I was curious to know how extensively the OMT techniques are taught in DO schools. That is, I was wondering if DO's learn as much, more, or less manual spinal manipulation etc., as Chiropractors do? Also, say a DO wanted to place the majority of his private practice emphasis on OMT techniques, what would be the best way to do this? How would he/she adverstise, given that the public isn't as familiar with Osteopathic techniques as they are with Chiropractic techniques?

most DO schools require around 600 hrs of omt class in addition to principles in osteopathic med classes. this is more than what is taught in chiro programs. as a DO you can do a residency or fellowship in omt if that is of interest.there is a good program at unecom. good luck

In addition to the 600 hours of OMT training one may recieve in medical school is a person required to do a residency in OMT in order to practice OMT?

NO, any DO graduate should be able to practie OMT. the residencies and fellowships are for those desiring additional training in specialized techniques, etc.

emedpa, do you even have a clue as to what you're talking about??? I am a chiropractor going back to DO school and I can tell you that KCOM, who has the most extensive OMM curriculum, dedicates 210 or so hours to OMM training. At Palmer Chiropractic College we had over 520 hours of strictly technique classes, not including electives on the subject, or physiotherapy classes, and not including our last year in the cllinic where we were required to perform a minimum of 212 adjustments to graduate (along with radiology and physical exam requirements). That is the only way that chiropractors treat patients, day in and day out, so
don't start spreading the typical medical propaganda ignorance on something you know absolutely nothing about.

Student247, I think it's great that you want to use OMM b/c I can tell you in all honesty that it works, whether you're a chiro or a DO. It works where traditional medicine fails, and I have seen some amazing things over my 8 years in practice. Why do I want to go back to be a DO if it works so great? Because I want to do even more for my patients. I want to be their complete family physician and you can beat your butt I'm going to continue to use both fields. DO's may not have the advertising and population recognition that chiros do but they have the medical contacts that chiros don't have. That's where you get your patients. If you have any questions about it, please e-mail me and I'd be happy to talk to you about it. (RUKnight1@excite.com).

Treybird

Wow, someone needs to calm down.

I was a PT prior to Osteopathic Medical school ( I am graduating in a month) and I can tell you the techniques learned in PT school are ALMOST identical to Osteopathic. As far as chiropractic...its a totally different hokey ball game there.
You will get your fill of OMT, but you will find that the other science classes will likely place a large time burden on your OMT skills. The point of the majority of Osteopathic Medical education is NOT to manipulate, manipulate, manipulate (like chiros), but rather integrate your physical and mental diagnostic skills into a complete form of medicine...whether that be surgery, pharmacology, the addition of a "smidgen" of OMT, or nothing at all.

PCOM has an hour, maybe two hours of OMM lecture a week. They are very poorly attended, despite veiled threats from professors. Many of the lectures are so bad that people just don't give a flip whether they go or not. Everyone crams for the exam (ie skims the notes the night before) yet somehow the vast majority of the final grades are clumped together in the mid 80's. Lab is an hour and a half a week all trimester except for the last 2 weeks when practicals are held. Many labs are spent goofing around without learning anything.

In short, at PCOM - OPP gets no respect.

That being said, there are a few gurus that choose to apply themselves and put the time and effort in to become very good with their hands.

Treybird-please accept my apology. I was only repeating what I have heard from several DO's I work with. I did some research and found that yes, the DO school omt average is around 200 hrs or so. my understanding is that chiros are limited to spinal manipulation while DO's can manipulate other portions of the body besides the spine. is this correct? thanks-e

emedpa, apology accepted, no hard feelings. As a chiropractor I am constantly having to defend what seems to be mucho misinformation out there. Each state is different in what they allow but in most states chiropractors adjust every area of the spine AND extremities. We do it all. We can x-ray and interpret all areas of the body and use CT, MRI's, lab analyses, etc. to help provide the best primary care we can. Obviously we don't treat organic diseases so when a chiro finds one he refers that patient on for further medical care. We are trained to diagnose and refer what is not within our scope of practice. If a chiro doesn't, then it's malpractice. If he tells his patient that he can cure liver disease with an adjustment than that is malpractice and he should be lose his license if he doesn't refer that patient on. Any more questions, feel free to ask.

Mr. happy clown guy As far as chiropractic...its a totally different hokey ball game there. .......Nothin' hokey about it my man, not if you know what you're doing. Maybe when you get some real life experience you'll see that.

Treybird

When I get some experience? What, with racking and cracking?? That is no defense for chiro philosophy! I was in rehab for years prior to medical school and had to constantly deal with a large percentage of chiros constantly using physical therapy WITHOUT a license (and billing for it), and using the legal system (attorneys) to get referrals for the "neck check". There is no "rocket science" to a lumbar roll etc regardless of the practitioner of the manipulation.
I have seen good results with OMT...especially muscle energy techniques (since I come from the muscular based/movement based theories of PT). But I have seen some of the "most hokey" theories and treatment procedures by chiropractors...there is no doubting that! From megavitamin therapy, to aromatherapy, to daily manipulation, to subluxation theories, to chelation therapy, to odd energy theories...chiros have done their hardest to illigetimize their own profession.

As far as your ability to read and interpret true radiographic tests for true pathology...leave that to the board certified radiologists and the primary care to the board certified primary care docs.

Chiropractic philosophy, at it's heart, is the same as osteopathy. Do a little investigating and you will see it's true. I am licensed to perform all physical therapy in most states. Sorry, clown, it's covered under a DOCTOR of Chiropractic license. You are not a doctor. Deal with it. All you do is repeat the same tired AMA-antitrust lingo but that's passe. Most MD's and DO's realize the role we play in healthcare, as evidenced by my referral sources. The medical profession has come around, and most are on excellent terms with local chiros.

You know NOTHING about chiropractic; the training, the philosophy, or the practice of. I can't discuss this with you because you don't have any rational frame of reference on the subject, only emotionally biased vomitus. If you want to discuss your misunderstandings with fact (not what you've heard, not what you think...fact), then let's have at it. You call muscle energy work science? Well, where's the research? Give me one double blind, peer-reviewed study that proves it works. I can show you many, many on lumbar adjusting and low back pain (some even from Spine and JMPT magazines...medical journals). You want research on the efficacy of chiropractic...the science and research on chiropractic, then give me your e-mail address. Try to act like a professional. Some day you may have to work with chiropractors, or worse, you may have to work for one. One of my best friends is a DO and he refers his adjustment patients to me. Why, because he knows that I am competent and effective.

I do feel sorry for your patients because your arrogance and ignorance make you dangerous. I understand that you are a student, fresh out of PT school...full of fire and brimstone, but understand that you are just professionally immature and need some real-life experience. By the way, aren't PT's fighting with all professions for some kind of identity (i.e. athletic trainers, chiros, massage therapists, etc.) So, I repeat:

......Nothin' hokey about it my man, not if you know what you're doing. Maybe when you get some real life experience you'll see that.

I'm just curious as to how a DC can be licensed to practice PT. Unless you have a PT degree you cannot (ethically) charge for physical therapy. "The patient/client management elements of examination, evaluation, diagnosis, and prognosis should be represented and reimbursed as physical therapy only when they are performed by a physical therapist.", "Physical therapy is defined as the care and services provided by or under the direction and supervision of a physical therapist. Physical therapists are the only professionals who provide physical therapy. Physical therapist assistants-under the direction and supervision of the physical therapist-are the only paraprofessionals who assist in the provision of physical therapy interventions."

The American Physical Therapy Association Guide to Physical Therapist Practice Second Edition.

If you are charging for PT and do not hold a PT degree you are misrepresenting your practice.

A chiropractor, by law in most states, can evaluate and rehabilitate any musculoskeletal problems. Again, there are state by state variations. Some states are limited only to the spine, while others are much more broad. How can we do it? The same way an MD can theoretically perform manipulation. It's just inherent in the license. That's what being a doctor is. We are doctors, and, by law, primary care givers as well.

No, I'm not misrepresenting myself. I have an undergrad degree in exercise phys and so I'm very well trained in the area of musculeskeletal rehab. We have different billing codes than PT's do even if we're doing the same thing. If you have issues with this, call your local health professions bereau and find out for yourself. I'm only the messenger. Chiropractic be definition is spinal rehabilitation.

TB

Wow, someone woke up on the wrong side of the bed...but let's get a few things straight.

First and foremost, double blind studies?? Well you can't do a double blind study in manipulation (you can't blind the MANIPULATOR), but you can to a subject blinded study if you do sham thrust, but those studies are poorly done based on low power of the study (few participants) and the ethical issue of sham thrust. There are a few OUTCOME studies, but those have had conflicting results. Chiros have long long LONG been known for shoddy science and questionable academia. Instead of denying this, pushing for REFORM should be your argument. There is a difference between a written paper and good solid science based research!!
Yes, there is muscle energy research , but it falls under the name of PNF (proprioceptive neuromuscular facilitation) or "contract relax" etc techniques. Not in abundance, but I was simply giving you an example. I do both PNF and manipulation in practice. I have no problems with either IN LIMITATION. I firmly believe that manipulation (if needed) should NOT NEED to be performed as a basis of treatment, and should NOT be needed more than a few times...postural correction and restrengthening is necessary.

That is not the issue...
One issue is that in MANY MANY states, chiropractors ARE NOT regulated by the state board of medical affairs, only by their OWN board (as in the state of Missouri). Allowing them to practice ANY procedure they are deemed trained (prostate exams, gyn exams, and physical therapy)...this is purely wrong and is absolutely unethical. How do I know this? I owned a copy of the Medical Board guidelines, and I spoke with a member of the board. What is ALLOWED is one issue and what is ETHICAL is another.
As a PT I practiced in Indiana (YOUR STATE), and wittnessed wide spread abuse of the "neck check" and overutilization of services and unethical billing practices.
I am not saying that Physicians or Therapists are immune to ethical problems, rather, it has plagued the field of Chiropractic for decades...you should be the first to admit this. If you are going to be a competent physician someday, you must first acknowledge procedures or theories that simply do not hold up (ie chelation therapy, subluxation theories, myofascial unwinding, etc). No one is immune to bad science, but it is poor form to say that it doesn't exist.

As far as "just out of PT school...sir I graduated in the early 90's, and I am graduating from medschool in a month. Let us not play the condescending clinical experience BS game...that doesn't hold water either.

Yes, chiropractors are not regulated by the medical board, nor should they be. We're not medical doctors. However, before you start to go off on how chiropractic is unregulated, please, do the research. We are very regulated. In Indiana, as you SHOULD know, we are all regulated by the Indiana Health Professions Bureau. That is the umbrella organization under which the medical board and chiropractic boards operate. Every chiropractic state board is regulated by whatever parent health professions committee regulates that state. Learn how your government works for change.

Do you want studies from Spine magazine supporting manipulation as an effective tool? Simple yes or no question. Spine is a medical journal, not a case study. Manipulation is manipulation whether it's from a chiro or a DO. If you want to argue me on this, I will send you a page on the physiology of manipulation. I've seen both professions do the same thing, so don't try and tell me they're different. If you think that, then you don't understand chiropractic at all. A subluxation exists. It may have a different name in medicine, but it exists. How many drugs and medical procedures are performed every day that work, but the exact mechanism is not known yet? How you can even slam chiropractic when half of medicines used today are not properly tested causing patient death from complications is beyond me. How about deaths from complications in surgery? Chiropractic has a very long history of not supporting our profession with experimentation but that has changed dramatically over the past 20 years. I suggest you pick up a medical journal once in awhile. Palmer College just received a 25 million dollar research grant from the NIH, but you would already know that since you're an expert on Chiropractic. Show me a research study on PNF. You're nothing but a glorified massage therapist and since you worked in Indiana, you know that IN doesn't trust you enough to allow you direct access. I wonder why that is??? Hmmmm...try a manipulation in Indiana as a PT again and trust me, you'll lose that license. Hopefully, before you seriously damage someone.

Do you know how chiros are trained? Have you been through Chiropractic school? You are such an expert on what a chiro is qualified to do? Maybe you should run the medical boards or national exams. Again, you are ignorant on the subject. Go pick up a school catalog and see what clases are taught before you start flapping your gums. Go take a chiro practical state exam, see how you like it. See how well you do, since you know everything we do already. You don't know squat about ethics because if you did you would get some education on a subject before you start slamming it. You're nothing but a PT puppet. You can't even think for yourself. You have no ethics. If you had ethics you would try to work with all the primary health care professions. Again, I hope none of my friends become your patient.

All I hear from you is rhetoric. I've not heard one bit of evidence showing that you know anything about what we do, our training, our scope of practice, etc. Nothing. Would you like me to send you some literature? Or do you just not read anything that might conflict with your fragile paradigm? You make it sound like we're the only profession slammed by widespread abuse. Hmmm, yea, I guess you don't see NEARLY as much of that in medicine or PT. Of course not. Maybe you should open your eyes and admit that your profession has just as many problems as mine. But then again, just do what you seem to always do and close your eyes and stick your head in the sand. It's what you seem to do best. Good luck, doc.

Cool thread.

I like all the passion.........

A few questions questions.

Are PTs formally trained in manipulation beyond techniques similar to muscle energy?

Are PT formally trained to do HVLA, strain-counterstrain, fascial ligamentous release, facilitated positional release, OCF, BLT, or lymphatics techniques?

Don't Chiropactors mainly do HVLA techniques that are focused on the spine. I thought that the cornerstone of Chiropactic was a belief that all disease is the result of "sublaxations" of the spine.

Isn't there a big differnce between Osteopathic HVLA and Chiro HVLA? Isnt Osteopathic HVLA focused on restoring range of motion and not exceeding pysiological barriers?

Aren't chiropactors more focused on static positional changes (hence all the X-rays)? Don't they routinely exceede barriers? Hence, all the CVA resulting from chiropactic C-spine manipulation.

Don't these differnces make OMT more gentle, safer and holistically focused on treating the whole person?

I am fairly familiar OCF. And, I have looked at a couple Chiro SOT books. SOT techniques look crude and rough when compared with OCF. DeJarnette's presentation seems to be a muddled, watered down version of Sutherland. What do you think of SOT?

Clown, could you please restrain yourself from slamming OCF here. We have already had that discussion..........

Oh yeah,

Its Chiropractic (like Osteopathic or Allopathic) not "Chiropractics."

For those of you interested in fact and not emotionally skewed rhetoric, please click on the following links:

CHIROPRACTIC BELIEF SYSTEMS
<a href="http://www.chiroweb.com/archives/ahcpr/chapter2.htm" target="_blank">http://www.chiroweb.com/archives/ahcpr/chapter2.htm</a>
CHIROPRACTIC TRAINING
<a href="http://www.chiroweb.com/archives/ahcpr/chapter3.htm" target="_blank">http://www.chiroweb.com/archives/ahcpr/chapter3.htm</a>
LICENSURE AND LEGAL SCOPE OF PRACTICE
<a href="http://www.chiroweb.com/archives/ahcpr/chapter5.htm" target="_blank">http://www.chiroweb.com/archives/ahcpr/chapter5.htm</a>
CHIROPRACTIC IN THE HEALTH CARE SYSTEM
<a href="http://www.chiroweb.com/archives/ahcpr/chapter7.htm" target="_blank">http://www.chiroweb.com/archives/ahcpr/chapter7.htm</a>
CONTENT OF PRACTICE
<a href="http://www.chiroweb.com/archives/ahcpr/chapter8.htm" target="_blank">http://www.chiroweb.com/archives/ahcpr/chapter8.htm</a>
CHIROPRACTIC RESEARCH
<a href="http://www.chiroweb.com/archives/ahcpr/chapter9.htm" target="_blank">http://www.chiroweb.com/archives/ahcpr/chapter9.htm</a>
The Manga Report - A Canadian study performed by a Ph.D.
<a href="http://www.chiropractic.on.ca/main.html" target="_blank">http://www.chiropractic.on.ca/main.html</a>
BIOLOGICAL RATIONALE FOR POSSIBLE BENEFITS OF SPINAL MANIPULATION
<a href="http://www.chiroweb.com/archives/ahcpr/chapter10.htm" target="_blank">http://www.chiroweb.com/archives/ahcpr/chapter10.htm</a>
BENEFITS AND RISKS OF SPINAL MANIPULATION
<a href="http://www.chiroweb.com/archives/ahcpr/chapter11.htm" target="_blank">http://www.chiroweb.com/archives/ahcpr/chapter11.htm</a>
SYNOPSIS, RESEARCH PRIORITIES, AND POLICY ISSUES
<a href="http://www.chiroweb.com/archives/ahcpr/chapter12.htm" target="_blank">http://www.chiroweb.com/archives/ahcpr/chapter12.htm</a>

Consortial Center of Chiropractic Research
<a href="http://www.c3r.org/" target="_blank">http://www.c3r.org/</a>
Federation of Chiropractic Licensing Boards
<a href="http://www.fclb.org/index.htm" target="_blank">http://www.fclb.org/index.htm</a>
Palmer Research
<a href="http://www.palmer.edu//PCCR/Efforts.htm" target="_blank">http://www.palmer.edu//PCCR/Efforts.htm</a>
Journal of Vertebral Subluxation Research
<a href="http://www.jvsr.com/" target="_blank">http://www.jvsr.com/</a>

<a href="http://www.nuhs.edu/" target="_blank">http://www.nuhs.edu/</a>
<a href="http://www.fcer.org/html/research/Info/Retrospective.htm" target="_blank">http://www.fcer.org/html/research/Info/Retrospective.htm</a>
<a href="http://www.essex1.com/people/cates/accc.html" target="_blank">http://www.essex1.com/people/cates/accc.html</a>

I will gladly answer intelligent, genuine questions about what I do, but I won't argue with someone not open to learning something new. Let's talk based on facts, not conjecture.

Stillfocused, I can't comment on SOT because it wasn't taught in the cirriculum at Palmer. I don't use it so I don't know anything about it. Just as there are many drugs to treat the same thing there are many techniques to treat the same thing. Some are post graduate. They all seem to work.

Hope this helps some of you.

TB

If you look back to my post you'll see that I said Chiropractors or anyone else for that matter cannot bill for "PT" and that you are misrepresenting your practice if you say you provide PT without being a PT. It's true that Chiros and PTs may perform many similar techniques but just as I cannot say that I am doing chiropractic work you should not claim to be providing physical therapy.

PTs do receive manipulation training (Kaltenborn is what I'm currently studying in Musculoskeletal) however we do not use the high powered thrusting movements that chiropractic uses. This puts us more on par with the Osteopaths.

Stillfocused:

I don't practice using x-rays as the only criteria for adjustment, neither do most chiros. I rely on
motion palpation and save the x-rays for ruling out pathology. You also look at the patient's health history, ortho/neuro exams, subjective complaints, etc. I'm interested in the motion of the joint because how well a joint moves determines its health. We adjust into the paraphysiological space becase that is what is needed to restore passive ROM. It's like unsticking a fixed cam. You need to move beyond the fixation to restore joint mobility. The subluxation theory states that a fixed joint will interfere with nerve flow. How different is that from DO philosophy that spinal misalignments interefere with the blood supply? It's six, half-dozen, or another. The subluxation complex theory just describes the neruological, vascular, muscular, and osteological processes involved in a spinal mislignment. If one is going to be a DO and does not subscribe to this than maybe they should think about some other profession. Chiropractic is a science, and art and a philosophy and some descibe what they do inphilosophical terms. That doesn't negate the science behind what they do, it just gives them a base for understanding why they do what they do. Without philosophy, you have nothing. Ask Dr. Still.

TB

An interesting link that I found, not saying I stand by or support it but it's what is out there.

<a href="http://www.chirobase.org/" target="_blank">http://www.chirobase.org/</a>

Let me make this clear...I have NEVER insulted you personally, yet you ATTACK ME. I state that NO PROFESSION IS IMMUNE TO ETHICAL PROBLEMS, yet you state that I only blame chiropractic.

