Frank Swain, aka SciencePunk, no longer calls himself a skeptic. This isn’t because he’s become less of one. On the contrary, he described himself as being “born of the skeptic movement” and “hugely enamoured” with it. But he has, in recent years, distanced himself from the “skeptic community” because he doesn’t want to be associated with its attitudes and behaviour.

It seemed a little odd when, towards the end of his talk, he introduced what he described as the most important part of it with the revelation that as a “white, middle-class, college-educated, science-background man”, he wasn’t qualified to talk about it. As it turned out, that was one of the few things Frank said that I agreed with. The topic at this stage was “who we invite and make space for in our community”, the community in question being the people who write or talk or campaign in any way on the kind of issues that skeptics are concerned about; the one Frank is hugely enamoured with but doesn’t want to be associated with.

Before he said that, we’d heard much about how macho, aggressive, arrogant, intolerant and hostile skeptics are and we were treated to a list of quotes of the “quacks are stupid” variety that he’d lifted from various skeptic blogs. We also heard how we were doing things wrong, from what he described as our “evidence or fuck off” approach to debate to our refusal to engage with people’s “scary” emotions. Even the format for skeptics meetings in pubs was “intimidating”. He didn’t pull his punches — here’s a typical quote:

…I don’t want to shoot my load too soon but there is something very important I want to say, which is that arguing from the basis of facts is ineffective and cowardly…

It was obvious that, however enamoured Frank might once have been, he doesn’t love us anymore. Now, in the “most important part” of his talk, he told us of lots of other people don’t love us either. People like women, mothers, humanities graduates and members of the Green party. As for ethnic minorities, “We do fail to take an interest in them, don’t we?” he said mysteriously, before moving swiftly on.

On women he was more forthcoming: women aren’t comfortable coming into “this very aggressive environment”, he claimed. He’d even had emails from women telling him as much.

I wish to goodness those women would email me so I could tell them to get a fucking grip!

As many readers of this blog know, I was not born of the skeptic movement myself. Rather, I am a born-again skeptic, having previously spent many years as a female humanities graduate and occasional user of altmeds, which never failed to disappoint me. I owe a debt of gratitude to the many skeptics who helped me on my path to enlightenment. Having spent some years trying to be all nice and polite and empathic when engaging with promoters of pseudoscience and opponents of vaccines, only to be repeatedly sneered at and insulted while my arguments — whether facts or anecdotes — were ignored, I can’t begin to describe how liberating it was to find all these blogs by people who weren’t afraid to call a spade a spade or quacks stupid.

As for skeptic meetings, I don’t recognise the “very aggressive environment”, Frank spoke of. One of the many ironies about his presentation is that, having attended many different skeptics meetings, I’ve only ever felt uncomfortable twice and both times were during his talk.

He made much of how important it is to think about how you would explain an issue to your mother. I agree. My son is six foot plus and nearly fourteen stone but I’d still give him a slap if I heard him use such a graphically macho expression as, “I don’t want to shoot my load too early”. Is this how Frank talks to his mother?

Worse was to come (no pun intended):

It’s only by understanding mothers and understanding that they are swayed by stories not facts…

Oh dear! It’s been a while since I felt as patronised as I did at that moment. Mercifully, most skeptics don’t say things like that or I wouldn’t touch them with my husband’s light sabre.

Much of what Frank said came across as either bizarre or gratuitously insulting. Take, for example, his view that that arguing from the basis of facts is ineffective and cowardly. Frank accuses skeptics of fetishising facts and of having “an obsession that you fight based on the factual accuracy of your idea”, which isn’t effective, he says, because people prefer stories and we have to “emotionalise” issues.

OK, I’ll concede there is some truth in that last point, which is why I write as I do. Just look at the colourful and interesting way I am telling the story of Frank’s talk, for example. And I make frequent use of stories of people suffering and dying at the hands of evil or stupid quacks in my blog posts. One of my favourite skeptic websites has an abundance of such stories. Funnily enough, the invariable response from my detractors is to dismiss them as anecdotes.

But what is “cowardly” about arguing from the basis of facts? Here’s Frank:

When you go in with a foregone conclusion and you know your numbers are right, you’re being particularly cowardly and very pedantic in my opinion and the worst thing about that is that you make no attempt to understand where that other person might be coming from.

