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Canadian Justice: Breast-Fondling Chiropractor Faces “Interpersonal Skills Training”

There is something unexpectedly sinister about this news report from my former home town in Canada. Apparently, a local chiropractor has been using his “medical training” to excuse his sexual misconduct. Here’s the story from the Halifax Chronicle Herald:

During a hearing in July, the woman said the chiropractor would frequently grip her around the ribs and hold tight, sometimes cupping her breasts, while speaking softly over her shoulder.

On other visits, she said, he would have her lie on a table and would undo one side of her johnny shirt, exposing her breast, place a thumb between her breasts and roll her onto her side by pressing the weight of his own body on her.

Dr. LaPierre testified he performed a technique called the Zindler manoeuvre. It involves applying precise, quick pressure to a restricted joint to restore movement. He said he would have explained the procedure to her the first time but not on subsequent treatments…

The second incident involved a woman who complained that in 2006 the chiropractor “massaged” her breast while trying to find the source of her back pain.

Dr. LaPierre said he was using a technique called “matrix repatterning” that required contact with the woman’s sternum. He said he didn’t recall where the rest of his hand was at the time. He determined the woman had a rib out of alignment.

What was the punishment for his behavior?

Dr. Phillip LaPierre must have a female observer present when he examines women for the next five years, must take training on interpersonal skills and must pay a fine and costs totaling $26,000 now that a panel of the Nova Scotia College of Chiropractors has found him guilty of sexual misconduct based on the two complaints.

It’s hard to imagine such a small fee in an American court of law. If a US physician were molesting his patients, I’m willing to bet that the fine would have an additional zero or two at the end.

But what bothers me most about this chiropractor is that he was disguising his molestation as therapeutic techniques of a scientific nature. Terms like “matrix repatterning” and “Zindler manoeuvre” are thin veils for sexual perversion. How many women did he treat with a breast massage “to locate the source of their back pain?” How many were too ashamed to come forward to complain? How many were just confused enough by the “sciencey-sounding” terminology to question their own disgust?

Although it isn’t fair to blame the misbehavior of one chiropractor on the profession at large (and of course there are cases of sexual misconduct in the medical profession too), this case does illustrate the ease with which one can bend pseudoscience to the will of the practitioner. That just doesn’t work in science-based medicine. There is a demonstrable, pathophysiological rationale behind everything we do – and the dignity and integrity of that process should not be underestimated.

I agree with my peer and colleague Peter Lipson’s observation that alternative medicine has alternative ethics. Indeed, foisting make-believe therapies upon trusting patients is the height of betrayal as a healthcare provider. Taking those “therapies” and using them as a cover for sexual perversion and molestation is totally unacceptable.

When there are no scientific checks and balances involved in one’s practice – anything goes. And for some Canadian women, “interpersonal skills training” for Dr. LaPierre is the only “justice” they can expect. Please don’t be shruggie about alternative medicine practices. The final common pathway of deception is destruction. This case is just one prime example of it.

Posted in: Chiropractic, Medical Ethics

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22 thoughts on “Canadian Justice: Breast-Fondling Chiropractor Faces “Interpersonal Skills Training”

  1. Joe says:

    Val wrote “Although it isn’t fair to blame the misbehavior of one chiropractor on the profession …”

    Please don’t take offense; but it would help if one recognizes that chiropractic is not really a profession; rather, it is a business based on a cult. Being a “professional” chiropractor is like being a “professional” astrologer. An auto mechanic is more a professional than either because the mechanic has standards and provides tangible results.

    It also does not help when one refers to them as “doctor;” after all, they do not possess legitimate, academic credentials. There are good reasons why their schools are not affiliated with academic institutions, despite their efforts. When one refers to a chiro as “Dr.” it sounds like you respect the quackery.

    If LaPierre were not called “Dr.”, women would be less likely taken-in. I hope his victims can sue, now, in civil court and get satisfaction.

    Some people advocate being nice to chiros in order to encourage responsible actions (i.e., acting like PTs). However, one has to thoroughly examine each claim to rational practice. They do not have the formal education to replace PTs, and I don’t trust their ability to educate themselves.

  2. steveisgood says:

    Joe, just as a point of interest, it’s perfectly acceptable to be called a professional astrologer, in that it is a person who gets paid to do astrology.

