Is Chiropractic education equivalent to MD?

[zenman]

There isn't a substitute for medical school...

- H

Did you really mean to make a blanket statement such as this?

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[billydoc]

Does anyone know if the treatment modality of electrotherapy along your back is mainly chiropractic, or is it also common among physical therapy and orthopedics?

I'm trying to figure it out because my aunt and uncle had been going to a "doctor" who does this and I think gives them dietary supplements of glucosamine and chondroitin for it, but never mention other traditional medicines. They're not sure what kind of doctor he is. Their health insurance covered the visits.

I'm concerned because my aunt recently hurt her neck due to a manipulation by this "doctor" and it really made her feel worse -- she couldn't even turn her neck for a few days! I made her go see a physician who prescribed for her a muscle relaxant and NSAID which is the traditional pharmacotherapy, and it's worked for her moreso than the previous doctor's treatment.

I've been using elctric stem quite a bit in my acupunctuture Tx. It's not for everybody,but works quite well when indeed necessary.

 

[PublicHealth]

I've been using elctric stem quite a bit in my acupunctuture Tx. It's not for everybody,but works quite well when indeed necessary.

According to the American Academy of Medical Acupuncture, more than twenty US states allow DCs with additional training to perform acupuncture:

http://www.medicalacupuncture.org/acu_info/licensure.html

 

[adamdowannabe]

Does anyone know if the treatment modality of electrotherapy along your back is mainly chiropractic, or is it also common among physical therapy and orthopedics?

I'm trying to figure it out because my aunt and uncle had been going to a "doctor" who does this and I think gives them dietary supplements of glucosamine and chondroitin for it, but never mention other traditional medicines. They're not sure what kind of doctor he is. Their health insurance covered the visits.

I'm concerned because my aunt recently hurt her neck due to a manipulation by this "doctor" and it really made her feel worse -- she couldn't even turn her neck for a few days! I made her go see a physician who prescribed for her a muscle relaxant and NSAID which is the traditional pharmacotherapy, and it's worked for her moreso than the previous doctor's treatment.

E-Stim is indeed a high utilized modality in the PT clinic, and in sports medicine by athletic trainers. It is indicated in use along the spinal muscles longitudinally, but contraindicated to place the electrodes across the spine, Based on the possible AR's obvious with electricity and neural tissue. I am not sure if chiropractors have perfected their application and send treatments across the spine or not. I happen to LOVE E-Stim, althought the machines have gotten very smart and almost user-error proof, the physics and chemistry of the effects of electricity on pain control, muscle atrophy and edema reduction is quite fascinating. If I had a spare 2K I would have on on my nightstand for personal use.

 

[611]

Chiropractor are also taught Not to place muscle stim over the spine.

 

[jesse14]

Here's a link that shows a multitude of studies done by chiropractors and chiropractic students at the CMCC in Tornto Canada:

http://registrar.cmcc.ca/members/pdf/Research2003.pdf

DC's are doing research and it's only going to grow!

 

[611]

FYI
http://www.nuhs.edu/show.asp?durki=480&site=2&return=17
http://www.nuhs.edu/show.asp?durki=480&site=2&return=17
It's a start

 

[611]

FYI
http://www.nuhs.edu/show.asp?durki=480&site=2&return=17
It's a start

 

[611]

x

 

[awdc]

Cool. So why have them? We already have PTs. I mean if all they are doing is PT, why should they be regulated by separate broads and be under their own statutory regulation? Why the need to call themselves "physicians"? Are PTs "physical therapy physicians"? And where are the studies to prove that chiropractic is more effective (in terms of either cost or efficacy) than PT? Where are the controls in terms of QI/QA? And where are the limits on scope - I don't see PTs claiming to treat otitis media, ADHD, or allergies. Nor do I see PT claiming they can serve as primary care physicians...

- H

Same reason why states have separate osteopathic boards apart from the medical board. It's political and because chiropractors believe they have something of value to add to healthcare. And historically, chiropractic has been a profession that has enjoyed a broader scope of practice than physical therapy (whether or not that scope of practice is justified) as well as direct access and thus necessitated a separate board. Has nothing to do with efficacy.

 

[Mike MacKinnon]

so i looked at the research and i dont see it published in peer reviewed medical journals; ergo it is not proving anything medically.

Again, DC's are alternative thearpy options not medicine based on science/research.

 

[qwopty99]

hey folks

i'm a Toronto native. i've always tried to keep an open mind about the nature of chiropractic - but i have some lingering doubts. for instance, i've looked online at journal ratings (ISI factors etc.) just out of interest, but couldn't find a category for "chiropractic" within the SCI classification.

i have a good friend who graduated from Toronto's CMCC in 2004 - so i asked her, what "category" does chiro fall under. she replied alternative or complementary medicine. WHAT? u mean chiro is not even considered a remote branch of medicine? (is this like naturopathy or worse, homeopathy?)

i've searched far and wide to try to "prove" the legitimacy of chiropractic. if we just go by medline (which includes several orders of magnitude more journals than does ISI), and type in the word "chiropractic", and look at some of the journals that appear (the following ALL appear multiple times):

Journal of manipulative and physiological therapeutics. (the first 6 entries, IF: 0.786, 39/52 in Health Care Sciences & Services)
Chiropractic & osteopathy (NOT in ISI)
Spine (IF: 2.299, 46/140 in clinical neurology)
Journal of alternative & complementary medicine (NOT in ISI)

there are a lot of other entries for journals that i don't include here - in journals like Emergency Medicine etc. describing medical emergencies caused by chiropractic intervention - not exactly the stuff that "promotes" chiropractic, e.g:

Vertebral artery dissection and cerebellar infarction following chiropractic manipulation. Emerg Med J. 2006 Jan;23(1):e1.

none of this serves as great evidence for the legitimacy of chiropractic. my doubts remain.

