General Chiropractic Council Hiring Staff to deal with Complaints

I have received a letter this morning from the GCC telling me about how my complaints are going. Unsurprisingly, they are finding the sheer volume rather difficult to cope with. I complained about four officers of the BCA for misrepresenting evidence.

The GCC Indicative Sanctions Guidance notes for the Professional Conduct Committee suggests that misrepresenting evidence is not looked kindly upon:

This term is used to describe a range of misconduct from presenting misleading information in publications to dishonesty in clinical trials. Such behaviour undermines the trust that both the public and the profession have in chiropractic as a science, regardless of whether this leads to direct harm of patients. Because it has the potential to have far reaching consequences, this type of dishonesty is particularly serious.

Others have made vast ‘omnibus’ complaints about chiropractors making misleading claims on their web site.

Well, the GCC has written to all the chiropractors concerned with the following letter:

10 July 2009

Dear XXXXX

TIMESCALE FOR lNVESTIGATION OF COMPLAINT AGAINST YOU

In a letter from the GCC dated 6 July 2009, you received preliminary notification of a complaint against you. That letter was not a formal notification under the provisions of the GCC’s Investigating Committee Rules (and nor is this letter).

No doubt you are aware that the GCC has received an unprecedented number of complaints in the last month or so – 590, as compared with an average of 40 per annum.

In these circumstances it will be necessary to increase our regulatory staff capacity before we issue formal notification of any complaints relating to chiropractic websites.

We anticipate that we will start issuing the relevant formal notifications in September 2009. They will not all be issued on the same date as we need to spread the workload both for staff and the Investigating Committee. I appreciate this is a stressful situation for you but I trust you will understand the reason for this timescale.

Please note that you don’t need to take any action in response to this letter, it is intended for information only.

Yours sincerely

Margaret Coats
Chief Executive & Registrar

Clearly, the GCC are taking this all very seriously. I would be very surprised if they did not. The GCC are bound to do so by law and have an overriding prerogative to protect the public. Last year, the GCC dropped its commitment to promote the profession as this was seen to be in conflict with its role in regulation.

It is a shame that things are being delayed. These issues need to be cleared up. I shall write some more soon about the possible future of the Chiropractic profession in the UK as a result of these extraordinary events.

On this theme…

19 Comments on General Chiropractic Council Hiring Staff to deal with Complaints

  1. It strikes me that they may be buying chiropractic some time with regard to the Singh case.

    Time is on their side more than on Simon's if they can hold off making rulings – after all, their investigations are likely to turn up some fairly flagrant abuses of evidence, so if they can delay it means less ammunition will be available for Singh's lawyers to use in demonstrating deliberate deception.

    Is there a date set for the next hearing?

  2. It might be tempting to see conspiracy at every step of the way here, but I will be slow in jumping to conclusions. The GCC's actions are consistent with them endeavouring to carry out their processes to their full extent – an act that will require a big ramp up in capacity and delays.

    It may be unfortunate that such a delay may well not help Simon. Frankly, I think Simon's case will follow its own course now.

  3. I agree that the GCC's actions are consistent with due process.

    My thoughts are more about the employees within the GCC who may be willing to stall over their own individual contributions to the investigation process. An organisation may not be part of a conspiracy, but that doesn't prevent its employees from seizing opportunities to swing a situation towards their own personal ends.

    I wouldn't be surprised if the September notifications start at the end of that month, with those those notifications that might contribute least to the case, with subsequent notifications trickling out over weeks (maybe months), where the most flagarant and dishonest dealings are reported last (because they need more thorough investigation of course).

    It would be interesting to see what the GCC are proposing as a work plan for dealing with their mountain of complaints – will it be structures in a way that will reduce this sort of thing?

    However, I think you are right about Simon's case – I am probably getting carried away based on anecdotal reports of conduct by the GCC so far.

  4. You know, if I was on the GCC, either as a lay or chiropractic member, I would be thinking quite hard about what sort of chiropractic profession is going to come out of the other side here.

    If the process looks fudged and poorly conducted then more and more damage will be done.

