Addressing Grade V Mobilizations

[Fiveoboy11]

Speaking for myself, when I took that Board exam in "physiotherapeutic modalities", it never crossed my mind that I could then take that and trick patients into thinking I was a PT. So deception probably isn't the motivation across the board (not Board). The term "physiotherapy" has been common to chiro licensure, at least in some states. As I said earlier, this may have changed by now following PT outcry and the language may have changed; I honestly don't know.

Use of the term "physical therapy", as I've said many times now, should be restricted to PTs. It shouldn't be allowed for anyone else to use that term.

Other terms, like "rehab", are just common terms that could relate to many fields, PT and chiro included.

The term "therapist" is another ill-defined term that could mean any number of things. But I'll grant you that a patient could misconstrue things and believe that a "therapist" is a "physical therapist" when they aren't. That "therapist" could, however, simply be a "massage therapist", in which case they are a "therapist".

And the word you're looking for is Chiropractic .

This isn't rocket science. Physical Therapy and Physiotherapy are the same thing. Chiropractors are not trained in either regardless of what some board exam said or a website says. Therefore it is misleading and practicing beyond their scope when a DC claims otherwise. Physiotherapy and physical therapy are not generic terms, and physiotherapy is not a catch all for passive modalities or an exercise routine a chiropractor pawns off on anyone who responded to the craigslist ad and then gets to be called a "therapist."

There is no legitimate reason for a chiropractor to use the terms physical therapy or physiotherapy or therapist, it is a means to float on the physical therapy profession, try to legitimize itself, claim professional superiority, make more money, etc.

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[ptisfun2]

True. Apparently chiropractors in AZ do not have to obey the law. Google "Chiropractor Physiotherapy AZ" and you can see all the class 1 misdemeanor worthy chiropractic websites.

Of course they have to follow the law. A compliant needs to be filed. There was a chiropractor in the town I live in who advertised 'physiotherapy' on their sign outside the office. I contacted the AZ PT Board (who has no jurisdiction over chiropractors) and they told me to contact the Attorney General's office in AZ. Not too sure what happened after that, but the sign is changed. I am guessing they were just told of the law and probably did not know about it before (because why would any health care professional read the practice act of another), and when informed, addressed it.
I know different state's APTA associations have had outreach where PTs who notice things like this follow up with the appropriate agency in their state.
I think it is just a matter of not knowing laws, and no one trying to 'pull a fast one.'
But easy to address. I think criminal charges would only occur, at least in AZ, if it could not be addressed administratively, and then the chiropractic board would get involved.

 

[truthseeker]

I suspect some of the semantics problems are related to unclear legislation. I know that in one of the states in which I'm licensed I had to take a separate Board exam for "physiotherapeutic modalities" or something like that (it's been awhile!). So, if a DC takes a Board exam for "physiotherapy", I'd imagine s/he might advertise that s/he does "physiotherapy". Or perhaps some of the legislative language has been more recently changed to better define "physiotherapy" (in light of objections by PTs), leaving some DCs with a license that contains older language? That's purely a guess, but I can see how that might happen.

And, yes, Chiro Boards will take disciplinary action against any DC breaking the rules, especially if a direct complaint is lodged.

Actually, they don't. Or didn't in my case anyway. Several years ago a local DC was advertising that his facility was where "physical therapy, medicine, nutrition, and chiropractic all come together under one roof" or something like that. He had all of his business cards writtent the same way. I actually interviewed a woman for a receptionist position who had worked there and she said that she was in charge of the physical therapy.

I filed a complaint and the guy basically said that it was his marketing person that did all of that and it wasn't his fault, his wife was sick and he was distracted yada yada yada. No discipline just an apology. I filed a direct complaint with the chiro board, informed the board of medical practice who also filed a complaint. I even called and asked to speak to the physical therapist.

 

[truthseeker]

physical therapy is more of a philosophy and evaluation/treatment approach than it is a thing you do. Too many people think that ultrasound or exercise or electrical stim or massage are "physical therapy" when really those are some of the tools that physical therapists use to treat people.

I can't do "chiropractic". but I can manipulate.

 

[facetguy]

Actually, they don't. Or didn't in my case anyway. Several years ago a local DC was advertising that his facility was where "physical therapy, medicine, nutrition, and chiropractic all come together under one roof" or something like that. He had all of his business cards writtent the same way. I actually interviewed a woman for a receptionist position who had worked there and she said that she was in charge of the physical therapy.

I filed a complaint and the guy basically said that it was his marketing person that did all of that and it wasn't his fault, his wife was sick and he was distracted yada yada yada. No discipline just an apology. I filed a direct complaint with the chiro board, informed the board of medical practice who also filed a complaint. I even called and asked to speak to the physical therapist.

