Chiropractor = Physiotherapist?

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2 quick questions,

I was recently at a high school football game with a PT/ATC who was covering the game with a chiropractor who proceeded to tell us that he received a physiotherapy certificate after his 2nd year of chiro school which certifies him to treat not only spine problems but everything from foot to shoulder pathology

I've been assured this is false, has anyone else ever heard of this?


Secondly, there are several faculty members at my university that are telling students that the job market for PT's is going to be horrible in the future and that there are too many applicants and pt students are not enough jobs.

Any thoughts?

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chiropractors love to do this because of the good name that physical therapists have in the public eye. they may do things that seem like physical therapy but it is against the law for chiropractors to say they "practice" physical therapy.

your faculty members have no idea what they're talking about (doesn't sound like they are PT faculty). if anything there will be a SHORTAGE OF PTs. the field currently has practitioners who completed BS, MS, and the relatively few DPTs. with the move to DPT less people are going to PT school (they'd rather do a 2 year program as a PA or something else - can't blame them) which means less PTs in the future. simple supply and demand.

whatever your interests, best of luck!
 
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Chiropractor (DC) = "Didn't make the cut at any mid/high level health programs but still want to play doctor." :rolleyes:


The fact that you've encountered this nonsense should come as no surprise. Chiropractors have long been forced to tack on whatever extra credentials they can to try and take their piece of the rehab pie. Ultimately it's the miniscule evidence-based segment of Chiropractic practitioners that truly suffer as they are lumped together with their unethical/unscientific snake-oil selling brethren.

If you're really considering Physical Therapy as a career, I would highly suggest you schedule some shadowing experiences in at least two different settings. Earlier this year I shadowed at a clinic recommended to me near my house (located in an upper income town outside Dallas, TX). The therapist I was shadowing was a three year graduate of UTSW's MPT program, and I was able to see first hand how she worked. I watched as in the course of an hour she was juggling five patients at once while working in a cramped and small "volume based" clinic which was just plain disorderly and messy; she seemed to enjoy her job, but the patient load/working conditions were horrible :thumbdown:. I would later find out that the clinic was part of a 6-center franchise with locations in and around the Dallas metroplex.

Following this, I called my Orthopedic Surgeon and asked him for a recommendation on another clinic roughly a mile from my home and he gave me the name/contact info; what a world of difference. The clinic was located in the industrial/business zone of my town with a massive rehab center in the back, and several closed examination rooms in the front. The owner and head PT of the place was friendly and knowledgeable, and was only seeing roughly three patients per hour, never more than four. She explained to me that she preferred the reduced rate of patients as she had more time to devote to each individual and better manage their cases. Her other employee, a 10 year veteran, picked up the slack. Her specialty was Orthopedics and I was extremely impressed with her practice as a whole :thumbup:. Funny how just one mile of travel made all the difference in the world.

I'm no longer perusing Physical Therapy as a career due to an increased interest in medicine/clinical diagnostics, but PT is certainly worth the while if you can find the right setting for you and don't mind the ever-tightening salary caps (although that's something EVERY student interested in healthcare should take into account!). Osteopathic Medicine might be a good route to look into, as they are the only physicians trained in OMM, could be a good balance of both for you. Good luck with your search, you'll find your nitch somewhere out there!
 
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Ditto to both posts above. :thumbup: Here are a few good websites on chiropractic. If you want to be taken seriously and be able to sleep at night, please consider a career in physical therapy over chiropractic.

http://chirotalk.proboards3.com/index.cgi (site of former / reformed chiropractors)

www.chirobase.org (just a good website regarding chiropractic)

Best of luck in your chosen profession. :luck:
 
2 quick questions,

I was recently at a high school football game with a PT/ATC who was covering the game with a chiropractor who proceeded to tell us that he received a physiotherapy certificate after his 2nd year of chiro school which certifies him to treat not only spine problems but everything from foot to shoulder pathology

I've been assured this is false, has anyone else ever heard of this?


Secondly, there are several faculty members at my university that are telling students that the job market for PT's is going to be horrible in the future and that there are too many applicants and pt students are not enough jobs.

Any thoughts?
If he did receive some sort of certificate it means nothing. The curriculum is 10 semesters in length and you cannot practice prior to that.
 
Quick notes
- PT is a great job/career...with the current market, you can get a great job in almost any area of the country...Pay rates are up...

- I average a job offer/opportunity ~1/month....1/ every 3 months that are pretty tempting.

- The dip in the PT market in the early 2000's (When I graduated) was thanx to the Balanced Budget Act (thanx B. Clinton...can't wait to see what Hilary might do)...This got a lot of career councilors down on PT...There was never a reduced need for PT, but rather a reduced compensation. The profession has come back stronger w/ the better ability to justify itself.

- As for the DC-PT Cert...Taking a 2 credit class in "Corrective Exercise", "Biomechanics", "Rehab" does NOT make you a Physical Therapist

- While I am on the soap box.....As for the Doctor of PT, Not sure that is the greatest path for the profession = Don't Bite the Hand that Feeds You (Side note, I am in Medical School....not that I fear PT's as competition, but I just don't want to see a good PT act as a poor doctor....the term doctor has really got watered down).....

I would have preferred to see more of a promotion of the specialty certifications (Experience + Credentials should be the path to PT career advancement, instead of 6 more months in grad school)
 
I am a chiropractor myself. It is true that the chiropractor should not have been there classifying himself as a "physical therapy." Most of you guys are right in that most chiro schools only take 4-6 semester of PT related classes. Having said that, I feel we should not be able to do PT. We should focus on what we are good at, the spine,

As for me, I am an ATC, CSCS, and Personal Trainer. I was an ATC/CSCS at Va. Tech before Chiro. School. An yes, I did get accepted in D.O school, PT school, and PA school. I am not a "MD wanna-be." I think we all have an area of expertise and in my practice, I have a PT, MD, ATC, and Massage therapist working along side me to provide the best care for my patients.

As for the two websites that a member posted...I agree that chiropractors are getting into too many questionable practices.

Best of luck to all of you guys!

William Wong, DC, ATC, CSCS, CPT
 
I am a chiropractor myself. It is true that the chiropractor should not have been there classifying himself as a "physical therapy." Most of you guys are right in that most chiro schools only take 4-6 semester of PT related classes. Having said that, I feel we should not be able to do PT. We should focus on what we are good at, the spine,

As for me, I am an ATC, CSCS, and Personal Trainer. I was an ATC/CSCS at Va. Tech before Chiro. School. An yes, I did get accepted in D.O school, PT school, and PA school. I am not a "MD wanna-be." I think we all have an area of expertise and in my practice, I have a PT, MD, ATC, and Massage therapist working along side me to provide the best care for my patients.

As for the two websites that a member posted...I agree that chiropractors are getting into too many questionable practices.

Best of luck to all of you guys!

William Wong, DC, ATC, CSCS, CPT


that is the kind of setting i would love to work at someday. can u please describe more of your chiro/md/pt/atc/massage clinic?
 
Well...Interesting discussion is going about chiropractic and physiotherapy. Basically i'm a student of that. Useful information is been provided here. Thanks for that.
 
Hi there,
I'm a newbie here. Actually i'm interested to do my Physiotherapy course in UK. kindly provide me some information regarding this. Hope you would do that.
 
I am a chiropractor myself. It is true that the chiropractor should not have been there classifying himself as a "physical therapy." Most of you guys are right in that most chiro schools only take 4-6 semester of PT related classes. Having said that, I feel we should not be able to do PT. We should focus on what we are good at, the spine,......

I am of the same opinion regarding manipulation.......most PT schools offer a nominal manipulation related course and then PTs promote themselves as skilled in manipulation. I feel PT should not be able to do manipulations of any sort. They should focus on what they are good at.
 
I am of the same opinion regarding manipulation.......most PT schools offer a nominal manipulation related course and then PTs promote themselves as skilled in manipulation. I feel PT should not be able to do manipulations of any sort. They should focus on what they are good at.

I'm actually giving an in-service tomorrow about therapeutic manipulation and imo it isn't a skill that requires extensive training for proper utilization (imo proper setup is 90%). Having said that, I don't think I'd have as good of technique as someone who does it several times a day but that's not going to stop me from using as it when I deem appropriate.
 
