A regulator run, for a decade, by believers in a thing that does not exist
The College of Chiropractors of Ontario has been influenced, if not outright controlled, by vitalists — practitioners who hold that subluxations block a healing force they call innate energy, and that correcting them addresses disease throughout the body.
There is no evidence subluxations exist. There is no evidence innate energy flows through the body. No evidence-based health profession accepts either premise. The Globe found that four of the regulator's then nine chiropractic council members held such views, established through a review of their published writing, speeches, interviews, podcasts, social media, book reviews and conference presentations.
Presidents espousing subluxation-based beliefs led the College in nine of the ten years preceding the investigation. None of the leaders named agreed to be interviewed. The College declined multiple interview requests, providing a letter saying it does not endorse any specific style of practice and requires members to practise within the scope and the applicable standards.
Who runs the College
Clifford Hardick — council member, former president
A London, Ontario chiropractor of more than fifty years. Speaking to students at Life University in Marietta, Georgia, he described the subluxation as the root of all disease, telling the auditorium "One cause, one cure." In other speeches and interviews he has said spinal adjustments release the body's healing powers and correct disorders including ADHD, ADD, asthma and lupus.
In a June speech at Life University he told cheering students that he had adjusted barely verbal autistic children who began speaking whole sentences within weeks.
In early 2017 he became executive chair of Maximized Living, since rebranded MaxLiving — a Florida company providing marketing programmes for subluxation-based chiropractors. Its sample recruitment scripts tell prospective patients that a subluxation is not merely causing pain but destroying the body, causing disease and early death.
He is the father of B.J. Hardick, whose own complaint was before the College while he sat on it. See The Precedent.
Elizabeth Anderson-Peacock — vice-president
In her book Pearls of Wisdom – Pure & Powerful she writes that the daily practice and application of the Laws of Life and Vitalistic Universal Principles distinguish chiropractic within healthcare.
Peter Amlinger — four-term former president, council member
In a 2014 interview he described an infinite potential within each of us, called innate intelligence, expressing itself over the nervous system — and said that healing on any level is possible if that intelligence can be released and kept flowing without interference.
In November 2015 a Facebook post by his Mississauga clinic showed a flyer linking the flu shot to Alzheimer's disease, with his comment suggesting a chiropractic adjustment instead. He told the Globe the posting went up without his permission, by an associate no longer with the practice.
In June 2018 he received a lifetime achievement award at a conference gala held by the Alliance for Chiropractic — in part for his leadership supporting vitalist, subluxation-based chiropractic.
Dennis Mizel — president 2008 and 2014, vice-president 2009–2013
The St. Catharines chiropractor states on his website that physical, chemical and emotional stress is the underlying cause of subluxations. He promotes a book on innate energy and subluxation, recommending it to every chiropractor, student and patient. Though educated in Canada, he made a $25,000 legacy donation to Life University, which describes itself as at the forefront of the vitalistic health revolution.
Keith Thomson — president 2004
The Kawartha-area chiropractor has said that because the body's innate recuperative powers are affected by and integrated through the nervous system, correcting spinal abnormalities that irritate it can produce favourable results in patients with various seemingly non-spinal conditions.
The Alliance for Chiropractic, based in Guelph, was founded in 1998 expressly to ensure the College introduced regulations and bylaws supporting a healthier practice environment for subluxation-based chiropractors. Twenty years later the regulator's vice-president and a former president attended its conference, where one of them was honoured.
Diligent about conduct. Inert about claims.
The Globe reviewed 60 patient-complaint decisions from the past decade. It could only review those challenged by the complainant and sent on to the Health Professions Appeal and Review Board, because the College does not normally make its decisions public.
The pattern was consistent. The regulator is diligent in disciplining chiropractors for unprofessionalism, sexually inappropriate behaviour and questionable business practices. When presented with evidence that members were making unscientific claims, using scare tactics or promoting unproven treatments for conditions unrelated to the spine, it took no action.
| Complaints that produced no action |
|---|
| Treating patients with autism |
| Treating patients with acquired brain injury |
| Claiming that subluxations would dramatically shorten a child's life |
| Making anti-vaccine claims |
| Billing a 76-year-old woman for a year of "corrective" treatment to improve general wellness |
None of these treatments was supported by medical evidence, according to the complaints. Of the 60 cases, the Appeal and Review Board confirmed the regulator's decision in all but five.
Read that against the College's public position. Its registrar has twice told national newspapers — in 2002 and again in 2018 — that members must practise within the scope and that the College acts on complaints when warranted. The complaints record is what that assurance looks like in practice.
How widespread the claims are
Two Canadian studies put numbers on it.
Anton Ninkov, a PhD student at the University of Western Ontario, and Paul Benedetti analysed 800 Ontario chiropractor websites. Roughly a third mentioned subluxation. More than half referred to asthma. Nearly a third mentioned colic.
A study co-authored by Timothy Caulfield, a Canada Research Chair, reviewed the websites of 80 commercial chiropractic clinics across the country.
| Condition advertised | Share of clinics |
|---|---|
| ADHD and attention deficit disorder | 37.5% |
| Allergies | 37.5% |
| Premenstrual syndrome | 32.5% |
| Bed-wetting | 30% |
There is no credible evidence supporting any of these treatments. Ontario is home to more than half of Canada's 8,400 chiropractors.
