Professor Frizelle’s Instant Classic: Let’s hear your evidence not your legal muscle

It isn’t often that you come across a newly-minted phrase that is destined to become a classic but Professor Frank Frizelle has managed it (pdf). In response to a legal letter on behalf of affronted chiropractors he issued this challenge: “let’s hear your evidence not your legal muscle”.

Read all about it at with Professor David Colquhoun who is (of course) entangled in this legal imbroglio: Chiropractors resort to legal intimidation. Dr Ben Goldacre has a strong commentary on this matter: Silence Dissent!

While chiropractors struggle to manifest to their customers an air of academic rigour, their actions in this letter demonstrate more than anything else how little they understand the simple day to day business of academic journals, journal clubs, work in progress seminars and indeed the entirety of medicine: we take the piss out of each others ideas. We criticise them. We tear them apart, mercilessly. When we criticise survival stats, or the interpretation and analysis of data, make no mistake: we are accusing each other of killing patients unnecessarily. This is the bread and butter of academia and medicine. Only very occasionally does anyone take personal offense. [sic]

Quite. Professor Frizelle’s response is robust, pithy and on-target: HolfordWatch hopes that the Chiropractors’ Association in New Zealand takes note of the response and the wider reaction to their actions.

Dr. Phil Hammond has a provocative programme coming up on Radio 4; he wrote a trailer for it: Why do doctors kill more people than airline pilots?

During the making of the Radio 4 documentary, all the NHS staff I spoke to were passionate about patient safety, but said a culture of blame and exposure was its enemy.

Errors will inevitably occur, but what staff need to prevent these happening again is time and support to understand and learn from them.

He is free to write these pieces and to broadcast about important issues. Presumably the BMA isn’t threatening legal action against him for washing dirty laundry in public and for every lukewarm acknowledgement that tries to claim that reforms are already in hand, there will be someone praising Hammond for drawing attention to these matters. As Goldacre says, this is how progress happens.

Law courts are rarely the appropriate venue for settling such matters. It would be helpful if the wider debate and criticism about various interventions and modalities could take place without intimidation, whether personal or legal.

Relevant Posts and Documents for Background

Professor Colquhoun was asked to write for the Journal of the New Zealand Medical Assocation, as a comment on article in that edition about the misuse of the title ‘doctor’ by chiropractors: Dr Who? Deception by chiropractors. The editorial appeared in the journal as Doctor Who? Inappropriate use of titles by some alternative “medicine” practitioners. The article was a companion piece for others in that issue:
1. Gilbey A. Use of inappropriate titles by New Zealand practitioners of acupuncture, chiropractic, and osteopathy. N Z Med J. 2008;121(1278). [pdf]

2. Evans A, Duncan B, McHugh P, et al. Inpatients’ use, understanding, and attitudes towards traditional, complementary and alternative therapies at a provincial New Zealand hospital. N Z Med J. 2008;121(1278).

Colquhoun reports the subsequent legal letter and Professor Frizelle’s response in his post: Chiropractors resort to legal intimidation. He carries a copy of Frizelle’s editorial that also reproduces the letter sent by Paul Radich, a lawyer who acts for the New Zealand Chiropractors’ Association Inc and its members: Defamatory Articles or Not (pdf).


Quackometer considers the matter: They Are Bone Doctors, Aren’t They? You will not only read more detail about the business practice of chiropractors but enjoy a, “Where are they now? So that’s what he’s doing” moment about a former drummer with The Clash who is now practising percussion of a different kind on human instruments.
Streisand Effect as shooting oneself in the foot or a self-inflicted lower spinal subluxation: the Streisand subluxation

jdc offers: More Legal Chill – from Spine Cracking Chiropractors and offers A Beginner’s Guide to Chiropractic. We would also add Dr Mark Crislip’s analysis of a paper on chiropractic and stroke and Dr Harriet Hall on the sad case of Sandra Nette who is now living in locked-in syndrome following chiropractic treatment that went badly awry.

