Its a bit premature for Zeno and GCC to write obituary of “Vertebral Subluxation”

lisabon2 On becoming a member of the GCC in 2007 one of the burning issues was the mechanistic definition of subluxation that the GCC had put on its website under FAQs. I had sent FAOI requests to the GCC because it did not make sense  that a GCC working group could come up with a definition for subluxation that was so meaningless.

One of the most experienced UK chiropractors Graeme Wight DC wrote directly to all chiropractic council members asking them to  change the FAQ: What is subluxation and is it dangerous?  and I investigated how they had arrived at such a pathetic definition. (see below).

The way the GCC defined the vertebral subluxation, no doubt has inspired the skeptics to mount their rocking horses again and make another mass complaint. Remember these complaints are a threat only because of the way the GCC has set up its complaints procedures and interpreted the chiropractic Act. Sceptics are also toying with the General Osteopathic Council who will not send these complaints to their PCC because they have a mechanism that allows them to dismiss vexatious complaints. Margaret Coats did not want to use the Osteopaths legal advice she paid a many coats-on-sun thousands of pounds to get a different legal opinion, one that stated any “case to answer” no matter how silly would go before the PCC. Make no mistake its not the skeptics who are attacking the chiropractic profession. They are just having a laugh making complaints, passing the bullets to GCC Chief Executive Margaret Coats who is firing them. 

Skeptics could care less about chiropractic or what we do, they are not interested in debate with CAM practitioners and would not be seen dead in a CAM clinic. This is a hobby, as when they  attempted  mass suicide on homeopathy remedies. CAM brings them together just they have anti CAM love in’s and I am sure they have a great time and I am not going to knock what turns on grown ups.

What has increased their pleasure factor is they now have a regulatory body who will listen to their stories and act on them. It must be like telephone sex with the lady in the bulb at the other end of the phone. The people who regulate acupuncture and homeopathy told them to piss off and get a life not Margaret.  Margaret is different she will act on any tip off use private investigators, wired patients, bully, intimidate people, whatever it takes. Defamation?? No ( after 18 months waiting the ICO have told the GCC to hand over the PI surveillance report on me and it is all in there.  It has always amused me how "Skeptics"  these "liberal humanists" are quiet happy to use this  Stazi style police force who put the fear of “God” in chiropractors as the instrument of their entertainment. It says more about them than any bullshit a CAM practitioner might say.

Skeptic Barista is putting together a credible case  with the help of the GCC as to why the Vertebral Subluxation is bogus. Apparently some people claim it causes all known diseases (if anyone has said that of course they should be locked up). Looking at the GCCs version of subluxation and how they explained it to Skeptic Barista  you can hardly blame him for thinking it was “Bogus” . They told him:  “The General Council has never considered the research evidence for the chiropractic vertebral subluxation complex” This is interesting because what they told me in a FOI in  2007  “The GCC subluxation was based on the WHO definition of subluxation and  “160 people, including experts and national authorities and professional and NGO’s, in over 54 countries” had reviewed this document prior to publication”. (However if this is untrue it woulf not be the first time the GCC has used FOI to misslead people.

Skeptic Barisa then explains how is letter  was distributed to members of the GCC’s Education Committee and discussed at their last meeting on 13 April and the failed to present any defence of the subluxation. Which is hardly surprising the GCC education commitee is chaired by physiotherapist Graham Pope his deputy is Medical Doctor Christopher Stephens, then you have 2 chiropractic skeptics Alan Breene and David Byfield  and Christina Cunliffe who goes the direction the wind blows.

However for Zeno to write the obituary of subluxation is premature to say the least. Clearly illustrated by his lack of insight into the chiropractic profession when he charges the poor old BCA of being "one of the guardians of the subluxation" . In fact the BCA and the GCC are praying for this complaint.

new GCC_edited-1 As Zeno will know the GCC wanted him to include non BCA chiropractors in his original complaint which would take the heat off the BCC. Their members were thinking of changing associations as they thought the BCA was a target. So for Skeptic information the BCA do not endorse the term Subluxation, in fact the BCA rejected the ACC paradigm because it included the word subluxation The president Mike Barber argued (badly) that there was not always neural involvement in a vertebral fixation and subluxation implied there was?? Neither do the GCC, or the AECC or WIC, endorse the term no doubt the McTims are about to advise all their members to stop using it and remove all their websites.

