October 4, 2021

Response to statements made by Dr. Rick Lau, vice-chairman of Chiropractic Doctors’ Association of Hong Kong (“CDAHK”), in the programme “Scoop (東張西望)” which aired on September 16, 2021 on the Jade Channel (the “Programme”).

To Whom It May Concern:

Over the past few weeks, there have been a number of damaging claims aimed at myself and the CDAHK concerning my statements in the Programme.

I am writing to respond to these claims, and to express strong displeasure at misinformed attempts to bring disrepute to myself and the chiropractic profession.

Background

Manual therapy in Hong Kong comes in many forms, including but not limited to chiropractic care, physiotherapy and Chinese medicine. The aim and design of the Programme is to educate the public on chiropractic care, how it is administered, and the education required to become a registered chiropractor in Hong Kong.

For the sake of transparency and context, I briefly outline below the structure and content of the Programme (conducted in Cantonese) below (with approximate timings in bold):

• 00:14 to 00:30: In the Programme, the patient in question was experiencing back pain and radiculopathy symptoms in their lower limbs.

• 00:31 to 00:44: After conducting a careful examination, including an X-ray study of the patient, I was able to detect misalignments in her pelvis and muscle strain.

• 00:45 to 00:55: The host then stated that manual therapy was an effective method of addressing back pain, including Chinese medicine and physiotherapy, and asked whether the methods of manual therapy differed amongst healthcare professions.

• 00:56 to 1:06: I then gave a brief overview of the differences. I mentioned that Chinese medicine practitioners use acupuncture or massage, whilst physiotherapists use stretching, strengthening exercise and electro-myostimulation or neuromuscular electrical stimulation. I then explained that these are treatments that usually occur on the surface level of the body (這些 “通常都是表面的”).

• 1:07 to 1:21: I then explained that chiropractors focused on the spine, and whilst administering such treatment, it is important to analyse the spinal structure of the patient and medical history, since failure to do so could lead to considerable risk of injuring the patient.

• 1:22 to 1:45: The patient then stated that she experienced noticeable differences after receiving chiropractic treatment, their symptoms of lower limb paralysis was alleviated, and that I had also taught them a few methods of stretching.

• 1:46 to end: The host then asked me how one can obtain a qualification as a chiropractor. I outlined the steps and extent of education and training required, including up to 4,000 learning hours, the fact that the beginning stages of the studies overlap with that of western medicine, including studies into the nervous system and dissection, followed by studies into bone examination and operation of medical equipment. Chiropractic students then have to intern, before taking the national board examination, before registering with the Department of Health to be chiropractors.

Response to Claims

Claim 1: My statement that physiotherapists apply stretching and strengthening exercise, and muscle stimulation, which I (allegedly) referred to as being ‘superficial’ (表面的), is deprecating to other professions, disrespectful and irresponsible

I did not claim nor imply physiotherapy (and Chinese Medicine) are practicing superficial treatment methods, nor was such meaning intended at all.

First, in view of the context outlined above, it is self-evident that I used the word “表面的” in an anatomical sense within the human body, or in other words, on an anatomical tissue level. The methods mentioned in the interview, namely, acupuncture, stretching, and strengthening exercise, are treatments that broadly target upper layer of body tissue in comparing with the tissue of spinal structures.  I explained that chiropractic treatment usually centres on the spine, which is situated at a deeper level within the body. It is not out of the ordinary to describe electro-myostimulation or neuromuscular electrical stimulation methods of treatment to relate to an elevated position in the body i.e. ‘surface level’.  Therefore, it should not be inferred, even from a laymen viewer’s perspective, that the use of the word “表面的” means Chinese medicine or physiotherapy is superficial, let alone be an inferior form of treatment to chiropractic care.

Second, use of the word “表面的” in describing stretching could not have been intended or construed as ‘superficial’ inferior treatment methods because the Programme (at 1:30) also shows that chiropractors will teach patients some stretching methods as part of chiropractic treatment. The Programme shows that not only do I endorse stretching as a treatment method, I also integrate it as part of my treatment towards patients.

