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Table 2 Misleading Claims: Major or Minor Misleading Classes

From: At-risk advertising by Australian chiropractors and physiotherapists

Category Minor: Unlikely to harm Major: Likely to harm
c1
Association membership presented as postnominals.
Persons displaying association membership in this way are presumably abiding by their association’s code of ethics when dealing with clients so the potential for harm is lessened.  
c2
Use of the title Dr. without professional clarification.
Relatively unlikely that a member of the public would be misled into thinking a chiropractor using the title Dr. is also a medical practitioner.  
c3
Use of Doctor of Chiropractic or DC without holding the qualification but having graduated with a chiropractic qualification from an accredited chiropractic program.
Unlikely to mislead the target audience because members of the public would be unlikely to know the distinction although if they misrepresent their academic qualifications they may do so in other areas.  
c4
Specialisation claim.
Practitioners using this designation presumably have a special interest in a particular area however this does not necessarily mean qualifications that would deem them ‘specialists’ and hence the public may be misled.  
c5
Claims to affect positioning of an unborn child.a
  Any advertisement claiming or implying that a technique can affect an obstetric breech presentation is misleading and potentially harmful.
c6
Misuse of the literature.
  High likelihood of misleading the target audience because almost inevitably the advertiser omits critical information from the literature cited or fails to provide a balanced report of the literature.
c7
Failure to mention possible adverse outcomes.
  Failure to mention possible adverse outcomes has a relatively high chance of misleading the target audience into believing that a form of treatment is free from possible adverse outcomes.
c8
Making unsubstantiated claims.
  An advertiser must have reasonable grounds for making a claim of effectiveness.b
c9
Misrepresenting awards. Eg. Presenting a business award as though it is a clinical award.
A practice which has won a business award may be more likely to comply with required practice standards and is therefore less likely to mislead patients in clinical practice areas.  
  1. Explanatory Note:
  2. aThe CBA published clear advice on advertising care of pregnant patients in its March 2016 statement on advertising:
  3. Chiropractors are not trained to apply any direct treatment to an unborn child and should not deliver any treatment to the unborn child. Chiropractic care must not be represented or provided as treatment to the unborn child as an obstetric breech correction technique [51].
  4. bThe courts have shown that determining what constitutes reasonable grounds is not left to the discretion of the advertiser. Rather, reasonable grounds in the view of the courts equates to “sufficient scientific knowledge” [52].