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Published in: Chiropractic & Manual Therapies 1/2019

Open Access 01-12-2019 | Research

At-risk advertising by Australian chiropractors and physiotherapists

Author: J. Keith Simpson

Published in: Chiropractic & Manual Therapies | Issue 1/2019

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Abstract

Background

Society expects professionals to promote their businesses in an ethical manner, refraining from misleading or deceptive marketing due to the potential to harm members of the community. In Australia this expectation resides in the Australian registration board advertising guidelines or the Health Practitioner Regulation National Law. Registration board data indicate there are many health care professionals failing to meet these expectations. The aims of this research were to determine the frequency, type and nature of at-risk advertising by Australian chiropractors and physiotherapists and whether there is a correlation between professional association membership and advertising guideline compliance.

Method

A cross sectional audit examining practitioner advertising was performed on representative samples of Australian chiropractors and physiotherapists. Two auditors examined advertising by 380 physiotherapists and 359 chiropractors for material potentially in breach of the regulatory authorities’ advertising guidelines. The advertising appeared on practitioner websites and linked Facebook pages.

Results

Two-hundred and fifty-eight (72%) audited chiropractors and 231 (61%) audited physiotherapists had breaches of the Advertising Guidelines on their websites and linked Facebook pages. The frequency of breaches by chiropractors was higher. The type and nature of the breaches by chiropractors was potentially more harmful. Membership in a professional association influenced neither the frequency nor the severity of breaches with chiropractors.

Discussion

Advertising breaches were common in both samples even though regulators and professional associations provide practitioners with explicit information on how to comply with advertising guidelines. Breaches by chiropractors were more numerous and more serious due to their greater potential to lead consumers to make inappropriate and potentially harmful healthcare decisions.
Stronger enforcement strategies may have a positive effect on compliance.
Footnotes
1
Where references were used on the website to substantiate claims, these were sourced, and the accuracy of the claims assessed.
 
2
Both the National Australian Physiotherapy Association and Western Australian APA State Branch were contacted by email and telephone requesting assistance by JKS. Neither would assist on member privacy grounds.
 