 

[12R34Y]

Question? Were they an instructor/adjunct or faculty member (professor, associate professor, assistant professor)?
As an example, I took an Anatomy course from an RN who also had a master’s degree in education. She wasn't faculty! She taught 6 credits/year. Many schools do this to avoid hiring full-time faculty, save money, and there are many non-PhD's who can do a fine job of teaching undergrads/professional students.

I had 2 professors (academic faculty of the molecular biology/physiology department) at my medical school who only had their MD's.

it happens not infrequently.

later

 

[ProZackMI]

I was just wondering if chiropractic education was equivalent to that of a medical doctor. Many chiros claim that their education is equivalent, but somehow I find it hard to believe.

Can anyone elaborate with statistics and their thoughts?

Thanks.

HEHEHEHEHEHEHE! Um, NO! It does not even come close.

Let's start with the basics:

1) To get into a DC program, you need 2-3 years of undergrad classes with a GPA of 2.0 - 2.5. You do NOT need a degree to get into MOST chiro schools. To get into almost all MD/DO schools, you need a BA/BS with a GPA of 3.0+.

2) No MCAT/GRE/PCAT/DAT etc. is required for chiro school. All med schools, DO or MD, require the MCAT with at least a 28 or higher.

3. MD vs. DC curriculum? Honestly, I have never bothered looking at the DC curriculum, but DCs get almost no schooling in pharm, true neurology, psych, comprehensive anatomy/physiology, etc. If you compare the faculty of med schools to chiro schools, you'll see most med schools with basic sciences PhD-trained faculty, many MD-PhD trained professors, and many MD-MS, or MD-MPH trained profs. MOST of the chiro profs only have a DC degree and many of the basic sciences profs have only an MS or MA. Very few PhDs and almost no DC-PhDs.

4. Comprehensive exams: USMLEX I and II compared to whatever joke of an exam chiros take. You decide.

5. Post grad residency: for an MD/DO, at least 2 years post MD/DO is required for basic practice. For most DCs, no residency is required.


There is no comparison.

 

[ProZackMI]

My family and I use a chiropractor for our primary care doctor.

I remember when my wife went into premature labor, our chiro made the diagnosis immediately just by the malposition of her spine. From the information he got from her x-rays and manipulations, he knew to start her on antibiotics to prevent chorioamnionitis.

But his medical expertise did not stop there, since my son was born at 35 weeks, our family chiro had the presence of mind to notice the retractions and grunting of his breathing and proceded to intubate him there on the spot. After a few manipulations he was able to diagnose my little boy with Respiratory Distress Syndrome. He immediately treated him with surfactant and was weened off the vent in a matter of days. In addition to this, he was very adept at placing umbilical arterial and venous lines.

I also have a friend who developed a symptomatic basilar artery aneurysm. He was hell bent on going to a neurosurgeon but changed his mind after I told him about my chiro. Since then, he has had percutaneous coiling done at the chiro's office on an outpatient basis.

Of late, while I was performing anethesia for a right lung transplant, I had to do a quick phone consult with my chiro since I don't trust the medical training either I or my attending had. Since I had floated a Swan-Ganz catheter in my patient, I wanted my friendly family chiro to explain the determinants of mixed venous oxygenation and the elements of the Fick equation. He had a little trouble dumbing it down for someone like me to understand. He really saved the day when I had to clamp off the right lung and rely on one lung ventilation. He explained the basics of one lung ventilation under anesthesia to me as well as why my Pulmonary Artery pressures were so high. Although the patient thanked me for a perfect anesthetic, I know my family chiro was the real hero. If I only knew manipulations instead of all this worthless damn clinical medicine...

I won't even go into my Aunt's vaginitis, he cured that too!

I hope this helps!

Can you saw "unauthorized practice of medicine"? That chiro has NO training to do any of those things and is practicing medicine without a license and is violating the state medical licensing law. If I knew his name and your state, I'd report him myself. In Michigan, that's a felony and he'd lose his chiro license. Your family chiro is no hero; he's a menace and a danger to his patients for committing battery and fraud.

 

[ProZackMI]

Understand that, while they are properly referred to as "doctors" in practice, the DC is not generally recognized as an academic degree. There are many teaching hospitals where a DC would not be referred to as "doctor" (there are policies stipulating who can and can't be called "doctor" to prevent confusing patients and staff). There are no institutions of higher education, other than chiropractic colleges, where a DC is an acceptable degree for admission to academic faculty. (And before everyone starts screaming about T. Yochum at Colorado, he lectures there, he is not a professor, he is not on tenure track, and he does not hold academic rank. Nurses, paramedics, PTs and RTs hold similar positions at many schools. That doesn't make them faculty).

Many community colleges hire DCs to each basic anatomy classes, and they are considered faculty.

- H

Just to nitpick about one point seanjohn brought up. Anyone who holds a professional or academic "doctorate", be it a PhD, MD, DC, PharmD, DPT, DDS, OD, DPH, JD, AuD, DVM, DO, DPM, EdD, etc. is a "doctor".

Anyone who has an earned academic or professional doctorate may use the title Dr. It's up to the holder of the degree to choose how he/she uses it.

However, various professions, like law, choose not to use the title as a general basis. You'd never see a lawyer, who holds a Doctor of Jurisprudence degree (JD), use the title "doctor" in common practice, but they are and can if they want to. Many other "doctors" choose not to use their earned titles.

