“This letter is a follow-up to my email correspondence dated April 12, April 20 (two emails on the same day), and May 3. I had identified myself as a BC resident and client of chiropractic in the article I attached to my first email, and I again identified myself as such in the May 3 email. I find it most troubling that I have yet to receive even a simple acknowledgement from CCBC, much less being engaged in any kind of meaningful dialogue.”

 

July 1, 2020

 

All Board Members and Registrar
College of Chiropractors of BC
900-200 Granville Street
Vancouver, BC V6C 1S4

 

Via email

 

Dear Board Members and Registrar:

This letter is a follow-up to my email correspondence dated April 12, April 20 (two emails on the same day), and May 3. I had identified myself as a BC resident and client of chiropractic in the article I attached to my first email, and I again identified myself as such in the May 3 email. I have attached all four of those emails. Please ensure that all CCBC board members receive a copy of all of my correspondence to date, including this letter, for their response.

I find it most troubling that I have yet to receive even a simple acknowledgement from CCBC, much less being engaged in any kind of meaningful dialogue. Even the Ordre des chiropraticiens du Québec acknowledged my email and I have been significantly engaged by the College of Chiropractors of Ontario. Had I been complaining about a chiropractor, I would have received some sort of response by now. As I noted in my emails, ignoring a concerned client is not in the public interest. The CCBC’s website describes its function as ‘serving and protecting the public’. I am still waiting to be served and my interests are not being protected.

My concerns are purely about the regulation of chiropractic and of the way chiropractors are portrayed in the media, not about the chiropractors themselves. I have been told that investigations against chiropractors can go on for several months, sometimes only to determine that no misconduct took place. I would expect the same rigor to be applied to concerns regarding the College itself. Please consider this letter to be a complaint about the CCBC. I expect it to be thoroughly investigated. Note that I have copied this letter to the BC Minister of Health, to my MLA, and others. If part of the issue here is that CCBC is under undue constraints by the Health Ministry, that is a larger problem that needs to be addressed. Conversely, if the CCBC is overstepping its mandate, I would expect that the Ministry would intervene and take action to correct the CCBC’s regulatory approach.

 My initial correspondence had been in reference to a CBC news article from March 30, 2020 on complaints against Ontario chiropractors regarding the connection between chiropractic and immunity. I had asked specifically for a response from the regulatory boards regarding how they would address the fact that the link between chiropractic and immunity is not non-existent, yet chiropractors across the country are being censored and the public is not getting the full story.

More broadly, the matter concerns the censorship of all chiropractors in Canada. I had filed a complaint with the CBC Ombudsman and have since received a response from Paul Hambleton, Director of Journalistic Standards. Essentially, his response was that the news report would not be removed from their website because it was consistent with information received from chiropractic regulatory boards, including the CCBC. (See attached email exchange and please note all the literature I had attached to my response.) Shortly before the Ontario report aired, CBC had posted another story misrepresenting what BC chiropractors are saying about immunity, in much the same fashion as in the Ontario report: BC chiropractors warned about ‘inappropriate’ claims on COVID-19 . As with the Ontario report, the BC report is one-sided and does not give a detailed explanation as to how chiropractic can enhance immune system function, presumably because the CCBC does not allow chiropractors to talk about it.

Given that our national public broadcaster is relying largely on the regulatory boards for its information, it is greatly concerning that the boards should be taking such a punitive and restrictive approach to regulating the profession. I have attached an excellent article by Charles Blum published in the Asia-Pacific Chiropractic Journal that very effectively describes the controversy regarding the link between chiropractic and immunity. Note that Blum’s argument is very similar to what I have argued in my articles. I have also attached an academic paper by Johnson et al., reviewing studies regarding the connection between illness, the spinal cord, and chiropractic. Please read these – and everything else I have attached – with an open mind.

I have learned from a number of BC chiropractors that, not only are they not permitted to discuss any connection between chiropractic and immunity, but that the CCBC is restricting them from speaking to anything apart from musculo-skeletal matters and are forbidding them to talk even about the nervous system. That is baffling to me, since they manipulate the spine, which houses the spinal cord, and muscle movement is intimately connected with the nervous system. Manipulation of musculature will as a matter of course involve the nervous system. It is impossible to have an intelligent conversation about muscular function without referring to nerve function. I am very inquisitive and I ask more than the bare minimum. Assuming that clients would be satisfied with minimal information is very condescending and incorrect. It is also contrary to informed consent.

As I noted in my third article (Input for Ontario), I have received not only postural benefits through chiropractic, I have also derived benefits to my sleep, digestion, vocal function, and mental health through elimination of traumatic memories, as well as physical and emotional stress reduction. This is all far beyond simple musculo-skeletal issues, and very much involves the nervous system. I have also noted that a dearth of research does not mean that a treatment is ineffective. Where there is a gap in the research, input from clients on their experience and response to a given technique is invaluable in directing their own treatment. This doctor-patient dialogue is typically what I experience with the medical profession whether a treatment has been rigorously studied or not. It is up to me to decide whether I am willing to partake of any technique, whether scientifically tested or not. The CCBC’s current regulatory approach is eliminating my ability and right to choose my own health care and to be fully informed of my options.

A model of evidence-based practice includes best external evidence, individual clinical expertise, and patient values and expectations. The CCBC’s approach eliminates all but the best external evidence. I have a right to decide for myself what form of health care I want for myself and I know better than anyone what form of health care works best for me. As I noted in my third article, by far the best health care I have received has been from alternative health care, including chiropractic, and never mind whether the techniques have been ‘proven’ scientifically. That is of no relevance to me. I care about how it works for me. I liken scientific studies of alternative health care to movie reviews – some will love it, some will hate it, and some will be indifferent, but ultimately what is important is what I think about it and no number of negative movie reviews is going to dissuade me from watching a movie I want to see.

