Articles by JCS

Response Down Under


                                                                                                                                                   

                               

Dear Dr Smith

Thank you for contacting the ABC [Australian Broadcasting, not American] regarding the article posted on ABC Radio National’s Background Briefing homepage, titled “Doctors speak out against chiropractors treating children”, on 22 April 2016.

Your email has been noted by the secretariat of the ABC Board and referred to Audience and Consumer Affairs. Audience and Consumer Affairs is a unit which is separate to and independent of content making areas within the ABC. Our role is to review complaints alleging that ABC content has breached the ABC's editorial standards. We have assessed the article against the ABC's editorial standards for impartiality and diversity of perspectives, which are explained in section 4 of the ABC’s Editorial Policies. The Editorial Policies are available here: http://about.abc.net.au/reports-publications/abc-editorial-policies/.

Audience and Consumer Affairs has reviewed the article in light of your concerns. A copy of your email has also been provided to ABC Radio for its consideration and comment. ABC Radio’s comments have been taken into account by Audience and Consumer Affairs.

We understand that you are concerned that the article was not fair and balanced.

Context

Background Briefing is a current affairs radio documentary program. As its homepage states, it explores issues of the day and seeks to examine Australian society in a lively on-the-road documentary style. Unlike the ABC’s The Health Report, The Science Show, and Catalyst, it is not a dedicated health or science program, and does not hold itself out as one. Background Briefing produces content for radio, together with complementary written content for its homepage. The primary, newsworthy focus of Background Briefing’s investigation was the Chiropractic Board of Australia’s success or otherwise in regulating registered chiropractors to ensure that they are practising evidence-based treatments. This issue was explored through the prism of advertising within the sector. Background Briefing considered the Chiropractic Board’s reminder to practitioners of the legal prohibition on chiropractors engaging in misleading advertising. A copy of the Chiropractic Board’s statement is here: http://www.chiropracticboard.gov.au/News/2016-03-07-statement-on-advertising.aspx.

Standard 4.2 - Impartiality and diversity of perspective

You have sought “equal time for chiropractors” to respond to the matters raised in the article.

Standard 4.2 of the Editorial Policies requires that the ABC must present a diversity of perspectives so that, over time, no significant strand of thought or belief within the community is knowingly excluded or disproportionately represented. The standard does not require that all issues pertaining to story be canvassed in a single report or article.

The article quoted a range of people representing a range of perspectives relevant to the focus of the investigation. In Australia, chiropractors are regulated by the Chiropractic Board of Australia and the Australian Health Practitioner Regulation Agency, also known as AHPRA. Comments from representatives of both the Chiropractic Board and AHPRA were included in the article. Melbourne-based chiropractor Ian Rossborough featured extensively. One of Dr Rossborough’s YouTube videos was included in the article. Dr Paul Bauert, Head of Paediatrics at Royal Darwin Hospital and the Vice President of the Australian Paediatric Society, provided comments. The article also included comments from spinal surgeon Dr John Cunningham.

Background Briefing’s homepage included links to:

  • Chiropractic Board of Australia’s background information note, dated 22 April 2016
  • the Chiropractors’ Association of Australia’s undated statement
  • a response video prepared by Dr Rossborough
  • Background Briefing’s full radio program on the issue

We note that the concerns expressed by each of Drs Krause, Bauert, McLeod and Cunningham were directly put to the representatives of the Chiropractic Board and of AHPRA, and to Dr Rossborough, as appropriate. Each had the opportunity to respond to the doctors’ concerns. Their responses are variously recorded in the article and the radio program.

Having regard to the focus of the article, and the range of perspectives that were included in it and the associated radio program, Audience and Consumer Affairs is satisfied that the article was in keeping with requirements of standard 4.2.

Yours sincerely

Denise Musto

A/Head, Audience and Consumer Affairs




Here's my response to Ms. Musto:

        Date:         May 31, 2016

 

TO:           Denise Musto

         A/Head, Audience and Consumer Affairs

 

RE:           “Doctors speak out against chiropractors treating children”, 22 April 2016.

