BC Chiropractors Question Validity of Whiplash Research Generated by Insurance Companies
For Immediate Release February 11, 2000
Vancouver - Insurance agents are, in effect, making medical decisions, according to the BC College of Chiropractors.
"Chiropractors treat thousands of patients suffering from whiplash each year. We are concerned for their recovery, not how they fit into an insurance model … especially if the model is flawed."
The care of patients must be left to practitioners trained in the most effective treatment of whiplash-associated disorders, not to insurance agents."
The BC College of Chiropractors is concerned that the Insurance Corporation of BC is covering up a recent scathing review of two studies on whiplash-associated disorders, including their "British Columbia Whiplash Initiative" (BCWI).
The BCWI was designed as a set of educational modules for British Columbia's medical doctors, and relied heavily on research findings from the 1995 Quebec Task Force on whiplash-associated disorders.
In an article in the autumn 1999 Pain Research & Management, The Journal of the Canadian Pain Society, authors RW Teasell MD and H Merskey MD state that the Quebec Task Force report was based upon a flawed and overly optimistic picture of the natural history of whiplash disorders, and an arbitrary classification and management system.
"If the Insurance Corporation of B.C. continues to use a flawed document as the basis of their insurance policy for treating whiplash-associated disorders, we know that patients will be the ones who are in danger, not ICBC's bank account," says Dr. Michael Vipond, president of the BC College of Chiropractors.
"It's bad public policy for an insurance company to systematically gather and analyze evidence and direct treatment on how to manage whiplash injuries," says Dr. Vipond.
Here is an overview of the article:
a) Two studies on
whiplash-associated disorders that were generated by insurance companies
were reviewed: the 1995 Quebec Task Force (QTF) on whiplash-associated
disorders and the 1997 British Columbia whiplash initiative (BCWI).
b) According to the
review, in The QTF guidelines, on which the BCWI is based, …whiplash injured
patients have been saddled with a management schema based on arbitrarily
chosen groupings, overoptimistic estimates of recovery, unreliable criteria
and untested management strategies.
c) … Both the QTF and
BCWI draw attention to the potential dangers of insurance industry initiatives
designed to persuade medical and allied health professionals to accept
viewpoints that appear overoptomistic and potentially self-serving.
d) ICBC funded and uses the BCWI to rationalize and promote its model,
which determines a person's recovery from whiplash injuries by discontinuation
of payments, and not by the resolution of symptoms.
e) The information is aggressively disseminated to clinicians [by the
insurance companies] with the expectation that it will modify clinician's
practices to the betterment of whiplash patients.
f) However, this produces a potential conflict of interest. It is unlikely
that any third party will use guidelines that will have negative economic
implications for the funding agency.
g) Hence, a potential danger of bias enters into insurance initiatives
for the development of treatment guidelines.
h) The BCWI [and QTF] employs concepts that have been widely rejected
by workers in the field of chronic pain, emphasizes psychological factors
of simple reassurance with and without evidence for them and downplays
serious organic issues, like nerve and muscle damage.
"ICBC should leave the care of the public to health care professionals," says Dr. Vipond.
The BC College of Chiropractors determines the standards of chiropractic health services and provides information to both the public and chiropractic doctors. The College also monitors the licensing, conduct and competence of all licensed chiropractors practicing in British Columbia.
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Media Contact: Margo Bates Publicity Inc. at 604-536-9501 Fax: 604-536-9506 or E-mail: mbpr@istr.ca
Available for interview: Dr. Michael Vipond, President, BC College of Chiropractors Dr. Don Nixdorf, Executive Director, BC College of Chiropractors
Source:
- Article --The Quebec Task Force on whiplash-associated disorders and the British Columbia Whiplash Initiative: A study of insurance industry initiatives, first appeared in the autumn 1999 issue of Pain Research & Management - The Journal of the Canadian Pain Society ¨
- Authors: Robert W Teasell MD FRCPC, Department of Physical Medicine and Rehabilitation, and Harold Merskey MD FRCPC, Department of Psychiatry, University of Western Ontario, London Health Sciences Centre, London, Ontario
Updated Noon, Friday, February 11, 2000
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