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Health

Kansas chiropractors spread misinformation about COVID vaccines, without consequence

101221_cm_Chiropractors
Jeffrey Phelps
/
AP
People listen to speakers at the Chiropractic Society Health Freedom revival on Sept. 19 in Oconomowoc, Wisconsin. At a time when the surgeon general says misinformation has become an urgent threat to public health, an investigation by The Associated Press found a vocal and influential group of chiropractors has been capitalizing on the pandemic by sowing fear and mistrust of vaccines.

Chiropractors have become major purveyors of misinformation about COVID treatments and have given hundreds of thousands of dollars to anti-vaccine events.

When hundreds of people filled up a Lenexa church on Sept. 20 to spread the gospel of “health freedom,” three Kansas chiropractors were among their top supporters.

Right at the top was Kansas City chiropractor Jay Goodbinder’s Epigenetics Healing Center at the “Royal” level of sponsorship, with a donation of at least $10,000. The Docere Life Center in Wichita weighed in at the “Silver” level of $1,500, and Thrive Chiropractic of Topeka was listed as funding a prize that could have ranged from $500 to $1,500.

In so doing, the chiropractors, who must meet professional standards to be licensed in Kansas and Missouri, put themselves on record as supporting an event that sowed fear of COVID-19 vaccinations with every speaker. There were tearful testimonials from parents who believed their family members were damaged, as well as lectures from scientists who purported to have evidence supporting the anti-vaccine point of view. And there was advice about strategies to avoid employer vaccine mandates.

Chiropractors, in fact, have become major purveyors of misinformation about COVID treatments and have given hundreds of thousands of dollars to anti-vaccine events, according to an investigation by the Associated Press.

Although the anti-vaccine chiropractors make up a small minority of the 70,000 practicing chiropractors in the country, they have become influential in resistance to the vaccine.

It’s a subject chiropractors are reluctant to talk about. Doctors at Docere Life Center and Thrive Chiropractic both declined to discuss their reasons for sponsoring the rally, which was organized by a group called Kansans for Health Freedom.

Goodbinder also declined to be interviewed but sent the following statement by email: “We as an organization, aim to support any group that is facing oppression. Whether that be for medical choices, lifestyle choices, creed, color, race or religion; we will always seek to help people who are struggling.”

Goodbinder was censured by the Kansas Board of Healing Arts in 2019 for “acts of unprofessional or dishonorable conduct,” including sponsoring misleading and false advertisements, holding himself out as a medical doctor and failing to document treatments he recommended for patients. He agreed to pay a $1,250 fine, submit to billing and documentation monitoring, and take continuing education courses on proper advertising practices.

Last year, the Federal Trade Commission sent a warning letter to Goodbinder’s Epigenetics Healing Center about its promotion that intravenous vitamin C and antioxidant glutathione treatments were effective against the coronavirus.

Few disciplinary actions

Theoretically, a licensed health care professional can face disciplinary action for violating ethical standards by spreading false information. Practically, though, there’s a lot of wiggle room and interpretation involved.

Although some speech on alternative COVID treatments would seem to fall under that ethics umbrella, there have been few disciplinary actions.

In Kansas, complaints against chiropractors, physicians and physician assistants have been on the increase since the pandemic began, said Tucker Poling, until recently the executive director of the Kansas Board of Healing Arts.

“The energy surrounding COVID and the public health crisis has definitely brought a lot more attention to what licensees say about public health issues,” he said.

The agency has had 69 COVID-related complaints against 47 licensees of all types, with 35 of those complaints related to false or misleading information provided directly to patients or through social media.

The first to make its way to a final decision was against chiropractor Amelia Rodrock, who practices in Lawrence.

Rodrock had posted statistics on Facebook about the 1918 flu epidemic that showed better outcomes for chiropractors than physicians. She also posted about a study, which she incorrectly attributed to a medical doctor, claiming chiropractic care results in improved immune competency, and urged readers to “see a chiropractor to increase your chances for survival from coronavirus.”

The licensing commission deemed that false advertising. It censured her, fined her $4,000 and ordered her to take 24 hours of continuing education on ethics and advertising.

In Missouri, complaints are logged with the state Board of Chiropractic Examiners. According to records there, the number of complaints against chiropractors decreased from 42 in 2018 to 16 last year. This year has seen a small uptick, with 17 complaints filed so far. The complaints are considered confidential.

One other avenue of oversight for COVID-related advertising comes from two federal agencies – the Federal Trade Commission and the Food and Drug Administration. Those agencies sent more then 300 warning letters to businesses of all types regarding false advertising for clients based on claims of treatment or cures not backed up by science. In addition to Goodbinder’s clinic, at least six other clinics, medical centers and supplement sellers in Kansas and Missouri have received such warning letters.

