Articles by JCS
November 30, 2011.
To: - Professor Graham Pegg
Pro Vice Chancellor and Executive Dean
Professor Grant Stanley
Dean Medical and Applied Sciences
Central Queensland University
Dear Professors Pegg and Stanley,
We (the undersigned) are doctors, clinical and basic scientists and clinical academics who, in our professional lives have, in one-way or another, become involved in attempts to protect health care consumers from the dangers associated with unscientific clinical practices. In so doing we have shared with each other our concern about the increasing numbers of universities that are allowing non-evidence based “pseudo” disciplines to be offered to their students. It is difficult to counter the massive amount of misleading, often fraudulent, information provided to consumers through the media and Internet. The task becomes very much harder however when tertiary institutes give to unacceptable practices an undeserved imprimatur by including them among the courses they offer for study.
We have been prompted to write to you after learning of your plans to offer chiropractic studies next year. The reasons for our concerns are noted below however we plan to broadly distribute the letter we are sending to you in an effort to catalyse discussion among academics and learned colleges about the need for our universities to remain champions of rigorous academic standards. These surely must include recognition of the importance of the primacy of the evidence base for our conclusions and practices. We have no doubt that you will agree with this sentiment and thus, at the risk of sounding patronising, we wonder if you have had a chance to look in depth at the nonsense claims so many chiropractors make for their “discipline” among whom is your newly appointed head of chiropractic studies!
Some chiropractors limit their clinical activities to musculo-skeletal problems causing back pain and there is an evidence base for their manipulations being marginally effective though lasting results from manipulation are not common whether the practitioners are physiotherapists, “osteopaths” or chiropractors. But a practice limited to spinal area musculo-skeletal discomfort is not what modern chiropractic is all about.
Most chiropractors believe and teach that spinal area “adjustment” can be used to treat the vast majority of medical problems. This confidence is based on the theory generated by the founder of this non-science who claimed that “innate intelligence” which controls all normal bodily functions is contained within the spinal column. He equated this phenomenon of “guiding energy” with metaphysical and physiological health. Interference with the flow of this energy resulted from spinal cord “subluxation” and thus manipulating the spine could restore the flow and correct 95% of all man’s ailments.
This concept remains current among many chiropractors and to have it given credence by a university is surely inappropriate? The theory forms the basis for the chiropractor’s peak association’s efforts to constantly broaden the role of chiropractic in primary health care. Its “vision statement” is “To achieve a fundamental paradigm shift in healthcare direction where chiropractic is recognised as the most effective and cost efficient health regime of first choice that is readily accessible to all people”. The 2011 Annual report of the Chiropractors Association of Australia notes “We are in a unique position to be in the forefront of primary care and the natural leaders in prevention and wellness for Australia. Our intellectual property over the power of subluxation and its impact on health is well understood by the CAA. (http://caaannualreport.realviewtechnologies.com/?iid=53753). In 2010 they reported “after ten years of hard slog by the CAA every chiropractor in the country will be permitted under legislation to use the title doctor”!
Chiropractors constitute the largest “professional” group who are members of the Australian Anti-vaccination Network and it is the involvement of chiropractors in “adjustments” for children suffering from everything from Attention deficit to bed-wetting to Asthma etc. that is particularly disturbing to us. http://www.universalhealth.com.au/services/pdf/chiropractic_paediatric.pdf>.
Professor Ebrall supported this type of paediatric practice when he was at RMIT. We can supply you with much more information on chiropractic should you have further questions. We suggest you view the short video demonstrating adjustment techniques for adults and children which you can find at http://www.ccp-guidelines.org/ccp-video.htm It demonstrates why there have been so many complications reported to result from the technique. The literature contains details of more than 700 cases of serious complications following “adjustment”. (Singh S, Ernst E: Trick or Treat, The Truth about Chiropractic Therapy P 177. Bantam Press 2008.)
While your announcement has resulted in this letter we are in no way singling out CQU for criticism; our comments apply to all the universities that currently offer chiropractic studies. Our concerns are not limited to chiropractic but extend to all tertiary institutions that are involved in legitimising anti-science. It would be most regrettable to find that financial pressures may be tempting universities to betray their academic heritage.
Your chiropractic students may well be exposed to excellent courses in anatomy and some basic sciences. However the inclusion of subluxation theory as evidence-based reality is unacceptable and will damage your reputation for academic leadership. We appeal to you as fellow academics to reconsider your plans and engage with us in a dialogue and action plan that addresses throughout the tertiary education sector the issues raised here in. We would be pleased to discuss the contents of this letter with you should you so desire.
Prof Michael Abramson, Professor of Clinical Epidemiology & Deputy Head, Department of Epidemiology & Preventive Medicine Monash University, School of Public Health & Preventive Medicine, The Alfred
Prof Robert Booy MBBS (Hons), MSc, MD, FRACP, FRCPCH, Head of Clinical Research, National Centre for Immunisation Research and Surveillance (NCIRS), Paediatrics & Child Health, Children's Hospital, Westmead, The University of Sydney
Professor Barry Brook, PhD, 2010 Community Science Educator of the Year award winner, Australian Research Council, Future Fellow, Sir Hubert Wilkins Chair of Climate Change, Director of Climate Science, The Environment Institute, School of Earth & Environmental Sciences, University of Adelaide
Prof Rachelle Buchbinder MBBS(Hons), MSc, PhD, FRACP, Director, Monash Department of Clinical Epidemiology at Cabrini Hospital; Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University
Prof Marcello Costa, FAA, Professor of Neurophysiology, Flinders University
Prof Chris B Del Mar, MA MB BChir MD FRACGP FAFPHM, Professor of public health, Faculty of Health Sciences and Medicine, Bond University
A/Prof Ian Darby, PhD, School of Medical Sciences, RMIT
A/Prof John Dixon, MBBS, PhD, FRACGP, DipRAGOG, Head of Obesity Research Unit at the Monash University School of Primary Health Care, Senior Clinical Scientist at the Baker IDI Heart & Diabetes Institute, Melbourne
Professor John M Dwyer AO, PhD, FRACP, FRCPI, Doc Uni (Hon) ACU. Emeritus Professor of Medicine UNSW. Founder of the Australian Health Care Reform Alliance. Clinical consultant to the NSW Government’s Inter-Agency committee on Health Care fraud.