Literature
2.
go back to reference Millbank J, Luca KD, Lyell A, Alder G. Health care complaints commission v Limboro [2018] NSWCATOD 117. New South Wales: CBA; 2018. Millbank J, Luca KD, Lyell A, Alder G. Health care complaints commission v Limboro [2018] NSWCATOD 117. New South Wales: CBA; 2018.
5.
go back to reference CoA, Australian Consumer Law. Avoiding unfair business practices. A guide for small businesses and legal practitioners: Commonwealth of Australia; 2016. CoA, Australian Consumer Law. Avoiding unfair business practices. A guide for small businesses and legal practitioners: Commonwealth of Australia; 2016.
6.
go back to reference Taco Company of Australia Inc v Tact Bell Pry Ltd (1982) ATPR 40–303. 1982, Federal Court of Australia. Taco Company of Australia Inc v Tact Bell Pry Ltd (1982) ATPR 40–303. 1982, Federal Court of Australia.
7.
go back to reference Svantesson D. Some observations on the regulation of misleading or deceptive conduct. National Legal Eagle. 2007;13(1):17–20. Svantesson D. Some observations on the regulation of misleading or deceptive conduct. National Legal Eagle. 2007;13(1):17–20.
16.
go back to reference Ryan AT, San Too L, Bismark MM. Complaints about chiropractors, osteopaths, and physiotherapists: a retrospective cohort study of health, performance, and conduct concerns. Chiropr Man Ther. 2018;26(1):12.CrossRef Ryan AT, San Too L, Bismark MM. Complaints about chiropractors, osteopaths, and physiotherapists: a retrospective cohort study of health, performance, and conduct concerns. Chiropr Man Ther. 2018;26(1):12.CrossRef
18.
go back to reference Sibbritt D, Kaye M, Millbank J, Stuhmcke A, Wardle J, Karpin I. How are complementary health professions regulated in Australia? An examination of complementary health professions in the national registration and accreditation scheme. Complement Ther Med. 2018;37:6–12.CrossRef Sibbritt D, Kaye M, Millbank J, Stuhmcke A, Wardle J, Karpin I. How are complementary health professions regulated in Australia? An examination of complementary health professions in the national registration and accreditation scheme. Complement Ther Med. 2018;37:6–12.CrossRef
19.
go back to reference Spittal MJ, Bismark MM, Studdert DM. The PRONE score: an algorithm for predicting doctors’ risks of formal patient complaints using routinely 740 collected administrative data. BMJ Qual Saf. 2015;24.CrossRef Spittal MJ, Bismark MM, Studdert DM. The PRONE score: an algorithm for predicting doctors’ risks of formal patient complaints using routinely 740 collected administrative data. BMJ Qual Saf. 2015;24.CrossRef
22.
go back to reference Krejcie RV, Morgan DW. Determining sample size for research activities. Educ Psychol Meas. 1970;30(3):607–10.CrossRef Krejcie RV, Morgan DW. Determining sample size for research activities. Educ Psychol Meas. 1970;30(3):607–10.CrossRef
24.
go back to reference DoH. The National Health Workforce Dataset (NHWDS) PHYSIOTHERAPY 2016, D.o. Health, Editor. 2016. DoH. The National Health Workforce Dataset (NHWDS) PHYSIOTHERAPY 2016, D.o. Health, Editor. 2016.
25.
go back to reference DoH. The National Health Workforce Dataset (NHWDS) Chiropractor Practitioners 2016, D.o. Health, Editor. 2016. DoH. The National Health Workforce Dataset (NHWDS) Chiropractor Practitioners 2016, D.o. Health, Editor. 2016.
28.
go back to reference Grod J, Sikorski D, Keating J. Unsubstantiated claims in patient brochures from the largest state, provincial, and National Chiropractic Associations and research agencies. J Manip Physiol Ther. 2001;24:514–9.CrossRef Grod J, Sikorski D, Keating J. Unsubstantiated claims in patient brochures from the largest state, provincial, and National Chiropractic Associations and research agencies. J Manip Physiol Ther. 2001;24:514–9.CrossRef
29.
go back to reference Sikorski D, Grod J. The unsubstantiated web site claims of chiropractic colleges in Canada and the United States. J Chiropr Educ. 2003;17(2):113–9. Sikorski D, Grod J. The unsubstantiated web site claims of chiropractic colleges in Canada and the United States. J Chiropr Educ. 2003;17(2):113–9.
30.
go back to reference Ernst E, Gilbey A. Chiropractic claims in the English-speaking world. NZ Med J. 2010;123(1312):36–44. Ernst E, Gilbey A. Chiropractic claims in the English-speaking world. NZ Med J. 2010;123(1312):36–44.
31.
go back to reference Bismark M, Tibble H, Moore JS, Morris JM, Paterson R, Fletcher M, Studdert D. Selling falsehoods? A cross-sectional study of Canadian naturopathy, homeopathy, chiropractic and acupuncture clinic website claims relating to allergy and asthma. BMJ Open. 2016;6(12). Bismark M, Tibble H, Moore JS, Morris JM, Paterson R, Fletcher M, Studdert D. Selling falsehoods? A cross-sectional study of Canadian naturopathy, homeopathy, chiropractic and acupuncture clinic website claims relating to allergy and asthma. BMJ Open. 2016;6(12).
32.
go back to reference Wardwell WI. A marginal professional role: the chiropractor. Soc Forces. 1952;30:339–48.CrossRef Wardwell WI. A marginal professional role: the chiropractor. Soc Forces. 1952;30:339–48.CrossRef
33.
go back to reference Wardwell W. Chiropractors: challengers of medical domination. Res Sociol Health Care. 1981;2:207–50. Wardwell W. Chiropractors: challengers of medical domination. Res Sociol Health Care. 1981;2:207–50.
34.
go back to reference Wardwell WI. Chiropractic’s unique evolution and its future status. J Can Chiropr Assoc. 1996;40(1):34–9.PubMedCentral Wardwell WI. Chiropractic’s unique evolution and its future status. J Can Chiropr Assoc. 1996;40(1):34–9.PubMedCentral
35.
go back to reference Sternberg D. Boys in plight: a case study of chiropractic students confronting a medically-oriented society: New York: University; 1969. Sternberg D. Boys in plight: a case study of chiropractic students confronting a medically-oriented society: New York: University; 1969.
36.
go back to reference Smith-Cunnen S. A profession of One’s own. Organized Medicine’s opposition to chiropractic. Lanham: University Press of America; 1998. Smith-Cunnen S. A profession of One’s own. Organized Medicine’s opposition to chiropractic. Lanham: University Press of America; 1998.