Only one case to date, however, has prompted anything more than a warning. In April, the FTC sued St. Louis area chiropractor Eric Nepute, alleging he falsely advertised vitamin D and zinc as more effective than vaccines in preventing and treating COVID-19. The agency has asked a federal court for an injunction and unspecified monetary penalties after it claimed Nepute did not adhere to its warning.

Prosecution is tricky

State licensing laws in Kansas and Missouri are clear on one thing: a chiropractor can’t prescribe medicine. That much is cut and dried. But when it comes to giving advice about medicines and supplements, regulators and licensees walk a fine line between free speech and ethical restrictions on false advertising.

Much depends on intent, according to Poling of the Kansas Board of Healing Arts.

“If someone is just sitting on their back porch expressing their personal opinion to close friends and not attempting to recommend drugs to treat a medical condition, that’s one thing,” he said. But if a patient comes in with a medical condition and gets a recommendation for a drug treatment, that can be problematic, he said, even if no prescription is written.

Muddying the waters further is the fact that medical doctors sometimes prescribe “off-label” uses for drugs that haven’t been recommended by the FDA as safe and effective. Dr. John Eplee, former chair of Immunize Kansas Coalition and now a Kansas state representative, said anecdotal evidence has sparked interest in hydroxychloroquine and ivermectin, though neither has been shown to be effective against COVID. But the fact that they can be used off-label can increase pressure on health care providers to prescribe them.

Advice on supplements is also a gray area, Poling said, because they could legitimately be recommended as part of an overall wellness regimen. “It’s really context specific.”

Discouraging the COVID vaccine could also be considered unprofessional conduct if a licensing board determines it was meant to deceive, defraud or harm the public, said Poling.

“If you are spreading harmful misinformation that could lead to sickness and death, that certainly is something the board could potentially take action on.”

Eplee said he has ethical concerns about chiropractic license holders who are giving advice to patients and also selling supplements, a practice that could be considered a conflict of interest.

“It is troubling when they want to recommend against vaccine in defense of selling their products,” he said.

But signing up to be a donor whose name appears on a program supporting an anti-vaccination rally may be the grayest area of all. There’s no specific rule against it for Missouri chiropractors, according an emailed response from officials of the Missouri Chiropractic Examiners board.

That said, the Missouri statute governing chiropractors does have language against solicitation of patients based on misleading or deceptive claims of cures or treatments.

Poling said public support of anti-vaccine groups would be difficult to prosecute as an ethical violation. Professionals have to adhere to certain ethical limits on their free speech to keep their licenses, but there’s some leeway in the statutes’ interpretation, he said.

For those reasons, regulators in Kansas and Missouri stress that any decision to prosecute depends heavily on the specifics of a case. Complaints coming in to those boards go through several levels of vetting before they make it to the licensing board, and even then the decision may result in a warning that never becomes public.

What chiropractic schools say

Chiropractic schools and associations in the Kansas City area have not directly told their members not to tout alternative COVID-19 treatments or to discourage the vaccine.

School officials were unwilling to discuss the issue in person, but a few sent emailed statements and responses to questions. The Missouri Chiropractic Physician Association said it “encourages the highest standards in patient care by promoting strict adherence to state and federal laws that regulate the chiropractic profession’s scope of practice.”

The American Chiropractic Association said it advises its members to follow guidance from the Centers for Disease Control and Prevention and state governments and to stay within their scope of practice to provide “evidence-informed care.”

“ACA members collaborate with and refer patients to health care providers whose scope of practice includes vaccination, an established public health practice,” it said. “ACA supports further research, development and improvement of vaccination strategies. ACA members promote behaviors that contribute to the control of infectious diseases and the advancement of practices that enhance individual health and well-being.”

Kansas City’s Cleveland University College of Chiropractic did not respond to a request for an interview. But the Palmer College of Chiropractic in Davenport, Iowa, said that its students discuss immunology and are trained to provide their patients with accurate information about diseases and the benefits and risks of vaccination, “while supporting the patient’s right to make an evidence-based choice.”

The school doesn’t take a position on ivermectin or hydroxychloroquine because they are outside a chiropractor’s scope of practice, said Jillian McCleary, its senior communication director.

Misinformation about vaccines has not made the job easier for advocates like Immunize Kansas Coalition, Eplee said. Mistrust of medicine has led to pushback against vaccine mandates, even though many other vaccines have come to be trusted without a requirement, he said.

“People are scared. Add to it the fuel of the internet and Facebook and all of the sudden alternative treatments are taking off,” he said.

But while vaccination has become a lightning rod, Eplee said he’s hopeful about the future. The vaccines will prove their safety and effectiveness as more people get immunized and cases drop, he said.

“Time is our friend on how it shakes out,” Eplee said.

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