I think what Frank is trying to say here is that the danger of being sure of one’s position is that we might fail to empathise with the other person and why they take the position they do. If that’s what he meant then it’s a fair point, which applies equally to those we argue against. It probably applies to most people arguing about most things they feel strongly about.

That Frank should make this point in such a hostile and aggressive way by calling it ‘cowardly’ struck me as another of the ironies about his talk. In any event, he is wrong. It is not cowardly to base an argument on facts and the reality is that people respond to both facts and stories, depending on where they’re at.

Here’s Frank on mothers again:

They hear these conflicting stories and above all else they want the best for their kid. They want to protect their child at all cost and it’s only by understanding this that you are then going to convince them that the MMR is the right way to go and you cannot do that with this arrogant attitude that you are right based on facts.

Rhetoric that sounds persuasive when spoken looks pretty empty on the printed page doesn’t it? How silly is the suggestion that skeptics don’t understand that mothers want to protect their children at all costs? And that one shouldn’t try to present them with the real facts because that’s “arrogant”? What are we supposed to do instead? Frank didn’t tell us.

It so happens that back in the mid-eighties when I was having my children, there was a big scare about the whooping cough vaccine. I was swayed by stories of the jab causing brain damage and I was equally swayed by stories of the miseries and dangers of whooping cough. The anti-vaxers caused me a great deal of anxiety and even less sleep than I was getting already with a young baby. So what did I do? I went looking for the bloody facts and I went on looking until I found them (not so easy in those pre-internet days). As a result of what I found out, both my children got all the jabs they were supposed to. I wish to goodness I’d known some of the facts that I know now before I’d been persuaded by people’s anecdotes to waste any time or money trying out quack therapies.

So I wasn’t persuaded by Frank’s argument about arguments. I felt his comments about blogging were a bit loopy as well. After pointing out — presumably for those of us too dim to realise it — that there’s a limit to what we can do on a blog and that a lot of people don’t come to the internet for information, Frank went on to say that the approach we choose to take and the tone in which we do so “narrows down our audience”. This is undeniably true. People who don’t want to read a skeptic perspective on anything will not read skeptic blogs. The danger, argues Frank, is that we only reach the people who think the same way as us; that we’re just an “echo chamber”.

It’s a curious suggestion that people only read stuff they think they are going to like and agree with and I invite anyone who thinks there’s any truth in it to look at the left hand column on this blog and peruse some of the comments that have been made about it — and me — by my readers.

In his introduction Frank had said,

The most powerful thing I can do as a writer is change someone’s mind, shape the way they see the world, change the way someone thinks…

I agree. What Frank failed to do in his talk is explain why he thinks skeptic bloggers aren’t doing this because I know from personal experience that they are and that skeptic bloggers can take a large part of the credit for the recent groundswell of support for skeptic causes from people who’d hitherto taken little or no interest.

My most fundamental disagreement with Frank is over his idea that anyone who promotes a sceptical approach to pseudoscience is a member of the ‘skeptic community’ and answerable for the crimes of any other member of said community. He referred to the recent twitter storm over Gillian McKeith during which somebody apparently called her a “stupid fucking cunt”.

What does it show about a community when we allow somebody to say something like that and they feel comfortable in an environment saying someone is a stupid fucking cunt?

Allow somebody?

I don’t buy into the notion that we are a ‘community’ in any meaningful sense of the word. As far as I’m concerned, the only thing I have in common with most other skeptics is an opposition to the dishonest promotion and public funding of altmed. Being a skeptic is a small part of who I am. Amongst other things, I am also a feminist. I write from a feminist perspective but I’m not in any ‘feminist community’. In common with other secularists, I am opposed to religious privilege but nobody talks about a ‘secularist community’ and I don’t mind standing shoulder to shoulder with feminists and secularists who use quack remedies when we’re campaigning for abortion or against faith schools.

When I see the nasty things that other secularists sometimes say about those with any kind of religious faith, I can get quite offended on behalf of the highly intelligent, thinking and liberal but religious members of my extended family. But I am not responsible for how other secularists behave — they have nothing to do with me and I don’t see why I should feel any different about other skeptics. I don’t defend the way a bunch of people I don’t know behaved over Gillian McKeith on Twitter but I can understand the anger behind it. It wasn’t because McKeith is an enemy of scepticism, as Frank suggested but because of what she did and what she had done before she did that. And if “all” that’s happened as a consequence is that she has stopped promoting herself on Twitter, as Frank lamented, then that sounds like a result to me.

