Foundation for Paediatric Osteopathy Conference 2017: Osteopaths embracing quackery

quackeryThis weekend (8th and 9th April 2017) it’s the Foundation for Paediatric Osteopathy Conference. The osteopathy profession in the UK currently has major issues with many osteopaths making misleading claims about what they can treat in order to lure patients into their practices. I have previously highlighted that this problem also exists with some of the training being offered to osteopaths. The Foundation for Paediatric Osteopathy Conference seems to be taking this misleading training information to a whole new level. Talks at the conference include:

  • “Osteopathic Support of the Immune System in Infancy and Childhood”
  • “Special Aspects of Treating Unborn Babies”
  • “Vaccination – the Science”
  • “The Immunity Spiral – How being ill can make kids better”

You will notice that there is a focus in the above talks on medical care and treatments. In the UK, osteopaths are not licensed to practice medicine so they have no business doing anything to do with the immune system, vaccination decisions or, heaven forbid, treating unborn babies! All of these are things that should be handled by medical professionals and osteopaths shouldn’t be learning about them. With regards to the immune system, there is no evidence that any osteopathic treatment can help the immune system. “Osteopathic Support of the Immune System” is therefore a fallacy.

The talk about “Vaccination – the Science” is particularly interesting. It’s being given by Dr Jayne Donegan who, from her website, appears to be anti-vaccination. She is also a homeopath and recommends it for a range of different conditions including bruising and shock, burns and scalds and fever management. Homeopathy isn’t effective for any of these conditions, or anything else for that matter. She supports disgraced doctor Andrew Wakefield who wrongly claimed that the MMR vaccine can cause autism. Oh dear. Might this talk result in more osteopaths becoming anti-vaccination? That can’t be a good thing for the health of their patients or the public as a whole. After the talk, the Foundation for Paediatric Osteopathy posted this on twitter “Dr Jayne Donegan inspired us about how to treat acutely ill children, and boost immunity naturally”. It’s quite incredible that osteopaths are being offered training in treating acutely ill children. Acutely ill children need proper MEDICAL help from a DOCTOR not quackery from an osteopath. They certainly don’t need their immune system “boosting naturally”.

The Foundation for Paediatric Osteopathy has recently been the subject of a complaint to the Advertising Standards Authority due to making unsubstantiated claims about the effectiveness of osteopathic treatment for babies, children and pregnant mothers. This complaint was informally resolved after they updated their website. However, they still do not comply with the guidance and continue to make misleading claims. This includes suggesting that osteopathy can help babies “recover from delivery” and treat indigestion and heart-burn in pregnant mothers. There is simply no evidence to support osteopathic treatment in these situations. They also suggest that babies would benefit from an “osteopathic check-up”. Babies receive perfectly adequate checks in the hospital after they are born and are subsequently monitored by health visitors. Osteopathy has no place in this and osteopaths are not the right people to be carrying out checks on newborn babies. By suggesting otherwise, osteopaths are blatantly misleading parents. Through their conference, the Foundation for Paediatric Osteopathy are now providing training to other osteopaths in the very things that they shouldn’t be treating and therefore spreading this misleading information more widely. Other authors have written about how osteopathy is closely linked with pseudoscience. Conferences like this suggest that osteopathy is fully embracing quackery.

Osteopaths seem to be continuously trying to widen their scope of practice, presumably to increase their income. However, by trying to move into areas that they have no skills and for which their treatments are not effective they are putting their own income ahead of the needs of patients. This is a dangerous game and in the long-term can only be harmful to the reputation of the profession.

UK Health Centre: Misleading information about osteopathy, chiropractic, homeopathy and acupuncture all on one site

The UK Health Centre website says that it provides “Access to Health and Medical Information on the Internet”. However, this is not a site that just provides information. It has an appointment booking service and the focus seems to be primarily on providing information that encourages people to make bookings for private treatment. Unfortunately, the information is therefore somewhat biased and in some cases very misleading. Some of the information on the site is actually of a good quality and provides evidence based advice. One example of this would be the information on vaccines. The area where the advice is much more misleading is alternative medicine. This includes osteopathy, chiropractic, acupuncture, homeopathy and herbal remedies. Mixing this misleading information about alternative treatments with more accurate information about conventional medical treatments is likely to cause confusion for the general public and could result in them opting to take treatments that are completely unsuitable.

