Chiropocalypse, Book 2

By Phil Plait | March 2, 2010 3:30 pm

If you’ve been paying attention here the past few months, you already know that the British Chiropractic Association is suing Simon Singh because he dared tell the truth about them in a newspaper article.

After the BCA aimed, cocked, and shot themselves in the foot, a lot of collateral damage has taken place as well. You may remember what I called Chiropocalypse, where a lot of other UK chiropractors suddenly found themselves in hot water, making claims on their websites they couldn’t back up… and instead of backing up their claims with evidence, chose instead to take their sites down.

Well, it looks like those chickens have come home to roost. According to an article in the Guardian, one out of every four chiropractors in Britain is under investigation for false claims.

Let’s see, what are the words I’m looking for? Ah yes: this.

Even better, it looks like this happened because skeptics stepped up the pressure in direct response to the BCA suing Simon. This is basically a case of The Streisand Effect, and a happier outcome is hard to imagine. Unless, of course, that ratio rises to 100% of all chiropractors making false claims.

Tip o’ the herniated disk to Nigel Gomm.

Comments (38)

  1. mena

    Did the title of this post make anyone think of a Sci-Fi Channel “original” movie about a bunch of humans getting terrorized by huge numbers of bats? Just me then…? ;^)
    Good news though. It really does still amaze me that people will believe the weirdest stuff, sometimes the weirder the more they embrace it. Thank you skeptics!

  2. Egaeus

    Schadenfreude at its finest.

  3. NewEnglandBob

    mena, just you.

  4. bigjohn756

    This sounds like a case of severe cerebral subluxation has occurred in the chiropractic industry.

  5. Kryptik

    OT, unless you count the bending backward involved by the parties in question in the link, but…

    http://thinkprogress.org/2010/03/02/state-denier-resolutions/

    Science is losing in the US, and it’s losing big. And it’s scaring the crap out of me.

    (Oh, and long time lurker, first time commenter (I think), love your work, Phil!)

  6. And if you dig deeply enough (or not so deeply on some sites), chiropractors in the US make similar, unsubstantiated claims. And so I wonder, is there a way to put pressure on them as well, ya know, without being sued for libel?

  7. Gr8GooglyMoogly
  8. Brian

    Wow. This could be a seriously effect blow to the profession. The whole industry might well end up tacitly admitting, via their public actions, that Simon Singh’s “libel” was nothing more than the plain truth all along.

    @Nicole: Well, the UK folks appear to be taking advantage of a specific set of laws that may not have precise analogues in the US. But yeah, if we can do something similar here, we definitely should.

  9. Jennifer B. Phillips

    Mena, my first impulse was ‘bat attack’ as well, fwiw. TaxaGeeks unite!

    The actual topic was most satisfying, however. Between the homeopathy rulings, the Lancet and and GBH decisions, and now this, the motherland has been impressively rational of late. I do hope that soon manifests as complete exoneration for Simon Singh.

  10. OtherRob

    @Ron #5:

    Should that shirt say, “Doctor of Chiroquacktic”? :)

  11. Bunk

    Hahahaha, I love it! Oops, that’s mean, must be a schadenfreudean slip.

  12. The questions that come to mind are:

    1. Should it be legal to peddle the placebo effect?
    2. Is it possible to do so without lying?

  13. JupiterIsBig

    Phil, I agree with you on the out there claims for Chiropractic – like that it can’t cure colic.
    But I wince when you agressively write stuff like “Unless, of course, that ratio rises to 100% of all chiropractors making false claims.”
    As someone wrote somewhere – if the Chiro only claims that they can help to relieve back pain, then they are just doing physiotherapy and there claims are probably not “bogus”.
    Anecdotally, my back pain was helped by treatment by a chiro. She is my best mate’s mum.
    I could not agree with some of her other methods other than manipulation and I did find that swimming, stretching and massage was better.

  14. TMB

    As Jupiter alludes to, there’s a disconnect between those two ratios: you say one in four chiropractors is under investigation for making false claims, and then talk about how happy we’ll be if “that ratio rises to 100% of all chiropractors making false claims.” What we don’t know is what fraction of chiropractors make false claims – if it really is all of them, then yes you can compare those two numbers. If it isn’t, then you can’t (for example, if only 1 in 4 chiropractors makes false claims, then we’re *already* at 100%! At least, if they have the correct 1 in 4.). My naive guess with no evidence is around 1/2… but if anyone has any evidence of what this missing fraction is, it would help put this in perspective!

    [TMB]

  15. jcm

    Hurray!!!!!

    To the BCA:

  16. Sharkweek

    I’ve seen a TV ad for a chiropractor that has a duck for a mascot, which I figure is pretty honest advertising. They tell their customers they’re quacks right from the start.

