Ontario Chiropractic Regulatory Board to Adopt Infamous "Appendix N" Limiting Marketing & Evidence to RCT's Only
In their November 2019 Board meeting the College of Chiropractors of Ontario (CCO) discussed adopting the draconian and anti-scientific tactics being used by the chiropractic regulatory board in British Columbia (College of Chiropractors of British Columbia). These tactics include the adoption of the infamous "Appendix N" from BC which was taken from the Australian Health Practitioner Regulation Agency.
"Appendix N" and the related policy from Australia, eviscerates the decades long model of Evidence Informed Practice by removing the incorporation of all levels of evidence in clinical decision making and instead limits "acceptable evidence" to randomized controlled clinical trials only.
There is nothing in the scientific, peer reviewed literature to justify this change.
These recommendations came from the CCO's Quality Assurance Committee's Report to the Council. The members of the Committee making these recommendations include:
- Dr. Kristina Peterson, Chair
- Dr. Janet D'Arcy
- Ms. Karoline Bourdeau
- Mr. Rob MacKay
- Dr. Joel Weisberg, non-council member
Staff:
- Mr. Joel Friedman, Director, Policy & Research
- Dr. J. Bruce Walton, Director of Professional Practice
- Ms. Jo-Ann Willson, Registrar and General Counsel
Despite their attempts to re-define evidence informed practice to allow RCT's only, the truth is that evidence informed practice involves considering all available scientific evidence, the clinical circumstances of the patient, the patient’s values and the clinical experience of the provider. Integrating these aspects, the provider then helps the patient make a decision that is in their best interests.
Instead, the College defines what evidence it will accept by removing any type of research where there are other possible explanations for treatment outcomes, the outcomes have not been replicated across multiple studies, they are not considered higher level evidence (RCT’s), basic science studies, case studies, self-assessment studies (Quality of Life Studies) and outcomes studies.
Then these Canadian chiropractic regulators tell those under their thumb what they can and cannot say to their patients. These efforts to reign in free speech and institute compelled speech are consistent with the movement to limit "truth" only to what government entities say it is which has spread from the United Kingdom, to Australia and now Canada.
Taking its cue from the Chiropractic Cartel operating in these countries, the Deniers who control the regulatory boards in the United States are seizing on how easily chiropractors in these other countries have lined up for slaughter.
In addition to the move forcing these anti-scientific guidelines on chiropractors and the public they serve, the Ontario Board is also looking at implementing the same Big Brother software tools that were used in BC to hunt down and go after chiropractors whose websites have words on them that indicate the chiropractor is violating their re-definition of evidence informed practice.
According to the meeting notes the QA Committee's budget submission for 2020 includes projected costs associated with implementing the "compliance verification tool" based on the submission that CCO received.
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