 

Dear Denise:

Thank you for your May 25, 2016, email response to my complaint concerning the attack on Dr. Ian Rossborough. Of course, I’d like to respond to your letter of explanation.

First of all, there is a fascinating history behind this incident that you probably have no understanding of the medical war against chiropractors, of which this issue is the latest medical battle to defame chiropractors in a century old war. Just as racism and sexism linger in our society, so too does medical prejudice continue to infect our society with wrong-headed attitudes based on bias, not facts.

To suggest this article was “fair and balanced” is misleading on numerous levels, including the chiropractic board’s response:

“Of particular concern is the number of treatment claims in advertising relating to infants and children. Claims suggesting that manual therapy for spinal problems can assist with general wellness and/or benefit a variety of paediatric syndromes and organic conditions are not supported by satisfactory evidence. This includes claims relating to developmental and behavioural disorders, ADHD, autistic spectrum disorders, asthma, infantile colic, bedwetting, ear infections and digestive problems.”

Obviously the board failed to look at the research before writing its opinion. I daresay very soon the board will be embarrassed by their ill-informed opinion once the research surfaces.

If the board and your writers had done their homework, they would have found numerous evidence-based studies on the issue of infantile colic. In fact, research now substantiates that chiropractic can help colicky babies. If the your reporter had “thoroughly researched” this topic about pediatric chiropractic care, a simple Google search would have discovered articles on PubMed.gov in support of chiropractic care for colicky babies, such as:

There are additional studies concerning the safety of chiropractic care for infants and children as mentioned on a new YouTube video: Australian Paediatric Chiropractor Hits Back! Perhaps you should interview this brave chiropractor, Dr. Glenn McGinnis, for risking his license in order to tell the truth about this “medical bullying” as he so aptly describes this witch hunt.

Your reporter also mentioned the comments of Dr. Paul Bauert, Head of Paediatrics at Royal Darwin Hospital and the Vice President of the Australian Paediatric Society and spinal surgeon Dr. John Cunningham.

Although these two doctors may expect your reporters and audience to accept their opinions as expert, in fact, both are wrong on this issue as the research proves. Let me ask how many hours of educational and clinical training do either Bauert or Cunningham have in pediatric chiropractic care? To be honest, they have none. How much research time has either put into this subject to support their opinions? Again, probably none. Just because they are MDs does not make them expert about chiropractic matters, just as they are not expert about dental matters.

With these obvious oversights in mind, why hasn’t your reporter done the fair and balanced gesture of confronting these two MDs about their erroneous comments? This is more evidence that their goal was not the truth, but to use this incident to unfairly bash the innocent chiropractor who committed no crime in this victim-less treatment.

Bigger Fish to Fry

As well, while asking for proof of their obvious non-expert comments about pediatric chiropractic care, may I ask why your reporters failed to mentioned the huge medical issues that occurred during the same week? It appears while squawking about this pediatric victim-less non-crime, they missed monumental medical stories of much greater value to more people.

A recent article in the British Medical Journal revealed the overall danger of medical care: “Medical error—the third leading cause of death in the U.S.[1] Yet I doubt this article will go viral in the media although it is much more important matter to more people than pediatric chiropractic care.

Why didn’t your news org go ballistic about this article considering this is a huge indictment of the failing of the medical model of disease and treatment? I daresay if dentists or chiropractors were accused of the same humongous iatrogenic deaths, the medical profession would be shouting for their immediate banishment.

Indeed, if “patient safety” were an inclusive issue for all professions, this article should raise this bigger issue than pediatric chiropractic care.

Good for the Gander

Another irony appeared recently in coincidental article in the Medical Journal of Australia: “Perspectives: Surgical management of low back pain.”[2]  The authors stated “Spinal surgery for chronic low back pain is controversial, and the disproportionate number of fusions in private hospitals is unexplained.”

