Inappropriate chiropractic terminology

Inappropriate chiropractic terminology asks who may give a manipulation?

Or, more specifically, we may give a "chiropractic adjustment?" There are important issues at stake; it's not just a matter of the hubris that many of us in our profession exhibit.

Who can call him or herself a Chiropractor?

It's really all about who can call him or herself a chiropractor; or a surgeon for that matter. Can one after attending a short course of say a year claim to belong to one of these professions?

This is a research paper on the use of the term chiropractic manipulation by non-members of the profession.

Inappropriate terminology is disturbingly quite common and reflects badly on the profession.

In a recent 2009 case, a four month old baby suffocated in the Netherlands whilst being treated by a cranio sacral practitioner. Questions are being asked as to whether said person is registered with the association in the Netherlands, and whether he gave a recognised chiropractic manipulation?

He certainly is not registered with the NCA and at this stage it is unclear whether he is an unregistered chiropractor, or has absolutely no connection with the profession.

However the implication given in the press is that he may have given a "Chiropractic Manipulation".

So, who can call himself a Chiropractor? Surely nothing less than

1. A person who has duly passed all the requirements of an accredited Chiropractic institution, AND
2. who is registered with his national Chiropractic association, having to comply with all the demands of such a registration.

Anything less, in my book, falls short. Seriously lacking and can only lead to the use of further inappropriate Chiropractic terminology.

Who can give a "Chiropractic manipulation"?

Surely, only a fully qualified and registered chiropractor.

Can a physiotherapist give a chiropractic adjustment? Certainly not.

Can a cranio-sacral practitioner give a chiropractic adjustment? Only if s/he or he complies fully with the requirements of training and registration of the profession.

Can an ortho-manueel therapist, not unlike a physical therapist, medical doctor or orthopaedic surgeon give a chiropractic adjustment? Certainly not.

RESEARCH PAPER: Wenban A.B.

Inappropriate chiropractic terminology

Inappropriate chiropractic terminology reviews a research paper on the use of the words used in manipulative language.

The misuse of the title DC and term chiropractic manipulation, in relation to injury associated with cervical spine adjustment, have previously been reported in the peer reviewed literature. The objectives of this study were to ascertain the following.

1. Prospectively monitor the peer-reviewed literature for papers reporting an association between a chiropractic manipulation and injury.
2. Contact lead authors of papers that report such an association in order to determine the basis upon which the title chiropractor and/or term chiropractic manipulation was used;
3. Document the outcome of submission of letters to the editors of journals wherein the term chiropractic manipulation, had been misused and resulted in the over-reporting of an induced injury by a DC.

Methods

One electronic database (PubMed) was monitored prospectively for inappropriate chiropractic terminology, via monthly PubMed searches, during a 12 month period (June 2003 to May 2004). Once relevant papers were located, they were reviewed.

If the qualifications of the care providers were not apparent, an attempt was made to confirm them via direct e-mail communication with the principal researcher of each respective paper. A letter was then sent to the editor of each involved journal.

A total of twenty four different cases of inappropriate chiropractic terminology, spread across six separate publications, were located via the monthly PubMed searches. All twenty-four cases took place in one of two European countries.

The six publications consisted of four case reports, each containing one patient, one case series, involving twenty relevant cases, and a secondary report that pertained to yet more instances.

In each of the six publications the authors suggest the care provider was a chiropractor and that each patient received chiropractic manipulation of the cervical spine prior to developing symptoms suggestive of traumatic injury.

Regarding two of the four case reports contact with the principal researcher revealed that the care provider was not a DC, as defined by the World Federation of Chiropractic.

The authors of the other two case reports did not respond to my communications. Regarding the case series, which involved twenty relevant cases, the principal researcher conceded that the term chiropractor had been inappropriately used and that his case series did not relate to DCs who had undergone appropriate formal training.

The author of the secondary report, a British Medical Journal editor, conceded that he had misused the title chiropractor. Letters to editors were accepted and published by all four journals to which they were sent. To date one of the four journals has published a correction.

Conclusions

The results of this year-long prospective review of inappropriate chiropractic terminology suggests that the words chiropractor and chiropractic manipulation are often used inappropriately by European biomedical researchers when reporting apparent associations between cervical spine manipulation and symptoms suggestive of traumatic injury.

Furthermore, in those cases reported here, the spurious use of terminology seems to have passed through the peer-review process without correction.

Additionally, these findings provide further preliminary evidence, beyond that already provided by Terrett, that the inappropriate use of the title chiropractor and term manipulation may be a significant source of over-reporting of the link between the care provided by DCs and injury.

Finally, editors of peer-reviewed journals were amenable to publishing letters to editors, and to a lesser extent corrections, when authors had inappropriately used the title chiropractor and/or term chiropractic manipulation.