    And, if I was in one of the other 'professions' that is seeking statutory regulation, such as acupuncture and herbalism, I would be rethinking my whole approach.

  5. Hands up all those who think UK bloggers will fade silently into the background if the GCC ultimately screw this up while the BCA case continues (or if the BCA win)?

    Good luck to the lot of you.

    Personally, I imagine the cases against chiropractors will have little or no bearing on the case unless the BCA find the kitchen too hot and leave. In that respect, a dragged out GCC investigation will just extend the public scrutiny and pain for the profession.

  6. Good for you guys in the UK. I commend that you act according to your sense of duty by becoming involved!

    I recently sent a letter to the NZ chiropractors association and New Zealand Board of Chiropractors, but am still waiting for a reply. I've reproduced the letter that I sent at the end of this comment.

    Unfortunately, the last time I wrote about NZ chiropractors I got threatened with legal action (thanks to Professor Frank Frizelle for sorting that one out!) I might add that I am no Simon Singh – when my threat arrived I nearly fell over in shock and my blood pressure hit the roof! The time after that (my complaints to the NZ ASA) the NZCA complained to my Vice Chancellor that I was bring my University into disrepute by complaining about chiropractors! (The complaints weren't upheld, but were resolved by the chiropractors making changes to their websites.)

    Also of interest in NZ is that, very recently, there seems to have been a change on some NZ chiropractor's websites, whereby they now say something to the effect of "chiropractic is not a treatment for condition X, but a lot of people who have been to chiropractors seem to have found that condition X was cured after leaving their chiropractor". I'm no philosopher, but I suspect there's a name for that sort of logic.

    The letter to which I am patiently awaiting a reply, will follow in a later post (tried addiing it here, bu tthere seems to be a word limit).

    By the way, the Royal Commission’s 1979 report is worth a read sometime (as does the commentary publised shortly afterwards in the New Zeland Medical Journal). Chiropractors and their assocations from around the world quite often quote it in defence of chiropractic safety.

  7. It is true that "Last year, the GCC dropped its commitment to promote the profession as this was seen to be in conflict with its role in regulation" but they haven't stopped spending money doing it – they're still putting monthly half page ads in the British Journal of General Practice – see http://northerndoctor.com/2009/07/03/chiropractic-and-ethics-in-the-bjgp/

    So it seems to be more a removal of the appearance of a conflict of interest than a change in behaviour. The conflict of interest is embedded in the GCC's business plan, and the financial interests of all the chiropractors on its council.

    For handling the complaints, Zeno's omnibus complaint requests evidence for all claims on chiropratic web sites, not just the claims castigated by the ASA, and complains about the use of the term "Dr." If the GCC could get agreement to delay processing those, it could handle the more focussed complaints sooner.

    Leaving complaints lodged in June until September to commence processing is terrible complaint management. It may also interact with their request for a new Privy Council regilation modifying their complaints process – a) it will show the privy council 'the need' for the change b) the changes may take effect before these claims are processed, and may affect these claims, whereas if the claims were already being investigated, it changed regulations might need to be retrospective (stongly frowned upon) to affect them.

  8. Dear Sir,

    As a member of the NZ public, I am seeking clarification regarding the Chiropractic Board of New Zealand’s position on use of the title ‘Dr’ or ‘Doctor’ by NZ registered chiropractors who do not have a traditional doctoral degree (e.g., PhD, DSc, or D.Phil.), doctor of chiropractic degree (DC), or general medical qualification (e.g., MB ChB or MD).

    Following a number of complaints recently upheld by the United Kingdom Advertising Standards Authority, which on several occasions has ruled against the use of the title ‘Dr’ or ‘Doctor’ by chiropractors because it is deemed misleading, I have become concerned that the use of the title ‘Dr’ or ‘Doctor’ by New Zealand Chiropractors may mislead potential NZ clients into believing that chiropractors possess general medical qualifications and that all of their claimed treatments (e.g., for colic) are supported by best research evidence.

