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The New Zealand Medical Journal

 Journal of the New Zealand Medical Association, 22-August-2008, Vol 121 No 1280

Chiropractic Board New Zealand response to "Dr Who?" editorial
Thank you for your invitation to respond to the editorial Dr Who? Inappropriate use of titles by some alternative “medicine” practitioners which appeared in the 25 July 2008 issue of the New Zealand Medical Journal.
The Chiropractic Board is a statutory authority with responsibility to protect the health and safety of the New Zealand public in the area of chiropractic under the provisions of the Health Practitioners Competence Assurance Act (2003), and it is from this perspective that the Board is concerned about the inaccuracies appearing in the article. The Board notes in particular:

Use of the term ‘doctor”

The article suggests widespread abuse of the title ‘doctor’ by chiropractors and others and uses the example of the Yellow Pages to emphasise this point. However, it should be noted that Chiropractors are permitted to use the title ‘doctor’ when this is suitably qualified to show that the title refers to their chiropractic role.
In addition, chiropractors are listed in the Yellow Pages under the heading ‘Chiropractors’ and it is clear they are not holding themselves out to be registered medical practitioners.
It should be noted that the Chiropractic Board is vigilant in its approach to the use of the title ‘doctor’ and publishes clear directions on the use of this terminology by members of the profession in its Code of Ethics and Standards of Practice as follows:
The use of the title ‘Doctor’ must be qualified, for example, John Doe, Dr of Chiropractic or Dr John Doe, Chiropractor. Failure to qualify the use of the title ‘Doctor’ may contravene the provisions of the Medical Practitioners Act 1995 and he or she may be committing an offence under that Act.
As an aside the Board notes that the protected title for medical doctors under the provisions of the Health Practitioners Competence Assurance Act (2003) is ‘medical practitioner’ not ‘doctor”.

Chiropractic qualifications

The article suggests that the qualifications of chiropractors are in some way spurious. However, it should be noted that outside the USA, the majority of institutions of Chiropractic education are in departments of universities, and some medical schools.

Emotive language

To mention one case of injury by a chiropractor before the Canadian courts and suggest that Chiropractors ‘kill’ people is highly emotive, sensationalist and misleading. 

‘Ruthless salesmanship’

The Board notes the concerns expressed in the article concerning ‘ruthless salesmanship’ by some members of the chiropractic profession, and the fact that there are practitioners who use techniques to ‘build high volume’ in their practices.
The Board shares some of these concerns and has previously been involved in High Court action to address this issue. It should be noted that similar action has been taken by the Victorian and South Australian Chiropractic Boards.
Based on the findings of the High Court the Board has introduced provisions in its Code of Ethics and Standards of Practice which include:
  1. A requirement that practitioners who recommend a patient pay an up-front lump sum payment for a predetermined length of care demonstrate acceptable clinical justification for this, and
  2. The requirement for a clear process of informed consent.
Thank you for this opportunity to respond to the article.
Karl Bale
Chiropractic Board New Zealand
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