Anti-vaccine chiropractors 65 – another CAA AVN supporter

[Originally published as Anti-vaccine chiropractors
redux 15 – another CAA AVN supporter]

Over two years ago, on August 8 2013, the Chiropractic Board of Australia issued a press release announcing it was “cracking down” on anti-vaccination misinformation from chiropractors:

The Chiropractic Board of Australia cracks down to protect the public.

The Chiropractic Board of Australia is cracking down on chiropractors who step outside their primary role as healthcare practitioners and provide treatment that puts the public at risk.

To protect public safety, the Board has:

• ordered practitioners to remove all anti-vaccination material from their websites and clinics
• removed several courses from the list of approved CPD programs, and
• introduced random audits of practitioner compliance with the Board’s registration standards.

And, yet, here we are.

Today’s star is Stacy Budlender, who operates a business called Caulfield Family Chiropractic, in Melbourne. Budlender is a member of the Chiropractors’ Association of Australia, the Gonstead Society, and the US anti-vaccination chiropractic pediatric organisation, the ICPA. From Health Engine:

Alarmingly, Budlender’s website states that she treats the following:

Ear Infections

ADHD Management

Bed Wetting

Colic

Chronic Fatigue

Just over one month ago Budlender’s website also claimed that chiropractic was used to treat autism. I would say that Twitter put an end to this bio page, which no longer exists:

Budlender uses both her business Facebook page, as well as her Facebook profile, to conduct her business and promote chiropractic; as we can see from these screenshots:

And:

Only yesterday, November 24 2015, we found Budlender rallying support against the new No Jab No Pay legislation – I’m guessing – on the Facebook page of the disgraced anti-vaccination organisation, the Australian Vaccination-skeptics Network. As you can see, hovering over her name reveals her trade, and her business:

should we be posting our opposition on the governments facebook page? I have voted liberal til now, never again.

On October 8 2015, Budlender asked an astonishing question on the AVN page:

Where could I find information on vaccine induced strokes. A 13 month old had multiple strokes and wondering if there’s a connection?

In 2011, Budlender liked this IMCV anti-vaccine post on the AVN page. The now broken link leads with this text:

The needle nuts are at it again…

“Needle nuts”. It still cracks me up, four years later.

And even back in 2010, Budlender was making astonishing anti-vaccine claims in support of the AVN:

Stacy Budlender Thankfully I have a wholistic gp who has no probs with not vacc. We have the most problems with the inlaws who say we are jeopardizing our sons life and it’s illegal not to vacc. That we can’t imagine the risks we’re placing on this poor innocent child blah blah!! They don’t want to know the truth, can’t even finish a sentence. Very frustrating considering her son and other grandchild r typical cases of long term vacc affects. Asthma, eczema, allergies, chrojns, colitis, diabetes and learning disorders!!

Meanwhile, over on Budlender’s profile we see the anti-vaccine propaganda flowing, Firstly we see the lies about Gardasil:

We also see unsubstantiated stories of alleged vaccine harm being treated as fact:

Across many of Budlender’s online fora I allege several substantial breaches of the Code of Conduct, the Guidelines for advertising regulated health services, and the Social Media Policy of the CBA. I will add a series of commonly breached sections of the previous at the end of this post, for ease of future access.

This section has been removed from Budlender’s website, so no longer applies:

There are, however, still many breaches – similar to the above – on Budlender’s Facebook page.

The increase in autism diagnoses, without identifying that the main reason for the increase is better identification and a broadening of criteria:

Questionable claims from the ICPA about pregnancy and chiropractic care:

The cell phone meme:

Chiropractic treatment of ear infections:

Adjusting a child. Why? What is this treatment for?

Again, what reason – using reputable evidence – is there for babies to be treated by a chiropractor, because the baby is “not feeling great”? Why is this marketing allowed in a regulated health profession?

This post is just outrageous:

A few times a week I often get asked why I adjust newborn babies and kids…

The simple answer is birth can be extremely traumatic!
Our children have more physical, chemical and emotional stress then ever before in the history of mankind.

Ah, yes; Palmer’s Wager: can you really afford not to believe in the power of the innate? Are you really going to gamble on your child’s health, by not seeing a chiropractor?