Frank did make the point that skeptics aren’t formally organised and therefore lack the infrastructure of the environmentalists. Nevertheless he constantly referred to skeptics as if we were bound together by something more than a shared interest in promoting an evidence-based approach and critical thinking.

We are a community; we know the same people, we have the same experiences, we read the same things…we have our own particular gods and monsters and we elevate these people who are our gods up to this level where no-one is allowed to criticise… anything that someone like Ben Goldacre or Simon Singh or Evan Harris says is beyond question. There’s this prevailing attitude that you don’t speak out against these top people.

Hogwash. Yes, there are a number of guru-like figures for skeptics but only because they have achieved a high profile by saying and doing things we agree with and because they have been the targets of bullying and abuse from people who stand for what we disagree with. But where does this idea that any individual skeptic wouldn’t speak out if he or she disagreed with anything any of these prominent figures said or did?  Because I certainly would. I am an admirer and frequent defender of Richard Dawkins, for example. Dawkins is said to be a guru for hard core atheists like me. Yet the only blog I’ve written about him was to argue that he was wrong and I’ll do the same favour for Ben or anyone else in a heartbeat should they give me cause to.

I think that’s very dangerous, it’s not a situation I think we should be in…We like to think of ourselves as critical, sceptical people,

So says Frank. Well that’s OK because that situation doesn’t exist outside of his imagination. The reason we think of ourselves as critical, sceptical people is because we are and I hope that nobody was so demoralised by Frank’s talk (which was notably short of constructive suggestions) that they’ll do anything differently.

Here are all the other blog responses that I’m aware of. I think most, if not all, are more sympathetic than mine.

http://myurlisname.blogspot.com/2010/08/prevention-or-cure.html
http://jstreetley.co.uk/blog/?p=303
http://noodlemaz.wordpress.com/2010/08/03/sceptical-about-skeptics/
http://arkadychenko-theblog.blogspot.com/2010/08/on-westminister-skeptic-and-problem.html
http://thethoughtstash.wordpress.com/2010/08/09/science-punk-at-westskep-the-aftermath/
http://thethoughtstash.wordpress.com/2010/08/05/yet-another-blog-post-about-westskep/

I’ve lost count of how many self-pitying blogposts by homeopaths I’ve seen begin with those words. The assault on homeopathy is continuing relentlessly and the poor homeopaths don’t know what’s hit them. I’m sure I’m not the only one who feels a bit sorry for them.

Only joking. Didn’t you just love watching Tom Dolphin’s turn at the BMA conference recently? For those who missed it, Dolphin — who is deputy chairman of the BMA’s Junior Doctors Committee — announced that, contrary to his headline-grabbing comments back in May, homeopathy isn’t witchcraft after all. He graciously apologised for the offence caused to all the witches who’d objected to the association with homeopathy. “I take it back — it isn’t witchcraft”, said a contrite Dolphin, before going on to explain what homeopathy really is.

It’s nonsense on stilts. It’s pernicious nonsense that feeds a rising wave of irrationality that threatens to overwhelm the hard won gains of the Enlightenment and the scientific method. We risk as a society slipping back into a state of magical thinking when made up science passes for rational discourse and wishing for something to be true passes for proof.

Amen to that and the motion to stop funding homeopathy was carried overwhelmingly. The only surprise — apart from the fact that it’s taken them this long to get this far — being that anyone voted against it. Most of the speeches against the motion were the usual pap: “paucity of evidence does not amount to lack of efficacy,” whined one speaker, ignoring the wealth of evidence of hundreds of clinical trials; “It works — ask the people of anywhere in the world,” bleated another.

But the speeches against weren’t all that bad. Here’s London GP, Paddy Glackin:

I’ve got a group of patients who go to the homeopathic hospital and it’s a great relief to me that they do because, frankly, I’ve got nothing else to offer them. I am completely stuck while they have found a place where they are getting better and if we remove NHS funding I don’t know what I’m going to do with them because they have been extenisvely investigated, extensively managed and the only person they are getting benefit from is the guy who waves some water in their face and is really sweet to them once a month. That keeps them well.

That the homeopathic hospitals should serve as place where doctors can dump untreatable patients is probably the best argument for continuing to fund homeopathy on the NHS. But even if the NHS had infinite resources, I still wouldn’t support it because homeopathy is indeed ‘nonsense on stilts’ and it’s time we stopped pretending otherwise.

Enough already!

