D.P.T. versus Chiropractor

[MotionDoc]

Facetguy,

Please understand that no one here is attacking you - and if they are and I missed it, let me apologize on behalf of the PT profession. I am sorry that you felt the need to have to justify yourself and your practice...your input and perspective is definitely valued on this forum, and outside - I am sure.

With that said, albeit misguided and directed towards the wrong individual, nothing said by my overzealous colleagues was necessarily false...a GROSS generalization? yes, definitely...but still true. The issue stems not just from the fact that these "negatives" of the chiro profession exist, but that those in the profession not among these "quacks" are either leaving it (as in the case of the chirotalk.com contingent) or sitting idly by defending their own practice (which I do not doubt for one second is legitimate) while essentially blind (by choice or not) to the crap surrounding them.

Not that what I say on this forum will have any affect on but a few individuals, but I would challenge Chiros like yourself to step up and admonish your colleagues to step up their game and abandon "questionable" practices...start at the state level and continue up the chain.

"Never doubt that a small group of thoughtful, committed individuals can change the world...indeed, it is the only thing that ever has."

For our patients,

-MotionD

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[Husker DPT]

My sources include online blogging for the last 10 years and personal experiences, i.e. have a college friend that became a DC and is now trying to leave the profession. I need to clarify a point, I strive for objectivity. When I first pursued exposure in this topic of discussion, I visited chiropractic websites. Would usually start off stating "I'm a P.T., would be interested in knowing more about your profession and the similarities/differences". It may seem like I am overzealous and biased, but I am not here to win an argument. I am answering a posters question for which I have an opinion. Let me further explain my stance: Within chiropractic there are two factions - Mixer and straight. You facetguy are obviously a mixer. The straights within your profession are anti-allopathic and anti-mixer and anti-physical therapy. That's where we hear the notion "Chiropractic eats its young". The DC lobbyists did allow chiropractic to advertise they perform "physiotherapy" which is the Canadian term for physical therapy, here in the United States and uses direct access to attempt to be a primary care medical provider using the term "portal of care entry provider" in a semantics game that confuses patients. Bottom line, mixer's strive to be research driven, ethical and non-religious with high pressure sales tactics. The "mills" are the straights and they make the 6 figures. I could still discuss this topic further, but I'll stop there for now.

 

[facetguy]

My sources include online blogging for the last 10 years and personal experiences, i.e. have a college friend that became a DC and is now trying to leave the profession. I need to clarify a point, I strive for objectivity. When I first pursued exposure in this topic of discussion, I visited chiropractic websites. Would usually start off stating "I'm a P.T., would be interested in knowing more about your profession and the similarities/differences". It may seem like I am overzealous and biased, but I am not here to win an argument. I am answering a posters question for which I have an opinion. Let me further explain my stance: Within chiropractic there are two factions - Mixer and straight. You facetguy are obviously a mixer. The straights within your profession are anti-allopathic and anti-mixer and anti-physical therapy. That's where we hear the notion "Chiropractic eats its young". The DC lobbyists did allow chiropractic to advertise they perform "physiotherapy" which is the Canadian term for physical therapy, here in the United States and uses direct access to attempt to be a primary care medical provider using the term "portal of care entry provider" in a semantics game that confuses patients. Bottom line, mixer's strive to be research driven, ethical and non-religious with high pressure sales tactics. The "mills" are the straights and they make the 6 figures. I could still discuss this topic further, but I'll stop there for now.

I do give you kudos for at least doing some searching, asking some questions. That's more than some can say, those who simply regurgitate what they've been told without so much as even thinking about it.

As to your friend the DC, I think his sour grapes may be more about his personal failures as a DC. That doesn't make him a bad person; it does suggest he chose the wrong profession. It also shouldn't be reason to cast aspersions upon the entire chiropractic profession.

The 'straights and mixers' issue does exist to a certain extent, I guess. My personal feeling, however, is that the 'modern chiropractor' is science driven, and as time marches on the old guard with old less-than-scientific notions is replaced by chiros like, well, like myself. As far as anti-allopathic sentiments, I'm not sure how deep that really runs. When a chiropractor is having a heart attack, s/he goes to the ER just like everyone else.

I wish I could say that the chiro profession has some giant, super-powerful lobbying presence, capable of infuencing lawmakers with ease. But that's not the case. We are a relatively small, relatively economically challenged (from a lobbying standpoint) profession. We didn't strongarm anybody vis a vis the term 'physiotherapy'.

On the primary care issue, nobody comes to my office thinking I'm a family physician. I submit that there is no 'semantics game' going on, nor are patients confused. Patients know what chiropractors do, and they know what family physicians do. It's pretty simple, isn't it?

There are some "mills" out there, and that's unfortunate. But let's not pretend that PTs and MDs don't work at some of those same mills. And ethical chiros can and regularly do make 6 figures (using your words). You don't have to be a scumbag to make that money (I don't consider myself a scumbag, anyway). By the way, many of the PTs I know make 6 figures too, and I say good for them.

Good discussion.

 

[black]

PT, Chiro, MD, RN, CNA, medical office assistant, and any other professional choice in the medical field or other field for that matter is a personal choice. You post in a PT student doctor forum whether PT or Chiro is better you'll get reasons why PT is good and Chiro sucks because people in this forum will be defending their choice. The only way you, your friend, or anyone else could decide on their future is to observe both in multiple clinics. Different clinics treat people differently in PT as well as Chiro and it even varies from region to region. This is a lifelong decision where other peoples opinions should have little bearing. If I gave you 10,000 reasons why to be an accountant would it make you want to be an accountant? No because certain people don't like accounting. I would hate to see another DC to PT thread or PT to MD if you don't enjoy what you do don't do it and the only way to find that out is observe. As for my advice? Tell them to do what they feel they will want to do for the rest of their lives, only the individual can answer that question and I would hate to steer someone wrong just to justify my decision to the world.

 

[lee9786]

Below is an entire forum regarding the chiropractic profession where the there are chiropractors themselves stating their own beliefs about their chosen profession. Look around for a PT message board that is designed to bash the profession. Tell us what you find.

http://chirotalk.proboards.com/index.cgi


I'm neither a PT nor a chiropractor but have researched both professions extensively because I, as a non-stake holder, am only in pursuit of the facts which will help me provide accurate insight regarding investing heavily both in time and dollars into a prospective career.

 

[clo]

wow.....some good reading for a slow night. I have to say I've met chiros who were WAY out there before.

