Australasian Science: Australia's authority on science since 1938

University challenged for giving undeserved credibility to alternative therapies

By Various signatories

Some of Australia's most prominent doctors, medical researchers and scientists have put their names to a letter criticising a university's decision to teach an alternative medicine course as if it were science.

Thirty four of Australia’s most prominent doctors, medical researchers and scientists have voiced their concern that the public are at risk of being misled about health treatments after another Australian university announced plans to teach an “alternative” medicine course as if it were science.

Doctors and scientists have written to Central Queensland University (CQU) criticising the university’s decision to train chiropractors, deploring what they see as a trend to offer courses in the sciences and health that are not supported by valid scientific evidence.

The signatories maintain that such initiatives diminish the academic reputation of participating institutes and Australian science as they give credibility to pseudoscience or blatant anti-science.

Prominent science writer and broadcaster, Professorial fellow Rob Morrison commented: “We want the public to be aware of the importance of the treatment they receive being based on scientific evidence. Alternative therapies may have a placebo effect, but wrapping them up as science and discussing them in the same way as treatments that pass rigorous efficacy and safety tests is harmful for everyone. When “alternative” practitioners claim that they can treat a range of serious illnesses as many alternative websites do, they need to be subjected to rigorous scientific scrutiny.”

Professor Marcello Costa from Flinders University said: “It is disturbing to see a centre of learning, of supposed excellence, teaching and perpetuating health practices based on beliefs in principles that are totally unscientific. It encourages the spread of quackery within the Australian health system, misuses the public’s health dollars, encourages unnecessary 'treatments' and may delay effective treatment when true disease is present.”

Professor John Dwyer, Emeritus Professor of Medicine at UNSW, added: “It is increasingly difficult to encourage patients to accept only evidence-based treatments for their problems when some universities and indeed private health insurers, provide unacceptable, often dangerous practices with undeserved credibility.”

Particular concerns about chiropractors
Among the concerns of the scientists and doctors is the claim of The Chiropractor’s Association of Australia that “innate intelligence” determines body wide health and that changes to spinal anatomy they call ‘subluxation’ interfere with the ‘guiding energy’ of innate intelligence. Chiropractic adjustments, they claim, can “cure 95% of what ails man.” (Singh S, Ernst E: Trick or Treat, The Truth about Chiropractic Therapy P 177. Bantam Press 2008.)

A statement released by the doctors and scientists asserts that the chiropractors’ claims are nonsense and non-science, better suited to the middle ages than the 21st century.

They are particularly concerned that the Chiropractors’ professions peak body, one of whose directors will head up the school at CQU, wants to see chiropractic become the major source of Primary Care in Australia.

Clinicians within the group are especially concerned that manipulation of the spines of babies and children is particularly disturbing, and that chiropractic paediatric websites claim that “adjustment” can help many potentially serious childhood conditions including “Fever, colic, croup, allergies, wheezing, poor posture, stomach-ache, hearing loss, headaches, asthma, bed-wetting, bronchitis, learning disorders, arthritis, poor concentration” and many other problems.

Professor Alastair MacLennan from the University of Adelaide emphasises that “While it was the announcement from CQU that triggered this collective decision to make our concerns public, the issue is much bigger than CQU’s chiropractic course and we condemn the ‘teaching’ of unproven beliefs such as homeopathy, naturopathy and iridology in public institutions. We are calling on all our academic colleagues in all universities to champion the primacy of scientific evidence in their courses and join us in helping the public avoid the truly “shonky” practices that are unfortunately still prominent in our communities. We need action from the Federal government to set high standards”.

The scientists list a number of concerns about chiropractic and other alternative therapies.

• They are not trying to stop the public accessing alternative therapists or unproven therapies but they want false claims about them to be policed effectively, and the public made aware about their lack of scientific evidence base.
• They approve of future well designed clinical trials of alternative therapies, and note the mostly negative results for such trials to date (e.g. Cochrane reviews).
• They advocate the stopping of federal funding to courses on unproven anti-science alternative medical therapies and urge that science–based universities stop giving their imprimatur to dubious health practices.
• They urge that health funds offer insurance plans that allow the public to opt out of paying for alternative therapies, and
• They urge that there should be greater government regulation of unproven claims for alternative therapies, both by therapists and for alternative medicines.

The Letter
To: - Professor Graham Pegg
Pro Vice Chancellor and Executive Dean
and
Professor Grant Stanley
Dean Medical and Applied Sciences

Central Queensland University
MACKAY, QLD.

November 30, 2011.

Dear Professors Pegg and Stanley,

We (the undersigned) are doctors, clinical and basic scientists and clinical academics who, in our professional lives have, in one-way or another, become involved in attempts to protect health care consumers from the dangers associated with unscientific clinical practices. In so doing we have shared with each other our concern about the increasing numbers of universities that are allowing non-evidence based “pseudo” disciplines to be offered to their students. It is difficult to counter the massive amount of misleading, often fraudulent, information provided to consumers through the media and Internet. The task becomes very much harder however when tertiary institutes give to unacceptable practices an undeserved imprimatur by including them among the courses they offer for study.

