"Blog/Social Media Comments by Individuals Opposed to Chiropractic Practices"
That was the subheading on the agenda for a regular meeting of the College of Chiropractors of Ontario. Underneath it were the tweets of the profession's critics.
Ryan Armstrong found his own posts listed there. He is a former biomedical researcher who has never been to a chiropractor, and who had filed formal complaints with the College against two of its members. His offence, so far as the agenda showed, was writing publicly about chiropractic.
Asked about it by CBC News, registrar Jo-Ann Willson did not dispute that the College was tracking critics. Her position was that the postings were not private — they were public-domain postings, on Twitter — and that the College needs to know what is being said. It is not just about the College, she said. It is about the profession the College regulates, so it is important to know what people are saying about it.
Consider what a regulator is for. A health college exists to protect the public from its own members. Whether nurses, dentists, physicians or laboratory technologists, the job is certification, ethical conduct and discipline where it is warranted. It is not audience research, and the public is not a constituency to be monitored.
Armstrong's own conclusion was the obvious one: after watching the College go after critics, he said he was sceptical his complaints would be taken seriously.
Who the College was watching
Armstrong's blog post — the one that drew the College's attention — is titled Chiropractic: A Modern Threat to Canadian Health. He describes it himself as hyperbolic. His actual position is narrower and more careful than the title suggests, and he has stated it consistently across every interview he has given.
He is not criticising all chiropractors. His concern is the practitioners often called "straight" or "principled" — a reference to the century-old 33 Principles of Chiropractic — who claim to treat a wide range of illness well beyond back and neck pain.
They believe they are literally channeling some kind of divine healing power through the spine that could heal almost any ailment.
Ryan Armstrong, to CBC News
His broader charge is that the field is poorly regulated, that some practitioners mislead the public on matters of science and medicine, and that they tend to position themselves against conventional medicine and science-based procedures. On the scale of it, his test is blunt: search for "chiropractor" and the name of almost any disease, and you will find a hit.
The complaints behind the surveillance
Armstrong had brought formal complaints against two chiropractors before his tweets appeared on the College's agenda.
The first alleged misleading and inappropriate advertising by a prominent chiropractor, through client testimonials claiming cures for diabetes, ADD, asthma, infertility and — in one particularly fiery speech — childhood speech disorders, all from a few spinal manipulations.
He had also written publicly about a well-known member of the College who spoke about "healthy alternatives to vaccinations," and about an Ontario chiropractor who performed an adjustment on the spine of a two-week-old baby.
Willson declined to comment on the individual complaints while the process was under way. She said all 5,000 members of the College are peer-reviewed, in part to ensure they stay within the profession's scope of practice, which the College defines as disorders arising from the structures or functions of the spine and the effects of those dysfunctions on the nervous system.
Read that scope definition against the complaints. Diabetes, ADD, asthma, infertility and childhood speech disorders are not disorders of the spine. If peer review is the mechanism that keeps members inside the scope, it was not catching the advertising that prompted the complaint.
The CCO once banned vaccination advice — then revoked the ban
This is the part of the story that deserves more attention than it received.
The College originally barred chiropractors from telling patients whether they should be immunized, and required them to refer such questions to a physician or a nurse. That is the correct answer: immunization is not within the scope of a profession defined by spinal function.
In 2011 the College revoked that ban.
What followed is visible on chiropractic websites across the country — claims that adjustments prevent influenza, and the recurring assertion that chiropractic helped contain the 1918 Spanish flu pandemic.
ChiroWatch has documented the consequences of that decision for years: the anti-vaccine evenings, the videos shown to whole families in waiting rooms, the practitioners who kept promoting the material through Standard of Practice S-015 and after it. The revocation in 2011 is the regulatory decision that made the rest of it possible.
- Anti-Vaccine Chiropractors ChiroWatch's full section on the practitioners and the campaigns
- Chiropractors and Children Includes Standard S-015 and the CCO's position that a member's website is an extension of their office
"A very flawed approach to regulating alternative practitioners"
Timothy Caulfield of the University of Alberta's Health Law Institute co-authored a 2016 study of complementary health practitioners' websites across ten major Canadian cities. It found that 38 per cent of chiropractors claimed to diagnose and/or treat asthma.
His conclusion was that chiropractic colleges are failing to protect the public from claims that have no basis in evidence, and that self-regulation as applied to alternative practitioners is a very flawed approach. He has met government health officials and understands the rationale — self-regulation is meant to set minimum standards for patient safety — but his position is that if a profession is not science-based, the honest course is to say so plainly and then have the argument about whether it should be a regulated health profession at all.
His practical suggestion is worth noting, because it routes around the colleges entirely: deal with dubious claims through other regulatory tools, such as the truth-in-advertising powers of the federal Competition Bureau.
He also allowed for change from inside. There are chiropractors trying to nudge the profession toward evidence, and one hopes, he said, that they will have sway over their colleagues.
The one the College did discipline
Willson told CBC that a small number of chiropractors do violate the College's rules on treatment claims or conduct, and that those cases are dealt with. Her example: the College suspended a London, Ontario chiropractor who kept ordering blood tests for patients after ignoring multiple verbal cautions. The same practitioner co-authored a book on treating cancer exclusively through holistic interventions.
CBC did not name him. The practitioner is B.J. Hardick, whose case ChiroWatch has documented for years — CCO complaints in 2009 and 2014, and a February 2018 discipline finding reached by Agreed Statement, with Marie Henein as his counsel. The book is The Cancer Killers: The Cause is the Cure, which he co-authored.
One detail the CBC story did not carry. Hardick's father, Clifford Hardick, was a president and council member of the College of Chiropractors of Ontario. He held that position during the window in which his son's matter was before the College.
That is not an allegation of interference, and nothing on this page should be read as one. It is a fact about a self-regulating profession small enough that the family of a member facing discipline can sit at the top of the body doing the disciplining — and it is the sort of fact a regulator monitoring its critics might prefer stayed unremarked.
Note what the example concedes on its own terms. The College acted only after multiple verbal cautions had been ignored, on a practitioner with complaints going back to 2009 whose published work advocates treating cancer without medicine. That is the case the registrar offered as evidence the system works.
Source documents
- Chiropractic critics being monitored by Ontario's College of Chiropractors Vik Adhopia · CBC News, Second Opinion · March 2018
- Chiropractic: A Modern Threat to Canadian Health Ryan Armstrong, PhD · Post-Truth Health — the post that appeared on the College's agenda
- How To: Complaints Against Canadian Health Professionals Ryan Armstrong, PhD · Post-Truth Health · 4 September 2018
- The Regulator and the Vitalists ChiroWatch — the Globe and Mail investigation into the College's leadership
- The Precedent ChiroWatch — the 2011 ruling cited in B.J. Hardick's 2018 defence
- Post-Truth Health — article index Includes Chiropractors and the Fetus and The Chiropractor's Toy
File a complaint — provincial directory Browse the Bad Chiro Files