I can tell by the way you argue, that you take things SOOO personally, you feel threatened. Don't.
First of all, don't you DARE compare a chiropractic college to university education...apples and oranges fella. Regardless of "hours" taught...HOURS DO NOT EQUATE to quality of material/testing/professors etc.

read this quote from a Kansas City Paper
"The Missouri Court of Appeals has overturned a large damage award to nineteen 1997 graduates of Cleveland Chiropractic College (CCC), in Kansas City, who had charged that their education had been inadequate. The suit, filed in Kansas City, Missouri, in 1999, charged that the school had failed to provide adequate teaching as promised by promotional literature and school representatives [1]. The suit sought a total of $22 million for breach of contract, unjust enrichment, and fraud. The allegations included:

During the recruiting process, school representatives said that the clinical experience they would receive would be invaluable in learning to diagnose various ailments and that the school would provide an "ample" supply of patients to complete their clinical requirements. Similar representations were made in literature used to recruit them.
Implicit in these representations was a promise that the students would not only earn a chiropractic degree but would acquire sufficient skills in the diagnosis and treatment of physical ailments to enable passage of their home state licensing examinations.
When the students approached their final year and eligibility to work in the Clinic as student interns, the school's faculty told them that, to meet the minimum clinical experience required for graduation, they would have to recruit patients from among their friends, family members, neighbors, co-workers, and, in some cases, complete strangers.
Although the Clinic director told one student that the school had never promised to provide patients, some student overheard admission representatives making the very same representations to prospective students touring the clinic.
Although some students had patients "passed down" to them by graduating interns, many students who received no "pass-down" patients and were not from Kansas City were unable to recruit enough patients to graduate on time. School representatives encouraged these students to "market themselves" in the community and create their own "mini-practice" by using the school's spinal screening equipment to interest patients in the Clinic. One student who found that this was not enough was advised by a faculty member to "cold-call" prospective patients listed in the Kansas City telephone directory.
While solicitation and marketing efforts enabled students to eventually meet the quantitative requirements for clinical service, they were not able to develop the diagnostic skills necessary for chiropractic practice because most of the recruited individuals were generally symptom-free and did not need any major chiropractic adjustment.
Adding insult to injury, the school profited handsomely or had the fees paid by the patients or by the students themselves on the patients' behalf for any treatments (whether needed or not) that the patients received.
As a result of inadequate instruction, the plaintiffs were not adequately prepared to pass their board examinations and were unable to enter into a chiropractic practice due to lack of basic experience in diagnosis. Virtually all of the plaintiffs found it necessary to take review and preparatory courses (at additional cost) before sitting for their respective board examinations. Some felt that their practical experience was so lacking that they were forced to educate themselves as unpaid interns under the tutelage of licensed chiropractors in their home states. This deficiency was a direct result of the school's failure to provide an "ample volume and variety of patients" to allow the students to relate their classroom education to real-world patients who had acute ailments and symptoms. "

This is widespread...it may not be you, you appear to be intelligent (though extrememly defensive), but it DOES HAPPEN.
Regarding PNF research...its out there in abundance, though most of it is regarding stroke rehab and shoulder rehab, these are just examples:

Nonoperative treatment of rotator cuff tears
Mantone JK - Orthop Clin North Am - 01-Apr-2000; 31(2): 295-311
From NIH/NLM MEDLINE



Palliative treatment for stroke
Volpe BT - Neurol Clin - 2001 Nov; 19(4); 903-920



Monopolar radiofrequency energy for arthroscopic treatment of shoulder instability in the athlete.
Fanton G S - Orthop Clin North Am - 01-Jul-2001; 32(3): 511-23, x
From NIH/NLM MEDLINE


The young dancer.
Solomon R - Clin Sports Med - 01-Oct-2000; 19(4): 717-39
From NIH/NLM MEDLINE

Shoulder impingement.
Morrison DS - Orthop Clin North Am - 01-Apr-2000; 31(2): 285-93
From NIH/NLM MEDLINE



Posterior shoulder instability.
Petersen SA - Orthop Clin North Am - 01-Apr-2000; 31(2): 263-74
From NIH/NLM MEDLINE



The painful shoulder in the throwing athlete.
Altcheck DW - Orthop Clin North Am - 01-Apr-2000; 31(2): 241-5
From NIH/NLM MEDLINE



Thermal versus suture treatment of symptomatic capsular laxity.
Savoie FH 3rd - Clin Sports Med - 01-Jan-2000; 19(1): 63-75, vi
From NIH/NLM MEDLINE


Histologic evaluation of the glenohumeral joint capsule after the laser-assisted capsular shift procedure for glenohumeral instability.
Hayashi K - Am J Sports Med - 1999 Mar-Apr; 27(2): 162-7
From NIH/NLM MEDLINE


Chronic patellofemoral pain syndrome: alternatives for cases of therapy resistance.
Schneider F - Knee Surg Sports Traumatol Arthrosc - 01-Sep-2001; 9(5): 290-5
From NIH/NLM MEDLINE

Effects of the use of cross-education to the affected side through various resistive exercises of the sound side and settings of the length of the affected muscles.
Arai M - Hiroshima J Med Sci - 01-Sep-2001; 50(3): 65-73
From NIH/NLM MEDLINE


Effect of warm-up and flexibility treatments on vertical jump performance.
Church JB - J Strength Cond Res - 01-Aug-2001; 15(3): 332-6
From NIH/NLM MEDLINE


[The rehabilitative therapy of patients with osteochondrosis of the cervical spine and manifestations of hypermobility bv means of therapeutic physical exercise]
Epifanov VA - Vopr Kurortol Fizioter Lech Fiz Kult - 2000 Jan-Feb; (1): 8-11
From NIH/NLM MEDLINE


Regarding "direct access" in Indiana, I dont
think PT's SHOULD have direct access, nor do I believe DC's should. Neither have the appropriate differential diagnosis capability...DC's have it because of typical indiana politics (they had it first and early).
Yeah, I know a bit about the politics of Indiana...I spoke in front of the Indiana House of Representatives Public Health Committee regarding this issue. Yeah, I may know "just a bit".

PTJay, <a href="http://www.chirobase.org/" target="_blank">http://www.chirobase.org/</a> is a small fringe group that is not representative of Chiropractic at all. It seems to be a favorite group that medical groups like to use when trying to slam Chiropractic b/c they feel that it justifies unfounded accusations. It would be like saying that the KKK represents Christianity. Go look at the websites that truly represent our profession.

I dont think PT's SHOULD have direct access, nor do I believe DC's should. Neither have the
appropriate differential diagnosis capability.

...trust me when I say that our education FAR exceeds that of a PT. That's why the law has designated us Doctor, and you...not. I noticed you haven't checked out the curriculum of Palmer. I agree that any school that doesn't live up to it's claims should be held accountable, but you only gave an example of one school, not a whole profession. You're damn straight that I take what I do personally. When someone decides they think they know how I should practice, having no concept of what a Chiropractic education is, yes, I take that personally. You have no concept of a DC education b/c you've never gone through the school, so you can't...and until you do, you're accusations and rants are baseless. I've worked with PT's before, and we've had a good relationship as long as they respect what I do. I respect what you do and I've never decided what limits should be placed on your profession (other than spinal manipulation). You honestly have no idea what you're talking about regarding our training. But why am I trying to convince you, you'll never get it. And you're right, I've been defensive when I don't need to be. Many professionals realize the expertise of chiropractors in what they do, and what a benefit chiropractic is when all else has failed. How can you know? You've never been in my shoes or seen the things I have in practice. My record of successes is all I really need to prove that it works. Maybe you've come in contact with some bad docs, and maybe they left a bad impression on you. Well, nothing I can do about that. I guess it's kind of sad that you're so shut off and not even willing to open you're mind to the fact that maybe you are wrong. But, again, that's not my issue. Good luck in the medical profession. Perhaps someday our paths will cross again.

TB

more research

J Manipulative Physiol Ther 1991 Mar-Apr;14(3):199-208 Related Articles, Books, LinkOut

The reliability of reliability.

Haas M.

Research Department, Western States Chiropractic College, Portland, Oregon 97230.

Forty-five original articles addressing the subject of examiner reliability were reviewed to determine if the findings were adequately substantiated by the statistical analyses and experimental designs employed by the authors. Only 10 studies were determined to have properly supported conclusions, while an additional three studies contained correct conclusions by coincidence. Eight investigations had invalid designs and three contained claims that were contradicted by the author's findings. Half the studies were found to have conclusions that were based on inappropriate or inconclusive statistical analysis. To date, the research presented in the chiropractic literature cannot substantiate claims concerning the reliability of any diagnostic instrumentation or palpatory procedures commonly employed by chiropractic physicians.

I promise this is the last article I will post here but you told me to check the chiropractic information myself. I did so and found an article from the Los Angeles College of Chiropractic which I believe would be representative of chiropractic.

J Manipulative Physiol Ther 2001 Oct;24(8):514-9 Related Articles, Books, LinkOut


Unsubstantiated claims in patient brochures from the largest state, provincial, and national chiropractic associations and research agencies.

Grod JP, Sikorski D, Keating JC Jr.

Los Angeles College of Chiropractic, Whittier, California, USA.

OBJECTIVE: To determine the presence or absence of claims for the clinical art of chiropractic that are not currently justified by available scientific evidence or are intrinsically untestable. DESIGN: A survey of patient education and promotional material produced by national, state, and provincial societies and research agencies in Canada and the United States. METHOD: Patient brochures were solicited from the 3 largest provincial, 3 largest state, and the 3 largest national professional associations in the United States and Canada. Similar requests were made of 2 research agencies supported by the national associations. Brochures were reviewed for the presence or absence of unsubstantiated claims. RESULTS: Of the 11 organizations sampled, 9 distribute patient brochures. Of these 9 organizations, all distribute patient brochures that make claims for chiropractic services that have not been scientifically validated. CONCLUSION: The largest professional associations in the United States and Canada distribute patient brochures that make claims for the clinical art of chiropractic that are not currently justified by available scientific evidence or that are intrinsically untestable. These assertions are self-defeating because they reinforce an image of the chiropractic profession as functioning outside the boundaries of scientific behavior.

Point taken.

PTjay,

How did you arrive at the conclusion that the article you cited above (J Manipulative Physiol Ther 2001 Oct;24(8):514-9) is representative of the chiropractic profession? Is one journal article all it takes for you to form a belief about an entire profession?
What assessment criteria did you use while critically appraising this article?

First of all I'd like to state that I believe Chiropractic does indeed have it's place. What I don't believe is that Chiropractors should provide false information about what their treatments can do for others or that they should claim to provide physical therapy when in fact they do not.

I believe the article cited to be representative of the misleading claims that the chiropractors make. The study was performed by students of chiropractic and the brochures under review were those distritbuted by the largest professional chiropractic associations in the United States and Canada. I may have misrepresented my point as you have taken my statements to be all encompassing of the chiropractic profession. I do not believe that chiropractic is all together useless and I do not believe that all chiropractors misrepresent their abilities, but if the largest organizations are providing bogus information it makes me seriously question the ethicality of the profession or at least those who lead the organizations. These organizations should be striving to represent the profession honestly with research to back up their claims.

With that said, no I do not rely on a single article to formulate assumptions about an entire profession. If you would like to see more of the journal articles that I have reviewed I can cite them for you.

I selected this article because it is in a journal that was cited by a previous poster. Unfortunately I only have the abstract which was posted earlier and therefore cannot go into the validity and realibility of the methods used in this research. I also do not know the criteria or operational definition of what is considered untestable or not justified by scientific evidence (but I can make an educated guess and I'd prefer to spend my time studying for my exams). However, since the journal was provided by the above poster I felt the article would at least satisfy him.

Back to studying McKenzie.

I couldn't resist entering the frey...

First let's not forget that osteopathy (the forerunner of osteopathic medicine) predates chiropractic in the US by several decades. Palmer visited Kirksville and observed several classes and enjoyed conversations with AT Still, before sneaking across the border to set-up his own school in Iowa. This is well known.

<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11620051&dopt=Abstract" target="_blank">http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11620051&dopt=Abstract</a>

While the biomechanics of manipulation is the same regardless of who performs it (MDs, DOs, DCs, PTs, LMTs, etc) there are important differences between OMT practiced by DO's and SMT practiced by chiropractors. First, chiropractors use SMT within the framework of a "nerve model" to remove subluxations. These subluxations are believed to actually exist and affect whole-body physiology via interaction with the CNS.

Historically, DO's used OMT to improve blood flow and fascilitate tissue waste-product removal; this is AT Still's, "rule of the artery is supreme." As a whole, DO's gave up this etiological theory decades ago, though some hold onto it for its heuristic value. Now, DO's use OMT to remove somatic dysfunction, broadly defined as "impaired or altered function of the somatic system; its skeletal, arthroidal, or neurovascular related elements. It is believed that by removing somatic dysfunction, a host may better recruit its own healing mechanisms. These approaches (removing somatic dysfunction versus removing subluxations) are not the same.

More importantly, DO's are trained as medical doctors and use OMT within a much broader context than chiropractors do. There are DO's who only have inpatient OMT practices using OMT to treat hospitalized patients with pneumonia, post-operative ileus, chronic ventilator patients, non-cardiac chest pain. Again, being medically-trained allows them to treat patients in the hospital and get paid by Medicare, something chiropractors cannot do.

I think that there are other important advantages to being a medically-trained manipulator in terms of ones experience with more complicated diseases, inpatient hospital care, sicker patients, etc. In many European countries, non-medical osteopaths and chiropractors do not hold professional doctorate degrees. They are more like master degree level PT's. They practice under the supervision of a medically-trained physician. I think the same could be arranged here in the US. Chiropractic schools could stop awarding a professional doctorate degree, and start awarding a Master's degree and chiropractors could work under the supervision of a medically-qualified practitioners as do licensed PT's.

I think the issue of medically versus non-medically trained manipulators is analagous to having PhD psychologists prescribe psychotropic medicines (as is happening in New Mexico and some other states). Yes, it is possible to teach a non-physician to prescribe, but is it good medicine? Certainly there are very, very gifted non-medical manipulators, but is this safe and effective patient care?

DO's were so concerned with keeping up with MD's that the profession let chiropractors sneak off with manipulation. The fact that the chiropractic profession has evolved and thrived the way it has is due to, in part, a failure of organized osteopathic medicine to stand-up 100 years ago and forecibly argue that manipulation *IS* the practice of medicine. The MD's would have probably thrown a fit over that assertion since they denied any utility of manipulation at all, but no one could predict the way things would end-up: MD's and DO's would learn to play nice-nice, and DC's would make a tidy bundle popping people's necks and backs, and we would still not know what works and why.

Now, we have a situation where a variety of different practitioners are treating patients with a variety of different manipulative therapies and no one knows what good any of it is for anyone. Just like studies of psychotherapy have shown that psychotherapy is, in general, effective for a vareity of psychological problems, these same studies have also shown that are few differences between specific "brands" of psychotherapy (psychoanalytic versus interpersonal versus cognitive behavioral). I think studies will eventually show the same general benefits for manipulation---regardless of its particular brand name.

Chiropractors keep pushing for a broader scope of practice: Manipulation under anesthesia, access to hospitals, prescription privileges, the right to practice "primary care", etc. Unfortunately, these issues will probably not be decided by science, but by politics and influence. I think organized medicine (MDs and DOs) need look critically at this situation.

My only reply to the above comments (that I have not already said)...is that I agree.
Medicine thrives best when it is a compassionate science. A self-critical entity that anylizes itself while never forgetting the vital components of the human touch.
We must ALWAYS hold a critical eye.

drusso,

Exactly what do you think organized medicine should do about those chiropractors?

I think you're sending out the wrong message to the future osteopathic physicians that frequent this site. They don't need to worry about what other professions are doing or not doing--they need to be worrying about their own profession.

Instead of watching what others are doing, DOs should be focusing on their own agenda. You stated that "DO's were so concerned with keeping up with MD's that the profession let chiropractors sneak off with manipulation." So instead of suggesting that organized medicine should look critically at the chiropractic situation, I think they would be better served by actually doing something productive--why not encourage more basic science and clinical research into OMT (before the chiropractic community continues to dominate the field of research into manipulative therapy).

Quite honestly, I believe the opposite to be true.

I believe that osteopathic medicine has moved in the forefront of both manipulation and medicine. The public is seeing more DO's in large university hospitals in diverse fields, and at the same time, realizing that DO's offer OMT much like what chiropractors do...giving patients GREATER trust in DO's (knowing that they are fully licensed physicians that graduated from medical school and passed 3 sets of boards and certification exams) and pushing DC's further into the fringe of untested/untrusted medicine.

It is the duty of science and medicine to inform the public of dubious products and treatments. Regulation allows for higher and better standards and attempts to ensure public safety. It is absolutely necessary to look at the claims and practices of "homeopaths" "naturopaths" and any practitioner that makes outrageous claims.

Putting on blinders makes one oblivious to ones surroundings.

Mr Happy Clown Guy,

I believe you are mistaken about who is at the forefront of manipulative therapy. Ask any current D.O. student how popular manipulative therapy is at their school and how often they plan to utilize it in their practice. Go out onto the street and ask an average layperson about what type of doctor performs manipulation of the spine--a majority will say chiropractor. Ask an average layperson if they know that D.O.s perform manipulation--they will likely reply, "D what?" My point is that there is a lot of work to be done before DOs are to re-gain recognition as being in the forefront of manual medicine.

Whenever I visit the DO site [almost always], I see a lot of self-defensiveness, arrogance, and I think inferiority complex. Are all DO students low achieving, no-confidence part of society or what? I was leaning toward Osteo schools, but the behavior of most students on this forum scare me. I think I will go for MD, and join the confident people there.... Do you blame me? You people do not have any self-confidence at all? Just read and compare the DO/MD forum and you will know what I am talking about. But for the record, in case it helps boost your confidence,
it is not the two letters behind your name that will determine what kind of doc you are, it is how good edu. you gate, regardless of the particular path you take...

Bye, may God grant all of you confidence and trust!

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by dmon:
<strong>drusso,

Exactly what do you think organized medicine should do about those chiropractors?

I think you're sending out the wrong message to the future osteopathic physicians that frequent this site. They don't need to worry about what other professions are doing or not doing--they need to be worrying about their own profession.

Instead of watching what others are doing, DOs should be focusing on their own agenda. You stated that "DO's were so concerned with keeping up with MD's that the profession let chiropractors sneak off with manipulation." So instead of suggesting that organized medicine should look critically at the chiropractic situation, I think they would be better served by actually doing something productive--why not encourage more basic science and clinical research into OMT (before the chiropractic community continues to dominate the field of research into manipulative therapy).</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Of couse there should be more basic and clinical research into OMT and manipulation in general! I'm not sending a message to the contrary. What I am trying to get more medical students to appreciate is the role that POLITICS plays in local, state, and national health care policy. It is my observation that medical students, as a whole, tend to be pretty niave about politics. They spend so much time studying science and playing the game and jumping through all the right hoops to get into medical school that they end up creating a very small, artificial worldview.

If you visit a law school, on the other hand, you will see law students studying very hard, but also committing almost an equal amount of time to various political activities. Why? They know that their profession really is not driven by sound logic and justice---it's driven by politics. Medical students tend to get involved in political activities only very reluctantly. I also think that medical student tend to look down their noses at classmates who are very politically involved with school and state medical issues.

Chiropractors, PAs, NPs, CRNA's, psychologists, etc will expand their practices rights not on the basis of sound science, but on the basis of fundraising, influence, and politics. Do you know that chiropractors belong to their professional organizations and support their state political action committees (PACs) in much higher rates than MD/DOs? Did you know that chiropractors and CRNAs give a larger percentage of their income to political issues than MD/DOs?

Are you a member of AMSA, the AMA, the AOA or some other organized physician group that supports political action? Why not?

Gebe,

People discuss things, people sometimes even argue. Yes, the world is full of imperfection...but this discussion is about OMT and chiropractics, probably something you know little about. The discussion has nothing to do with insecurities...but if you are one of those people that look at a Jaguar in the parking lot and say "I wonder what he is insecure about or compensating for"...then I guess you will say what you want.

With regard to asking the public...I HAVE asked patients. And when I tell them I am a DO (even in the emergency department) they say "hey yeah, you guys can crack backs too!" The general response to chiropractors is with a raised eyebrow and a chuckle under the breath.

I encourage all medical students to join PAC's, to stay affiliated with the AMA, AOA, and their professional organizations.

RE: "With regard to asking the public...I HAVE asked patients. And when I tell them I am a DO (even in the emergency department) they say "hey yeah, you guys can crack backs too!" The general response to chiropractors is with a raised eyebrow and a chuckle under the breath."

--mr happy clown guy

Mr Happy,

I think you're only fooling yourself. Of course your PATIENTS, friends, and family are going to know what a DO is and does; but I'm talking about your average person--in a BIG city--will not know what a doctor of osteopathy is or does.

Also, it doesn't represent the profession very well by adding comments such as "The general response to chiropractors is with a raised eyebrow and a chuckle under the breath." It just makes you appear unprofessional and childish.

My friend, I spent my last 2 years in allopathic hospitals where perhaps only 10% of the docs are DO's...my patients have no idea what kind of doctor or medical student I was. I was even told by a residency director (MD) that he looks forward to having DO's in his residency because "they can manipulate and do everything else".
It certainly is not a problem of mine that Chiropractors have been their own worst enemy regarding shoddy science and claims that are outrageous. This is a self-regulatory issue that has obviously failed on the part of chiropractic. Until they clean themselves up, they will not gain the recognition that they so desire!

Shoddy science? I think you need to keep current with the literature--the chiros are performing a majority of the published research (indexed in Medline) regarding manipulation. You should really get your facts straight before comment on something. I hope your not that careless when it comes to issues with your patients.

WOW! What a huge variety we got going on here!
I'm a little nervous to enter myself, being a first year chiro student, but hey, what the hell.
First of all, chiropractors all have a very different sense of what the medicine should entail. One bad DC or one bad idea gives us all a bad name, when most of the chiros out there are very skilled and competent. Yes, we diagnose, and are excellent at it. Yes, we take a four part board exam series, that is required to get liscened. Yes, we read radiographs, and as for "leaving radiology to the radiologists", look at a wonderful text called Essentials of Skeletal Radiology, second edition, by Yochum and Rowe. Yochum is a DC! And he teaches at the CU Health Sciences Center (yes, a med school, as well as CCC). Not only that, he has been named faculty of the year there for the past 5 out of 6 years, has been the only person to win it more than twice, and the only person to win it twice in a row. The man obviously knows his stuff. I would actually be surprised if you haven't already used this text.
Moving on, chiropractors can not be generalized as they have been so often in this thread. There are a group of them who would like to prescibe meds and do minor surgery...there are groups on the opposite side of the spectrum who believe that only adjusting C0/C1 and C1/C2 will cure all of your problems, but the general direction of chiropractic is a holistic health approach that treats the patient as a whole, not the disease. Should we be generalized? Well, it would make things a whole lot easier, but since there are SO MANY different ideas of what works and why, we just can't seem to come to an agreement on anything. And, yes, this hurts us as a profession, but it doesn't mean that manipulation works any less effectively. The fact is, we just don't know enough about the nervous system and all of the body/mind interactions... and these things are very hard to test....especially using randomized controlled double blind studies. But just because you can't see it, doesn't mean it isn't there. Granted, lack of proof doesn't ensure existance either, but at least the possibility is there, and we aren't just riding on possibilities, we have seen things happen in clinical practice.
That is why chiropractic has lasted as long as it has. Not because osteopaths "let" us have manipulation, but because we believe in the treatments, and so do our patients. And we possess a greater skill in manipulation. Of course you can always learn the biomechanics of an adjustment and say you know how to adjust. But every body is different, and you're not always going to get the same response with the same adjustment. Adjusting is like a golf swing, you have to practice, practice, practice. As was mentioned before, we get the most experience is school, and better yet, our adjusting classes are very well attended. Enthusiastically, even.
Almost lastly, the reason we are so active in our organizations is to ensure that more legislation doesn't get passed to take away our right to be doctors. We are more skilled than PT's and we deserve the recognition.
Also, Treybird, if you are still out there...do you still have to go through all the basic science program of being a DO? I was just curious how that worked since I have heard of a lot of DC/DO, MD/DC combo degrees lately. Hasta

By the way, the research that is being done, is being done by chiros, and chiros and osteos together.