You left us hanging. What happened?

 

[facetguy]

physical therapy is more of a philosophy and evaluation/treatment approach than it is a thing you do. Too many people think that ultrasound or exercise or electrical stim or massage are "physical therapy" when really those are some of the tools that physical therapists use to treat people.

I can't do "chiropractic". but I can manipulate.

I like that view.

 

[banares]

Regarding all the discussion involving physiotherapy, I just received this email from the TPTA (Tennessee) regarding protected terms and titles...

Physical Therapy
Physical Therapist
Physiotherapy
Physiotherapist
Physical Therapist Assistant
Physiotherapist Assistant
P.T.

Did you know that it is illegal for anyone in the state of Tennessee to use any of those terms unless they are a physical therapist or physical therapist assistant licensed in the state of Tennessee?

I'm sure it differs from state to state, but I thought it was at least worth mentioning that physiotherapy is protected here in TN.

 

[Fiveoboy11]

Regarding all the discussion involving physiotherapy, I just received this email from the TPTA (Tennessee) regarding protected terms and titles...

Physical Therapy
Physical Therapist
Physiotherapy
Physiotherapist
Physical Therapist Assistant
Physiotherapist Assistant
P.T.

Did you know that it is illegal for anyone in the state of Tennessee to use any of those terms unless they are a physical therapist or physical therapist assistant licensed in the state of Tennessee?

I'm sure it differs from state to state, but I thought it was at least worth mentioning that physiotherapy is protected here in TN.

http://www.doctormay.net/Travel Services.html
http://drsheanow.com/custom_content/c_3813_why_choose_shea_chiropractic.html
http://coolchiro.com/custom_content/c_98600_services__techniques.html
http://lenoirchiro.com/custom_content/c_96927_meet_the_doctors.html
http://1choicechiro.com/custom_content/c_18957_services__techniques.html?search=1

That took about 5 minutes to find.

 

[facetguy]

Regarding all the discussion involving physiotherapy, I just received this email from the TPTA (Tennessee) regarding protected terms and titles...

Physical Therapy
Physical Therapist
Physiotherapy
Physiotherapist
Physical Therapist Assistant
Physiotherapist Assistant
P.T.

Did you know that it is illegal for anyone in the state of Tennessee to use any of those terms unless they are a physical therapist or physical therapist assistant licensed in the state of Tennessee?

I'm sure it differs from state to state, but I thought it was at least worth mentioning that physiotherapy is protected here in TN.

How long have those terms been protected there in TN?

 

[GTT4DPT]

Looks like 4 out of the 5 offices are using the same website vendor: chiroMatrix. Seems like they're set up to just pump these things out:

http://demo.chiromatrix.com/

 

[facetguy]

Looks like 4 out of the 5 offices are using the same website vendor: chiroMatrix. Seems like they're set up to just pump these things out:

http://demo.chiromatrix.com/

Not sure what you're saying here. Should chiropractors need to become experts in programming their own websites, or should they leave it to someone with more expertise? One of the main points of this thread is that PTs are experts in what they do and others shouldn't try to do PT. Likewise, website designers have expertise and should do what they do.

Did I miss your point?

 

[facetguy]

This is unrelated, but I saw it on TV this morning.

How many of you wear long white lab coats? Is this a little goofy? Is this PT trying to project something she's not?

http://www.amazon.com/Instant-Relie...F8&qid=1358427450&sr=8-1&keywords=peggy+brill

Just curious how you guys feel about this.

 

[truthseeker]

Sorry,

The guy basically said that he was sorry and gave a bunch of excuses as to why he used the terms he did. No punishment that I am aware of. He said that his wife was sick, the marketing company he used did it without is knowledge, he intended to hire a PT and an MD but it was proving to be difficult.

He accused me of entrapment by calling and asking to speak to the PT (he knew it was me because of caller ID i suppose)

the guy ultimately (maybe 2 years later) sold his practice and moved away. this was a guy who had his purchasd 30 minute "radio show" on which he basically said that there was no limit to what chiropractic could effectively treat including asthma, bedwetting, etc . . . To our local population it sounded like a radio show but was basically a 30 minute live commercial with call ins.

 

[GTT4DPT]

Did I miss your point?

Sorry. You did miss my point but only because I didn't make one. I'd drafted another paragraph there, but it started to get unweildy, so I edited to bare bones and posted.

This is what I was originally thinking: if FiveO or anyone wanted people to follow their state's laws on this, it might be easier to contact ChiroMatrix with the examples listed, cite the relevant law, and maybe give some reasonable window of time for getting their patrons to clean up their text before following up with whatever board or panel has oversight.

