ASA Adjudication on Wigan Family Chiropractic Clinic

Ad

A magazine ad, for the Wigan Family Chiropractic Clinic, was headed "ASK your chiropractor ... This month our spotlight is on low back and neck pain. If you have been suffering, even if for many years, then please feel free to ring our clinic for a friendly informal chat with one of our team of Doctors on 019XXX, who will be able to help you further". Below, text stated "Why would I go to a Chiropractor? If you have a back or neck problem then it makes sense to see [sic] Doctor of Chiropractic as they specialise in treating the spine, as well as the rest of the body. Chiropractic is quite simply the best way to treat most spinal problems causing neck and back pain ... What do Chiropractors treat? When it comes to treating your spine, our Doctors specialise in successfully treating a wide range of problems, including: most types of neck and back pain, spondylosis, spondylitis, degenerative disc disease and so-called slipped discs (all essentially meaning spinal 'wear and tear'), spondylolisthesis, spinal stenosis and trapped nerves (i.e. sciatica and carpal tunnel syndrome). Our Doctors successfully treat most causes of neck or back pain. Who can a Chiropractor treat? Our Doctors are well experienced in treating everyone ...You do not need to be referred by anybody to see one of our Doctors ... What happens when I get treated? ... Only a Doctor of Chiropractic is trained and qualified to give you an adjustment ...". Under the heading "ASK our patients", text stated "WHIPLASH Suzi Williamson came to our clinic in severe pain after a car accident. She was treated by Dr Mike Paull; What problem(s) first brought you into our clinic? 'Chronic pain down my neck and shoulders, constant heaviness and uncomfortable feelings ...' LOW BACK PAIN Nicol Carden-McVann, came to our clinic a few months ago with severe low back pain that had been affecting her for seven years before seeing Dr Trevor Crump. What problem(s) first brought you into our clinic? 'Extreme pain in my lower back and hips.' How have you found the treatment and how has it benefited you? 'The pain has gone completely and I have now been able to go back to the gym.' ... If you would like your back or neck problem diagnosed and successfully treated by one of our Doctors, please feel free to ring us ...".

Issue

A chartered physiotherapist challenged whether:

1. the claim "Chiropractic is quite simply the best way to treat most spinal problems causing neck and back pain" could be substantiated;

2. the claim "Only a Doctor of Chiropractic is trained and qualified to give an adjustment" could be substantiated; and

3. the references to "Doctors" and "Dr" implied that the chiropractors were medically qualified.

The ASA challenged whether:

4. the testimonials misleadingly implied chiropractic had been proven to be effective for treating whiplash and chronic pain.

CAP Code

Response

1. Wigan Family Chiropractic Clinic (WFCC) said the claim "Chiropractic is quite simply the best way to treat most spinal problems causing neck and back pain" was a reference to "most" spinal problems and sent the ASA an abstract of a research study, which they believed substantiated the claim.

2. WFCC said the term "adjustment" tended to be used uniquely by Chiropractors as it implied a specific Chiropractic procedure as opposed to the more generalised manipulation used by Physiotherapists.  They said there were also a number of Chiropractic adjustments, which were only practiced within the Chiropractic profession, such as the Thompson terminal point technique and the Gonstead technique.  Nonetheless, they said the claim "Only a Doctor of Chiropractic is trained and qualified to give an adjustment" could have been worded more carefully and they would not use the claim again.

3. WFCC said they were vigilant in stating that they were Doctors of Chiropractic.  They said there were 18 mentions of Dr or doctor in the ad, 16 of which stated either "doctor of Chiropractic" or "Dr Mike Paull, Chiropractor".  They said it was an error that they forgot to add Dr to the other two references, but would be more careful in the future.  They said, however, that the heading of the ad stated "Ask your chiropractor", all the staff listed in the ad had the word "chiropractor" next to their names and "Chiropractic" was part of the clinic name; therefore they believed it was unlikely that readers would be misled into thinking they were medical doctors.

4. WFCC sent the ASA some web pages referencing various research studies, which they believed substantiated the claim that chiropractic was effective for treating whiplash and chronic pain.

Assessment

1. Upheld

The ASA considered that an abstract of a research study was not sufficient evidence to substantiate the claim that chiropractic was the best way to treat most spinal problems causing neck and back pain.  We also noted that the conclusion of the abstract stated that chiropractic ... may be effective for reducing levels of disability and perceived pain ...", not that chiropractic was better than all other treatment methods. Because we had not seen evidence to substantiate the claim, we considered the claim was misleading.

On this point, the ad breached CAP Code clauses 3.1 (Substantiation), 7.1 (Truthfulness) and 50.1 (Medical and scientific claims).

2. Upheld

Although we understood that the term "adjustment" was more widely used in chiropractic, we understood that other healthcare professionals, such as osteopaths and physiotherapists, were also qualified to give an adjustment.  We concluded that the claim that only a Doctor of Chiropractic was trained and qualified to give an adjustment was misleading and welcomed WFCCs assurance that they would not use the claim again.

On this point, the ad breached CAP Code clauses 3.1 (Substantiation) and 7.1 (Truthfulness).

3.  Upheld

We noted WFCCs assertion that only two references to "Doctors" or "Dr" failed to make clear that they were Doctors of Chiropractic.  However, we noted numerous other references without qualification throughout the ad, such as ... ring our clinic for a friendly informal chat with one of our team of Doctors ...", ... our Doctors specialise in successfully treating a wide range of problems ...", "Our Doctors successfully treat most causes of neck or back pain", ...all our Doctors are trained in radiography ...", "You do not have to be referred by anybody to see one of our Doctors ...", "She was treated by Dr Mike Paull" and "If you would like your back and neck problem diagnosed and successfully treated by one of our Doctors, please feel free to ring us".  Although we acknowledged that the ad was headed "ASK your chiropractor" we considered that, because the term "Doctor" and "Dr" were included in the ad without a clear explanation of the difference between a general medical qualification and a qualification in chiropractic, readers were likely to infer that the clinic practitioners held general medical qualifications.  Because they did not, we concluded that the ad was likely to mislead.

On this point, the ad breached CAP Code clauses 7.1 (Truthfulness).

4. Upheld

We noted CAP Code clause 14.3 stated that testimonials alone did not constitute substantiation and the opinions in them must be supported, where necessary, with independent evidence of their accuracy.  We did not consider that the evidence sent by WFCC, which consisted of a page from a claims solicitors website and a reference to an article in an orthopaedic medicine journal, were sufficiently robust to substantiate the claims made in the testimonials that chiropractic had been proven to be effective for treating whiplash and chronic pain.  Because we had not seen evidence to support the claims made in the testimonials, we concluded that the testimonials gave a misleading impression of the likely efficacy of chiropractic treatment for those conditions and could discourage people from seeking advice from a general medical practitioner.

On this point, the ad breached CAP Code clauses 3.1 (Substantiation), 7.1 (Truthfulness), 14.1 and 14.3 (Testimonials and endorsements), 50.1 (Medical and scientific claims) and 50.3 (Discouragement of essential treatment).

Action

The ad must not appear again in its current form.  We urged the Wigan Family Chiropractic Clinic to seek guidance from the CAP Copy Advice team before advertising again.

Adjudication of the ASA Council (Non-broadcast)