First of all, there are no DC/DO combo programs...at least none that are in the United States and are accredited; that is a ridiculous notion. Everyone that enters medical school must do the first two years of academics...regardless of previous degree (PhD, PT, MS, RN, PA, NP, DC).

Second, Mr. Happy is correct in saying that Chiropractic has been its OWN WORST ENEMY! By poor self-regulation, low admission standards, lack of true research (scientific medically reviewed literature) of any sort, and simply OUTRAGEOUS and silly claims in chiropractic promotional literature!
Chiropractors do themselves NO FAVORS by supporting Anti-vaccination claims, subluxation theories as cure-alls, treating ADHD with herbs or manipulation, chelation therapies, manipulation of children for autism or learning disabilities, and the jokes of applied kinesiology!
True, there are great and well meaning DC's that are truely interested in musculoskeletal health, but there are soooo many that make untested, unscientific claims...that it really hurts your profession.
I too was a PT prior to medical school, and I saw my own fair share of questionable chiropractic practices...too many to state. The bottom line is that chiropractic will always be on the edge of health care, the area with the naturopaths and the homeopathic practitioners. Blame yourselves not others.

dmon,
what I find funny is that you do little to deny the outrageous claims and questionable practices by chiropractors. True science must ALWAYS be looked at with a critical eye...why is that so hard for you to admit?

Lets look at a bit of anti vaccination propaganda by a chiropractor
"The theory of vaccination, and it is only a theory, has never been thoroughly tested and proven. Yet, it is a theory that many hold very dear to their hearts. Most of this fervour is the direct result of massive marketing campaigns by the pharmaceutical and medical industry. As a matter of fact, any research being done on vaccines is funded by the drug industry and there is virtually no research done on vaccine hazards. Any studies that have been done, do not extend for more than a two week period. Why? There are billions of dollars at stake. What a shock!"

From Healing Hands, Volume 1, Number 3, June 1999.
Patient First Chiropractic & Wellness Centre

Yeah, when you start a study and the control group/experimental group begin to get terribly sick /die by "lack of treatment or with holding treatment due to experimentation" medical ethics kicks in and you cease the study.

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by JenMac:
<strong>That is why chiropractic has lasted as long as it has. Not because osteopaths "let" us have manipulation, but because we believe in the treatments, and so do our patients. </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Just because you and your patients believe in it isn't "proof" that it works.

99% of the people before Columbus set sail for American believed the world was flat. Doesnt' make it right.

I'm not against Chiropractic. I just think they should be limited in what they can do. No, I do not think chiros should be called PCP's. No, I do not think chiros should be allowed to prescribe, or even read radiographs. No, I do not believe in the subluxation theory. And lastly, no, I do not think children need to be adjusted to remain in optimal health, as many chiros claim.

I have resisted jumping in but now here I am. I at one time had thought of going to Chiropractic school but decided not to. One of the big reasons was there was no one to help finance my education. Yes, I realize loans were available but my interest was going into the military and the military would not pay for Chiropractic school and the military does not commission Chiropractors as officers as they do on a regular basis with nurses, PTs, MDs, and DOs. I checked into it and found that Chiropractors have the highest default rate on HEAL Loans of any healtcare providers.

I take issue with JenMac regarding "we are more skilled than PTs". In regards to manipulation? Well when I checked into chiro, the US and Canada were the only 2 countries that had chiropractic colleges (thank God), this may have changed but in the rest of the world it is PTs and DOs who manipulate. I will say here in the US, chiros as a rule are more skilled in manipulation but we as PTs can and do learn manipulation/mobilization and yes, we can learn the high velocity techniques.

Another thing, JenMac, do not put yourself on par with a MD/DO primary care physician, you do not have the medical training. When they start hiring DCs as primary care physicians in acute care hospitals, then you can be on par but not until then. As for the MD/DC or DO/DC, I bet the majority of those folks were DCs first prior to going back to medical school. You will have a doctor of chiropractic but then again a lawyer has a Juris Doctrate also.

I have a nurse friend who went to massage therapy school and had a DC teaching anatomy and it blew here away at his lack of knowledge with regard to medical terminology.

Chiropractic schools as a whole will take anyone, I know, I have several friends who went to DC school and have checked into it myself. You may be more skilled at manipulation than your average PT, but that is a minute part of the healthcare system. Can you tell me what the war time duty of a chiropractor is in the military. Nothing, they do not have a war time duty. Well my friend, for a PT it is treating thermal burns and wounds. Actually, today in the acute care hospital I work in, I debrided a gluteal and scrotal wound, pulse-a-vacked it and dressed the wound.

I admire you being idealistic but you are in your first year of chiro school learning about subluxations that do not exist.

As for chiros doing physical therapy, I haven't seen any working in any rehab hospital treating Stokes, Spinal Cord Injuries, Traumatic brain injuries, multiple fractures, MS, CF, peripheral neuropathies, etc...Why, you don't have the training. More skilled my butt. You used Ultrasound, E stim, traction, and a few exercises and call it PT. What a joke. Come on over and teach a R hemiplegic how to walk again or a partial SCI. You do not have the skills. PTs schools have a higher standard of student that they take than DC schools. DC schools let in 3-4 classes per year. Diploma mills. Can you tell me how many DO and MD schools let that many in??

I had the opportunity to have shoulder surgery recently. Had my MRI and enjoyed my conversation with the radiologist. He proceeded to tell me how Chiros send their patient for the MRI, then max out the persons Auto Insurance at the $10,000 limit and what amazed the radiologist was how all these patient reached maximum medical benefit at the same time the $10,000.00 limit was met. Now that would be a study worth doing to see if there is a direct correlation.

Actually, I have decided to go on to medical school (MD or DO). I did meet some nice people especially at Palmer, Dr. McMaster, PhD. He was editor of a magazine called Chiropractic. I don't know if it is still published but it was good. It called Chiros on the carpet on alot of issues and seemed to have a good research foundation.

Oh one more thing, I worked with a MD who was a DC prior to medical school. He is now a physiatrist(not a psychiatrist), a rehab MD. He told me that his MD training smoked his DC training, in other words night and day. Yes, he was required to go through all the basic sciences again. At first, he was pissed, but he said he would not have passed the USMLE step I other wise if he had relied on his DC ed. It is really apples and oranges he told me. No comparison. Oh and he went to the National C of C in right outside Chicago, Lambard??

Well, I am off. I got off more than I wanted to. Sorry, buttom line you are not a primary care physician, an expert at manipulation, depends on the DC, good luck. 123dvt

Wow what a pissing contest we have here. My weiner is bigger than yours.....the fact is that in all aspects of life there are myths and then there is reality. Quite often the myths become reality and falsehoods become truths. Often the two are manipulated (no pun intended) to distort reality. This is quite evident in the realm of manipulation and who owns it, can perform it better, under which license etc., etc., etc.. The DC would like to believe and like the public to believe that spinal manipulation is the basis for good health. It's the end all for all patients. Hey it's their ONLY TOOL, what the hell are they supposed to say? Now the DC wants to pretend they are primary care docs but they're really not. We all know that. In reality the public doesn't go see a DC when he has high blood pressure, or a skin condition. They go for back/neck pain. Now if manipulation was so wonderful and was curative of so many patients then I would imagine there would be patients lined up to the moon and back to have their backs cracked for relief of their pain (I know ask any DC and they will tell you how many patients they have helped blah, blah, blah, blah). Fact is, back pain remains an enigma to them and the medical profession and evidence on the efficacy of manipulation is largely sketchy and anecdotal at best. I'm sure if you compared chiropractic manipulation to sticking a candle up your ass for back pain the results would be neck and neck (again no pun intended). This is really why most DO's have abandoned it as well, save for the nms docs perhaps. It's just another modality. I've been to a DO that would adjust my cervical spine and prescribe an antibiotic when I had sinusitis. At no point did I believe the adjustment did anything for the resolution of my condition. He may have but I didn't. As for who can perform it better and do you have to be a "doctor", are you kidding me? You can teach a chimp to take a joint segment to it's end range and provide a thrust. Wanna make it seem so damn complicated, gimme a break already. Lastly the part about DC's being "doctors" and doing "PT", they haven't a clue as to how ignorant they are. Just becase you took xxxx hours in basic science courses that qualifies you to do "rehab"? Or makes you a "doctor"? The imbeciles think "PT" is the administering of physical agents. Oh they have seminars and certifications as "sports physicians" and they write articles in local papers like they actually have experience treating these patients but in reality all they do is crack backs. When Johnny has an ortho problem who does he go see? An MD or DO trained in ortho ( not one that did mall screenings for free, or cracked his whole girlfriends family in his senior year to get enough credit to graduate). No instead his parents got him to an MD or DO and after the diagnosis they were referred to a PT to perform the actual "rehab". When an amputee needs prosthetic training does he see a DC? When an infant with Cerebral Palsy needs neuro re-ed does he see a DC? When a patient with ALS or some other progressive disease needs "rehab" does he see a DC? When Johnny has just had reconstructive surgery for a torn ACL does the doc send him to a DC? It's their wet dream to actually do "rehab" but it doesn't happen. Period. So when you read these silly posts about defending a defenseless profession (see NACM) just pay it no mind. They will wither and fade like the decaying DC practices that litter the lanscape of cities all across America.

Sure are a lot of hotheads around here.

1. Med school is MUCH harder
2. Chiros aren't PCPs
3. Lots of terrible DCs out there getting bad press.

On the other hand, there are DCs out there who are excellent at spinal rehab, more so than many PTs I've been around(I've worked in both). Also, LACC has a postgrad rehab certification course that is uniformly excellent. PTs win hands down for stuff like stroke rehab, extremities, hospital care.

For myself, I would see a PT for most injuries, but if I could find a DC who is skilled at exercise, direct/indirect stretching and proprio training then I would use him/her for spinal problems. Unfortunately, they are not too numerous for a number of reasons.
If you think about it, high velocity manipulation is just another modality, although a fairly difficult one to do well. Whoever can do this and
master exercise rehabilitation truly posesses the most complete skills.

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by gebe:
<strong>Whenever I visit the DO site [almost always], I see a lot of self-defensiveness, arrogance, and I think inferiority complex. Are all DO students low achieving, no-confidence part of society or what? I was leaning toward Osteo schools, but the behavior of most students on this forum scare me. I think I will go for MD, and join the confident people there.... Do you blame me? You people do not have any self-confidence at all? Just read and compare the DO/MD forum and you will know what I am talking about. But for the record, in case it helps boost your confidence,
it is not the two letters behind your name that will determine what kind of doc you are, it is how good edu. you gate, regardless of the particular path you take...

Bye, may God grant all of you confidence and trust!</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Dude, if you're so worried about what you hear from people on line (certainly less than 2 or 3%--and I'm being generous--of all DO/MD students) then why the bloody hell are you applying to med school.

Something about thickness of skin comes to mind...

Hey JenMac,

Thanks for posting in the OMT and Chiro debate. I felt like the only one there for awhile. I finally got so fed up with the ingnorance and absolute stupidity that I felt like I was just spinning my wheels. Why should we have to explain ourselves? We know it works, and so do our patients. That's all I really care about.

Yes, unfortunately I will have to do it ALL over again. The reason I'm going back is not b/c I've
given up on chiropractic, although I can't stand dealing with the politics anymore, but b/c I want to join the Air Force and can't do that as a Chiro yet. Maybe once I'm in I can make a difference but you have to to make changes from the inside. We'll see. Where do you go to school? I know that my first two years will be a breeze after the education I got at Palmer. Maybe I'll teach some DO's how to adjust :D

TB

Freeeedom! JenMac wasn't talking about combined DC/DO programs. Do you have a brain? She was talking about those of us with a DC and DO degree. And yes, we are our own worst enemies, but that doesn't change the fact that we rule when it comes to adjusting our patients. Go read the research. You have absolutely NO clue as to what is or is not out there.

As for the overuse of antiobiotics, go talk to someone who's had antiobiotic-resistant TB...oh, wait, you can't...they're all DEAD!! Go look at the Texas Back Institute to see what they think about chiros. The fact is that most of you who have never gone to chiropractic school have no idea what we are qualified to do. Think what you like, but until you've gone through it, you have nothing to contribute on this matter other than petty ignorance. I'd like to hear from some other DC's to weigh in on this issue.

I love that I can diagnose and a PT can't. I love that in Indiana we can have direct access and PT's can't. I LOVE that we can manipulate and they can't. It sucks to be a PT in Indiana. It is GREAT to be a chiro and now matter how much you think we can't be primary care providers, we are. I LOVE that fact. And no amount of jealous sniping can change that. I had a great day today and helped many people. And you know what? None of them asked me to show them the reasearch. Know why? They didn't care!! All they cared about was that I got them better, and these were patients referred to me by a DO!!!! Oh how that must shatter your worlds. LEARN FROM THE MASTERS!!!

Treybird,

Where are you planning on going for school? Just curious. Good luck, and I hope you enjoy it as much as I have.

4 more weeks to graduation!!!! <img border="0" alt="[Clappy]" title="" src="graemlins/clappy.gif" />

Treybird,

Hey, dude. I congratulate you for wanting to do the Air Force route. However, Chiropractors will never be commissioned as officers because they have no war time duty. Bottom line, you will not change that for a second.

I never said manipulation did not work. It does work but not for every condition that walks through your door.

DCDO,
You are right there are good DCs out there that use rehab and manipulation well.

Also, in addition to my wound care responsibilies. I do spine rehab in acute care. I am the first person to initiate rehab for s/p cervical fusions, Lumbar laminectomies, and microdiskectomies--just to name a few. There are many areas of rehab a DC will never have the opportunity to treat just because of the nature of healthcare. DCs for 99% of hospitals do not do acute s/p surgical rehab.

You are right there are many DCs that may be better than some PTs, however, we as PTs treat a whole alot more medical conditions than DCs. Our training in broader than just spinal manipulation. Now I realize that DCs are moving more into rehab b/c it pays well and for survival purposes, it is a good thing to do.

One quesiton I have always wanted to ask a DC is this, How did Dr. Palmer cure that mans hearing loss by manipulating a spinal segment when hearing is controlled by CN VIII??

Treybird,

You have so much to learn and I am glad you are coming back from the dark side. Legally you are right, PTs can not diagnose, however, we learn the same orthopedic skills and neurological skills that you do, big guy. It does not suck being a PT in Indiana. Why are you leaving DC if it is so great.

What can a Chiro Diagnose? Subluxation a L4-5 that does not exist. Please tell me what you have diagnoses lately.

Let me tell you what I have caught in the acute care hospital. (1) A rotator cuff tear, not real important except the guy had a stroke and fell. Well, at the time the medical staff was trying to save his life so the cuff tear wasn't so important but I still caught during rehab. (2) A DVT, oh yeah, you did get that medical terminology in DC school. Deep vien thrombosis, pain, swelling in the calf. Important, hell yeah, it can break loose and kill you. (3) One of my patients had multiple falls prior to admission to the hospital. Most recent caused a compression fracture at L2-3. Why was he falling so much. Well, he had a stoke many years ago and his evertors are non functional. Well, foot drop/drag city with multiple falls. His neurosurgeon said it was very important to avoid another fall to prevent permanent paralysis. Oh may friend it was the PT that found this little missed fact. Missed by his DC and MD. So home boy, I found it and got him a AFO (ankle foot orthosis). Guess what, no more falls.

So get off your high rocking horse with your, I can diagnose BS. Bottom line. PTs top to bottom can hold there own and in most cases kick your gluteus maximus, medius, and minimus. Just the facts.

FutureMD/DO, I absoultely agree with you that Chiropractic can't cure anything. All it does is align the spine, get the joints moving, and reestablish nerve flow to the organs and muscles they innervate. That's it. It's no more complicated than that. I've never claimed to cure anything and if you went to a DC who claimed he could "cure" anything, run. That's malpractice, pure and simple. I also realize that some spinal cases are an emergency and require surgical treatment. AND, I would not touch a patient after surgery until released by their doctr. I understand my limitations perfectly, but a PT does not. I realize that PT's play a very important role in the healthcare system, as do DC's. That's been my only point through this whole debate. We play an important role as well, and we are qualified to do what we do. If a DC works outside their scope of practice, which are clearly defined by state law, than he is comitting malpractice. Whether you, as a PT, DO, or MD, FEEL that we are is not of concern to me. I don't say that in a mean or negative way.

As for helping Harvey Lillard with his hearing, we all know that the T1 and T2 nerves (of the sympathitic nervous system) control vasodilation in the head region. He didn't adjust CN VIII, he adjust their blood supply.

You never know how far chiros can go in the Air Force. We would probably double-up on some other activity. Who knows.

TB

DCDO, I will be leaving for school in mid-August. I am still waiting to hear from Indiana U. before I make a final decision. I've been accepted to a few DO schools, but IU is my first choice. Where did you do your trainings?? Thanks for the good luck wishes. I'm not looking forward to the long trek ahead, again. I guess the big thing is getting BACK into studying. Oh, and I hate the smell of cadavers.

TB

TREYBIRD!! Thank god you are here! He he he, I thought I might get that reaction...it was that whole different paradigm thing you mentioned two pages ago. I am currently at Colorado College of Chiropractic in Denver. It's a great school, but brand spankin new, so it's got it's issues too. Did you ever read Gatterman's texts? Yeah, she's at our school. She's awesome, I love her.
Anyway, whew, look at what I've started! I think it's great. You guys all think you have all the answers and it's great for your patients that you have so much passion! You just need to broaden the ol horizons a bit....
Ummmm, lessee, only a few more things....ah yes, I recently worked for a DC here in Denver, who works with orthopedic spine surgeons at Swedish Medical Center every Thursday, along with his normal practice where he does sports physicals for the high school kids, has a PT within his office, (as well as 2 acupuncturists and 5 massage therapists), has been known to diagnose such off the wall things such as glomerulonephritis (and refering them out), and, oh my god, he's residency trained too! I know there are only a handful of them out there, but residency trained DC's do exist. It's completely optional of course. He is also a fav among the insurance companies for IME's because he DOESN'T run up the bill. (as an example)
And I thought I would point out that Blue Cross/Blue Shield of IL ran a study where they made some select DC's, PCP's. They wanted to know what would happen. Health care costs dropped 40% and patient satisfaction skyrocketed. Look, I know we are our own worst enemy. There are a lot of crazy ideas out there. A lot of crazy literature too. And yes our school's standards are low (which I too hate, but it didn't change my opinion on the profession), but I have noticed they are rising all the time. As for the school I am in, we have two classes/yr and cap the size at 80 students. Diploma factory? That just doesn't match. I was just hoping to try and crack open the door for some new ideas in this allopathic world. Maybe Treybird is right, maybe it's just hopeless. For now. But keep your eyes open, chiro is only getting better, and won't fade away. Look at the research. (About both manipulations and subluxations, which do exist.)And please, I forget who said something about radiology....please take a look at that text I mentioned. It's a really good radiology text!
As for the military...well, we are working on that as well. A bill just passed this fall actually that gives us coverage for Vets. Things will change there too. And I know that our belief and our patients belief in the treatment doesn't constitute "proof", but it doesn't mean that it doesn't work either. It does work. I think a lot of people don't go to chiros because their docs put them down so much! But that's just me.
As for all you PT's, I definitely hit a nerve...for that I apologize. I have never been to PT school. I worked in a PT clinic once, but that was unlike everything you all have mentioned. However, NONE of you have been to chiro school either. You are just repeating what you have heard about chiros. I realize that there is (quite a bit of) friction between the two professions. I really think it's unnecessary to put chiros down when you don't have all the facts. Why would you want to limit chiros scope of practice? Why wouldn't you want all the tools to help your patient, no matter what discipline? Because it'll hurt your practice, that's why. We're good, we're good, but we're not out for acceptance from the allopathic field (although most of us do enjoy working with you...), we are only seeking the satisfaction of our patients.
Treybird, I think that is awesome you wanna go into the AF, good luck! And good luck to all of you too. I was just trying to plant a seed, that's all. :) TTFN
P.S. NOT ALL OF US RUN UP INSURANCE BILLS, CLAIM WE CAN CURE CANCER

Anyone else looking for some good radiology? Check out anything written by Russel Erhardt, DC, DACBR. I took his 100 hour post-graduate X-ray seminar series and the guy was awesome. And apparently the medical profession thought so too because he used to teach to medical radiologists on a regular basis. Did anyone say that Chiros shouldn't be radiologists??

Hey, I have an idea. Would any of you PT's like to get adjusted?? Seriously, if you are ever in Ft. Wayne, IN, please stop by my office and we'll take care of you. I'll even light the voodoo candles I keep in my office and make sure the office Pagen priest is present so that nothing goes wrong....ha ha...those silly Chiros. Who do they think they are? :cool:

Wow, you guys are in your OWN LITTLE WORLD OF DENIAL aren't you???

I have posted many illegitimate claims and outrageous sayings by chiropractors and yet all I hear is "PT sucks, we work with back surgeons, we rule". Good arguments.