Why bother tracking down individuals afoul of the law if this company already has contact info for 80% of them? Let them make an effort to notify their customers and clean it up internally. It could very well be an honest mistake.

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I'm wondering now about the laws in Texas. I'd seen a sign posted for "Physiotherapy" at a chiro clinic. My honest thought was "maybe they have a Canadian PT on staff." I can imagine this being a confusing thing.

 

[facetguy]

Sorry. You did miss my point but only because I didn't make one. I'd drafted another paragraph there, but it started to get unweildy, so I edited to bare bones and posted.

This is what I was originally thinking: if FiveO or anyone wanted people to follow their state's laws on this, it might be easier to contact ChiroMatrix with the examples listed, cite the relevant law, and maybe give some reasonable window of time for getting their patrons to clean up their text before following up with whatever board or panel has oversight.

Why bother tracking down individuals afoul of the law if this company already has contact info for 80% of them? Let them make an effort to notify their customers and clean it up internally. It could very well be an honest mistake.

-----------

I'm wondering now about the laws in Texas. I'd seen a sign posted for "Physiotherapy" at a chiro clinic. My honest thought was "maybe they have a Canadian PT on staff." I can imagine this being a confusing thing.

Chiromatrix is just a website company. I don't think they have any involvement in state laws, etc.

I do think much of this "physiotherapy" issue stems from recent changes in various state laws put in place at the request of the PT profession. And I don't blame the PTs for doing so, or at least trying to do so. But as I said earlier, if a DC has been using the term "physiotherapy" in his ads, signage, etc for 25 years, and now there's a law change, I think it's reasonable that some DCs might not get the memo.

But bottom line: the law is the law. If someone is using a term they can't use, then it's up to them to fix it or face the penalty. A warning or grace period in the case I outlined above would seem reasonable though.

 

[banares]

How long have those terms been protected there in TN?

I honestly don't know how long they've been protected, and I understand your point concerning previous usage of the terms.

I think that as a profession, physical therapy needs to up their game when it comes to protected rights/terms/titles, advocacy, and community education. I think it's totally unfair to complain about another profession using our terms when we're not pushing to make sure the public knows what they mean in relation to physical therapy. And as much as PTs like to demonize Chiropractors, we could certainly learn a lot from y'all.

 

[facetguy]

... And as much as PTs like to demonize Chiropractors, we could certainly learn a lot from y'all.

Uh-oh, that might not go over well in here. Let's start the Five-O freakout countdown clock.

 

[Fiveoboy11]

Uh-oh, that might not go over well in here. Let's start the Five-O freakout countdown clock.

I've bought Liebenson's and Muscolino's book so there goes that.

 

[Fiveoboy11]

Chiromatrix is just a website company. I don't think they have any involvement in state laws, etc.

I do think much of this "physiotherapy" issue stems from recent changes in various state laws put in place at the request of the PT profession. And I don't blame the PTs for doing so, or at least trying to do so. But as I said earlier, if a DC has been using the term "physiotherapy" in his ads, signage, etc for 25 years, and now there's a law change, I think it's reasonable that some DCs might not get the memo.

But bottom line: the law is the law. If someone is using a term they can't use, then it's up to them to fix it or face the penalty. A warning or grace period in the case I outlined above would seem reasonable though.

Maybe the chiropractic boards should pay attention and act accordingly and punish those who don't obey the law. Healthcare professionals should never rely on a website making company to be experts in the content.

 

[GTT4DPT]

Chiromatrix is just a website company. I don't think they have any involvement in state laws, etc..

Right. They likely don't lobby for anything, but if they specialize in helping chiropractors market themselves, I don't think it's unreasonable that they should be up-to-date on laws that restrict how things are marketed and therefore could get their customers in trouble.

Should a bulk email provider know about CAN-SPAM and make sure their customers understand its implications? Probably, and I'm pretty sure most of them do. Should these guys know about these laws and make sure their customers do as well. Probably. I don't know what their strict legal obligations are, but it just seems like a good business practice.

You could file complaints left and right without giving anyone a chance to correct a problem they were unaware of.

Or you could contact each chiro individually and likely get responses akin to the one truthseeker mentioned ("sorry, no intent to do anything sketchy, it was the marketing guy").

Or you could just contact the marketing company and make a point that they should keep their customers aware of the law or you'll start filing complaints about all of their customers in violation. In a world of limited resources and unending chaos, that seems like a pragmatic and efficient use of time. I could be wrong.

 

[Jarrodmac10]

This is unrelated, but I saw it on TV this morning.

How many of you wear long white lab coats? Is this a little goofy? Is this PT trying to project something she's not?

http://www.amazon.com/Instant-Relie...F8&qid=1358427450&sr=8-1&keywords=peggy+brill

Just curious how you guys feel about this.