I'm actually giving an in-service tomorrow about therapeutic manipulation and imo it isn't a skill that requires extensive training for proper utilization (imo proper setup is 90%). Having said that, I don't think I'd have as good of technique as someone who does it several times a day but that's not going to stop me from using as it when I deem appropriate.


Agreed, FNG.
In my fellowship program we had this discussion, how learning thrust manipulation is actually easier than many of the other techniques covered in entry level curriculum, such as MET, or grade I-IV manipulation. Much more motor control & finesse is required for the latter two techniques by comparison. Con-ed courses just make more $$ using thrust as the final stage in series based courses, not because it's difficult. (Besides, how many people self-manipulate or do it to friends without any education??)
 
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I am a chiro student and agree that adjusting is not the hardest skill to learn in the world but knowing when and where to adjust and when not to adjust is also an important part of the equation.
 
I am a chiro student and agree that adjusting is not the hardest skill to learn in the world but knowing when and where to adjust and when not to adjust is also an important part of the equation.


I agree that knowing when, where, and when not, to adjust is extremely important, and as you post: "an important part of the equation" and indeed, that is part of your comprehensive DC education.

You do not indicate your DC student year------so, it is difficult to critically evaluate/comment upon your opines on manipulation skills. Students can get a bit over excited/ over confident/ over anxious.......and thusly Over-estimate/evaluate their level /experrtse of manipulative skills ........ Trust me DC80- As you progress in your manipulation endeavors- you will, hopefully, come to know and recognize the difference. That is a good thing.

What is paramount here is that: manipulation is not manipulation, is not manipulation. Many outside the DC education like to dismiss it, or diminish it, as an "easily learned skill". Nothing could be further from the truth. As you(as well as I did) mature in your skills, you will come to ascertain, acknowledge, and appreciate the difference. (I absoluetly cringe when I see what some call/proclaim to be "manipulation").

I have been the recipient of bad, to mediocre manipulation, as well as superbly skilled manipulation. There is a huge difference. ------And Patients deserve the best- not mediocre.

Do not allow others to distort/mislead you on this. Please use your opportunities, as a student, to learn, and work to develop, refine, master, and VALUE- your manipulative skills. Do not underestimate or allow others to disengeniously devalue, these skills.

If I may make an analogy: Just about anyone, including 'Aunt Mary', can, in short order, learn to play 'heart and soul' on the piano, and therefore conclude, "being able to play the piano is easy". However that does not make them, or qualify them, as a pianist....

We have all heard the old adage: "A little knowledge can be dangerous". Similarily, Those that take a weekend seminar, or 12 hr manipulation course (taught by?.....well ????....THAT is a whole different topic, .....for another thread), have a "little knowledge"........


Would you want an 'Aunt Mary' doing your bypass, or your hip replacement surgery? ........OR your spinal manipulations?

On this, please refer to:
http://www.chiro.org/Professional_Regulation/


Additionally, please allow me to also refer you to:
http://smperle.blogspot.com/2009/07/talent-is-long-patience.html#comments

Additionally, I would like to direct you to some excellent DC/DC-student resources and sites:

http://spinedocsonline.com/

AND:
http://health.groups.yahoo.com/group/spinedocs/
 
I am a second year PT student at a strongly evidence based DPT program. My goal with this is to dispel some myths and educate others, including those attacking the PT profession and the lay public who are becoming more knowledgeable about what we as PTs do. Forgive me if I follow the trend of departing from the OP's question.

The assumption many make is that manipulation is the be all end all solution to musculoskeletal, and, hopefully in the minority, medical conditions which only medicine can treat. The fact is, manipulation is only a tool which should be a part of a comprehensive PT rehabilitation program including other skilled interventions in order to have a long-term benefit from treatment at all and eliminate regular "adjustments". If you haven't heard, there is evidence saying that the effects from manipulation do not appear to be due to a biomechanical change/physical realignment, only neurophysiological effects which can significantly reduce pain via short-term effects. Having said that, at least with regards to LBP (low back pain) current quality research shows that manipulation (grade 5 mobs), regardless of choice of technique, can only work in a subgroup of patients who meet a number of specific criteria. Otherwise, it has been shown, you might be wasting your time and that valuble health care dollar. In my musculoskeletal disorders course we're refining our skills with these techniques and learning which patients to use them with, on top of screening for referral to an MD for red flags, etc...Far from a 12 hour course or whatever.

PTs have been trained in these techniques for years as a requirement in DPT programs, and studies show that we are safe and effective with our technique. PTs have actually made many advances in manual therapy, including manipulation, as we are are heavily involved in research in the ~220 PT programs in the U.S., most of which are within well known and respected public institutions. So you know, manipulation has been in our literature since 1925.

Regarding the touted skill by some of testing for specific vertebral segment mobility/alignment, (again those studies, sheesh) research shows poor reliability/agreement of sometimes less than chance with these techniques. There is greater reliability about identifying which segment is painful. Still, PTs are trained in these skills. On top of that, literature suggests that generally you cannot localize forces to a specific segment anyway, aside from maybe PA glides which are not even manipulation techniques. I do agree with others here who have said that manipulation is relatively easy to do compared with other techniques.

Finally, wherever I mentioned a study or research, I actually can back that up but wasn't sure if that is acceptable for a public forum such as this. I deleted several citations just before submitting.

This might be helpful though:
www.apta.org/manipulation/
 
I am a second year PT student at a strongly evidence based DPT program. My goal with this is to dispel some myths and educate others, including those attacking the PT profession and the lay public who are becoming more knowledgeable about what we as PTs do. Forgive me if I follow the trend of departing from the OP's question.

The assumption many make is that manipulation is the be all end all solution to musculoskeletal, and, hopefully in the minority, medical conditions which only medicine can treat. The fact is, manipulation is only a tool which should be a part of a comprehensive PT rehabilitation program including other skilled interventions in order to have a long-term benefit from treatment at all and eliminate regular "adjustments". If you haven't heard, there is evidence saying that the effects from manipulation do not appear to be due to a biomechanical change/physical realignment, only neurophysiological effects which can significantly reduce pain via short-term effects. Having said that, at least with regards to LBP (low back pain) current quality research shows that manipulation (grade 5 mobs), regardless of choice of technique, can only work in a subgroup of patients who meet a number of specific criteria. Otherwise, it has been shown, you might be wasting your time and that valuble health care dollar. In my musculoskeletal disorders course we're refining our skills with these techniques and learning which patients to use them with, on top of screening for referral to an MD for red flags, etc...Far from a 12 hour course or whatever.

PTs have been trained in these techniques for years as a requirement in DPT programs, and studies show that we are safe and effective with our technique. PTs have actually made many advances in manual therapy, including manipulation, as we are are heavily involved in research in the ~220 PT programs in the U.S., most of which are within well known and respected public institutions. So you know, manipulation has been in our literature since 1925.

Regarding the touted skill by some of testing for specific vertebral segment mobility/alignment, (again those studies, sheesh) research shows poor reliability/agreement of sometimes less than chance with these techniques. There is greater reliability about identifying which segment is painful. Still, PTs are trained in these skills. On top of that, literature suggests that generally you cannot localize forces to a specific segment anyway, aside from maybe PA glides which are not even manipulation techniques. I do agree with others here who have said that manipulation is relatively easy to do compared with other techniques.

Finally, wherever I mentioned a study or research, I actually can back that up but wasn't sure if that is acceptable for a public forum such as this. I deleted several citations just before submitting.

This might be helpful though:
www.apta.org/manipulation/

Much of what you say is true (I'm too tired right now to go point by point). But be aware that, just as PTs are learning more manipulation, DCs are learning more and more about the importance and science of active rehab. This isn't a 'turf' comment, so don't get too excited. It's just reality.
 
I wonder where both the chiro and PT professions will be ten years from now. I can say it is certainly looking more optimistic for PT.

The thing is it is about turf. Chiropractic students and professionals are concerned about the DPT. The one thing they've always had is autonomy to practice and this is the main reason the clinical doctorate was implemented. If the PTs can show effectiveness in treating LBP, utilize "joint mobilization" techniques effectively, and demonstrate a low risk of treatment than what else does the chiropractic profession offer that the PT profession wouldn't? Nutrition supplements? Don't dietitians do this? Add onto this low risk of treatment and credibility within the healthcare community and you have a very precarious position for the chiropractic profession in my opinion.