20__ joins the news circle: New Zealand Chiropractors Association/Murray from Flight of The Conchords is pretty cool.

Thinking Is Dangerous covers this story and adds in some detail about a UK chiropractor, “Dr” Christian Farthing that explains precisely why this may be an issue that causes consumer confusion: Another Back-Cracking Q’Attack
Update August 9: JREF Forum: New Zealand chiropractors threaten academic journal.
Coracle describes the attempt at intimidation as: Weak-minded, ignorant and superstitious.
August 10: Samuel Homola, a retired chiropractor comments that the majority of chiropractors believe that “spinal adjustment should not be limited to treatment of musculoskeletal problems” although “there appears to be little evidence to support the value of spinal manipulation for nonmusculoskeletal conditions”: Chiropractic: A Profession Seeking Identity.
Bruce Thyer and Gary Whittenberger investigated the willingness of chiropractors’ representatives to agree to consider treating hypertension and arthritis: A Skeptical Consumer’s Look at Chiropractic Claims: Flimflam in Florida?
August 11: Norbury discusses the prime facie plausibility of chiropractors because they are regulated: Chiropractors Get Cross.
Closer to home, it seems that New Zealand blogs are picking up the story. Evidence-based Thinking has a fine account: NZ Chiropractors vs NZ Medical Journal. There is some confirmation that the matter of the use of an appropriate, non-misleading title might be settled in a straightforward fashion by applying existing law.
Silly Beliefs shakes its head in disbelief at the own Chiropractors’ Association’s own goal: Chiropractors attack NZ Medical Journal

So why didn’t the idiots just keep quiet rather than getting lawyers involved and creating a fuss over an article that the public would otherwise have been oblivious to. If they had kept mum then I wouldn’t have heard about it and you wouldn’t be reading this. Remember the Catholic Church giving The Da Vinci Code unimagined and unintended publicity, alerting the world to the very thing they were trying to hide? Rather than learn from this mistake they did it all again trying to get South Park‘s episode Bloody Mary censored. As a result the show got the highest viewer rating ever received. Now following the stupidity of the likes of the Catholic Church, the NZ Chiropractors’ Association Inc believes that by creating a public fuss over their silly pseudoscience they can somehow hide their flawed beliefs from us.

August 12: The ushering in of the Glorious Twelfth sees Open Parachute applauding Professor Frizelle’s stand against the legal letter: Evidence should trump “legal muscle”

Related Reading for Threats

Quackometer and the Society of Homeopaths triggering an I’m Spartacus wave of support
Dr Ann Walker’s affront to Professor Colquhoun’s snort about blood cleansing that prompted the Ann Walker Festival of Appreciation
Quackometer and the wonderful world of ‘Professor Dr’ Joseph Chikelue Obi and Netcetera that prompted another I’m Spartacus movement.
Clifford Shoemaker triggers the Kathleen Seidel I’m Spartacus movement (Spartacus bloggers listed)
Who can forget the fabulous Gillian McKeith and the exquisite proportionality of her response to PhDiva, Professor John Garrow and Ecletech? Or the letter that is currently hosted by Chilling Effects?

In addition to the legal letters, there are the bread and butter threatening letters or comments that bloggers receive on a regular basis.
Professor David Coluqhoun wrote: Response to a threatening letter from Mr Holford
Holford Myths published A Comment from Patrick Holford
jdc has blogged about Legal Chill and Other Threats detailing recent complaints by Dr John Briffa.
Quackometer has, of course, received an admonition from Patrick Holford: No Comment
Losing the UK theme for a moment, Happy Jihad’s House of Pancakes posted about: Another threatened lawsuit!