37.
go back to reference Kaptchuk TJ, Eisenberg DM. Chiropractic: origins, controversies, and contributions. Arch Intern Med. 1998;158(20):2215–24.CrossRef Kaptchuk TJ, Eisenberg DM. Chiropractic: origins, controversies, and contributions. Arch Intern Med. 1998;158(20):2215–24.CrossRef
38.
go back to reference Meeker W, Haldeman S. Chiropractic: a profession at the crossroads of mainstream and alternative medicine. Ann Intern Med. 2002;136:216–27.CrossRef Meeker W, Haldeman S. Chiropractic: a profession at the crossroads of mainstream and alternative medicine. Ann Intern Med. 2002;136:216–27.CrossRef
39.
go back to reference Chapman-Smith D. The Chiropractic Profession. Its Education, Practice, Research and Future Directions. DeMoines: NCMIC Group Inc.; 2000. Chapman-Smith D. The Chiropractic Profession. Its Education, Practice, Research and Future Directions. DeMoines: NCMIC Group Inc.; 2000.
40.
go back to reference Simpson JK. The five eras of chiropractic & the future of chiropractic as seen through the eyes of a participant observer. Chiropr Man Therap. 2012;20(1). Simpson JK. The five eras of chiropractic & the future of chiropractic as seen through the eyes of a participant observer. Chiropr Man Therap. 2012;20(1).
41.
go back to reference Strahinjevich B, Simpson JK. The schism in chiropractic through the eyes of a 1st year chiropractic student. Chiropr Man Ther. 2018;26(1):2.CrossRef Strahinjevich B, Simpson JK. The schism in chiropractic through the eyes of a 1st year chiropractic student. Chiropr Man Ther. 2018;26(1):2.CrossRef
43.
go back to reference Cruess R, Cruess S. Expectations and obligations. Professionalism and medicine's social contract with society. Perspect Biol Med. 2008;51(4):579–98.CrossRef Cruess R, Cruess S. Expectations and obligations. Professionalism and medicine's social contract with society. Perspect Biol Med. 2008;51(4):579–98.CrossRef
44.
go back to reference Hawn C. Take two aspirin and tweet me in the morning: how twitter, Facebook, and other social media are reshaping health care. Health Aff. 2009;28(2):361–8.CrossRef Hawn C. Take two aspirin and tweet me in the morning: how twitter, Facebook, and other social media are reshaping health care. Health Aff. 2009;28(2):361–8.CrossRef
45.
go back to reference Gagnon K, Sabus C. Professionalism in a digital age: opportunities and considerations for using social media in health care. Phys Ther. 2015;95(3):406–14.CrossRef Gagnon K, Sabus C. Professionalism in a digital age: opportunities and considerations for using social media in health care. Phys Ther. 2015;95(3):406–14.CrossRef
46.
go back to reference Von Muhlen M, Ohno-Machado L. Reviewing social media use by clinicians. J Am Med Inform Assoc. 2012;19(5):777–81.CrossRef Von Muhlen M, Ohno-Machado L. Reviewing social media use by clinicians. J Am Med Inform Assoc. 2012;19(5):777–81.CrossRef
51.
go back to reference GlaxoSmithKline Australia Pty Ltd v Reckitt Benckiser (Australia) Pty Limited (No 2) [2018] FCA 1. 2018, Federal Court of Australia. GlaxoSmithKline Australia Pty Ltd v Reckitt Benckiser (Australia) Pty Limited (No 2) [2018] FCA 1. 2018, Federal Court of Australia.
52.
go back to reference Dabbs V, Lauretti WJ. A risk assessment of cervical manipulation vs. NSAIDs for the treatment of neck pain. J Manip Physiol Ther. 1995;18(8):530–6. Dabbs V, Lauretti WJ. A risk assessment of cervical manipulation vs. NSAIDs for the treatment of neck pain. J Manip Physiol Ther. 1995;18(8):530–6.
53.
go back to reference Dillin W, Uppal G. Analysis of medications used in the treatment of cervical disk degeneration. Orthop Clin North Am. 1992;23(3):421.PubMed Dillin W, Uppal G. Analysis of medications used in the treatment of cervical disk degeneration. Orthop Clin North Am. 1992;23(3):421.PubMed
54.
go back to reference Fallon JM. Chiropractic and pregnancy: a partnership for the future. ICA Int Rev Chiropr. 1990;46(6):39–42. Fallon JM. Chiropractic and pregnancy: a partnership for the future. ICA Int Rev Chiropr. 1990;46(6):39–42.
55.
go back to reference Fallon JM. The effect of chiropractic treatment on pregnancy and labour: a comprehensive study. Proceedings of the World Federation of Chiropractic. In: Proceedings of the World Federation of Chiropractic: World Federation of Chiropractic; 1991. p. 24–31. Fallon JM. The effect of chiropractic treatment on pregnancy and labour: a comprehensive study. Proceedings of the World Federation of Chiropractic. In: Proceedings of the World Federation of Chiropractic: World Federation of Chiropractic; 1991. p. 24–31.
56.
go back to reference Steel A, Adams J, Sibbritt D, Broom A, Frawley J, Gallois C. Relationship between complementary and alternative medicine use and incidence of adverse birth outcomes: an examination of a nationally representative sample of 1835 Australian women. Midwifery. 2014;30(12):1157–65.CrossRef Steel A, Adams J, Sibbritt D, Broom A, Frawley J, Gallois C. Relationship between complementary and alternative medicine use and incidence of adverse birth outcomes: an examination of a nationally representative sample of 1835 Australian women. Midwifery. 2014;30(12):1157–65.CrossRef
57.
go back to reference Winsor H. Sympathetic segmental disturbances II. The evidence of the association, in dissected cadavers, of visceral disease with vertebrae deformities of the same sympathetic segments. The Medical Times. 1921; 49(November):267–71. Winsor H. Sympathetic segmental disturbances II. The evidence of the association, in dissected cadavers, of visceral disease with vertebrae deformities of the same sympathetic segments. The Medical Times. 1921; 49(November):267–71.
Metadata
Title
At-risk advertising by Australian chiropractors and physiotherapists
Author
J. Keith Simpson
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Chiropractic & Manual Therapies / Issue 1/2019
Electronic ISSN: 2045-709X
DOI
https://doi.org/10.1186/s12998-019-0247-x

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