Evidence-based care? Experts and patients question chiropractic industry


March 29, 2019 17:23:59

Rosemary Hawas was just 38 when she had a large part of her bowel removed.

Key points:

  • Kinesiology is not taught as part of a chiropractic degree
  • A random sample of Australian chiropractors by 7.30 found more than 20 per cent advertised kinesiology
  • A recent review for the federal government found there is no solid evidence kinesiology works.

“It’s all about my stomach now,” she said.

“I’m only working part time, because I always have this urge to go to the toilet.”

She had stage three bowel cancer and underwent radiation and chemotherapy.

Two and half years before her diagnosis, Ms Hawas went to see a newly-qualified chiropractor, Dr Robert Delac, about her gut problems, which included nausea, bloating and rectal bleeding.

As part of his assessment he used kinesiology, an alternative medicine practice which purports to detect what is wrong with the body by testing muscle responses when vials of liquid are placed on the body.

The practice, which is not taught as part of a chiropractic degree, appears to be relatively common amongst Australian chiropractors.

A random sample of 100 members of the Australian Chiropractic Association checked by 7.30 found more than 20 per cent also advertised kinesiology.

But a recent review for the Federal Government found there is not any solid evidence that it works.

“It’s mumbo-jumbo,” said John Cunningham, a Melbourne spinal surgeon and frequent commentator on chiropractic issues.

Evidence for treatments

The question of how much evidence there is for some treatments offered by chiropractors has been thrown into the spotlight since the video of chiropractor Dr Andrew Arnold dangling a baby upside down as part of a spinal adjustment went viral.

Victorian Health Minister Jenny Mikakos expressed her horror and ordered a review of all the evidence for infant spinal manipulation.

But according to some medical and legal experts, some treatments used by chiropractors are not held to the same level of evidence as other medical disciplines.

“There’s a double standard of health care in society I think these days,” Mr Cunningham said.

“On one hand we have medical practitioners who provide a very high standard of care, but then you have this other space of wellness, of health bloggers and dietary advisors and chiropractors who are simply never going to be held to the same standard.”

Shari Liby is a medical negligence lawyer for Maurice Blackburn representing Ms Hawas.

She wants to see the chiropractic regulator, the Chiropractic Board of Australia, take a more pro-active approach to ensuring evidence-based care.

“What we can see because of the frequency of calls we get [is] there needs to be much more robust oversight in chiropractic care,” she said.

Kinesiology question

Ms Hawas was treated by Dr Delac with kinesiology.

“Dr Delac [said] that I had a parasite, that I had a blastoparasite in my bowel,” Ms Hawas said.

He also diagnosed her with adrenal fatigue and food intolerances, and prescribed a series of herbal and homeopathic remedies.

“Dr Delac said it wouldn’t take overnight but it would take some time to fix it, but it will get fixed.”

But the chair of the Chiropractic Board of Australia, Dr Wayne Minter, says kinesiology is unable to accurately diagnose parasites.

“I would find that wouldn’t be plausible rationale,” he said. “That would be unacceptable.”

Dr Delac did not recommend any standard tests to confirm a parasite, including an endoscopy, faecal sample or blood tests.

He later told the Australian Health Practitioners Regulatory Authority (AHPRA) he was under the impression Ms Hawas was talking to her GP about the symptoms.

She was not, though she was speaking to her GP about other gastrointestinal problems including gastritis.

She told 7.30 that in her mind she was already being treated for her lower gut problems by Dr Delac.

Concerns for complimentary treatments

Medical doctors are concerned that the risk of treatments like kinesiology is that patients think their symptoms are being treated so do not follow up with medical doctors for a proper diagnosis.

Mr Cunningham said patients can be confused about the difference between medical doctors and other doctors.

“They’re still walking around with this title ‘Dr’, so when you have a doctor practicing kinesiology, why wouldn’t you think it’s legitimate?” he said.

But Dr Minter, chair of the Chiropractic Board of Australia, says patients must also bear some responsibility for telling all their treating practitioners of all their symptoms.

“Patients have responsibilities to fully inform their health practitioner of all their symptoms regardless of who they’re seeing,” he said.

Not speaking to her GP a decision Rose Hawas regrets

Ms Hawas regrets her decision to have her symptoms treated with kinesiology from a chiropractor rather than having her symptoms investigated by a medical doctor.

“Hindsight’s a great thing and looking back, exactly. I would have done exactly that,” she said.

“I’m not a professional and I didn’t know any better, and I’ve learned from it, big time.”

The Chiropractic Board of Australia cleared Dr Delac when Ms Hawas complained to AHPRA and it investigated.

The Board found there was no evidence Dr Delac had failed to appropriately refer Ms Hawas.

It found she was seen on multiple occasions by her GP for “other gastrointestinal issues” where she had made “no reports of rectal bleeding” and had only intermittent discussions about the bleeding with Dr Delac.

It noted that “Dr Delac did not refer her for further investigations due to being under the impression she was already being seen by various health practitioners.”

He declined an interview with 7.30 and did not respond to detailed questions, simply giving a statement saying he had been investigated and cleared.

When Dr Minter was asked by 7.30 whether the Chiropractic Board would look again at Rosemary Hawas’s case, he said it would.

Watch the story on 7.30









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1 Comment on "Evidence-based care? Experts and patients question chiropractic industry"

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