The money. British Columbia stopped paying for chiropractic in 2002, Ontario in 2004, Alberta in 2009, Saskatchewan in 2010. No Atlantic provincial plan covers it. Manitoba reduced coverage in 2018. It remains a billion-dollar-a-year industry in Canada, carried by private insurance and by patients paying directly.
Self-regulation and the title "Dr." came with Ontario's Regulated Health Professions Act in 1991. Other provinces followed, Newfoundland last, in 2009.
What the CCA said in public, and what it told its members
In May 2018, after the National Post reported paediatricians' concerns about chiropractic treatment of children, Dr. David Peeace, chairman of the Canadian Chiropractic Association, publicly defended the practice. His letter appeared in the paper on 16 May.
Shortly afterward he sent an urgent internal directive to all association members — obtained by the Globe and Mail — telling them to stop publicly discussing anti-vaccination and the treatment of children for ADHD, autism and asthma.
He wrote that public scrutiny and criticism of chiropractors' online claims had noticeably increased, that the issues raised by the National Post concerned the profession's most vulnerable patient group — children — and that this is also the group with the least evidence-based research behind it. He urged members to review their websites for claims that critics could use to disparage the profession and damage its reputation.
The concern expressed to members is reputational. The letter to the public asserted that infants treated within the scope enjoy successful outcomes. Both were written by the same man within weeks of each other, and the private one concedes the evidence problem the public one denied.
The association's formal position on immunization is that vaccination is not within the scope of chiropractic practice, and that patients should consult public health authorities. Postings by chiropractic leaders in several provinces contravene it.
The CCA told the Globe it is urging provincial regulators to be more proactive against misleading advertising and unscientific claims, that it respects the regulator's complaint-driven process, and that it is advocating to the national federation of chiropractic regulators for modernisation. It met the federation's leadership on 25 July 2018, and a national meeting with provincial regulators followed on 19 October.
The association has no regulatory powers. As one reform-minded chiropractor observed to the Globe, the striking thing is that the CCA is almost becoming the regulatory board by default — while some of the College's positions appear designed to protect vitalist practitioners rather than the public.
See also Chiropractors and Children for the full text and analysis of the Peeace letter and the association's 2019 statement.
The same pattern in other provinces
British Columbia. In May 2018 Dr. Avtar Jassal, vice-chair of the province's College of Chiropractors, resigned after CBC discovered he had posted an anti-vaccine video on Facebook.
Nova Scotia. Dr. Chad Mykietiuk, president of the Nova Scotia College of Chiropractors, is co-owner of Wellness Media, a chiropractic promotional materials company. In July 2018 the company promoted a poster on Facebook classifying vaccines as stressors capable of causing subluxations and illness in toddlers and teenagers. The poster was removed after the Globe raised it with the province's college. He did not respond to a request for comment.
In both cases the person promoting the material was not a rank-and-file member but the vice-chair or the president of the body responsible for regulating everyone else.
The reformers inside the profession
This page would be dishonest without the countervailing account. There is a faction within Canadian chiropractic pushing for evidence-based musculoskeletal practice and an end to unscientific claims.
Marc Bronson, a Kirkland Lake chiropractor who graduated from CMCC in 2006, has publicly named vitalist council members and criticised the regulator's reluctance to act. He told the Globe he is tired of being associated with such practitioners and considers their anti-vaccination views and out-of-scope practice a public health risk. Five years before the investigation he started a Facebook group for science-based colleagues; by 2018 it had more than 8,000 members worldwide, about 2,000 of them Canadian. He described it as bringing together a silent majority no longer content to be silent.
The Canadian Memorial Chiropractic College, the country's largest teaching institution, declined an interview but provided a letter stating that its curriculum emphasises current science and best practice, and that evidence-based practice has replaced dogma and unfounded vitalistic concepts. A 2011 study of the curriculums of sixteen North American chiropractic colleges found CMCC among only three making no mention of subluxation in their academic catalogues.
At the time of the investigation the College's new head was David Starmer, education coordinator for the CMCC simulation lab and regarded as an evidence-based practitioner. Bronson noted it was the first time in his twelve years of practice that an evidence-based chiropractor had led the board.
That leaves the teaching college at odds with roughly half the regulator's leadership — a profession whose school has moved on from a doctrine its regulator still holds.
Source documents
- Chiropractors at a crossroads: The fight for evidence-based treatment and a profession's reputation Paul Benedetti and Wayne MacPhail · The Globe and Mail · November 2018. The authors wrote Spin Doctors: The Chiropractic Industry Under Examination, long recommended on this site.
- Chiropractors respond — letter from Dr. David Peeace, Chair, CCA National Post · 16 May 2018 · via PressReader — the public defence
- Chiropractic critics being monitored by Ontario's College of Chiropractors Vik Adhopia · CBC News · March 2018
- The Precedent ChiroWatch — the 2011 ruling and its reuse in 2018
- The College That Watched Its Critics ChiroWatch — the Council agenda item on the profession's critics
File a complaint — provincial directory Browse the Bad Chiro Files