    Under one definition of what a professional is, it is simply someone who gets paid to do their…thing. I get paid to play guitar, ergo, I’m a professional musician. A guy gets paid to snap-crackle-n-pop a spine, he’s a professional spine-snap-crackle-n-popper.

    I agree that chiropractic is not a “profession” however, in that it is not like a nurse, an electrician or a plumber.

    Also, to your point about them being called “Dr.”: Legally in Canada, they are allowed to be called Doctor, but not for any medical/academic reasons….they sued under the auspices of slander and libel laws, demanding that people stop calling them quacks back in the early 90′s and won.

    I recently layed it out a little better on my blog following the news that Prime Minister Harper has named a former chiropracter his Minister of Science and Technology, http://somecanadianskeptic.blogspot.com/2008/11/watch-your-back-goodyears-good-year-may.html

  3. Joe says:

    steveisgood on 20 Nov 2008 at 9:35 am “… it’s perfectly acceptable to be called a professional astrologer …”

    You are correct (well, not “perfectly”); however, it exalts their jobs. Since they do not meet the traditional meaning of “professional”, I do not feel the need to use it. In a modern meaning of the term (people with a unifying theme to their work) chiros are unified in their beliefs in fictitious subluxations and Innate Intelligence, and their opposition to criticism.

    I have no problem calling you a professional musician. I object to using that term for an ignoramus or a fraud. Except, if you call someone a professional ignoramus (e.g., George W.M.D. Bush) or a professional fraud.

    My condolences on your sci and tech Minister.

  4. Kimbo Jones says:

    Sigh. Sometimes I think we canucks let things fly a little too far under the radar. Then the seed is planted and it grows and grows until all of a sudden chiropractors are so “valuable” that instead of just stripping this sexual predator of his “license”, we fine him a measly 26 grand and let him keep his job per regular counseling. Once you let nonsense dictate medical practice, nonsense can be used to justify anything to unsuspecting patients who may be unwilling or unable to question authority. “Now I’m just going to massage your vagina with my penis to align your sacral vertebrae…hold still, now.” [Shudder.]

    (Note: That last bit was inappropriate “humour” and not at all an attempt to argue that would be the next thing to happen.)

  5. Fizzizist says:

    Being a Canadian myself I agree that we should take a lesson from the states and add a few more zeros to our fines on things such as this.

  6. Jurjen S. says:

    steveisgood, at the risk of coming off as overly pedantic, there’s a difference between someone who performs job x being a “professional x” on the one hand, and that job x being a profession on the other. I’m rather old-fashioned in that regard; I consider a “profession” to be something you need to have a university-level education to do, e.g. law, medicine, engineering, etc. Being a nurse, plumber or electrician is a trade, not a profession, even though in the vernacular, one can be a professional nurse (as opposed to a volunteer one), or describe the way an electrician does his job as “professional.” It’s rather 19th-century of me, I acknowledge.

    What I’m wondering regarding the chiropractor in question is why he wasn’t charged with multiple counts of sexual assault. Being licensed doesn’t mean you get more leeway than the ordinary person; if anything, it means you’re held to a higher standard.

  7. steveisgood says:

    Jurjen, just as a point of interest, at least in Ontario, in order to be a registered Nurse, one now needs to have a University Education.

    But more relevantly, my earlier point was to point out that there are different definitions of what constitutes a ‘professional’, and both are perfectly true. The problems come when they get confounded, and one person’s job gets elevated (as a professional chiropractor would), whereas another gets diminished (as an MD would).

    This creepy-creepy chiropractor is still professional in the colloquial sense, though I think we all agree that he’s as qualified to be called “Doctor” as I am….

    oh…and I’m not qualified. Unless a political science degree means that I can perscribe drugs (oh, to dream).

  8. MBoaz says:

    “Some people advocate being nice to chiros in order to encourage responsible actions (i.e., acting like PTs). However, one has to thoroughly examine each claim to rational practice. They do not have the formal education to replace PTs, and I don’t trust their ability to educate themselves.”

    Hi Joe,

    I don’t know that I agree with you re: chiropractors being unable or unqualified to function as PT’s, with a bit of additional training of course. PT schools have no monopoly on the information they teach. My understanding is that chiropractors learn a great deal of legitimate anatomy, physiology, orthopedic testing, etc., they just don’t really learn how to administer any sort of effective therapeutic intervention, aside, perhaps, from some of the rehab. exercises that some chiros. use (PT exercises!) I believe that there are a great deal of smart, knowledgeable chiropractors out there who just believe in stupid things. Of course there are also a great many cranks and morons who probably skipped anatomy class but sat at the edge of their seat for Subluxation Theory 101.

