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Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists


From the desk of the editor

Welcome to the July 2014 homepage edition of i2P (Information to Pharmacists) E-Magazine.
At the commencement of 2014 i2P focused on the need for the entire profession of pharmacy and its associated industry supports to undergo a renewal and regeneration.
We are now half-way through this year and it is quite apparent that pharmacy leaders do not yet have a cohesive and clear sense of direction.
Maybe the new initiative by Woolworths to deliver clinical service through young pharmacists and nurses may sharpen their focus.
If not, community pharmacy can look forward to losing a substantial and profitable market share of the clinical services market.
Who would you blame when that happens?
But I have to admit there is some effort, even though the results are but meagre.
In this edition of i2P we focus on the need for research about community pharmacy, the lack of activity from practicing pharmacists and when some research is delivered, a disconnect appears in its interpretation and implementation.

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Recent Comments

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News Flash

Newsflash Updates for July 2014

Newsflash Updates

Regular weekly updates that supplement the regular monthly homepage edition of i2P. 
Access and click on the title links that are illustrated

Comments: 1

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Feature Contribution

Woolworths Pharmacy - Getting One Stage Closer

Neil Johnston

It started with “tablet” computers deployed on shelves inside the retailer Coles, specifically to provide information to consumers relating to pain management and the sale of strong analgesics.
This development was reported in i2P under the title Coles Pharmacy Expansion and the Arid PGA Landscape”
In that article we reported that qualified information was a missing link that had come out of Coles market research as the reason to why it had not succeeded in dominating the pain market.
Of course, Woolworths was working on the same problem at the same time and had come up with a better solution - real people with good information.

Comments: 5

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Intensive Exposition without crossing over with a supermarket

Fiona Sartoretto Verna AIAPP

Editor's Note: The understanding of a pharmacy's presentation through the research that goes into the design of fixtures and fittings that highlight displays, is a never-ending component of pharmacy marketing.
Over the past decade, Australian pharmacy shop presentations have fallen behind in standards of excellence.
It does not take rocket science - you just have to open your eyes.
Recently, our two major supermarkets, Woolworths and Coles, have entered into the field of drug and condition information provision - right into the heartland of Australian Pharmacy.

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The sure way to drive business away

Gerald Quigley

I attended the Pregnancy, Baby and Children’s Expo in Brisbane recently.
What an eye and ear opening event that was!
Young Mums, mature Mums, partners of all ages, grandparents and friends……...many asking about health issues and seeking reassurances that they were doing the right thing.

Comments: 1

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‘Marketing Based Medicine’ – how bad is it?

Baz Bardoe

It should be the scandal of the century.
It potentially affects the health of almost everyone.
Healthcare providers and consumers alike should be up in arms. But apart from coverage in a few credible news sources the problem of ‘Marketing Based Medicine,’ as psychiatrist Dr Peter Parry terms it, hasn’t as yet generated the kind of universal outrage one might expect.

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Community Pharmacy Research - Are You Involved?

Mark Coleman

Government funding is always scarce and restricted.
If you are ever going to be a recipient of government funds you will need to fortify any application with evidence.
From a government perspective, this minimises risk.
I must admit that while I see evidence of research projects being managed by the PGA, I rarely see community pharmacists individually and actively engaged in the type of research that would further their own aims and objectives (and survival).

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Organisational Amnesia and the Lack of a Curator Inhibits Cultural Progress

Neil Johnston

Most of us leave a tremendous impact on pharmacies we work for (as proprietors, managers, contractors or employees)—in ways we’re not even aware of.
But organisational memories are often all too short, and without a central way to record that impact and capture the knowledge and individual contributions, they become lost to time.
It is ironic that technology has provided us with phenomenal tools for communication and connection, but much of it has also sped up our work lives and made knowledge and memory at work much more ephemeral.

