Dr. Keith Thomson, President Advertising Committee College of Chiropractors of Ontario 130 Bloor St. West Suite 902 Toronto, ON M5S 1N5 November 30, 2001 Dear Dr. Thomson and Advertising Committee: I am writing you in reply to the CCO¼s request for feedback on advertising policies. As a concerned and active member of the CCO and within the chiropractic profession, I have some serious concerns with these matters. Let me begin with my story. A chiropractic ad and a testimonial is what introduced me to chiropractic and as a result my lifelong battle with asthma, allergies, and pain is much improved. I would not be as healthy as I am today if it wasn¼t for that chiropractic ad. The fact that chiropractic saved my life is also why I am a chiropractor todayäto help others. With regards to advertising policies and in no specific order: 1. Chiropractic specialities: there are many in our profession who have taken considerable time and expense to take pediatric diplomates and fellowships accredited by CCE colleges and as such should be able to designate themselves as a specialist in such an area. When other fields such as medicine can designate many different specialties, it seems ludicrous to only allow 3 specialties in chiropractic just because they¼re the only ones taught through CMCC. I strongly feel that pediatrics should be designated a recognized specialty. 2. Testimonials are what has made chiropractic what it is today. With all the restrictive advertising policies and misconceptions about what chiropractic is about, it is mostly by word of mouth of patient successes that chiropractic has become the fastest growing health care profession in the world. We must be allowed to tell the public how successful chiropractic is through our patients outside of our offices. 3. Offers of free or discounted services. As a practitioner is allowed to set his/her fees for services performed within their offices, it is well within their right to perform such services outside their office at a fee that he/she designates to allow people that might otherwise not be able to receive a checkup, an opportunity to do so. 4. Professional bodies. If a member belongs to a professional association, that member should be able to express that involvement, eg. CCA, CAC, ICA,etc. It shows their professionalism and commitment to their profession. 5. Contact or communication with potential patients. The role of a doctor is to help people. Many people have concerns or hesitations about chiropractic and would not go the extra step to become educated about it on their own. Such is the role of advertisingäto educate people about what you do. Telephoning a family member or friend that a patient has asked you to call to answer questions about their health should not be considered an offence but an act of kindness from the doctor. How many doctors would even take the extra time to call someone? If the patient then decides to come in the office because he/she is now educated that chiropractic may help them, that should not be considered solicitation (that word sounds so awful!) 6. Peer-reviewed references. That term comes up many times within CCO guidelines. Many of these guidelines seem to refer to the Glenerin Guidelines as its source for peer-reviewed information. Such use of information is a narrow minded approach to assessing credibility of information, as Glenerin only involved a small group of individuals that appear to have represented a small, specific mindset of the profession. The Council on Chiropractic Practice (CCP) guidelines are a much wider spectrum and have been accepted by the National Guideline Clearinghouse of the United Nations. I would be happy to provide each member of council a copy of these guidelines for review and future adoption as basis for åpeer-reviewed¼ information. 7. Examination/screening procedures. The goal of advertising is to educate the public about the potential benefits your services may have for them AND to give them an opportunity to receive such services if they wish. If a doctor has the ability or information that may help someone but restrains from or is restrained from expressing this information to help someone, I believe THAT is unethical. We should give the public some credit that they are intelligent enough to make decisions about their own health care IF they are given information and what steps they can take to receive such care. The medical profession has always had blind trust of the public and many in the public have suffered (see stats from New England Journal of Medicine, British Medical Journal, Journal of the American Medical Association) because of lack of information about side effects of medications and possible alternatives. If the CCO is to protect the public, chiropractors must be ENCOURAGED to advertise what chiropractic can offer people to improve their health and lives in a natural way. As a result, public presentations and examination/screening procedures must be allowed. 8. The ad with the big cross through it seems very misleading and uninformative. What about that ad is wrong? There is no attached explanation as to what is good or not good about the ad. Any intended benefit for CCO members seems to have been lost as many of my colleagues did not seem to understand this either. I thank you for your request for feedback on the advertising proposals and look forward to your responses to the above matters. Please remember that the majority of those that advertise, like myself, are doing so to fulfill a purpose of helping people. In a world full of stress and confusion, chiropractic shines a light that people are looking for. Let¼s allow chiropractors to let that light shine. A concerned and committed chiropractor, Dr. Freddie So, B.Sc., D.C. #3318 2318-1 Lakeshore Rd. W Oakville, ON L6L 1H3 (905) 827-2444 (905) 827-1922 (fax) Dr. Keith Thomson, President Quality Assurance Committee College of Chiropractors of Ontario 130 Bloor St. West Suite 902 Toronto, ON M5S 1N5 November 30, 2001 Dear Dr. Thomson and Quality Assurance Committee: I am writing you in reply to the CCO¼s request for feedback on the standard of practice with respect to experimental techniques. As a concerned and active member of the CCO and within the chiropractic profession, I have some serious concerns with these matters. Experimental techniques etc. I object to the term åresponsible and substantial segment of the ä¼ Who determines who is responsible. This is very vague and could be insulting. Although I do not practice most of the techniques listed as experimental, any practitioners I have met that do perform these techniques seem to be MORE RESPONSIBLE as they have taken the extra time to learn these techniques to improve their skills and to help their patients. Subject of independent research in a peer-reviewed journal and performed by no less than two partiesäIf research was accepted by a åpeer-review¼ process by an accepted scientific journal, why do you need further validation by two or more independent parties. It seems the peer-review process should be validation enough of any procedure/technique. Eg. Certain techniques listed (CBP) have MORE peer-reviewed papers than those commonly taught at CMCC (ie. Diversified). In fact motion palpation and orthopedic testing have been shown to have little inter-examiner reliability, yet it is the only technique taught at CMCC. I received my 2002 Registration Renewal Dues form in the mail recently and I like many of our registrants could not help but be somewhat alarmed and offended by the wording regarding experimental techniques, technologies devices or procedures. The allegation that registrants, who use such techniques listed by the CCO on the form as experimental, are not responsible is quite serious. I ask that the following be performed: 1. Explain in detail why you want this information and how it will be used. 2. Recall the Renewal form and replace it with a less offensive form. I await your prompt reply and attention this most serious matter. A concerned and committed chiropractor, Dr. Freddie So, B.Sc., D.C. #3318 2318-1 Lakeshore Rd. W Oakville, ON L6L 1H3 (905) 827-2444 (905) 827-1922 (fax)