We have been prompted to write to you after learning of your plans to offer chiropractic studies next year. The reasons for our concerns are noted below however we plan to broadly distribute the letter we are sending to you in an effort to catalyse discussion among academics and learned colleges about the need for our universities to remain champions of rigorous academic standards. These surely must include recognition of the importance of the primacy of the evidence base for our conclusions and practices. We have no doubt that you will agree with this sentiment and thus, at the risk of sounding patronising, we wonder if you have had a chance to look in depth at the nonsense claims so many chiropractors make for their “discipline” among whom is your newly appointed head of chiropractic studies!

Some chiropractors limit their clinical activities to musculo-skeletal problems causing back pain and there is an evidence base for their manipulations being marginally effective though lasting results from manipulation are not common whether the practitioners are physiotherapists, “osteopaths” or chiropractors. But a practice limited to spinal area musculo-skeletal discomfort is not what modern chiropractic is all about.

Most chiropractors believe and teach that spinal area “adjustment” can be used to treat the vast majority of medical problems. This confidence is based on the theory generated by the founder of this non-science who claimed that “innate intelligence” which controls all normal bodily functions is contained within the spinal column. He equated this phenomenon of “guiding energy” with metaphysical and physiological health. Interference with the flow of this energy resulted from spinal cord “subluxation” and thus manipulating the spine could restore the flow and correct 95% of all man’s ailments.

This concept remains current among many chiropractors and to have it given credence by a university is surely inappropriate? The theory forms the basis for the chiropractor’s peak association’s efforts to constantly broaden the role of chiropractic in primary health care. Its “vision statement” is “To achieve a fundamental paradigm shift in healthcare direction where chiropractic is recognised as the most effective and cost efficient health regime of first choice that is readily accessible to all people”. The 2011 Annual report of the Chiropractors Association of Australia notes “We are in a unique position to be in the forefront of primary care and the natural leaders in prevention and wellness for Australia. Our intellectual property over the power of subluxation and its impact on health is well understood by the CAA. (http://caaannualreport.realviewtechnologies.com/?iid=53753). In 2010 they reported “after ten years of hard slog by the CAA every chiropractor in the country will be permitted under legislation to use the title doctor”!

Chiropractors constitute the largest “professional” group who are members of the Australian Anti-vaccination Network and it is the involvement of chiropractors in “adjustments” for children suffering from everything from Attention deficit to bed-wetting to Asthma etc. that is particularly disturbing to us. http://www.universalhealth.com.au/services/pdf/chiropractic_paediatric.pdf>.

Professor Ebrall supported this type of paediatric practice when he was at RMIT. We can supply you with much more information on chiropractic should you have further questions. We suggest you view the short video demonstrating adjustment techniques for adults and children which you can find at http://www.ccp-guidelines.org/ccp-video.htm It demonstrates why there have been so many complications reported to result from the technique. The literature contains details of more than 700 cases of serious complications following “adjustment”. (Singh S, Ernst E: Trick or Treat, The Truth about Chiropractic Therapy P 177. Bantam Press 2008.)

While your announcement has resulted in this letter we are in no way singling out CQU for criticism; our comments apply to all the universities that currently offer chiropractic studies. Our concerns are not limited to chiropractic but extend to all tertiary institutions that are involved in legitimising anti-science. It would be most regrettable to find that financial pressures may be tempting universities to betray their academic heritage.

Your chiropractic students may well be exposed to excellent courses in anatomy and some basic sciences. However the inclusion of subluxation theory as evidence-based reality is unacceptable and will damage your reputation for academic leadership. We appeal to you as fellow academics to reconsider your plans and engage with us in a dialogue and action plan that addresses throughout the tertiary education sector the issues raised here in. We would be pleased to discuss the contents of this letter with you should you so desire.

Yours sincerely

Professor John M Dwyer AO, PhD, FRACP, FRCPI, Doc Uni (Hon) ACU. Emeritus Professor of Medicine UNSW. Founder of the Australian Health Care Reform Alliance. Clinical consultant to the NSW Government’s Inter-Agency committee on Health Care fraud.

