osteopaths, Chinese medicine practitioners, ‘musculo-skeletal therapists’ and naturopaths on the complementary side of the practitioner fence, and physiotherapists and medical practitioners on the other conventional side (the venerable Professor John Murtagh has even written a book on the topic).

Patients will continue to utilise these services. The most important thing is that chiropractors are made aware of their limitations and refer when appropriate. University training clinics are the ideal places to learn such skills.

However, RMIT does have a duty to explore evidence in this area – it certainly goes without saying that RMIT University really should get its act together in developing a research program at its chiropractic school. Though it also goes without saying that this has been a problem in clinical training courses across the professions.

This professional division exists between chiropractic ‘purists’ who believe that all disease is sourced in the spine, and those who are more integrative in outlook. ‘Purists’ are now well in the minority – though it is admittedly a vocal one – and their numbers have been diminishing further as chiropractic training has moved into universities.

Taking training out of the university sector will only support this fringe group, not stop it.

In is arguments the submission focuses on this ‘old’ chiropractic, suggesting that ‘chiropractors say’ that 80% of all health problems are caused by spinal problems. Whilst this is true for a segment of the chiropractic professions, chiropractic internationally is bitterly divided, and this isn’t a representative view of the whole profession.

Additionally, concerns about the impact of chiropractic on public health measures such as vaccination aren’t necessarily supported by the evidence in this area.

It is true that some chiropractors do advise against vaccination, but most chiropractors don’t. Canadian studies have even found that two-thirds of chiropractors have vaccinated their own children, though no data exists for Australian chiropractors (though it should be noted that the Canadian profession is in fact less ‘mainstream’ than the Australian one).

It is also true that international studies also show that children who see a chiropractor are less likely to receive full immunisation. And they show this pretty consistently.

However, implying that such data means that chiropractors are automatically advising patients not to use vaccines amounts to classic attribution error – mixing causality with correlation.

Other factors are at least equally as likely. For example, families who see chiropractors are probably less likely to vaccinate anyway, as parents with an alternative medicine orientation’ are more likely to reject vaccination – regardless of what their healthcare provider says.

This error also informs the submission’s focus on the Australian Vaccination Network – a group that is not run by health professionals of any persuasion. The 120 chiropractic members of this organisation, who the submission focuses on, equates to less than 3% of Australia’s 4387 nationally registered chiropractors, and are most likely from the fringe of the profession.

Rejection of vaccination amongst chiropractors usually relates to original chiropractic philosophy, which saw all disease linked to the spine and vaccines interfering with healing. Such outdated views are disappearing, and are the minority of the profession.

In fact, by having courses in the university sector, students are exposed to positive information on public health measures such as vaccination. In fact, international studies demonstrate that anti-vaccination rates of CAM practitioners are directly related to conventional health science levels in courses, and that most anti-vaccination ‘education’ in chiropractic comes from outside the formal training sector.

There are clear risks to therapies used by chiropractic – particularly spinal manipulation. This is why the profession is regulated and minimum standards of training are imposed. In fact Chiropractic Boards in Australia receive far more complaints about spinal manipulation by unregistered practitioners than do about chiropractors.

There are other risks as well – notably financial exploitations through over-servicing. However, this does constitute a breach under the national registration scheme legislation (as does misleading advertising), and regulatory arrangements are in place to discipline such practitioners.

There are undeniably a lot of charlatans in the field, and the submission is right to criticise them. However, the 50 New South Wales practitioner websites she uses to illustrate what ‘chiropractors say’ represent well under 5% of practitioners in that state.

Tarring the whole profession with the same brush as its ‘lowest level’ does little to recognise the complexities and breadth that exist in the profession. The issue is one that is grey, not black and white. Failing to view the world as such is dogmatic and, dare I say, quite unscientific (and skeptics really should know better).

Additionally, to say that RMIT is responsible for the actions of students once they graduate draws an incredibly long bow. Universities simply aren’t in control of their alumni once they graduate.

For the same reason St Mary’s Hospital Medical School (now Imperial College Medical School) shouldn’t be punished for the claims of Andrew Wakefield – which have done far more damage to vaccination rates than a few rogue chiropractors.

If the authors of such submissions are truly interested in public safety rather than initiating a crusade against a specific health profession, their time would be better spent highlighting the actions of specific practitioners to the appropriate regulatory authorities.

Such mechanisms and safeguards already exist, not only in practitioner regulatory arrangements but also other pieces of legislation, such as that enacted by the Australian Competition and Consumer Commission against misleading allergy treatment claims.

With Australia having one of the highest public levels of support for complementary and alternative therapies in the developed world, it would be a very brave minister or vice-Chancellor that closed down an established course with no real benefit to the public for doing so.

