Two accounts of one conversation

We have received some entertaining correspondence.

The recent 2014 Australian Skeptics National Convention has just been reviewed in the February issue of The Australian Chiropractor (TAC), the country’s leading chiropractic news and views report published by the Chiropractors’ Association of Australia.

Even though the magazine is not for distribution outside the chiropractic profession, someone kindly shared with us the contents of this review of our convention, presented in the form of a letter to the editor by Dr Michael Epstein (Chiropractor).

In his letter Epstein noted that his favourite part of the two day program was the consumer protection panel which featured Alan Kirkland, CEO of Choice; Delia Rickard, deputy chair of the Australian Competition and Consumer Commission; and three TV personalities from ABC TV’s The Checkout (including Julian Morrow). The panel was moderated by Michael Marshall of Merseyside Skeptics in the UK.

According to Epstein’s letter in TAC, he “jumped at the opportunity” to ask Alan Kirkland why the magazine portrays chiropractic as a pseudoscience. He believes that in response “the panel attacked” him, asking whether he was an ideological chiropractor.

Epstein also cited his alleged response, saying that it was in part scripted, and claimed that after he invited the panel to the research presentation at the upcoming International Conference on Spinal Manipulation, “the room went quiet.”

Because we had a slightly different memory of this discussion, we’ve had a look at an audio recording of the panel. Below is a transcript of how this little interaction took place:

……………

EPSTEIN: My name is Dr Epstein. I’m a chiropractor for 31 years, practising most of it here in Australia, member of one of the professions listed originally with the AHPRA – one of the original ten. My question is put to Alan [Kirkland] – why the consistent perpetual association of chiropractic with pseudoscience [some tittering from a small number of people in the audience] when our standard care is actually quite high and quite safe?

KIRKLAND: Yeah, that’s a very fair question and my throwaway comment was probably a bit cheap and ill-considered before. To accept we’ve had issues with chiropractors it’s not with the profession as a whole, it’s with a particular slice of the profession that makes claims that are less scientifically-based. When we’ve covered it in the past we’ve been quite balanced in terms of outlining where there’s evidence in favour of the positive benefits of chiropractic and how to work out what kind of chiropractor you might be seeing. So I apologise for slamming the entire profession.

MARSHALL: I’d just like to add to that. In terms of the chiropractic you practise, do you practise primarily for back and sports injuries or do you believe in the innate intelligence that Daniel David Palmer first came up with the chiropractic – that he was able to cure deafness with chiropractic. Which elements do you cover primarily in your practice?

EPSTEIN: [here you can compare this to the answer he cites in TAC]
The way I’d answer that is overall I find it unteniable [sic] for health concepts that existed prior to the understanding of antibiotics and human homeostasis to be promoted today as encapsulating the philosophy of chiropractic. How I practise is entirely evidence-based. I look at people’s bodies, I look at their spines and I take a thorough history and I work out if they have mechanical problems that need to be corrected. I basically say to people to define what I do as a chiropractor is I do my best to non-surgically realign the spine.

MARSHALL: But is this to deal with musculoskeletal injury or one of the things beyond that, because this is where the real distinction comes in. And you say it’s evidence-based, the interesting thing is if look at the majority of the peer-reviewed literature on it there’s not a real effect there, certainly not for the intelligence theory, and even if you look at lower back pain there’s only weak evidence for it. I think this is why there is a large degree of skepticism on chiropractic because the evidence hasn’t been there. But as soon as the evidence is there and it’s published and we can review it and check it, and it stands up, I think that’s when people will start following it a lot more.

EPSTEIN: Next week is the International Conference on Spinal Manipulation showing what is existing right now in our understanding of original case research and randomised control studies. Overall the majority of people that I see have musculoskeletal problems. However, it’s been observed from the beginning that people might come in with a spinal problem and as you work on realigning the spine non-surgically – and it can be done – you see other health ailments they present with they may not mention to you, seem to go away.
Many things haven’t been reported, many things are not as robust in their research protocols. However, overall the procedures are safe and one of the reasons why chiropractic got established as one of the original ten professions is not because the government wanted it, it’s because the people wanted it. And they were seeing they were getting results that they were not getting from other practitioners, medical and physiotherapy.

MARSHALL: I’d like to move on to other questions…

EPSTEIN: Sure.

MARSHALL: … but I’d actually genuinely love to be at that conference to see the messaging that’s there. But the fact that you’re saying that maybe the research isn’t robust yet, I think that that’s where people get off the train. Once the research is robust, then we follow it, but until that point, and I think it’s probably true of many of the things we’ve talked about and many of the areas that we look at as skeptics, I think we just have to wait until the evidence is robust and if it’s never robust then we have to….

EPSTEIN [interrupting]: What’s robust?

MORROW: I’m not talking necessarily about chiropractic here, but one of the things you see in a whole lot of areas is the infrastructure and architecture of professional respectability and authority is that it’s very easy to set-up. There are all sorts of associations of this and accreditations of that. You know there are international colleges of reiki and these sorts of thing. And they all ape the structures and messaging of authoritative bodies and that makes it very hard for citizens because you have to look past the first phase cues in making your decision.

……………

The discussion moved on from there, covering accreditation and other questions, and leaving the topic of chiropractic.

So there you have it. Dr Epstein was not attacked by the panel, and he did not silence the room with an invitation to the spinal manipulation conference – by and large, they listened in polite silence, and were quiet at the end because the discussion quickly moved on to other topics.

Just putting the record straight.
Kirkland-consumer-panel