June 11, 2004.

The Honorable George Smitherman,
Minister of Health,
Government of Ontario,
10th Floor, Hepburn Block,
80 Grosvenor St.,
Toronto, Ontario M7A 1R3

Dear Honorable Minister:

I am a diagnostic radiologist with over three decades of experience in diagnosing chiropractic mishaps and an expert witness on behalf of plaintiffs injured by chiropractic. In 1991 the College of Physicians and Surgeons of Alberta requested that I review the practice and assess chiropractic as an “alternate care”.

Recent comments in the Toronto Star, June 4, 2004, relate to the delisting of chiropractic by OHIP. Pran Manga, Professor of Health Economics, University of Ottawa is quoted: ”This is the stupidest thing they have ever done. Ontario is the only province in Canada, the only jurisdiction in the world, where chiropractic is being delisted. “ This statement is not just hyperbole, it is false. Five provinces never insured chiropractic. Most recently, Newfoundland and Labrador have refused to do so and British Columbia has near completely delisted chiropractic coverage.

As you no doubt are aware, the chiropractors are gathering tens of thousands of signatures to protest the deinsurance of chiropractic and plan a rally at Queen’s Park on June 17th. As Premier Ralph Klein stated over a decade ago, “My day is not complete without a protest.”

I am including a few copies of files (I have over a thousand files), relating to chiropractic. I hope they are informative and will strengthen your resolve in keeping your commendable decision. There is nothing stopping chiropractic from offering patient-funded insurance for those that wish it.

A short comment on each of the enclosures:

1. Dr. Hamilton Hall, orthopedic surgeon, Director of Canadian Back Institute. An analysis of “The Effectiveness and Cost-Effectiveness of Chiropractic Management of Low Back Pain.” Dr. Hall lists at least 70 valid/significant criticisms of the Manga report.

2. Frontpiece of the Manga Report (Pran Manga, PH.D. Economist, University of Ottawa. I am sure this report can be accessed from the Ministry of Health Archives.

3. Executive Summary of Manga Report.

4. Dr. Gaetan Tardif, President of Canadian Association of Physical Medicine and Rehabilitation. Director of Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Ottawa. His critique of the Manga Report published in the Canadian Medical Association Journal, November 1, 1994. Please note this question asked by Dr. Tardif: “Why has the prevalence of back pain seemingly changed very little but the incidence of disability exploded to epidemic proportions?” (p.2).

5. Annals of Internal Medicine. June 3, 2003. Note conclusions and implications relating to spinal manipulative therapy.

6. New England Journal of Medicine: Vol. 339, # 15, Oct. 8. 1998. Comparison of physical therapy, chiropractic manipulation and an educational booklet for the treatment of patients with low back pain, After the assessment period, all approaches were equally effective with the $1.00 booklet costing about 1/3 that of physical therapy and chiropractic.

7. The National Council Against Health Fraud (NCAHF). Fact Sheet on Chiropractic.
Dr. William T. Jarvis, Professor Emeritus, Division of Public Health, Faculty of Medicine, Loma Linda, California. Dr. Jarvis is a recognized authority on chiropractic for which he received his Ph.D.

8. Chiropractic Marketing. The question asked by Dr. Tardif, item #4 above, is answered in “How to Go From Nothing to the Practice of Your Dreams”....”Practice-building strategies that will have you getting more patients and making more profit than you ever thought possible”.

Approximately one third of chiropractic seminars detail strategies for building practices including the “million dollar practice”.

9. As claimed by the majority of chiropractors, they are capable of treating virtually everything from cradle to grave. Note boulevard sign re: West Nile Virus and Sars .

The cost to the public purse is not only chiropractic billings. There are numerous mishaps, most serious of which are strokes and death resulting from chiropractic neck manipulations. On March 16, 2004, a statement of claim was filed at the Court of Queen’s Bench of Alberta, Action #0401-03787. A young woman in her early twenties will require nursing/custodial care for the rest of her life. The claim is for $10,250,000 plus other costs to be determined. If she lives fifty years, it will cost the public system at least $5 million.

I trust the enclosures will reaffirm your decision.


Marvin Levant M.D. FRCP(C)

cc: Premier Dalton McGuinty
Mr. Phil Hassen, Deputy Minister
Mr. George Zegarac, Associate Deputy Minister