Generally speaking, however, the title "doctor" is most commonly associated with physicians, health care professionals, and scientists in the US. So, a chiro is a "doctor" by virtue of his degree. Whether a college considers the DC degree to be an academic degree or not is irrelevant. You don't see many DCs applying for tenured positions at undergrad/grad institutions that are not affiliated with chiro schools. You rarely see MDs as faculty at non-medical or health-related schools either. You WILL find JDs in business school faculty, criminal justice faculty, and legal studies faculty. You WILL find DVMs in vet tech and biology faculty.

 

[ProZackMI]

Here is where I'll disagree with you. MDs can be, and are, hired to teach at Universities on topics other than medicine. Most faculty hiring standards (such as Harvard's "purple book") include the MD/DO as meeting the basic educational requirement to be faculty. The DC generally does not. While there has been one case, oft quoted, of a DC acting as a clinical instructor, to my knowledge there are no professors hired on the strength of a DC alone (although DC, PhDs have been, that is as a result of the PhD, not the DC).



I agree you've earned the title. I would expect you to introduce yourself that way in professional conversation. But, much like the PharmD, DNP, or PhD researcher, when in an academic medical center and in patient care areas I would expect that you wouldn't be called "doctor" to avoid staff and patient confusion. This is not the case in every medical center, but with the proliferation of doctoral degrees (as you point out) more and more centers are addressing this with specific policies.

I am not trying to take away what you have earned, I do respect the work you've done. For me you are like a cleric in a religion I do not practice. I respect the work you do and the effort it took to get there, but I don't subscribe to the basis behind it. Please do not interpret my post otherwise.

- H

I work primarily out of a hospital. My girlfriend is a PharmD-MPH. She is always referred to as "doctor" by physicians, patients, nurses, etc. I work with several PhD psychologists in the psych unit. They are all called "doctor". The PsyD LLP is also called "doctor". There are PhD biomed engineering people and PhD med physics people who are called doctor. There are dentists with staff privis here. We have an OD working the low vision clinic who is called "doctor".

NO one gets confused. If an introduction is made, it is qualified. "Hello, Mr. Jones, I'm Dr. Smith, the clinical dosing pharmacist here at the coagulation clinic, and I'll be working with Dr. X on monitoring your Coumadin levels..." Or, "Hello, Mrs. Jones, I'm Dr. Smith, a clinical psychologist and I'll be...." A competent professional always introduces him/herself and then qualifies his/her duties/role.

Now, the main question is, why would an allo or osteo hospital have a DC on staff? There would be no need or reason for this.

 

[ProZackMI]

Here is where I'll disagree with you. MDs can be, and are, hired to teach at Universities on topics other than medicine. Most faculty hiring standards (such as Harvard's "purple book") include the MD/DO as meeting the basic educational requirement to be faculty. The DC generally does not. While there has been one case, oft quoted, of a DC acting as a clinical instructor, to my knowledge there are no professors hired on the strength of a DC alone (although DC, PhDs have been, that is as a result of the PhD, not the DC).



I agree you've earned the title. I would expect you to introduce yourself that way in professional conversation. But, much like the PharmD, DNP, or PhD researcher, when in an academic medical center and in patient care areas I would expect that you wouldn't be called "doctor" to avoid staff and patient confusion. This is not the case in every medical center, but with the proliferation of doctoral degrees (as you point out) more and more centers are addressing this with specific policies.

I am not trying to take away what you have earned, I do respect the work you've done. For me you are like a cleric in a religion I do not practice. I respect the work you do and the effort it took to get there, but I don't subscribe to the basis behind it. Please do not interpret my post otherwise.

- H

By the way, academic convention holds that an MD, DVM, DDS, and JD are equivalent to the PhD in the academic setting. Example: http://www.abanet.org/legaled/council/prior.html#1.

Some MDs, DVMs, PharmDs, and DDSs, teach in undergrad nursing schools, PT schools, optometry schools, chiro schools, med tech programs, and OT schools.

The JD is = to a PhD in non-law settings, such as teaching undergrad business law, legal studies, criminal justice, and even in some cases, political science or journalism. The JD is = to a PHD in bioethics programs too. An MD is = to a PhD in public health, bioethics, medical sociology, and a few other programs.

However, I have seen "MDs need not apply" for positions in anatomy/physiology/pharmacology programs. The MD is considered inferior to the PhD in those areas. In general, an MD alone would not be sufficient for a non-health related academic position.

You never see DCs on the faculty of med, osteo, PT, pharm, vet, nursing, optom programs. You do see MDs and DOs in DC faculty, however.

 

[FoughtFyr]

Can you saw "unauthorized practice of medicine"? That chiro has NO training to do any of those things and is practicing medicine without a license and is violating the state medical licensing law. If I knew his name and your state, I'd report him myself. In Michigan, that's a felony and he'd lose his chiro license. Your family chiro is no hero; he's a menace and a danger to his patients for committing battery and fraud.

Sarcasm apparently doesn't translate well in the forum

- H

 

[FoughtFyr]

I work primarily out of a hospital. My girlfriend is a PharmD-MPH. She is always referred to as "doctor" by physicians, patients, nurses, etc. I work with several PhD psychologists in the psych unit. They are all called "doctor". The PsyD LLP is also called "doctor". There are PhD biomed engineering people and PhD med physics people who are called doctor. There are dentists with staff privis here. We have an OD working the low vision clinic who is called "doctor".