I'm fortunate enough to have found one who not only knows what he's doing but has a genuine interest in getting you healthy and back out doing your activities. I've been injured several times from biking accidents and he's done well with getting me back up and running.

 

[facetguy]

wow.....some good reading for a slow night. I have to say I've met chiros who were WAY out there before.

I'm fortunate enough to have found one who not only knows what he's doing but has a genuine interest in getting you healthy and back out doing your activities. I've been injured several times from biking accidents and he's done well with getting me back up and running.

I guess you know by now that Lance Armstrong and his team(s) have always relied on chiropractors as part of the medical team. Teamwork!

 

[clo]

I guess you know by now that Lance Armstrong and his team(s) have always relied on chiropractors as part of the medical team. Teamwork!

2 years ago or so I was out mountain biking with a couple friends of mine. I went to just this log pile and miscalculated big time. my front tire hit this rock on the other side and I did an endo over the bars.

I started to tuck and roll (like i've done in the past) but i only made it to the top of my forehead area. thank god I was wearing my helmet like always. I never lost consciousness but I did black out for a second or so i think.

I hit the left side of my forehead, momentum kicked my head back to the right and I was able to slump over onto my back. I immediate sat up and lay back down. Other than a stiff neck I was fine. I went to the hospital and had my head and neck checked out and everything turned out fine.

I went to my chiro who treated my neck and the stiffness was gone within a month or so.

On a side note.....the helmet?? frickin amazed at how well it did it's job. I cracked it fully from top to bottom front to back. and it cracked in the direction my head went.

It's hanging in my basement as a reminder of how lucky I was.

all that to reiterate that there are good ones out there who know what they are doing.

 

[Husker DPT]

Facetguy, your response style is interesting. It's downplaying, and I think frankly it's deliberate. There is a straight and mixer debate "I guess". I'm not guessing, the profession is currently divided. Practice management groups exist to optimize marketing, revenue streams with memorized scripts and use of "subluxation" reduction to manage disease. This approach is best utilized if you are a "straight" practitioner, and I feel sorry for ethical mixers but they have a big battle: The reputation promulgated by the straights and the lack of consistent m.d. referrals. Hey, you're a mixer, that's great. But lets delve deaper and look at other topics. Look at the marketing to your profession. Look at use of weird gadgets from the mainstream activators, to the offbeat heat sensing subluxation quackery, and even the fraud behind high dollar more efficacious devices like the DRX9000 (In all fairness, I am fascinated by the Cox flexion/distraction table). And the premise. If you go to 10 chiropractors separately or in a row, they will all find different subluxations. You can never be subluxation free, and are never seen and informed you don't have a subluxation! Because detecting spine subluxations, interpractitioner and with palpation and xray are not reliably detected and have never been "proven" to even exist. And the chiropractic mission statement is that primary care physicians (don't use the I believe in the ER if I have a heart attack or broken bone argument) are overutilized by the public. And the second part of the chiropractic mission statement is that doctors are pill pushers for big pharma. Don't pretend like this is only a minor part of the chiropractic meatball. And if you're a student and/or layperson, do the needed research before representing expertise on a topic. I mean, come on. I think chiropractic students are earnest and chiropractors are generally speaking good intending with the desire to help people. What I'm telling a prospective student deciding between chiropractic, physical therapy and any other profession for all I care is that the chiropractic profession is laced with internal problems. Do the research. Over the last decade I've interviewed more than just one person I can assure you. So, do as I did, don't just take my word for it.

 

[Husker DPT]

Oh, and despite what facetguy may state, the chiropractic lobbyists did successfully: 1. Lobby to obtain the title physician (look in the phonebook to confirm and ask yourself - why?), 2. Lobby to use the term "physiotherapy" in their marketing (again, look in your phonebook for confirmation and ask yourself?), and also 3. Lobby to use the term "portal of entry provider" (not in the phonebook, but you can find this). These are facts. Go look it up, anyone. For more fun reading, look up Life University (the second most famous chiropractic school next to Palmer) on Wikipedia. Once again, I could go on but I'll stop for now.

 

[lee9786]

I actually thought "physiotherapy" was a protected term for Physical Therapists. I also didn't know about "physician" Chiropractor just the Dr. Chiropractor.

 

[Husker DPT]

Nope. Every phone book in the country now has chiropractic listed under "Chiropractic Physicians" and the adds state "Physiotherapy" under the list of services offered. Take 5 minutes, open a phone book, and check it out. Chiropractic Physician = portal of entry provider, whereas General Pracitioner = primary care provider. Not confusing to the laypublic? Chiropractors have direct access, meaning insurance will pay for the services without a referral from a m.d. And what do you hear from the straight chiropractor upon arrival? You don't need to go to your general practitioner. They are pill pushers, and when that does work you're referred to a surgeon. Let's treat the subluxations of the spine on the road to optimal health. You need nutritional supplements, which I conveniently sell, and lets start the frequency with 1-2x/week. I have a plan that is cheaper with more visits up front, so we can sign you up for a 1, 3, 6 or even 12 month package to get you going on the road to optimal health. And bring in the family, that will get you the cheapest package we have, but hurry the offer ends next week.

 

[Husker DPT]

In all fairness to facetguy, mixers do exist. This is the smaller faction of ethical chiropractors that rebuke subluxation as a selling point and use manipulation and even physical therapy tools i.e. therex, modalities or whatever with an earnest desire to get pt's discharged expediently with goals met. These guys are good with musculoskeletal differential diagnosis, very good with interpreting xrays, and I have talked with them frequently over the last decade engaging in intelligent conversations about patient care. They have a more difficult time earning revenue. Like I said, no one knows me here from a hole in the wall but I am objective and I've done more research on this topic than most. Now lets look at additional benefits of physical therapy. You can change specialties without further schooling. Pediatrics, great, outpatient or skilled rehab okay. Want more flexibility? Let's try home health. Or you can open a clinic or go into management. Do you need additional schooling? Nope. The other health care provider that can make that claim is the PA. Medical physicians need fellowship training with the changing of specialities and often times nurses require additional training to increase the pay and skill of their setting. With chiropractic, you either become an associate (term for chiropractor hired by another chiropractor) in which case you make 30-40K/year in a nonmill clinic or a maybe 50-60K in a patient mill or set out a shingle, add a business loan to your 150K student loans (that's the cost of a DC) and hope patients come. Now look outside around your neighborhood at the shear number of chiropractic offices. Chiropractic utilization figures vary from 3% to 5% up to 7% of the general population depending on the source. Slim pickings, and the chiropractors that are hiring are usually running the high volume subluxation stations. I like the multidisciplinary clinics for pain management, and if I did open one of these I would think about hiring a chiropractor. And if a chiropractor did own one, I'm all for it if the model avoided the quackery. But there are a lot of pain clinics already around and these are usually referral driven. Now, back to the question of the original poster. If your friend decides to go to chiropractic school, fine. I probably would like your friend and facetguy seems like a friendly individual. This discussion just isn't about personality or charisma however.