    The point is, there are more than a few chiropractors out there who do possess the background knowledge, who can differentially diagnose your knee pain, who know the right exercises for that post-op supraspinatus tear, etc. Some can even competently interpret your x-ray. Something about babies and bath water. . . .

    Also, are physical therapists really the benchmark for the prescription of evidence based therapies? I’m not being snarky, I honestly don’t know. Is everything they do supported by evidence? Will my torn quadriceps really heal faster or more completely if I do those leg extensions? If not, is my PT a quack for prescribing it?

    Thanks for the conversation,

    Matthew

  9. Joe says:

    Jurjen S. on 20 Nov 2008 at 4:36 pm “What I’m wondering regarding the chiropractor in question is why he wasn’t charged with multiple counts of sexual assault.”

    This was not a criminal hearing. I suppose the complainants had the option of going to the local prosecutor, whose standards are different from the board of quackery.

    On the other hand, I find it interesting that the guy got a minor reprimand in the face of the recent item here on what it takes to delicense an MD. I think it was Kimball Atwood who wrote that sexual mis-conduct is among the few things that will bring swift and definitive action from the medical board.

  10. Joe says:

    MBoaz on 20 Nov 2008 at 10:17 pm “I don’t know that I agree with you re: chiropractors being unable or unqualified to function as PT’s”

    According to their own survey http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B75KC-4F1H9GS-5&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=754fe88415cd702aa52be6484f7005b8 nine out of ten chiros believe in their subluxation. Also, four out of five think their subluxation influences visceral disease.

    Look at http://www.chirobase.org and see the investigations where, for example, a journalist visits multiple chiros and is told his left leg is longer than the right one, his right leg is longer, his legs are the same length. Or read Dr. Kinsinger’s report about going to eight chiros (who claim to be primary care physicians) complaining of symptoms that I would recognize as an emergency, and none of the chiros recognized it.

    The odds are stacked against you if you try to find a rational chiro.

    Then, there is the prctice- chiros can be licensed without ever seeing (treating) an unhealthy person. They usually have to recruit their healthy friends to come to their student clinics so they can log enough customers to pass. At chirobase you can read about some students who sued their school over failure to provide good clinical experience. They lost; but not because the school provided a good experience- they lost because the school had not promised to provide good clinical training.

    When you see a PT, you visit someone who has real, clinical experience.

    As for a chiro’s ability to read and assimilate PT literature, to get a good education on their own. Anyone can do that. Would you trust your health to someone who simply read books on the topic? And, remember, you are dealing with a person who was dumb-enough to go to chiro school.

    Sure, there are a small number of competent people who are chiros. As I said, each claim requires a rigorous examination. When you go to a PT, that examination has been passed and who does not have the chiro’s delusion of advanced, general diagnostic knowledge.

  11. Joe says:

    Dang,

    “prctice” should be “practice.”

    “… When you go to a PT[, that examination has been passed] and who does not have the chiro’s delusion of advanced, general diagnostic knowledge.”
    Should be “[ who has passed that examination]”

    I should not post before my second cup of coffee.

  12. Anne says:

    In the article you linked to, it says that the disciplinary committee found that the chiro’s inappropriate touching of patients was incidental and without sexual intent. That’s why the light punishment.

    Alternative health practitioners aren’t the only ones who commit sexual molestation of their patients in the guise of medical procedures. Real M.D.’s do it too, and some don’t even bother to try to disguise it. I think it’s less a product of bad science than it is of the power dynamics of doctor/pseudo-doctor and patient. In my opinion, this kind of behavior has no relationship to the issue of whether chiropractic, or whatever it’s called, is pseudoscience.

  13. Diane says:

    Speaking of pseudoscience, here is the [url=http://www.matrixrepatterning.typepad.com/]website of the chiro practitioner[/url] who came up with the “technique.”

    Note that it says (as a book ad): “A complete self-care program for relief of chronic pain, The Matrix Repatterning Program for Pain Relief is a low-impact body-scanning and [b]energy-balancing[/b] technique you can use to check your body for stress and tension, and relieve pain permanently.”

    There seems to be a flurry about researching this… more “tooth fairy” science (as per Harriet Hall), I suspect.