Prof Alastair H. MacLennan AO, MB, ChB, MD, FRCOG, FRANZCOG, Head of Discipline of Obstetrics & Gynaecology, School of Paediatrics & Reproductive Health, The Women's and Children's Hospital, The University of Adelaide

Prof Marcello Costa, FAA, Professor of Neurophysiology, Flinders University

Dr Steve Hambleton, MBBS FAMA, Federal President, Australian Medical Association

Prof Hatem Salem AM, MD,FRACP,FRCPA, Executive Director of the Australasian Society of Hemostasis and Thrombosis, Executive Director of the Australian Centre for Blood Diseases, Director of Haematology, The Alfred, Co-Head of Central Clinical School, Monash University

Emeritus Prof Michael Field, Sydney Medical School (Northern), Royal North Shore Hospital, The University of Sydney

Prof Ray Lowenthal AO, MBBS MD FRCP FRACP FAChPM Consultant clinical haematologist/medical oncologist, Royal Hobart Hospital Clinical Professor, University of Tasmania Member, Menzies Research Institute, University of Tasmania

Prof John J McNeil AM, MBBS, MSc, PhD, FRACP, FAFPH, Head, Monash University School of Public Health and Preventive Medicine, Alfred Hospital

Prof Robert Booy MBBS (Hons), MSc, MD, FRACP, FRCPCH, Head of Clinical Research, National Centre for Immunisation Research and Surveillance (NCIRS), Paediatrics & Child Health, Children's Hospital, Westmead, The University of Sydney

Prof Michael Abramson, Professor of Clinical Epidemiology & Deputy Head, Department of Epidemiology & Preventive Medicine Monash University, School of Public Health & Preventive Medicine, The Alfred

Professor Barry Brook, PhD, 2010 Community Science Educator of the Year award winner, Australian Research Council, Future Fellow, Sir Hubert Wilkins Chair of Climate Change, Director of Climate Science, The Environment Institute, School of Earth & Environmental Sciences, University of Adelaide

Prof Rachelle Buchbinder MBBS(Hons), MSc, PhD, FRACP, Director, Monash Department of Clinical Epidemiology at Cabrini Hospital; Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University

Prof Chris B Del Mar, MA MB BChir MD FRACGP FAFPHM, Professor of public health, Faculty of Health Sciences and Medicine, Bond University

A/Prof John Dixon, MBBS, PhD, FRACGP, DipRAGOG, Head of Obesity Research Unit at the Monash University School of Primary Health Care, Senior Clinical Scientist at the Baker IDI Heart & Diabetes Institute, Melbourne

A/Prof John Eden, MB BS MD FRCOG FRANZCOG CREI, Reproductive Endocrinology University of NSW, Director Barbara Gross Research Unit RHW, Director Sydney Menopause Centre RHW, Director Women’s Health and Research Institute of Australia

Dr Ken Harvey, MBBS FRCPA, Chair of the Governing Council of Health Action International, Asia Pacific (HAIAP), Latrobe University

A/Prof Hubertus PA Jersmann ,MBBS, MD, PhD, FRACP, Respiratory and Sleep Physician, Dept Thoracic Medicine, Royal Adelaide Hospital

Dr Robert H Loblay, MB BS, PhD, FRACP, Senior Lecturer in Immunology, Department of Medicine, University of Sydney, Director, Allergy Unit, Department of Clinical Immunology, Royal Prince Alfred Hospital

Loretta Marron BSc Assoc Dip (Bus) AAII MACS

Dr John McLennan, MBBS FRACP, Paediatrician, Royal Children's Hospital, Monash University
Clinical Professor Guy Marks MBBS PhD FRACP FAFPHM, Head of Respiratory and Environmental Epidemiology, Woolcock Institute of Medical Research, Sydney, Respiratory Physician, Liverpool Hospital

Prof Rob Morrison OAM, PhD, Professorial Fellow, School of Education, Flinders University
Prof Ian F. Musgrave, PhD, Senior Lecturer, Discipline of Pharmacology, School of Medical Sciences, Convener, Toxicology Special Interest Group, ASCEPT, University of Adelaide

A/Prof Hans Schneider, MD, FRACP, FRCPA, FACB, Director, Alfred Pathology Service, Monash University

A/Prof Ian Scott, MBBS, FRACP, MHA, MEd, Director of Internal Medicine and Clinical Epidemiology, Princess Alexandra Hospital, Brisbane; Associate Professor of Medicine, University of Queensland
Emeritus Prof Anthony J Smith, Clinical Pharmacology, Calvary Mater Hospital, University of Newcastle

Prof David L Vaux, BMedSci (Melb) MBBS (Melb) PhD (Melb) FAA. NHMRC Australia Fellow, Assistant Director, Walter and Eliza Hall Institute, University of Melbourne

Dr Michael Williams, MBBS, MMedSc, Consultant Paediatrician, Mackay

Signatories who wished to remain anonymous to the media:
Dr .... PhD, School of Medical Sciences, RMIT
Prof .... University of NSW
Prof ... Department of Medicine, Monash
Prof ...WCHRI
Prof ... University of Queensland
Prof ... University of Adelaide
Prof ...The University of New South Wales

In July/August 2011 Australasian Science published an article criticising RMIT's paediatric chiropractic clinic, which was headed by Professor Phillip Ebrall. See http://www.australasianscience.com.au/article/issue-julyaugust-2011/chir...