I don't need to go to chiropractic school to be convinced of its poor admission standards or shoddy science requirements and/or teachings! Much similar to the fact I don't need to get a combined PhD/MD degree at Harvard to say that is "challenging". Do you EVEN HAVE ADMISSION REQUIREMENTS for DC programs?? Is there ANY type of self regulation or licensing exam or RE-licensing exam or CME requirments????
Here is an example of the admission standards for DC's...

A survey comparing U.S. chiropractic colleges with five other types of professional schools has found that chiropractic schools had the lowest standards. Publications and telephone inquiries were used to compile information on (a) the percentage of the previous year's entering class with a bachelor's degree, (a) the minimum grade point average (GPA) required for admission, and (c) the average GPA of the previous year's enrollees. The researchers noted that although the degree of undergraduate success may reflect the potential for professional success, further research would be needed to confirm this. The study found:

Type and Number
of Schools,% with
Bachelor's Degree, Avg. Minimum
GPA Required, Avg. GPA of Enrollees
Medical (17)
99.35%
3.16
3.56
Optometry (16)
76.88%
2.55
3.30
Osteopathic (16)
97.00%
3.00
3.26
Dental (15)
66.87%
2.79
3.13
Podiatry (7)
89.40%
2.76
3.06
Chiropractic (16)
42.25%
2.38
2.90

Reference
Doxey TT, Phillips RB. Comparison of entrance requirements for health care professions. Journal of Manipulative and Physiological Therapeutics 20:86-91, 1997.

Ya know, and here is a quote from ONE OF YOUR OWN (very hokey) JOURNALS! Quoted from from Matthew McCoy, D.C., editor of the Journal of Vertebral Subluxation Research, who said (in part):

"Want to know what really makes me mad as hell? We have probably less than 100 full time researchers in the chiropractic profession and we can't even afford to pay them a livable wage. The least we should be able to do is rely on our research journals, foundations and institutions to make sure idiots like this do not work in our profession. Their obvious skewing of data, mining of the literature and political agendas are obvious to anyone with a head just a tad sharper than a bowling ball. . . .

As for DIAGNOSING in Indiana?? Diagnosing what? Secondly, PTs can manipulate in Indiana, I didn't know this until I spoke at the State House, but many of them ARE manipulating. It is just termed a grade 4 mobilization but I saw it, it is the EXACT same thing!
Finally, instead of using POLITICAL means of increasing my health care practice act, I decided to return to school. I suggest that to any Allied Health professional (PT, PA, NP, DC) as apposed to using the law to meet an agenda. I am glad you are doing this Trey. (By the way, it is nearly May, I honestly doubt IU will be able to give you a spot. THey are pretty competitive at this point, but good luck anyway.)
Trey, don't forget I am a PT that is now a DO...I think I know how to manipulate...I'll save the gas to drive elsewhere.

I have one question.

That chiropractor person said this...

"How you can even slam chiropractic when half of medicines used today are not properly tested causing patient death from complications is beyond me."

Half of all medicines aren't properly tested? You sure about your figures?

No, actually IU is still accepting, but thanks for your typical pearls of wisdom. Fortunately I don't get my self-esteem from PT's. I'll let you know when that acceptance call comes through. Oh, wait, you'll be busy pretending to be a physician. I don't remember anyone I know going to a PT for an adjustment. It's kind of cute how you like to pretend that you PT's can adjust like Chiropractors. It's like watching a little kid pretend to be like his daddy. And I'm sure that all your 1/2 year of DO experience has made you much more competent at adjusting than most Chiros b/c, as you already know, YOU ARE GOD!!!

WishUponAStar: I'm sorry, what did you say the stats were? What are the efficacy and death stats on medicine?? Ok, maybe not 50%, what 25%? even 10%? Hmm, could you campare that to Chiropractic's efficacy and death stats?

I LOVE this letter from the Dept of Health & Human Services:

<a href="http://www.worldchiropracticalliance.org/media/hhsletter.htm" target="_blank">http://www.worldchiropracticalliance.org/media/hhsletter.htm</a>

PT's skunked AGAIN.

VA bill passes Senate
Final wording covers subluxation correction

On Dec. 20, 2001, the U.S. Senate voted to approve a bill that would make chiropractic
available through the Veterans Affairs health system. The vote took place days after the
House of Representatives gave its approval of the bill, containing language that permits
chiropractors to provide subluxation correction.

Amazing how the govenrment would offer coverage for a service that, according to the PT's and some DO's, doesn't exist. Must be more evidence of the government wasting our tax dollars on non-entities. Oh, no, it must be that overwhelming political pull that Chiros have over the AMA.

<img border="0" alt="[Clappy]" title="" src="graemlins/clappy.gif" />

I LOVE this letter from the Dept of Health & Human Services:

<a href="http://www.worldchiropracticalliance.org/media/hhsletter.htm" target="_blank">http://www.worldchiropracticalliance.org/media/hhsletter.htm</a>

PT's skunked AGAIN.

VA bill passes Senate
Final wording covers subluxation correction

On Dec. 20, 2001, the U.S. Senate voted to approve a bill that would make chiropractic
available through the Veterans Affairs health system. The vote took place days after the
House of Representatives gave its approval of the bill, containing language that permits
chiropractors to provide subluxation correction.

Amazing how the govenrment would offer coverage for a service that, according to the PT's and some DO's, doesn't exist. Must be more evidence of the government wasting our tax dollars on non-entities. Oh, no, it must be that overwhelming political pull that Chiros have over the AMA.

<img border="0" alt="[Clappy]" title="" src="graemlins/clappy.gif" />

Let's look at the CHIROPRACTIC DEFINITION OF SUBLUXATION (not the medical definition):

In 1973, Congress authorized payment under Medicare for chiropractic treatment of "subluxations demonstrated by x-rays to exist." In 1972, to enable payment, chiropractors held a consensus conference that redefined "subluxations" to include common findings that others could see. The document, several pages long, described the supposed x-ray manifestations of 18 types of "subluxations," including "flexion malposition," "extension malposition," "lateral flexion malposition," "rotational malposition," "hypomobility" (also called "fixation subluxation"), "hypermobility," "aberrant motion," "altered interosseous spacing," "foraminal occlusion," scoliosis, and several conditions in which "gross displacements" are evident [4]. I have been unable to determine how many billions of dollars chiropractors have received from Medicare since the law took effect.

Some of these terms are fancy names for the minor degenerative changes that occur as people age. The conditions often have nothing to do with a patient's symptoms and are not changed by chiropractic treatment. Some, as acknowledged by the conferees, are not even visible on x-ray films. In 1997, Congress amended the law to permit payment for subluxations diagnosed by other means -- a policy scheduled to take effect on January 1, 2000.

Chiropractors also differ about how to find "subluxations" and where they are located. In addition to seeing them on x-ray films, chiropractors say they can find them by: (a) feeling the spine with their hand, (b) measuring skin temperature near the spine with an instrument, (c) concluding that one of the patient's legs is "functionally" longer than the other, (d) studying the shadows produced by a device that projects a beam of light onto the patient's back, (e) weighing the patient on special scales., and/or (f) detecting "nerve irritation" with a device. Some subluxation-based chiropractors say that subluxations at the top of the spine are the ones that count [A, B] some focus on the bottom of the spine, some work at both ends, and others locate and treat them throughout the spine. Undercover investigations in which many chiropractors have examined the same patient have found that the diagnoses and proposed treatments differed greatly from one practitioner to another.

Subluxation is also a medical term. The medical definition is incomplete or partial dislocation -- a condition, visible on x-ray films, in which the bony surfaces of a joint no longer face each other exactly but remain partially aligned. No such condition can be corrected by chiropractic treatment.

Two years ago, in an attempt to "unify" chiropractic terminology, the Association of Chiropractic Colleges issued the following definition:

A subluxation is a complex of functional and/or structural and or pathological articular changes that compromise neural integrity and may influence organ system and general health.

In 1997, the Foundation for Chiropractic Education and Research issued a pamphlet called "Subluxation: What It Means to You," which states:

What the above means is that a subluxation is a joint problem (whether a problem with the way the joint is functioning, a physical problem with the joint, or a combination of any of these) that affects the function of nerves and therefore affect the body's organs and general health.
In the late 1980s, the Vertebral Subluxation Research Institute (VSRI) was launched by Terry Rondberg, D.C., of Chandler, Arizona. Rondberg is president of the World Chiropractic Alliance (WCA), a group that promotes subluxation-based practice and is president of Chiropractic Benefit Services, a malpractice company that insures subluxation-based chiropractors. He also publishes The Chiropractic Journal (a newspaper for chiropractors), the Journal of Vertebral Subluxation Research and Health Watch (a newsletter that attacks what it considers to be "the dangers and abuses of medical and drug interests."). VSRI taught chiropractors how to recruit "research volunteers" and convert them into lifetime chiropractic patients. Its chiropractor clients were instructed to use telemarketing and other approaches to ask people to volunteer for a nationwide study on spinal conditions. During the first office visit they would be examined and given a brochure -- "The Silent Killer" -- which explains how subluxations can be caused by physical, chemical, and emotional trauma. (The brochure claimed, for example, that food additives, air pollutants, spoiled food, fear, worry, hate, greed, sadness, grief, emotional shock, and severe disappointment can cause muscle spasms that result in subluxations.) During the second visit, they would be advised to have their subluxations treated. TheVSRI program was concluded in 1991 [6]. A subsequent WCA survey found that 65% of members who responded said that their patient education material referred to the vertebral subluxation as the "silent killer."

Wow, that is alot of deep crap.
Anyway, Trey, I was truly saying "good luck", IU is a great school (as I have worked with many of their students) and you should be very proud if you went to medical school there!

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Treybird:
<strong>Oh, wait, you'll be busy pretending to be a physician. I don't remember anyone I know going to a PT for an adjustment. It's kind of cute how you like to pretend that you PT's can adjust like Chiropractors. It's like watching a little kid pretend to be like his daddy. And I'm sure that all your 1/2 year of DO experience has made you much more competent at adjusting than most Chiros b/c, as you already know, YOU ARE GOD!!!

WishUponAStar: I'm sorry, what did you say the stats were? What are the efficacy and death stats on medicine?? Ok, maybe not 50%, what 25%? even 10%? Hmm, could you campare that to Chiropractic's efficacy and death stats?</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I think that it's a little ironic, that a DC (who claims to be a PCP) is jeering at the 4th year med student "playing doctor." Taber's defines a primary care as "Integrated, accessible,health care, provided where the patient first seeks medical assistance, by clinicians, who are responsible for most of a patient's personal health care, including health maintenance, therapy during illnesses, and consultation with specialists." I can not think of one time where I have seen a DC treat a common illness such as CHF, OM, CAD, pneumonia, URTI, UTI, or DM. I have yet to see a DC directly refer a patient to a pulmonologist, a CV surgeon, or a hematologist-oncologist. As a fourth year med student, Clown guy has prescribed more medications, consulted with a larger number of specialists, ordered and interpreted more varied tests, performed more surgery, and treated a wider variety of disease than any DC. (hell, as a third year medical student, I've probably done the same.) If anyone has any performed in a manner similar to a true physician, it's been Clown guy.

Secondly, if you want to criticize the shortcomings of medicine (which you will soon be a part of), you had better have a better alternatve. I would like to see the efficacy of manipulation on any of the above conditions. Antibiotic-resistant TB? What has chiropractic done to remedy this problem? I wonder what the efficacy and mortality rate is for manipulation when used to treat status epilepticus? How about PE? Or a dissecting aorta? How about diffuse ST elevations and PR depressions? If you want to point out some problems, you'd better have a better solution. Sh*t or get off the pot.

Finally, regarding VA health and subluxations: just because it's law, doesn't mean it's scientifically sound. Edmund Crelin, a Yale anatomist, has done research on the effect of subluxations on nerve impingement. He found that for a nerve to be impinged by the spine, enough force must have been generated to fracture the spine. Hmmm.

Look, as I hope some of you can now see, the real issue here is not one of science, rather one of health policy. Regardless of whether manipulation works (as peformed by a DO, MD, DC, or PT), the question is ultimately who should have the responsibility and liability of diagnosing and treating patients?

As a DO, I have a lot of experience and success with manipulation for a variety of musculoskeletal and even some nonmusculoskeletal disorders. I think that manipulation can be a useful ADJUNCT to a variety of other treatment modalities. I am uncomfortable with non-physicians diagnosing and treating potential MEDICAL problems.

If a DC wants to work with a group of spine surgeons, fine; power to him. I will bet you ANY amount of money that the DC does not get the "first crack" at working up patients. I've seen this practice model in action before: Patients present a multispecialty group are evaluated by a surgeon or physiatrist who determines what the underlying problem is any refers the patient within the group to the appropriate professional: PT, OT, physiatry, ortho or neurosurgery, or manual medicine. In these situations, the DC or other manual therapist is working under the supervision of a medically trained physician who has already "worked-up" the patient.

As for the VA bill, it was stalled by efforts of the AMA and AOA:

<a href="http://www.chirobase.org/08Legal/VA/aoa.html" target="_blank">http://www.chirobase.org/08Legal/VA/aoa.html</a>

<a href="http://www.chirobase.org/08Legal/VA/ama.html" target="_blank">http://www.chirobase.org/08Legal/VA/ama.html</a>

The real issue is how much scope of practice are medically-trained doctors going to let other groups co-opt? Think about it...The chiropractic profession is not interested in working "cooperatively" with organized medicine. Hell, no! They want to act in the best interest of their members by expanding chiropractic scope of practice and reimbursement. They would even like to restrict manipulation to DC's only when, in fact, DO's were the first group to professionalize the practice of manipulation in the United States, and not one study exists showing that DC's are intrinsically better trained to perform it! It's not about science people!!

<a href="http://www.aoa-net.org/Government/stateaffairs/spinalup200.htm" target="_blank">http://www.aoa-net.org/Government/stateaffairs/spinalup200.htm</a>

<a href="http://www.chiroweb.com/archives/17/17/20.html" target="_blank">http://www.chiroweb.com/archives/17/17/20.html</a>

<a href="http://www.va.gov/OCA/testimony/03oc00FM_USA.htm" target="_blank">http://www.va.gov/OCA/testimony/03oc00FM_USA.htm</a>

<a href="http://www.amerchiro.org/government/va/fringe_100900.shtml" target="_blank">http://www.amerchiro.org/government/va/fringe_100900.shtml</a>

Ponyboy (from the Outsiders, right??? how creative)

Finally, regarding VA health and subluxations: just because it's law, doesn't mean it's
scientifically sound. Edmund Crelin, a Yale anatomist, has done research on the effect
of subluxations on nerve impingement. He found that for a nerve to be impinged by
the spine, enough force must have been generated to fracture the spine. Hmmm.

So, are you saying that when the FDA okays a drug, or medical procedure, that doesn't necessarily mean it's scientifically sound?? So, just because you, as a physician, use some medical technique or drug, that doesn't mean it's physiologically, scientifically, rationally, or logically sound. Come on, you can't come up with something better than that?

Are you still trying to define Chiropractic by the foot-on-the-garden-hose theory??? Man, we abandoned that theory 50 years ago. Where ya been??? Try reading about the central integration theory instead. There's a little neurology involved so break out your little neuro textbook and if your going to slam Chiropractic, at least do it in this century!!

I think that it's a little ironic, that a DC (who claims to be a PCP) is jeering at the 4th year med student "playing doctor." Are you that hurting for irony in your life?? Eat some leafy green vegetables, esp. spinach, and you get all the irony you need.

I can not think of one time where I have seen a DC treat a common illness such as CHF,
OM, CAD, pneumonia, URTI, UTI, or DM. I have yet to see a DC directly refer a patient to a pulmonologist, a CV surgeon, or a hematologist-oncologist.

You never will see a Chiropractor treat those conditions. It's not within our scope of practice, but as far as the referring goes, when did you work for a Chiropractor before?? In all your experience with DC's, you worked with one on a daily absis when??? Maybe no Chiro has ever referrred to YOU. I've referred many, many times. Ok, short list of the conditions I've diagnosed (b/c I can in Indiana) and referred on for medical care (conditions the family docs MISSED, I might add): popliteal blood clot (saved her life), prostate cancer that had spread to the coxa, rib fracture missed by the company MD, gall stones (denied by the patients MD), need I go on Mr. I'm-the-expert-on-what-every-chiros-does-all-the-time-even-though-I've-never-worked-with-one? Now, before you go off on a snit, am I saying that Chiro's haven't made mistakes??? Absolutely not. But it definately goes both ways, and yes, for the 11 hundredth time, chiros can diagnose. Whether you rant and rave over we can or can't, in most states we can. Deal with it.
-------------------------------------------

Clown: What the above means is that a subluxation is a joint problem
It is a joint problem, with a neurological and muscular component. Again, go read up on the central integration theory and it will explain it all to you. If you are serious about some anatomical schooling, then send me an e-mail and we can discuss it off the record. For me, a subluxation is a philisophical concept. I use strictly motion palpation, ortho-/neuro analysis, subjective complaint, etc., to decide where I adjust the patient. The health of a joint is determined by how well it moves. I use x-rays to rule out pathology. Some of the Chiro organizations are rooted in philosophy. But obviously the Chiropractic profession is fractured in deciding who represents them, so the WCA does not represent everyone. It doesn't represent me. None of them do. There are many, many MD's that are not in the AMA and the AMA does not speak for every MD. If you want to talk about me and what I think and I how I treat patients (or refer as needed) then let's have it. I have an excellent working relationship with several MD's and DO's in Ft. Wayne. If Chiropractic was so dangerous and we are not to be trusted b/c of our incompetence, then why the referrals to me?? That's all I'm asking. Are Chiro's a threat to your self-esteem or professional identity? If not, then learn to coexist b/c we're not going away.

By the way, thank you for wishing me luck. My interview really rocked. The last two Chiros that went to IU were ranked 1 and 2 in their class. I interviewed late so I didn't expect to hear anything too quickly. I should know by June 1. We'll see.

TB

The chiropractic profession is not interested in working "cooperatively" with organized medicine.
If you mean become subservient to the medical profession, no we're not cooperative. When you're ready to treat us like peers, then yes, I'm all for it. But we're not "beneath" the god-like medical ego. We are a distinct profession. You're just PO'd that the DO profession sold out to the medical profession 100 years ago. We decided to stay and fight for autonomoy. Sounds like you're bitter about that. By the way, did you know that there are many MD's out there who think of you DO's as second-class citizens? So, I guess the law of survival states that you need to step on someone else to feel some sort of professional validation. Face it, you've met an MD or two who gave you little respect as a DO...fess up.

They would even like to restrict manipulation to DC's
Not true. I've never heard any DC organization call for the restriction of manipulation from DO's, just PT's. Are you paranoid?

not one study exists showing that DC's are intrinsically better trained to perform it! It's not about science people!!
That's right, it's common knowledge. No study needed. Kind of like, "did you know that the sky is blue?" "Oh, wait, better set up a study on that." Again, I refer to the fact that I receive referrals from DO's in my area. Why do you think that is? Could it be that I've adjusted more people than them? Practice makes perfect, and I'm getting close, bay-bee.

TB

Couldn't have said it better myself, Trey. Just one more note, there are chiro schools in the world beyond the US and Canada...In Austrailia, New Zealand, Europe.... Lady Di even had her own personal DC. More and more schools are becoming university based, as well. Yes, we have had an interesting and self destructive past (and we're still here..hmmm), I'm the first to admit it, but things are on the rise and getting better EVERYDAY. You're in danger of getting blindsided with that tunnel vision.

OH! and Mr. Happy, about that JMPT article, that is great. I think it's awesome that a DC is trying to draw some attention to the fact that we need more research. He's only trying to better our profession. And the profession, is only getting better. I just thinks it's odd you think JMPT is so hokey when DO's use, read, and sumbit to it too.

Well, it is nice to see you are actually addressing issues as apposed to avoiding them and saying absolutely ridiculous things about therapists and Physicians.

Unfortunately the educational aspect and other outrageous claims are still at the core of the chiropractic problem. The articles I listed were just an example of the problems of chiropractic science...a problem that they continue to compound.
Undoubtedly, the bogus claims, shoddy science, and poor admission standards have hurt the credibility of your profession.
And if there still remains overuse of x-rays, anti-immunization propaganda, vetrinary chiropractic, activator methods, pediatric manipulation to aid ADHD, homeopathic treatments, "nutrition therapies" and chelation therapies...chiropractic will NEVER be taken seriously.
By the way, while I am glad that you are performing physical exams on your patients and aiding in finding medical diagnoses...realize that is what ANY allied/nursing care professional is SUPPOSED TO DO! When I was a PT, I aided the surgeons in making the diagnosis,or in the discovery of infection etc. No big deal, that is what everyone does! As far as lifesaving...well, I really think you were being observant and helpful rather than heroic. It is our job.

And by the way, remember, you MAY BE A DO someday Trey, I wouldn't bash them too much...you haven't even passed your FIRST exam yet! You have a long way to go regardless of the DO or MD route...being humble will get you far...because WE ALL THOUGHT we would dominate medical school, and that is a bit harder than one may think.

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Treybird:
<strong>
So, are you saying that when the FDA okays a drug, or medical procedure, that doesn't necessarily mean it's scientifically sound?? So, just because you, as a physician, use some medical technique or drug, that doesn't mean it's physiologically, scientifically, rationally, or logically sound. Come on, you can't come up with something better than that?