I recall the feminist conferences I attended in the 1970s and the fervent discussions we had about how the NHS was failing us. The ideas that were floated at the time contributed to the change in the culture of the doctor-patient relationship we’ve witnessed over the past few decades. These days we demand that our doctors are honest with us, that they listen to us and take us seriously and aren’t paternalistic and condescencing…don’t we?

A few years ago, I attended a talk given by Dr David Reilly, who qualified as a doctor of proper medicine but now works at the Glasgow Homeopathic Hospital. Dr Reilly started his talk by claiming there were some 200 positive trials for homeopathy. Thereafter he refused point blank to talk about homeopathy and he disregarded any challenges to the principles of homeopathy from the audience, stating he hadn’t come to discuss it. What he’d come to talk about was the work of the Glasgow Homeopathic Hospital and what he took an hour to say could be summed up thus:

Give some people a lovely, tranquil environment, a lot of time, a listening ear and a good bedside manner and they start to feel better.

This works regardless of whether any remedy prescribed has any active ingredients and we know, of course, that homeopathic remedies don’t. The reason I remember Dr Reilly’s talk so well was because it echoed precisely what we’d said at those meetings over thirty years ago and it has absolutely nothing to do with homeopathy. Back then, we all felt the NHS had an ugly paternalistic face and that it treated us something like the pie cases on a Fray Bentos assembly line, filling us with drugs instead of steak and kidney and sending us on our way. What we wanted to happen was something like this:

(1) Train doctors to ask sensitive questions to help patients get everything off their chest and to listen intently while patients prattle on about themselves.
(2) Allow doctors to spend an hour with each patient every visit.

Sorted. No need to refer anyone to a homeoquack so we can stop funding them pronto.

We knew then as we know now that the second requirement wouldn’t be fulfilled any time soon in a publicly-funded health care system, and that this would obviously impact negatively on the first requirement. Thus the new and improved generation of today’s GPs still end up, as Dr Paddy Glackin suggested in his speech, prescribing too many unnecessary meds that don’t work anyway and don’t get rid of chronically unwell patients who have nowhere else to go. That’s what the homeopathic hospitals are for.

Crikey, I could almost talk myself round into supporting them, were it not for the fact that I am haunted by the spectre of my dying mother being ejected from an NHS hospital without them even changing her nappy and with a fucking cannula still stuck in her arm because they were so short of beds and staff. Wanting to get rid of patients because you don’t know what else to do with them isn’t reason enough to lie to them and to spend £4 million out of the public purse annually financing the lie. As I once heard oncologist Prof Michael Baum say to a hysterical homeopathy user, “You can buy your homeopathy if you want but you can’t have it at the expense of other women’s lives”. It may only be a tiny portion of the NHS budget — as they never stop reminding us — but you can buy a lot of Tamoxifen for that.

It might seem callous to suggest that people who want the NHS to fund their homeopathy should buy themselves a tube of Smarties and ring the Samaritans for a nice chat instead. But these are hard times and if the NHS can’t afford proper meds, it needs to stop wasting money on pretend ones. It also needs to have the debate on the placebo effect that Martin Robbins called for in the Guardian recently. Perhaps most importantly, it needs to work out how to harness the benefits of the homeopathic consultation for the good of all patients. Just to reiterate: the benefis have nothing to do with homeopathic remedies. Let’s stop pretending that every health problem has an ingestible solution. That’s what homeopaths do and it’s a load of crap.

What’s next?

No doubt there are some who think that, once the NHS stops funding homeopathy and once Boots and other chemist shops stop presenting the remedies as if they do indeed have ‘therapeutic indications’, then there’d be nothing left for skeptics to do and we’ll shut up and move on to something else. But they’d be wrong. The problem is that homeopaths are liars. Yes, I know a lot of the lies are unintentional because they are delusional but for others there is no excuse. Take, for example, the oft-repeated claim of the “five systematic reviews” that supposedly amount to evidence for homeopathy. This lie is as common as pigeon shit and easily exposed for being exactly that. I caught and exposed the odious American homeoquack Dana Ullman repeating it here and in a previous blog I did the same favour for Jayne Thomas of the Society of Homeopaths, who had the audacity to repeat the falsehood on national TV. Martin did an excellent job in another Guardian column more recently.