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Academics on the payroll: the advertising you don't see

Staff Writer

This article was first published in The Conversation and was written by Wendy Lipworth, University of Sydney and Ian Kerridge, University of Sydney
In the endless drive to get people’s attention, advertising is going ‘native’, creeping in to places formerly reserved for editorial content. In this Native Advertising series we find out what it looks like, if readers can tell the difference, and more importantly, whether they care.
i2P has republished the article as it supports our own independent and ongoing investigations on how drug companies are involved in marketing-based medicine rather than evidence-based medicine.

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I’ve been thinking about admitting wrong.

Mark Neuenschwander

Editor's Note: This is an early article by Mark Neuenschwander we have republished after the soul-searching surrounding a recent Australian dispensing error involving methotrexate.
Hmm. There’s more than one way you could take that, huh? Like Someday when I get around to it (I’m not sure) I may admit that I was wrong about something. Actually, I’ve been thinking about the concept of admitting wrong. So don’t get your hopes up. No juicy confessions this month except that I wish it were easier for me to admit when I have been wrong or made a mistake.
Brian Goldman, an ER physician from Toronto, is host of the award-winning White Coat, Black Art on CBC Radio and slated to deliver the keynote at The unSUMMIT for Bedside Barcoding in Anaheim this May. His TED lecture, entitled, “Doctors make mistakes. Can we talk about it?” had already been viewed by 386,072 others before I watched it last week.

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Dispensing errors – a ripple effect of damage

Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA

Most readers will be aware of recent publicity relating to dispensing errors and in particular to deaths caused by methotrexate being incorrectly packed in dose administration aids.
The Pharmacy Board of Australia (PBA), in its Communique of 13 June 2014, described a methotrexate packing error leading to the death of a patient and noted “extra vigilance is required to be exercised by pharmacists with these drugs”.
This same case was reported by A Current Affair (ACA) in its program on Friday 20 June

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Take a vacation from your vocation

Harvey Mackay

Have you ever had one of those days when all you could think was, “Gosh, do I need a vacation.”
Of course you have – because all work and no play aren’t good for anyone.
A vacation doesn’t have to be two weeks on a tropical island, or even a long weekend at the beach. 
A vacation just means taking a break from your everyday activities. 
A change of pace. 
It doesn’t matter where.
Everyone needs a vacation to rejuvenate mentally and physically. 
But did you also know that you can help boost our economy by taking some days off? 
Call it your personal stimulus package.

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Explainer: what is peer review?

Staff Writer

This article was first published in the Conversation. It caught our eye because "peer review" it is one of the standards for evidence-based medicines that has also been corrupted by global pharma.
The article is republished by i2P as part of its ongoing investigation into scientific fraud and was writtenby Andre Spicer, City University London and Thomas Roulet, University of Oxford
We’ve all heard the phrase “peer review” as giving credence to research and scholarly papers, but what does it actually mean?
How does it work?
Peer review is one of the gold standards of science. It’s a process where scientists (“peers”) evaluate the quality of other scientists' work. By doing this, they aim to ensure the work is rigorous, coherent, uses past research and adds to what we already knew.
Most scientific journals, conferences and grant applications have some sort of peer review system. In most cases it is “double blind” peer review. This means evaluators do not know the author(s), and the author(s) do not know the identity of the evaluators.
The intention behind this system is to ensure evaluation is not biased.
The more prestigious the journal, conference, or grant, the more demanding will be the review process, and the more likely the rejection. This prestige is why these papers tend to be more read and more cited.

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Dentists from the dark side?

Loretta Marron OAM BSc

While dining out with an elderly friend, I noticed that he kept his false tooth plate in his shirt pocket. He had recently had seven amalgam-filled teeth removed, because he believed that their toxins were making him sick; but his new plate was uncomfortable. He had been treated by an 'holistic dentist'. Claiming to offer a "safe and healthier alternative" to conventional dentistry, are they committed to our overall health and wellbeing or are they promoting unjustified fear, unnecessarily extracting teeth and wasting our money?