Spats relating to publications in academic journals are commonplace. Ben Goldacre told the story of the various covert and legal shenanigans surrounding David Horrobin and evening primrose oil – another example of hurt feelings and CAM.
Dr Aubrey Blumsohn maintains the Scientific Misconduct blog that is full of examples involving bad behaviour and intimidation, many of which involve major pharmaceutical companies rather than CAM.

Update Aug 16: British Chiropractors Join the Legal Intimidation Party by issuing a legal writ against Simon Singh for his discussion of chiropractic in a Guardian article about Trick or Treatment? Alternative medicine on trial.

Update Aug 19: It seems that more legal trouble or just hassle is brewing for the forthright Professor David Colquhoun as it seems that despite the popularity of his video short, integrativebaloney@Yale, it proved a saddle burr to others who were able to prevail and have it removed from YouTube. Plain speaking: Wellington, Russell and Wakley on managers, reform, medicine and quacks.

Tim Sands wins a special pun award for his coverage in Nature‘s blog: Kiwi-practors’ legal wrangle.

Dougal at Looking Out To Sea might echo that sentiment. He has a punchy summary of the chiropractors’ tactics (or those of their associations) for both this story and the more recent one involving the British Chiropractic Assocation and Simon Singh: If you don’t have anything nice to say, say it on lawyer’s headed notepaper.

It should be pretty obvious now that these two associations have little interest in medical science or patient wellbeing. If they did then stifling criticism would not be their first reaction.

Update 5 Sept: Chiropractic wars. Part 3: internecine conflict. Professor Colquhoun brings us up to date on the latest exchange of letters on this vexed topic.




Filed under Ben Goldacre

27 responses to “Professor Frizelle’s Instant Classic: Let’s hear your evidence not your legal muscle

  1. That was a wonderfully robust response in the journal, wasn’t it. Hopefully it will serve as an example to other journals and newspapers who find themselves threatened in this way,

  2. Well impressed with the NZJM response!

  3. Mary Parsons

    That is exactly the right response – I intend to quote it at every available opportunity.

  4. Wulfstan

    What are those sublux snappers thinking? This can’t work out well for them. They might have written a response to set out their case and the journal would have published it and aside from a little light laughter, that would have been the end of it.

    Would it be appropriate to write and congratulate Prof Frizelle on his intellectually and constitutionally robust riposte?

  5. Pingback: Chiropractors resort to legal intimidation

  6. I think that Professor Frizelle and the Journal of the New Zealand Medical Association might be grateful to know that there is support for their response to the New Zealand Chiropractors’ Association and a wider feeling that such matters should be settled through discussion, not in law courts.

    Robust criticism is not, de facto, defamatory. There is a place for light-hearted phrases such as those quoted from Professor Edzard Ernst:

    in his humorous article In praise of the data-free discussion. Towards a new paradigm 5 when he states “data can be frightfully intimidating and non-egalitarian”.

    However, Professor Frizelle expresses the wish: “Let the debate continue in the evidence-based tone set by Colquhoun and others”. In the UK, we have seen the confusion caused by Gillian McKeith’s title – there is a serious discussion to be had about the issue of “consumer’s expectations of those who use the title doctor”.

    NB: all quotations are from Frizelle’s Defamatory articles or not? (pdf)

    We’ve updated the main post several times as more people cover this story.

  7. Pingback: NZ Chiropractors vs NZ Medical Journal « Evidence Based Thought

  8. Pingback: British Chiropractors Join the Legal Intimidation Party « Holford Watch: Patrick Holford, nutritionism and bad science

  9. starpath

    New Zealand media have so far not widely taken up this issue and provoked public debate. I wonder why?

  10. Thank you for letting us know that starpath, and how very irritating. Is it possible that no-one has been in touch with them or that NZ media don’t read science blogs? Although this last would be very disappointing.

    As you can tell from UK wrangles concerning chiropractors, it certainly is a debate that is worth having.

  11. Todd D. Gastaldo, DC

    Organized medicine’s original defamation was “quackery” – everyone ELSE was a “quack.”