Like everything the climate changes with time. I wonder what's in store for both of these professions ten years from now. Both are in a state of change.
 
I wonder where both the chiro and PT professions will be ten years from now. I can say it is certainly looking more optimistic for PT.

The thing is it is about turf. Chiropractic students and professionals are concerned about the DPT.

I'm not sure that's exactly true. I'll admit I've been out of the academic scene for awhile, so I can't say exactly what is being discussed in those circles. I can say, however, that DCs out in the field aren't thinking about nor discussing the DPT thing much, if at all. I can honestly say that it has never once come up in any discussions with fellow DCs.


The one thing they've always had is autonomy to practice and this is the main reason the clinical doctorate was implemented.

Some of my PT friends, and perhaps some PTs here, aren't so sure it's a good idea to 'bite the hand that feeds', so to speak. Autonomy seems like a good idea, but who knows how it will work out or if it will make much difference. It was my understanding that PTs in some states have autonomy already. Perhaps I have that wrong, I'm not sure.

If the PTs can show effectiveness in treating LBP, utilize "joint mobilization" techniques effectively,

Does anyone doubt that PTs can treat LBP well now?

and demonstrate a low risk of treatment than what else does the chiropractic profession offer that the PT profession wouldn't? Nutrition supplements? Don't dietitians do this? Add onto this low risk of treatment and credibility within the healthcare community and you have a very precarious position for the chiropractic profession in my opinion.

Unlike PTs, who have always been part of the 'team', chiropractors have always been outsiders who have succeeded despite being outsiders to the system. We have succeeded because we have been effective at helping people. That's not to say no one else has helped people, but DCs clearly fill some void in the healthcare system, or else we would have gone extinct long ago. And that's not to say we operate in a vacuum, totally oblivious to the healthcare system in general. And, as I think you know already, we do more for patients than offer "nutrition supplements". And the "low risk of treatment" that you mention twice is, I'd guess, meant to imply that DCs are somehow dangerous, which is simply false.

Like everything the climate changes with time. I wonder what's in store for both of these professions ten years from now. Both are in a state of change.

True.
 
Unlike PTs, who have always been part of the 'team', chiropractors have always been outsiders who have succeeded despite being outsiders to the system. We have succeeded because we have been effective at helping people. That's not to say no one else has helped people, but DCs clearly fill some void in the healthcare system, or else we would have gone extinct long ago.

DCs have succeeded because they and (mostly) their lobbying front are/were very successful in the manipulation state and national legislatures. That is pretty much the only reason.
 
DCs have succeeded because they and (mostly) their lobbying front are/were very successful in the manipulation state and national legislatures. That is pretty much the only reason.

That's funny. The chiropractic profession is small and relatively poor from a financial standpoint. That equates to little lobbying power. Nice try though. And somewhere, your old writing composition teacher is smiling over your use of double entendre with 'manipulation'.:)
 
That's funny. The chiropractic profession is small and relatively poor from a financial standpoint. That equates to little lobbying power. Nice try though. And somewhere, your old writing composition teacher is smiling over your use of double entendre with 'manipulation'.:)


May be a poor choice of wording on my part, but I will reply at length to your post this weekend when I have some extra time to do so...
 
May be a poor choice of wording on my part, but I will reply at length to your post this weekend when I have some extra time to do so...

That's OK. Go out and do something fun instead. Life's too short.
 
Ok, so I realize that the debate over whether or not Chiropractors are real doctors is and has been very heated. Firstly, I'd like to say that the term "doctor" is not solely reserved for medical physicians. A "doctor" is a person who has received a Doctorate degree, whether the degree be Ph.D, Sc.D, M.D., D.O, D.C, D.P.M, D.D.S., etc... Doctor means educator. Medicine, Osteopathy, Chiropractic, Podiatry, Pharmacy, Dentistry, Psychology (any many others) are all specialized/Terminal branches of education. Anyone with a doctorate degree is first and foremost an educator. They possess the knowledge to inform others in a competent fashion about their specific field.

Many people with doctorates (for the exception of those with research-based degrees) may choose to practice their specific field (practitioners). This is where the term doctor has been skewed. Doctors of Medicine, also termed medical physicians, are health-care professionals whose scope of practice is focused on the diagnosis and treatment of disease and injury, primarily through the use of drugs and/or surgery. This is what the general public thinks of when they hear/see of the word "doctor". Medical physicians are widely accepted as the only people to be correctly called "doctor". Obviously, this is a misnomer. For a long period of time, medical physicians were the only source of health-care treatment because at that time, there was not very much research done on human health. Dentists, who are Doctors of Dentistry, are doctors who focus on mouth and tooth health. They were not referred to as doctors, rather as dentists. This was not because they weren't themselves doctors (they of course were/are), but because it was just easier and more common to say dentist. Podiatrists, or Doctors of Podiatry, are health-care professionals who... (You get the picture). All health-care practitioners holding doctorates are REAL doctors. There is nothing fake about any of them, after all, how can there be? All of their degrees are from schools that are accredited by the department of education, aka, THE GOVERNMENT. All of them must pass state exams in order to gain licensure. The only legitimate argument about Chiropractors and Medical physicians is that neither are the other. Chiropractors never claimed to be medical physicians, nor have medical physicians claimed to be chiropractors.

Chiropractors purposely turned down the AMA's offer to become part of their association because they knew they were a separate identity. As far as saying Chiropractors are "quacks", that is a completely uneducated statement. Chiropractors are primary-care physicians who receive nearly identical education as medical physicians, the main difference being pharmacology and surgery. Chiropractors take the same amount of course hours in all of the same basic sciences (chiropractic students take more hours of anatomy than do medical students), and overall, more class time hours. Chiropractors have to take a four-part board exam in order to gain licensure... If you cannot see the progression of this by now... So to say Chiropractors aren't real doctors, that is completely untrue. To say that is to say Podiatrists aren't real doctors, Psychologists aren't real doctors, Dentists aren't real doctors, Pharmacists aren't real doctors, and so on... Clearly it isn't a true statement. Again, the only valid argument would be to say, "Chiropractors aren't real medical doctors", which is completely correct!! Chiropractors, nor any other doctor (besides medical of course) claim to be medical doctors. To do so would be ridiculous.

The requisites to be a doctor are not the ability to prescribe drugs/perform surgery. Unfortunately, western medicine has drilled into our heads that only Doctors can prescribe and perform surgery, so therefore the only real doctors are ones that do so. Look at the state our country is in, we are in the 30's on the list of most healthy countries. Our spending for health-care is astronomical, YETTTTT WE AREN'T THE HEALTHIER FOR IT! I have a deep and honest respect for medical doctors and the services they provide. Without drugs and surgery, many people alive today would not otherwise be. Medical doctors are excellent in treating life-threatening diseases and their emergency care is excellent. Medical doctors to have an ultimate downfall though, for the most part, they are only treating the symptoms of diseases, not the diseases themselves. Many of the diseases medical doctors treat, such as diabetes, heart disease, cancer, hypertension, obesity, stroke, etc... which are already far into the diseases progression. Chiropractors, Naturopaths, and Osteopaths (not as many as in the past) are doctors who are more focused on disease prevention. Chiropractors are doctors who are most noted for their manipulation of joints, especially those in the spine. Chiropractic manipulation has been shown to be the most effective in treating back and neck pain, and it is also the least expensive (for the patient and insurance companies).

What many people may not know is that Chiropractors are trained in nutrition, exercise, natural supplements, and lifestyle guidance so that they can teach patients about how to live the healthiest life they are able to live. Most of the diseases medical doctors treat are diseases of affluence; obesity, diabetes, heart disease, some cancers. These diseases all stem from leading unbalanced and over-indulgent lifestyles. Obviously there are genetic components to each of the diseases, but that is because their parents/grandparents also lived similar lifestyles, and thus passed on the gene for disposition. The argument that Chiropractors claim to treat aids, cancer, etc.. are completely ridiculous. Chiropractors do in fact treat AIDS patients. They do not treat the disease itself, rather they work on pain management, diet, exercise, and lifestyle choices that will help the patient live a healthier life and therefore have a better chance at beating the terrible disease. The same goes for the cancer argument. Chiropractic does not cure cancer obviously, but it is completely possible that it may prevent it (through the diet, exercise, and lifestyle guidance). Nearly every chronic disease is 50/50. 50% nature, 50%nurture. Meaning that even though we may be genetically predisposed to certain diseases, does not dictate that we will get them, hence the focus on prevention. A healthy lifestyle is obviously the best "medicine". Chiropractors help patients to make their lives healthier and thus reducing the chance of getting diseases. Medical doctors help patients that already have the diseases by treating their symptoms. The delineation between the two disciplines is clear.