The potential harms through other forms of medicine are far beyond anything likely via chiropractic, yet they are not subject to such restrictions, requirements, nor censorship. I expect to be afforded the opportunity to decide for myself what kind of health care I will accept. In order to decide what I will or will not accept, I must also be afforded the opportunity to have a fulsome discussion with my trusted chiropractor, including having my questions answered to the best of his ability, and not being censored in what information he is permitted to convey. It is critical that I be allowed to benefit from the full scope of his knowledge, whether that be academic or practical experience, and whether extensive research has taken place or not. I can not ask about aspects I do not know about, and I do not know about successes he has had with other clients. Only through open dialogue can I learn about the possible treatments and techniques and their potential benefits, risks, or side effects. Only then can I give my informed consent.

I had considered putting in an application to participate on the CCBC’s Patient Relations Committee. However, I find it most unsatisfactory that the only input the CCBC is interested in via this committee is regarding sexual misconduct:

The purpose of the Patient Relations Committee is to ensure that registrants have a clear understanding of appropriate patient boundaries and to prevent misconduct of a sexual nature.

This mandate is woefully inadequate and results in the patients themselves being censored.

The mandate of the Patient Relations Committee should be to discuss anything that is of concern to the patients, rather than having the CCBC decide for them what should be of concern. I have received care from four BC chiropractors – three of them male – and have never had any concerns of a sexual nature. I am, however, most concerned about the ever-tightening noose that the CCBC is placing around BC chiropractors’ necks. It would be prudent for the CCBC’s Governance Committee to review this aspect of the CCBC’s operations and open up the Patient Relations Committee’s mandate.

 I note the following items listed on the CCBC’s website under the Patient’s charter of rights :

The College of Chiropractors of British Columbia believes chiropractic patients have the right to:

  1. be treated with courtesy, dignity and respect
  2. provide or refuse consent to treatment at any time
  3. participate in decisions regarding their chiropractic care
  4. receive clear information from the chiropractor providing care about:
    1. their diagnosis, prognosis and the proposed treatment plan
    2. other options for care
    3. any significant risks to the proposed treatment plan and other options
  5. receive ongoing, clear updates about their progress, and if appropriate, a referral or recommendation for alternate treatment

By consistently ignoring my correspondence, and by limiting the mandate of the Patient Relations Committee to matters of sexual misconduct, the CCBC is in violation of item 1. By limiting the matters that chiropractors may discuss with their clients, the CCBC is preventing clients from giving their informed consent and from making informed decisions about their treatment, which violates all of the above items. From my perspective as a client, these matters are far more alarming than disseminating information that may not have been scientifically tested or where research is limited. Let the client decide based on available information – that is, available from all sources and not just from refereed journals. That is informed consent. As well, where a patient is experiencing unexpected benefits, as I have, preventing a fulsome and informed discussion about matters that are beyond purely musculo-skeletal matters is not in the client’s best interest and again violates the Patient’s Charter of Rights.

I would like a thorough response to all of my correspondence and to these specific concerns:

Why has the CCBC not responded to my previous correspondence?

Why are chiropractors being limited in what they are allowed to discuss with clients?

Why are chiropractors being limited to giving only treatment that has been scientifically tested and shown to be effective when the same is not true of the medical profession?

Why are accepted standards of practice not sufficient, as they are with the medical profession?

What is the source of the negative bias against chiropractors?

Why is the input and experience of clients not accepted as relevant in determining the efficacy of their own personalized chiropractic treatment?

Why is the Patient Relations Committee’s mandate limited to sexual misconduct?

Would the CCBC consider expanding the Patient Relations Committee’s mandate to include any and all client concerns related to chiropractic, including the regulation of it? If not, why not?

I look forward to your timely response.

Sincerely,

Anita B., Burnaby BC

cc:

Honorable Adrian Dix, BC Minister of Health

Honorable Katrina Chen, MLA Burnaby-Lougheed

BC Chiropractic Association

Dr. Amy Robinson, Canadian National Association of Chiropractors

Alison Dantas, Chief Executive Officer, Canadian Chiropractic Association

Dr. Ayla Azad, Director of Professional Practice, Canadian Chiropractic Association

Tari Stork, Director of Public Affairs, Canadian Chiropractic Association

Robert Harris, Executive Director, Canadian Chiropractic Research Foundation

Paul Hambleton, CBC, Director of Journalistic Standards

Encl:

  1. Email dated April 12, 2020. Chiropractors and immunity – the scientific support the CBC, Armstrong, and Caulfield couldn’t find
  2. Email dated April 20, 2020. Re: Chiropractors and immunity – the scientific support the CBC, Armstrong, and Caulfield couldn’t find – UPDATE ON THE PERO STUDY AND CRITIQUE OF WFC REPORT
  3. Email dated April 20, 2020. Re: Chiropractors and immunity – the scientific support the CBC, Armstrong, and Caulfield couldn’t find – A DIFFERENT PERO STUDY FOR YOUR CONSIDERATION
  4. Email dated May 3, 2020. Re: Chiropractors and immunity – the scientific support the CBC, Armstrong, and Caulfield couldn’t find – INPUT FOR ONTARIO
  5. Email dated May 15, 2020. Re: CBC Response
  6. Blum C. Chiropractic and the Immune System: Disentangling Context and Looking at the Big Picture. Asia-Pac Chiropr J. 2020;1:001 DOI https://doi.org/10.46323/2021017 .
  7. Johnson D. et al. Biochemical & Endocrinological Changes Due to Neuropathologic States That Can Lead to Gentoxic Consequences: A Testable Hypothesis for Health Effects Induced by Spinal Pathomechanics. J. Philosophy, Principles & Practice of Chiropractic. Reprinted June 15, 2020.