Some of you may have seen the recent media attention regarding chiropractic, all chiropractors registered in Australia need to adhere to the codes and guidelines set out by the legislation, some registrants unfortunately do not behave appropriately. Below is the policy statement from one of the professional associations which outlines the provision of “wellness” care.
“Chiropractic Australia is a professional organisation that advocates quality, safe and ethical chiropractic care within the framework of evidence based practice. As such Chiropractic Australia endorses the Australian Government’s Primary Healthcare Strategy which promotes the concept of wellness and disease prevention. Chiropractic “wellness” care, often referred to as “maintenance care”, has been accepted by many chiropractors as an integral part of chiropractic practice (1-6). A recent study on clinical practices of chiropractors in Victoria (7) reported that 39 per 100 patient visits were related to maintenance or wellness care. However, while the two terms “wellness” and “maintenance” have often been used interchangeably, particularly within the chiropractic profession, for the purposes of this Policy Statement they have distinct meanings. Maintenance care has been described as treatment provided to preserve a condition without additional functional improvement of the patient’s health outcome. (8) Wellness care is a patient-centred process, which emphasises the development of health promotion and disease prevention. (9) Wellness care provided by chiropractors that incorporates advice on smoking cessation, good nutrition, weight control, physical activity and other lifestyle changes is strongly supported by high quality research evidence. (10)
However, where wellness care consists solely of periodic spinal analysis and spinal manipulation for the correction of asymptomatic spinal “subluxations” this kind of approach is not supported by Chiropractic Australia. Further, the use of periodic and long term spinal manipulation as part of a maintenance or wellness approach for the prevention, delay or reversal of spinal degenerative disease is also not sufficiently validated and is also not supported by Chiropractic Australia. (11). However, there is evidence that suggests periodic spinal manipulation may be of benefit in the ongoing treatment of spinal problems such as chronic low back pain (12,13) but there is little evidence as yet supporting the use of spinal manipulation in other aspects of disease prevention or health promotion. (14)
As primary health care practitioners, chiropractors are well placed to play an important role in wellness promotion and disease prevention, in areas such as physical activity, nutrition, mental health and other lifestyle considerations. It is inadvisable to provide treatments lacking evidence of safety and effectiveness when other available treatment options have been demonstrated to be beneficial. However, where a patient has unsuccessfully been treated by standard methods it may be reasonable to trial a more experimental alternative. In cases where patients elect to undergo treatments which have not been fully validated they should be informed of the lack of scientific evidence supporting the proposed treatment and provided with a balanced view of the clinical justification for such treatment. (16,17)
For more information and for a complete list of references please refer to: http://chiropracticaustralia.org.au/wp-content/uploads/2015/07/Wellness-Care-Policy.pdf “