European Chiropractors like myself will continue to use the term and if by some miracle I am charged with fraud as the sceptics and the GCC would have you believe is possible, I will refer them to the World Health Organisations definition of chiropractic: The World Health Organisation defines Chiropractic as a “health care profession concerned with the diagnosis, treatment and prevention of
disorders of the neuromusculoskeletal system and the effects of these disorders on general health. There is an emphasis on manual techniques, including joint adjustment with a particular focus on subluxations”. Later it explains the subluxation as;A lesion or dysfunction in a joint or motion segment in which alignment, movement integrity and/or physiological function are altered, although contact between joint surfaces remains intact. It is essentially a functional entity, which may influence biomechanical and neural integrity. 

Subluxation theory as: A theoretical model and description of the motion segment dysfunction, which
incorporates the interaction of pathological changes in nerve, muscle, ligamentous,
vascular and connective tissue this has been taken from  Meridel Gatterman’s excellent book Foundations of Chiropractic – Subluxation which puts subluxation theory into its historical and contemporary context and presents the evidence that the theory is based on.

This latest complaint raises the question what name should chiropractors attach to “Spinal Joint dysfunction”  Skeptics recognise that over the years chiropractors have used over three hundred names to describe the “spinal leision” . I agree subluxation is a bit of a mouthfull, perhaps we should call it a Quack, or a Zeno, or name it after Simon Singh. Subluxation is a noun, for example, I might use the noun “God” in discussion even though I dont believe in God its just a word a name. Therefore if subluxation is the noun most chiropractors agree to name “spinal joint dysfunction”, there must be some physiological changes that occur when a joint is injured. Skeptics have information that some people believe it causes all know diseases however my understanding is it effects receptors in the spinal joint which connect to the central nervous system. Now if I am ill-informed I look forward to the sketics explaining what happens when a spinal joint is injured.

I would point out, I dont have a problem with the medical use of the term subluxation which is also a name for spinal join dysfunction” Any skeptic with a bit anatomical knowledge would know joints allow a measurable range of motion. At the very extreme range of movement the joint would be dislocated at the other extreme the joint would be fused (a complete loss of movement) . Chiropractors adjust joints that have a reduced range of movement, which may influence biomechanical and neural integrity. A

Vertabra To surmise: we  have the skeptics and the GCC defining something that  neither believe exists when it obviously does around the little red bits.

If it smells like a rose and looks like a rose it probably is a rose no matter what the GCC call it. The GCC education committee would like to call, joint dysfunction a “fixation”, I propose we call it a Zeno in honour of the man you may bring down the GCC and return the chiropractic profession to practicing under common law.

Anyway those interested in how the GCC came up with their explanation of the subluxation can read on.

On the 10th of July 2007 council members received the following communiqué from the GCCs chief executive Margaret Coats.

Dear colleagues

I understand that all chiropractic members of Council will have received direct from Dr Wight a copy of his letter of 5 July with regard to the content of answers to frequently asked questions on our website.  Attached for information is copy of my reply to his letter, from which you will see that this is an agenda item for September.  For avoidance of doubt, new members of Council will wish to note that standard protocol is that all correspondence on matters relating to the business of the GCC go via the office – members of Council do not provide individual responses.

Margaret

This was Coats way of telling us new members that chiropractic council members must know their place, and "standard protocol" (spin) comes from her office.She then wrote to Graham Wight

10 July 2007

Dear Dr Wight

I acknowledge receipt of your letter of 5 July 2007. On a point of accuracy, as I explained in my letter of 15 May, the wording of the answer to the frequently asked question What is subluxation and is it dangerous? was agreed by all members of Council on 1 May 2007.

Having said that, Council will be considering suggestions for change from the professional associations when it meets next on 5 September. I will ensure that your letter is included with the relevant agenda item.

Yours sincerely

Margaret Coats

Chief Executive & Registrar

 

Under normal circumstances this would seem reasonable to council members and have been left there. I knew how Margaret Coats operated and this was going to be my first excursion into what went on behind the scenes at GCC. Former council members had warned me about Coats and Dixon in words to the effect; “if you are going to roll in the mud with pigs remember they like it”.