    I am aware of the following information from the 1979 Report of the Royal Commission into Chiropractic regarding use of the title of ‘Doctor’ by chiropractors:

    “We [the Royal Commission] are aware that the term “doctor of chiropractic” as distinct from the more modest term “chiropractor” has come to New Zealand from North America, where it has a cultural basis and a degree of traditional acceptance. As far as New Zealand is concerned we find the usage unnecessary and objectionable…” (p.184)

    “What we [the Royal Commission] do suggest is the terms “Dr” and “Doctor”, or “Doctor of Chiropractic” must not be used or displayed in any notice, sign, letterhead, or other material designed for public information” (p.269)

    “…chiropractors who are not registered medical practitioners be restricted in their use of the title ‘doctor’, and that some usages of the title by them be made illegal as well as providing grounds for disciplinary action” (p.315)

    I would also point out that the Health Practitioners Competence Assurance Act (2003) states that “a person may only use names, words, titles, initials, abbreviations, or descriptions stating or implying that the person is a health practitioner of a particular kind if the person is registered, and is qualified to be registered, as a health practitioner of that kind” (p.7).

    Although I personally believe that the intent of the Act is clear, the Medical Council News (2006) provided clarification by stating that practitioners of complementary and alternative medicine should not “do anything to suggest that he or she practices or is willing to practice medicine unless he or she is a medical practitioner and holds a current practising certificate” (p.5) and, “when the title ‘Dr’ is used in a health service provider environment, it is easy for the public to be misled and believe the person they are dealing with is a registered medical practitioner” (p.5).

    Given that that use of the title ‘Dr’ or ‘Doctor’ was clearly not encouraged by the Panel of the 1979 Royal Commission’s report (even with a disclaimer that a practitioner is a chiropractor), I am intrigued and concerned as to why the use of the title ‘Dr’ or Doctor’ by NZ chiropractors is now so commonplace and fiercely defended.

    I look forward to your response.

    Yours faithfully, etc

  9. Dear Sir,

    As a member of the NZ public, I am seeking clarification regarding the Chiropractic Board of New Zealand’s position on use of the title ‘Dr’ or ‘Doctor’ by NZ registered chiropractors who do not have a traditional doctoral degree (e.g., PhD, DSc, or D.Phil.), doctor of chiropractic degree (DC), or general medical qualification (e.g., MB ChB or MD).

    Following a number of complaints recently upheld by the United Kingdom Advertising Standards Authority, which on several occasions has ruled against the use of the title ‘Dr’ or ‘Doctor’ by chiropractors because it is deemed misleading, I have become concerned that the use of the title ‘Dr’ or ‘Doctor’ by New Zealand Chiropractors may mislead potential NZ clients into believing that chiropractors possess general medical qualifications and that all of their claimed treatments (e.g., for colic) are supported by best research evidence.

    I am aware of the following information from the 1979 Report of the Royal Commission into Chiropractic regarding use of the title of ‘Doctor’ by chiropractors:

    “We [the Royal Commission] are aware that the term “doctor of chiropractic” as distinct from the more modest term “chiropractor” has come to New Zealand from North America, where it has a cultural basis and a degree of traditional acceptance. As far as New Zealand is concerned we find the usage unnecessary and objectionable…” (p.184)

    “What we [the Royal Commission] do suggest is the terms “Dr” and “Doctor”, or “Doctor of Chiropractic” must not be used or displayed in any notice, sign, letterhead, or other material designed for public information” (p.269)

    “…chiropractors who are not registered medical practitioners be restricted in their use of the title ‘doctor’, and that some usages of the title by them be made illegal as well as providing grounds for disciplinary action” (p.315)

    I would also point out that the Health Practitioners Competence Assurance Act (2003) states that “a person may only use names, words, titles, initials, abbreviations, or descriptions stating or implying that the person is a health practitioner of a particular kind if the person is registered, and is qualified to be registered, as a health practitioner of that kind” (p.7).

    Although I personally believe that the intent of the Act is clear, the Medical Council News (2006) provided clarification by stating that practitioners of complementary and alternative medicine should not “do anything to suggest that he or she practices or is willing to practice medicine unless he or she is a medical practitioner and holds a current practising certificate” (p.5) and, “when the title ‘Dr’ is used in a health service provider environment, it is easy for the public to be misled and believe the person they are dealing with is a registered medical practitioner” (p.5).