  14. Diane says:

    Sorry about the code – I see this comment section does not enable code.

  15. Joe says:

    Anne on 22 Nov 2008 at 4:34 pm wrote “In the article you linked to, it says that the disciplinary committee found that the chiro’s inappropriate touching of patients was incidental and without sexual intent.”

    You don’t have to agree that the board’s findings had merit. That is, you can think for yourself, as we have, and realize this guy is a sexual predator. The board was just following the chiro standard of protecting their own. (The fact that predators exist in other practices is not a mitigating factor.)

    As I noted, above, an article at SBM noted this (sexual impropriety) is one of the few things that will have one’s medical license revoked, quickly.

  16. MBoaz says:

    Anne,

    Agreed.

    Joe,

    Thanks for the link. I agree that the rational chiros. are a minority. Based on the survey, it looks to be about 10:1 in favor of the crazies, and at best 10:2.

    I don’t accept your anecdote re: chiropractors receiving no clinical experience. I believe the story, and it’s too bad the students lost that lawsuit (would’ve set quite the precedent). I wouldn’t trust someone with my health who “just read the book,” but again, I don’t think that that’s what is happening for the most part. Also, I don’t think it’s fair or constructive to suggest that people who are “dumb enough” to go to chiropractic school couldn’t handle the job of a PT. I respect physical therapists, but it’s not brain science/rocket surgery. I could make the same argument about people who are “dumb enough” to go to church. I think that otherwise intelligent people believe in stupid crap, but it’s not fair to make broad assertions regarding a person’s or group’s overall intelligence or ability based solely on what is likely their stupidest belief. It’s easy for us as skeptics to criticize others who probably never learned how to critically evaluate some claims. There’s no dearth of misinformation out there, and I’ll admit that before I learned how to critically evaluate a clinical research article, I was taken in by some garbage studies and terrible journalism. I just didn’t know how to tell the difference between a good and bad study, but it’s a skill, not an innate ability. People are being defrauded left and right out there, but it’s an issue of scientific literacy much more so than cognitive ability.

    Anyway, I definitely agree that there are some, the true believers, who never could or would acquiesce, even in the face of perfectly presented, incontrovertible evidence. Those are the bad guys, the true-blue dumb-asses. Everyone else is a victim.

  17. Joe says:

    MBoaz on 22 Nov 2008 at 9:13 pm “I don’t accept your anecdote re: chiropractors receiving no clinical experience. … I wouldn’t trust someone with my health who “just read the book,” but again, I don’t think that that’s what is happening for the most part.”

    That is fine- show proof of otherwise. Note- the chiro schools all claim to do otherwise, their claims are not reliable. You can find a lot at http://www.chirobase.org Also, there are Net boards populated by chiros who realize they were poorly served by their schools, I think you can find links at chirobase.

    As far as people being dumb-enough to go to chiro school or to church- they are fools. I do not apologize for that, it isn’t my fault. However, religion is based in philosophy, whereas chiro is based on demonstrably falsifiable (and falsified) notions about reality. People who subscribe to chiro, as merchants or customers, are fools. (Well, maybe the merchants are shrewd money-grabbers.)

  18. Militant Agnostic says:

    One can only hope that these patients press criminal charges against this creep. I don’t think a judge or jury would buy the inadvertent explanation. That the chiro board found this be inadvertent is quite damning of the whole pseudo profession.

    Never a mind a fine – this guy should be spending some time in the slammer and be in atreatment program for sex offenders.

    What is the purpose of interpesonal skills training – to increases his abiltity to persuade women to let him fondle their breasts?

  19. Fred Dagg says:

    Harriett and Joe,

    to paint the whole Chiropractic profession or any profession with the illegal activities of one individual is unfair. No one holds the total medical profession responsible for the actions of Britians most active mass murderer, Dr Harold Shipman, nor the medical practitioner who prescribed Elvis all those drugs. I think Elvis died as a consequence of prescribed drug abuse. So please be fair, otherwise your writings are no more logical than those people you ardently criticize.

  20. Joe says:

    Fred Dagg on 03 Jun 2009 at 4:32 am wrote “Harriett and Joe,

    to paint the whole Chiropractic profession or any profession with the illegal activities of one individual is unfair.”

    I didn’t do that. Chiropractic was put in a bad odor when its governing board allowed a sexual predator to continue to work.

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