To keep things under her control Coats has intercepted mail addressed to council members, this gave her the power to decide what lay council members needed to know and intimidate others. She could do little about mail sent to directly to chiropractic members, so she depended on a few chiropractic “rats” to keep her informed.

In response to Coats e-mail I sent the following e-mail to all council chiropractic members;

 From: Richard Lanigan
Sent: Tuesday, July 10, 2007 2:59 PM
To: Margaret Coats; Alan Breen; Christina Cunliffe; David Byfield; Graham Heale; Kalim Mehrabi; kevin Marisa Pinnock; Mark Cashley; Mike Kondracki; Peter Dixon Steve Williams

Subject: RE: Communication from Dr Wight

Dear colleagues,

Graeme Wight contacted me on this matter before I was elected on to council and I have corresponded with him on this matter a number of times prior to being elected. The correspondence prompted me to submit a Freedom of Information Request as to which “chiropractic” references were used to come up with the first explanation of subluxation put on the GCC website. There were no references to its origins.

The information I was given in theri response was that, “The GCC subluxation was based on the WHO definition of subluxation and  “160 people, including experts and national authorities and professional and NGO’s, in over 54 countries” had reviewed this document prior to publication.

 After getting a few responses I sent the following to the chiropractic members of council.

I was told that the working group never met to discuss the definition, they put their suggestions on a piece of paper and Margaret picked the one she like best; (David Byfield’s) Perhaps someone could tell us if the working group considered the WHO definition in their deliberations or was this an after though when the criticism came in. I believe “subluxation” was initially presented on the GCC web site as merely loss of joint moment without any reference to a WHO definition. How on earth was it messed up so badly, that all four associations are in agreement. 

Bearing in mind how often the PCC rejects overseas evidence because it is “not in the context of UK healthcare”  surely it makes sense to have UK chiropractors who use the term subluxation in practice, define subluxation theory for the UK public. Defined properly so “other health care professionals can understand”, it can even be used as a chiropractors diagnosis in notes and not contravene the COP.

 A member of the working group that defined the subluxation then responded.

I would like to fill in some of the gaps as best as I can remember although I have not kept complete notes.

This was always going to be a difficult area and so a "working party" was set up to offer suggestions for Q&A’s. This party never actually met. Each member sent in their proposals to Margaret by email who collated them and phoned round to individuals to discuss suggestions. From there the website was updated. Unfortunately the working group did not see a draft as I recall and as I say, never met to discuss matters. The question was raised at Council in response to Dr Wight’s passionate correspondence and there was some debate. A vote was taken and so the version on the website is our official Council one. To change this version would take another decision of Council. Part of the debate included the explanation that, "the term ‘subluxation’ doesn’t mean something that poses any danger to you." A suggestion made was that it could read "the term ‘subluxation’ doesn’t necessarily mean something that poses any danger to you. This was not adopted. I am not aware of there being any consideration of referenced alternative definitions by Council. Dr Wight referred to other definitions, such as the SCA definition, but I do not believe that any were brought before Council.

 On the basis of this, I spoke with a number of people who were on the “working group” and saw the correspondence between the working group. On the basis of this I was able to conclude the following.

 From: Richard Lanigan [mailto:richard@familychiropractic.co.uk]
Sent: 14 July 2007 15:02
To: Kevin Grant; Christina Cunliffe
Cc: Margaret Coats; Alan Breen; David Byfield; Graham Heale; Kalim Mehrabi; Marisa Pinnock; Mark Cashley; Mike Kondracki; Peter Dixon; drsteve.williams
Subject: RE: Communication from Dr Wight

The minutes of a meeting of the GCC recorded that a working group of chiropractors had been set up to answer “Frequently Asked Questions” for the GCC web site. One of the group’s responsibilities was to explain “The vertebral subluxation complex” and state if it was “dangerous”. This was the GCC version for public consumption.

The reality, as I understand it, was the “working group” never met to discuss the task, simply wrote some comments on a piece of paper and gave them to Margaret. Margaret then chose the one she liked best, and did not consult the group for feedback on her decision. Then when the GCC was criticised for her choice, someone decided to include the WHO definition without consulting the working group  who had been given the FAQ task in the first place.