Why is this child being adjusted, and used for chiropractic cradle-to-grave marketing? What is the evidence base for this?

More claims that chiropractic can treat ear infections:

Over on Budlender’s profile we see the claim that chiropractic adjustments of subluxations can treat asthma:

Testimonials also  come in many forms. They are illegal. The chiropractor has a duty to have them removed from view.

Who gives themselves 5 Stars?

This is online marketing. This is a testimonial:

This is a customer featuring in or making a claim about the service.This is a testimonial:

This link to a YouTube testimonial is against the law:

And this link to another YouTube testimonial video is against the law:

Thanks for  reading.

As stated above, here’s a general list of common breaches from which the reader can pick, should they wish to lodge a complaint over anything they’ve read today:

Code of conduct for chiropractors.

1.2 Professional values and qualities

[Practitioners] have a duty to keep their skills and knowledge up to date, refine and develop their clinical judgement as they gain experience, and contribute to their profession.

All practitioners have a responsibility to recognise and work within the limits of their competence, scope and areas of practice. Areas of practice vary according to different roles; for example, health practitioners, education providers, researchers and managers will all have quite different competencies and scopes of practice.

2.1 Providing good care. Introduction

a. appropriately assessing the patient, taking into account their history (history includes relevant psychological, social and cultural aspects), views and conducting an appropriate physical examination

b. ensuring that the diagnosis/clinical impression is appropriate, relevant, justifiable and based on sound clinical reasoning

d. formulating and implementing a reasonable management plan (including providing treatment/care and advice and, where relevant, arranging investigations and liaising with other treating practitioners)

2.2 Good practice

a. recognising and working within the limits of the chiropractor’s competence and scope and area of practice, which may change over time

b. maintaining adequate knowledge and skills to provide safe and effective care, including providing treatment/care and advice and where relevant, arranging investigations and liaising with, or referring to, other health professionals

e. considering the balance of benefit and harm in all clinical management decisions

g. providing treatment/care options based on the best available information and practising in an evidence-based context and not being influenced by financial gain or incentives

h. ensuring that services offered are provided with the best possible skill, care and competence

m. ensuring that the chiropractor’s personal views do not adversely affect the care of their patients, and

n. evaluating practice and the decisions made and action taken in providing good care.

3.4 Confidentiality and privacy

b. seeking consent from patients before disclosing or sharing information

g. ensuring that all staff are aware of the need to respect the confidentiality and privacy of patients and refrain from discussing patients in a non-professional context

j. ensuring that use of social media and e-health is consistent with the practitioner’s ethical and legal obligations to protect privacy

3.5 Informed consent

b. providing an explanation of the treatment/care recommended, its likely duration, expected benefits and cost, any alternative(s) to the proposed care, their relative risks/benefits, as well as the likely consequences of no care

c. obtaining informed consent or other valid authority before undertaking any examination or investigation, providing treatment/care (this may not be possible in an emergency) or involving patients in teaching or research, including providing information on material risks

3.6 Informed financial consent

a. ensuring that any financial agreement is based on the clinical needs of the patient

3.7 Children and young people

b. placing the interests and wellbeing of the child or young person first

d. ensuring informed consent to providing care for children involves the patient’s parent and/or guardian being provided with clinically relevant information for the chiropractic management of the child; unless a chiropractor judges that a child is of sufficient age and mental and emotional capacity to give their own consent to a service and relevant state and territory laws are complied with

e. ensuring that risks of care and alternatives to care are sufficiently explained as these are essential elements of informed consent

4.1 Use of diagnostic and therapeutic modalities in chiropractic practice

a. a full and thorough assessment of patients using tools, tests and procedures that are appropriate for the gathering of information necessary to form a reasonable diagnosis or clinical impression

c. only using diagnostic tools, tests and procedures in accordance with established protocols for their appropriate use

d. evaluating and reporting the data obtained in a contextual way to ensure that a reasonable and relevant diagnosis/clinical impression is formed, and that appropriate and necessary care is provided

e. when using tools, tests and procedures in formulating a diagnosis/clinical impression, management plan and/or for prognostic purposes, the tools used should be for conditions where there are demonstrated acceptable levels of reliability and validity, and

f. not misrepresenting the clinical value or significance of the findings of any tool, test or procedure.