I am not claiming that I know the policies of every institution in the U.S. Nor am I claiming that such policies (concerning the manner in which staff are referred to) exist in every institution. I am saying that I have worked in institutions that have sought to control the manner in which staff address one another as a percieved patient safety issue. And I don't think think such policies are rare. I have worked in 8 institutions to date as a medical student or resident physician in 3 separate U.S. states. Some policy of this type existed in 3 of them (not geographically centered). With the prolifieration of mid-level providers, the expansion of both academic and clinical nursing doctorates, and the push for more allied health (e.g., PTs) to hold doctorates, I would expect more institutions to create such policies. One hospital where I rotated as a medical student did have a serious problem from just this issue. At that time medical students were referred to as "Student Doctor" or often just "Doctor". A code occured and the room (as usual) filled with staff. A near-by physician came to the door and asked "is a doctor present?" A nurse answered "Yes, Dr. X is". The physician left, never realizing Dr. X was, in fact, a medical student. There are times that not differentiating between MD/DOs and other "Doctors" can be confusing. I think the problem directly correlates to the size of the institution (i.e., at the small community hospital everyone likely knows that Dr. X is a Pharm.D.)

NO one gets confused. If an introduction is made, it is qualified. "Hello, Mr. Jones, I'm Dr. Smith, the clinical dosing pharmacist here at the coagulation clinic, and I'll be working with Dr. X on monitoring your Coumadin levels..." Or, "Hello, Mrs. Jones, I'm Dr. Smith, a clinical psychologist and I'll be...." A competent professional always introduces him/herself and then qualifies his/her duties/role.

All of which is true, but in a crisis, and in a large institution, I contend the issue might (and anecdotally has) arise. And in a crisis there may be little time for introductions. BTW - you apparently have quite sophisticated patients. Most of mine seem to assign role by gender (i.e., all women are nurses and all men doctors) despite repeated explanations and introductions.

Now, the main question is, why would an allo or osteo hospital have a DC on staff? There would be no need or reason for this.

While I agree fully, the truth is, in the era of consumer driven healthcare, some have added DCs to their outpatient clinics.

- H

 

[ProZackMI]

I am not claiming that I know the policies of every institution in the U.S. Nor am I claiming that such policies (concerning the manner in which staff are referred to) exist in every institution. I am saying that I have worked in institutions that have sought to control the manner in which staff address one another as a percieved patient safety issue. And I don't think think such policies are rare. I have worked in 8 institutions to date as a medical student or resident physician in 3 separate U.S. states. Some policy of this type existed in 3 of them (not geographically centered). With the prolifieration of mid-level providers, the expansion of both academic and clinical nursing doctorates, and the push for more allied health (e.g., PTs) to hold doctorates, I would expect more institutions to create such policies. One hospital where I rotated as a medical student did have a serious problem from just this issue. At that time medical students were referred to as "Student Doctor" or often just "Doctor". A code occured and the room (as usual) filled with staff. A near-by physician came to the door and asked "is a doctor present?" A nurse answered "Yes, Dr. X is". The physician left, never realizing Dr. X was, in fact, a medical student. There are times that not differentiating between MD/DOs and other "Doctors" can be confusing. I think the problem directly correlates to the size of the institution (i.e., at the small community hospital everyone likely knows that Dr. X is a Pharm.D.)



All of which is true, but in a crisis, and in a large institution, I contend the issue might (and anecdotally has) arise. And in a crisis there may be little time for introductions. BTW - you apparently have quite sophisticated patients. Most of mine seem to assign role by gender (i.e., all women are nurses and all men doctors) despite repeated explanations and introductions.



While I agree fully, the truth is, in the era of consumer driven healthcare, some have added DCs to their outpatient clinics.

- H

Excellent points. It's my experience that most doctorally-prepared professionals (except MDs/DOs), in a hospital setting, will introduce themselves by their names sans honorifics. "Hello, Mr. Jones, I'm Bob Smith, a clinical pharmacist, and I'll be checking your Coumadin levels today." Or, "I'm Sandy, the physical therapist." Those who insist on using their titles are often insecure or trying to inflate themselves. Nevertheless, I've never heard of an incident at the 4 hospitals where I've worked where a patient was confused, or a nurse or other professional confused a pharmacist, optometrist, or psychologist with a physician -- even at the large hospitals.

Why? If someone calls code and needs a "doctor", do you think any sane psychologist or pharmacist or biomed engineer is going to respond? Do you think any DPT is going to answer a call for a patient coding? Is the duty nurse going to mistake a PharmD for an attending? Very doubtful.

A competent duty nurse will know the difference between an attending physician, a physician with hospital privis, an intern, a resident, and a lowly medical student. If he/she doesn't, he/she won't be employed long. Confusion arises out of ignorance (mostly on the part of patients) or incompetence. In the scenario you described, the nurse and the medical student were to blame. At my hospital, medical students are the only ones who are expressly forbidden from using a title. They can only use their names with the title "medical student". No student doctor title is allowed. However, other professions with doctoral titles are allowed to use them.

The ONLY exception is for NPs who hold doctorates. The title is discouraged unless they are administrators.

 

[FoughtFyr]

Excellent points. It's my experience that most doctorally-prepared professionals (except MDs/DOs), in a hospital setting, will introduce themselves by their names sans honorifics. "Hello, Mr. Jones, I'm Bob Smith, a clinical pharmacist, and I'll be checking your Coumadin levels today." Or, "I'm Sandy, the physical therapist." Those who insist on using their titles are often insecure or trying to inflate themselves. Nevertheless, I've never heard of an incident at the 4 hospitals where I've worked where a patient was confused, or a nurse or other professional confused a pharmacist, optometrist, or psychologist with a physician -- even at the large hospitals.

And I have heard of only one. But I do know of three hospitals that have policies expressly addressing the issue. Time will tell if such policies become more widespread.

Why? If someone calls code and needs a "doctor", do you think any sane psychologist or pharmacist or biomed engineer is going to respond?

Actually pharmacists respond to every code in the institution where I am training. Not unusual at all.

Do you think any DPT is going to answer a call for a patient coding? Is the duty nurse going to mistake a PharmD for an attending? Very doubtful.

