A website for Chiropractic First, www.chiropractic-first.co.uk, seen in November 2017, included a section titled “Meet The Team”, with subsections for its Manchester, Leeds and Birmingham locations and management team. Photos of staff members were accompanied by their names and titles; the majority of the chiropractors were referred to as “Dr [NAME] DC”. Clicking on the photo of those chiropractors brought up a detailed profile headed “Dr [NAME] DC” followed by a subheading which stated “Doctor of Chiropractic”. The name and title accompanying the photo of one chiropractor was “Dr [NAME]”, and “Dr [NAME] Doctor of Chiropractic” on his detailed profile. Another chiropractor was referred to as “Doctor [NAME]”, with “Doctor [NAME] Doctor of Chiropractic” on his detailed profile.
The complainant challenged whether the ad misleadingly implied that the chiropractors employed by the advertiser were medical doctors.
Chiropractic First Group Ltd said their intention was to always be completely clear about who they were as chiropractors and what role they could play in helping people with their health. They understood from the UK chiropractic governing body the General Chiropractic Council (GCC) that they were entitled to use the prefix “Dr” so long as they clearly stated the degree afterwards (“DC”), and/or the words “Doctor of Chiropractic”. They said they were careful to always make reference to being chiropractors and used those terms as appropriate. They accepted that the biographies of two team members were not laid out in that format and had amended their website accordingly.
They said they had taken as much care as possible to clearly outline both “DC” and “Doctor of Chiropractic” in the ‘Meet the Team’ section of the website, and further believed that their company name “Chiropractic First” did not imply that they were anything but chiropractors. They had chosen that name deliberately to avoid confusion, as they wanted the public to know the exact service they offered. They also highlighted that the first line of each of the biographies made specific reference to how the individual became exposed to the profession and why they chose that career path.
The ASA considered that in ads for healthcare practitioners, consumers were likely to interpret the title “Dr”, or variations on it, to mean that the practitioner held a general medical qualification. Chiropractors were healthcare professionals regulated by statute, and we understood their governing body, the GCC, allowed chiropractors to use the courtesy title “Doctor of Chiropractic”, sometimes abbreviated to “DC” or “DoC”. Where healthcare professionals who were regulated by statutory bodies were permitted to use a courtesy title which incorporated the term “Dr”, we considered that in order to avoid misleading consumers such titles should be clearly and prominently qualified with a statement making clear that the title was a courtesy title only, and that the practitioner did not hold a general medical qualification.
The “Meet the Team” web page on Chiropractic First’s website featured photos of team members at each of Chiropractic First’s locations, and the five chiropractors were described as either “Dr [NAME] DC”, “Dr [NAME]” or “Doctor [NAME]”. We considered consumers were likely to understand that the two individuals referred to as “Dr/Doctor” held general medical qualifications. We considered that instances where the title “Dr” or “Doctor” was used without being immediately qualified within the title with either “DC” or “Doctor of Chiropractic” (i.e., “Doctor [NAME], DC” or “Dr [NAME], Doctor of Chiropractic) were misleading to consumers whether or not the ad included a clear and prominent statement about the term “Doctor of Chiropractic” being a courtesy title and that the practitioner did not hold a general medical qualification.
We acknowledged that Chiropractic First had amended such references so that they now included the term “DC”. However, we considered that consumers were unlikely to know that “DC” was an abbreviation of “Doctor of Chiropractic”, and we therefore considered that consumers were also likely to infer that the individuals referred to as “Dr [NAME] DC” held a general medical qualification. In the absence of a clear and prominent statement making clear that “DC” related to the title “Doctor of Chiropractic”, that it was a courtesy title only, and that the practitioners did not hold general medical qualifications, we considered the titles on the initial “Meet the Team” web page were misleading to consumers.
Clicking on the photos of the individuals brought up biographical information about them and how they came to practice chiropractic. Each profile was headed with the same format of “Dr [NAME]” or “Dr [NAME] DC” as was used in the initial presentation on the “Meet the Team” web page, followed by a subheading which stated “Doctor of Chiropractic”. We considered that term provided more information to consumers than the abbreviated form “DC”, but we nonetheless considered consumers were also likely to infer from that term that the practitioner held a general medical qualification. However, none of the profiles included a clear and prominent statement that “Doctor of Chiropractic” was a courtesy title and that the practitioner did not hold a general medical qualification.
We noted that three of the profiles included information about the individuals’ chiropractic qualifications – for example, that they had studied for four or five years to attain a Masters degree in chiropractic. Two also stated that the individuals were registered members of the GCC and members of chiropractic membership bodies. While that information provided more context about the qualifications and professional status of those individuals, we considered it was not sufficient to counteract the impression, created by the use of the titles “Dr/Doctor” and “DC/Doctor of Chiropractic” in the headings and subheadings, that they held general medical qualifications.
Because the various iterations of the term “Dr [NAME] DC” and “Doctor of Chiropractic” on the website were not clearly and prominently qualified with a statement that they were courtesy titles and the practitioners concerned did not have general medical qualifications, we concluded the ad was misleading.
The ad breached CAP Code (Edition 12) rules 3.1 3.1 Marketing communications must not materially mislead or be likely to do so. (Misleading advertising) and 3.9 3.9 Marketing communications must state significant limitations and qualifications. Qualifications may clarify but must not contradict the claims that they qualify. (Qualification).
The ad must not appear again in the form complained about. We told Chiropractic First Group Ltd not to use the titles “Dr” and “Doctor” without immediate qualification with the courtesy title “Doctor of Chiropractic” or its abbreviations “DC” and “DoC”. We also told them not to use the courtesy title “Doctor of Chiropractic” or its abbreviation “DC” unless it was clearly and prominently qualified with a statement that the title was a courtesy title and the practitioner did not hold a general medical qualification.