Osteopathy

The UK Health Centre website promotes osteopathy as a treatment for a wide range of medical conditions including:

  • Whiplash
  • Asthma and chest problems
  • Diabetes
  • Long term illness
  • Stress
  • Depression
  • Tiredness
  • Osteoporosis
  • IBS
  • Glue ear
  • Infections
  • Insomnia
  • Growing pains
  • Dysmenorrhoea (period pains)
  • Issues specifically related to pregnancy (such as morning sickness, wounds from childbirth)
  • Common infant problems (including colic, colds and teething pain)
  • Conditions arising from oxygen deprivation during birth
  • Monitoring baby’s growth and development
  • General poor health

Osteopathy has not been shown to be effective for any of these conditions and therefore advertising such treatments breaches advertising regulations. It is in conflict with the guidance provided by the General Osteopathic Council (regulatory body for osteopathy in the UK), the Advertising Standards Authority and the Committee of Advertising Practice (http://www.osteopathy.org.uk/news-and-resources/document-library/practice-guidance/gosc-asa-cap-letter-to-osteopaths/ and https://www.asa.org.uk/asset/44783612-C34B-4084-9B8A7036F01C43D7/ ). This misleading information could result in someone booking an appointment with an osteopath when their treatments are completely unsuitable. Some of the conditions on the list, such as asthma, are serious medical conditions that should only be handled by a suitably qualified MEDICAL professional and definitely not an osteopath.

Chiropractic

Although less outrageous than the treatment claims made for osteopathy, the information provided about chiropractic is also misleading. The site suggests that chiropractic treatment can improve the immune system, provide a solution to fertility problems and also to treat asthma. None of these claims can be substantiated and this information is therefore misleading. Elsewhere it says “The National Institute for Health and Clinical Excellence (NICE) support the use of chiropractic for treatment of acute lower back pain as they have analysed the results of studies that prove its effectiveness in this area.” Actually, the recent NICE guidelines have downgraded the role of chiropractic in treatment of low back pain due to a lack of evidence for its effectiveness.

Besides treatment for specific medical conditions, the site has other misleading information about chiropractic such as “It is considered most beneficial to undergo chiropractic treatments on a regular basis in order to prevent future damage to the skeleton.” Wow! There is no evidence to suggest that chiropractic is suitable as a preventative treatment. Furthermore, suggesting that not having such treatment might result in “future damage to the skeleton” is blatant and unsubstantiated scaremongering to try and get people to take treatments.

Interestingly, they do highlight risks of chiropractic: http://www.healthcentre.org.uk/chiropractors/chiropractors-safety.html . What’s rather puzzling is that the site doesn’t consider similar risks of osteopathy even though many of the same risks apply to both.

Acupuncture

The UK Health Centre website recommends acupuncture or acupressure for a range of different conditions including:

  • Tooth pain
  • Other pain
  • Muscle tightness
  • Nausea
  • Erectile dysfunction
  • Bronchitis
  • Anxiety
  • Stress
  • Drug use / alcoholism
  • Overeating
  • Fertility
  • Conditions during pregnancy including tiredness, anxiety, tenderness in the breasts, varicose veins, induction of labour, to correct foetal position

Acupuncture hasn’t been shown to be effective for any of these conditions and claiming otherwise is misleading. This also conflicts with the Advertising Standards Authority guidelines for acupuncture.

It then goes on to say that effectiveness of acupuncture for some conditions is in a “grey area”. Conditions that it puts into this category include depression, neck pain, stroke, sciatica, tinnitus, asthma, addictions (substance abuse). However, there is no such thing as a “grey area” in treatment effectiveness. Either a treatment has been proven to work or it hasn’t – in this case it hasn’t and suggesting otherwise is misleading.

Like osteopathy, some of the items on the list are serious medical conditions that should only be handled by a suitably qualified MEDICAL professional and definitely not treated with acupuncture.

Homeopathy

The site suggests that homeopathy is an effective treatment for hay fever (http://www.healthcentre.org.uk/allergies/hay-fever-homeopathy.html ) and snoring (http://www.healthcentre.org.uk/sleep-disorders/snoring-natural-alternative-homeopathic.html ). It then goes on to say that homeopathy is the most suitable treatment during pregnancy (http://www.healthcentre.org.uk/sleep-disorders/snoring-natural-alternative-homeopathic.html ). None of these claims are backed by any sort of evidence and are misleading the general public into potentially taking a treatment that is completely ineffective.

Herbal Remedies

The UK Health Centre website suggests that herbal remedies are effective for allergies, menopause, erectile dysfunction, skin tags and sleep problems. There is no evidence to back up these claims and they are therefore misleading the general public.

Actions Taken and Next Steps

I contacted UK Health Centre in November 2016 to ask them to amend the misleading content on their site. In the first instance I opted to focus on the content about osteopathy to see if they would be willing to correct their site. If they responded positively I then planned to tackle the other issues. Here is the e-mail I sent:

“I’m following up on the information provided about osteopathy on your website. A number of the claims made about osteopathy on your site do not have evidence to support them and are therefore misleading prospective patients and the general public. Furthermore, making these kinds of claims breaches advertising regulations and is in conflict with the guidance provided by the General Osteopathic Council (regulatory body for osteopathy in the UK), the Advertising Standards Authority and the Committee of Advertising Practice. See this link for the guidance they provided to osteopaths: http://www.osteopathy.org.uk/news-and-resources/document-library/practice-guidance/gosc-asa-cap-letter-to-osteopaths/ Many of the pages on your site breach these guidelines and provide misleading advice. This includes references to treatment for whiplash, asthma and chest problems, stress, depression, tiredness, osteoporosis, IBS, glue ear, infections, growing pains, common infant problems and “general poor health”. Furthermore, your site suggests that preventative osteopathic treatment is appropriate and that “osteopathy can provide health benefits to most people”. However, there is no evidence to support either of these claims and therefore your site is misleading prospective patients and the general public.

