Unrestrained hubris is the undoing of many a person. There are no codes of conduct, no interventions which will curtail it. Sometimes only banishment will suffice. To allow hubris to flourish, as has been the norm for chiropractic for so long, poses a risk to public health and safety.
Most of the information in this post was obtained from a closed, Australian chiropractic Facebook group. After much deliberation with friends, I have decided that the public interest far outweighs the interests of a group which cannot legitimately claim privacy, with a member list tallying 624, so far.
Public safety is paramount to the self-serving interests of these chiropractors who flagrantly breach codes of conduct, health policies, and any semblance of professional courtesy, in their chase for legitimacy, based on the unwarranted treatment of magic, invisible conditions (subluxations); this is a legitimacy they do not deserve.
The first time I came across the habit of chiropractors conducting their secret treatments in hospitals was in my recent series on anti-vaccine chiropractors. In Anti-vaccine chiropractors 33 we met Catherine Langford, a member of the Chiropractors’ Association of Australia. She conducts her business at Twig Chiropractic, in South Australia. On her Facebook page Langford included this picture, of herself “adjusting” a neonate in the North Eastern Community Hospital, in Adelaide:
As I stated in the original post, I contacted the hospital to ask about their policies of allowing chiropractors to adjust on premises, to no avail. I’ve heard nothing back from the hospital. As I also noted in the original post, I don’t know if this is Langford’s own baby, or a customer’s.
The Langford example was very public. She proudly posted it to her Facebook page, twice. I now want to turn to the private examples from other chiropractors.
Helen Alevaki is the President of the Chiropractors’ Association of Australia Victoria branch. Alevaki conducts her business at chiropractic4wellness.
In a post from the chiropractic group, Alevaki admits to sneaking into maternity wards under the guise of being a friend of the baby’s parents, who are indeed her customers, to check brand new babies:
Alevaki’s admission was posted in response to a question asked by Oliver Croke, son of CAA National Board Member Tony Croke, as to everyone’s “favourite adjustment ever”:
About a week after that admission I was startled by another thread, in which a stream of chiropractors admitted to conducting their business inside our hospitals.
Andrew Victor Smith is a chiropractic student at Murdoch University, and a chiropractic assistant at Nervana Chiropractic. We met the anti-vaccine Smith in Anti-vaccine chiropractors 9: Smith asks his peers:
Need advice on adjusting people in hospital.
My brother went in for a fairly emergency appendectomy, and there were apparent complications. Long story short he will be in for a few days, on antibiotics and blood thinners.
I know his best chance at recovery is in a subluxation free state, and due to the heparin was going to visit him with the activator.
Have people had problems adjusting friends/family in hospital? Or is the best way just to wait for the most opportunistic time, adjust him and claim ‘we didn’t hear any clicking sounds’ when the nurse asks?
Jenny Roppola is the first respondent. Roppola is a former Board Member of the Chiropractors’ Association of Australia National franchise. Roppola worked at Ginninderra Chiropractic, in the ACT. Roppola admits working on her baby in the NICU, and then allowing a colleague to do the same. She told the nurses, later, what she had done:
Adjusted my daughter (14 weeks prem) in NICU as soon as I was allowed to touch/hold her. Did sacral work SOT style…. Never said a word…. Then when she got bigger and I was able to breastfeed behind screens, a colleague came in to work on her…. Nurses even commented on how we had the best behaved baby in there…. Told nurses later, especially after her ‘colic’ settled so well and quickly.
Smith further confirms that the they know the behaviour is unprofessional:
I can understand that, with a newborn an adjustment and a cuddle/play look similar to the uninitiated.
My brother is 24, and a big guy. Best chance is sitting him up and using activator down his spine.
Worst that can happen is getting kicked out of a hospital I guess?
Olivia Gleeson is a member of the Chiropractors’ Association of Australia. She also works at Nervana Chiropractic in Western Australia. She freely admits that she has adjusted “lots of bubs in hospital”. She also admits that her friend Alison Young (Scott), a former Board Member of the Chiropractors’ Association of Australia Western Australia outlet, also adjusted babies in hospital. Young, formerly of Nervana Chiropractic, now runs the business, The Innate Child.
I have adjusted lots of bubs in hospital, I just go in do my work and then go home. Ali adjusted Tom in the Nicu a couple of hours after birth and the nurse wasn’t happy but my hubby said we are doing it anyway
Roppola then offers some further advice to Smith:
I’ve done sacral SOT type work on a few preggers and post-partum women. Use the curtains when you visit your brother and get creative….. (That doesn’t sound so good……).
