Osteopathy: Making a valid point…

Posted on July 31, 2011

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 Based on the information you provided, it appears you have a valid point !


In April this year I commented (Be Careful What You Wish For) on an article called ‘If the CAP fits’ that was published in the British Osteopathy Association Journal .  In this article, osteopathy Mary Monro expressed her the view that a lack of complaints to bodies like the Advertising Standards Agency was partly to blame for the limited range of conditions that the CAP codes allow osteopaths to claim to treat.

“We are told that the CAP code only allows us to mention a short list of possible conditions that we can claim to treat.  This is partly down to lack of evidence and partly down to a lack of complaints.   CAP almost never receive complaints about osteopaths’ advertising so (until very recently) they have no idea what we do.”

She also said that osteopaths should not restrict themselves to the CAP code list and that if they did the list would never get any bigger.

Online access to the article seemed to vanish shortly after I blogged about it, however a pdf copy of it was sent to me and is available here. Osteopathy Today April 2011pdf.

Although the General Osteopathic Council have already undertaken a mission to review members websites in order to highlight potentially misleading claims, many osteopaths were still making a variety of claims that I felt fell well short of the CAP codes.  So having read that article, I wondered just how many osteopaths shared Mary Monro’s view …… I decided it was time to find out!

I picked 11 websites belonging to either UK registered osteopaths or UK osteopathic organisations, all of them were making claims to use osteopathy to treat a range of conditions that were not authorised under the CAP codes.  All of these conditions would need robust evidence to substantiate the treatment.  ASA complaints were submitted for each of these sites.   Each of the complaint received a response from the ASA, many of them included the words:

Based on the information you provided, it appears you have a valid point, and with a view to acting quickly, we have instructed them to remove the claims you highlighted from their website.”

In some cases the ASA also found other claims that they considered to be “problematic” and these would also need to be removed.   In 3 of the cases the ASA decided to deal with the issues under their formal complaints procedure.  This means the advertiser would be formally asked to provide evidence to substantiate the claims, however any of the 11 osteopaths would have been able to defend their claims if they felt they could.

So exactly what treatment claims did the ASA decide would have to be removed in order to comply with the CAP codes:

“Colic, Asthma, Sleep disturbances, Glue ear, Flat head syndrome, Feeding difficulties, Screaming/irritability, Recurrent infections, Ear Infections, Sinus Problems, Headaches, Behavioural problems, Leaning difficulties, Irritable bowel syndrome, Period pain”.   Also included were    “Symptoms of Cerebral Palsy and other forms of Brain Damage in babies and children, Whiplash, Threatened Miscarriage  and  arthritis

Clearly some of these are serious medical conditions and are well beyond what most people would normally consider as treatable by a visit to an osteopath.

Some, like colic, are fairly benign although they can be distressing for both parent and child. These claims clearly target parents frustration and feed on the need to ‘do something‘ for their child.  Others like cerebral palsy target those who are vulnerable and suffering from long term and often incurable conditions.   Threatened miscarriage plays on the obvious fears for the health and welfare of an as yet unborn child, particularly if there is a history of problems during pregnancy.

It is also good to see Whiplash claims included in the list of conditions that the ASA had issues with.  A number of osteopathy sites were asked to remove this claim, many more are still making it!

I don’t intend to name all the sites or osteopaths involved, it is enough to say that none of them felt they had sufficient evidence to defend their claims and agreed to remove them from their websites when requested to by the ASA.    It is worth pointing out at this stage that all of these claims not only breached the CAP codes, but also the General Osteopathic Council Code of Practice.

Maybe I just picked the wrong osteopaths, because clearly none of them felt the urge to take up Mary Monro’s call to defend  their claims, present their evidence and thus increase the list of CAP permitted conditons.  All of them agreed to remove the website claims, that includes those involved in formal investigations.

However, I will highlight 3 organisations included in my complaints, partly because of the prominent position they play within (cranial) osteopathy in the UK, but mainly because there are still unresolved issues.  Whilst the individual clinics seem to have complied with the ASA’s advice, these organisations appear to need a little more encouragement!   

 The Sutherland Society.  One of the most popular cranial osteopathy website in the UK seemed to be the Sutherland Society.  Information and quotes from this site are common on UK cranial osteopathy websites and many provided links back to the Sutherland Society.