For those who say that Chiropractors are quacks because of DD Palmer (in the 1800's) claiming he could cure every disease, are basing their opinions on something that is essentially medieval thinking. If basing a profession on its founding fathers were realistic, then medical doctors are also "quacks". In the 1700's and 1800's, medical physicians believed that all diseases were due to "tainted" blood and therefore their treatment plan consisted of bleeding patients out by either cutting vessels and draining blood from them, leaches, emetics, and diuretics. If the blood loss didn't kill them from the blood letting, then the electrolyte imbalance from the emetics and diuretics surely did the trick. Clearly what happened hundreds of years ago cannot be the deciding factor on today's world. There is far too much research on health today for that to be the case. For those who say, show me the double blind clinical research on the efficacy of Chiropractic, I'd say read the JAMA and its findings on Chiropractic and how it was the MOST effective treatment for low back pain. For those who say "well a part of your philosophy is the infamous vertebral subluxation and its so-called ability to hinder our innate intelligence, therefore reducing our level of health". This is the weak point of Chiropractic. Not only is there a lack of adequate funding for such research to be done properly (thanks pharmaceutical companies!), but also the design of such an experiment would be extremely complex if not impossible. In-vivo research is really only possible when looking at biochemistry. It is relatively easy with today's technology to find the agonist/receptor complex. It is a clear and definable entity. This is where medicine gains it merit. It is not the fault of Chiropractors that vertebral subluxations are so hard to study. One cannot receive a "placebo" adjustment. In drug studies, participants receive either the actual drug, or a placebo, and regardless they are receiving drug. In Chiropractic research, one cannot just give one group adjustments and the other... I don’t know, a crossword puzzle ...(just a little joke).

The general public believes that we (scientists/medical doctors) can find the cure to EVERYTHING in a lab, which is clearly untrue (at the moment). Although science has made incredible strides in research on health, we are, at the end of the day, only human. We are not capable of finding every answer to every question. Just because there is not a peer-reviewed journal article on a treatment, does not mean that it is not effective. It just means that A. It hasn't been thoroughly studied, or B. We don't understand it, and therefore haven't found a way to study it yet. Even when the FDA approves drugs for release, and even though they know how the drug works, there are still unforeseen adverse side effects that may surface (look at all of the drugs taken off of the market because they were found to be unsafe). Again, there is no such thing as perfect ANYTHING: no perfect research, no perfect treatment, no perfect drug, no perfect doctor, NO PERFECT HUMAN!. Science is only capable of one thing: disproving. Those who say it is "scientifically proven" don't understand the downfalls of the scientific method. Science proves absolutely nothing, it merely shows trends. Anyone with a Ph.D will tell you this. I realize I’ve gone off on a tangent here but people only pick bits and pieces of info and base their entire opinion on a subject using them. For those who believe that Chiropractic is unsafe because of vertebral artery dissection in the upper cervical spine, here is an interesting tidbit. (http://www.chiroandosteo.com/content/14/1/16). Many of the reported cases of people having strokes due to upper-cervical manipulations were not patients under the care and supervision of CHIROPRACTORS. They were under the care of either a. people pretending to be chiropractors, b. physical therapists/physiotherapists, or c. osteopaths. Alright, I am getting off of my soapbox now. I would really appreciate it if people were to respond to my post (in a professional and respectful way of course). Thank you for your time.
 
Clearly what happened hundreds of years ago cannot be the deciding factor on today's world.

I have not read all of your post, but thought I'd chime in on this as a small counterbalance to the one-sidedness of your viewpoint. I have personally heard chiropractors state that spinal adjustments will increase fertility in women, eradicate depression, and more. Is this the kind of medieval, non-existent thinking you were referring to? I promise it is very much alive and well among today's chiros (although there's thankfully those among them who decry this one-adjustment-cures-all thinking).

Chiropractors have their place in the circle of healing I think (and there are those who disagree with me on that), as they have a unique perspective and approach that can warrant fruits. But while your enthusiasm is admirable, I think you've portrayed that profession through rose colored glasses. I couldn't honestly portray ANY medical profession with such one-sided optimism.
 
The difference is that the chiros still teach DD Palmer's theories and many subscribe to it. How many MDs still bleed people? I would venture a number. Zero.

The debate over the quality of education between the two disciplines has been hashed and rehashed numerous times, and the number of hours is not a valid comparison.
 
The chiropractic profession has its challenges in the years ahead. If you don't change with the times you will be left behind. I wonder where this profession will be twenty years from now.
 
"Chiropractors are primary-care physicians who receive nearly identical education as medical physicians, the main difference being pharmacology and surgery."

Wow, what a vulgar display of lies! Identical education as physicians? You've gotta be kidding yourself! Do you Chiros have 4 years of medical training? Plus 4 years of residency? Plus additional years of fellowships? To call it the same is just stupid.

A lot of chiros go into seminars about making money and how to make patients come back for more. The basis of the training is manipulation and alternative med. Nowadays, they call themselves rehab medicine. Some even use physical therapy when they don't have physical therapists on staff. They call themselves physicians when that term is to refer to medical doctors. They even made a study about physical therapy being the biggest threat in the chiropractic profession. That's why chiros are calling themselves rehab medicine. Which are you really? Physicians or physical therapists? Looks like you're all confused as to who really want to be?

What a bunch of posers.
 
From what I understand in some states the term "Chiropractic Physician" still is allowed by law. How the word "Physician" is not protected at this day and age is beyond me.
 
The teachings of D.D. Palmer are not taught in chiropractic college anymore. What is taught is respect for the origins of the practice. It is like the crazy reservation this country has for christopher columbus; did he come here on a boat? Yeah. Did he help laydown a few bricks? Yeah. Did he make a lot of mistakes along the way? Yeah. And so from his, and others mistakes, we evolve and refine.

Chiropractic college is now strongly based in scientific research. Just ask anyone who has to write up case studies and has to create a research seminar in order to get a D.C. degree. All the professors at these schools are active in research as well.

Chiropractic college is heavily reinforced with more than PT's learn. This includes 4 semesters of radiology, 2 semesters of physical diagnosis, course upon course regarding nutrition and exercise, physiotherapy, and adjustments. Are chiropractors specialists in all of these areas? No. Can they interpret and implement these skills? Yes, if they WANT to. Most chiropractors adjust and that is it, that is all they get reimbursed for. But being legally categorized as physicians, they need to recognize everything and refer to cover themselves.

The big difference in PT and chiropractic, is PT is rehabilitation treatment for major flaws. Chiropractic is treatment and prevention. You go to a PT when you are not functioning correctly. You go to a chiropractor TO function correctly, TO maintain yourself, and IF you find yourself functioning abnormally and the problem is muscoskeletal and/or neurological in nature. Chiropractors utilize the same types of treatment that PT's do, but can do so to a wider variety of people because you don't need to be hurt in order to come in. They are different arts, with some overlap, but hardly the same.

If you want to work with the aging, those coming off of surgery, in a nursing home, and athletic injuries then go to PT school. If you want to work with everyone, child and grandparent, healthy and ailing then become a chiropractor.
 
The teachings of D.D. Palmer are not taught in chiropractic college anymore. What is taught is respect for the origins of the practice. It is like the crazy reservation this country has for christopher columbus; did he come here on a boat? Yeah. Did he help laydown a few bricks? Yeah. Did he make a lot of mistakes along the way? Yeah. And so from his, and others mistakes, we evolve and refine.

Chiropractic college is now strongly based in scientific research. Just ask anyone who has to write up case studies and has to create a research seminar in order to get a D.C. degree. All the professors at these schools are active in research as well.