Jim Ainsley also admits that he frequently goes into hospitals to work on his customers. Ainsley works at Care Chiropractic Queensland. I emailed to ask if he was a CAA member, but, got no reply – neither from Ainsley, nor the CAA.
have been thee lots of times never had a prob.
Stephanie Le Coz is a member of the Chiropractors’ Association of Australia. We have met the anti-vaccine member of the Australian Vaccination Network in Anti-vaccine chiropractors 23. Le Coz conducts her business at Penshurst Chiropractic Centre. She also admits to conducting her business inside our hospitals. Please pay particular attention to Le Coz’s comment:
Have adjusted my mother and my CA post surgery . Do not worry and go for it xxx
There is a reason I wanted you to pay attention to that comment. Le Coz has worked on people, in our hospitals, post surgery; and some people liked the comment? Who?
Tony Croke is a National Board Member of the Chiropractors’ Association of Australia, and he condones the behaviour as depicted by Le Coz. We have met the anti-vaccine, former decade-long AVN member, Croke before, here and here. He runs a business called Liberty Chiropractic. This guy is a leader of Australian chiropractic. He is a spokesperson. We have a huge problem here:
Alice Nguyen works at a business called Optimum Health Essentials, in NSW. She is a member of the Chiropractors’ Association of Australia. This person mistakenly believes that patient consent is all that is needed for chiropractors to enter hospitals to treat their customers. Nguyen is also a doula:
Go for it! when they see you are working on your brother with focus and intent from a place of love, they will very unlikely intervene. Besides, it’s his consent, and consent means everything in a hospital setting.
Katelyn McGregor works at Pioneer Family Chiropractic in Victoria. McGregor admits to frequently practising her business inside hospitals, and provides tips for Smith to avoid detection. I emailed McGregor and the CAA so as to ascertain her CAA membership status, but, got no reply. Once again, please pay particular attention to the comment:
U don’t need to broadcast it but it’ll be fine. Ditto to being in there often, all good. Go at visiting time when their’s lots of people around and wack the curtain around. I visited my mum in neuro wards of lots of hospitals. No biggie… And ur right , he needs adjusting. Get well to him x
McGregor’s comment was liked by Tony Croke, that National Board Member of the Chiropractors’ Association of Australia. When the board condones it, it means go for it, right?
James Love is a UK-based chiropractor, trained in Australia. He runs a business called Love Chiropractic. He is a member of the Chiropractors’ Association of Australia, and the United Chiropractic Association (UK). So, heads up, UK readers. He is registered in Australia and the UK. You will find this one hard to believe. Love adjusted a person in A and E. In the emergency department. He just pulled back the curtain and went for it:
I’ve adjusted a patent of mine who was in A&E, just closed the curtains after the nurses visit, no worries.
Tim Shakespeare is probably the closest thing to the personification of hubris amongst this bunch. He works at Healing Wave Chiropractic, in NSW. Shakespeare is an anti-vaccine chiropractor and disciple of Billy DeMoss, the deranged Californian. He has referred to the recent Australian Academy of Science immunisation handbook as “Mein Kampf”. I’m serious. Lately, Shakespeare has been reminding his colleagues of the long-awaited return of anti-vaccine chiropractor, Tim O’Shea, to our shores. You’ve met Shakespeare here, here, here, and here. He is a Board Member of the Chiropractors’ Association of Australia New South Wales outlet. Shakespeare went into a maternity ward, wearing his chiro shirt, to adjust his brand new niece. And he doesn’t care what anyone thinks:
Why should they care? They think its next to useless anyway…
I adjusted my niece with a CWD (Chiropractic World Domination) t-shirt on.
Bryce Fleming also works at Healing Wave Chiropractic. Is there something in the water? Fleming is a member of the Chiropractors’ Association of Australia. For Fleming, deceit is all about confidence:
I have adjusted a few peeps in hospital too. The more confident you are being there, the less questions get asked
Smith returns to inform his peers that the adjustment did indeed take place, and that it will happen again:
Doesn’t matter, he got adjusted then and he will get adjusted in hospital again
Tom Dawson is an anti-vaccine member of the Chiropractors’ Association of Australia. He runs a business called Wellbeing Hawthorn. We’ve met Dawson before in Anti-vaccine chiropractors 3. Dawson also seems to think that the patient’s demands override every professional ethic in regards to visiting rights:
If the PT wants you to, you can do it, simple as that, I actually lifted a man in Albury off a guerney in the base hospital there 17 years ago, put him in the car and drove him over to Wodonga( Vic licence only) as the medicos said they couldn’t help him anymore and just left him there. I offered to take him back but he walked out and went home. Saw him and his family last week. Nowadays I just set up and go for it whenever asked.
