Australian Chiropractor Disciplined for
Recommending Excessive Services

Stephen Barrett, M.D.

The Supreme Court of South Australia has upheld a decision by the Chiropractors Board of South Australia that chiropractor George Michael Belle had engaged in unprofessional conduct in his management of a patient who had consulted him for back pain [1]. The evidence showed that Belle had treated her back pain for three visits but proposed a long-term "corrective care" program of neck care that was inappropriate because it was "insufficiently tailored to her individual circumstances and the number of treatments proposed in the intensive care adjustment schedule was excessive." The Court agreed:

The effect of the Board’s finding is that the appellant was not so much concerned with treating Mrs Hill’s low back pain in three to six treatments as with promoting the corrective care plan to cure her postural curvature by a régime of treatments requiring 88 visits at a cost of $2,692. . . . The appellant’s conduct was clearly unprofessional. There is no basis for disturbing this finding of the Board.

The Court also upheld the Board's conclusion that Belle had acted unprofessionally by making disparaging remarks about orthopedists and physical therapists [1].

Background History

Belle runs the Acacia Chiropractic Center at Morphett Vale, which is part of a 7-clinic chain called ChiroPartners Clinics. The group's Web site states:

Chiropractic is concerned with the relationship between your spine, your nervous system and your health.

Your nervous system controls and coordinates every function of your body. It is your nervous system that allows you to adapt to and live in your environment. A large portion of your nervous system passes through your spine. Your spinal cord acts as the major cable exiting your brain. It travels down the inside of your spinal column and branches off into spinal nerves from various levels of your spine. These spinal nerves then exit between individual spinal vertebrae and go to the various parts of your body.

To be healthy it is essential that your nervous system functions properly and is free from any interference caused by subluxations. Subluxations can cause interference to the nervous system at any point along the spine where the nerves exit. This can adversely affect the function of various parts of your body, and ultimately your health. . . .

Only a thorough Chiropractic examination like that performed at ChiroPartners clinics can thoroughly assess your nervous system for subluxation interference. Get yourself and your family checked today! [2]

The site further states:

Our examination procedures are geared toward detection and correction of the "Vertebral Subluxation." The procedures we use are specifically selected for your spine and nervous system health.

Your examination will consist of a thorough spinal and nervous system examination which includes 'orthopaedic' testing, side to side weight measuring and 'range of motion' assessment. With these procedures your ChiroPartners doctor can begin to detect areas of your spine that have become compromised by Vertebral Subluxation problems.

Your evaluation will also include a painless and non-invasive computerised examination called a Paraspinal Thermal Image Scan. This instrument detects minute differences in spinal temperatures from one side of the spine to the other.

Heat is a by-product of circulation, which is controlled by the autonomic nervous system. From this we can see how subluxation may be affecting these functions of your nervous system [3].

The prevailing scientific view is that thermal imaging (also called thermography) has no proven diagnostic value for spinal problems [4]. However, ChiroPartners claims otherwise:

Thermal imaging is a diagnostic test we use . . . to scan the tissues adjacent to your spine for differences in temperature (or infrared heat) from side to side. The difference is compared by a computer to pre-established normal values in the same way blood tests are. It is safe, painless and reliable and uses no radiation. Thermal imaging is unique because it displays a snapshot of how your nervous system is functioning. Because your nervous system is the master system of your body and changes in it can effect your health status, this examination provides critical information which is vital to your care.

We use this invaluable tool to give you the best and safest care possible. There are over 8000 research papers throughout the world which indicate that thermal imaging is a highly effective and reliable tool. What's more, thermal imaging has been found to detect the cause of many conditions which have eluded other diagnostic tests.

Because of the convenience and ease of use with thermal imaging, it allows us a fast and effective measure of your progress through Chiropractic care because we can easily re-assess your nervous system status through the course of your care and demonstrate to you the progress you are making. What's more, it's a great way to assess you on a maintenance basis to ensure that your chiropractic care and your lifestyle are giving your nervous system the best ongoing opportunity to function at it's peak and this means great ongoing health for you! [5]

Significance of the Case

The Supreme Court document provides considerable detail about Belle's management of the patient whose complaint triggered the chiropractic board action. The woman—a Mrs. Hill—was recruited as a patient at the Royal Adelaide Show, where she had undergone a thermal scan of her neck at the ChiroPartners' exhibit. She was then referred to Belle's clinic where she underwent further scanning. On the following day, she returned with her husband and was shown a videotape about "subluxation degeneration." A few days later, she returned again and was asked to sign a document called "Your Corrective Care Plan," which called 88 visits over the following 12 months. The proposed cost was $2,692, which was said to be less than the "normal" charge of $3,728. Hill said she was told that her health plan would be billed for the full amount even if she did not complete the proposed treatment. Instead of signing, she discussed the situation with a physiotherapist and complained to the chiropractic board.

"Subluxation degeneration" is one of several chiropractic concepts used to persuade patients to contract for lengthy treatment programs that supposedly prevent future trouble. I believe that (a) "subluxation degeneration" is a practice-building gimmick rather than a medically defined problem and (b) long-term contracts always involve unnecessary treatment. The percentage of chiropractors who use this approach is unknown but is probably between 10% and 20% worldwide. The Chiropractors Board of South Australia concluded that Belle's approach was inappropriate because it was not tailored to her individual circumstances. Public protection would be better if chiropractic boards would do more about common scare tactics, thermal imaging, and useless subluxation-based "corrective care."

I was unable to locate any information online about whether Belle was (or will be) penalized for what he did. The ChiroPartners Web site still lists him as practicing. He even ran for election to the chiropractic board (now called the Chiropractic & Osteopathy Board of South Australia), but came in last out of six candidates and did not get elected [6].

References

  1. Judgment of the honourble Justice Debelle. Belle v Chiropractors Board of SA. Supreme Court of South Australia, Aug 23, 2006.
  2. Chiropractic. ChiroPartners Web site, accessed Aug 29, 2006.
  3. The initial visit. ChiroPartners Web site, accessed Aug 29, 2006.
  4. Barrett S. A critical look at thermography. Chirobase Web site, Aug 24, 2006.
  5. Thermal imaging. ChiroPartners Web site, accessed Aug 29, 2006
  6. Martin PJ. 2006 election results: Election of four (4) members to the Chiropractic & Osteopathy Board of South Australia. Chiropractic Board of South Australia, June 20, 2006.

This page was revised on August 30, 2006.

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