Obviously this is quite a damning indictment from the leading medical journal that will probably go unmentioned by these Chicken Little journalists who cry “baby abuser” on unfounded evidence but turn a blind eye to the unwarranted spine surgeries being done.

A related online article published by the MJA InSight newsletter on April 26, 2016, Spinal Fusion Surgeries Questioned,[3] also was painfully clear the urgent need to stop the tsunami of back surgeries:

“Spinal fusion surgeries for chronic low back pain are on the rise, despite the lack of research to back their efficacy, and experts are now calling for tighter guidelines, including a waiting period.”

Dr. Richard Williams, orthopaedic surgeon and spokesperson for the Royal Australasian College of Surgeons, told MJA InSight that a key regulation should be that patients must wait a period of 12 months before a spinal fusion surgery was performed, noting "Most patients will recover after these 12 months” without any surgery. Of course, chiropractic care is the leading non-drug, non-surgical treatment for the same condition.

This is a topic that Dr. Cunningham actually has some expertise as a spine surgeon, although I daresay he most likely will disagree with this article that suggests:

“Spinal fusion surgeries for chronic low back pain are on the rise, despite the lack of research to back their efficacy, and experts are now calling for tighter guidelines, including a waiting period.”[4]

It would be interesting to put Dr. Cunningham’s feet to the fire to defend the tsunami of unnecessary back surgeries done annually that have made him a wealthy man. Let him explain why the evidence doesn’t support the biggest money-maker in all medicine – spine surgery – and why he continues to do them.

After all, what’s good for the goose is good for the gander!

Yet another shot across the bow for Dr. Cunningham occurred when spine surgery was deemed the ultimate placebo by a mutinous Australian spine surgeon, Ian Harris, in his new book, Surgery, The Ultimate Placebo: A surgeon cuts through the evidence.

According to Dr. Harris, spine fusion is not only ineffective but often leads to complications and, even when it appears to work, it's usually because of the placebo effect:  

“Millions of people have had spine fusions for back pain and I am not at all convinced that the benefits of this surgery outweigh the considerable harms…there is very little evidence that spine fusion surgery for back pain is effective. It is very expensive (the implants alone are often tens of thousands of dollars per case), often leads to complications, often requires further surgery, is associated with increased mortality, and often does not even result in the spine being fused.”[5]

        Dr. Harris understands the incentive of big money motivates these spine surgeons:

“At an average cost of $100,000 each, I am certainly not convinced that it is worth $50 billion a year. Somebody is winning here and it isn't the patients.”

Back Onya

Please let the chiropractic professionals take a few shots at the orthopedic profession with the recent opinions of the MJA experts and Dr. Harris.

Indeed, that would be “fair and balanced” reporting. Indeed, where are the cautionary tales in the media warning patients about opioid painkillers addiction and the high failure rates of spine fusions that are a very real threat to thousands of people every year?

Now you might understand the real agenda in this war of words is not “patient safety” concerning pediatric chiropractic care, which is actually a red herring argument. In fact, it’s about money, and a lot of it for spine surgeons. Undoubtedly the medical pediatricians would also like to see chiropractic pediatricians go away, too. Indeed, the medical profession enjoys being a virtual monopoly despite its obvious deficiencies.

Certainly you can understand that non-drug, non-surgical chiropractic care for the epidemic of low back pain is a huge problem for the medical society to ignore. Now with the admission by the MJA that back surgeries “lack research” and call for a “12-month waiting period,” the last thing Dr. Cunningham wants is to have chiropractors cut into his income.

And the easiest way for him is to defame chiropractic care is with the help of a complicit press unaware of these issues. What can be more emotional than the supposed abuse of babies as your ill-informed article portrayed with the treatment by pediatric chiropractors?

Anti-Trust Déjà Vu

As if the attack on pediatric chiropractic care was not poorly misdirected, another attack upon the chiropractic profession by the medical society occurred with the recent call by the Royal Australian College of General Practitioners telling its members not to refer patients to chiropractors.