Talking of the Society of Homeopaths, apart from telling porkies on national TV and bullying skeptics who tell the truth about them, what exactly is it for? Browsing the Society’s website, I came across its Code of Ethics and Practice and skimmed through it. One line leaped out at me:

“No advertising may be used which expressly or implicitly claims to cure named diseases”.

Quite right too. However, given the dishonesty that is the very essence of the whole cult of homeopathy, I wasn’t particularly surprised to come across this claim on a member’s website (actually the first hit on Google after entering ‘registered with the Society of Homeoapths’):

Basically any condition you would see a GP for can be treated homeopathically.

It doesn’t name any diseases, it simply claims to be able to treat any condition under the sun. WTF??

I am approaching the age my mother was at when she discovered the lump in her breast that turned out to be a malignant tumour necessitating a mastectomy, which allowed her to live for another 30 years. If only she’d seen a homeopath instead of her GP, eh?  She might have saved herself a lot of trouble and just died a slow, agonising premature death like Penelope Dingle did.

Yes, people should be free to make their own choices about health as long as they fund their more eccentric choices out of their own pockets rather than everyone else’s. Does that mean that UK homeopaths working outside of the NHS should be able to say whatever nonsense they like on their websites and in their promotional literature? I think not. Thanks to the efforts of skeptics fed up with seeing desperate people being conned by unscrupulous quacks, the chiropractic ‘profession’ now has to mind its ps and qs. It’s high time the homeopaths got a piece of the action.

A few months ago I visited a chiropractor just to see what would happen. I blogged the whole episode here but, in a nutshell, I told him I had come out of curiosity, taking advantage of a special offer £20 introductory appointment, which was being touted in a shopping centre on a busy Saturday. As a cover story I mentioned I had occasional lower backache but it wasn’t really a problem, I was just curious to see if he could explain it. He asked a lot of questions and wanted me to have a couple of x-rays. I declined. He gave me the hard sell on the importance of regular chiropractic care to prevent degenerative disease. I listened and nodded politely then left and that, as far as I was concerned, was the end of the matter.

But there’s apparently an old adage I didn’t know about until it was mentioned by someone on the Bad Science forum. It goes like this:

Q: What do you get if you visit a chiropractor?

A: Another appointment.

Like everyone else, chiropractors have a living to earn. Of course, most of us don’t try to make a living delivering an unnecessary and scientifically unsupported therapy to people who don’t need it. But I guess those who do aren’t going to let anyone who’s already set foot on their premises had both feet through the door get away without at least one more attempt to lure them back.

Here’s a letter I received from the Clinic Director.

I have recently reviewed your case records and it appears that you have discontinued your care programme. Of course I sincerely hope that you are doing well and will not suffer any setbacks.

We feel a responsibility to every patient that consults and I am therefore concerned that your symptoms may reappear or your condition may become chronic due to your not visiting the clinic for care. I would be happy to discuss your case with you if you so wish either by telephone or in person if you would prefer to pop into the clinic. If you choose the latter simply call the Front Desk to schedule some time. They will be happy to help you.

Whatever your decision I want you to know that we stand ready to be of assistance to you at any time in the future.

How caring and concerned they are! Introductory appointments at that place cost £95 a go. Subsequent appointments are likely to be cheaper and will no doubt seem like a bargain in comparison.

I toyed with the idea of ringing her up to ‘discuss my case’ just to see if she would continue to give me the hard sell or whether she’d do the decent thing and say, “Well, if you’re not suffering any symptoms or problems, there’s no need to come back” but I couldn’t be arsed. These are people who give up their Saturdays to harangue shoppers into submitting to having their spines “checked” (i.e. poked and prodded through several layers of clothing) and then do their damndest to get you to make an appointment at their clinic. If she’d actually read my case notes, she shouldn’t have sent the letter in the first place. The fact that she did is enough to persuade me that the primary concern here is not getting people well but getting them to part with their cash.

So I responded with an email:

“Thank you for your recent letter soliciting my further custom.

I was surprised to receive this given that I had only had one initial appointment, which I booked as a result of the special offer you had been promoting in Brent Cross shopping centre the previous week. I booked this appointment more out of curiosity than anything else and I had not started any ‘care programme’.

However, I welcome this opportunity to raise a couple of concerns with you.

When I visited your premises for an appointment with Jim, I noted a number of posters on the wall of his room containing what appeared to be misinformation about ’subluxations’.

One of them said:

“A subluxation. The silent killer. Chiropractors correct subluxations.”