Finally, regard must be had to the fact that certain words or phrases are capable of more than one meaning. Imputing the only negative connotation associated with the use of the words “表面的” (namely, that it means ‘superficial’) without proper regard to the context in which it was used, and using this misconception to attack me and the CDAHK is premature, unfair, and serves only to elicit controversy when there is none.

For the avoidance of doubt, I emphasise that I do not, and did not view physiotherapy as a superficial let alone an inferior form of treatment, nor an inferior method to chiropractic.

Claim 2: My statement that ‘chiropractors would thoroughly analyse a patient’s history and spinal structure’ may mislead viewers into thinking that (1) manual therapy is only provided by chiropractors, and (2) that only chiropractors know how to perform appropriate patient assessment and treatments. As such, I have shown disrespect to another profession.

This complaint is also a non-starter. Firstly, nowhere during the interview in its entirety did I claim nor imply that only chiropractors focus on the patient’s history and skeletal structure with detailed analysis. Merely because chiropractors would thoroughly analyse a patient’s history and spinal structure does not preclude the possibility or capability of other healthcare professions from doing the same.

My elaboration on what it means to analyze the skeletal structure is important for public education, and also echoes the in-depth examination of the patient and her X-ray as shown earlier in the Programme (at 00:31 to 00:44), in which such ‘careful examination’ was being demonstrated. Chiropractic treatment involves the alignment of the spine by hand (and at times, equipment), and it is important to reassure prospective patients that such a procedure is grounded upon a thorough and professional analysis into the patient’s anatomical needs.  This elaboration is consistent with the requirements of Section 1.11 of the Code for chiropractors to: “Promote public confidence in the chiropractic profession - a learned profession dedicated to the promotion of health, the prevention of illness and the alleviation of suffering.” As such, I would reiterate that merely because chiropractors engage in an in-depth analysis of the patient’s medical history and spine structure does not mean other practitioners do not also do so.

For the avoidance of doubt, I would emphasise that different professions may adopt a variety of tools to evaluate a patient’s condition, and may utilize manual therapy as part of patient care. Chiropractors are not the only profession capable of manual therapy.

Claim 3: I claimed that chiropractors and medical doctors are essentially the same thing. In particular, when I stated that chiropractic students require professional training in orthopedics examination (骨科檢查), this would cause people to misunderstand chiropractors to be orthopedic practitioners.

I have never claimed that chiropractors are the same as orthopedic practitioners or western medicine doctors, nor can my statements be misconstrued as such.

First, merely because two professions share an overlap in courses studied does not mean they are the same, or can be equated with one another.

Second, it remains true that in order to gain a chiropractic certificate, chiropractors have to study up to 4,000 hours, and share an overlap in courses studied with western medicine doctors. It further remains true that chiropractic students undergo an in-depth and comprehensive education into osteology, use of medical equipment, vocational training, and a qualification examination in order to be a qualified chiropractor. Such a comprehensive overview is again to provide reassurances to prospective patients that registered chiropractors undergo a rigorous training process, and possess sound knowledge of the human anatomy and medical equipment as prerequisites to administer treatment. Over the course of educating the public, it is necessary to outline the strenuous training we undergo.

In no way, shape or form does providing an explanation of the in-depth education of chiropractors be akin to conflating them with medical doctors. In this connection, the assertion that there is a risk of such misunderstanding is far-fetched.

Conclusion

The above complaints are based on a disfigurement of what I said in the Programme. The complaints seek to put words in my mouth and jump to conclusions before accusing me of crimes I did not commit. Worse still, they seek to discredit and criticise without first clarifying what was actually being said. The unfortunate result is that they incite unnecessary animosity.

As is common ground, all healthcare profession to serve the broader community with mutual respect and professionalism.  I will do what is necessary to ensure this mutual respect and professionalism between healthcare professions be maintained and upheld.

Yours sincerely,

Dr. Rick Lau

Vice Chairman

Chiropractic Doctors’ Association of Hong Kong