If this boycott were to happen, the net result would be millions of more cases of opioid painkiller abuse, addictions, deaths, and unnecessary back surgeries leading to a lifetime of disability for many patients.

Legally, this may also be a slippery slope to an antitrust lawsuit. This call for a boycott of chiropractors by the RACGP is reminiscent of an illegal boycott in the U.S. that led to antitrust litigation in a federal lawsuit, Wilk et al. v. American Medical Association et al.[6]

Now we witness the same unsubstantiated hysteria illustrating the same medical mindset that typifies a monopoly more interested in defamation and domination than in scientific truth.

A shocking revelation at the Wilk trial was the lack of evidence to the AMA’s main legal defense of “patient safety” to justify its boycott of chiropractors just as we now see with the assault on Dr. Rossborough – not one injured patient testified against the chiropractors.

According to the judge, “The AMA did not, during the entire period of the boycott, have reason to hold that view. It is clear that there were some therapeutic benefits of chiropractic that the AMA knew about.” She noted many medical doctors testified that chiropractic care got people well in half the time as medical care.

Afterwards, the judge admitted to a reporter this medical war was primarily an economic turf battle. "Absolutely," Judge Getzendanner later confessed. "Chiropractors compete with doctors. There's no question about it; it's basic competition."[7]

Hopeful Litigation

Indeed, your reporters played into this medical defamation better than Dr. Cunningham could have wished to deflect a spotlight on his own profession.

However, imagine the impact this suggested MJA policy would have on the lives of thousands of Aussies, the money that would be saved by avoiding the high cost of surgery, hospitalization, rehab and the inevitable chronic pain that follows failed back surgery and the risky use of opioid (heroin) painkillers.

But these important issues were virtually ignored in the media in lieu of one DC who adjusted an infant in a victim-less non-crime. Suddenly these television, radio, and newspaper personalities piled on acting as if there were a slew of dead babies caused by chiropractic care, making them more dangerous or controversial than back surgery or narcotic pain pills.

I do hope this issue goes to litigation since that may be the only way for the facts to come forth. Just as Mr. George McAndrews, the leading attorney in the Wilk case, found when he deposed medical experts, none of them had any expertise in the issues involved and expected the court to accept their opinions as facts. In fact, what the court found were medical witnesses who simply repeated their own lies.

But issue after issue was proven misleading or totally false by attorney McAndrews, who submitted evidence and expert witnesses contradicting the medical propaganda that chiropractors were “dangerous”, “poorly trained”, “rabid dogs”, “killers” and “utterly ridiculous”.

Is this not the same baseless accusations we now hear Down Under? As examples of misinformation:

  • Dr. Frank Jones, said “I think that this is an unnecessary and seemingly almost cruel process that there is actually no evidence to support.”[8]
  • Dr. John Cunningham who said “There's not many things that make an orthopedic surgeon emotional, but when you see a premature baby having its back cracked [implying fracture], it literally makes my eyes water.”[9]
  • Pediatrician Dr. Chris Pappas said “no scientifically proven benefits of chiropractic manipulation for young babies and children exist.”[10]

I would love to hear these three medical curmudgeons repeat this misinformation under oath at deposition considering there is ample research for pediatric chiropractic care and there was no injured baby with its “back cracked.” Indeed, this is a victim-less non-crime that has erupted into a witch hunt stirred by the ranting of these biased MDs.

Actually, these comments are the lies of misguided, ill-informed and biased MDs who willingly misled the public and press in order to defame their competition, just as we found in the American antitrust case, Wilk v. AMA.

We now see the same antitrust violation emerging Down Under with the recent call by the Royal Australian College of General Practitioners telling its members not to refer patients to chiropractors. RACGP Dr. Frank Jones is leading this witch hunt by writing to health ministers from all eight states and territories urging a "unified response" to the chiropractic treatment of infants and making outlandish comments in the media to incite baseless public furor against chiropractors.

