Anti-vaccine chiropractors 67 – Shireen Hodgetts

On August 8 2013, the Chiropractic Board of Australia sent a strong warning to Australian chiropractors that it would no longer tolerate anti-vaccination and other misinformation in the profession:

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.

On March 7 2016, the Chiropractic Board of Australia sent a strong warning to Australian chiropractors that it would no longer tolerate anti-vaccination and other misinformation in the profession:

The Board is very concerned about any chiropractors with advertising (including websites) that may not meet the required standards despite repeated guidance being provided by the Board.

In order to provide further clarity to both practitioners and the public, the Board provides the following clear advice on advertising matters.

Advertising regulated health services

Inappropriate claims of benefit

Patients must be adequately informed when making health care choices. Advertisers must ensure that any statements and claims made in relation to chiropractic care are not false, misleading or deceptive or create an unreasonable expectation of beneficial treatment.

The Board is concerned about a number of practitioners who are making claims in advertising that there is a relationship between manual therapy (e.g. manipulation) for spinal problems and achieving general wellness or treating various organic diseases and infections; or that spinal problems may have a direct role in various organic diseases and infections. There is insufficient scientific evidence to support these claims…

Antivaccination advice

Chiropractors should not display, promote or provide materials, information or advice that is anti-vaccination in nature and should not make public comment discouraging vaccination.

The Code of conduct for chiropractors notes that all chiropractors have a responsibility to promote the health of the community through disease prevention and control, education and, where relevant, screening.

If patients request information about vaccination, they should be referred to an appropriately qualified health professional for advice.

Shireen Hodgetts is a registered chiropractor who owns a business named Integrated Chiropractic, in South Australia. She is a member of the Chiropractors’ Association of Australia:

Hodgetts 8 AHPRA rego

Hodgetts has featured in this series before – in Anti-vaccine chiropractors 33 – in which it was shown that – along with her former Twig Chiropractic business colleague, Catherine Langford – Hodgetts shared anti-vaccination misinformation on her business page and Facebook profile.

Langford – who was sanctioned for treating babies in hospital without permission – has since left the business. Indeed, the photo of Langford adjusting a baby in a hospital is now famous around the nation. Langford now works at Santosha Health and Wellbeing in South Australia:

Hodgetts 9 profile Catherine Langford left Integrated Chiropractic in 2014

On May 6 2016, Hodgetts shared this article which claims that vaccines cause autism:

Hodgetts 10 May 6 2016 autism vax

On May 6 2016, Hodgetts also shared this article which claims that vaccines cause autism:

Hodgetts 11 May 6 2016 vax autism

On April 28 2016, Hodgetts shared this 2010 story about the Fluvax debacle. This story is irrelevant to current influenza immunisation:

Hodgetts 12 April 28 2016 fluvax ban

On February 2 2016, Hodgetts shared this misinformation surrounding the highly effective and safe HPV vaccine:

Hodgetts 15 February 2 2016 HPV vax

On January 30 2016, Hodgetts shared this anti-HPV immunisation misinformation from the discredited American College of Pediatricians:

Hodgetts 16 January 30 2016 HPV vax ACP

On April 25 2016, Hodgetts shared this bizarre article from Collective Evolution:

Hodgetts 13 April 25 2016 heart aura

On March 20 2016, Hodgetts shared this anti-GMO article which cited the discredited Stephanie Seneff’s claims about the rise in autism diagnoses:

Hodgetts 14 March 20 2016 Seneff GMOs autism

On January 11 2016, Hodgetts shared this fear-mongering article which claims that Wi-Fi is killing millions of people:

Hodgetts 17 January 11 2016 wifi killing millions

The following addenda contain excerpts from the Chiropractic Board of Australia’s codes, guidelines, and social media policy from which the reader may wish to choose when lodging a complaint about Shireen Hodgetts.

The Chiropractic Board will surely take strong action against this repeat offender.

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Addendum 1

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

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Addendum 2

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.

Maximum penalty—

a in the case of an individual—$5,000; or

b in the case of a body corporate—$10,000.

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

Advertising may contravene the National Law when it:

– makes use of time-limited offers which influence a consumer to make decisions under the pressure of time and money rather than about their health care needs.

_____________________________________

Addendum 3

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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