If that is the case, the problem here is not the semantics of subluxation or the GCC definition, the problem is the due process that preceded it and the nonsense used to try and justify the process to registered chiropractors. Not one of the chiropractors I spoke to  thought the subluxation definition was decided by  a majority of those chiropractors on the “working group” and that’s why we pursued it. This is exactly why the profession and many patients have little confidence in the GCC, they do not trust the information coming out of head office.

Rather than waiting for “leaks”, I hope this time the GCC admit to Graham, et al. that mistakes were made and will be put right. Hopefully a “working group” with terms of reference will be set up who will consult with the 4 associations. And when they have made their decision on the FAQ’s, then and only then do they report back to Margaret for her to have the FAQs put on the website.

Does anyone have a better idea.

Richard

Coats response to council members was immediate.

The Chairman (Peter Dixon) has asked me to bring to your attention the following facts

· The General Council agreed that the working group would not need to meet but should communicate via email

· The office produced a first draft on which the working group commented

· The office produced a further draft which the Chairman signed off, as agreed by the General Council

· The first draft contained the WHO definition of subluxation, but it was removed on the ground that it might be too technical for the general public

· The General Council had commented on the WHO guidelines in December 2005 and at that time had no issue with the WHO definition of subluxation – its only notified concern to WHO was the specification of full-time education, whereas the Bologna Agreement encourages a wide range of flexible learning paths

· The answers to the FAQs will be on the agenda for 5 September, when Council will be considering correspondence from the professional associations

· There has been no problem of due process

Margaret

 Her explanation was not difficult to pull apart . Realising I was happy to confront her and was not intimidated by her, she started telling council members that my presence on council was causing her great stress and making her ill. Flagging the idea that she might sue the GCC for constructive dismissal if I was not brought under control. This is what I circulated it to all council members. My comments are the ones in bold.

Dear Margaret

I am afraid I am none the wiser.

The General Council agreed that the working group would not need to meet but should communicate via email. ( I have only seen one series of e-mails between three members of the working group, did the others not bother? Can I see the final comments sent in by the group members that you based the first draft on?)

• The office produced a first draft on which the working group commented

The office produced a further draft which the Chairman signed off, who were as agreed by the General Council ( Was this done without further consultation with the working group of “chiropractors” who were to develop the answers. Sorry to be pedantic but the council minutes state “Council AGREED that a working group should develop answers to the following frequently asked questions, to be signed off by the Chairman” Correct me if I am wrong, the working groups terms of reference were to develop, not just provide some “comment” for “The Office”?

The first draft contained the WHO definition of subluxation, but it was removed on the ground that it might be too technical for the general public (Subluxation theory is too technical for many chiropractors, however this hardly justifies using a definition that does not explain what subluxation chiropractors mean when they use the term, and not providing references for members of the public not cerebrally challenged.  The public is asking for direction and the GCC sends them somewhere else. Members of the public may be upset when the get there and find a “subluxation chiropractor” telling them that chronic spinal dysfunction will affect surrounding soft tissues adversely and could cause CNS symptoms.  Not to worry thousands of the GCC booklet “How to make a complaint” are freely available)

The General Council had commented on the WHO guidelines in December 2005 and at that time had no issue with the WHO definition of subluxation – its only notified concern to WHO was the specification of full-time education, whereas the Bologna Agreement encourages a wide range of flexible learning paths

The answers to the FAQs will be on the agenda for 5 September, when Council will be considering correspondence from the professional associations. ( The right way would have been to have consulted the associations before publishing the FAQ’s. Words like, door, bolted, and horse come to mind )

There has been no problem of due process

My mistake, there were no problems with GCC due process, Graeme Wight is just a grumpy old man after all those years in practice and there is no truth in the rumour that the profession and many chiropractic patients have little confidence in the GCC.

Those big birds that live in Australian, what are they called?

 Richard

  Coats did not respond, she got her poodle Peter Dixon (GCC chairman)to ask, Who I had been talking to. This type of intervention ended the discussion and would happen every time I developed a head of stem with Coats.

Dear Richard

I don’t think this type of e-mail correspondence is getting us anywhere. You will have the opportunity, of course, to express your views on this topic in the proper environment of the council meeting on September 5th, when the full context can be explored.

You have seen one series of e-mails you say. When did you see them? and can you forward them to me please?

Yours Peter

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