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Planning for Profit in 2015 – Your key to Business Success

Chris Foster

We are now entering a new financial year and it’s a great time to reflect on last year and highlight those things that went well and those that may have impacted negatively in the pursuit of your goals.
It's also a great to spend some time re-evaluating your personal and business short, medium and long term goals in the light of events over the last year.
The achievement of your goals will in many cases be dependent on setting and aspiring to specific financial targets. It's important that recognise that many of your personal goals will require you to generate sufficient business profits to fund those aspirations

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Attracting and Retaining Great People

Barry Urquhart

Welcome to the new financial year in Australia.
For many in business the past year has been described as a challenging period.
Adjectives are a key feature of the English language.  In the business lexicon their use can be, and often is evocative and stimulate creative images.  But they can also contribute to inexact, emotional perceptions.
Throughout the financial pages of newspapers and business magazines adjectives abound.
References to “hot” money draw attention and comment.  The recent wave of funds from Chinese investors, keen to remove their wealth from the jurisdiction and control of government regulations is creating a potential property bubble in Australia.

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Updating Your Values - Extending Your Culture

Neil Johnston

Pharmacy culture is dormant.
Being comprised of values, unless each value is continually addressed, updated or deleted, entire organisations can stagnate (or entire professions such as the pharmacy profession).
Good values offer a strong sense of security, knowing that if you operate within the boundaries of your values, you will succeed in your endeavours.

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Evidence-based medicine is broken. Why we need data and technology to fix it

Staff Writer

The following article is reprinted from The Conversation and forms up part of our library collection on evidence-based medicines.
At i2P we also believe that the current model of evidence is so fractured it will never be able to be repaired.
All that can happen is that health professionals should independently test and verify through their own investigations what evidence exists to prescribe a medicine of any potency.
Health professionals that have patients (such as pharmacists) are ideally placed to observe and record the efficacy for medicines.
All else should confine their criticisms to their evidence of the actual evidence published.
If there are holes in it then share that evidence with the rest of the world.
Otherwise, do not be in such a hurry to criticise professions that have good experience and judgement to make a good choice on behalf of their patients, simply because good evidence has not caught up with reality.

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Laropiprant is the Bad One; Niacin is/was/will always be the Good One

Staff Writer

Orthomolecular Medicine News Service, July 25, 2014
Laropiprant is the Bad One; Niacin is/was/will always be the Good One
by W. Todd Penberthy, PhD

(OMNS July 25, 2014) Niacin has been used for over 60 years in tens of thousands of patients with tremendously favorable therapeutic benefit (Carlson 2005).
In the first-person NY Times best seller, "8 Weeks to a Cure for Cholesterol," the author describes his journey from being a walking heart attack time bomb to a becoming a healthy individual.
He hails high-dose niacin as the one treatment that did more to correct his poor lipid profile than any other (Kowalski 2001).

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Culture Drive & Pharmacy Renewal

Neil Johnston

Deep within all of us we have a core set of values and beliefs that create the standards of behaviour that we align with when we set a particular direction in life.
Directions may change many times over a lifetime, but with life experiences and maturity values may increase in number or gain greater depth.
All of this is embraced under one word – “culture”.
When a business is born it will only develop if it has a sound culture, and the values that comprise that culture are initially inherent in the business founder.
A sound business culture equates to a successful business and that success is often expressed in the term “goodwill” which can be eventually translated to a dollar value.

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Pharmacy 2014 - Pharmacy Management Conference

Neil Johnston

The brave new world of health and wellness is not the enemy of Pharmacy, it is its champion.
Australian futurist, Morris Miselowski, one of the world's leading business visionaries, will present the Opening Keynote address on Pharmacy's Future in the new Health and Wellness Landscape at 2.00pm on Wednesday July 30.
Morris believes the key to better health care could already be in your pocket, with doctors soon set to prescribe iPhone apps, instead of pills.
Technology will revolutionise the health industry - a paradigm shift from healthcare to personal wellness.
Health and wellness applications on smartphones are already big news, and are dramatically changing the way we manage our personal health and everyday wellness.