 

[Husker DPT]

The poster "black" above has some good advice. Job shadowing is probably the most important active demonstration of initiative one can engage in for choosing a profession. I personally job shadowed 3 medical physicians including my PCP, 2 physical therapists, 1 chiropractor (yep), a speech therapist, occuptional therapist, and a respiratory therapist in multiple setting including outpatient, hospital, cardiac and pediatric. I formally changed majors 2 times (originally elementery education) and have 5 minors because of the volume of classes I took in 5 years of undergraduate training. Job shadowing is crucial for exposure to what the day-to-day life of a career entails and I advocate for this frequently. But, here's the thing. It's not the only thing. Other research is required as well. Income is a consideration. How about is the job going to be around in 10 years. Is the job market saturated? What about employee satisfaction rates, and what about demographic distribution of jobs. My wife is a food chemist. We have about 6 places in the United States she can work without us needing to move or her needing to travel often because of the location of the central hubs of the major food manufacturers. And, how about travel requirements? All research is valuable. Including, posting on the internet.

 

[facetguy]

What's the secret to having so much free time. You're killing me. But I can't resist.

Facetguy, your response style is interesting. It's downplaying, and I think frankly it's deliberate. There is a straight and mixer debate "I guess". I'm not guessing, the profession is currently divided.

I said "I guess" because the terms 'straights' and 'mixers' are largely utilized by those outside the chiro profession, particularly the term 'mixers'. I don't introduce myself as "Hi, I'm Dr. Facetguy and I'm a mixer". At post-grad classes and conventions, there aren't chiros walking around with 'straight' and 'mixer' nametags. Sure, there are differing philosophies within the profession, so "I guess" you are right in a sense. But I think you are overstating things, I guess.

Practice management groups exist to optimize marketing, revenue streams with memorized scripts and use of "subluxation" reduction to manage disease. This approach is best utilized if you are a "straight" practitioner, and I feel sorry for ethical mixers but they have a big battle: The reputation promulgated by the straights and the lack of consistent m.d. referrals.

I've always been a bit skeptical about some of the practice management companies out there, as they do get into some hokey stuff. But running a practice does require one to wear many hats, some of which may not fit well, so to speak. Having someone who can help you organize, for example, or help you with billing issues, or help you with advertising, that can be helpful to the business end of things. Most PTs don't own a practice but are employees and never have to worry about these business issues. As to "subluxation", if it makes you feel any better I don't use that term, ever. It's just not necessary and causes confusion.

Hey, you're a mixer, that's great.

I prefer to think of myself as a good chiropractor. But if I'm stuck with choosing either straight or mixer, I'd say you're right. However, if I have a patient that I only perform manipulation on (and I do have those), I guess to that patient I'm a 'straight'. But the next patient I may do ultrasound, stim and manipulation...mixer? How about joint mobs and myofascial work? Or how about discussing workplace ergonomics with a patient? Do straights do that? I'm not sure. My point is that, inside the chiro profession, there isn't this bold line dividing us into 2 camps; that's a division largely perpetuated by those outside the profession.

But lets delve deaper and look at other topics. Look at the marketing to your profession. Look at use of weird gadgets from the mainstream activators, to the offbeat heat sensing subluxation quackery, and even the fraud behind high dollar more efficacious devices like the DRX9000 (In all fairness, I am fascinated by the Cox flexion/distraction table).

There have been some odd 'techniques' out there, with or without gadgets. Some of these gadgets turn out to be pretty useful. The Activator instrument you mention (or similar devices) actually have some research behind them and can be useful in certain situations. I use an Activator on a relatively small number of my patients, including those with bone density issues, vascular concerns, lots of spasm, or even if they are squeemish about "neck cracking". But it comes in handy. I use Cox/flexion-distraction everyday. As to the decompression units (e.g., DRX9000), I think they are like everything else for LBP: it'll help some, it won't help some, and may aggravate a few. The only difference with the decompression tables is the cost, but most (or all) of that ends up being out-of-pocket for the patient. And if that patient has tried everything and is facing surgery (or has already failed surgery) yet still can't play with his kids due to back pain, who are you to say that he shouldn't try decompression, especially if he's paying for it himself?? Should a DRX9000 be first line treatment? Of course not.

And the premise. If you go to 10 chiropractors separately or in a row, they will all find different subluxations. You can never be subluxation free, and are never seen and informed you don't have a subluxation! Because detecting spine subluxations, interpractitioner and with palpation and xray are not reliably detected and have never been "proven" to even exist.

The chiropractic profession is not a homogeneous bunch, and that can either be a blessing or a curse. It's a curse (as a matter of speaking) because a patient may indeed get different opinions in terms of technique used, etc. But it's a blessing because there is a variety of different treatments available, one of which may happen to be the one that helps you. There is much more of an "art" component to chiro than there is in PT, and that's not meant to be a swipe at PTs. But PTs tend to use well-deliniated protocols that don't vary much PT to PT. The standardization can be a good thing. I haven't really thought this analogy through as I'm too busy right now to do so, but a Big Mac will be pretty much identical at any McD's you visit around the country...that's PT. Chiro will provide some variation. Each has it's proponents, no doubt.

And the chiropractic mission statement is that primary care physicians (don't use the I believe in the ER if I have a heart attack or broken bone argument) are overutilized by the public.

Totally wrong. Why would chiros care if you see your PCP for a sore throat or for toe fungus? Swing and a miss on that one.

And the second part of the chiropractic mission statement is that doctors are pill pushers for big pharma. Don't pretend like this is only a minor part of the chiropractic meatball.

Again, an overstatement. The numbers of DCs that are that hardcore is very small. All of us as Americans, however, should be concerned about the state of healthcare in general, and this includes the overuse of medications as an answer to everything. We already know that lifestyle modification is the key, not more medications...everyone knows that (including you). The difficulty is implementing those changes. This is too big a topic to get into here. But we are overmedicated as a society. Does that make MDs evil? That's silly.