Chiropractic college is heavily reinforced with more than PT's learn. This includes 4 semesters of radiology, 2 semesters of physical diagnosis, course upon course regarding nutrition and exercise, physiotherapy, and adjustments. Are chiropractors specialists in all of these areas? No. Can they interpret and implement these skills? Yes, if they WANT to. Most chiropractors adjust and that is it, that is all they get reimbursed for. But being legally categorized as physicians, they need to recognize everything and refer to cover themselves.

The big difference in PT and chiropractic, is PT is rehabilitation treatment for major flaws. Chiropractic is treatment and prevention. You go to a PT when you are not functioning correctly. You go to a chiropractor TO function correctly, TO maintain yourself, and IF you find yourself functioning abnormally and the problem is muscoskeletal and/or neurological in nature. Chiropractors utilize the same types of treatment that PT's do, but can do so to a wider variety of people because you don't need to be hurt in order to come in. They are different arts, with some overlap, but hardly the same.

If you want to work with the aging, those coming off of surgery, in a nursing home, and athletic injuries then go to PT school. If you want to work with everyone, child and grandparent, healthy and ailing then become a chiropractor.

You have drunk the Kool aid.

First you suggest that chiropractors are not taught the subluxation theory, I know new grads who still believe that you can fix diabetes with adjustments, asthma, food allergies, bed wetting, autism, etc . . . I also know that the chiropractors have been the leading voices against childhood immunizations. Science, bah.

Next, you compare DC school with PT school. We are taught radiology, we are taught entire systems, we are taught to recognize "other", i.e. things outside our practice. We actually do more than ultrasound. I notice how you carefully stated that you have "physiotherapy" as part of your curriculum even though recent grads say that they do Physical therapy. I actually had to file a complaint with a local DC because on his advertisements and business cards he said his clinic was where "nutrition, physical therapy, medicine, and chiropractic come together under one roof." The DC board did nothing. He wrote a letter to them and it was copied to me full of excuses, he hired a marketing person who acted without his authority etc . . .

About 6 months later, I interviewed a woman to be a receptionist who had worked in his office for a year or more. I asked her what she did there and what her responsibilities were and she replied that she was in charge of the physical therapy.

So don't tell me that you know ANYTHING about what I (we) do because you think that you do it and you most certainly do NOT.

Our practice is not founded upon a failed, invalid theory.

Next, we treat all ages of people with all different diagnoses from CHF to rotator cuff surgery to LBP, to headaches, to CP, to amputees and on and on. When you say that you "keep people well", you do that how? by maintaining normal neurological "flow"? By tapping into the "innate intelligence" of the human body? Sounds like Palmer is still alive and well in the curriculum. There is no evidence NONE, that suggests that monthly spinal manipulation keeps people any more well than drinking a glass of water every day, and arguably there is risk for harm with cervical manips so the water is better.

The only reason you see well people is because you sell them your religious, subluxationist point of view and scare them into recieving largely out of pocket and unnecessary manipulations to pad your own wallet. If you disagree, explain this to me. Someone has a leg length discrepancy and you tell them that and adjust their spine and/or SIJ. When they leave they don't get a lift for the short leg. Why is that? So that they can come back and get adjusted again in a week when their back hurts again. Next scenario, someone has pes planus and foot pain, you give them footlevelers and send them on their way. $400 or more and you have done nothing but put an orthotic in their shoe that may or may not be fit properly with the proper posting. (90% of the footleveler orthotics I have seen in my practice do NOT have the appropriate construction)

The list goes on.

The classes DCs go to for "continuing ed" are just as likely to be a practice building class to learn how to get patients for life, or to be sold on a DMX3000 or a ProAdjuster (>$100,000) instead of actually learing new material and growing professionally.

I would love to hear you respond to this. Or are you a drive-by poster?
 
Van, it's useless to respond. You won't change any minds here.
 
You have drunk the Kool aid.

First you suggest that chiropractors are not taught the subluxation theory, I know new grads who still believe that you can fix diabetes with adjustments, asthma, food allergies, bed wetting, autism, etc . . . I also know that the chiropractors have been the leading voices against childhood immunizations. Science, bah.

Next, you compare DC school with PT school. We are taught radiology, we are taught entire systems, we are taught to recognize "other", i.e. things outside our practice. We actually do more than ultrasound. I notice how you carefully stated that you have "physiotherapy" as part of your curriculum even though recent grads say that they do Physical therapy. I actually had to file a complaint with a local DC because on his advertisements and business cards he said his clinic was where "nutrition, physical therapy, medicine, and chiropractic come together under one roof." The DC board did nothing. He wrote a letter to them and it was copied to me full of excuses, he hired a marketing person who acted without his authority etc . . .

About 6 months later, I interviewed a woman to be a receptionist who had worked in his office for a year or more. I asked her what she did there and what her responsibilities were and she replied that she was in charge of the physical therapy.

So don't tell me that you know ANYTHING about what I (we) do because you think that you do it and you most certainly do NOT.

Our practice is not founded upon a failed, invalid theory.

Next, we treat all ages of people with all different diagnoses from CHF to rotator cuff surgery to LBP, to headaches, to CP, to amputees and on and on. When you say that you "keep people well", you do that how? by maintaining normal neurological "flow"? By tapping into the "innate intelligence" of the human body? Sounds like Palmer is still alive and well in the curriculum. There is no evidence NONE, that suggests that monthly spinal manipulation keeps people any more well than drinking a glass of water every day, and arguably there is risk for harm with cervical manips so the water is better.

The only reason you see well people is because you sell them your religious, subluxationist point of view and scare them into recieving largely out of pocket and unnecessary manipulations to pad your own wallet. If you disagree, explain this to me. Someone has a leg length discrepancy and you tell them that and adjust their spine and/or SIJ. When they leave they don't get a lift for the short leg. Why is that? So that they can come back and get adjusted again in a week when their back hurts again. Next scenario, someone has pes planus and foot pain, you give them footlevelers and send them on their way. $400 or more and you have done nothing but put an orthotic in their shoe that may or may not be fit properly with the proper posting. (90% of the footleveler orthotics I have seen in my practice do NOT have the appropriate construction)

The list goes on.

The classes DCs go to for "continuing ed" are just as likely to be a practice building class to learn how to get patients for life, or to be sold on a DMX3000 or a ProAdjuster (>$100,000) instead of actually learing new material and growing professionally.

I would love to hear you respond to this. Or are you a drive-by poster?


The subluxation is outdated terminology for a dislocated vertebrae. Dislocated vertebrae leads to an assortment of problems in that the pressure disrupts surrounding structures and also cuts off nervous impulses and blood flow. Chiropractors put it back in place, restoring function. There is nothing innate about it, or religious or any other fairytale magical explanation.

As far as curing diabetes, bed wetting (urinary incontinence) or any other sort of chronic aliment or disease, I doubt it and those that propose to say they can are lying. Perhaps, if there is related pathology cutting off the nervous impulse to the organ and that is corrected allowing the messages from the brain controlling that organ to again get through there MAY be relief. Asthma has been researched and shown to be an immune dysfunction that is highly genetic, so I don't believe there is anything neurological there that could be fixed. Autism is also a dysfunction that I do not believe can be cured through manipulation; that is a disorder of language, sensory systems and social skills which are functions controlled within the lobes of the brain and cranial nerves.

Physical therapy is taught at chiropractic school, but it is called physiotherapy. It is not as in depth obviously as PT school is nor does it cover all the different types of physical therapy out there. It is for muscle rehabilitation, not respiratory, not cardiac etc.. The point of that is to help patients who have alterned musculoskeletal presentation and help them to use muscles correctly, or simply to strengthen them or increase flexibility. If a chiropractor used the term "physical therapy" in their advertisement, that is legal but a patient should know better than to go in there looking for anything outside of exercise prescription for muscle control and what have you. Also, chiropractors are taught how to use the same machines PT's do such as the electric stim, laser therapy, cold therapy etc.

The theories of chiropractic were muddled a bit, but in this day and age where research is king, and running a research based practice is taught ( in order to prove that chiropractors are evolving), the future of chiropractic is brighter, and more and more people are becoming sick of the almost mechanical practices of most doctors that run their practices based on the most common options for treatment and diagnosis. Our country is over drugged and the drugs are ruining lives. More and more MD, DO are starting to integrate healing practices where drugs are not always the first line of action. The flaw is in that medical school does not teach nutrition to the students, so they don't know how to help in that regard except for the cliches of "eat more fruit and vegetables, don't eat too much fat. Go to the gym..."