You never will see a Chiropractor treat those conditions. It's not within our scope of practice, but as far as the referring goes, when did you work for a Chiropractor before?? In all your experience with DC's, you worked with one on a daily absis when??? Maybe no Chiro has ever referrred to YOU. I've referred many, many times. Ok, short list of the conditions I've diagnosed (b/c I can in Indiana) and referred on for medical care (conditions the family docs MISSED, I might add): popliteal blood clot (saved her life), prostate cancer that had spread to the coxa, rib fracture missed by the company MD, gall stones (denied by the patients MD), need I go on Mr. I'm-the-expert-on-what-every-chiros-does-all-the-time-even-though-I've-never-worked-with-one? Now, before you go off on a snit, am I saying that Chiro's haven't made mistakes??? Absolutely not. But it definately goes both ways, and yes, for the 11 hundredth time, chiros can diagnose. Whether you rant and rave over we can or can't, in most states we can. Deal with it.
TB</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">There is a large difference between the FDA and the senate passing laws on billing rights. The FDA is responsible for consumer safety of patients and makes its approvals based on scientific evidence. The senate can pass whatever bill they want without scientific knowledge (and depending on who pays them the most money).

My knowledge from chiropractors comes from my girlfriend's father (a DC) who I used to work for. Also, when I speak of referrals, I mean bonafide, worked up referrals. Did you phone up the cancer institute and schedule an appointment with the oncologist, send him a letter describing the PSA, your findings on the rectal exam (did you do a rectal?), and chest x-ray? Did you order the liver panel, the Alk Phos, and interpret the abd U/S before you phoned the general surgeon? Anyone can put a label on something and call it a diagnosis. But what really matters is if the diagnosis and referral is correct and worked-up. I have yet to see one patient who has been sent to the hospital or the clinic with a good diagnosis and work-up from a DC and I have never seen my former boss send a patient directly to a specialist.

If DC's can honestly diagnose any medical condition and have it permanently on a patient's State Medical File (medicaire, medicaid, whatever), I think that it's a testament not to a DC's ability but to the laxity of regulatory affairs. A medical condition should only be diagnosed by someone who can definitively treat the disease. Just as a family doc cannot diagnose a perforated viscus unless he has performed the surgery, a DC should not be making any definitive diagnosis unless he can treat it.

Finally, if this nerve impingement stuff is so outdated, why do I find this on ChiroWeb?

"Accidents, falls, stress, tension, overexertion, and countless other factors can result in a displacements or derangements of the spinal column, causing irritation to spinal nerve roots. These irritations are often what cause malfunctions in the human body. Chiropractic teaches that reducing or eliminating this irritation to spinal nerves can cause your body to operate more efficiently and more comfortably."

Maybe I'm not the only one who needs to get into this century.

To everyone,

I think its unfortunate that this constant "play-the-other-down" attitude exists between our chosen professions. Just the other day I went to see a chiropractor about this dull ache I get in my neck after a long day of studying. He asked me what I was studying for and when he found out that I am to be starting medical school this fall, he immediately got defensive with me. Telling me about how medicine kills people and what not. In fact, he even questioned my motives about why I wanted to go into osteopathy. He claimed that osteopathy only re-adopted OMT within the last few years. If that was true, then why do all the DOs I know, both young and old, know how to do the art? He also went on to tell me that osteopaths sold out to medicine and what not. Excuse me, but A.T. Still was a doctor (MD)in the first place. And what the heck? I didn't go to this guy to talk about osteopathy versus chiropactics. I went to see him about my neck!

My point is, our professions need to work together in order to achieve what is best for our patients. MDs/DOs need to give credit to chiropractors for helping to relieve patients' headaches and back pains, where traditional medicine has failed. And chiroprators also need to realize the limits of their practice and be able to refer a patient to a specialist when it's necessary. It works both ways. Besides what do we get by defending ourselves to one another? . . . pride? Too much of it is destructful, trust me I know. There is nothing better than a little humility now and then to help us know that we are not gods, but rather, people doing our best to help our patients.

DFrancyk

JenMac, you go girl. Thanks for the support.

And by the way, remember, you MAY BE A DO someday Trey, I wouldn't bash them too much.
I will be a DO someday and I'm not bashing the profession, just some of the ignorance within the profession. Isn't that what you're doing? Chiropractic as a profession works, even though there is ignorance within the profession. Trust me when I say that I will take that opportunity with as much humility and reverence as I did going to Chiropractic school. And when the time arises to defend DO's, I will do it with as much zeal as I do the Chiro profession. I don't take being accepted into DO school lightly and I'm excited to have that opportunity, but I won't drop my Chiro paradigm either. I know there's a tough road ahead but I know that I can conquer it, as I'm sure you did. I had an excellent basic sciences education at Palmer and I know that will make DO school easier than had I not gone. When you've gone to Palmer then you can comment on the quality of it's education. Until then, you have no idea about our level of education. The two professions, at the heart, have the same philosophy from opp sides of the same coin.

I never said that the Chiropractic profession didn't have problems. All professions do. The problem I have is with people outside the profession telling us what our limitations are. As with anything else, changes have to be made from within, and they are. The profession itself has made great strides just in the last 20 years. Some of the issues you mentioned are not mainstream Chiropractic so I won't even address them. Activator is a viable and useful technique, and vet. Chiropractic is just as valid as human. If you, as a DO, feel that spinal misalignments affect the integrity of a human, then why not an animal? Again, it is not mainstream practice and should not be performed by someone who has not been trained adequately in the field. Pediatric adjustments should be made to correct vertebral misalignment and nerve interference, and that's it. Children should not be "trated" for ADHD with an adjustment, and most Chiros will tell you that. Again, we don't treat organic diseases, only spinal misalignments. I don't know how many times I have to repeat that before it sinks in.

As far as lifesaving...well, I really think you were being observant and helpful rather than heroic. It is our job.
I never said I was heroic, but of course you would take it that way. My point was that Chiro's have the training to make such obsevrations, thank you very much.

My point is, our professions need to work together in order to achieve what is best for our
patients. MDs/DOs need to give credit to chiropractors for helping to relieve patients' headaches and back pains, where traditional medicine has failed. And chiroprators also need to realize the limits of their practice and be able to refer a patient to a specialist when it's necessary.

DFrancyk: I agree with you 100%. This has turned into a pissing contest. My point has always been it's about what's best for the patient and I agree that my profession has limitations. I am the first one to admit that if treating something is outside the scope of our practice, then refer them out ASAP. I don't believe that adjusting a patient will cure cancer, cellulitis, liver disease, etc. But most DO's/MD's have no idea what Chiropractors can do or can't do b/c you don't know what our training is. Only the Chiro profession and legal system can place those restrictions. Once you start telling us how to practice then it sounds like you're getting defensive that we're stepping onto your territory. Relax, we're not looking to steal your organic disease patients, but you can bet that 99% of the population are walking around with spinal misalignements that, if left uncorrected, will cause problems down the road.

Just like a cavity that goes undetected until it hits critical mass and causes pain, pain is a poor indicator as to whether there are spinal misalignments or not. And do you NOT think that a spinal misalignement won't affect the nervous system at that level?? Honestly?? If not, where were you in A & P? Stretching of the joint capsules and distortion of the outer 1/3 of the annulous fibrosis causes an influx of sensory info at that segemental level causing interference with the other nerves at that level, like the static you get on your cell phone going under a power line. As those nerves carry motor info to the organs and muscles innervated by that segmental level, those organs and muscles will be affected. This is an oversimplification, but it's just meant to illustrate how spinal misalignments do affect the nervous system, not just the muscles (which, by the way, are controlled colely by the nervous system. If it can affect muscles, it can affect other systems as well. Chiropractor shave traditionally vied the human body differently than medicine. I don't know why, other than differences in paradigm. BUT, I think that ultimately we compliment each other. I think that we all have a place in healthcare.

I've not heard ANY of you DO's out there point out one shortcomming of your profession. All I've heard is how bad Chiropractic is, what our limitations should be, and what changes we need to make. You admit your problems as a profession and I'll admit ours. But all you've done is attack and criticize. Of course I'm not going to bow down to that kind of attack. Give us respect and I'll give you respect. That's where it all begins. So, if any DO's or MD's would like to have a constructive dialogue, then let's do it. But don't start out attacking or we'll just end up in another pissing contest.

TB

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Treybird:
<strong>Ponyboy (from the Outsiders, right??? how creative)

Finally, regarding VA health and subluxations: just because it's law, doesn't mean it's
scientifically sound. Edmund Crelin, a Yale anatomist, has done research on the effect
of subluxations on nerve impingement. He found that for a nerve to be impinged by
the spine, enough force must have been generated to fracture the spine. Hmmm.

So, are you saying that when the FDA okays a drug, or medical procedure, that doesn't necessarily mean it's scientifically sound?? So, just because you, as a physician, use some medical technique or drug, that doesn't mean it's physiologically, scientifically, rationally, or logically sound. Come on, you can't come up with something better than that?

TB</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Ponyboy was saying that gov't approval isn't NECESSARY) Necessity and sufficiency are two different things. Sufficient conditions such as scientific testing, etc. make FDA approved drugs SOUND. Learn some logic before you apply these arguments.

mooooo

It's pretty easy to sit on the sideline and throw out a comment once in awhile, isn't it? How's that for logic? I guess you didn't read what I last wrote before your illuminating comments, eh? You feel the need to go back and start with the pissing contest again? Do you feel better now that you've gotten that off your chest? Try something constructive. :p

moooooooooooo

Oh hell, I can point out many faults with OMT education in particular...these are often shared with chiropractic, but not to the same extent.
Cranio-sacral techniques are absolute fringe techniques that have ZERO experimental proof and are shaky theoretical grounds. The continued support for this technique CONTINUES to bite DO's in the ass! The same can be said for Chapman's Points and the continued use of NON-objective measurements of spinal mobility and the absolute LACK of outcome data regarding manipulation. Other than patient satisfaction, true outcome data is lacking.
I was the FIRST to criticize these things in school...as a PT you have research out the WAZOO...you had better be able to document objective data or you simply will not get reimbursed. I did a fair share of research as a student, but OMT research has a tendency to be "soft", as with chiropractic. That simply will not do.

Come on dude...the Activator Method?! THat is right up there with magnets and copper wrist bands. As far as pediatric manipulation, well, I can tell you haven't done much true academic research. Interrater reliability for palpatory diagnosis is absolutely terrible...terrible. Pediatric manipulation has NO PLACE in medicine of any sort.

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Treybird:
<strong>It's pretty easy to sit on the sideline and throw out a comment once in awhile, isn't it? How's that for logic? I guess you didn't read what I last wrote before your illuminating comments, eh? You feel the need to go back and start with the pissing contest again? Do you feel better now that you've gotten that off your chest? Try something constructive. :p

moooooooooooo</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Maybe cuz I don't sit here and check this thread every five seconds.

Happy Clown:

I agree that there still needs to be more specific research, and it's nice to see that Palmer is finally starting to get that done, along with National College near Chicago. The problem to date, and you have to agree with me here, is that we don't have the high dollars supplied by drug companies for research. We're only now starting to get NIH funding. It's not for a lack of interest in research b/c most big schools, like Palmer, have dedicated some serious space towards research, it's a lack of funding.

I know manipulation works because I've seen it work. And I'm talking about the mainstream techniques that are taught as standard in most schools, not the fringe techniques. I will be the first to admit that there are some serious nut job techniques out there, like neuro-emotional technique (i.e. channeling energy from God or some such etheral electricity source). I guess , like anything else, there are fringe elements, but they are not representative of the mainstream. I have a very big problem with Chiros who claim they can cure things. Most will tell you they can't and most have very good relationships with local docs in case they run into something they need to refer out. My only goal is to get patients out of pain and back to feeling better. Chiropractics biggest problem is unification. It's our downfall and one of the reasons we can't always get things done. There was a split early on in the profession and we've never recovered. It's one of the things I truly hate about my profession. Activator is good for children and old people b/c it's very specific and can be less invasive. Just for the record, I don't use it. I hate having it done to me b/c it hurts and it's annoying, but some people have walked in and out my door b/c I didn't do activator. I really don't know enough about it to comment beyond that. I was never interested in it b/c I like to use my hands, not a little spring-like door stopper.

I agree that interdoctor palpation reliability does suck. 100 different DO's/DC's could potentially find 100 different things but hopefully the doc uses all resources necessary to find where the problems are, including checking reflexes, ROM, EMG studies, postural analysis, ortho/neuro tests, etc. I referred a patient to a neurologist for a second opinion and the patient told me that this doc did the same exact ortho-neuro tests and told her the same exact thing I did, only he charged her about $400 more. The point is that hopefully most DO's and DC's are truly workinig the patient up to find out where the problems are.

So, they must have loved you in DO school. Why don't you get into research since it sounds like you're very oriented in that direction. I hate doing research. It bores the hell out of me. But, I like to read up on studies to see what's going on. Have you ever checked out the JMPT or Spine? Good mags. So, are you in practice now or residency?

TB

moooooo, let it go guy....it's over...the dialogue has begun....try being constructive.

Oh, I have been interested in research, except mine apparently was a bit too much for the hard core osteopaths...it included "Q-angle measurements in male and females and correlation with patello-femoral disorders?"...called "too reductionistic and not osteopathic enough" "3 techniques for measuring forward flexion and the reliability of each to determine pathology"...called "not osteopathic enough". also indwelling elctrode determination of muscle activation during select "muscle energy techniques". Also, a study determining if "touch alone creates a considerable plecebo affect", this would occur if a defined medical diagnosis was given, medical treatment of NSAIDS and mild narcotics was kept constant between the 2 groups, except the control group would have NO HUMAN TOUCH during evaluation and treatment, while the experimental group would have "sham treatment".

The only way to PROVE manipulation really works, is to create objective data for it...AND TO TRY TO DISPROVE IT.
These were some of my projects, and proved a bit too scary for funding. But otherwise, you are left with soft data and testimonials. Not good. Oh, I believe manipulation works to a degree...but as a PT (when I did not manipulate; but did perform PNF {muscle energy} and intense soft tissue and myofascial techniques), I was able to get 80-90% of my low back pain and cervical pain patients 75% better (subjectively measured with return to ADL'S with less pain) in roughly 3-5 visits...2 weeks. That simply begged the question regarding outcome data for LBP patients and technique specific data. My patients got better VERY quickly with virtual NO return to therapy other than the 5 visits. (except for fibromyalgia/chronic pain patients which have a CONSIDERABLE psychiatric component and overall low aerobic/anaerobic tolerance)

I am an Emergency Medicine resident (start in june) with intention of doing a fellowship in Sports Med.

I think your research ideas sound great. Are you sure you don't want to do research at Palmer. We'd love to have you. There is definately a placebo affect by putting your hands on someone. No doubt about it. But you can't do reasearch in a vacuum b/c life is not in a vacuum. Our minds have a lot of control over the body, pain, healing, etc. and touch. Even though it may only be a placebo effect, and unknown variable, it is an important component in treatment. Think how more relaxed your patients are when you come over, talk to them and reassure them that they'll be alright. They can relax a little, if they're not uncouncsious or in shock, and decrease some of the stress hormones that are making things worse. Know what I mean? I understand that you want to isolate and get the direct skinny on whether manipulation works, but can you really rule out the human element of it all? I think research should be done in a way that mimics the real life situation. Maybe that's what case studies are for. My naivete coming through. That's why I don't do reasearch.

My undergrad degree is in exercise physiology (from Rutgers) and I've been thinking about Sports Medicine via Family Practice. It all depends on what the Air Force allows me to do. Where did you go to school and where are you doing your residency?

TB

Treybird - I had a quick question for you. You stated previously that as a DC you read your own Xrays. On my clinical rotations, the MD/DO's will make their own interpretations, and then wait for comfirmation from the radiologist. Do you still need a radiologist peform an "official" read, or is your interpretation the final word? If so, does this affect your malpractice premiums?

As a DC we are fully qualified to take and read x-rays, which, I assume is part of our malpractice insurance. They've never asked my whether I read my own X-rays or not and I get charged just the same. We had a year and a half of X-ray analysis in school and we are tested on radiology both nationally and on state license exams. I, however, chose not to take my own X-rays, because I can't afford a unit, so all X-rays I require are automatically referred out and read by a radiologist. I am confident in my Chiropractic analysis of X-ray and know enough pathology to know when to refer something out for a second opinion. I won't diagnose pathology. I will review any X-rays I order for my own knowledge and will call and ask the radiologist any questions I have. One of the biggest things that Chiros get sued for is missing a diagnosis. Chiros can go on in their post-grad education and specialize in radiology. It is a 3 year residency and they are just as qualified as any medical radiologist.

TB

Come on dude, you were doing really well there until the "just as qualified as a medical radiologist" stuff came about. But that is ok.
As a chiropractor, one deals with selected pathology...typically that of the spine. And in a court of law, even IF you missed a bone carcinoma, you would NOT be held to the same standards as a Radiologist. A "chiropractic radiologist" WOULD NEVER be considered an expert witness...nor would their diagnosis hold up in a hospital.

To answer the question simply, a radiologist or orthopedist ALWAYS will re-order and re-interpret chiropracic radiographs...always. A chiropractic x-ray or interpretation does NOT HOLD UP medically.
I have seen it time and time again in FP, orthopedics, and in Radiology. That is just the way it is in real life.
Radiology is one of the top 5 most difficult residencies to achieve in post graduate medical training...primarily because of their extensive knowledge of anatomy and in particular PATHOLOGY of every sort.

I went to Indiana University for undergrad, went to U. of St. Augustine for graduate work, went to UHS for medical school and to Wright State for Residency. Sorry if the above sounds harsh, it is not intended to incite.

Well, all I can tell you is what I've been told. I have no practical experience as a chiro radiologist so I'd have to defer you to one b/c they could tell you more about what they do, their level of education, standards of practice and legality. As I said, I don't take my own X-rays so for me it's a non-issue.

Trust me, if we missed a carcinoma on an x-ray that we took, you'd better believe that we'd be held accountable. With our level of education in X-ray, granted not nearly like a radiologist, but more than the average MD or DO, we would legally be held accountable. I've heard about docs getting sued b/c they missed a pathology on an X-ray. Now, some states limit where you can X-ray (like Michigan - only the spine), but in Indiana I can X-ray anything and whatever I X-ray I'm responsible for. It's part of the license. Believe it or not we do have a lot of responsibilties in our practice, even if we're second guessed by the medical profession.

Radiology is one of the residencies I'm currently considering. What do you know about interventional neurovascular radiology? I've heard it's pretty cool. I really do like radiology but would probably miss the direct patient contect.

TB

Ok I will address 2 things.

First, as a medical student (especially years 3 and 4) then as a physician, you will be bombarded with radiographs daily. From the most mundane chest film, to CT's of the head or MRI's of the shoulder. Every physician and every student will see his/her share of fractures and lucunar infarcts. It is even on step 2 of the USMLE and COMLEX for medical students...regardless if you took a radiology rotation or not. Because of the way medicine is percieved if a DC misses a carcinoma...sure, he can be sued but not for NEARLY as much as if he was MD/DO...the expectations are FAR FAR MORE. No one EXPECTS the DC to know the beginning osteolytic changes of metastatic carcinoma. Medico-legal expectations and standards are far different. You can sue anyone, but if the standards are higher for one profession...so are the expectations.

Second, radiology is a great field. Residencies are VERY difficult to get into these days...and invasive fellowships are competative. A radiology residency I believe is 3-4 years after the internship year. <a href="http://www.scutwork.com" target="_blank">www.scutwork.com</a> has a link for radiology residencies if you are interested.

In Indiana there's a cap on what a person can sue for, MD or DC, but any lawyer, regardles of what they EXPECT, will sue for the max amount and yes, a Chiro is trained to spot the beginnings of osteolytic or osteoblastic carcinoma, as well as most other bone pathologies. A Chiro will get sued for as much as any doctor, we just don't get sued as often. Not because we're better, but b/c people are on the prowl when it comes to suing MD's. They almost expect to sue if some little thing goes wrong, hence the cap.

Anybody who is licensed to take and read X-rays is held to the same standard regardless of whether you're an MD or DC. If you don't agree with this then I can put you in touch with the lawyers who serve the ACA. We are told this every year when we have our risk management updates. I doubt they're just telling us this to boost our egos. I get the feeling that you think we have less standards or that there are less expectations placed on Chiros. I can tell you that this is not true as I live it every day. I know what the expectations are and I know what the legalities are. And I know that if I screw up, I'm just as liable for that screw up as you, albeit mine are not life-threatening. Research aside, why do you have such a negative attitude towards Chiropractic? I mean it just sounds very condescending. Have you been to one? Did you have a bad experience with one? If you're not happy with the DO research then why did you become a DO and not an MD?

Ok, tell me you're NOT a Bobby Knight fan. I actually rooted for IU in the Final Four. Well, Mike Davis actually. Are you from Indiana? Why did you choose ER medicine?

Taken from the Chiropractic Act of Indiana:
"However, chiropractic does not include any of the following:
(A) prescription or administration of legend drugs or other controlled substances;
(B) performing of incisive surgery or internal or external cauterization;
(C) penetration of the skin with a needle or other instrument for any purpose except for the purpose of blood analysis;
(D) use of colonic irrigations, plasmatics, ionizing radiation therapy, or radionics;
(E) conducting invasive diagnostic tests or analysis of body fluids except for urinalysis;
(F) the taking of x-rays of any organ other than the vertebral column and extremities ; and
(G) the treatment or attempt to treat infectious diseases, endocrine disorders, or atypical or abnormal histology."

The law itself does not allow DC's to interpret anything but skeletal radiography. How can DC radiologists be anywhere near the same level as medical radiologists? How can DC's have anywhere near the same exposure to radiologic pathology as MD/DO's?