Could you please remove all of your misleading articles about osteopathy from your website or amend them to make it clear what osteopathy can / cannot actually treat? I look forward to hearing from you.”

I received no response so sent a follow up in December 2016. Again there was no response. The information they provide is misleading the general public and has the potential to cause people to take unsuitable treatments. As such, the information on this site represents a risk to the public. I have therefore reported UK Health Centre to the Advertising Standards Authority (ASA). It will be interesting to see the outcome of this.

NetDoctor: The medical advice website that recommends alternative medical treatments that have been shown not to work

The NetDoctor website provides online information and medical advice to patients. This includes medically focused articles and the opportunity to have specific questions answered by the NetDoctor team. NetDoctor subscribes to appropriate ethical guidelines including “Any claims relating to the benefits/performance of a specific treatment, commercial product or service will be supported by appropriate, balanced evidence.” However, some of the advice provided on the NetDoctor website is not evidence based and includes recommendations of “alternative” treatments that have been shown to be ineffective. Specific issues with the content of their site include:

  • Recommending treatments which do not have an evidence base or have been shown not to work. This includes osteopathy, chiropractic, acupuncture and homeopathy.
  • Sometimes providing an online diagnosis based on very little information.

I contacted NetDoctor about the misleading advice on their site. Whilst there are many articles that are misleading and lack an evidence base behind the recommendations being made, I opted to highlight just three of the worst offenders when contacting NetDoctor.

Here is the message I sent to NetDoctor on 20/09/16:

I think it’s great that patients have a resource like your website where they can go for independent medical information and advice. It is also good that you subscribe to appropriate ethical guidelines including “Any claims relating to the benefits/performance of a specific treatment, commercial product or service will be supported by appropriate, balanced evidence.” However, some of the articles on your website give advice that is not evidence based, does not follow the ethical guidelines and is therefore misleading to patients.

I’d like to highlight three specific articles that are amongst the most misleading. The first article
(http://www.netdoctor.co.uk/ask-the-expert/pregnancy-and-family/a10060/i-am-pregnant-what-can-i-do-to-stop-myself-feeling-sick-all-day/)
provides advice to someone who is feeling sick during pregnancy. Within this article, homeopathy and acupuncture are recommended. However, neither of these recommendations are evidence based. Homeopathy, for instance, has been repeatedly shown to be no more effective than placebo for any condition and is “scientifically implausible” (see http://www.publications.parliament.uk/pa/cm200910/cmselect/cmsctech/45/4502.htm) I therefore believe it is completely inappropriate for your website to recommend homeopathy as a treatment for sickness during pregnancy.

The second article
(http://www.netdoctor.co.uk/ask-the-expert/aches-and-pains/a2561/do-i-have-sciatica/
) includes an online diagnosis of sciatica and then goes on to recommend an osteopath because “they can treat this kind of problem quite successfully”. Firstly, from the very brief description of symptoms from the patient it would seem to be inappropriate to make a diagnosis (“you almost certainly have sciatica”). Furthermore, the NICE guidelines for sciatica recommend specifically against the use of spinal manipulation (such as that provided by an osteopath) and the recommended treatment is therefore not evidence based. It would surely be far more appropriate to refer the patient to their GP so that they can be given an actual diagnosis and an appropriate treatment.

The third article
(http://www.netdoctor.co.uk/ask-the-expert/brain-and-nervous-system/a304/homoeopathic-remedies-for-cerebral-palsy/)
advises a parent of a child with cerebral palsy to use homeopathy. As mentioned earlier, this has been repeatedly shown to be no more effective than placebo for any condition and is “scientifically implausible”. This advice is therefore not evidence based. There is the risk that parents of a child with cerebral palsy reading this may decide to pursue homeopathy treatment when other conventional treatments would be much more appropriate.

None of these articles comply with your own ethical guidelines, do not provide a balance, evidenced based view and are therefore misleading to patients. Could you please remove these and any similar articles from your website? I look forward to hearing from you.

Having heard nothing I sent a follow up on 19th October. To date, I’ve still had no response. It’s rather concerning that a site like NetDoctor is promoting treatments that are either unproven or have actually been shown not to work. It’s particularly disappointing that they are failing to comply with their own ethical guidelines and have not taken any action to address these problems when they were highlighted. This really brings into question the rest of the advice provided on the site.