I want to cite a few examples of policy documents which may be pertinent to the behaviour of these chiropractors, and to the possible breaches they are committing. There are probably several more which can be added. Feel free to add more in the comments.
From the Queensland Department of Health, on the requirement for adequate credentialing of medical and other staff, including allied health. Chiropractors are not listed, but, the closest they would come to “clinician” status is allied health. I say that begrudgingly, and with apologies to allied health staff. I can only imagine that this policy document reflects broader national requirements demanded of all practitioners wanting visiting rights in our health facilities:
Credentialing and defining the scope of clinical practice
All identified clinicians are to be credentialed and have a defined scope of clinical practice to support the delivery of safe and high quality health care within Queensland Department of Health.
This policy applies to the Queensland Department of Health and is relevant to professionals identified in the Professional stream requirements section of this document.
Clinicians employed within Hospital and Health Services should refer to the Credentialing and Defining the Scope of Clinical Practice Health Service Directive.
– patient safety: ensuring clinicians practice within the bounds of their education, training and competence and within the capacity and capability of the service in
which they are working
– consistency: aligning with National standards and other Queensland Health credentialing processes
– due care and diligence: all parties act with due care and diligence to support procedural fairness. Credentialing and defining scope of clinical practice processes are underpinned by transparency and accountability.
Implementation Standard for specific mandatory professional stream requirements
5. Allied Health Professionals
The Queensland Department of Health relevant agencies (i.e.: HSSA, HSCI) shall:
– ensure all allied health professionals intending to engage in complex clinical practices not traditionally performed by their profession are credentialed and have a documented defined scope of clinical practice.
– ensure all allied health professionals working in Queensland Public Health System facilities but not employed by a Hospital and Health Service are credentialed and have a documented defined scope of clinical practice
See that last part again: those not employed in a hospital, but, wanting to work in a hospital, must be credentialed and have a documented, defined scope of clinical practice. You cannot do that when you are sneaking into hospital wards and conducting clandestine manipulations on hospital patients, without the knowledge of treating practitioners.
Another area of concern with these chiropractors, many of whom are anti-vaccine, is their brazen disregard for immunisation policy directives. From NSW Health:
Occupational Assessment, Screening & Vaccination
REQUIREMENTS UNDER THIS POLICY DIRECTIVE
Transmission of vaccine preventable diseases in health care settings has the potential to cause serious illness and avoidable deaths in patients, staff and other uses of the health system as well as others in the community. NSW Health Policy Directive PD2011_005 Occupational assessment, screening and vaccination against specified infectious diseases provides a framework for immunisation and screening of health care workers, other clinical personnel and students to minimise the risk of transmission of these diseases.
The following sections describe the requirements for students, other clinical personnel (including locums), new recruits and existing health service staff and the procedures to be followed by agencies, educational institutions and health facilities in fulfilling the requirements of the policy directive.
And, interestingly, all other clinical personnel must comply with the policy directive, and have evidence of protection against specific infectious diseases:
Other clinical personnel including locums
Other clinical personnel, including locums, must:
- Provide evidence of protection against the infectious diseases specified in PD2011_005 and comply with the requirements of PD2011_005 at their own cost, prior to appointment; and
- Submit a Form 1: New Recruit Undertaking/Declaration and Form 2: TB Assessment Tool to the health facility.
The locum recruitment agency must:
- Inform all locum personnel of the requirements of PD2011_005.
- Ensure that all locum clinical personnel have completed each section of Form 1 and Form 2 and have evidence of protection against the specified diseases.
- Ensure that locum clinical personnel are not referred to a health facility if they do not comply with the requirements of PD2011_005.
The health facility must:
1. Assess the individual’s evidence of protection and whether TB screening is required.
2. Issue a Certificate of Compliance if the individual complies fully with the requirements of PD2011_005.
Again, given the brazen and public anti-vaccinationism of at least some of them, what are the chances that any of these chiropractors are going to be able to comply with these immunisation directives?
I haven’t even touched on infection control, and workplace health and safety issues; not to mention insurance and other liabilities, should an adjustment go awry, in secret.
One document I will cite is the Chiropractic Board of Australia’s own Code of Conduct for Chiropractors.
From the introduction:
1.1 Use of the Code
This Code seeks to assist and support health practitioners to deliver appropriate, effective services within an ethical framework. Health practitioners have a professional responsibility to be familiar with this Code and to apply the guidance it contains.