A/Prof John Eden, MB BS MD FRCOG FRANZCOG CREI, Reproductive Endocrinology University of NSW, Director Barbara Gross Research Unit RHW, Director Sydney Menopause Centre RHW, Director Women’s Health and Research Institute of Australia
Emeritus Prof Michael Field, Sydney Medical School (Northern), Royal North Shore Hospital, The University of Sydney
Prof Bruce Foster AM, MBBS MD, FRACS, Deputy Director of the Department of Orthopaedic Surgery, Women's and Children's Hospital, Chairman, Bone Growth Foundation Inc, University of Adelaide
Prof Ian Frazer, MD MBChB FAA, Director, Diamantina Institute for Cancer, Immunology and Metabolic Medicine (DI), University of Queensland
Dr Steve Hambleton, MBBS FAMA, Federal President, Australian Medical Association
Dr Ken Harvey, MBBS FRCPA, Chair of the Governing Council of Health Action International, Asia Pacific (HAIAP), Latrobe University
Prof Philip Hogg, BSc, PhD, 2010 Eureka Prize Winner: Medical Research Translation, Lowy Cancer Research Centre, University of New South Wales, NSW
A/Prof Hubertus PA Jersmann ,MBBS, MD, PhD, FRACP, Respiratory and Sleep Physician, Dept Thoracic Medicine, Royal Adelaide Hospital
Dr Robert H Loblay, MB BS, PhD, FRACP, Senior Lecturer in Immunology, Department of Medicine, University of Sydney, Director, Allergy Unit, Department of Clinical Immunology, Royal Prince Alfred Hospital
Prof Ray Lowenthal AO, MBBS MD FRCP FRACP FAChPM Consultant clinical haematologist/medical oncologist, Royal Hobart Hospital Clinical Professor, University of Tasmania Member, Menzies Research Institute, University of Tasmania
Prof Alastair H. MacLennan AO, MB, ChB, MD, FRCOG, FRANZCOG, Head of Discipline of Obstetrics & Gynaecology, School of Paediatrics & Reproductive Health, The Women's and Children's Hospital, The University of Adelaide
Loretta Marron BSc Assoc Dip (Bus) AAII MACS
Dr John McLennan, MBBS FRACP, Paediatrician, Royal Children's Hospital, Monash University.
Medicine, Alfred Hospital
A/Prof Guy Marks, Head, Department of Respiratory Medicine, Liverpool Hospital, Director of Respiratory Medicine, SSWAHS (Western Zone), Clinical Professor, Medicine Clinical School, Woolcott Institute of Medical Research
Prof John J McNeil AM, MBBS, MSc, PhD, FRACP, FAFPH, Head, Monash University School of Public Health and Preventive
Prof Eric Morand, MBBS(Hons), FRACP, PhD, Deputy Head, Department of Medicine, Southern Clinical School Head, Arthritis Research Group, Monash Centre for Inflammatory Diseases
Prof Rob Morrison OAM, PhD, Professorial Fellow, School of Education, Flinders University
Prof Ian F. Musgrave, PhD, Senior Lecturer, Discipline of Pharmacology, School of Medical Sciences, Convener, Toxicology Special Interest Group, ASCEPT, University of Adelaide
Prof Brett Neilan, ARC Federation Fellow 2008 - 2013, School of Biotechnology and Biomolecular Sciences, The University of New South Wales, Eureka Prizes for Scientific Research (2001), Multidisciplinary Research (2005), and Water and Environmental Research (2009)
Prof Hatem Salem AM, MD,FRACP,FRCPA, Executive Director of the Australasian Society of Hemostasis and Thrombosis, Executive Director of the Australian Centre for Blood Diseases, Director of Haematology, The Alfred, Co-Head of Central Clinical School, Monash University
A/Prof Hans Schneider, MD, FRACP, FRCPA, FACB, Director, Alfred Pathology Service, Monash University
A/Prof Ian Scott, MBBS, FRACP, MHA, MEd, Director of Internal Medicine and Clinical Epidemiology, Princess Alexandra Hospital, Brisbane; Associate Professor of Medicine, University of Queensland
Emeritus Prof Anthony J Smith, Clinical Pharmacology, Calvary Mater Hospital, University of Newcastle
Prof David L Vaux, BMedSci (Melb) MBBS (Melb) PhD (Melb) FAA. NHMRC Australia Fellow, Assistant Director, Walter and Eliza Hall Institute, University of Melbourne
Dr Michael Williams, MBBS, MMedSci), Director of Child & Adolescent Health, Mackay Base Hospital
Prof Heddy Zola, BSc(Hons), PhD, Research Director, Hanson Institute, SA Pathology, Women's and Children's Health Research Institute