If you don't believe in spinal health, I suggest you look at the stages of vertebral degeneration. It is an ugly chronic problem that will disrupt neurological and circulatory flow, common sense will tell you that. If you don't believe me, ask anyone that has it or anyone that has ever broken their back or neck. Stage 4 demonstrates the same symptoms and deficits. Upper cervical manipulation takes skill, and is not routine. There has been some evidence of stroke related to pressure placed on the basilar artery during an upper cervical manipulation, which is why that particular manipulation is not done often, if at all.

Adjustments for leg length do not entail spinal manipulation, the femur and the hips are responsible for that. If you adjust the hip and the length of the legs are now equal, you don't need to give any sort of compensatory product to the patient. Most people go to see their chiropractor a few times a month, if they choose to utilize it that way. This is most common in athletes and older patients that may need adjustments throughout the month due to physical tolls their bodies experience. One rule of thumb I have been told is that if you are not better in 6 visits, unless you are dealing with a chronic condition, or choose to get maintanence, then don't go back. And if you have insurance, that will cost you between 60-100 dollars with a co-pay.
Foot pathology needs to be figured out initially, and once it has been, referred. In the instance of pes planus, this may mean an orthopedic surgeon if serious, or a podiatrist of course because they specalize in that area.

I would like to consider myself beyond what chiropratic was, and a leader in what it will be as a research based practice of spinal and musculoskeletal health. The standards I hold myself to personally are far above that which are needed to get through chiropractic college. If someone is in it to make money, then yes I am sure they would waste their time going to seminars on "keeping and maintaining patients for life". They can waste all the time in the world there too, because just like everyone else in practice, it comes down to fulfilling a need and patient satisfaction. You do those things and you will have patients for life. I would rather spend my time on CE learning about new techniques, new ailments, new treatments and expanding the horizons. There is no one right way to treat everyone, and chiropractic is just one part of the picture. I like to be informed about other types of practice and what is going on in other fields to help myself along with what I know, and in the end I don't care about anything else. I am young, and perhaps too eager, but I want to continue to learn because I want to have the answers for patients as well as be satisfied with myself.

I know PT's, I have been to PT's and I have nothing against them, they are needed. I have learned a lot about chiropractic in my short time around it, and I know the leadership has to change and those, including myself, in school now need to make sure it changes through integrity in practice. I don't know the types of chiropractors, or chiro students you have been exposed to, but those going around talking about DD Palmer and innate intelligence, and vitalism, need to find something else to do because they are ruining it for people like me, and turning away patients that would benefit from good chiropractors.

I obviously am not in PT school, so if you would be kind enough, what type of ideals and values are stressed there? Where exactly are the origins of physical therapy practice found? What support is there that PT is without reservation, absolutely needed? I have heard of PT itself being criticized from those that are in PT school, though I have never heard of it. Is research pushed as heavily in PT school and practice? I know that PT's have to do continuing education if they have their doctorate, why wouldn't they too just take classess on maintaining practice as a business for profit, are PT's above this?
 
Dislocated vertebrae leads to an assortment of problems in that the pressure disrupts surrounding structures and also cuts off nervous impulses and blood flow.
All you did there is take the word "subluxation out of your response. You are still talking about the same thing. Nowhere in the literature has there been a finding that vertebrae become "dislocated" or subluxed in the chiropractic sense. Show an Xray to 10 chiropractors without giving them the history of the patient and see if you don't get 10 different locations of "the dislocation".

Asthma has been researched and shown to be an immune dysfunction that is highly genetic, so I don't believe there is anything neurological there that could be fixed.

Google chiropractic and asthma and see what your colleagues think.

Physical therapy is taught at chiropractic school, but it is called physiotherapy.

Physical therapy is a framework of thought, not a task. It is a set of evaluation and treatment skills, not instruction in exercise and how to use modalities.

If a chiropractor used the term "physical therapy" in their advertisement, that is legal but a patient should know better than to go in there looking for anything outside of exercise prescription for muscle control and what have you. Also, chiropractors are taught how to use the same machines PT's do such as the electric stim, laser therapy, cold therapy etc.
It is most certainly NOT legal. Physical therapy is a legally protected term. In order to say you are doing physical therapy you must be a licensed PT in your state. Just as if I manipulate a joint I can't say that I am doing chiropractic. or look at someone's eyes and say I am an optometrist.

If you don't believe in spinal health, I suggest you look at the stages of vertebral degeneration.

Of course I believe in spinal health. I don't believe that chiropractic adjustments has anything to do with it. Have there been any studies that compare the spinal health of people who have had regular adjustments vs cohorts who have never been to a chiropractor? That is what it would take to support what you are being told. I have very good friends whose father is a DC. They have recieved adjustments there entire lives and they each miss 1-2 weeks per year with back pain. I realize that it is anecdotal but it is in opposition to your proposed theory of chiropractic and how it improves spinal health.

It is an ugly chronic problem that will disrupt neurological and circulatory flow, common sense will tell you that.
There you go again talking about subluxation without using the word. derangement of a vertebra enough to cause changes in neurological or circulatory function would certainly be readily identifiable with imaging, yet it has never been defined or even identified with any reliability. Explain that to me>

Adjustments for leg length do not entail spinal manipulation, the femur and the hips are responsible for that.

So are you saying that you adjust the hip for a LLD? I think you manipulate the SIJ and maybe L5 for symptom relief but if they have a true LLD, they need a lift.

Foot pathology needs to be figured out initially, and once it has been, referred. In the instance of pes planus, this may mean an orthopedic surgeon if serious, or a podiatrist of course because they specalize in that area.

Yes, but in many, many cases, I find that the training of chiropractors in my town is woefully inadequate to properly assess foot structure, yet they prescribe custom orthotics. I find that puzzling.

I would like to consider myself beyond what chiropratic was, and a leader in what it will be as a research based practice of spinal and musculoskeletal health. The standards I hold myself to personally are far above that which are needed to get through chiropractic college.
Good for you. If you truly believe that, do some independent research and find out how much of what you are being taught is scientific and how much is propaganda. There is little good research out there with DCs as their primary author, heck most of the research supporting manipulation as a treatment for mechanical back pain is done by PTs. There is no evidence that a properly adjusted spine lends better spinal health. I would suggest that it is just as likely that someone with lifelong manipulations would have hyper mobile spine as they would have a healthier spine.


I am young, and perhaps too eager, but I want to continue to learn because I want to have the answers for patients as well as be satisfied with myself.

It is good to be eager, and better to be passionate. Do more research into the profession you are joining before you spend a lot of money on school. Don't just talk to the professors because they have a vested interest in keeping the class full. You seem like a smart person.

I know PT's, I have been to PT's and I have nothing against them, they are needed. I have learned a lot about chiropractic in my short time around it, and I know the leadership has to change and those, including myself, in school now need to make sure it changes through integrity in practice. I don't know the types of chiropractors, or chiro students you have been exposed to, but those going around talking about DD Palmer and innate intelligence, and vitalism, need to find something else to do because they are ruining it for people like me, and turning away patients that would benefit from good chiropractors.

I obviously am not in PT school, so if you would be kind enough, what type of ideals and values are stressed there?
Solve the problem, don't just treat the symptoms
Where exactly are the origins of physical therapy practice found? What support is there that PT is without reservation, absolutely needed?
PT started with women working with polio patients a long time ago and has evolved from there.

I have heard of PT itself being criticized from those that are in PT school, though I have never heard of it.
There is some criticism of the DPT as simply increasing student loan debt without increasing the income level. There are other threads on that. ("what are your thoughts" on SDN is a good one)
Is research pushed as heavily in PT school and practice?
Very much so. In fact there are numerous peer reviewed journals that are written exclusively by PTs for PTs, as well as dozens more where PTs are contributors.

I know that PT's have to do continuing education if they have their doctorate, why wouldn't they too just take classess on maintaining practice as a business for profit, are PT's above this?