Secondly, in regards to level of training:
EXPERT WITNESS CASELAW: STATE CASE - INDIANA
Chiropractor on Medical Reports of Physicians
Faulkner v. Markkay of Indiana, Inc.
663 N.E.2d 798 (Ind.App. 1996)

EXPERT: Chiropractor: Phillip Sprinkle
ISSUE: Admissibility

The Indiana Court dealt with a customer who slipped and fell in a grocery store.
The issue for expert testimony was whether a chiropractor, Sprinkle, would be permitted to restate the opinions of orthopedic surgeons and a neurosurgeon upon who he relied.
The court found as the chiropractor lacked similar training and could not be cross examined on this issue, he would not be permitted to restate the opinions of the doctors.
The court stated:
The evidence rules do not permit the admission of materials, relied upon by an expert witness, for the truth of the matters they contain if the materials are otherwise inadmissible. Here, the materials were inadmissible because Dr. Sprinkle, a doctor of chiropractic, does not have the same education, training or expertise as the physicians who prepared the reports. We cannot allow an expert's reliance on hearsay to be employed as a conduit for placing the physician's statements before the jury. The expert witness must rely on his own expertise in reaching his opinion and may not simply repeat opinions of others.

Who said anything about X-raying organs? Didn't I say the laws varied from state to state?? Did I ever say that a Chiropractor was considered an expert witness over a neurologist or orthopedist?? Hmmm, maybe what I said was that I referred patients to an orthopedist or neurologist for further study. Wouldn't that indicate that they were the specialist? Did the voices in your head indicate that I said something different?

PonyBOY get a life. You're like my little dog who gets excitied and tinkles on strangers. Can you do anything constructive? Try putting that much studying and research into your work in medicine b/c your opinion means absolutely nothing to me, or my professional peers, for what I do. Glad it irked you enough to do some research though. Thanks for that update on Indiana law. Can you tell me the laws on Illinois since I may be going to school there and I need to know what to do to transfer my license. Oh, check out NJ too while your at it. Thanks. Keep up the good work. What would the medical profession do without your watchdog diligence?

TB

Can anybody move beyond the "my johnson is bigger than your johnson" stage and have an open, non-attacking, mutually respectful conversation?? Is that too hard, cause this is really getting old. You must feel all mighty against one Chiropractor.

Hi Treybird,

I am about to graduate from TUCOM in a few weeks, and I start internal medicine at UC Irvine in southern cal in June.

Sorry it took me a while to get back to you. I am enjoying this thread though.

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Treybird:
<strong>Who said anything about X-raying organs? Didn't I say the laws varied from state to state?? Did I ever say that a Chiropractor was considered an expert witness over a neurologist or orthopedist?? Hmmm, maybe what I said was that I referred patients to an orthopedist or neurologist for further study. Wouldn't that indicate that they were the specialist? Did the voices in your head indicate that I said something different?

PonyBOY get a life. You're like my little dog who gets excitied and tinkles on strangers. Can you do anything constructive? Try putting that much studying and research into your work in medicine b/c your opinion means absolutely nothing to me, or my professional peers, for what I do. Glad it irked you enough to do some research though. Thanks for that update on Indiana law. Can you tell me the laws on Illinois since I may be going to school there and I need to know what to do to transfer my license. Oh, check out NJ too while your at it. Thanks. Keep up the good work. What would the medical profession do without your watchdog diligence?

TB</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Look buddy, you're the one going on about how DC's get MORE training in radiology than the average MD/DO. ("With our level of education in X-ray, granted not nearly like a radiologist, but more than the average MD or DO, we would legally be held accountable.") I'm simply asking a question. How can you say that DC's have more radiology training if you don't look at anything but the bones?

You're the one who said, "I get the feeling that you think we have less standards or that there are less expectations placed on Chiros. I can tell you that this is not true as I live it every day." I simply provided information that said otherwise.

I have only presented arguements that have been backed by legal and scientific fact. But yet, you try to insult me personally? And now, you ask for an "open, non-attacking, mutually respectful conversation"? If you don't want this discussion to be a pissing contest, don't go around saying that DC's are better or as good as MD/DO's (regardless of it's veracity). Somebody will call you on it.

Look, you're always crying out for evidence-based discussion. And yet, as soon as I post evidence-based material that is contrary to some of your statements, you hurl insults and sarcasm at me. You made your statements regarding the education of DC's, I disagreed. I posted support for my disagreement, you returned with a very unprofessional reply. I have made my professional reply. Make yours.

I'm sorry but is the above post from the same person who asked for this discussion to turn into a "non-attacking, mutually respectful conversation"?

When I get respect, you'll get respect.

Do you feel that the above comments before mine were respectful? You don't feel the need to comment on anyone else's comments but mine? Whatever, dude. Must be tough all ganging up on the one Chiro. Hmmmm...how brave.

I don't agree with the post before you at all. That was uncalled for but your comments were as well. Let's try to remember the golden rule, treat others as you would like to be treated, not how others treat you.

Ouch! that was a shot below the belt. I know! Your mama so ugly.... no. How about your mama so fat..... no, nevermind.

Holy war-of-words Batman!

Back to the radiology issue. The issue being, about 2/3's of all radiographs in the hospital are of internal organs or neurological structures and 1/2 of all structures radiographs in the ED are internal organs etc...That is why Ponyboy made a case against your previous statement about "better than the average MD/DO" while reading films. We READ ALOT...and they are anything from chest xray(lungs/heart) to obstructive series (2-3 views of the abdomen) to CT of the head or pelvis. When Xrays are taken, the general concensus is that there had better be an acute problem for a patient to exposed to radiation!

I don't think we are gonna agree regarding the legal issue. I can guarantee that because the general public and professional world see the MD/DO degree more difficult to obtain and with more difficult training and standards...people expect more from them. Example...if you order a thoracic film of the spine (due to thoracic pain and a true somatic dysfunction of the spine) and you miss a dime size lesion in the right upper lobe...people WILL NOT hold you to the same standards as they would a physician! You simply do not see that type of pathology, and you certainly are not looking for it. Sure, if it was me I would try to sue you...but the amount would be alot more if it was a MD/DO missing that call.

I have never had a bad one on one experience with a chiropractor...only the legal and professional issues when I was a practicing PT. As a PT, my exroommate's brother was a DC and he told me openly about how he charged for physical therapy in his office. It was insulting because there was no therapist present...regardless of what the law allowed, I found it terribly unethical. There have been alot of other psuedoscience issues etc. Hell, I have had my fair share of debates with hard-core DO students!

Why did I ONLY apply to DO programs, well, I really did want to do research while in school. And I wanted to do Physiatry or Orthopedic Surgery (initially) and I thought I would be the REHAB KING (considering I am a PT and DO).
Then I saw the light of Emergency Medicine (ha!), it is perhaps the most challenging and fun field of medicine I have worked in. You have to know everything. Other choices would be radiology or cardiology if I had to choose.

Treybird,

I apologize for that remark being directed at you under my screen name. I assure it was not written by me...apparently i was not logged out of SDN when i left my computer and the message was posted by someone else. Again, i apologize. If you notice, i've deleted the post as well.

Scott

slindsay198, thank you and apology accepted. Good luck at PCOM. I was granted an interview there but decided to stay in the Midwest. I hear it's a great school.

happy clown, we'll just have to agree to disagree and leave it at that.
When I was going through undergrad, I did my exercise physiology internship at the Robert Wood Johnson Hospital Cardiac Rehab and was convinced that if I ever went into medicine that I would go into cardiology. Now I'm not sure. I was reading the book How To Choose A Medical Specialty and you're supposed to rank all the things your looking for in a specialty (i.e. decent time off, good money, patient contact, variety, regular hours, etc.) and I came out with emergency medicine. We'll just have to see what happens when I go through rotations. I'm still leaning heavily towards radiology and family practice. At least with FP I can still adjust my patients. What do you know about forensic psych? Did you do a psych rotation? If so, what did you think?

Have you found there to be any bias in your residency against you for being a DO? I've heard stories of that happening.

TB

dcdo, are you looking forward to IM? Where would you like to go afterwards? Did you like TUCOM? Where did you go to Chiropractic school?

TB

Treybird,

I'm pretty excited to get started, and I've wanted to do IM since the beginning of med school. Afterwards, not too sure, doubt I will subspecialize but you never know. I do like cardiology. If I stay in IM I should be able to do manipulation in the outpatient clinic. I went to LACC, graduated in 1994.

I wouldn't put too much weight in those "career choice" things...the real proof happens when you do a rotation in that specialty...here's what my last 2 years have been like:
3months floor IM
1 month OBGYN
1 month gen surg
2 months ortho surg
2 weeks rads
2 weeks anesthesiology
2 months FP
1 month cardio
1 month pulm/critical care
2 months peds EM
3 months adult EM
1 month psych
2-3 months board prep and vacation/interviews

So, by the halfway point of your 3rd year, you begin to see what you like, and don't like.
The easiest residency to get a spot in is Psychiatry (sorry psych guys) the most difficult is ortho or dermatology followed by EM and radiology.
Now, of course there is the DO only match...which is far less competative and is in primarily DO hospitals (mostly in Mich, Ohio, NY, NJ, PA, etc). I did the ACGME match, and I did feel a bit of discrimination...not alot though. I'm going to a great program in Ohio (Wright State Univ).
I found my self using ALOT of PT based stretches/excercises and postural corection in the Emerg. Dept and FP. The biggest problem with manipulation is that if you are doing a MD (ACGME) rotation...then you can't do manipulation. You obviously can't do anything your attending is not proficient with...and if you do it with out asking...trouble.

DCDO: How did you like LACC? I graduated from Palmer in '94 as well. Good year. How did you find your experiences in DO school compared to LACC? Do you plan on staying on the west coast? I've been to San Fran before, but that's been my only west coast experience. Very different lifestyle from the East coast, where I grew up. I'm NOT looking forward to the basic science stuff again but can't wait for the clinical rotations.

happy clown: I absolutely don't expect to use any manipulation during residency as I plan on doing mine in the Air Force. Using manipulation will probably be a post-AF modality. I will probably go for flight surgeon and I don't see whipping out my chiro table on the tar mac. Did you find that you had to do some tightrope walking so as to not step on any attending's toes. I've heard that it can be trying at times, to say the least. What did you think of your ob/gyn and gen surgery rotations? I've heard that surgery residents have an ungodly on-call schedule. Where the boards tough? Did you take both the COMPLEX and USMLE's? I have to take both for the AF which is why I'm hoping to get into IU. I'm much more aligned with the DO philosophy but I don't feel like jumping through all the extra hoops to do the same things as MD's. Have you read The Intern Blues yet? Great book, sucky year.

TB

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Treybird:
<strong> Did you take both the COMPLEX and USMLE's? </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">It's COMLEX.

Treybird,

LACC was pretty tough as far as DC schools go, and they were very science and rehab-inclined. Much harder than Cleveland CC as far as I know. In fact, several students transferred to a now defunct straight DC school because LACC was too "medical." It is a good place for conservative NMS oriented practitioners.

Even so, medical school was much harder. The tests were more difficult, and there weren't tons of old tests floating around, which was a good thing. Also, the competition is obviously higher. That said, you will definitely have an edge over other students since you've had to do basic sciences, and the history/physical stuff will come to you a lot quicker.

In retrospect, MD school probably would have been a better idea for me, as I didn't really learn anything in the manipulation/musculoskeletal realm that I didn't already know. I suspect this will probably be even more so for you since you have 4 years more experience than I do. However, I wouldn't want to trade the classmates I have for any others.
Taking both sets of boards is a good idea if you are considering a competitive specialty or are interested in being in California. I would take COMLEX first and then the USMLE about a week or so later, because the USMLE will be the more important test. The COMLEX can be a "dry run" of sorts. Studying for the 2 isn't any different other than needing a particular blue review book for OMM, which is a quick read.

Good luck.

I took the USMLE THEN the COMLEX...oddly enough, I got the same COMLEX grade on both steps one and two.

Surgery was surgery, ya know if you hate it you hate it, if you like it you like it.
OBGYN was awful.
Ortho was cool, but the residents were pretty tired.

Manipulation was new to me in DO school...but I could have taught the postural and many aspects of the Muscle Energy (PNF) sections. The orthopedic musculoskeletal exam WAS taught by me as part of test prep...I know my orthopedics. But that has been my contention...most manipulative evaluation techniques have such poor inter-rater reliability, that at many times I thought it was total "non science" fluff. But, it was an easy "A".

DCDO: I had a friend who went to Palmer and then the DO school in St. Louis and he said pretty much the same thing that the tests were harder. But he also said that it was alot easier b/c of his prior training. I hope so. I'll be going for my MBA as well so I hope that I don't have to kill myself with the basic science stuff. I've not heard that LACC was too medical but everyone has their own thing I guess. Some may have even thought that Palmer was too science, who knows. When I took my NY state boards I met some people from LACC. We had a pretty good time on Long Island. It was during the Jets training camp (at Hofstra U.) and we got to watch them a little on breaks. I will so not miss taking Chiro boards. Did you know that it costs close to $900 to take part 4? Screw that. They didn't have it when I graduated but my girlfriend is an RN and it cost her like $175 to take her RN board. I think we're getting shafted on that deal. Where's TUCOM? I'm with you, though. I'm really not looking forward to the manipulation classes again. I just want to nail down my clinical stuff and move on. From what I understand, DO's manipulate completely backwards from how we adjust. If Chiros do it black, DO's do it white. Plus they use a lot more muscle energy stuff than I do. Did you take a board review for the two boards or did you just study on your own? Have you had to take any national OMM practical exam like we did as Chiros? Are you doing the one year Osteopathic internship? What a pain-in-the-ass. Aren't there like 5 states that won't allow you a license unless you've done a 1-yr DO internnship? Did you find the COMLEX and USMLE's harder than parts 1 & 2 of the Chiro boards? I tool the Irene Gold board reviews and that really made it easier. I didn't take a board review for the MCAT but I know I could have done better if I had. We'll see.

Happy Clown: Did you find that the EM residency was very competitive? Isn't Wright State in OH? Did you do the one year DO internship? Does anybody do that anymore? What have you heard about CCOM, KCOM and UMDNJ-SOM? Is UHS in Des Moines, IA? Gotta love those easy "A" classes. I don't have much fear of the neurology as we were hit pretty hard with that in DC school, much more than orthopedics. I would have to say that the neurology classes were some of the hardest, but the best. If neurology wasn't so depressing than I would have considered it.

TB

I have read through all the threads here and would like to give Treybird some backup. I am a 2nd year Chiropractic student at NUHS (NCC) and can assure everyone that the curriculum is EXTREMELY INTENSE. We go to school year round with no more than 2 weeks off at a time. Although the program only takes 3 1/2 years, it is actually a 5 academic year program.

With that said, all Chiropractic schools are private; therefore need students tuition to keep the school running. This often leads to schools accepting some real questionable characters. It is these people who often perform the oddball procedures referred to in one post. Another way many schools recruit students is the no bachelors degree requirement (NUHS is the only school to my knowledge that requires a BS). I think this is absolutely rediculous for many reasons. Completing an undergraduate degree makes you a more well rounded and responsible person. I can't imagine graduating from Chiropractic school at 23 and being let out into the world to practice. I also don't know how many posters on this forum are aware of the straight/mixer issue in Chiropractic. Straight chiropractors are only concerned with adjusting spines, no matter the complaint. They are not interested in performing a history or physical/neuro exams. These are probably the docs who stroke out patients during cervical adjustments due to not recognizing the warning signs. By the way, the incidence of this is 1 in 2 million cervical adjustments- much lower than probably all surgical and pharmaceutical complications. I digress.. Many of these "straight" chiro schools are under probation for their lack of proper basic science education. Now, on the complete opposite side of the spectrum are the "mixers". We are tought in school to be primary care physicians. Now this does not mean we have the same level of training as an allopathic primary care doc, but it is damn close. We learn all relevant diagnosic tests, lab work, rehab, X-Ray, and something we blow allopaths away in- extensive classwork in nutrition.

Now, I have absolutely nothing against allopathic physicians. I visit my MD often, and I have to reservations about anyone visiting one. However, for certain conditions, there is very little or nothing that traditional medicine can do. What do the allopaths do with a patient with chronic neck/back pain? Probably give them anti-inflammatories and refer them to orthopedic surgery. This should be the absolute last resort for all patients. Chiropractors have proven they can treat many forms of musculoskeletal disorders, so why not just accept that? It is true that there was little evidence on the efficacy of chiropractic in past decades, but believe me, this is changing. NUHS has completed two multi-million dollar studies on back and neck pain in the last year. These grants came from the NIH- Now what would be the rational for giving a chiropractic school 2 multi million dollar grants if the NIH did not believe chiropractic is effective? As Treybird indicated earlier, Palmer is also undergoing many large grant research projects.

Well, I'll get off my soap box now. I welcome any comments-
niugrad

By the way, the scope of practice in Illinois for DC's states:
"The treatment of human ailments without the use of drugs and without operative surgery, as per the Illinois Medical Practice Act"
niugrad

I really really really don't want to discuss about the treatment approach to chronic neck pain. The medical differential is enormous and obviously includes more than musculoskeletal etiologies (oncology, ENT, psychiatric, rheumatological). And I really don't think you want to debate "blowing the allopaths away" regarding nutrition, ordering labs, or ordering diagnostic tests. I have stood through pimp sessions that would make your toes curl up.

Trey,
Emergency Medicine is in the top 5 for competative residencies (read Isserson's Guide to Getting a Residency)...that will help you nail down very helpful information about each specialty.

No, I am not doin the AOA internship, I do not agree with the philosophy and it offers no added benefit to a 30+ year old resident. I took both the USMLE and COMLEX board exams and obviously found them EXTREMELY challenging and I know people who failed one or the other. Praise God I don't have to take step one again!
UHS is in Kansas City MO.
All the "big" DO programs are great...each have individual problems. The only programs I would have reservations about are LECOM, Pikesville, and the newest program in development in Virginia. But all have rigorous standards to uphold and EVERYONE must pass all 3 steps of the COMLEX to be licensed...as well as complete a residency. Personally, the most challenging classes were biochemistry, pharmacology, and pathology. Gross anatomy was just time consuming.

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Tori's manbitch:
<strong> </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Treybird:
<strong> Did you take both the COMPLEX and USMLE's? </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">It's COMLEX.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">But slightly complex too..

niugrad: Thanks for th backup, but where were you three post pages ago when I needed you?? Nonetheless, good to have you aboard...even if you are at National...ha ha, just kidding. We're all brothers here (and sisters, JenMac). Keep hope alive.

Happy Clown: I'll check out Isserson's Guide. Is it something I can get at Border's? I'll be a 38+ year old resident by the time I get to that stage and I don't feel like pissing around with that AOA internship either. Do you think that the trend is for that to disappear soon? Do you know how not doing it will limit your choices of practice? I do anticipate Pharm being a pain-in-the-ass b/c I've never had it before. Biochem is just time consuming. I've had it in college and Chiropractic school so we'll see. Not looking forward to memorizing all that crap again. I've never once had to recall the citric cycle to one patient to date. I'm not a big fan of histology or microbio either. Did you have any genetics classes? What did you hate about your ob/gyn rotation?

acurarte: Right on, Freudian slip. Some people just can't sit back and enjoy the grand paradox opting instead for getting lost in the details. Then again, some people are just incredibly anal.

TB

As long as the AOA is around I'm sure the internship will be too. But not doing it will only limit you in the 4 or 5 states that require the AOA internship. I'm not doing it either. There are residencies that are dual certified.

The COMLEX/USMLE were A LOT harder than the DC board exams. I took a review course for part 1 but it was a huge waste of money, and I stopped attending after a few sessions. There are good enough review books out there, at least for part 1.

NIUGRAD, I hate to burst your bubble, but DC school is not adequate primary care physician training. It might seem like it at the time, but it really doesn't compare. Portal-of-entry yes, but not primary care.

dcdo: I can't even remember the DC boards since I took them 10 years ago (God has it been that long???). Why did you stop going to the review? Was it expensive? Do most students do better with the review than without? Do you feel pretty confident in your primary care skills now? Do you feel like you can handle most things that walk through your door? Are you still adjusting patients? And lastly, do you know specifically which states require the AOA internship? Sorry about the questions. Just trying to take it all in and since you've done both I can get a lot more perspective from you.

TB

P.S. Anybody know anything about KCOm and it's reputation (i.e. respect from the profession)

I felt the review was basically just slow basic lectures, not any better than reading a good book on your own. Maybe it's a matter of learning styles, as I'm sure there were people who liked it. It is expensive, around $600-900 if I recall.

My primary care skills are far better now. Do I feel ready for anything that walks in? Just basic stuff, there's a lot more than meets the eye with many people. I certainly couldn't go out there now. I have used manipulation for some patients in outpatient rotations. Just as important though, DC school gave me a good grounding in diagnosing NMS conditions.

I don't know the 5 states, but somebody will probably chime in here somewhere.

Kirksville is a great school and, of course, is in the same state as UHS...where I went.

There is a book called " A DO's guide to getting an MD residency: DO's eat their young" and it will go into depth about side-stepping the silly antiquated AOA intership rule. In 10 years, I would bet that law will be null and void anyway...in at least 3 of the 5 states. It serves only the well being of the Hospitals and the AOA...NOT the resident/student/physician/patients. (Fla, PA, MI, OK, WV are the big 5)
Isserson's Guide can be found at any Medical Bookstore and can be ordered via internet or at the book store itself. I have both books, and if you send me a check for $25 I will send them to you. Seriously...not kidding.

DCDO: Are you in your internship now? How does that work? Are you canstantly researching stuff and is it more of a learn as you go kind of thing. In other words, you don't read up on malaria until you have a case. Do the attendings give you reading assigments and then test you or what? How does it work in residency? At least you have the beach, even if you never get to see it.