And if you're a student and/or layperson, do the needed research before representing expertise on a topic. I mean, come on. I think chiropractic students are earnest and chiropractors are generally speaking good intending with the desire to help people. What I'm telling a prospective student deciding between chiropractic, physical therapy and any other profession for all I care is that the chiropractic profession is laced with internal problems. Do the research. Over the last decade I've interviewed more than just one person I can assure you. So, do as I did, don't just take my word for it.

Any prospective student should do the research and ask the questions. It's a big decision. But chiro is "laced with internal problems"? C'mon. Using your logic, no one should ever ever consider going to DO school then...now there's a divided profession (OMM vs. no OMM). And what about the PTs who want more direct access versus those who believe you shouldn't bite the hand that feeds? Whoa, cross PT school off the list, kids.

 

[facetguy]

Oh, and despite what facetguy may state, the chiropractic lobbyists did successfully: 1. Lobby to obtain the title physician (look in the phonebook to confirm and ask yourself - why?), 2. Lobby to use the term "physiotherapy" in their marketing (again, look in your phonebook for confirmation and ask yourself?), and also 3. Lobby to use the term "portal of entry provider" (not in the phonebook, but you can find this). These are facts. Go look it up, anyone. For more fun reading, look up Life University (the second most famous chiropractic school next to Palmer) on Wikipedia. Once again, I could go on but I'll stop for now.

So what?

 

[facetguy]

I actually thought "physiotherapy" was a protected term for Physical Therapists. I also didn't know about "physician" Chiropractor just the Dr. Chiropractor.

Use of the term "chiropractic physician" varies state by state. This is not a new term that was just lobbied for and granted. It has been around for decades, as has "physiotherapy".

 

[facetguy]

Nope. Every phone book in the country now has chiropractic listed under "Chiropractic Physicians" and the adds state "Physiotherapy" under the list of services offered. Take 5 minutes, open a phone book, and check it out.

I honestly don't know one way or the other if that's true or not. Regardless of what phone books say, however, state law determines whether DCs can use the term "chiropractic physician" or not, and that varies state to state. The Yellow Pages publishers don't get to make that decision.

Chiropractic Physician = portal of entry provider, whereas General Pracitioner = primary care provider. Not confusing to the laypublic?

As I've said before, the lay public knows what chiropractors do and they know what family physicians do. No one has ever shown up at my office asking for a prostate exam. (Well one guy did once, but he was a little weird, so I referred him to PT...just kidding!!)

Chiropractors have direct access, meaning insurance will pay for the services without a referral from a m.d. And what do you hear from the straight chiropractor upon arrival? You don't need to go to your general practitioner. They are pill pushers, and when that does work you're referred to a surgeon. Let's treat the subluxations of the spine on the road to optimal health. You need nutritional supplements, which I conveniently sell, and lets start the frequency with 1-2x/week.

Do you know why this is fantasy? Because in the real world, whether you are a 'straight' or a 'mixer', patients can sue you for malpractice. Telling a patient they don't ever need a medical physician is probably the fastest way to get yourself sued. And there is no chiropractor on the planet that would deny a well-timed surgery is necessary. You're letting your imagination run a little wild here.

I have a plan that is cheaper with more visits up front, so we can sign you up for a 1, 3, 6 or even 12 month package to get you going on the road to optimal health. And bring in the family, that will get you the cheapest package we have, but hurry the offer ends next week.

I have to give you this one. There are some DCs that do this, although I don't think it's all that widespread as it's illegal in at least some states. But these plans are not appropriate.

 

[clo]

you two notice the OP hasn't posted in a few days? This topic could go on and on. opinions are like....well you know.

facetguy, keep doing what you are doing. there are some of us who know how to find good chiros and we appreciate you.

same for the PT's out there.

i think to some extent there is a need for both.

 

[facetguy]

In all fairness to facetguy, mixers do exist. This is the smaller faction of ethical chiropractors that rebuke subluxation as a selling point and use manipulation and even physical therapy tools i.e. therex, modalities or whatever with an earnest desire to get pt's discharged expediently with goals met. These guys are good with musculoskeletal differential diagnosis, very good with interpreting xrays, and I have talked with them frequently over the last decade engaging in intelligent conversations about patient care. They have a more difficult time earning revenue. Like I said, no one knows me here from a hole in the wall but I am objective and I've done more research on this topic than most. Now lets look at additional benefits of physical therapy. You can change specialties without further schooling. Pediatrics, great, outpatient or skilled rehab okay. Want more flexibility? Let's try home health. Or you can open a clinic or go into management. Do you need additional schooling? Nope. The other health care provider that can make that claim is the PA. Medical physicians need fellowship training with the changing of specialities and often times nurses require additional training to increase the pay and skill of their setting. With chiropractic, you either become an associate (term for chiropractor hired by another chiropractor) in which case you make 30-40K/year in a nonmill clinic or a maybe 50-60K in a patient mill or set out a shingle, add a business loan to your 150K student loans (that's the cost of a DC) and hope patients come. Now look outside around your neighborhood at the shear number of chiropractic offices. Chiropractic utilization figures vary from 3% to 5% up to 7% of the general population depending on the source. Slim pickings, and the chiropractors that are hiring are usually running the high volume subluxation stations. I like the multidisciplinary clinics for pain management, and if I did open one of these I would think about hiring a chiropractor. And if a chiropractor did own one, I'm all for it if the model avoided the quackery. But there are a lot of pain clinics already around and these are usually referral driven. Now, back to the question of the original poster. If your friend decides to go to chiropractic school, fine. I probably would like your friend and facetguy seems like a friendly individual. This discussion just isn't about personality or charisma however.

PT is an excellent profession for all the reasons you cite and more.

As to chiro utilization, you are correct in a sense. When it comes to LBP, however, the numbers are higher. More in the range of 33%-40% of those seeking care for their pain.

"Hoping patients come" after you open a practice isn't the best business approach. Like most businesses, you have to get out and network, meet with and speak to people, gain the trust of your community. People will get a sense as to whether you are a quack or not. Gaining the trust of area MDs is also helpful, as they will learn which DCs to trust and which to avoid. This can all take a little time but is the best way to build a sound practice that doesn't rely on unethical practices. And it's more applicable to chiros than to PTs, because (don't shoot me here) people don't seem to care as much who their PT is (as long as the MD referred them, that's good enough) but they do care who their DC is because, as discussed earlier, there tends to be more variation among DCs.