However, taking away the very thing that has progressed chiropractic beyond outdated philosophy to a modern health profession could have serious ramifications for the public.

• Mr Jon Wardle is a naturopath, complementary medicines researcher at the University of Queensland School of Population Health, and a director of the Network of Researchers in the Public Health of Complementary and Alternative Medicine

Comments 23

  1. rachaeldunlop says:

    I think John makes some valid points and I too would like to see the figures for how many chiros subscribe to pseudoscientific beliefs. It doesn’t matter how many years of education you get if it’s the wrong type of education and John’s point about “it’s better to be in unis than not” is moot if students are still being taught there are imaginery subluxations. If as he says there is so much science in these courses, then why even bother calling it chiropractic – just make it physiotherapy which is the same without the unscientific bits. It seems to me that chiros could contribute to health care if they lost the anti-vaccination, anti-germ theory, we-can-cure-anything-with-chiro stuff, but then aren’t they essentially not chiros anymore? They are physios?

    I read with interest COCAs comments on the new code of conduct and they were unequivocal in their statements that there should be more legislation preventing chiros from giving any advice about vaccinations – unless they are suitably qualified. But chiros do – Nimrod Weiner gives free 2 hour seminars about it every few months – and a cursory glance at Google shows he is not alone is his ideas on this issue. John says there are a small percentage who work outside their area of expertise but it is not difficult to find those who will claim to treat ADHD, asthma, even a clinic which claimed chiro increases your kids IQ. Where’s the evidence for that? Sure there are mainstream clinicians who are also anti-vax and use say homeopathy (no evidence for efficacy) and acupuncture (scant evidence for efficacy) and these are also the subject of criticism. But I don’t see many MBBS saying they can increase your IQ by cracking your back.

    I’m interested to know what exactly constitutes pediatric chiropractic qualifications – John defends access for children – but what do they learn that other chiros don’t?

    The big picture here is that pseudoscience should not be taught in universities. And chiropractic is not the only culprit in this regard.

    • Bill says:

      A naturopath commenting on a DC? (Or vice versa) Lol
      That is hilarious on every level.

  2. Tim Mendham says:

    I agree that “Australians have a right to choose their health provider as they wish”, but likewise they should be informed of the issues with any such provider, especially if the service being offered is suspect, and particularly so if it is being offered to children. John Wardle himself says “the evidence base for chiropractic in children is low”, so why practice it until the evidence base is higher? Children’s safety is paramount in any treatment, medical or otherwise. But children are specifically targeted by chiropractors. The promotion for a current series of smeinars, put on by a Dr Glenn Maginness, on chiropractic services for children offers such incentives as: “How to create the ‘It’s normal for children to be adjusted’ mindset with your clinic and your community”, “How to have the majority of your patients as children” and “How to convert your local MD into a ‘general referrer’ of chiropractic patients (both adults and children).”
    Inclusion of any subject in a university calendar gives that subject cudos derived from the imprimatur of a distinguished seat of learning. One would like to assume that that seat of learning’s reputation is not based on suspect activities. So while it’s true that “Universities simply aren’t in control of their alumni once they graduate”, perhaps RMIT should look to its own staff. RMIT Associate Professor Phillip Ebrall, Discipline Head (Chiropractic) “responsible to the Head of the School of Health Sciences for all matters pertaining to chiropractic as a discipline of RMIT University”, seems to be a supporter of astrology. “I am proudly Aries” he says on his blogsite (http://www.ebrall.com/ebrall.com/who_am_I.html). Prof Ebrall is also a member of the Management Committee of the Australasian College of Chiropractors. By any measure, astrology is not a science, and astrology and universities do not and should not mix. When anyone holds such unscientific beliefs, it raises an eyebrow, at least. But Prof Ebrall is not just anyone; he holds a senior academic position within RMIT’s chiropractic activities. One would hope that he does not apply the same non-scientific approach to the evidence for chiropractic as he apparently does to astrology. Running clinics based on practices that are low on evidence should not be an area to which universities give their stamp of approval.

  3. Jon Wardle says:

    Hi Rachael,

    I wouldn’t say that chiros who practice more conventionally are just physios. There is a definite professional culture (which actually goes far beyond subluxations, though this is where most people focus) that differentiates them from physios. This is like saying that massage therapists are the same as physios. Similar, yes. Same, no. It’s the same reason nurses and midwives are separate professions; or psychologists, counsellors and psychiatrists. The list goes on.

    The problem is that you don’t hear a peep from the majority of chiropractors who work in the background in private practice not making ludicrous claims or holding free anti-vaccination seminars, and therefore the fringe are the ones that automatically have a higher profile. Ho