Nope, I don't DPTs are going to respond to a code. But, in a large academic institution could a resident be inadvertently be "directed" by a non-MD/DO?

What about student nurses who have only heard Dr. X the PharmD referred to as "Doctor", when they hear Dr. X rounding with the ICU team and make recommendations, couldn't they easily assume those were orders? Heck, I've had interns that made that error.

A competent duty nurse will know the difference between an attending physician, a physician with hospital privis, an intern, a resident, and a lowly medical student. If he/she doesn't, he/she won't be employed long. Confusion arises out of ignorance (mostly on the part of patients) or incompetence.

Really?!? Consider a large, academic medical center. Ours has ~1,500 residents and fellows and more than 40,000 allied health. The physician composition of the code team changes monthly based on the rotating schedule of the residents. A paramedic team covers outpatient areas. And you expect that everyone can identify all members of the team? Are you kidding? Add in a few extra "doctors" (and don't believe for a minute that there aren't non-clinical doctorates who refer to themselves as "doctor" every chance they get) and things get REALLY confusing.

In the scenario you described, the nurse and the medical student were to blame. At my hospital, medical students are the only ones who are expressly forbidden from using a title. They can only use their names with the title "medical student". No student doctor title is allowed. However, other professions with doctoral titles are allowed to use them.

Actually I believe it was an innocent error. The students at that time were introduced to staff as "Student Doctor" and encouraged to use the title. The medical student, a late 4th year, was pretty visibly confident, and the nurse who answered was staffing the area of the code, one that was primarily outpatient where few medical students were. When he arrived with the code team, and was called "Doctor" by members of that team, she made an easy assumption. Are you suggesting she should have asked for ID?

The ONLY exception is for NPs who hold doctorates. The title is discouraged unless they are administrators.

Ahh. So now we are differentiating a bit. So there could be a problem here. So the title is "discouraged". I believe the institutions that have the policies have done so as to not be forced into "validating" one non-MD/DO doctorate over another. It is easier if you just write the over-reaching policy for patient care areas. No one is suggesting that when presenting academic work, sitting in a formal meeting, working in a lab, or even sending/recieveing correspondence, that the holder of any doctorate isn't properly called "doctor". But I do see the wisdom of such a policy in patient care areas.

- H

 

[PublicHealth]

How about we just refer to FoughtFyr as "God" and everyone else as "lowlife scum?"

 

[FoughtFyr]

How about we just refer to FoughtFyr as "God" and everyone else as "lowlife scum?"

Wow, a little below the belt don't you think? I've not attacked anyone personally and am a bit surprised by this as you usually take the high road. I'm sorry if someone stridently defending their opinions (after all, I'm the first to admit these are only my opinions; I try to provide the science behind them when I can) bothers or offends you, I kind of believe it to be the point of forums such as these.

- H

 

[ProZackMI]

Wow, a little below the belt don't you think? I've not attacked anyone personally and am a bit surprised by this as you usually take the high road. I'm sorry if someone stridently defending their opinions (after all, I'm the first to admit these are only my opinions; I try to provide the science behind them when I can) bothers or offends you, I kind of believe it to be the point of forums such as these.

- H

Hey, you didn't offend me one bit. You made some very valid points and I apologize for overgeneralizing. I can only report what I have seen through my own eyes and heard through my own ears. I can see why such a restrictive policy is necessary, but I also have not seen it personally.

Thanks for the debate and I concede.
Zack

 

[FoughtFyr]

Hey, you didn't offend me one bit. You made some very valid points and I apologize for overgeneralizing. I can only report what I have seen through my own eyes and heard through my own ears. I can see why such a restrictive policy is necessary, but I also have not seen it personally.

Thanks for the debate and I concede.
Zack

Zack,

On topic, how are you (as an MD, JD) properly referred to in court? Is it "Doctor" or "Councelor"? Or mix and match for effect?

- H

 

[FoughtFyr]

A post elsewhere on the forum "on-point" to this discussion:

http://forums.studentdoctor.net/showpost.php?p=3371531&postcount=11

- H

 

[ProZackMI]

Zack,

On topic, how are you (as an MD, JD) properly referred to in court? Is it "Doctor" or "Councelor"? Or mix and match for effect?

- H

I've been an MD now since 1998 or 1999, so I'm used to be being referred to as "Doctor" most of the time by patients, colleagues, and staff. In law school, the professors use the Socratic method in most first and second year classes. So, on any given day in class, the professor might call out, "Mr. Smith, can you recite the salient facts of Speilberg v. Lucas?" If I was "Mr. Smith", I never, ever corrected the professor, unlike the dentist in class who felt it necessary to say, "That's DOCTOR Smith!"

Frequently, when I'm outside the work situation, I get referred to as Mr. or Zack or Zachary. I have a baby face for a 35 year-old and have a young voice, so most older people just call me by my first name. I never correct them. I don't even sign "MD" after my name if it's not work-related.

I just took the bar exam last week (and my brain is still dead), so I'm not an attorney yet and haven't been to court as an advocate yet. If I pass the bar exam (I'll know in May), then I plan to move over from medicine into law. Most lawyers do not use their doctoral title despite having a professional doctorate just like MDs, DCs, ODs, PharmDs, etc. It's part of the legal convention/custom. Although, many lawyers are called "doctor" in academia (not law school) and you do see more and more lawyers append the J.D. after their names. In fact, in Michigan, I am seeing more younger attorneys use the J.D. after their names than ever before. I think it's a good thing!

In court, however, an attorney, even one with an MD or PhD or DDS, is always referred to as Mr./Ms or Counselor. It's just part of the legal tradition and custom. I suspect, however, with time, lawyers will start using their doctoral title. In Europe, mostly in the Germanic and Slavic countries, most attorneys are called "Doctor".