 

[facetguy]

you two notice the OP hasn't posted in a few days? This topic could go on and on. opinions are like....well you know.

facetguy, keep doing what you are doing. there are some of us who know how to find good chiros and we appreciate you.

same for the PT's out there.

i think to some extent there is a need for both.

Yeah, I know what you mean. I'm hoping this doesn't drag on much more, now that I've got carpal tunnel from typing so much!

 

[_FNG_]

 

[lee9786]

I love the wording DPT versus Chiropracter. Sounds like a WWF competition.

 

[facetguy]

I love the wording DPT versus Chiropracter. Sounds like a WWF competition.

And I love the fact that you said "WWF" and not "WWE". I still can't bring myself to say WWE. It's just not the same.

 

[black]

PT is an excellent profession for all the reasons you cite and more.

As to chiro utilization, you are correct in a sense. When it comes to LBP, however, the numbers are higher. More in the range of 33%-40% of those seeking care for their pain.

"Hoping patients come" after you open a practice isn't the best business approach. Like most businesses, you have to get out and network, meet with and speak to people, gain the trust of your community. People will get a sense as to whether you are a quack or not. Gaining the trust of area MDs is also helpful, as they will learn which DCs to trust and which to avoid. This can all take a little time but is the best way to build a sound practice that doesn't rely on unethical practices. And it's more applicable to chiros than to PTs, because (don't shoot me here) people don't seem to care as much who their PT is (as long as the MD referred them, that's good enough) but they do care who their DC is because, as discussed earlier, there tends to be more variation among DCs.

This is an inherent problem with PT, as we bash chiro here for there bad eggs the problem with PT is the same. I was referred to a PT within the clinic of the surgeon I consulted for a knee injury. The PT only gave me exercises, do this exercise for me, then this one, use this exercise equipment. Looking back I could have done everything they did by myself after the first day. In contrast I was referred to a private clinic by another physician for a different issue. He gave me three functional exercises performed manual therapy on the area (strain-counterstrain technique if I remember correctly) for six 45 minute sessions. If I counted the exercises I was given from the first it would number in the 20s vs the second where there was only 3.
My point is this: there are bad chiros and bad PTs and the average public doesn't know the difference of either until you find a good one but who switches? Not many.

 

[PostLessOne]

you two notice the OP hasn't posted in a few days? This topic could go on and on. opinions are like....well you know.

Actually, I have been reading the topic as it develops. And I'll try to get my fair headed friend to take a look at it as well.

Overall, it kind of seems like the consensus is

1. Lots of defaulted student loans by chiros
2. Whole websites set up to say the profession's a bad bet
3. Lots of negative things said about chiros that the chiro here admits are true at least some of the time

And on the other side of the debate, we have a chiro saying it's not as bad as all that, but acknowledging that the problems are real some of the time.

Given we're talking about a big investment of time and money for my friend, and a difference in completion date of 8 months, here's what I am going to recommend :

I'm going to recommend that my friend puts in the time to apply to state PT schools, starting the summer after next. I think she should also apply to a few chiropractor schools as a backup. If she gets into PT school, she should go, otherwise she should not waste another year reapplying and should go to a chiropractor school instead.

Facetguy : as the primary supporter and defender of the chiropractic profession, do you concur with my plan? It seems like this plan would be the safest overall bet.

 

[facetguy]

Given we're talking about a big investment of time and money for my friend, and a difference in completion date of 8 months, here's what I am going to recommend :

I'm going to recommend that my friend puts in the time to apply to state PT schools, starting the summer after next. I think she should also apply to a few chiropractor schools as a backup. If she gets into PT school, she should go, otherwise she should not waste another year reapplying and should go to a chiropractor school instead.

Facetguy : as the primary supporter and defender of the chiropractic profession, do you concur with my plan? It seems like this plan would be the safest overall bet.

A few thoughts. First, while it may seem like an eternity, waiting a year to get into the school s/he wants would be my recommendation. After all, s/he will be working in that chosen profession for MANY years, so in the grand scheme of things, a year isn't such a waste and could even be used to strengthen the app, gain experience, travel, or get drunk every day (just kidding on the last one).

Secondly, there's no doubt that PT school is the safer bet. Graduate, get a job, show up to work, make a decent living and pay off your loans (if applicable). Pretty safe. Chiro, on the other hand, isn't so guaranteed. It's a much more individual effort with more risk. The upside for chiros is a much higher income potential, having your own business and the freedoms that come with it, being 'the boss' (if that's important to you).

In the end, it really depends largely on your friend's personality, individual drive, business saavy (or is that savvy?), ability to create his/her own path. If your friend is the shy, quiet type, I'd say go PT, as it will be difficult to build a chiro practice with that personality type.

Gotta roll for now. Let me know if I can explain further.

 

[KyleDC]

Hello all,
I am currently getting ready to finish up chiro school. I'll be the first to tell you that half (at least) of our profession is backwards. There are still wayyyyy too many chiros that practice in a non-evidence based fashion. These chiros rely heavily on theories that were introduced in the late 1800's and never proven. I believe that if we are to be considered a part of mainstream healthcare, we need to be held to the same standards as the other healthcare fields. That standard being an Evidence based, research driven practice!!!

That being said, there is also a growing part of our profession that realizes this and is working very hard to turn our image in the right direction. I consider myself to be a part of this group and I am very excited about the profession I am entering. There is a huge need for back pain, neck pain, headache, and various other MSK condition specialists! I am hoping to work in an office (get this!) WITH a PT, MD, or DO. We as chiros are very well trained in manipulation and treating many disorders of the spine. A typical DPT gets limited training in back manipulation where chiros get over three years of daily practice in manip. Partner manipulation with Graston, ART, Mckenzie protocol, etc. and we are very well equipped to be non-surgical spinal specialists.

I believe we need to work together to fully encompass WHAT THE PATIENT NEEDS.

Thank you!

 

[Husker DPT]

Kyle, I respect your post. And you are dead on. The contemporary approach of chiropractic is to embrace evidence based practice and we know this is the only way for the profession to move forward. However, that is the current minority as Kyle admitted even though facet denies this. Most posters here don't know this because you are laypublic and students. If you look at facetguys replies, they are argumentative without addressing my statements. His posts literally analyze choice sentences and make arguments that are incorrect. Straights and mixers, nonchiropractic lingo? WRONG. Flat out lie. Sorry, play again. That is internal lingo. 99.9% of the population doesn't even know what that means. The DC mission statement is not anti-allopathic? Lie man. It's a school recruiting tool even. I didn't make this up. The contemporary approach is to join the health care team, but the subluxation detection/correction has been historically used to treat all disease. The vast majority of practicing DC's embrace everything that I have stated. Face originally stated "the big bad lobbyist group doesn't exist" and then stated "so what?" when I pursued the topic further. Contradictory, argumentative, and thanks to KyleDC, exposed as biased to the students that peruse this site. Want to discuss this more face? Let's continue this on chirotalk. Where the chiros will come out of the woodworks and we can all watch the aftermath.