Some states don't require any CEUs but that is rare. Most require a good amount of CEUs and it doesn't matter what degree they have. DPT doesn't require any more or less hours than a MSPT or BSPT. There are fewer and fewer MSPT or MPT programs anyway. There are no BSPT programs anymore and haven't been for several years.
 
Vanbamm honestly if you can get out chiro school without an enormous amount of debt then I'd highly recommend doing it. Chiropractic is a dying profession attempting to redefine itself IMO. It doesn't have support within the medical community. It offers services already offered within the medical community. PTs do a lot of what chiros claim to do but are moving even more towards utilizing an evidence based approach. Chiropractic is attempting to reidentify itself in the areas of prevention and nutrition. PTs work with prevention as well. As for nutrition there is already specialists that work with this area that require an intensive training process. They are the dietitians.

It is an uphill battle for the chiropractic profession. They don't have respect with much of the medical community (physicians, et al.). They have a reputation of overtreating and the risk of patient injury or litigation is higher than that of other MSK experts. Prevention is important but pays the practitioner little. Don't pay attention to the salary data on the bls. Expect to make a tough living as an honest Chiropractor. The temptation to overtreat and overmanipulate will be there because of your high student loan debt.

I don't see it getting much better for the Chiropractic profession in the years ahead. Enrollment in schools is down while the best students are either going into medicine or pursuing the DPT. Chiro schools are desperate and will take anyone.

Honestly if you want to apply radiology skills go for the MD/DO. There is OMM available so you can still do manipulations/Mobs whatever you want to call them. PTs do musculoskeletal evaluations but don't order imaging. They do manual therapy though so if you can live without the imaging concept then go for the DPT. If you know all of this and are still gung ho for the DC then do that. I hate to see people putting themselves in a likely precarious position for years to come. I think that's what the chiropractic profession is going to get you. Take my opinion for what its worth.
 
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...and the risk of patient injury or litigation is higher than that of other MSK experts.

What??? You totally made that up.

(The remainder of your post is purely your opinion, to which you are entitled.)
 
What??? You totally made that up.

(The remainder of your post is purely your opinion, to which you are entitled.)

I have no quantitative comparison data on the professions so take this as another opinion. The conclusion is based upon Chiropractor's own testaments of overtreating and working outside their scope of practice. There also seems to be a small but present positive association with cervical manipulations and stroke despite the lack of evidence supporting the benefits of such treatment. I believe there was a lawsuit case in Canada recently about this. The litigation comparison was comparing DCs to PTs more than DCs to MDs/DOs. We all know the physicians have a target on their back. I don't hear too much about PTs getting sued or people getting seriously injured. I guess this is because they work within the medical model more so they're probably more inclined to refer back to the physician when appropriate. A probably bigger reason is that they don't have the big money so lawyers don't bother. Might as well go for the big money.
 
I understand where you all are coming from, and the further I get into school, the more I learn what I agree with and what I don't agree with. I find myself disagreeing more than I do agreeing on a wide variety of things that most chiropractors blindly believe in. At some point things need to change, or I will find myself either in DPT or DO school.

I don't have anything against chiropractic and think there is a time and place for it, but if those that practice it don't start thinking for themselves and begin to integrate the knowledge of traditional medicine and care, then yeah I believe it will eventually die out. I can see that for those on the outside looking in, there is a lot of criticism which I think is justified. Chiropractic needs new leadership, a new focus and needs to get its act together soon. It is too bad you find all these things out for yourself after you spend time in school and around campus practice longer.
 
I have no quantitative comparison data on the professions so take this as another opinion. The conclusion is based upon Chiropractor's own testaments of overtreating and working outside their scope of practice.

So taken, although you stated it as a fact in the earlier post.

There also seems to be a small but present positive association with cervical manipulations and stroke despite the lack of evidence supporting the benefits of such treatment.

What you mean is 'incredibly small', so small that is has proven difficult to even quantify. Please maintain perspective and scale.

I believe there was a lawsuit case in Canada recently about this. The litigation comparison was comparing DCs to PTs more than DCs to MDs/DOs. We all know the physicians have a target on their back. I don't hear too much about PTs getting sued or people getting seriously injured. I guess this is because they work within the medical model more so they're probably more inclined to refer back to the physician when appropriate. A probably bigger reason is that they don't have the big money so lawyers don't bother. Might as well go for the big money.

I don't think PTs get sued much either, and I agree with your reasons why. I would add another reason, at the risk of sounding inflammatory although it's not intended that way, and that is PTs don't have the same level of responsibility. Don't take that the wrong way; in fact I don't even like the turf battle notion being discussed in this thread because I think PTs do important work. But, diagnostically, PTs don't have to worry much about missing things, which is where at least some lawsuits come from. You aren't looking at films and you aren't making the diagnosis. That's all being done by the referring doc first, which reduces the PT's liability.
 
. . . diagnostically, PTs don't have to worry much about missing things, which is where at least some lawsuits come from. You aren't looking at films and you aren't making the diagnosis. That's all being done by the referring doc first, which reduces the PT's liability.


Here you are mostly correct as our practice is currently typified. However, we do see patients directly. It doesn't happen as much as it probably will in the future, but it does happen. I am certain that as actual direct access begins to happen more regularly PTs will start to get sued more. The last sentence you wrote is in reality, mostly wrong. Patient comes into the family practice doc's office with back pain, there are minimal initial diagnostics done, maybe just a screening but the real clinical evaluation is done by the PT. Imaging is done but that is hardly diagnostic unless there is a tumor or fracture. The fact that they see someone else first does reduce liability, but it is not because the doc really evaluated them. Where I work, they are trusting us to do the evaluation.
 
Here you are mostly correct as our practice is currently typified. However, we do see patients directly. It doesn't happen as much as it probably will in the future, but it does happen. I am certain that as actual direct access begins to happen more regularly PTs will start to get sued more. The last sentence you wrote is in reality, mostly wrong. Patient comes into the family practice doc's office with back pain, there are minimal initial diagnostics done, maybe just a screening but the real clinical evaluation is done by the PT. Imaging is done but that is hardly diagnostic unless there is a tumor or fracture. The fact that they see someone else first does reduce liability, but it is not because the doc really evaluated them. Where I work, they are trusting us to do the evaluation.

I agree that family physicians don't always do the greatest MSK evaluations, and I'm sure that once the patient gets to the PT, the PT will frequently add detail to the evaluation. And, sure, there aren't always diagnostic imaging studies done initially and even when such studies are done they don't often point to the pain generator or dysfunction (they do still rule out pathology). But the fact remains, particularly from a med-legal standpoint, that the patient was first seen by the MD/DO/DC first, diagnosed, then referred to the PT. As such, the PT is largely covered from the related liability.
 
I agree that family physicians don't always do the greatest MSK evaluations, and I'm sure that once the patient gets to the PT, the PT will frequently add detail to the evaluation. And, sure, there aren't always diagnostic imaging studies done initially and even when such studies are done they don't often point to the pain generator or dysfunction (they do still rule out pathology). But the fact remains, particularly from a med-legal standpoint, that the patient was first seen by the MD/DO/DC first, diagnosed, then referred to the PT. As such, the PT is largely covered from the related liability.

true, but in all honesty, if someone is referred to me from a DC I just don't believe that their differential diagnosis training is really any better than mine. The med-legal buffer is there, i agree. However, it is only because of the need, by insurance companies, for a referral to PT for payment. My point is that PT is for the most part available directly to the patient in 44 states. It just doesn't happen much because the payers haven't jumped at it yet. There are a few that are and there hasn't been any malpractice accusations that I can find.

i was actually intrigued by your reply to Lee about the malpractice stuff. i called our hospital's malpractice insurer and they said that they didn't insure chiros and the PTs were almost always packaged into a hospital's coverage. They referred me to another source but it was 515 on friday and I had to go, they wouldn't have been open anyway.

I am going to try and find out relative rates of malpractice suits for different providers.
 
true, but in all honesty, if someone is referred to me from a DC I just don't believe that their differential diagnosis training is really any better than mine. The med-legal buffer is there, i agree. However, it is only because of the need, by insurance companies, for a referral to PT for payment. My point is that PT is for the most part available directly to the patient in 44 states. It just doesn't happen much because the payers haven't jumped at it yet. There are a few that are and there hasn't been any malpractice accusations that I can find.

i was actually intrigued by your reply to Lee about the malpractice stuff. i called our hospital's malpractice insurer and they said that they didn't insure chiros and the PTs were almost always packaged into a hospital's coverage. They referred me to another source but it was 515 on friday and I had to go, they wouldn't have been open anyway.