This Code will be used:
• to support individual health practitioners in the task of providing good health care and fulfilling their professional roles and to provide a framework to guide professional judgement
• to assist the Chiropractic Board of Australia (the Board) in its role of protecting the public by setting and maintaining expectations of good practice – if professional conduct varies significantly from this Code, health practitioners should be prepared to explain and justify their decisions and actions, and serious or repeated failure to meet this Code may have consequences for registration.
From Section 2, on the provision of care in an appropriate manner, with appropriate clinical history, and with appropriate liaison with other health professionals:
2. Providing good care
Care of the patient is the primary concern for chiropractors in clinical practice. Providing good care includes:
a) assessing the patient, taking into account his or her history, views and an appropriate physical examination; the history includes relevant psychological, social and cultural aspects
b) ensuring that the diagnosis/clinical impression is reasonable, relevant, justifiable and based on sound clinical reasoning
c) formulating and implementing a reasonable management plan (including providing treatment/care and advice and, where relevant, arranging investigations and liaising with other treating practitioners).
I’m not sure how any of the above can be undertaken with any degree of certainty or integrity in a secret, rushed visit in a hospital facility where the chiropractor knows they are not welcome to manipulate their customers.
Further to the point of working with other practitioners: how can this happen when chiropractors sneak into health facilities, pretending to be an everyday visitor? How can there be any collegiality between health practitioners, given the implicit deceit? In which example has any chiropractor consulted with the primary health care practitioner, the real doctor? From Section 5:
5. Working with other practitioners
5.1 Respect for colleagues and other practitioners
Good care is enhanced when there is mutual respect and clear communication between all health professionals involved in the care of the patient. Good practice involves:
a) communicating clearly, effectively, respectfully and promptly with colleagues and other practitioners caring for the patient
b) acknowledging and respecting the contribution of all practitioners involved in the care of the patient.
And this brings me to another point. How are these chiropractors going to maintain accurate patient records? They sure as hell won’t be writing in the patient’s notes. This would be another breach of their own Code of Conduct. From Section 9:
9.4 Health records
Maintaining clear, appropriate and accurate health records is essential for the continuing good care of patients. Chiropractors should be aware of relevant State and Territory legislation in relation to health records management. Good practice involves:
a) keeping accurate, up-to-date and legible records that report relevant details of clinical history, clinical findings and determinations, investigations, information given to patients, medication and other management
b) ensuring that records are held securely and are not subject to unauthorised access, regardless of whether they are held electronically and/or in hard copy
c) ensuring that records show respect for patients and do not include demeaning or derogatory remarks
d) ensuring that records contain sufficient information to allow another chiropractor to continue the management of the patient and to facilitate continuity of chiropractic care
e) making records at the time of events or as soon as possible afterwards and include a record of every patient consultation.
I think what this practice really shows is the utter disdain held for evidence-based medicine by these chiropractors. Policies and procedures are implemented for good reason: the health and safety of the patient is paramount, and a good part of this is made possible by the maintenance of accurate health records, and with the collegiality of evidence-based health teams working together in the interests of the patient’s health. To have magic-reliant cowboys stroll into this environment, in secret, with curtains drawn, shows the lack of respect they have for other practitioners, and their own codes of conduct, which amazingly claim ethics as one of their central tenets. Remember, these people are aiming to take their place beside trained medical professionals as primary health care providers. They don’t even have the decency to consult with a real doctor; the same doctors of whom they are so disdainful, yet whose courtesy title they crave.
The Friends of Science in Medicine have provided a statement regarding the information presented above. I didn’t bother contacting the Chiropractors’ Association of Australia, again. I wouldn’t have expected them to reply anyway, as you have already seen.
Friends of Science in Medicine statement:
The highly unprofessional and potentially dangerous practices documented here demonstrate just how undisciplined is this “profession” despite the government’s initiative to protect the public by having all Chiropractors registered nationally. Their adherence to ethical standards of practice is the responsibility of the Chiropractic Board of Australia. A rapid and firm response from this Board following these revelations will be expected and monitored by “Friends of Science in Medicine” and no doubt many other professional bodies emphasising the importance of having credible scientific evidence of clinical effectiveness underpin the delivery of health care in Australia.
Importantly, not one chiropractor in that closed group, who witnessed those threads, cautioned against this activity. Not one. Present and former CAA board members joined in, promoted, and condoned the activity. This speaks volumes.
Tell me: what does it take to deregister a chiropractor these days? And, why do we allow them to use the courtesy title, “Dr”?
Update October 7 2013.
The ABC is looking to get in touch with people who have used chiropractors to talk about their experiences, good or bad. If you are interested in talking to them please email: firstname.lastname@example.org