 

[Husker DPT]

Facet, PT's can open a business too. And we have a higher potential referral base i.e. ortho patients for rehab in addition to the MSK pain population. You don't have to be shy to be a P.T. I mean, what, come on. I'm not buying the Kool aid, and I ain't drinking it either. KyleDC, best of luck to you. Your perspective and honesty as well as training in manipulation can make you an integral part of a healthcare team. Best of luck to you amidst the crowd the BJ Palmer embracing crowd.

 

[facetguy]

Kyle, I respect your post. And you are dead on. The contemporary approach of chiropractic is to embrace evidence based practice and we know this is the only way for the profession to move forward. However, that is the current minority as Kyle admitted even though facet denies this. Most posters here don't know this because you are laypublic and students. If you look at facetguys replies, they are argumentative without addressing my statements. His posts literally analyze choice sentences and make arguments that are incorrect. Straights and mixers, nonchiropractic lingo? WRONG. Flat out lie. Sorry, play again. That is internal lingo. 99.9% of the population doesn't even know what that means. The DC mission statement is not anti-allopathic? Lie man. It's a school recruiting tool even. I didn't make this up. The contemporary approach is to join the health care team, but the subluxation detection/correction has been historically used to treat all disease. The vast majority of practicing DC's embrace everything that I have stated. Face originally stated "the big bad lobbyist group doesn't exist" and then stated "so what?" when I pursued the topic further. Contradictory, argumentative, and thanks to KyleDC, exposed as biased to the students that peruse this site. Want to discuss this more face? Let's continue this on chirotalk. Where the chiros will come out of the woodworks and we can all watch the aftermath.

I stand by everything I've said. You can choose to misrepresent my statements if it makes you feel better.

 

[facetguy]

Facet, PT's can open a business too. And we have a higher potential referral base i.e. ortho patients for rehab in addition to the MSK pain population. You don't have to be shy to be a P.T. I mean, what, come on. I'm not buying the Kool aid, and I ain't drinking it either. KyleDC, best of luck to you. Your perspective and honesty as well as training in manipulation can make you an integral part of a healthcare team. Best of luck to you amidst the crowd the BJ Palmer embracing crowd.

Of course PTs can open a business; I never said otherwise. I simply stated, had you been paying better attention, that most PTs are employees not business owners, and that is fine. Believe me, there are days when I wish I were an employee. For chiropractors, however, owning one's own practice is a much better way to go.

What does your "higher potential referral base" have to do with anything, other than perpetuating your "PT versus chiropractor" mindset? Get over it already.

And I never said you had to be shy to be a PT. I hope you are paying better attention in your classes than you are to my posts.

 

[facetguy]

Hello all,
I am currently getting ready to finish up chiro school. I'll be the first to tell you that half (at least) of our profession is backwards. There are still wayyyyy too many chiros that practice in a non-evidence based fashion. These chiros rely heavily on theories that were introduced in the late 1800's and never proven. I believe that if we are to be considered a part of mainstream healthcare, we need to be held to the same standards as the other healthcare fields. That standard being an Evidence based, research driven practice!!!

That being said, there is also a growing part of our profession that realizes this and is working very hard to turn our image in the right direction. I consider myself to be a part of this group and I am very excited about the profession I am entering. There is a huge need for back pain, neck pain, headache, and various other MSK condition specialists! I am hoping to work in an office (get this!) WITH a PT, MD, or DO. We as chiros are very well trained in manipulation and treating many disorders of the spine. A typical DPT gets limited training in back manipulation where chiros get over three years of daily practice in manip. Partner manipulation with Graston, ART, Mckenzie protocol, etc. and we are very well equipped to be non-surgical spinal specialists.

I believe we need to work together to fully encompass WHAT THE PATIENT NEEDS.

Thank you!

I totally agree, although I'd probably say that it's less than half of chiros that still prescribe to ancient notions. But the point, as KyleDC states, is that the profession is (and has been for awhile now) moving in the right direction. It's interesting how many chiro-bashers aren't willing to recognize that. I, too, wish KyleDC much luck in the future.

 

[Husker DPT]

Misrepresent your statements? I'll leave that to the readers. Paying better attention in my classes? Nice. That is ironic, as you have not read my posts conseq with great detail. I have already stated that I'm in practice. In fact, > 10 years, one of the first DPT classes, former director of an outpatient pain clinic, current lead therapist in one of the biggest rehab facilities in the midwest, former employee of the year in one of the biggest health care conglomerates in the midwest across 2 states, with experience in outpatient, skilled, pediatrics, home health, long term care, management including marketing. I've dpne a DME startup, now work almost exclusively with amputees and I've made documentation and billing templates as well as refined business plans in this profession. I've had this discussion with well over 100 chiropractors, and I've seen more intelligent discussions than yours I promise you. And if I'm PT vs chiropractor than so is Kyle. Because according to your assertion, anyone that acknowleges the straight faction as the dominant chiropractic body within the profession represent a hostile entity in your world to be treated with ad hominem attacks, condescension and ridicule. Once again, I invite you to take your passion and post on the chiropractic website chirotalk. I maintain my same stance, and welcome the ethical chiropractors attempting to get evidence based practice as the mainstream philosophy but as Kyle says, there are "wayyyyyyyyyy" too many who are not. > 50% according to his count. And that is conservative. If you're a student, which I'm not, treat this as the philosophy debate which I am representing and not a character debate. DC's are not bad people, subluxation mills however are unethical. Do the research before you qualify statements with proposed expertise. All right face, I'm ready for your typical response including personal attacks.