    Given that that use of the title ‘Dr’ or ‘Doctor’ was clearly not encouraged by the Panel of the 1979 Royal Commission’s report (even with a disclaimer that a practitioner is a chiropractor), I am intrigued and concerned as to why the use of the title ‘Dr’ or Doctor’ by NZ chiropractors is now so commonplace and fiercely defended.

    I look forward to your response.

    Yours faithfully, etc

  10. It isn't just Chiropractors who are misusing the title 'Dr'. I was stood beside a local dental practice last week and noticed their nameplate. Four dentists, four doctors apparently, yet all just BDS. I know medical doctors are generally MB ChB not PhD or MD but dentists?

  11. I agree that this is consistent with due process.

    If the resource issue is genuine, then rushed invesitgations would concern me a lot more.

  12. Dentists in Australia and the U.K. also use the "Dr" title, by tradition. Neither dentists nor the public suppose that dentists can treat non-dental ailments, so there is no issue of overlap.
    [Disclosure: I come from a family with doctors, no dentists]

  13. I am waiting for the BMJ to be harangued for elitist medical protectionism by the alternative cults, their contrived 'education' operatives, practical business hustlers and duped customers.
    We must stop attaching the word – medicine – to alternative as this masquerades as a forged passport allowing the cults to illogically attempt entry to scientific territory and feed off the gullibility of those who, under the influence of listening to whales mating, confuse the natural coincidence of recovery and adaption with cash for cults.
    I am currently drafting a letter to my local FE college to question the inclusion of so many crystal dangling and toe-tickling courses they run (I can see the point of capital accumulation – but not based on utter guff in an educational institution that has ambitions to develop a HE profile and connections with established universities.
    re Peter in Dundee – I think US dentists call themselves Dr but that may be related to their qualifications?

  14. " Jack of Kent said…
    I agree that this is consistent with due process.

    If the resource issue is genuine, then rushed invesitgations would concern me a lot more."

    I think the resource issue is genuine, Jack. there are only two members of staff in the Fitness to Practice team at the GCC plus the Invesitgating Committee is currently only just quorate (5 members needed http://www.gcc-uk.org/files/link_file/The_GCC_(Constitution_of_the_Statutory_Committees)_Rules_Order_of_Council_2009.pdf [page 5], only 5 names on the list plus vacancies http://www.gcc-uk.org/page.cfm?page_id=9). And of course there will already be complaints in progress to be dealt with.

    I can imagine the workload – just the photocopying for each complaint to be cosidered at Investigating Committee must be a min 10 sets of papers and like legal files, some bundles will be several inches thick.

    Then the question of how many cases in a day can the Investigating Committee get through? If small, say 5 or 6 pages, maybe 10 mins each so poss 5 per hour = max 40 per day. By these calculations, it will take 15 days alone to consider the 590 individual complaints. Plus the time needed to draft charges for any that proceed to Professional Conduct Committee. I don't see any 'standard' charges listed in any of the GCC papers so it seems likely that each charge sheet is drafted on its own merits.

  15. I am quite happy to call my dentist doctor.

    At least he studied proper medicine at a proper university and is registered with a properly constituted medical authority – not a bunch of self seeking manipulative (any way you choose to interpret it) grasping quacks screwing the gullible with fantasy nonsense invented by a crooked charlatan who killed his father for the wonga.

    My dentist might only do gnashers, gums and gobs but the maxillo-facial consultant who operated on my jawbone last week does not do much more than that. Mind you, he is actually a doctor AND a dentist which is pretty impressive. Ironically he is called Mister !

  16. Andy,
    Processing of your complaint should not be affected.

    The letter specifically covers "complaints relating to chiropractic websites". Your complaint against Richard Brown & co. is not about websites, and should not be delayed. It would be very undesirable for the GCC to delay processing your complaint because the BCA officers are repeatedly publishing misleading articles in support of chiropratic, and any delay allows them to increase the amount of harm done.

    It may be worth contacting the GCC and running this argument past them.

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