Frank Jones, the President of the College, states in his letter that “continuation of these chiropractic services represents a public safety risk.”

Okay, Dr. Jones, please present the research to support your belief. Instead, he seems to rely upon the fallacy often used by MDs, “Trust me, I’m a doctor!”

Indeed, this case is clearly Wilk déjà vu Down Under. Perhaps the antitrust laws are different there, but this boycott is a shameless attempt to monopolize the healthcare market by defaming their main rivals with unproven allegations.

Judge Susan Getzendanner mentioned such slander in her Opinion:

“The activities of the AMA undoubtedly have injured the reputation of chiropractors generally…In my judgment, this injury continues to the present time and likely continues to adversely affect the plaintiffs.  The AMA has never made any attempt to publicly repair the damage the boycott did to chiropractors’ reputations.”[11]

The judge described the conspiracy as “systematic, long-term wrongdoing, and the long-term intent to destroy a licensed profession.” She ruled, “By labeling all chiropractors unscientific cultists, injury to reputation was assured by the AMA’s name-calling practice,”[12] which was exactly the goal of the medical curmudgeons—to defame its main competition, to invalidate chiropractic  expertise/treatments, and to capture the healthcare marketplace.

Is this not exactly what we’re now hearing Down Under?

Also during the Wilk trial, newspaper journalists were also deposed who were shills of the AMA, including syndicated columnist Ann Landers who was on the payroll of the AMA, a fact she denied until trial. I would love to hear your reporters and those from other news orgs explain their imbalanced reporting on this case, especially the lack of research into the issue of pediatric chiropractic care.

Obviously the media has its priorities badly skewed when they ignore these medical issues choosing instead to attack an innocent chiropractor. Indeed, in this light, how can your news org consider itself “fair and balanced”?

Although your editors at this time may feel no need to reinvestigate this pediatric chiropractic issue, not to revisit this issue with this new wealth of information would be tantamount of a witch hunt to ignore real medical threats instead harping on an imaginary chiropractic issue.

I urge you to reconsider your decision that “Audience and Consumer Affairs is satisfied that the article was in keeping with requirements of standard 4.2.”

Indeed, in light of this new information that your staff overlooked, if this issue goes to trial, you should expect your reporters and editors to be asked the same questions that Mr. McAndrews put to their counterparts here. To ignore this scientific research and expert opinion is to mislead the public and to defame Australian chiropractors.

I do hope to hear back from you on this matter, just for the record.

Regards,

JC Smith, MA, DC

 

 



[3] BMJ 2016; 353 doi: http://dx.doi.org/10.1136/bmj.i2139 (Published 03 May 2016) Cite this as: BMJ 2016;353:i2139

[4] Charlotte Mitchell, Spinal fusion surgeries questioned, MJA InSight, 26 April, 2016

[5] “Back pain? Try some placebo surgery,” Ian Harris, THE AGE, February 26, 2016

[6] Wilk et al v AMA et al., US District Court Northern District of Illinois, No.  76C3777, Susan Getzendanner, presiding judge; Judgment dated August 27, 1987.

[7] Bryan Miller, Chiropractors vs. AMA, Chicago Reader ,June 27, 1991

[8]Doctors speak out against chiropractors treating children,” by Ann Arnold from the program “RN” on the Australian Broadcasting Corporation network, April 22, 2016.

[9]Doctors speak out against chiropractors treating children,” by Ann Arnold from the program “RN” on the Australian Broadcasting Corporation network, April 22, 2016.

[10]  Watching a chiropractor work on a baby’s spine is worse than it sounds By Vanessa Brown and Rebecca Sullivan, News.com.au, April 26, 2016

[11] Associated Press, “U.S. Judge Finds Medical Group Conspired Against Chiropractors,” New York Times (1987)

[12] S Getzendanner, US District Judge, Permanent Injunction Order Against the AMA (Sept. 25, 1987), published in JAMA, 259/1 (January 1, 1988):81

                                                                     

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