 

[Husker DPT]

Most PTs are not business owners because we have multiple options. For DC's there are only two options as aforementioned. Own or be an associate for a very low salary. And you can't pay back the monstrous chiropractic student loans as an associate, so you pretty much have to own your own business. Practically no choice. I don't even think you read my posts, just devise arguments whether or not they apply. PTs have multiple career venues, so we're not forced into ownership like DC's are. Kyle, chime in here with your experiences. Let me guess facet, "I don't listen", I just "forgot something", subluxation mills are "ancient", and anti-allopathic sales tactics are representative of my lack of understanding "your posts". You can post anything you want. You can say you're a blue dragon. That doesn't make it true. Hey, students here. Go to a chiropractor, see if you have a dx: subluxation. Go to chirotalk, post some questions. Do your research, be a critical thinker. Don't be apologetic, be informed. Now all that being said, I have referred to one chiropractor who I did trust for manipulation. So good ones do exist. They are in the minority as I've said all along. Kyle, use this to establish a relationship in the healthcare profession.

 

[facetguy]

What I thought earlier had been a good discussion has obviously devolved into a meaningless venture, and that's a shame.

 

[KyleDC]

Husker and Facetguy, thank you for the well wishes. As I said before, I'm currently finishing up chiro school. Over the past year and a half I've been actively talking to, exchanging emails with, and visiting MANY chiropractors in hopes of finding a good associateship with a doc that shares my views. I would say that 95% of these chiros I talked to operate "subluxation mill" practices. It is very frustrating, but I feel it will make my job that much easier being the minority who hopefully helps people instead of steal their money. I've only recently found an office in the area that I'm from that takes the multi-disciplinary approach with a DC, DPT, MD, and DO.

"subluxation mills" are unfortunately still a very big part of our profession (at least in my experiences). I have classmates that would tell you with a straight face that a cervical manipulation can help fight off a cold. (ARE YOU SERIOUS?) I think that in any argument between a DC and another healthcare professional, we as chiros are fighting an uphill battle. We've just pulled too much crap!

As I said too though, the chiros that haven't sipped the kool-aid have a lot to offer in the realm of non-surgical spine care.

Facetguy, I know it seems like I'm bashing our profession but from a student's perspective and what I've seen and learned so far, we have a loooong way to go.

Husker, congrats on a very accomplished career. Do you have any advice in trying to take the multi-disciplinary approach? How should I approach a pain or rehab clinic and present myself as a non-surgical spine specialist?

 

[DOctorJay]

can someone comment on Atlas Orthogonal Chiropractic

 

[Husker DPT]

Kyle, I do. When I used to attempt to refer to chiropractors for manipulation, I can confidently state >75% of the time the patient would basically tell me "the DC said you were wrong" in a nutshell. Doesn't matter what the diagnosis or involved segment was. It's not knee pain, it's a subluxation. Peripheral nervous injury? No such thing. All related to the central nervous system from nerve root impingement from that darn subluxation. And yes, this caused asthma, colds, sinus infections, complicated diabetes. Because it interrupts the flow of the innate energy that fuels the body! Unlock the power! Release the innate! The remedy? The sales pitch. Why would you need PT or allopathic medicine, chiropractic adjustments are indicated for the next 12 months. That's what these students here need to know. Kyle, I have lived as a PT in 2 states. In Iowa I worked at a manual therapy pain clinic. I have an arsenal of about 3 manipulations for the thoracic spine, lumbar spine and pelvis. When those didn't work, but the pt fit the manipulation clinical prediction rule, I would refer to the one chiropractor that I trusted. How did I meet him? He first referred me a patient. He then followed up with me with a phone call to discuss the patient. I found him to have a high knowlege base and anti-innate. I think that might work with a multitude of different health care providers. Most individuals do not know what the innate is, so I might leave more internal jargon out but that could be a start. Kyle, try some of this and pm me with how it's going. I do marketing, I'm sure I could think of something else.

 

[facetguy]

Husker and Facetguy, thank you for the well wishes. As I said before, I'm currently finishing up chiro school. Over the past year and a half I've been actively talking to, exchanging emails with, and visiting MANY chiropractors in hopes of finding a good associateship with a doc that shares my views. I would say that 95% of these chiros I talked to operate "subluxation mill" practices. It is very frustrating, but I feel it will make my job that much easier being the minority who hopefully helps people instead of steal their money. I've only recently found an office in the area that I'm from that takes the multi-disciplinary approach with a DC, DPT, MD, and DO.

"subluxation mills" are unfortunately still a very big part of our profession (at least in my experiences). I have classmates that would tell you with a straight face that a cervical manipulation can help fight off a cold. (ARE YOU SERIOUS?) I think that in any argument between a DC and another healthcare professional, we as chiros are fighting an uphill battle. We've just pulled too much crap!

As I said too though, the chiros that haven't sipped the kool-aid have a lot to offer in the realm of non-surgical spine care.

Facetguy, I know it seems like I'm bashing our profession but from a student's perspective and what I've seen and learned so far, we have a loooong way to go.

Husker, congrats on a very accomplished career. Do you have any advice in trying to take the multi-disciplinary approach? How should I approach a pain or rehab clinic and present myself as a non-surgical spine specialist?

I wasn't directing that at you. I understand your frustrations as a soon-to-be new grad, and I hope you find success.

I still have to say, though, that I'm not convinced of 'subluxation mills' overtaking the profession. Perhaps it's the area in which I live, I don't know. My experience over the last 10+ years is that, if anything, there is less of that kind of practice out there and, as you had said, the profession is moving in a positive direction. A practice that is always looking for new associates is more likely one that is a high-volume sublux mill, so perhaps new grads are led to those types of practices and can come away feeling as though that is all that's out there. I would say, however, that for every mill there are scores of good chiro practices, 1 or 2 docs, doing good work for their patients and representing the profession well.

Personal injury "mills", especially in larger urban areas, yes, they do exist. But that's not just a chiro thing; most are multidisciplinary.

 

[Husker DPT]

Facetguy, I can agree with you in many ways. Chiros are better than PT's and DO's at manipulation. DO's get trained in it, and really don't use it as they are now indiscernable from MD's in terms of practice. Or let me just say, I've never met a DO that does use it. There are probably ones who do. Anyway, chiro's get more training in radiograph analysis as well. And if you practice in an ethical manner, and are successful good. Kyle, best of luck.

DOctor Jay, atlas orthogonal DC's represent one faction of numerous philosophies that state distal manipulations are basically not necessary as the atlas is a very tempermental segment capable of minute shifting that must be adjusted with a skilled AO DC to control the nervous system at it's very most superior segment.