5.1 Respect for colleagues and other practitioners

b. acknowledging and respecting the contribution of all practitioners involved in patient care

6.4 Public health matters

a. understanding the principles of public health, including health education, health promotion, disease prevention, and control and screening

b. participating in efforts to promote the health of the community and being aware of obligations in disease prevention, including screening and reporting notifiable diseases where relevant

6.5 Provision of care in a healthcare facility

Good practice involves:

a. seeking permission to access and provide care

b. adhering to and following the policies and procedures of the facility

c. communicating effectively with other practitioners involved in the management of the patient

d. keeping the the facility informed of any care

e. ensuring professional indemnity insurance (PII) coverage to cover care in that facility, and

f. keeping adequate records.

9.6 Advertising

a. complying with the National Board’s Advertising guidelines and relevant state and territory legislation and Commonwealth law.

b. making sure that any information published about services is factual and verifiable

10.2 Chiropractors’ health

c. understanding the principles of immunisation against communicable diseases

 

Guidelines for advertising regulated health services

6.2 Prohibited advertising under the National Law

Section 133 of the National Law prohibits advertising that:

• is false, misleading or deceptive or is likely to be so
• offers a gift, discount or other inducement to attract a user of the health service without stating the terms and conditions of the offer
• uses testimonials or purported testimonials
• creates an unreasonable expectation of beneficial treatment, and/or
• encourages the indiscriminate or unnecessary use of health services.

6.2.1 Misleading or deceptive advertising

Section 133 of the National Law states:

1. A person must not advertise a regulated health service, or a business that provides a regulated health service, in a way that –

a. Is false, misleading or deceptive or is likely to be misleading or deceptive

Eg:

– mislead, either directly, or by implication, use of emphasis, comparison, contrast or omission

– only provide partial information which could be misleading

– imply that the regulated health services can be a substitute for public health vaccination or immunisation

– advertise the health benefits of a regulated health service when there is no proof that such benefits can be attained, and/or

– compare different regulated health professions or practitioners, in the same profession or across professions, in a way that may mislead or deceive.

6.2.2 Gifts and discounts

Section 133 of the National Law states:

1. A person must not advertise a regulated health service, or a business that provides a regulated health service, in a way that –

b. Offers a gift, discount or other inducement to attract a person to use the service or the business, unless the advertisement also states the terms and conditions of the offer

Advertising may contravene the National Law when it:

– contains price information that is inexact

– contains price information that does not specify any terms and conditions or variables to an advertised price, or that could be considered misleading or deceptive

– states an instalment amount without stating the total cost (which is a condition of the offer), and/or

– does not state the terms and conditions of offers of gifts, discounts or other inducements.

6.2.3 Testimonials

Section 133 of the National Law states:

1. A person must not advertise a regulated health service, or a business that provides a regulated health service, in a way that –

c. Uses testimonials or purported testimonials about the service or business

6.2.4 Unreasonable expectation of beneficial treatment

Section 133 of the National Law states:

1. A person must not advertise a regulated health service, or a business that provides a regulated health service, in a way that –

d. Creates an unreasonable expectation of beneficial treatment

6.2.5 Encouraging indiscriminate or unnecessary use of health services

Section 133 of the National Law states:

1. A person must not advertise a regulated health service, or a business that provides a regulated health service, in a way that –

e. Directly or indirectly encourages the indiscriminate or unnecessary use of regulated health services

 

Social media policy

When using social media, health practitioners should remember that the National Law, their National Board’s code of ethics and professional conduct (the Code of conduct) and the Guidelines for advertising regulated health services (the Advertising guidelines) apply.

Registered health practitioners should only post information that is not in breach of these obligations by:

• complying with professional obligations
• complying with confidentiality and privacy obligations (such as by not discussing patients or posting pictures of procedures, case studies, patients, or sensitive material which may enable patients to be identified without having obtained consent in appropriate situations)
• presenting information in an unbiased, evidence-based context, and
• not making unsubstantiated claims.

Additional information may be available from professional bodies and/or employers, which aims to support health practitioners’ use of social media. However, the legal, ethical, and professional obligations that registered health practitioners must adhere to are set out in the National Boards’ respective Code of conduct and the Advertising guidelines.

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