David Cameron out of touch with contemporary evidence say University of Nottingham academics!
David Cameron’s pledge to cut car whiplash claims has been challenged by University of Nottingham academics and physiotherapists Roger Kerry and Alan Taylor. Backed by leading USA researcher James Elliott, they have called into question the Government’s exposé of the whiplash injury industry in the UK.
Whilst accepting the critique of the unethical and corrupt practices within the ‘whiplash injury industry’ and a justified call for an end to so called referral fees. Kerry, Taylor and Elliott who have written extensively on neck issues and teach evidenced based practice in whiplash injury, have called into question the second layer of the broadside. Here there is a suggestion that “all whiplash injuries are artificially contrived”, therein casting doubt on the medical legitimacy of the diagnosis at all levels. They contend that challenging the current argument is not difficult. The suggestion for instance, that ‘whiplash Injury’ is not a clinical entity is both ill informed, irresponsible and not up to date with contemporary research on the subject. They are able to draw attention to high quality objective evidence from internationally recognised MRI studies demonstrating changes in neck muscle properties in people who have suffered whiplash (e.g. Elliott et al 2010, Spine). Furthermore, they highlight trial and experimental evidence has demonstrated that chronic whiplash associated disorder (WAD) can be reliably indentified. WAD is thus, for some a very real physical problem.
The Government’s diatribe unfortunately, calls into question the genuineness of all whiplash injury claims. This notion has, according to some, been supported further by recent media reports of a Physiotherapist winning a so called “landmark case” proving that ‘whiplash injury’ doesn’t exist (Daily Mail Jan 29th 2012). These reports do of course champion the proposals, but are a predictable, inaccurate spin of the facts of the quoted case, i.e. Robinson Vs Hussain, which was not technically a ’whiplash injury’ case (in fact the exact opposite of such).
For many involved in front line care delivery, the unfortunate part of this politicised rhetoric is that the proposed actions could easily lead to an irretraceable stigmatisation of the percentage patients who genuinely suffer following road traffic accidents. If wholesale changes to the industry are undertaken, there is genuine fear that evidence-based health interventions will be withdrawn for patients who have genuine, demonstrable WAD. It is important that before politically fuelled knee-jerk reforms are made, that dialogue takes place between MPs and health care practitioners such as Chartered Physiotherapists, who have been at the forefront of clinical practice and research in this area.
Government rhetoric may well be designed to galvanise public opinion and has clearly been taken up with typical emotional aplomb by tabloids such as the ‘Daily Mail’. However, it only serves to generalise and then stigmatise those patients who have genuine complaints affecting their day-to-day function. Such patients may now, in the light of this important new research, be identified by appropriate evidence based scientific tests, which the Government appear to have conveniently overlooked.
Roger Kerry (University of Nottingham, UK)
Alan J Taylor (University of Nottingham, UK)
James M Elliott (Northwestern University, USA)
Elliott J, Jull G, Noteboom JT, Darnell R, Galloway G, Gibbon WW. (2006) Fatty infiltration in the cervical extensor muscles in persistent whiplash-associated disorders: a magnetic resonance imaging analysis. Spine;31(22): pp 847-55
Elliott JM, O'Leary S, Sterling M, Hendrikz J, Pedler A, Jull G. (2010) Magnetic resonance imaging findings of fatty infiltrate in the cervical flexors in chronic whiplash. Spine;35(9): pp 948-54