Another claimed:

“Subluxations were found to be the cause of several health problems, including tonsillitis, vomiting, hyperactivity, sleepiness, lower resistance to infections especially ear, nose and throat infections.

Subluxations: a serious interence with normal communication from the brain to the body. This interference may cause sickness and disease. No-one, especially a child, should have to live with subluxations. Have your family checked for subluxations frequently.

Refs: Hendricks, C.; Larkin-Thier, S Otitis Media in Young Children Chiro: The J of Chiro Res & Clin Invest 1989; 2 (1): 9–13 J Am Osteopath Assoc. 1966 May;65(9):964-72. Manipulative therapy of upper respiratory infections in children.”

Yet another claimed that, “Preventive chiropractic care can help with many types of health problem.”

Jim’s responses to my various questions were in keeping with the hypothesis that so-called subluxations can cause all manner of ailments.

However, the most recent research on the subject of subluxations concludes:

“No supportive evidence is found for the chiropractic subluxation being associated with any disease process or of creating suboptimal health conditions requiring intervention. Regardless of popular appeal this leaves the subluxation construct in the realm of unsupported speculation. This lack of supportive evidence suggests the subluxation construct has no valid clinical applicability.”

Ref: Mirtz et al, Chiropractic & Osteopathy 2009, 17:13doi:10.1186/1746-1340-17-13

http://www.chiroandosteo.com/content/17/1/13

As I’m sure you are aware, the General Chiropractic Council recently issued guidance to members:

>>GUIDANCE ON CLAIMS MADE FOR THE CHIROPRACTIC VERTEBRAL SUBLUXATION COMPLEX
The chiropractic vertebral subluxation complex is an historical concept but it remains a theoretical model. It is not supported by any clinical research evidence that would allow claims to be made that it is the cause of disease or health concerns.

Chiropractors are reminded that

* they must make sure their own beliefs and values do not prejudice the patients’ care (GCC Code of Practice section A3)
* they must provide evidence based care, which is clinical practice that incorporates the best available evidence from research, the preferences of the patient and the expertise of practitioners, including the individual chiropractor her/himself (GCC Standard of Proficiency section A2.3 and the glossary)
* any advertised claims for chiropractic care must be based only on best research of the highest standard (GCC Guidance on Advertising issued March 2010)<<

In light of this guidance, I trust the posters will be binned.

Kind regards”

(Jim isn’t his real name).

The news that the subluxation was dead in the water emerged a few weeks ago in a correspondence between the GCC and Skeptic Barrista, who very helpfully blogged about it here. Zeno wrote a comprehensive obituary here.

D D Palmer, inventor of the original subluxation, was a snake oil salesman.  He based his invention on an idea that we know now to be wrong: that all bodily functions are controlled by the nerves. He thought he could feel bones out of place in the spine and decided for no good reason that these so-called misalignments — which he decided to call subluxations — were the cause of most cases of disease. Funnily enough, these chiropractic subluxations, didn’t show up in x-rays, an inconvenience chiropractors addressed by changing the definition of subluxation from the partial dislocation that Palmer imagined to

A lesion or dysfunction in a joint or motion segment in which alignment, movement integrity and/or physiological function are altered, although contact between joint surfaces remains intact. It is essentially a functional entity, which may influence biomechanical and neural integrity.

Source: The World Health Organisation quoted by Wiki.

But that was a long time ago — well before the BCA’s libel action against Simon Singh forced the spotlight onto what chiroquacks have been getting away with and the subsequent campaign to get them to clean up their acts.

How are chiropractors responding to the news of the old subby’s demise? The answer is ‘predictably’. This is the response I got to my email:

Thank you for your email. We have indeed received the information from the GCC  regarding the use of the term subluxation until more research supports the concept. Of course we have already removed the posters, as I am sure many other clinics will be, to make sure we are in compliance of all GCC regulations.

Kind regards

I take this to mean that the chiros at this particular practice will stop using the word and quite right too. But I am not reassured that they won’t do what other chiropractors have been doing for a long time and use any number of synonyms: “joint misalignment, joint dysfunction, facet syndrome and articular derangement” are the examples helpfully provided by the GCC to mean pretty much the same thing, even though the correspondence from the GCC to Skeptic Barista makes it clear that there is no clinical research evidence to support the concept whatever it is called. Understandably, the writer of the email to me is ostenisbly optimistic that one day there will be evidence that supports the concept and maybe there will be. Give them time. They’ve only had 100 years so far.