Mr. happy clown: I agree that the AOA internship is nothing but a self-serving pain-in-the-ass, and, as usual, FL goes right along with it. FL and NJ seem to be the hardest when it comes to jumping through hoops for a license. I hope it becomes null and void. You don't see other states reversing themselves and adding themselves to the list, do you? Aren't some programs starting to combine the AOA interneship into the regular internship? Would you recommend an MD residency over a DO residency? Is there a difference, and if so, in what way? Does it only matter if you're competing for a specialty outside of primary care? Have you heard anything about military residencies? Easier? Harder?
Thanks for the offer on the books but I will probably wait a few years before I get them so the info will be updated for me when I'm ready. I won't be seeing an internship for another 4 years. I've written down all the books you've recommended though. Have you treid selling them on e-bay?

TB.

P.S. Does anyone else, who has time to watch TV, thins that Scrubs rules?? I LOVE that show, and Elliot is hot, ion a neurotic way. Dr. Cox is hilarious. Are most attendings that bad?

No states will ever reverse themselves, most likely states will revoke the AOA internship law sometime in the future...or make it easier to gain reciprocity.

As for internship, you will always have alot of reading to do, as well as presentations. In my residency, there are meetings 1-2 x's/wk for 4 hours each and journal club once a month. THere is grand rounds daily, depending on the service you are on. And of course, the daily pimp sessions which serve to motivate one to read on a nightly basis. THough, one may not read up on malaria, you should have ample justification why you order certain tests and medications...shotgun methods are absolutely frowned upon (ordering a chem 14 when a chem 7 will do...or just ordering a potassium level).

As for my decision to do an allopathic residency, I just chose the best residency for me. I wish to pursue some research and learn in a large tertiary care center that is university affiliated and is not financially burdoned. Also, without the AOA internship, I am cutting my residency by one year...which would be enough to allow for a one year fellowship.

"Scrubs" is loosely based upon the book "House of GOd", and the interns on the show act like they are straight outta high school...so I avoid it. The book is a Must read.

I start on June 24th

I read The House of God and saw the movie (circa 1978). It was ok. I enjoyed The Intern Blues much better. It had essentially the same themes as The House of God but these were journal entries made by 3 peds interns. I enjoyed it much better b/c it wasn't fictionalized with literary license. Ever read it? The author is Robert Marion, M.D.. Yea, Scrubs is silly, but that's why I like it. Something tells me you take life waaaaaay to seriously sometmies. Type-A much?

Once you become board certified, is it easy to move from state to state, as far as reciprocity goes? What are daily pimp sessions and a journal club? Do you actually find any time to sleep at all? I'm wondering if I should just do all my sleeping now before school begins. Where would you like to do your fellowship? Sports Med, correct?

TB

Pimp sessions are just the "fun" question-answer times between you and your attending or whomever. I dread them, but I'm used to them.
Journal club is when residents read and discuss recent journal articles. Discuss the weakness of the studies and debate their conclusions.
As far as sleep...well I like it, that is why I am doing EM...NO CALL when you are on the EM service!! Great.
Fellowship location is undecided...I just got engaged, so there are one other person to consider from this point on!!

Sounds wonderful. And you have time to sleep and see your family when?? Yea, I can see how pimp sessions would be a drag depending on who's running it and who the residents are with you. If you have a group that just asks the most inane questions it can be annoying. How many journal articles are you expected to read a week? Which journals do you like? Does EM have a high burnout rate? I assume you work in the ER. I don't know if I could handle the gore. We'll see. Does radiology have a difficult residnecy, time-wise. What makes it so difficult? Did you do a radiology residency?

TB

I forgot to ask, what are prelim and transitional programs? Are they necessary? Do they count towards your PGY-1 or are they pre-PGY-1? If so, what's the point of doing one?

TB

I don't see what all the fuss is about. Let the chiropractors zap patients with needless X-rays so that they can develop Papillary Carcinoma of the Thyroid!!! <img border="0" alt="[Wowie]" title="" src="graemlins/wowie.gif" /> J/K

I'm a fourth year at Westernu/COMP and few of my classmates are going to use OMT in their practice. My class is full of future Radiologists and Anesthesiologists cuz that's where the you can still make over 200K start. Damn...Dr. Still would be pissed of.

Unfortunately, I'll be doing a very non-osteopathic anesthesiology residency at Tufts University in Boston. Oh well... Life goes on.

Yo man.... DOctor begins with the letters D.O.

Trey,

a transitional year or preliminary med year is only one year (PGY1) and is necessary for some residencies (radiology, PM&R, Anesth, or any osteopathic residency). Most EM programs (allopathic) do not require the transitional year, it is straight PGY1-3 in most cases (some are 1-4 or 2-4).
Radiology is very competetive, and is a pretty cool residency...it also offers a nice life outside of the hospital. I did 2 weeks of radiology alone, and it was great. Of course, you are bombarded with radiology in most other specialties also...especially EM.
EM has changed alot over the past fiew years, as fewer IM docs man the ED and more board certified EM docs come into play. The burnout rate for EM docs is probably no worse than any other field, and one of the pluses with EM is the "no call" policy which allows for more "at home" time. Each field has burnout, and I would venture a guess that IM has the highest dissatisfaction.

The journals I get are:
Annals of EM
Academic EM
Journal of the AMA
Journal of the AOA
Journal Watch (covers articles from all over)
The Consultant
Post Graduate Medicine
Physician and Sports Medicine

I agree with happy clown guy...

Of the ER docs that I have run into at a county hospital, the FP and IM trained ER docs always seemed mor STRESSED OUT than the Board-Certified ER docs. (Cuz they bit off more than they can Chew)
There is a turf war going on between ER and FP. ER is trying to shut out FPs in the er by making Board certification a must to work down in the ER.

FPs fight back by making ER docs pass the FP boards to work in the clinic when they burn out.

the problem is.... ER docs trained at EM residencies don't burn out as often as FP trained ER docs.

Once again the FP is the Bitch of the system.(PA's and NP"S got them cornered)

Happy:

Are you starting to feel confident in EM? How long have you been doing your residency? I should hear from IU by the end of next week. They meet on Fri to decide my fate. What the hell, it's only the rest of my life. I guess in the long run it won't make a difference. Is your fiance in medicine? I just got engaged as well. She's an RN. Do some ER docs come at it from FP? Don't some FP work at like RediMeds on the weekend? Do you plan on moonlighting once you get board certified? When do you take part 3 of your boards? Is that COMLEX and USMLE as well? Here's a simple question. If you came up on the scene of a car accident, and you were the only one around, would you feel confident that you could handle the situation and stabilize the patient until the EMS arrived?

TB

P.S. Looks like most people have dropped out of this room. Anybody else out there??? Voyeurs!!!

I have so much more to learn...a ton. EM is great fun, but knowing what to do in every situation is impossible. I look forward to everyithing coming together.
In the past, some FP's "manned" small ED's but mostly they were IM guys manning the ED's in rural hospitals. THere has been major pressure by the American College of Emergency Physicians and the American Acadamy of Emergency Medicine to allow ONLY board certified/residency trained doctors in the Emergency Dept. this allows for greater quality and more $$ for these types of docs. At the same time it puts a crunch on moonlighting in the ED. FP guys get the "clinic" but EM guys need the ED.
Nope, my fiance has nothing to do with medicine, this makes me extremely happy! It provides for an escape...hopefully someday we will own a business together (wipe the tears from your eyes).

P.S. Looks like most people have dropped out of this room. Anybody else out there??? Voyeurs!!!

No one else is posting on this board because it's no longer a discussion. It's just a Q&A between a pre-med (and a very neurotic pre-med at that) and some MS IV's. Boring.

??? did they need your approval or something?

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Freeeedom!:
<strong>??? did they need your approval or something?</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">No, just saying that we're not joining in on the discussion because it's gone to the mundane Q's of "Where should I do my residency?" "Should I take the USMLE?" Blah, blah, blah.

Ponyboy: Let's discuss. What do you want to talk about? I'll talk to you, but I'm not going to get into mud slinging again. If you have an open mind, then let's talk. If you've already got a closed mind on the subject and you're just looking to "slam a Chiropractor", then forget it. it's pointless. Sorry we've been so boring but I didn't see you pipe in with any questions. And I don't see that gathering as much info as you can, so you're prepared to make excellent decisions regarding the rest of your life, as being neurotic. Happy Clown has experience, and I want to know what it is.

Freeeeeeeedom!!! Amen.

Happy: They say it takes about 5 years of being in practice, at least for Chiros, to get to the point where you feel confident to the point that you handle anything that walks in the door. I would imagine it just takes time for you to see the same things over and over again to the point of feeling like you can handle 99% of what walks in the door. Yea, it's a good feeling when it all comes together. What kind of business do you guys want to own? Used CD store? A Subway shop?

TB

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Treybird:
<strong>Ponyboy: Let's discuss. What do you want to talk about? I'll talk to you, but I'm not going to get into mud slinging again. If you have an open mind, then let's talk. If you've already got a closed mind on the subject and you're just looking to "slam a Chiropractor", then forget it. it's pointless. Sorry we've been so boring but I didn't see you pipe in with any questions. And I don't see that gathering as much info as you can, so you're prepared to make excellent decisions regarding the rest of your life, as being neurotic. Happy Clown has experience, and I want to know what it is.

Freeeeeeeedom!!! Amen.

Happy: They say it takes about 5 years of being in practice, at least for Chiros, to get to the point where you feel confident to the point that you handle anything that walks in the door. I would imagine it just takes time for you to see the same things over and over again to the point of feeling like you can handle 99% of what walks in the door. Yea, it's a good feeling when it all comes together. What kind of business do you guys want to own? Used CD store? A Subway shop?

TB</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">

about the business stuff....I heard you can make a lot of money if you own nail shops or strip clubs....

I guess I see others points about the Q and A. If you want to send a private message Trey, feel free.

Well, I don't think I would open a strip club, I would hate to clean the bathrooms.

But I am considering opening a cafe or bar/lounge in a few years...when the timing is right.

Trey: I never slammed chiropractic. Every time I've posted, I've only refuted arguments that you made against allopathic medicine.

In regards to med school, relax. It's much easier if you let things figure out themselves. It makes things much more pleasant for you and the people around you.

In terms of being able to treat everything that walks through the door: the most important thing is to be able to start on the diagnostic algorithm path. Once you're on the path, you can take the time to figure out what it is and how you would treat it. (this is, of course, after the ABC's). In many places where we've been given a lot of responsibility (ER, family med clinics), I have seen third year medical students perform very well and often in accordance with what the attending would do. This isn't to say that we know everything (and we are no where near the level of a resident or attending) but we are comfortable with a large variety of problems.

Ponyboy: I'm cool. Most of my questions are answered, I think. It just seems like in medicine you can almost "make your own major" so to speak. You have so many options and so many different ways of accomplishing things. It's great that you can do that but like anything else when you're on the other side it seems like a bigger deal than it is. Believe it or not, I'm not a neurotic person. But, I figure if I have an ear I might as well ask some of the questions I've had from what i've read and heard. I remember the diagnostic algorithm path with my Chiro training. Same thing, albeit less complicated. I remember that it took time to find my style and get comfortable with a routine. I know that it will be the same way in medicine and I look forward to that.

I don't have grudges against allopathic medicine, obviously, or I wouldn't be going into medicine. But it is egotistical and arrogent of medicine to attack Chiropractic while there are surgeries and drugs in medicine that are experimental and dangerous too. In other words, medicine has no business pointing fingers. If we can agree on that, than I'm cool. I don't think Chiropractic is perfect, and more research needs to be done, but that goes for both sides. Let's point out the weakness of both professions, if that's what we're going to concentrate on. I'd rather concentrate on the positive aspects of both, but whatever. As I said before, Chiropractic has not had the funding for the research needed until recently. Hopefully that will change.

Happy Clown: Thanks for your help.

Hello out there......(chirp, chirp).........(chirp, chirp)......nothing but the crickets.

I have to say that Chiroprators do provide a good serivce, and can help. However, as a paramedic I have gone on calls for heart attack patients where there was a supposed "Doctor" on scene, when in truth the "Doctor" was just a chiropractor. If a man having a heart attack could be cured by an adjustment, then I would agree that Chiropractors are legitimately Doctors. This is obviously not the case. In fact Paramedics are forbidden by law to relinquish patient care to any individual with less Legally Recognized Medical Training then they have, and in the two states where I have worked, a Chiropractor does not meet this criteria. So if a Paramedic with one year of training can't relinquish patient care to a Chiropractor but can to a Physician (DO or MD) of any specialty, then a Chiropractor is definately no doctor of medicine. In my opinion, the free market economy simply created schools for people who just want to learn about OMT and related subjects; they are called chiropractic colleges. No matter what the rhetoric, until Chiropractors are given DEA numbers, and training in "Organic Illnesses", they will never be considered doctors. To me it seems silly to say that because a DC can read x-rays and MRI's that a DC has received comparable training to that of a physician. Knowing how to read an x-ray is worthless without the background knowledge of organic systems, disease pathologies, and all that crappy biochem that isn't in Chiropractic school.

And if it was the same, why go to medical school?

Mire,

I think you are a little confused. You are using the word "doctor" as if it were synonymous with medical physician. I'm sure you are aware that there are many different types of doctorate degrees. I think it is probably common error of the uneducated to think that the word "doctor" pertains to medical physicians only.
Also, I don't recall anyone stating that a chiropractor could treat a heart attack victim with an adjustment--where did you get that silly idea? And maybe you should look into the chiropractic curriculum and see what classes are included in their training bfore you speak about them. I know that you didn't, or else you would know that they have classes in physical and clinical diagnosis, pathology, and of course, biochemistry. In the future, it may be wise to actually research a topic before you write about it--especially if it is negative criticism--because when your wrong, it really puts your credibility into question.

With all due respect, I believe you misread my post. My point is simply that chiropractors are no more doctors of medicine then a doctor of philosophy. Not to take away from their medical training, but I am saying that you simply can't compare the two educations; they are too dissimilar. DC's are a very specialized subset of people who earn a doctorate level degree in a discipline that does not incorporate the necessary fields of study required to equate them with physicians. Secondly, my point about the heart attack victim is that when I arrived on scene the Chiropractor tried to assume patient care. He did this saying, "its ok I'm a doctor." This is not only inappropriate, but illegal for a chiropractor to do. Simply put, Chiropractors do not have equivelent training to Physicians. Therefore, they should not think of themselves as Primary Care Doctors. And if I am so misinformed about the DC curriculum then why is that they are not considered Physicians with all the rights and privaleges of an individual who has completed a program that incorporates said disciplines as mentioned in my previous post? I will tell you why...Because it is not the same thing!!! And even if some schools do cover this material, it doesn't change the facts of the situation. Most Chiropractors understand their role in medicine, which is important, but a rose need not call itself a tree simply because it grows in the same garden. I am not assigning worth to either discipline, and I am most likely restating what has allready been said. I am only adding my experience to the fray. I apologize for offending anyone who reads this. That is not my intention. In fact, I was a patient of a DC for a long time, and I sincerely believe that his care was beneficial, appropriate, and professional.

If a man having a heart attack could be cured by an adjustment, then I would agree that Chiropractors are legitimately Doctors. This is obviously not the case.....then a Chiropractor is definately no doctor of medicine....until Chiropractors are given DEA numbers, and training in
"Organic Illnesses", they will never be considered doctors. To me it seems silly to say that because a DC can read x-rays and MRI's that a DC has received comparable training to that of a physician. Knowing how to read an x-ray is worthless without the background knowledge of organic systems, disease pathologies, and all that crappy biochem that isn't in Chiropractic school

Doesn't sound like Dmon misread what you wrote. You were pretty clear to me, arrogant and condescending as well. First of all, Chiropractors are NOT doctors of medicine, I think we can all agree with that. We never claimed to be. We're doctors of Chiropractic, with enough training in basic daignosis to recognize when something is beyond our scope of practice and refer that patient out. We don't have to put a name on it, we just have to know where to send them. We are portals into the healthcare system, esp. when dealing with populations that "hate going to their doctor", such as the Amish. If Chiros weren't adequately trained, many people who avoid allopathic or osteopathic care, but trust Chiros, would be in a world of hurt if their Chiro didn't refer them when they needed it.

Now, neuromusculoskeletally we are adequately trained on a doctor level to treat those conditions within our scope and, again, refer those that are outside of our scope, despite what you think. You seem to think that WE think we're medical doctors. No one here ever said we were. And Dmon's right, go sit in on a chiropractic radiology class or sit in on our radiology report classes before you decide to piss around judgement on what YOU consider legit or not. Try not to look down your sarcastic nose at us as being inferior to you. We're equal but different. We serve different functions within the healthcare system. Just ask the many MDs who do refer to a DC when they relaize that some things are even beyond their control.

Mire,
You are right on buddy! If you really want to get technical, why should a chiropractic degree be a doctorate anyway? In Texas, you can get into chiropractic school with 60 hours of college and a pulse. So how does adding four years to this add up to a doctorate? Hell, this hardly qualifies as a Masters in most institutions. If this were the case, a PA like myself should have earned a doctorate right? I went to 6 total years of school also before going to medical school. And I guess we should be allowed to go by the title Doctor PA right? NO!!! Because we are not physicians!!! I went to eat Sushi last night and there was a clinic right next door called HEALTHCHOICE FAMILY CLINIC. The name Dr. XXXXX was printed on the door, and words like "Master Whiplash Certification", and "Pain Disorders" was also on the door. NOWHERE on the door, or sign did it say that this was a chiropractic clinic, and this is simply the case of a chiropractor trying to pass himself off as a physician. Anyone could mistake this place for a real medical clinic, and this is just wrong. There was however one dead giveaway that this was a chiropractic clinic though, and that was the fact that it was located in a strip center. You never see chiros anywhere else do you? Ever looked up the list of docs in a professional building outside a hospital and found a DC listed? You can take up for DC's all day long, but as long as you have so many of them misrepresenting the profession and calling themselves doctors DC's will never gain nationwide respect. And as a former paramedic, I had a run in or two with a chiropractor trying to call himself doc as well on a scene (usually an MVA). I feel sorry for the legitimate DC's out there who have to face an uphill battle daily due to the overwhelmingly large number of bad DC's out there. DC's have their place, but if you had enough DO's you wouldn't even need them. That is reality, like it or not.

Uh oh now it's going to get nasty.

In Texas, you can get into chiropractic school with 60 hours of college and a pulse

And that's different from Lake Erie Osteopathic College how???

So how does adding four years to this add up to a doctorate?

Ah, the ignorant never cease to amaze. 5 years, bubba, not 4. 10 semesters through the summers. In case you need a calculator, that's 3 1/3 years, chronologically. I have 9 years of school and I would say that's a little more than your overwhelming 6. By the way, where does it say on the med school app that a degree is required?? Seems to me that you don't need a degree, just the required pre-reqs.

a PA like myself should have earned a doctorate right?

I'm sure you'd like to think so. Man, that just reeks of bitter jealousy. Have you tried to take the MCAT yet? Do you even meet the pre-req's for med school with your PA training? Instead of just dreaming about being a doctor, go ahead and take the MCATs. See how ya do, bubba. Then you wouldn't have such hatred seething in your heart. Can I have an amen, brother??

You can take up for DC's all day long, but as long as you have so many of them misrepresenting the profession and calling themselves doctors DC's will never gain nationwide respect.

We already do, bubba, just not with you. All I care about are my patients and what they think. And I think I garner mucho respect from the ones who've already been to their docs, pumped with drugs and are still in pain, 4 weeks out of work already. We don't need your respect becuase it isn't worth anything to me. All you do is hurt yourself. Big bad paramedic. I suppose you like to call yourself a doctor when no one's looking right?? C'mon, admit it. You look in the mirror with your little white coat on and wonder what it would be like to be a Chiropractor. To succeed where others have failed. Admit it, bubba. It's time to come out of the closet. :cool:

DC's have their place

Mine's right outside the Failed Low Back Surgery clinic, across the street from the Completely Screwed Up That Carpal Tunnel Surgery office complex, down the street from the Oops! We Should Have Sent Them To The Chiro building. <img border="0" alt="[Clappy]" title="" src="graemlins/clappy.gif" />

Wow, I thought this topic was dead.

Two big egos...one small board..."the clone war has begun".

Whoa now treybird!!!

I just have one question for you. If as a chiropractor you can do so much, and basically have the same diagnostic skills as a doctor why are you going to medical school? Sincerely, I am not trying to condescend. You are probably an excellent DC, but you seem very content with what you allready know, and how much school you allready have. Why go to medical school? It would appear to me that your passionate defense of chiropractics has revealed some kind of self loathing within in you. Maybe deep down you know that being a Chiropractor can't fill the void that only a legitimate medical education can.

All I can think to say is that just because you have one example of Dr. XXXXX who is a quack, and an example of a school with horribly low admission requirements, doesn't mean a whole lot. I worked for a DC in a *bonafide* office building, and NUHS in IL requires a Bachelor's degree. There are my examples. But then again, they are not representative of the whole. You guys are telling us (and everyone else on this thread by the 6th page...) things we already know as far as scope of practice, own worst enemy, blah blah blah blah. Fact is, we are still here, going strong, and probably going to continue to be the thorn in your side, letting you know we actaully possess a skill that you don't. Especially because you put in so much energy to put us down. (and don't get started on all your superiorities....we have already acknowledged them or previoulsy fought that battle). And if DO's could wipe out our practice, I think it would have happened by now. Fact is, DO's don't go to DO school to learn to adjust, and few use it in practice. Even if they do, we still receive more training....I could go on and on (and on) but it seems SO REDUNDANT! However, I have to say right on Trey. Your energy for this debate astounds me! Keep it up bro!

