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Chiropractic Australia president Rod Bonello responds to RACGP.

"The RACGP stands accused of an “injustice” against patients after it urged GPs to stop referrals to chiropractors.
On Wednesday, the college said GPs should “seriously reconsider any support for chiropractic involvement” in the care of patients, saying the evidence base for chiropractic was little better than placebo.
The statement – which effectively ostracises chiropractors from mainstream healthcare — also includes a demand that the Federal Government strip Medicare funding for chiropractic treatment.
But Professor Rod Bonello, president of Chiropractic Australia, said the statement was over the top.

“It’s entirely reasonable to be very frustrated with the behaviour of individual practitioners who do the wrong thing, but to recommend that doctors do not refer to chiropractors is an inappropriate response.” Professor Bonello said he did not support interventions such as that shown in the recent YouTube video of a popular Melbourne chiropractor manipulating the spine of a four-day old infant. “I can understand that from a conservative medical perspective, that would be seen as outrageous. If all chiropractors behaved in that manner, then the RACGP would be right," he said.

“But they’ve done an injustice to the doctors’ patients by denying them the opportunity of chiropractic care when it is indicated.”
Medicare funding for chiropractic care via GP chronic disease management items is worth around $16 million a year. Last year, there were 700 GP referrals to chiropractors for children under the age of five.

While some doctors have called for a ban on paediatric chiropractic care, Professor Bonello said that spinal conditions in children like scoliosis or torticollis could benefit from chiropractic care, but that such interventions were not common.
“The thing with paediatric care is that the research lags far behind, more than it does for other groups. It’s very difficult to get ethics approval for research on children generally.”
But he said it was “disingenuous” to suggest conventional medical practice was always evidence-based in comparison.
He pointed to estimates that up to a third of commonly accepted medical practice did not have strong research behind it. “That doesn’t mean its wrong," Professor Bonello said. "It simply means that research lags being practice; it always has. “The evidence certainly favours chiropractic management of acute lower back pain, but if a practitioner wants to offer a treatment that is not strongly validated, then the practitioner needs to let the patient know. "And that’s the same for anyone practising healthcare.”
Professor Bonello said that Chiropractic Australia has not yet formed an official response to the RACGP statement, but that the basis on which the organisation was founded was to “help reform the chiropractic profession”.
Australian Doctor is seeking a response from the Chiropractors Association of Australia.

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