The list of conditions and claims on this site was comprehensive to say the least and included claims for cerebral palsy and brain damage, their main page also displayed a disclaimer that I questioned and the ASA had issues with, it has now been removed.  

The Sutherland Society was listed on the ASA’s webstite on 20 July 2011 – Here: Informally Resolved Cases.

However it seems not all the misleading claims have been removed –  ‘Pregnancy and Childbirth‘  ‘Babies and Children‘ and  ‘Learning Difficulties and Special Needs‘.  These are now back with the ASA.

The London School of Osteopathy (LSO clinic).  This is a London based osteopathy teaching body, who claim “Research is an integral part of the LSO course” – They also run a teaching clinic that made a number of claims that were the subject of my complaint.     I have no idea what the quality of that research is, but their clinic website could certainly do with some to back up the claims.  But they chose not to defend!

The London School of Osteopathy was listed on the ASA’s website on 22 June 2011- Here: Informally Resolved Cases.

As a part of this case the LSO clinic was asked to remove claims including Whiplash, and “symptoms of chronic conditions e.g. asthma, arthritis“. Despite being listed as ‘informally resolved’ those claims are present today ( 31 Jul 2011) and the ASA have been informed.

The Foundation for Paediatric Osteopathy /Osteopathic Centre for Children (FPO/OCC).   Since submitting my complaint about the FPO the site has undergone a change of identity.  What was the Foundation for Paediatric Osteopathy is now the Osteopathic Centre for Children (OCC).  Other than a name change, the OCC is essentially the same organisaion.  The FPO and OCC have the same Company number (2545759) and Charity number (1003934) and the OCC were repeating the same claims as the FPO site:

However, patients who visit us for treatment have presented with the following conditions: autism; gastric reflux; hyperactivity; behavioural difficulties; dyslexia; eczema; colic; glue ear; cerebral palsy; epilepsy; insomnia; asthma; hypersensitivity; headaches; back pain; diabetes; plagiocephaly and talipes. This list is not exhaustive.” 

On 15 June 1022, I was told that the ASA had spoken to the OCC and “discussed with them at some length the requirements of the CAP Code and the advice on medical conditions“.  The ASA sought and  received assurances that the FPO site had been withdrawn and that the OCC would consult, as a matter of urgency, with the Copy Advice team in order to make the OCC website CAP complaint.

The ASA also said that: (my bold emphasis)

“I think those assurances are sufficient to close this case without any further action. I have made FPO / OCC aware though that, should we receive further complaints about the same claims after they have had a reasonable amount of time to correct them, then we will pursue a more formal course of action.” 

Well a quick check today (31 July 2011) shows that the OCC website is still making many of the same misleading claims as the old FPO site.  The ‘patients presented with the following conditions’ argument is exactly the same as that challenged on the FPO site

“However, patients who visit us for treatment have presented with the following conditions: asthma; autism; back pain; behavioural difficulties; cerebral palsy; colic; diabetes; dyslexia; eczema; epilepsy; gastric reflux; glue ear; headaches; hyperactivity; hypersensitivity; insomnia; plagiocephaly and talipes. This list is not exhaustive.”

They also make suspect claims on a few other pages.

The OCC web page states that they offer 30,000 osteopathic treatments per year to babies, children, pregnant and post-partum mothers.  That’s a lot of treatments offered to vulnerable patients for some potentially serious conditions, so you would rightly expect them to hold good quality evidence to support these treatments.

I have no idea if the OCC actually contacted the Copy Advice team, or how long the ASA view as a ‘reasonable amount of time‘ for making changes, but these claims have now been sent back to the ASA.   The OCC may just remove these claims (I’ll let you know), but if they genuinely feel that they can they can justify offering  30,000 treatments per year for conditions like cerebral palsy, autism, diabetes and dyslexia then they should be prepared to present the evidence!

If the OCC have no evidence, then that makes the statement on their main web page even more worrying:

The Osteopathic Centre for Children (OCC) is a charitable organisation based in the UK that seeks to ensure that paediatric osteopathy – a gentle, effective and environmentally-friendly treatment – is established as the first option for parents and carers concerned for their child’s health.

The first option for anybody concerned about a child health should be a properly qualified medical doctor, not an organisation lacking evidence to support their exaggerated claims!

 

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Posted in: ASA, Osteopathy