    The newer “nicer” defamation is “CAM” – everyone ELSE is “CAM” – which of course is also false….

    See RANZCOG: Obgyns as CAM practitioners: Fraudulent use of the title ‘Doctor’ by registered medical practitioners

    See also: NZMJ Editor Frizelle: Babies are harmed by POLITICAL ‘legal muscle’

  12. Wulfstan

    Wow, I’d like to say that the chiro-list link is one of the most nonsensical that I’ve ever come across but that would be denying the state of the internet.

    Can I take a guess and say that this is one of those savants who are so anxious to let the world know what they think that they copy in multiple people and mailing-lists every time they jot down their shopping?

    To save anyone else the trouble – no, no argument or evidence as to why Colquhoun, Gilbey or the original writers were wrong in the way that they expressed the evidence or their opinions.

  13. Wulfstan – you might think that about the multiple cc habit but we couldn’t possibly comment.

    Completely off-topic, are you psychic?

  14. Todd D. Gastaldo, DC

    Wulfstan offered ad hominem – and this…

    “To save anyone else the trouble – no, no argument or evidence as to why Colquhoun, Gilbey or the original writers were wrong in the way that they expressed the evidence or their opinions.”

    In fact, as I noted:

    Business College Lecturer ANDREW GILBEY based an entire article on the
    following falsehood:

    “[T]here are theoretical and evidential differences between CAM and
    mainstream medicine…”
    –Gilbey A. NZMJ 25 July 2008, Vol 121 No 1278; ISSN 1175 8716

    FACT: MOST medical practices presently considered an integral part of the
    mainstream allopathic specialty called OBSTETRICS are not only “unproven
    by science” but obviously CRIMINAL.

    For details regarding the obvious crime of OBGYNs – complete with the Four OB Lies and the fact that OBGYNs indirectly ADMIT ON VIDEO that they are routinely closing birth canals up to 30%…

    See again:

    NZMJ Editor Frizelle: Babies are harmed by POLITICAL ‘legal muscle’

  15. Wulfstan

    It’s not really ad hom (in the colloquial sense of the term) if it’s true.

    I challenge you to deny that you copy your musings to multiple groups and individuals.

    I challenge you to produce evidence not opinion – but not here. Start your own blog so you can disseminate your musings to those are are interested.

    I challenge you to read An ex-chiropractor speaks out and learn from it.

  16. Hang on, it’s… a FACT that MOST of OBSTETRICS is CRIMINAL?

    Does that mean that >50% of births end in court or that >50% of births should end in court? If it’s the former, it should be easy to prove – in fact, couldn’t it be done by providing the number of births per year and comparing to the number of obstetric prosecutions per year? If it’s the latter, isn’t that opinion rather than fact? Or do capital letters instantly confer factuality on an assertion?

    PS – dvnutrix, are you channeling Francis Urquhart?

  17. They may both start with a vowel but there is nonetheless a vast difference between evidence and opinion. It takes more than the over-liberal use of capitals and spamming to convince me otherwise.

    Francis Urquhart. It is one of those things that I mean to do if I ever see a decent DVD set on offer – I didn’t see House of Cards (?) when it was broadcast. Do you recommend it?

  18. HOC: I saw it when it was first on TV. I know I enjoyed it at the time, but find it hard to remember what it was actually like. Probably worth it for Ian Richardson’s performance, though [Susannah Harker wasn’t bad either]. He is sort-of an evil version of Humphrey from Yes Minister.

    There’s a best-of video on youtube, but that would probably spoil it for you! A couple of *very* brief clips are also available:

    [Spoiler alert] This is the best-of: – the series finale comes about 56 seconds in [/spoiler]

  19. Pingback: Back crack quack attack - it’s a legal matter, baby « Dr Aust’s Spleen

  20. Todd D. Gastaldo, DC

    Admin edit: moved to off-topic.

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