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Generation and Application of Community Pharmacy Research

Neil Johnston

Editor’s Note: We have had a number of articles in this issue relating to pharmacy research.
The PGA has conducted a number of research initiatives over the years, including one recently reported in Pharmacy News that resulted from an analysis of the QCPP Patient Questionnaire.
Pharmacy Guild president, George Tambassis, appears to have authored the article following, and there also appears to be a disconnect between the survey report and its target audience illustrated by one of the respondent comments published.
I have asked Mark Coleman to follow through, elaborate and comment:

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From this page you can share Is the CHF (Consumer Health Forum) representative of consumers? to a social bookmarking site or email a link to the page.
Social Web

Is the CHF (Consumer Health Forum) representative of consumers?

Mark Coleman

articles by this author...

Mark is a semi-retired pharmacist.

i2P has often commented on the orchestration of various lobby groups and their suspect behaviours when orchestrating their seemingly unrelated activities.
They seem to have gotten their chorus to be sung in tune.
Gerald Quigley referred to these "dark forces" in his article in this month's edition.
Their activities are disruptive, damaging and distracting to say the least and some border on the illegal.
They also have a common thread in that members of the Skeptics Society are common within their membership allowing the various groups to work in concert.
i2P readers need to be aware of these activities because they may have to mobilise their resources to counter behaviours that affect pharmacy-directly and indirectly.

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Is the CHF (Consumer Health Forum) representative of consumers?
This is a question we have recently asked after discovering the curious mix of voting members and non-voting members of the CHF.
One pharmacist made a comment at the foot of the first article on CHF

“Interesting article re the diverse membership of CHF and could be difficult for consensus on some issues, will have to look further into voting and whether decisions are representative of general consumers or may favour particular member organisations.”

And that is a possibility when coupled with the following written by Judy Wilyman, a student undertaking a PhD at Wollongong University, and a writer for i2P.

Judy states:

 "When I wrote to the Australian Consumers Health Forum (CHF) to inform them of the untruthful information on many Skeptic blogs/websites about vaccination, the letter which I sent only to the CEO, Carol Bennett, was not answered, but was posted on Rachael Dunlop's (vice-president of the Skeptics) Skeptic blog two days later.
Why would the CHF not be investigating the public's concerns about vaccination?
This consumer organisation did not answer the public's concerns about vaccination.
 The Consumer Health Forum (CHF) is composed of members from large associations and industry whose interest would not necessarily represent the interests of consumers on vaccination.
Members include Medicines Australia, Merck, Sharp and Dohme (the distributor of HPV vaccine in Australia), Novartis, and other organisations and self-help illness groups.
These members can be viewed on the link provided.
Carol Bennett passed my letter (asking her to investigate consumer concerns about vaccination), to the vice president of the Australian Skeptics - Rachael Dunlop - to publish on her blog: this is not demonstrating that the CHF is a representative forum for consumer’s rights on health issues."

The influence of Skeptics is pervasive.
One has to assume that Carol Bennett is also tainted by this organisation given her behaviour in dealing with correspondence that ought to have been private and for her personal use only.
But it does illuminate why the CHF has cooperated with two other organisations highly critical of a pharmacy leading organisation, the Pharmacy Guild.

Also i2P has long asked an organisation headed by top echelon Skeptics why they haven’t investigated the medical fraud that surround so-called evidence to back the sale of most medicines.
This organisation, the Friends of Science in Medicine, has studiously avoided this question presumably because most of the academics that are members would be standing in line for funding and grants from the very Pharma companies that are committing fraud.

And I wonder how much of the Skeptic activity, that proliferates in all forms of media that publishes misinformation, supporting uninhibited and multi-use of vaccines, finds its way directly or indirectly from Big Pharma or its front organisations to these “lobbyists”.

Mainstream media has been an obvious target for some time.
Thank heavens the ABC’s Catalyst Program stood up to all the negative flack it was subjected to over its expose’ of statins.
It seems now that Catalyst Show ABCTV is taking firm aim at 'evidence based' medical care in the form of an expose’ about statin drugs which lower cholesterol.