I wonder if the NPs, DPTs, and PAs with doctorates will use the title? I think it would be somewhat misleading.

 

[PublicHealth]

I've been an MD now since 1998 or 1999, so I'm used to be being referred to as "Doctor" most of the time by patients, colleagues, and staff. In law school, the professors use the Socratic method in most first and second year classes. So, on any given day in class, the professor might call out, "Mr. Smith, can you recite the salient facts of Speilberg v. Lucas?" If I was "Mr. Smith", I never, ever corrected the professor, unlike the dentist in class who felt it necessary to say, "That's DOCTOR Smith!"

What is it with medical professionals pursuing law?

 

[ProZackMI]

What is it with medical professionals pursuing law?

Dissatisfaction with the current state of affairs I suppose. Managed health care, too many FMGs, many factors I suppose. Are you considering going for your JD after your MD and residency?

 

[pinkwank]

dc's in no way receive the education to diagnose and manage illness. i can't believe anyone would suggest otherwise. from what i've seen dc's do more harm then good. i have seen vertebral/subcapsular/etc fractures, vertebral artery dissections, etc. you would be hard pressed to find a physician who would recommend a pt to a chiropracter in the city i reside.

 

[PublicHealth]

Dissatisfaction with the current state of affairs I suppose. Managed health care, too many FMGs, many factors I suppose. Are you considering going for your JD after your MD and residency?

Maybe sooner?

And that's DO, not MD.

 

[PublicHealth]

dc's in no way receive the education to diagnose and manage illness.

Who said that they did? Most good DCs practice within their scope of practice and treat NMS problems. Lately, many have expanded their practices to include acupuncture, clinical nutrition, and physical rehabilitation.

 

[seanjohn]

I have a question for everyone, more specifically those knowledgeable about scope of practice laws for chiropractors.

I live in Canada, and one of my friends is in chiropractic school in first year. He said that in his clincal diagnosis class he's learning how to diagnose ear and eye problems using an opthalmoscope and an otoscope. He's also learning how to use a blood pressure cuff, and a stethoscope. Now, to me that seems like what they're teaching him is beyond the scope of chiropractic practic, which is supposed to deal with musculoskeletal problems.

Are chiropractors legally allowed to diagnose ear and eye problems and use an opthalmoscope and otoscope? If they are then it seems that they're essentially entitled to diagnose anything that a medical doctor can, and it seems as though their scope of practice is all inclusive to all organ systems, and all parts of the body, and not simply limited to musculoskeletal disorders.

Can anyone clarify this for me?

 

[PublicHealth]

I have a question for everyone, more specifically those knowledgeable about scope of practice laws for chiropractors.

I live in Canada, and one of my friends is in chiropractic school in first year. He said that in his clincal diagnosis class he's learning how to diagnose ear and eye problems using an opthalmoscope and an otoscope. He's also learning how to use a blood pressure cuff, and a stethoscope. Now, to me that seems like what they're teaching him is beyond the scope of chiropractic practic, which is supposed to deal with musculoskeletal problems.

http://www.cmcc.ca/undergrad/Dept_Prof_Ed/Clinical_Diagnosis.htm

 

[FoughtFyr]

Who said that they did?

You, just two posts down...

http://www.cmcc.ca/undergrad/Dept_Prof_Ed/Clinical_Diagnosis.htm

Most good DCs practice within their scope of practice and treat NMS problems. Lately, many have expanded their practices to include acupuncture, clinical nutrition, and physical rehabilitation.

Umm, acupuncture, clinical nutrition, and physical rehabilitation are not part of chiropractic. Those are best left to the professionals actually trained to provide them.

- H

 

[PublicHealth]

Umm, acupuncture, clinical nutrition, and physical rehabilitation are not part of chiropractic. Those are best left to the professionals actually trained to provide them.

- H

They're within the DC's scope of practice in many US states:

http://www.chiroweb.com/archives/ahcpr/chapter5.htm

 

[FoughtFyr]

They're within the DC's scope of practice in many US states:

http://www.chiroweb.com/archives/ahcpr/chapter5.htm

Oh, I'm not debating that chiropractors have gotten them legally included in their scope, what I am arguing is that none of these modalities are actually part of chiropractic. Palmer did not include any of them is his teachings. It is only now that chiropractic, under fire for a lack of EB practice, has to draw on other modalities, some proven, some not, where their training (much like their "training" in medicine) is generally sub-par when compared to those actually prepared to solely practice those treament modalities. Or are you now trying to caim that in 3 1/3 calendar years the chiropractic student learns all of chiropractic, all of medicine, all of acupunture, all of physical rehab and all of clinical nutrition? Boy, and here I thought medical school was tough. LMFAO.

Heavenly Yours,
- H

 

[611]

Oh, I'm not debating that chiropractors have gotten them legally included in their scope, what I am arguing is that none of these modalities are actually part of chiropractic. Palmer did not include any of them is his teachings. It is only now that chiropractic, under fire for a lack of EB practice, has to draw on other modalities, some proven, some not, where their training (much like their "training" in medicine) is generally sub-par when compared to those actually prepared to solely practice those treament modalities. Or are you now trying to caim that in 3 1/3 calendar years the chiropractic student learns all of chiropractic, all of medicine, all of acupunture, all of physical rehab and all of clinical nutrition? Boy, and here I thought medical school was tough. LMFAO.

Heavenly Yours,
- H

I thnk those fundamental tools of diagnosis should basically be used by Chiropractors to know when NOT to treat a medical problem and refer out. Especially BP, just has to be part of the patient record.

