Manitoba chiropractors need proactive oversight over members, says health lawyer

Self-regulated health professions need to take a more proactive role in policing their members, says one lawyer, in the wake of a CBC investigation into questionable claims being made by certain Manitoba chiropractors.

"Their job is to protect the public," said Toronto-based medical malpractice lawyer Paul Harte.

"It's just ludicrous that any health professional in Canada would be arguing about fluoridation in our water or arguing against flu vaccinations — completely contrary to government policy and the, well, exhaustive research base that is available," he said.

"There's no reason why the regulatory body can't be doing the same Google searches and calling the same information," said Harte.

The investigation, published earlier this week, uncovered numerous online claims made by Manitoba chiropractors which public health experts say contradict many health policies and medical research.

Harte said Ontario legislation has recently been introduced to involve the Minister of Health in the regulation of health colleges, including the ability to name additional members from outside a health profession to a college's discipline panel. 

Regulatory changes on the horizon

Currently the Manitoba Chiropractors Association acts as both the advocacy group and regulator of its members, while certain health professions, such as physicians, have a college that is separate from its association.

However, as part of the transition towards the new Regulated Health Professions Act introduced in 2009, the regulatory role will shift to a newly minted College of Chiropractors of Manitoba. This act will also change the framework for how professional bodies investigate complaints and discipline members, providing more transparency to the process.

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Lawyer Paul Harte said the changes in Ontario came in response to regulators' failure to respond to complaints from the public and says some of the claims made by certain chiropractors in Manitoba illustrate a similar problem.

"It confirms my views generally that governments have to be more proactive in regulating professions and can't simply delegate the responsibility to the profession itself," said Harte.

Requests to the Manitoba Chiropractors Association for additional comment were not immediately returned.

Beware of messaging amid cuts: Liberal MLA

Physician-turned-Liberal MLA Jon Gerrard said despite the questionable claims made by a minority of chiropractors, it should be recognized that many provide high quality evidence-based care for many people with back injuries and other types of ailments.

He cautions the profession, however, that a few bad apples could turn the public health coverage of chiropractic treatments into a target.

"Chiropractors, I believe, should be particularly careful right now given the current government which is out to reduce health care expenditures," said Gerrard.

Manitoba is the only province in the country that universally covers a portion of chiropractic treatments for all residents, to a limit of 12 visits per year for a total cost of $11.9 million in 2016. Other provinces such as Alberta and Ontario both delisted chiropractic treatments in 2004 and 2009, respectively.

Asked about whether or not chiropractic will be delisted as part of the expected wide-ranging health care cuts in the upcoming provincial budget, Minister of Health Kelvin Goertzen wrote in a statement.

"Our government is committed to fixing the finances of our province in order to ensure the sustainability of services today and in the future. As we approach budget 2017, difficult decisions will be made. We won't speculate on potential changes to funding models, however all funding models are under review."

While Gerrard and NDP health critic Matt Wiebe both expressed concern over some of the chiropractors' claims, both agreed Manitoba Health should continue covering treatments.

"When you're looking at any kind of health care service that people are accessing right now that helps the overall health picture, I think it would be a mistake to go backwards and take that front-line service away from people," said Wiebe.

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