To watch:

Part 1 - http://mpegmedia.abc.net.au/tv/catalyst/catalyst_s14_ep24_heart.mp4

 Part 2 - http://www.abc.net.au/catalyst/stories/3881441.htm

Even more disturbing... The attempts to stop this show from airing - http://www.abc.net.au/pm/content/2013/s3881383.htm

Curiously, when the patent rights for Lipitor ran out some months ago for Pfizer, all the negative media and research pushed through rapidly into mainstream media.  
Which begs the question: what kind of machine can suppress and attenuate 'the truth' from reaching you?

Recently, Judy Wilyman addressed a global conference in San Francisco and presented her research on the problems found with HPV vaccine.
She received a great reception and was well-funded by her university to present this evidence-based information (and there is very little of it surrounding the issues of vaccination).
On her return to Australia, Judy prepared a number of press releases for mainstream media.
Keep in mind, this is evidence of a high quality developed here in Australia.
Note the attitude in some of the responses:

Judy Wilyman writes:

Hi All,
Here is the reply that I have sent to a journalist who has chosen not to report the scientific evidence that I presented at the Cancer Science and Therapy Congress in the US last week. Australians should be concerned that journalists are now deciding which 'science' they will allow the public to see and debate. Here is my reply:

Jane Hansen
Journalist Sunday and Daily Telegraph

Dear Ms.Hansen,
I am intrigued by the reply that you gave to a community member who requested that you report on the information that I recently presented on the HPV vaccine at the Cancer Science and Therapy Congress in San Francisco. It has come to my attention that you gave the following reply to this request:

Jane Hansen's comment:
"Yes, I've read this. I'm going to go with the scientists and medicos who have studied this long and hard before I go with an 'academic' with no medical background who is a known anti-vaccine advocate. My guess is you have no background in science or medicine either, so please don't bore me again with your conspiracy agendas."

It is interesting that a journalist is putting her 'faith' in the qualifications that individuals have and not the scientific-evidence that the individual is presenting. This is not debating the science and I hope that you do not call yourself an 'investigative journalist'. Your comment represents incompetent reporting and amounts to the reporting of 'opinions' and even propaganda. This type of reporting is putting the health of Australians at risk. Your job as a journalist is to report all the arguments that are presented and allow objective discussion of the arguments - not select the science you present.

It seems that you are also misinformed about the implementation of public health policy. Public health policy is for the benefit of 'the public' hence all public members are entitled to present arguments for and against these policies. In fact, public discussion and consent is required before public health policy is implemented. In addition, infectious diseases are an environmental health issue and the policy did not involve the medical profession until deaths and illness to infectious diseases had declined in 1950. If you had investigated this topic you would have found that Professor Fiona Stanley wrote those words in 2001. Hence a medical degree is unnecessary to speak on this topic even if it was not in the context of a public health policy.

My qualifications are a Master of Science (Population Health) and I am currently studying the medical politics of health issues in a PhD at Wollongong University. If you were an investigative journalist you would also have discovered this information instead of accepting the misinformation that you have heard from lobby groups with vested interests.

It is disappointing for Australians to see the standard of reporting that is occurring on health issues in the media. You have joined Janet Albrechtsen (News Ltd), Sarrah Le Maurquand (News Ltd), Caroline Marcus (News Ltd), and Jonathon Holmes (ABC) who have all presented their opinion that 'there is no other side to this debate'.  Dismissing the arguments that myself and many other professionals are presenting as 'a conspiracy' theory is spin and preventing the public from addressing the bias in the science that is being used in government policies. The health of Australians is at risk because journalists are presenting propaganda by selecting the arguments they will present to the public.

Kind regards,
Judy Wilyman MSc (Population Health)
PhD Candidate

The other “hobby-horse” of the FSM and the Australian Medical Association (AMA) is the chiropractor’s right to practice their profession. Chiropractors are accredited through a scientific university course almost identical to that of medical practitioners.
They are grudgingly acknowledged by medical professionals to be of “some good” for back problems.
I am wondering whether the FSM and the AMA have deep pockets, because there is already a ruling in favour of the chiropractors that will create a platform for legal action.
The following was published in Dynamic Chiropractic in 1999.