 

[PublicHealth]

Oh, I'm not debating that chiropractors have gotten them legally included in their scope, what I am arguing is that none of these modalities are actually part of chiropractic. Palmer did not include any of them is his teachings. It is only now that chiropractic, under fire for a lack of EB practice, has to draw on other modalities, some proven, some not, where their training (much like their "training" in medicine) is generally sub-par when compared to those actually prepared to solely practice those treament modalities. Or are you now trying to caim that in 3 1/3 calendar years the chiropractic student learns all of chiropractic, all of medicine, all of acupunture, all of physical rehab and all of clinical nutrition? Boy, and here I thought medical school was tough. LMFAO.

Heavenly Yours,
- H

Most of this training is done following completion of the DC degree. For example, acupuncture training is available through the International Academy of Medical Acupuncture: http://www.iama.edu/

DCs interested in enhancing their skills in clinical nutrition may pursue a Master's degree in this area: http://www.bridgeport.edu/pages/3246.asp

Diplomate programs are also available for further training in specific subfields of chiropractic, including neurology, orthopedics, sports, rehab, etc.

 

[nomorelaw]

Most of this training is done following completion of the DC degree. For example, acupuncture training is available through the International Academy of Medical Acupuncture: http://www.iama.edu/

DCs interested in enhancing their skills in clinical nutrition may pursue a Master's degree in this area: http://www.bridgeport.edu/pages/3246.asp

Diplomate programs are also available for further training in specific subfields of chiropractic, including neurology, orthopedics, sports, rehab, etc.

How does a chiro practice neurology?

 

[PublicHealth]

How does a chiro practice neurology?

http://www.acnb.org/policy_and_procedures.html

http://www.acnb.org/

 

[ProZackMI]

I have a question for everyone, more specifically those knowledgeable about scope of practice laws for chiropractors.

I live in Canada, and one of my friends is in chiropractic school in first year. He said that in his clincal diagnosis class he's learning how to diagnose ear and eye problems using an opthalmoscope and an otoscope. He's also learning how to use a blood pressure cuff, and a stethoscope. Now, to me that seems like what they're teaching him is beyond the scope of chiropractic practic, which is supposed to deal with musculoskeletal problems.

Are chiropractors legally allowed to diagnose ear and eye problems and use an opthalmoscope and otoscope? If they are then it seems that they're essentially entitled to diagnose anything that a medical doctor can, and it seems as though their scope of practice is all inclusive to all organ systems, and all parts of the body, and not simply limited to musculoskeletal disorders.

Can anyone clarify this for me?

In the United States, absolutely NOT! This is blatantly illegal. They can use diagnostic instruments in aiding their NMS tx, but to go beyond that is outside the scope of their training and practice. So is nutritional counseling.

 

[ProZackMI]

Oh, I'm not debating that chiropractors have gotten them legally included in their scope, what I am arguing is that none of these modalities are actually part of chiropractic. Palmer did not include any of them is his teachings. It is only now that chiropractic, under fire for a lack of EB practice, has to draw on other modalities, some proven, some not, where their training (much like their "training" in medicine) is generally sub-par when compared to those actually prepared to solely practice those treament modalities. Or are you now trying to caim that in 3 1/3 calendar years the chiropractic student learns all of chiropractic, all of medicine, all of acupunture, all of physical rehab and all of clinical nutrition? Boy, and here I thought medical school was tough. LMFAO.

Heavenly Yours,
- H

What gets me is that my training in nutrition was grossly inadequate at MSU Human Med School, but I guess it's more than enough at most chiro schools, huh? Now that's funny!

 

[ProZackMI]

http://www.cmcc.ca/undergrad/Dept_Prof_Ed/Clinical_Diagnosis.htm

That's just puffery and fluffery. So they have one class in psychological evaluations and one class in "Female problems". If any DC lays a gloved hand on a female patient, gets out a speculum, or incorporates the use of stirrups in his physical assessment, he is not only going to lose his license, but most likely he will also do time/probation and be registered as a sex offender.

Having a class or two in something does not make one an expert. I took a class in oral pathology in medical school. Do you want me to diagnose and treat your caries? I've done some basic surgery, so hell, why not let me take your mom's gallbladder!

 

[seanjohn]

In the United States, absolutely NOT! This is blatantly illegal. They can use diagnostic instruments in aiding their NMS tx, but to go beyond that is outside the scope of their training and practice. So is nutritional counseling.

Here are the scope of practice laws for chiropractors in Ontario:

"Scope of practice

3. The practice of chiropractic is the assessment of conditions related to the spine, nervous system and joints and the diagnosis, prevention and treatment, primarily by adjustment, of,

(a) dysfunctions or disorders arising from the structures or functions of the spine and the effects of those dysfunctions or disorders on the nervous system; and

(b) dysfunctions or disorders arising from the structures or functions of the joints. 1991, c. 21, s. 3.

Authorized acts

4. In the course of engaging in the practice of chiropractic, a member is authorized, subject to the terms, conditions and limitations imposed on his or her certificate of registration, to perform the following:

1. Communicating a diagnosis identifying, as the cause of a person's symptoms,

i. a disorder arising from the structures or functions of the spine and their effects on the nervous system, or

ii. a disorder arising from the structures or functions of the joints of the extremities.

2. Moving the joints of the spine beyond a person's usual physiological range of motion using a fast, low amplitude thrust.