  17. Autumn

    The problem with those saying, “well, some chiropractors don’t claim anything like the ‘quack’ chiropractors”, is that the term “chiropractor” is denoted by beliefs which are in error in almost every respect. If a massuese or physiologist calls themselves a chiropractor, then they invite the scorn of the informed just as much as they callously invite the dollars of the ignorant.
    If a well qualified surgeon claimed to practice “psychic surgery”, he would be doing a disservice to the actual craft he knew by calling it by the name of a fraudulent and laughable quackery.
    To all the “honest” chiropractors, stop it. Stop trying to bring in the extra buck by attaching your reputation to a malicious and stupid brand of snake oil. And also, stop over-using X-ray machines which you are probably not capable of understanding.

  18. MadScientist

    I still want to see changes to the law to admit the supremacy of truth as a defense in court. If someone is a liar or peddles woo-woo, the general public should have the right to say so without being harassed.

  19. G. Tingey

    Wait until the actual case comes to court – uness the BCA back down first.

    With things like Eady loose in the British legal system, it is still (unfortunately) possible for Simon Singh to lose.
    Our Libel law needs scrapping serious reform, right now!

  20. Can the BCA back out at this point? I was under the impression that it was past the point of no return. Or maybe that was just my hope.

  21. I’m reminded of this issue every time I buy gas for my truck; they have one of those ad and music services blaring over the speakers at the station near my work, and every other ad is for a local chiropractic office going on about how getting an alignment can boost your immune system and cure all sorts of completely implausible ailments. “Bring in the whole family for an alignment, and boost your resistance to diseases like the H1N1 flu! Your kids won’t have to get sick this winter!!”

    Irritates the sh*t out of me.

  22. TheBlackCat

    1. Should it be legal to peddle the placebo effect?

    No, because:

    2. Is it possible to do so without lying?

    No, by definition the placebo effect works when someone thinks they are getting a treatment when they really aren’t. This violates informed consent, a cornerstone of ethical medicine that requires doctors to explain what they are doing to patients and why, what the benefits and risks might be and what their chances are, and to let them make as well-informed decision as is possible. You can’t do that with the placebo effect because, by definition, it requires lying to the patient. And, although I am not a fan of slippery-slope arguments in general, I think in this case that is a line we should not cross.

    It is different in placebo-controlled studies because patients are told they might be getting a placebo or they might not and they must agree to that. They don’t know in their specific case what they are getting, but they do know there is a chance they might get a placebo. But that sort of thing is not allowed for patient care, and if a doctor told me I had a chance of getting real medicine and a chance of getting a sugar pill I would find another doctor. Besides, it would entail charging people the same for a sugar pill as real medicine because otherwise the patient would know that they are getting a placebo.

  23. ndt

    Plognark, depending where you are, that chiropractor might be breaking the law. The US has relatively strict laws about the claims healthcare practitioners can make. There is a loophole for dietary supplements, but I’m not aware of a loophole for chiropractors.

  24. Bababooey

    I don’t understand the problem. I know several people that have gone to chiropractors after car accidents and seem to think the guy fixed them up.

    I myself have not gone to one, but it seems like they provide a good service for people. I’m just very confused by this whole thing. LIke I said, seems like lots of people have been satisfied by seeing one of these guys.

  25. Ginger Yellow

    “The questions that come to mind are:

    1. Should it be legal to peddle the placebo effect?
    2. Is it possible to do so without lying?”

    The recent House of Commons select committee report on homeopathy discusses these questions in some detail. It’s well worth reading.

    Bababooey: The thing is, “chiropractic” means (at least) two things. The first is simply manipulation of the spine. As hinted at above, when chiropractors treat back pain they’re basically doing physiotherapy. Pretty much no skeptic/conventional doctor has a problem with that and there’s decent empirical evidence that it can help (as with other forms of physiotherapy). The other thing it means is a woo-based theory of illness centred on the concept of vertebral subluxation. Chiropractors espousing this theory claim that manipulating the spine can treat all sorts of conditions. This is where the problem is.

    Well, there’s also another problem: “I know several people that have gone to chiropractors after car accidents and seem to think the guy fixed them up.”

    As skeptics are fond of saying, the plural of anecdote is not data. But, in this instance, the data for back pain is pretty decent.

  26. amphiox

    I am reminded of the old saying about the glass houses and the throwing of stones. Or that one about the Frenchman and his cannon (aka petard).

    Singh could conceivable lose the libel case and end up winning the bigger cultural/social battle. If I recall correctly, on legal technicalities, the defense lost the Scopes trial.

    Yeah, the data for back pain is not bad. And frankly there is so much back pain (damn you, Sahelanthropus, whatever possessed you to think that walking on two legs was a good idea?) chiropractors could make a decent (and honest!) living on short term back pain treatment alone.

  27. Left_Wing_Fox

    @24: The placebo effect is a little more than just that though. It’s the psychological effect of the expectation of treatment. Studies on the placebo effect have shown that different placebos can be more or less effective than other placebos, based on color, delivery, presentation, taste, etc.