Australian Medical Association Taken to Task

Australian Government Moves to End AMA Efforts to "Exclude Chiropractors"

By Editorial Staff

Dynamic Chiropractic 1999;17(3)

The efforts of the Australian Medical Association (AMA) to restrict chiropractic in Australia was reviewed in the ACCC Journal,1 the official publication of the Australia Competition & Consumer Commission (ACCC), the Australian counterpart of the U.S. Federal Trade Commission. The article, "The AMA and chiropractic: a trade practices viewpoint," chronicles the struggle of medicine and chiropractic to co-exist, both down under and in the United States. Until the passage of the State and Territory Competitive Policy Reform Acts of 1995, the Australian Medical Association was free to set whatever policies it wished against their members associating with doctors of chiropractic. For example, in 1977, the federal assembly of the Australian Medical Association passed this resolution:

"The Australian Medical Association does not recognize any exclusive dogma such as homeopathy, osteopathy, chiropractic and naturopathy. It is unethical for doctors to associate professionally with practitioners of such dogmas."

In 1981, the resolution was updated with the "s" word:

"The Australian Medical Association does not recognize any exclusive dogma such as homeopathy, osteopathy, chiropractic and naturopathy or any other practices which are not based on sound scientific principles.

Gone was the admonition that it was "unethical" to associate with the chiropractic profession on a professional level. Still, the AMA had not designed to recognize chiropractic et al. The professions of "exclusive dogma" were still the black sheep and herded far out to pasture. And AMA members weren't about to venture that far afield.

What the Australian Medical Association did was to affect a secondary boycott. A secondary boycott is where one party in concert with a second party takes action to restrict the supply of goods or services by a third party to a fourth party. In this case, the AMA worked in concert to restrict the ability of chiropractors to serve the people of Australia.

In September 1992, the AMA felt compelled to publish the little booklet Chiropractic in Australia. They reiterated their policy statement:

"The AMA maintains that a medical practitioner should at all time practice methods of treatment based on sound scientific principle, and accordingly does not recognize any exclusive dogma such as ... chiropractic..."

Today, the ACCC still receives many complaints about the "boycott" of chiropractors by the AMA. These complaints allege that the AMA policy still discourages MDs who are members of the AMA from:

  • referring patients to chiropractors;
  • sharing premises or practices with chiropractors;
  • working alongside chiropractors in hospitals or other institutions where work places are shared by varied medical disciplines; and
  • engaging in research work with chiropractors.

The ACCC has contacted the federal, state and territory branches of the AMA about these complaints and any policies or practices that would affect the way medical doctors and chiropractors interact. All branches of the AMA advised the ACCC that they had no policy prohibiting or discouraging members from dealing with chiropractors. The ACCC was told that individual members are free to decide whether or not they wish to form a professional association or alliance with chiropractors. This was in sharp contrast to a recent quote in the media by Dr. Gerald Segal, president of the Victoria Board of the AMA. He stated that it is unethical for AMA members to refer patients to chiropractors.2

The ACCC has already let it be known that AMA members are free to associate with chiropractors. The AMA will be required to publish an ACCC-produced statement to that effect in their journal to better inform their members. Should the AMA refuse, they will most likely be taken to court, not by the Australian chiropractors, but by the Australia Competition & Consumer Commission.


  1. The AMA and chiropractic: a trade practices viewpoint. ACCC Journal, October 1998. p 7-11.
  2. Experts back care battle. Sunday Herald Sun, October 19, 1997, p. 24.

One chiropractor commented when sending this material to i2P: “This vituperation still exists, and most medicos do not know of this ruling. Secondary and tertiary boycotts still exist and are seemingly encouraged, though surreptitiously.”

I think we are all feeling a bit fed up with the behaviour of Skeptics, the FSM and the AMA – all seemingly in bed together.
Legal action may not be far away.

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