3. Putting a finger beyond the anal verge for the purpose of manipulating the tailbone. 1991, c. 21, s. 4."

Here's what irks me. Since they've thrown in the nervous system in their scope of practice, that essentially enables them to do anything and everything except for prescribe medication and perform surgery. These chiroquackters can say they're diagnosing eye disorders because the central nervous system is located in the spine, and they're trying to diagnose problems with the optic and occulomotor nerve. Similarly, they can say they're trying to diagnose problems in the ear due to the presence of the vestibulocochlear nerve, saying that they're diagnosing problems with the nerves...meanwhile they're trying to diagnose cataracts, glaucoma, or ear infections, which is absolutely ridiculous, wrong, and harmful to the general public.

I've heard so many stories of unethical practices performed by chiroquackters in Canada, just so they can make an extra buck or two. How many times has a patient come into the office of a chiroquackter for their STRUCTURAL scoliosis with a 50 degree curve, only for them to find out that it can be "treated" by chiropractic adjustments. Meanwhile, these patients are in urgent need of bracing in order to stabilize the patient and prevent progression at the very least, but more likely in need of surgery. So the chiroquackter keeps treating this patient, changing the landmarks when they measure the curve each time, thus completely changing the angle of the curve, telling the patient they're getting better. When this is all happening the patient is in serious danger, having a left-sided curvature that can and will crush their vital organs such as their heart all because of the spin doctors called chiropractors, who call themselves 'doctors,' who should never have been licensed to practice ANYTHING in the first place, because the whole profession is built upon quackery, cultish beliefs, and faulty science.

 

[nebrfan]

I thnk those fundamental tools of diagnosis should basically be used by Chiropractors to know when NOT to treat a medical problem and refer out. Especially BP, just has to be part of the patient record.

Chiropractor.....refer OUT? Why the need?? Obviously, ALL medical problems are, at their root, caused by subluxations impinging on the body's natural life-force and flow of neural information. All you gotta do is crack that subluxation, baby!

 

[PublicHealth]

Oh, I'm not debating that chiropractors have gotten them legally included in their scope, what I am arguing is that none of these modalities are actually part of chiropractic. Palmer did not include any of them is his teachings. It is only now that chiropractic, under fire for a lack of EB practice, has to draw on other modalities, some proven, some not, where their training (much like their "training" in medicine) is generally sub-par when compared to those actually prepared to solely practice those treament modalities. Or are you now trying to caim that in 3 1/3 calendar years the chiropractic student learns all of chiropractic, all of medicine, all of acupunture, all of physical rehab and all of clinical nutrition? Boy, and here I thought medical school was tough. LMFAO.

Heavenly Yours,
- H

Oh, come on. And MDs and DOs today are adhering EXACTLY to teachings of ancient physicians? I'm sure all the B.C. physicians had ready access to highly sophisticated medical technologies in use today. DOs were originally trained to manipulate by A.T. Still. The field developed in opposition to allopathic medicine. Today, DOs are operating on brains, performing LASIK, doing ECT, and resecting cancers. Professions evolve. Sure, sometimes it's for survival, but these changes generally benefit clinicians as well as their patients.

Show me data supporting your claim that chiropractors are "generally sub-par when compared to those actually prepared to solely practice those treament modalities." There are many chiropractors who are very well-versed and trained in acupuncture, clinical nutrition, and physical rehabilitation.

 

[seanjohn]

Chiropractor.....refer OUT? Why the need?? Obviously, ALL medical problems are, at their root, caused by subluxations impinging on the body's natural life-force and flow of neural information. All you gotta do is crack that subluxation, baby!

That was brilliant.

Clearly, most of these chiroquackters are "diagnosing" and "treating" (I use those terms VERY loosely, since we all know chiroquackters cannot diagnose, or treat ANYTHING competently, nevermind musculoskeletal problems) things that are way out of their scope of practice, and they're essentially attempting to practice medicine. Just as the early chiroquackters were jailed for practicing medicine without license, so should modern day chiroquackters, since it seems like that's what they're attempting to do.

I'm going to let the government of Ontario know about what these chiroquackters are actually doing in their practice, and hopefully they get jailed for practicing medicine without a license, or better yet they pass legislation to make the practice of chiroquack illegal in this province.

 

[jesse14]

That was brilliant.

Clearly, most of these chiroquackters are "diagnosing" and "treating" (I use those terms VERY loosely, since we all know chiroquackters cannot diagnose, or treat ANYTHING competently, nevermind musculoskeletal problems) things that are way out of their scope of practice, and they're essentially attempting to practice medicine. Just as the early chiroquackters were jailed for practicing medicine without license, so should modern day chiroquackters, since it seems like that's what they're attempting to do.

I'm going to let the government of Ontario know about what these chiroquackters are actually doing in their practice, and hopefully they get jailed for practicing medicine without a license, or better yet they pass legislation to make the practice of chiroquack illegal in this province.

Let me be as polite as possible....are you crazy?? First i'm told on this forum that DC's cant dx nor can they do differential dx because their training isn't up to par, yet when the CMCC incorporates tools to help the DC learn these skills it is said that "its illegal" or they're "trying to practice medicine". So which is it?? Should DC's just learn to adjust with no knowledge of other medical conditions or should they learn to RECOGNIZE problems so they can refer out. My dad, a DC of 25 years, takes a BP of almost every patient he sees who is complaining on neck pain. He does this because hypertension contraindicates the use of a cervical adjustment and he will NOT touch someones neck who he feels is at risk for disection partly due to an increased BP. He always refers out to the MD accross the hall in his medical building. Now, i'm not so sure why foughtfyr says chiro school is 3 1/3 years long b/c at the cmcc there are three 10 month years of school and one 12 month clinical placement. So, i feel in that time, they can learn how to use these tools to help them be proficient in detecting medical abnormalities that contraindicate chiro services. It just seems to me, in all honesty, that no matter what DC's do they are the "bad guys". I guess all DC's need is the praise of their patients they have helped, but that is just my opinion of course.
Thank you.