Queensland chiropractor adjusted patient in Cairns Hospital intensive care unit

In 2013, a story broke regarding chiropractors who were bragging of sneaking into hospitals. The story was even covered in Fairfax press.

In November 2013, the then-president of the Chiropractors’ Association of Australia, Laurie Tassell, tore his members a collective new one in his president’s report, published in the official periodical of the CAA, The Australian Chiropractor:

1 The unethical use of websites to claim cures for conditions that cannot be supported by research evidence continues to be a major problem for the profession. At the time of the NDF [National Development Forum], the CBA had received 155 new complaints regarding the inappropriate use of websites. This is an issue that continues to astound me. Maybe when some of you receive substantial fines or suspension you will understand the significance of your selfish and unprofessional actions.

2 The damage to the profession from the unprofessional use of social media – personal attacks on chiropractors who might hold different views to you, bragging about entering hospitals without permission and posting photos with well known speakers openly critical of vaccination are not acceptable. Complaints to the CBA have been lodged and some of you will be subject to disciplinary action. Once something is posted on the net it is in the public domain. Private or closed sites are being accessed and trolled.

Tassell 1 November 2013 TAC CAA President's Report

When we fast-forward two years, to 2015, sanctions were indeed handed out to some of the chiropractors who had admitted to sneaking into hospitals (but, strangely, not all of them).

All of these incursions are breaches of several sections of the Chiropractic Board of Australia’s Code of conduct for  chiropractors. At the very least, these sections have been breached:

CBA 9 Code of Conduct 6.5 Provision of care in a Healthcare facility

CBA 10 Code of Conduct 5.1 Respect for colleagues and other practitioners

CBA 11 Code of Conduct 9.1 Professional behaviour

With all of this in mind it is astonishing that we are still uncovering these breaches, at least since 2013.

Alan Courtney and Andrea Collins run a chiropractic business called Trinity Family Chiropractic, in Cairns. Andrea Collins was a professional member of the disgraced anti-vaccination pressure group, the Australian Vaccination-skeptics Network (which now has a public health warning against its name). Collins is also a member of the Chiropractors’ Association of Australia.

On September 5 2014, Collins posted on her business page that she had been hospitalised with a very serious throat infection, enough so as to warrant intravenous antibiotics and other medication:

It was a scary time for myself and our family especially not knowing what the identity of the bacteria creating the swelling and pain in my throat was. All I can say for sure it was an aggressive little b***** and gave us a run for our money.
Nearly 3 weeks in hospital was no fun, most of it spent attached to a drip whilst a cocktail of antibiotics, nor-adrenaline,steroids and morphine was pumped into me.

Collins then added this startling admission that her colleague, Alan Courtney, adjusted her whilst she was in the ICU of Cairns Base Hospital:

In the middle of it all, I was very aware that at the end of the day my health is my responsibility, the drugs were a necessary step to kick start my own healing reserves but not the total solution. Dr Alan was adjusting me even in intensive care.

Courtney 1 September 5 2014 Trinity Family Chiro Collins adjusted in ICU

We must wonder of which subsections of the Code of conduct 6.1 Courtney had undertaken and completed before adjusting a patient in the ICU of a public hospital.

Elsewhere on the Trinity Family Chiropractic Facebook page, we see further breaches.

On April  23 2016, TFC posted this curious, defamatory Linked In blog post written by serial defamer, Phillip Ebrall; the Ebrall article was written in response to the thorough, investigative ABC Background Briefing radio program, Chiro Wars:

Courtney 2 Ebrall post

On April 16 2016, TFC posted a link to the crank cancer cure – and anti-vaccine – documentary series, The Truth About Cancer:

Courtney 3 Truth About Cancer

To give an idea of the contents of The Truth About Cancer, this is how anti-vaccination activist, Janne Witt, described her viewing of the series (from anti-vaccination group, Unvaccinated Australia):

Truth About Cancer synopses by Witte antivax etc

On March 11 2016, just four days after the Chiropractic Board of Australia issued a stern press release regarding false and misleading advertising claims which were still being made by chiropractors, TFC posted this:

Courtney 4 adj immune boost flu bug

On March 4 2016, TFC posted this outrageous article from the anti-vaccination-infected, subluxation-based Australian Spinal Research Foundation – a registered charity! – which claims that “subluxation-based care” can improve neurological outcomes for autistic children. The article is based on a single case report. You read that correctly:

There is a fascinating exploration of the role that chiropractic could play in helping bring the neurology back to normal. A case study was published reporting improved outcomes of a three year old child with autism undergoing chiropractic [2].  The case in question exhibited marked improvements in her condition following subluxation-based care [3].

Courtney 5 autism ASRF

On February 23 2016, TFC posted this anti-fluoridation article:

Courtney 6 anti fluoride

On December 8 2015, TFC posted this testimonial arising from the chiropractic treatment of their own daughter, in which it is claimed that chiropractic adjustments assisted in overcoming vomiting:

Courtney 7 vomiting daughter adjusted

On December 4 2015, TFC posted the ubiquitous, misleading 10 Reasons from anti-vaccine chiropractor Jennifer Barham-Floreani:

Courtney 8 10 Reasons JBF

On November 30 2015, TFC posted this article claiming that chiropractic adjustments “reverse multiple sclerosis and Parkinson’s disease”:

Courtney 9 adj reverse MS and Parkinsons

On November 26 2015, TFC posted an article claiming that chiropractic care treats a variety of conditions, some of which are clear breaches of the CBA’s advertising guidelines:

Courtney 11 7 reasons colic asthma etc

On March 24 2015, TFC claimed that chiropractic care treats colic in infants. Unlike chiropractor Ian Rossborough, TFC show that they are aware of the definition of colic:

Courtney 10 colic 2014

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 any complaint about Trinity Family Chiropractic and its practitioners.

We look forward to meaningful action from the Chiropractic Board of Australia.

_________________________________

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

_____________________________________

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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6 Responses to Queensland chiropractor adjusted patient in Cairns Hospital intensive care unit

  1. Mick says:

    If ‘Dr Andrea’ was on noradrenaline, she must have been very, very sick indeed. the cognitive dissonance and pigheaded refusal to acknowledge facts is astounding.

    • Sue says:

      Indeed – she must have had septic shock – not just a throat infection. How anyone could imagine that ‘innate’ could heal the body from such a serious infection is astounding.

  2. Maggie Miller says:

    I’m going to give her a little credit…at least she did recognize that chiropractic and wishing water wouldn’t fix her illness, and went to the hospital – as well as doing the at-home IV meds afterwards. Sure, she had to give credit to the back-cracking. And at least she is trying to eat well and come back slowly.
    However, I can’t understand how the adjustments were done in the ICU, as here in the US, patients are under almost constant nurse observation (many of our ICUs are actually semi-circular so patients are always in view). Maybe that’s one reason we have that happening less often here, as far as I am aware.

    • Tom Gordon says:

      Agreed – I’m not sure how a patient on NorAd was left unsupervised for long enough that a Chiroquacktor could perform “adjustments”.

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