    To that end, I think it’s perfectly appropriate for doctors and drug companies to deliver the medicine in a way that maximizes the placebo effect for effective drugs or useful treatments. I agree that it’s a breech of ethics to prescribe a substance that relies solely on the placebo effect as a method of treatment.

  28. Disappointed, I thought the word you were looking for was schadenfreudilicious.

  29. Are you guys going to follow our lead? What’s the options for complaining against false claims in the US?

    Have you seen the UK’s General Chiropractic Council’s report on the evidence that Martin mentioned in the Guardian Article? If not, read my blog post giving its conclusions.

    I’m sure there will be a lot of bloggers and academics focussing on it over the coming weeks!

  30. Regarding the question about whether the BCA can back out now or if it’s past the point of no return, the answer is: they can back out at any time, but if they do then they pay. And while there is a chance that they’ll win, it is sadly in their best interests to stick to their guns now it’s gone this far. Think of it like this: they back out, they have essentially lost the case and have to deal with all the bad PR that comes with backing down, plus paying around £100k in costs. In otherwords, they’d be paying for their own loss and bad PR. That is not a smart move in most cases. The alternative is to take the chance that they’ll win, thereby gaining good PR (see, we told you it works, etc), and not losing any money at all. If they lose, they pay anyway, but this way it isn’t a guaranteed loss.

    Of course, the smart thing would have been not to sue. I believe the BCA is on the record as saying they never actually expected Simon to defend the suit.

    In the process they have annoyed their own members, too. Winning is their only chance of saving themselves at this stage, I believe. So yeah, I’d be staggered if they simply dropped the case. The only reason I can think of for them to do so would be intense pressure from their members, and although their members are grumbly, I don’t believe they are demanding the case be dropped. Apart from anything, it’s highly likely that many don’t believe their colic treatments are bogus at all. They do advertise them on their websites, after all.

    Note: I am not a lawyer.

  31. TheBlackCat

    The only reason I can think of for them to do so would be intense pressure from their members, and although their members are grumbly, I don’t believe they are demanding the case be dropped.

    The one thing you are not taking into account are lawyer’s fees. Continuing with the case may end up costing them more then just dropping it depending on how much their lawyers are charging.

  32. Ginger Yellow

    I’m pretty sure the BCA’s lawyers took the case on a contingent fee basis.

  33. I wish there were a national US body similar to the UK’s Advertising Standards Authority, to go after the quacks of all flavors that advertise “cures” or “helps” for this, that and the other. Unfortunately, there really isn’t.

    Some (not all) US chiropractors are using social media, such as Facebook and Twitter, to make such statements as:

    Chiropractic has been shown to reduce ADD/ADHD symptoms n kids and adults.

    No, it hasn’t, and no, it can’t.

  34. JupiterIsBig

    #26 @Bababooey “I don’t understand the problem. I know several people that have gone to chiropractors after car accidents and seem to think the guy fixed them up.”
    As I said it worked for me.
    I have friends who are physiotherapists – their favourite saying is “That’ll get better in two weeks with treatment, but it might take about 14 days withoug treatment”.
    IMHO Massage and attention are great for helping some sorts of pain. I don’t think it’s %100 placebo. I think it’s a combination of distraction, gentle manipulation, human attention (c.f. picking fleas) etc.

  35. Jay Fox

    For me, chiropractic has been a godsend due to two different drunks taking aim at my cars while I was in them.

    The cops do not seem to be interested in my ability to find impaired drivers.

    For the kind of back pain that I occasionally suffer from, chiropractic offers nearly immediate relief for the price of a single visit. When I go to an MD for the same pain, if they do anything at all it is prescribe expensive drugs that do not perform as well as chiropractic. They must be taken continually to dull the pain, and when they run out, the pain is still there, along with any withdrawal symptoms.

    Having said all that, I do not believe that chiro can prevent the flu or other disease by itself. To suggest otherwise is wishful thinking. But, here’s the thing. It has been shown that chronic pain can indeed suppress the immune system to the point that some ailments may then get a foothold. By managing pain or discomfort, one may improve their overall health condition. It’s pretty hard to maintain a positive attitude when it feels like someone stuck a shiv in your back. So chiropractic can, tangentially, improve overall health in some people.

    Will it work for everyone? Probably not. My own observations suggest that the great majority of chiropractors are frauds in it for the money. Some actually do more harm than good. Finding one that listens to your complaint and provides appropriate treatment is a lot of trial and error, mostly error. Stay away from the ones making outrageous claims and sift through the rest. There are good ones out there. Another personal observation is that the good ones usually come from the MD side and are multidisciplinary. They know conventional medicine well and are quick to steer you to an MD if something is out of their purview. Those chiropractors know their limits and do not make outrageous claims.

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