The growing pains of osteopaths
Challenging misleading healthcare claims
|You are receiving this Newsletter because you have told us you wish to be kept informed of the activities of the Nightingale Collaboration. If you no longer wish to receive these Newsletters, please click on the link at the bottom of this email to unsubscribe. You can view it online here.|
The growing pains of osteopaths
The Advertising Standards Authority has today published new guidance on advertising claims made by osteopaths
Like all other advertisers, osteopaths have to comply with the ASA's CAP Code and the ASA/CAP publish specific guidance to help them — in addition to the more general guidance on health claims and their substantiation.
However, it seems that some osteopaths thought the CAP Code and guidance required some clarification.
Today, the ASA have published even more detailed guidance for those advertising osteopathy services.
This new document provides that clarity and further restricts the claims they can make about the use of osteopathy with pregnant women, children and babies, particularly non-musculoskeletal conditions such as colic and problems allegedly caused by 'birth trauma'.
A cursory glance at osteopaths' websites will find many such claims. See, for example, the results returned by this simple search for colic: osteopathy clinic site:.uk colic. This is a widespread problem.
The new guidance is yet another joint initiative by the ASA and the osteopaths' statutory regulator, the General Osteopathic Council (GOsC) to reign in their registrants and they have written to all 4,800 UK of them informing them of the new guidance and the consequences of failing to comply:
The GOsC and the osteopaths' trade body, the Institute of Osteopathy (IO) will be following this up with further communications and articles in various magazines and the GOsC will also be contacting the various osteopathy training organisations to make sure students are fully aware of their responsibilities. We hope that many students will ask questions of their tutors about why they are being taught something they are not allowed to advertise because of the lack of good evidence. Perhaps the GOsC should be asking themselves the same questions and revist their educational requirements.
There is a lot of work to be done by osteopaths.
For example, the Osteopathic Centre for Children — part of the Foundation for Paediatric Osteopathy whose tag line is "Paediatric osteopathy is the gold standard in holistic healthcare for children" — state:
In many ways these are mild claims; one osteopath's website more worryingly states:
What parent would not be distressed by such stark warnings and sign their new-born up for immediate (and life-long?) treatment?
Getting back the the ASA's new guidance on osteopathy, it states:
The Bronfort review was commissioned by the General Chiropractic Council (GCC) in 2009 after I submitted 523 complaints to the GCC about claims being made by chiropractors on their websites — the GCC needed the review because they didn't have a clue about the evidence for the claims their registrants had been making. It was little more than a quick literature review carried out by chiropractors in the US.
Even though Bronfort et al. considered all manner of treatments including reflexology, massage and chiropractic manipulations and not just osteopathic techniques specifically, it did look at various paediatric conditions. In terms of the non-musculoskeletal conditions, Bronfort identified a number of systematic reviews and additional RCTs for these conditions. None was positive for any treatment.
However, it only gave results for the treatment of manual therapies for musculoskeletal conditions for adults and is silent on pregnant women, children and babies, so it's quite a leap to extrapolate to those patient groups from adults.
The National Council for Osteopathic Research (NCOR), funded by osteopaths and the GOsC, is currently undertaking a systematic review of manual therapies in the treatment of children and babies. It'll be interesting to see what they finally publish.
Meanwhile, it seems that the ASA believe that osteopaths are trained to treat pregnant women, children and babies and that they should therefore be allowed to make claims about these patient groups, despite being no good evidence that osteopathy is effective for these conditions. This simply raises the question as to what they are being taught if there is no good evidence it is effective for those groups in the first place.
The question of dose response is not addressed either nor the potential for harm — particularly the many claims that it is 'safe and gentle'.
However, that only applies to musculoskeletal conditions: the new guidance prevents them from directly or indirectly referring to conditions such as colic, growing pains, excessive crying and those allegedly caused by 'birth trauma'. As we have shown above, these are frequent claims.
Because they are statutorily regulated, the ASA states osteopaths may:
The caveat of holding the necessary standard of evidence is important, but it is not clear to us why statutory regulation should confer any special privileges: whilst the Osteopaths Act 1993 does provide for a means of regulating some aspects, it's primarily a means of protecting the title 'osteopath', ensuring registrants are appropriately insured and that there's a code of conduct and a complaints procedure. Notably, the Act does not prescribe any scope of practice, nor proscribe any treatments. This leaves the public open to being misled.
The new guidance sets out four principles:
The principles don't say anything new, but the fourth one is important: osteopaths can claim to treat pregnant women, children and babies, but they can only do so in terms of the conditions listed above and it clearly states the conditions they should not claim to treat.
The guidance also gives some examples of claims that are likely and unlikely to be acceptable. The ASA, quite rightly, steer clear of saying outright what is and isn't acceptable: every claim has to be analysed individually in its proper context. We hope that osteopaths will take note of these carefully and not try to take advantage of any perceived equivocation.
It might take osteopaths a while to clean up their websites.
All in the head
The weakest point of the new guidance is what it permits to be claimed about cranial osteopathy/craniosacral technique. It is a frequent treatment of choice by osteopaths for babies and children. Prof Ernst describes it:
It's entirely fanciful, of course, but many osteopaths seem to believe it is effective for many childhood conditions and is seen by some as the 'bait and switch' used by some osteopaths to get new customers from a very early age.
But at least now they cannot claim that they can feel these movements nor that they can then manipulate the skull to alleviate anything.
This guidance is a great step forward. Osteopaths now have absolute clarity about what they can and cannot claim for pregnant women, children and babies and we hope to see speedy changes to websites.
We also welcome the actions taken by the General Osteopathic Council to ensure their registrants stop misleading the public and we hope they will follow through when they are made aware of non-compliant websites; we also hope they will be pro-active in this and not simply wait around for others to submit complaints.
We now hope the ASA and the General Chiropractic Council will now do the same for chiropractors — it is long overdue and, arguably, a much larger problem. The list of allowed chiropractic claims will be shorter, of course, and the list of unacceptable claims longer. Much longer.
02 December 2016
To be kept informed of our activities:
Subscribe to our News feed, either to your RSS reader or via email.
Follow us on Twitter.
If you know someone who might like to receive our Newsletters, please ask them to subscribe on our website.
Alan & Maria
Copyright © 2019 The Nightingale Collaboration. All Rights Reserved.
|To unsubscribe from this Newsletter, click here.
To change your subscription, click here.
- Yet another bad year for homeopathy
- Nelsons Homeopathic Pharmacy #3
- Nelsons Homeopathic Pharmacy #2
- The Society of Homeopaths: failing to make the case for homeopathy
- The end of homeopathy on the NHS in Bristol?
- NHS Homeopathy: 20 years of decline
- The different faces of the Society of Homeopaths
- The growing pains of osteopaths
- Diluting misleading claims - ASA update
- NHS homeopathy in Scotland - on a shoogly peg
- About The Nightingale Collaboration
- How to find out who owns a website
- Finding deleted and changed webpages
- Advertising Standards Authority
- How to submit a complaint to the ASA
- The decline of homeopathy on the NHS
- Landmark decisions for homeopaths
- Making a complaint
- NHS Lanarkshire to end referrals to Glasgow Homeopathic Hospital
- WDDTY #2 - The Second Wave