 

[facetguy]

can someone comment on Atlas Orthogonal Chiropractic

This is an uncommon technique that utilizes what looks like a drill press to adjust the atlas in a purportedly very specific direction. I have no personal experience with this technique. As with any therapy, it has its fans and supporters. I could venture a guess that the early developers of this technique envisioned the atlas sliding laterally (or somehow misaligning) and compressing the spinal cord, causing all manner of ill health, which would then be alleviated by moving the atlas back where it belongs. It's much more likely however that this technique does work in some cases due to the high mechanoreceptor density in the upper cervical area and their stimulation via this techique. All guesses though, as I have no expertise with this method of treatment.

 

[Husker DPT]

I think Montel Williams had an AO DC on a year or two ago complete with delivery of a treatment. It's probably on youtube. Montel was a fan. But when you see the device and the application you'll understand why it is considered a fringe treatment with evidence that is anectdotal. A major problem with this technique is that the minor shifting of the atlas, according to the proponents, is reliably detectable on xray both pre and post treatment and between visits. AO DC's even market vs. their other DC counterparts to the patients and state if you aren't an AO DC, you shouldn't do it.

 

[clo]

I'm starting to lose interest in this debate. I think everything has be said that could be said no?

 

[Husker DPT]

C/o, you've tried to shut down this thread since your reply #68 before kyle posted and before we even got to the meat and potatoes of the discussion. You're not a physical therapist (I checked your profile), you've been pro-chiropractic this entire time, and Kyle just got his feet wet with some posts. So why have you been repeatedly either defending chiropractic or trying to shut the thread down? I'm furnishing education that is necessary to these prospective physical therapists about a mainstream dilemma in regards to a potential referral base. This will impact the lives of these professionals and their patients. If you've lost interest, here's the beauty of an online forum: Quit reading. Beat it.

 

[clo]

First of all it's clo not c/o. It's bad enough that people can't get my real name right.

I'm touched that you think I have the power to shut down this thread. Certainly not my intention at all. I am very intrigued by this topic which is why I'm here.

No, I'm not a physical therapist, nor a chiropractor, I am a VERY GOOD personal trainer. If you were a DPT or a Chiro who referred out to personal trainers; well I'd be one of those guys.

I recently joined this forum because I've ALWAYS been interested in rehab and if you've read other posts I've started after months of trying to figure out what I'm going to do I decided to go PTA.

Yes, i'm pro chiropractic but I'm also pro physical therapy. I see the value in both and networks and refers people who come to me with injuries to you guys.

Having been associated with both DPT's and chiro's I've always been aware of the "hating" that goes on between the two. So I am defending chiropractic care because I know from first hand experience and through referral of clients (some who were DPT's themselves) that there is some good that comes from it.

You? do you feel any good comes from it? I have found your posts very educational; though seemingly one sided I'm going to go back and re read them.

So "Quit Reading" and "Beat it" NO. Not going anywhere.

Hang on.....my post #68 implies nothing about shutting down this thread Husker. I merely stated that the OP had not replied to any of the recent posts. in fact this is what i said: you two notice the OP hasn't posted in a few days? This topic could go on and on. opinions are like....well you know. facetguy, keep doing what you are doing. there are some of us who know how to find good chiros and we appreciate you. same for the PT's out there. i think to some extent there is a need for both.

I see nothing in there about "wanting this thread shut down"

C/o, you've tried to shut down this thread since your reply #68 before kyle posted and before we even got to the meat and potatoes of the discussion. You're not a physical therapist (I checked your profile), you've been pro-chiropractic this entire time, and Kyle just got his feet wet with some posts. So why have you been repeatedly either defending chiropractic or trying to shut the thread down? I'm furnishing education that is necessary to these prospective physical therapists about a mainstream dilemma in regards to a potential referral base. This will impact the lives of these professionals and their patients. If you've lost interest, here's the beauty of an online forum: Quit reading. Beat it.

 

[Husker DPT]

My posts do not reflect the intent to persuade, they represent the intent to inform. Does Kyle demonstrate a one-sided perspective? Is he an agenda-driven anti-chiropractic poster? Why isn't he such labeled, as I have been? Because he's a chiropractor, and yet he states 95% of his research yields employment potential at subluxation station high volume mills. Reduce the subluxation, cure a cold, release the innate! I do repeatedly reiterate that good chiropractors do exist and have value, but they are the minority within this profession. And you're not the first poster in this thread to suggest I am biased in some fashion, overzealous to quote another. I am illustrating the holistic idealogy, anti-allopathic sentiment of the profession at large. I would be perhaps overzealous if this was a minor faction of the chiropractic body. But it is the vast majory. Ask Kyle. I'm not biased. I'm informed. Big difference.
Fine, stay around. If you're as good as you say you are, you'll do what I do. Vocalize your stance on topics when you've invested time and research, and done the due diligence. Like I said, I've blogged on this topic for years. My first blogs were "Hey guys, how are we the same, how are we different". No knife throwing. It was my first bite of a meteor sized apple and it took me a long time to get close to the core. My informants were valid sources i.e. chiropractors. Here I gave everyone the luxury of brief summaries with relatively short posts. You'd have to invest a lot more time and energy on this topic to claim expertise, let me tell you.

 

[clo]

Fair enough....and I apologize if I misread your posts. I do find this topic quite fascinating since I'm interested in both fields.

 

[facetguy]

When KyleDC says that he has classmates that will tell you that cervical adjustments will cure a cold, I don't think he meant 95% of his classmates. Where does this 95% figure come from? To be quite honest, and again maybe it's the Northeast region of the US where I live, but I'm hard pressed to even think of ONE subluxation mill in my surrounding area. If anything, these high-volume offices seem to be getting fewer and farther in-between, not more common. I would like to think that the reason for this is that there are more rational chiros out there, and that hopefully because the public is better educated about this stuff. As time goes on, and I've seen it already in my professional lifetime, the chiro profession will continue to move in the science-based direction (as it has been for decades now), gain the trust (and referrals) of other medical professionals, and will lose the stigma that is unfortunately still perpetuated by some.

 

[NWfuturePT]

Clo, you mentioned you refer clients to PT's and chiros. I'm curious as to what guidelines you use to decide whether to recommend a client see a PT or a chiro?
I understand that you have years of training experience, and you may very well have a good hunch as to what is going on with the client, but it is beyond your scope to determine which practitioner is most appropriate to treat the client. I think that all PT's are glad there are good trainers out there who recognize when there is need for further intervention. That being said, even great personal trainers do not have the training in evaluating movement dysfunction- that is what PT's do and are trained in. It involves understanding how complex systems in the body work together.
If you believe your client has needs beyond what you can do for them, what information do you use to decide whom they should be referred to? Why not just refer them to their PCP who can make that decision?