Many PTs in the hospital setting, either acute or inpatient rehab, wear lab coats for the same reasons MDs wear them, to prevent getting vomit or blood on their attire. If I worked in wound care I'd be the first to put on a lab coat haha.

 

[ptisfun2]

I do think much of this "physiotherapy" issue stems from recent changes in various state laws put in place at the request of the PT profession. And I don't blame the PTs for doing so, or at least trying to do so. But as I said earlier, if a DC has been using the term "physiotherapy" in his ads, signage, etc for 25 years, and now there's a law change, I think it's reasonable that some DCs might not get the memo.

But bottom line: the law is the law. If someone is using a term they can't use, then it's up to them to fix it or face the penalty. A warning or grace period in the case I outlined above would seem reasonable though.

Right. This really isn't a big deal. At least in AZ. I called the PT board, they said they had no jurisdiction over chiropractors, and to call Attorney General Office. I did, they said the would send a letter informing chiropractors about this part of PT practice act. Sign changed. I do not think anyone was doing it maliciously. They probably had an old sign or moved from a state without a protected term, and just assumed it would be ok. I truly do not believe there is any evil underground chiropractor work going on. I have absolutely no idea what the chiropractic practice act says in AZ, but if someone told me I was in violation, I would say, 'My bad. Did not know. I will fix it.' The End. So then no disciplinary action is required.

 

[Fiveoboy11]

Right. This really isn't a big deal. At least in AZ. I called the PT board, they said they had no jurisdiction over chiropractors, and to call Attorney General Office. I did, they said the would send a letter informing chiropractors about this part of PT practice act. Sign changed. I do not think anyone was doing it maliciously. They probably had an old sign or moved from a state without a protected term, and just assumed it would be ok. I truly do not believe there is any evil underground chiropractor work going on. I have absolutely no idea what the chiropractic practice act says in AZ, but if someone told me I was in violation, I would say, 'My bad. Did not know. I will fix it.' The End. So then no disciplinary action is required.

I'm going to have to disagree here. I have seen chiropractors advertise physical therapy without a PT on staff. The fact that many chiropractic websites go into detail regarding physical therapy vs physiotherapy, what's the difference makes a good argument to me that there is malicious behavior.

Because a state practice act does not necessarily protect the term physiotherapy doesn't mean a chiropractor should feel compelled to advertise physiotherapy. It's not a requirement for them to advertise it. There's no reason to in the first place.

 

[Fiveoboy11]

Many PTs in the hospital setting, either acute or inpatient rehab, wear lab coats for the same reasons MDs wear them, to prevent getting vomit or blood on their attire. If I worked in wound care I'd be the first to put on a lab coat haha.

If it was a white coat with "MD" on it and we argued that MD stood for manual doctor then it'd be inappropriate. People who work in hospitals know that phlebotomists, nurses, PA's, nurse practitioners, etc often wear white coats. I guess I haven't really noticed physician's wearing them too much.

 

[Azimuthal]

Chiromatrix is just a website company. I don't think they have any involvement in state laws, etc.

I do think much of this "physiotherapy" issue stems from recent changes in various state laws put in place at the request of the PT profession. And I don't blame the PTs for doing so, or at least trying to do so. But as I said earlier, if a DC has been using the term "physiotherapy" in his ads, signage, etc for 25 years, and now there's a law change, I think it's reasonable that some DCs might not get the memo.

But bottom line: the law is the law. If someone is using a term they can't use, then it's up to them to fix it or face the penalty. A warning or grace period in the case I outlined above would seem reasonable though.

Said chiropractors websites requires said chiropractors' approval to be published. When you choose a domain and ask for a website to be made, they are not blindly created. I understand what you are saying about new laws, however, I also believe that each professions' boards or advocacy group should be on top of those things. If these groups are not, why? I'd think that such legislation would be no small matter.

 

[jesspt]

This is unrelated, but I saw it on TV this morning.

How many of you wear long white lab coats? Is this a little goofy? Is this PT trying to project something she's not?

http://www.amazon.com/Instant-Relie...F8&qid=1358427450&sr=8-1&keywords=peggy+brill

Just curious how you guys feel about this.

I was actually required to have a white lab coat for my inpatient clinical, as well as my first job in an outpatient ortho dpeartment of a hospital.

 

[facetguy]

I was actually required to have a white lab coat for my inpatient clinical, as well as my first job in an outpatient ortho dpeartment of a hospital.

I hadn't really thought about the hospital-based practice. The PTs I know and interact with professionally are all outpatient folks, and nobody wears a long white labcoat. That's where my mindset was, then I saw that book cover and thought it looked odd. But it makes more sense now.

Now everyone go out and buy her book.