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A division in UK chiropractic

Professor Edzard Ernst explains why GPs should avoid referring patients to some chiropractors, but not others

Recently the GCC distanced themselves from the concept of subluxation (see my blog post of 10 June). Now the GCC has issued a reminder to UK chiropractors that:

• when practising, the care they “select and provide must be informed by the best available evidence, the preferences of the patient and the expertise of practitioners…”

• when advertising, claims for chiropractic care “…must be based on best research of the highest standard” only.

(GCC Guidance on Advertising, March 2010)1

Meanwhile on 8 September it was announced that the ‘Alliance of UK Chiropractors’ is about to be founded, apparently in protest at the above actions:

The United Chiropractic Association (UCA), Scottish Chiropractic Association (SCA), and McTimoney Chiropractic Association (MCA) have proposed the formation of an Alliance of UK Chiropractors (AUKC).

These organizations have affiliated to promote and protect the founding principles of chiropractic as a vitalistic drug-free profession based on the identification and reduction of vertebral subluxations.

This will be the largest coalition of chiropractors in the UK. In light of the recent events we have been reporting, the Foundation supports the AUKC in their plan to address current and emerging issues within the profession.2

To make matters really exciting the BCA is apparently seeking the right for its members to prescribe drugs:

…it has come to our attention that the British Chiropractic Association (BCA) members hope to obtain prescriptive rights for chiropractors from the Medicines Healthcare Regulatory Authority.

According to its website, ‘the BCA is the largest and longest established association for chiropractors in the UK and represents well in excess of 50 percent of internationally registered UK chiropractors’. Furthermore, they state that as the ‘largest and longest-standing association for chiropractors in the UK, [they] require the highest standards of education, training, and conduct from members’. There are factions of the profession whose actions will lead chiropractic to no longer be a drugless form of healthcare.3

And what does all of this mean for GPs? Actually, I am not quite sure.

It seems that UK chiropractic is heading for a division: the ‘fundamentalists’ are likely to adhere to the dogma of their founding fathers. Thus they might believe in the notion that ‘subluxations’ are the cause of all human diseases and treat them with spinal manipulation. GPs might want to think twice before referring patients to such practitioners.

The ‘mixers’ are likely to give up the concept of subluxation, become back specialists and might even prescribe drugs. This may not seem like a revolution to GPs but it would certainly be one for chiropractors who, until now, prided themselves on providing ‘drug-free’ treatments.

Professor Edzard Ernst is professor of complementary medicine at the Peninsula Medical School, University of Exeter

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