College urges GPs to stop referring to chiropractors

The RACGP is telling GPs to “seriously reconsider any support for chiropractic involvement in patient care”.

In a hardline stance, the college is also urging the Federal Government to scrap Medicare chronic disease management items for chiropractors.

There has been growing concern about paediatric chiropractic care, with 700 infants up to the age of four referred by GPs to chiropractors under Medicare last year.

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A further 2800 referrals were made for children between five and 14 years of age — an increase of around 130% since 2010.

Dr Evan Ackermann (pictured), chair of the RACGP expert committee on quality care, said: “Consistent with the general thrust of ensuring MBS expenditure having an evidence base, the Chronic Disease Management items for osteopathy and chiropractic should be removed.

“There is no evidence for chiropractic or osteopathy care in any chronic condition, let alone any chronic disease in children.

"The evidence base for chiropractic care in any condition is low quality, and arguably no better than placebo, with the harms being systematically downplayed.

"There are serious concerns about the claims and services provided by chiropractors, and the seeming ambivalence of the chiropractic board to take action regarding standards in the sector.

"For these reasons I would ask all GPs to seriously reconsider any support for chiropractic involvement in patient care."

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He told Australian Doctor that the private health industry also needed to be more consistent in its evidence-based funding of services.

The RACGP's call followed demands by the head of paediatrics at Royal Darwin Hospital, Dr Paul Bauert, that chiropractors should be banned from treating anyone under the age of 17 until the safety and efficacy in paediatric practice could be proven.

Dr Bauert told ABC’s Background Briefing last Sunday that current evidence supported the use of chiropractic in treating some back problems, “but all their other claims are beyond belief, and can carry a range of significant risks”.

According to the ABC program, the Chiropractors Association of Australia continues to run ads in its newsletter for chiropractic courses to treat colic and tongue-tie in babies despite the Chiropractic Board of Australia's recent edict that chiropractors refrain from promoting non-evidence-based treatments.

Melbourne spinal surgeon John Cunningham lodged a complaint to AHPRA in February, calling for the chiropractic board to be sacked for failing to sanction false advertising among its practitioners.

When presented with a YouTube video of a popular Melbourne chiropractor manipulating the spine of a four-day-old infant born two weeks premature, Dr Cunningham told the ABC: “There's not many things that make an orthopaedic surgeon emotional, but when you see a premature baby having its back cracked, it literally makes my eyes water.”

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More information:

ABC's Background Briefing program