I am going to try and find out relative rates of malpractice suits for different providers.

Why would a hospital insure a chiropractor?

I don't know the rates of malpractice for the various healthcare professions. I know it's very low for chiros and I'd imagine it's at least as low for PTs.

We'll agree to disagree on the diagnostics aspects.

On the topic of direct access for PTs, do you feel as though payers will eventually jump in? I'm not sure why they would, but I haven't given it much thought.
 
Why would a hospital insure a chiropractor?

I don't know the rates of malpractice for the various healthcare professions. I know it's very low for chiros and I'd imagine it's at least as low for PTs.

We'll agree to disagree on the diagnostics aspects.

On the topic of direct access for PTs, do you feel as though payers will eventually jump in? I'm not sure why they would, but I haven't given it much thought.

Sorry, not clear, I called the hospital's insurance company to see if they had frequency of cases. I thought that they might also insure chiropractic offices. They don't.

On direct access, I think they will jump in. When they see reduced costs without increased risk, it only makes good business sense for them, plus, it is legal in most states AND most PTs are graduating now with the DPT so it will be politically easier for them to make the switch.
 
Sorry, not clear, I called the hospital's insurance company to see if they had frequency of cases. I thought that they might also insure chiropractic offices. They don't.

On direct access, I think they will jump in. When they see reduced costs without increased risk, it only makes good business sense for them, plus, it is legal in most states AND most PTs are graduating now with the DPT so it will be politically easier for them to make the switch.

Among the PT community, is there discussion about any potential downsides to direct access?

Re: malpractice insurance, my policy ($1M/3M) is about $2000/yr, pretty cheap, which I would suspect reflects very low risks. I have no idea what a PT policy costs (at least as cheap, I would assume). I've been with the same company for years now, but I do get ads from other insurance companies, so getting chiro malpractice coverage is no problem. I guess it's a whole different animal than hospital-type policies.
 
Among the PT community, is there discussion about any potential downsides to direct access?

Re: malpractice insurance, my policy ($1M/3M) is about $2000/yr, pretty cheap, which I would suspect reflects very low risks. I have no idea what a PT policy costs (at least as cheap, I would assume). I've been with the same company for years now, but I do get ads from other insurance companies, so getting chiro malpractice coverage is no problem. I guess it's a whole different animal than hospital-type policies.

Some discussion against direct access but not much and usually from technician type PTs. What I mean is, those that work more directly with orthopedists or work for a physician owned PT clinic. those folks more often follow a protocol rather than assess on their own and design an individual plan of care based upon their findings.

I have no idea what my malpractice insurance is because is a small part of a larger institutional payment.
 
But the fact remains, particularly from a med-legal standpoint, that the patient was first seen by the MD/DO/DC first, diagnosed, then referred to the PT. As such, the PT is largely covered from the related liability.

I disagree here - if a patient was referred to me, I perform a treatment technique that is negligent/harmful, then I'm not legally liable? I don't think so. I'll find myself in litigation in a hurry.
 
I disagree here - if a patient was referred to me, I perform a treatment technique that is negligent/harmful, then I'm not legally liable? I don't think so. I'll find myself in litigation in a hurry.


I think what he means is that the big malpractice risk is not recognizing that someone who you think has BPPV is actually having a stroke, a-fib, or a brain tumor. I.e. missing something that we don't normally treat.

Of course if we do a treatment that is inappropriate or dangerous, or done incorrectly and there is harm, we can be sued.
 
I think what he means is that the big malpractice risk is not recognizing that someone who you think has BPPV is actually having a stroke, a-fib, or a brain tumor. I.e. missing something that we don't normally treat.

Of course if we do a treatment that is inappropriate or dangerous, or done incorrectly and there is harm, we can be sued.

Agreed.
 
Okay I haven't been on here for YEARS but I'm always up for a good fight. First of all if you aren't a D.C. then you obviously have no credibility in discussing what a D.C. learns in school. You weren't there=you don't know. Likewise trying to compare it to what a PT knows is ridiculous D.C's don't know crap about what a P.T. was taught.

Having said all that there are a few D.C., P.T.'s around and one a former President of the Texas Chiropractic Association. So to argue they are TOTALLY different fields is just territorial idiocy. Obviously, coming from someone who knew both fields they clearly overlap in many, many areas. There's only 1 body and you just can't have many, many different views on the same information.

My background is D.C., R.N. and going into an MSN-FNP program. Having seen two different fields already I can say the basic sciences in most, if not all, D.C. programs is adequate b/c I've seen the requirements elsewhere and they are the same if not less. The clinical education is adequate for examination, xray, ortho/neuro etc. but horrible in Ob/Gyn/Ger/Diff Dx in chiro. Yes, D.C.'s do get trained in Diff. Dx. but seldom have a large enough census to be exposed to anything other than musculoskeletal disorders. Diff Dx. on MSD is adequate but then there is always the student loan payment coming up so most times, if not all, a chiro 'finds' something to treat in the interest of preventative medicine. So it doesn't look good for Chiro's.

Arguing education, to me, is pointless. If you fulfill the requirements approved and required in any clinical doctorate program you are a Doctor. A doctor of "what" is the difference. The education of a D.C. is, for the most part, fine and in some cases exceptional in it's field (CAM MSD). Comparing anything beyond basic sciences to a medical education is ludicrous...comparing it to a Osteopathic education is closer b/c of the years of D.O. training in manipulation. However, as a past Pres. of the Oklahoma Osteopathic Assoc. pointed out to me, MD/DO's are complete doctors and D.C.'s are not. That about sums it up. Are D.C.'s better than D.PT's ? I think not...for the most part equal.

Having said all this I believe there is very, very little use for D.C.'s in the future of modern healthcare. It's a profession with a limited use and lifespan that is redundant with all of Physical Therapy and some of Osteopathic. Now that PT's have additional training and are already integrated into mainstream healthcare where would Chiropractic, truely, be useful? What gap is there in the system to fill? There really isn't one.

In defense of Chiropractic though it's fate should be decided by the marketplace not by Gov't or anyone else. If people want it and are willing to pay for it then fine. If Gov't programs take over healthcare and we look at best bang for the buck then the ol' argument that chiropractic is cost effective really goes out the window. It's cost effective if treatments are limited...if left to the practitioner it will never be cost effective b/c the patient is paying back that D.C.'s student loans and mortgage.

In a nutshell, most of you are right in that D.C.'s get off the higher ground in practice b/c of financial undisciplined behavior that skews their clinical practice. Their education is fine and done by competent teachers in most cases except for the clinicals which are almost always done by other D.C.'s with a few M.D.'s thrown in (type and quality differ alot). So crackin' backs and nutritional info is good...anything else and you're really not getting the best bang for your healthcare buck. That's the truth. There are always exceptions and a patient should look for those.

As a patient and practitioner I don't think MD's reign supreme. Most times I already know what I want/need and have to "use" them to get the meds/treatment I need. This is not an isolated incident. In most cases, they are no better in examination, history taking, etc. than me. If they care to spend the time (I CANNOT OVER EMPHASIZE THIS ENOUGH!!!) then they have a bigger tool box and better references to draw from to help patients but they seldom do. Whether it's b/c of laziness, apathy or time constraints Physicians are no different from any other practitioner...it's hard to find the proverbial "good one" in any health care field b/c most practitioners don't spend enough time with patients, thinking, planning good treatment. It's talk & walk most of the time, 10 minute exam and cursory look & feel then out the door. I see it, have done it and hear the complaints when my co-workers do it (MD/DO's).

In closing...I think PT's are great but have a chip on their shoulder. I think D.C.'s are competent but ignorant and lazy and I think MD/DO's are competent but arrogant and sometimes lazy. So what does all this mean? Buyer beware. A human beings' education, title and experience doesn't mean you will get the "best" care from a certain "type" of practitioner...it does help narrow your search but ultimately whatever the problem a patient has to find a practitioner that 1) cares 2) competent 3) creates a treatment plan that's effective for them.

Now...flame away!:eek:
 
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