This thread is getting repetitive. It has been established that:
1)The academic qualifications of matriculants to medical school are, on average, greater than their chiropractic counterparts. (study cited several pages ago)

2)Medical schools covers a wider breadth of medical science and is more rigorous than chiropractic school.

3) Chiropractors are not medical doctors and are not qualified to treat diseases outside of certain musculoskeletal complaints.

4) Chiropractic has been shown to be effective for the treatment of lower back pain.

5) To date, quality outcome-based research is not available to prove the effectiveness of chiropractic on other diseases.

We should move on in the discussion.

Treybird, if you were not so busy salivating over the chiropractic debate you might have seen me conversing on the forum's other threads. Then you would have seen that I took the MCAT, was accepted to multiple medical schools, and will start in August. And don't call me Bubba just because most of your patients are named that. I also find it comical that you worked your butt off to find one medical school that accepts someone after 60 hours, but could you tell me across the board who has more education entering professional school, prechiro or premed? The truth is that chiropractic is synonymous with "distrust", "questionable", and often "out there!". At least I have the balls to admit that my profession is nowhere near the level of a doctorate, but you are plain arrogant. You really never did resond to my statement regarding the fact that chiros misrepresent themselves all the time. What about the example in my post where the word chiropractic was not even on the door or sign? I don't doubt that DC's offer a worthy service, but I just doubt that they all do. Is there some kind of adjustment to remove a foot out of your mouth by the way?

I just read what Mire wrote, and I am still smiling. How true that must be. Anyone know the CPT code for adjustment of foot from mouth? And Treybird, know matter what you say, chiro school is 4 years. You can add up summers, Christmas breaks, and the Vietnamese New Year for all I care, but everyone knows it is four years. And everyone knows that a lot of pre-chiros get in with the basic 60 credits where I beg you to show me a medical student who did the same thing. And in case you didn't know, many medical schools go all year round with a few weeks off here and there, but physicians don't go around saying that it took them 5 years to finish med school if you include study hours past 1AM. Bottom line, 9 years of education is way more than you should have done to get done with DC school. I might agree it could take 7-8, but anyone who did it in 9 had a lot of free time. Don't make assumptions Treybird about people before you emit such a long statement with so many bubba inclusions. Got that foot past the 3rd molar yet?

One last inflammatory response to such an ignorant post by Treybird. My previous profession included being a Navy Corpsman, an EMT-P, most recently a PA in the civilian world and Army Reserves, and now a medical student. You can always measure a profession by how much the military utilizes them, which is about none for people like you as you know. Anyone see an chiro's on Band of Brother's running from foxhole to foxhole seeing who needed a combat adjustment?

There is not a single day I wake up wishing I was a chiropractor. Care to trade tax returns and see who did better this year or any other. What kills you is that a PA could get more respect than a chiro, and make more money. I am continuing my journey through medicine because it is what I love, and I don't mind giving up the 6 figure salary to do it. I would take a pay cut to be a physician, because it is my dream. Don't patronize people without knowing anything about them. My original post was not aimed at you personally by the way, and neither will any of my future responses. You will get the last word because I am not going to respond to your ignorance any further. Care to try and get me to resond? You won't be able. I wish you luck getting that foot out of your mouth so you can get the last word. Something tells me you will.

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by PACmatthew:
<strong>

Don't patronize people without knowing anything about them. </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">This seems awfully ironic on this thread....

Hey JenMac, welcome back. I noticed they seem to ignore what you have to say. Not very gentlemanly, if you ask me. You speak the truth. Just don't patronize them. It gets them excited.

PACmatthew, hasta, bubba. Sounds like you have a foot fetish. Good luck with that.

Anyone want to get adjusted? The door is always open.

I definately have less respect for chiropractors after reading all of these posts, and surfing around on SDN.

I'm sorry you feel that way.

JerseyGirl, I'm sorry you feel that way too, esp. since we both hail from the Garden State. I suspect you didn't have much respect for us before this so I highly doubt that this forum changed your mind on that issue. How about respect for your fellow DO students in this forum? You must feel that they've been angels throughout this debate.

I agree, however, that this really has gotten unprofessional. So, let's start over.
Would anybody like to discuss the differences between Chiropractic and Osteopathy. No slamming, or attacking, or condescending...myself included. This is supposed to be a forum for open discussion and my guess is that many of you don't understand Chiropractic, our scope of practice, or our level of education. Some just don't care, and to you I say, fine. You're entitled to your opinion. If you don't want to discuss, go start the DC's vs. DO's forum. For those of you seriously interested in learning something new, let's talk.

Many of you posting seem to find it very easy to put us down or dismiss us. Why is that? This is an honest question, not an attack: Do you feel insecure by the way that MD's treat DO's and that some of you need to slam Chiropractic to feel better? that is a sincere, non-condescending question. I know that some of you DO's out there support us, and detest what has been written by your peers. If so, speak up. Self-police. Some of you think that it is Jen and I who are the aggressors, and the others are just innocent victims in our scathing wake. How can the minority be the aggressors? Do you honestly feel that we've been treated fairly in this forum? That we've been treated with the respect that you would show each other? Is this how you would treat a Chiropractor in the field? I can honestly say that I have a great relationship with the DO's and MD's that I've met in practice. Most have questions about what I do, even skepticism, but they keep an open mind and learn something new. If you feel that we've been unprofessional, then take some of the blame as well. This has not been a one-sided conversation. We've all had the chance to vent, and now it's getting old. So, who would like to discuss?

TB

I'm really interested in the difference between chiropractic and OMM. I've yet to even start my first year of DO school (2.5 months to go!) so my knowledge of the subject is very limited, but I've shadowed both DCs and DOs.

It appears as though the HVLA techniques used by both disciplines are identical (to me, anyway), and that DCs who employ muscle work as well as HVLA adjustments are performing something very similar to some of the OMM I've seen. I know DCs and DOs speak about the patient's dysfunction in different ways, but the actual techniques look quite similar.

Can someone please correct me if I'm way off? I'd like to learn more.

One of the difficult things about these GOOFY forums is that when 2 people debate there is loss of continuity...the affect of the voice is missing.

If there was anything that I learned from my lengthy debate with Treybird is that he honestly cares about his patients...he is not in chiropractic to push mega vitamins or to manipulate the OA joint to treat hypertension. As we know, he intends on going to medical school.

Ego's get in the way sometimes. PAC Matt, yours is rather large. I like you, I am impressed with the fact that YOU ARE ENTERING MEDICAL SCHOOL...just be prepared to be humbled. Prepare to learn that JUST MAYBE what you had been doing in the past may have been incorrect in theory...and that all of us aren't QUITE as smart as we think we are.
Despite what the Armed Forces lets us do.

Hey Solie. First off, congrats for shadowing both professions in trying to make an informed decision. I can't comment on osteopathic manipulation b/c I don't have any experience in that arena. I'll refer you to my counterpart, happy clown.

From what I do understand, you hit the nail on the head. At the heart of the matter, we have the same basic philosophy in that vertebral misalignments can affect the way the body functions. This is strictly philosophy. For Chiros, we believe that it affects the nervous system, for DO'c the circulatory system. We both use manipulations, although we approach it from different angles and call it different things, it's the same thing essentially. The biggest difference is that Chiros don't use medicine or surgery as a treatment. Now, you will find Chiros that run the spectrum in philosophy from those who don't believe in adjusting anything besides the first two vertebrae. They believe that all disease stems from this. They are the Amish of the profession and I think that kind of thinking is dangerous and malpractice. Then you will find some Chiros who will do everything up to dispensing medicine and doing surgery. In their trainging, they did partake in clinical rotations. Check out National U. or Northwestern U. for more specific training requirements. Some Chiros rely heavily on nutritional supplements. Some small percent get into really bizarre, way-out techniques that do not represent the majority in any way, shape or form.

I think I've hit the highlights. If I didn't answer your question, please let me know. If you have any other questions, let 'em rip. Happy clown, care to jump in on this one?

Happy: I agree that trying to debate on this forum is too intermittent to hold any real steam. You can't debate, only discuss. Thanks for the support. We've reached common ground. I can see it now, I'll get into my internship and you'll be my attending or senior resident. :D

I realize the limitations of Chiropractic and the long road ahead, but at least the schools are starting to take some responsibility in initiating the research necessary to lay this debate to rest. Outside of the medicine and surgery, I honestly don't see that much difference in Chiropractic and Osteopathy, at its heart. We both view the patient as a whole, not a disease, and we both use manipulation to help patients get out of pain. Do I think there are some loony Chiros out there? Absolutely. Do they represent the majority? Absolutely not.

Good dialogue today.

Treybird, I don't think it's very accurate to say that DC's and DO's are the same except for the medicine and surgery thing. I agree OMM and chiro technique share similar philosophies but on the whole modern Osteopathic Medicine is not very related in philosophy to Chiro practice. If this were true, then DO's would primarilly use manipulation and then drugs and surgery as a supplement to it. With the exception of a few DO's that specialize in OMM, most practice medicine with the reverse philosophy--Drugs and Surgery with OMM as a supplement. They are taught, though, that underlying all of their treatment should be emphasis on the whole patient and not just one body part or symptom. Several decades ago they were, when a lot of DO's still saw OMM as the end all be all of medical treatment. This was Still's initial philosophy and it held up for many years until the field of medicine began to make strides in the 20's and 30's. However, the early DO's and their success as well as modern scientific evidence today does prove the efficacy of OMM. Chiro's are more closely related to the DO's of old, then modern DO's who don't use medicine in accordance with OMM, but rather OMM in accordance with medicine. I personally have no problems with chiropractors, but if it came down to myself needing treatment, I would rather see an OMM specialist. With their medical background, it just seems to me that on the whole, they would have a larger piece of mind. With the exception of OMM specialists, if you are looking at Osteopathic medicine as an extention of chiropractics then you may be disapointed. Good luck in medical school.

PAC, I believe your posts are a bit out of line.

"You can always measure a profession by how much the military utilizes them"

Perhaps all of your military background gives you this perspective, but I think you'll find that there are many valued professions in civilian society that have no representation at all in the military.

How would you measure artists? philosophers? what about the vast majority of scientists and teachers? What about doctors that specialize in geriatrics or pediatric diseases?

Maybe you think nothing of these people, but many highly value their contributions to society. Many value chiropractors as well.

"Don't patronize people without knowing anything about them. "

I do think we should all take this one to heart. That goes for everyone reading this board...

You can't always directly control what people have to say, but you CAN control your own responses.

salary? presteige? NOTHING.. once you get beat down in your first year of medical school and realize there is seven more years to go (and either 150grand of debt or a long government service agreement), those will be very distant rewards indeed. If the presteige is all your looking for in a job, you might find there isn't enough of it in medicine to pay you for your lost years and suffering. If you really DO do it because you love it... then why couldn't someone love chiropractics every bit as much? What right have you to try to take that away from them to make yourself feel better?

R&R doc-
Let me see if I undertand: t-bird posts that chiropractors and DO's are similar except for DO's practicing medicine and surgery, and your entire argument is that he's wrong because DO's practice lots of medicine and surgery? hmm...

Thanks for answering my questions--I'm learning a lot on this thread. :)

Bones,

I think what I stated is pretty clear. It is also not an argument, but rather a perspective. I have studied philosophy for the past 4 years, and I have learned, and experienced first hand, the difference between a constructive discussion and a pissing contest. This is not a question of right and wrong. Things aren't always black and white.. I'm just saying, from my perspective, that a DO is closer to a traditional MD, than a Chiropractor. That is a fact. If Treybird is thinking that it is the other way around, he will be disapointed at Osteopathic Medical School. I don't know why everyone takes everything so personally, it is nothing but immaturity and it takes away from constructive discussion. Now the next step, if you disagree is to tell me a reason why you think DO's are more like DC's than physicians; however, I don't think many would agree with that. That's just a hunch, and I could be wrong.

" Since light travels faster than sound. Some people appear bright until they speak."

--Rock and Roll

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Treybird:
[ They are the Amish of the profession and I think that kind of thinking is dangerous and malpractice.
/QB]</font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">He he he. I couldn't agree more. BUT, Northwestern and National don't teach surgery or medical intervention. They teach an evidence based approach to chiropractic. Which I think is awesome because we are prepared to interact with MD's and comanage cases, if necessary. I think the only school that teaches minor surgery is Western States in Portland. And Oregon would be the only place you could practice that broad of a scope of practice anyway. Correct me if I'm wrong?

Bones!! Welcome to the foray. Good to see ya again.

Chiro's are more closely related to the DO's of old, then modern DO's who don't use medicine in accordance with OMM, but rather OMM in accordance with medicine.

R&Rdoc: I would agree with that statment 100%. But that doesn't take away from what the early DO's did. They've just shifted their paradigm a little to the right...or left, depending on where you're standing, since then. I think what DO's did then and now is just as valid as what chiros do. If you're more comfortable with someone in your own profession, that's understandable. You feel more comfortable with your own. But that doesn't mean that what a DC does is less valuable. I can't quote you research articles on the efficacy of Chiropractic, all I can do is speak from experience, and I have more experience at treating patients with manipulation than any students in DO school. No matter what modern osteopathic medicine's philosophy is, it still springs from the original. You shouldn't lose sight of where your profession came from. It will keep you true to your art. We can't explain all the ways that aspirin works, we just know it does, so we use it.

With the exception of OMM specialists, if you are looking at Osteopathic medicine as an extention of chiropractics then you may be disapointed. Good luck in medical school.

Actually, I'm very confident with my adjusting abilities (aka OMM) after being in practice for 8 years. Now I want to learn about medicine, with a whole person approach. Who knows, I may even go into radiology or surgery. Thanks for the good luck.

Solie: Good luck. If you want any more specific information regarding chiropractic or websites that can lead you to info, send me an e-mail.

JenMac: Keep goin' girl!! No, National and NW don't teach surgery. I'm sorry if I implied that. They just do rotations in hospitals. I've heard about a school that teaches minor surgery but I don't where they could use it.

TB

Treybird, I'm sorry I am a little naive about some of this stuff, however my mother was manipulated by a DO (unfortunately for her I'm in MD school)so I know it works. What if you end up at a DO school and out in practice and manipulate your patient with a modality similar to the two fields ie HVLA (again correct me if I'm wrong in their similarity) What do you mark down in the chart? A DC technique or a DO technique? Is it possible to practice both DO and DC manipulation on the same patient or is that a breech in the laws of referring? Personally, I think that it would be good for the patient, but does the law prevent it?

Clarification for all, including pacMatthew. Armed forces do utilize chiropractors. There is a staff chiropractor at all Air Force bases I have been stationed at, and a full clinic at most. These are fully funded and staffed by military personel. Do you see them on the front line? (a.k.a. Band of Brothers) What a silly thing to ask.

The military utilizes all specialties of medicine because families and retirees are also treated by military doctors. So yes, they have plenty of pediatricians and geriatricians in the military. The military doesn't utilize chiropractors to any significant degree because 30% of the miltary physicians are DO's. And DO's in the military often practice a great deal of manipulation, while a chiropractor could ONLY practice manipulation (hence not a very broad scope of practice in the military's eyes).

As for artists and philosophers; This is a medical discussion and it should have been obvious that I was referring to medical specialties when I was speaking of the military usage of them. And if you have a degree in Art of Philosophy, the military will absolutely commission you as an officer. You will just likely find just find yourself doing things other than your major area of study, just as a chiropractor might have to do if they accepted a commission in the service. And don't get me wrong, there are some chiropractors in the military that are practicing their craft.

Ice Man: I honestly don't know how that would work. Are there two seperate codes for a DC manipulation and a DO manipulation? I use the CPT code 98941. What does a DO use? If there are two seperate codes and you used both techniques than you bill using the code that pays more. If anyone can help me on this one that would be great.

I suppose that once I've been trained in OMM I will end up just incoroporating into the techniques I already use. That's what happens in practice anyway. We're taught many different techniques but once you're in practice you end up sort of developing your own style, which combines most of the techniques you've learned. I suppose adding OMM to that bag of tricks would work the same way. Sometimes OMM would work better for a patient, sometimes a Chiro adjustment. Sometimes both. That's where the art of manipulation comes into play. We're taught that Chiropractic is a science, a philosophy and an art. That's true of medicine as well. I'm sure that OMM has some great stuff that would compliment what I already do and vice versa. In the long run you just do what works best for the patient and don't worry about whether or not it was a DO or DC manipulation That's just semantics.

bustinbooty: That's part of a study that's being done by the military, authorized by Congress, to study the efficacy of Chiropractic in the military. It's been going on for years now and I suppose they will never actually finish it.

You will just likely find just find yourself doing things other than your major area of study, just as a chiropractor might have to do if they accepted a commission in the service. And don't get me wrong, there are some chiropractors in the military that are practicing their craft.

That's what I was told was the big hang-up with adding Chiros to the military. I spent many years looking into it b/c that's what I wanted to do. I even thought of applying to that study I mentioned before. One base they were doing that study at was in Illinois, I think. Like PAC said, the big question is, what would we do in times of war? One AF officer told me we could be trained as PA's or something since we already have the basic training down. Whatever works. I can't see adjusting soldiers on the front line. Talk about having to perform with a gun to your head. Too much pressure. I didn't want to go into the military and not be able to pratice as a chiro. I was offered jobs as a warrant officer, healthcare administrator, chopper mechanic, etc. I was like, whatever dude. Can't see myself adjusting a Blackhawk. Do you think this guy was just after the commision?? :confused:

TB

Yes, there are separate codes for osteopathic manipulation and chiropractic manipulation. Look at your CPT book.

Where is the pre-chiropractic or chiropractic forum? It?s seems all the other health professions have a forum except chiropractic. Why is that??

R&R,
?I think what I stated is pretty clear. It is also not an argument, but rather a perspective. I have studied philosophy for the past 4 years, and I have learned, and experienced first hand, the difference between a constructive discussion and a pissing contest.?

Impressive- four years of philosophy. If you have studied philosophy, you should appreciate the broad use of the term ?argument?, as in the philosophy I?ve had that?s the way we frame all constructive discussions- your line of reasoning is your ?argument.?

While my post had a passing reference to the circular nature of your argument, it never involved a personal attack.

However the tone of your response to me makes me wonder about your intentions:

"Since light travels faster than sound. Some people appear bright until they speak."

?I don't know why everyone takes everything so personally, it is nothing but immaturity and it takes away from constructive discussion.?

Take it personally? <img border="0" alt="[Laughy]" title="" src="graemlins/laughy.gif" />
Do you assume that anyone disagreeing with you on this board must be a chiropractor? I didn?t give you much information to make that assumption. Actually I?m a DO student like yourself, but I?m not quick to take sides. I evaluate arguments by their merit and not their author.

Your thesis does not match your conclusions, nor does it match with what treybird said. He clearly stated that chriopractors and DO's share philosophical roots, while maintaining different theories of dysfunction and different scopes of practice. I happen to think he's right, and while you say you disagree with him, I see nothing in your post that does so clearly.

I would argue that "OMM philosophy" is no different than "DO philosophy"- after all, thats what they put in all the brochures- (and what they teach us in class). If you disagree with me on that topic, we can debate it.

You state:
"I agree OMM and chiro technique share similar philosophies but on the whole modern Osteopathic Medicine is not very related in philosophy to Chiro practice."

To me that sounds like a contradiction- at least with the premise I listed above. This premise is well accepted in the profession, and you can see it on any of the osteopathic philosophy boards. Sure DO's don't all use OMM, but the philosophy of the body as a unit- and discovering health in the patient rather than targeting diseases- these ARE the basis of modern DO philosophy, if there be such a thing.

If you think I misrepresented your argument- tell me how, or restate it by laying out your premises and how they relate to what Treybird posted. I simply don't see the value of disagreeing for the sake of disagreeing, and that was my impression of your post.

"Now the next step, if you disagree is to tell me a reason why you think DO's are more like DC's than physicians"
<img border="0" alt="[Laughy]" title="" src="graemlins/laughy.gif" />
Don't be silly, DO's ARE physicians. Chiropractors, (so far as I know) are not. Obviously I never made any such claim, nor did Treybird so far as I know. Who exactly are you trying to pick a fight with and for what purpose?

relax, it's almost summer.
:cool:
bones

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by PACmatthew:
<strong>
You can always measure a profession by how much the military utilizes them, which is about none for people like you as you know. Anyone see an chiro's on Band of Brother's running from foxhole to foxhole seeing who needed a combat adjustment?

As for artists and philosophers; This is a medical discussion and it should have been obvious that I was referring to medical specialties when I was speaking of the military usage of them. And if you have a degree in Art of Philosophy, the military will absolutely commission you as an officer.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">PACmatthew

let me just get this straight now...

Are you saying that the only value of HEALTHCARE professions are in what capacity the military utilizes them?

How about individuals? are individuals only as valuable as their capacity to serve in the military? <img border="0" alt="[Wowie]" title="" src="graemlins/wowie.gif" />

These are the natural extrapolations of your logic. If this is what you belive, please say so.

bones :cool:

I think we all need an adjustment. I know I do. I just spent two days doing my amcas and aacomas applications, and boy does my neck hurt. Any of you have any problems with amcas changing the characters in your essays? i.e.&gt; question marks where apostrophies should be?

okay, I got a few minutes... so who wants cervical HVLA from a guy who does martial arts in his free time? :p

I've been wanting to try out a new HVLA wrestling move...courtesy of the WWF.

Hey, how many Chiros does it take to screw in a lightbulb??

One, but it takes 8 visits.

HAHAHAHAHAH...that cracks me up.

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Treybird:
<strong>I've been wanting to try out a new HVLA wrestling move...courtesy of the WWF.

Hey, how many Chiros does it take to screw in a lightbulb??

One, but it takes 8 visits.

HAHAHAHAHAH...that cracks me up.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">LOL

I have great respect for those who can laugh at themselves!

How many DO's plan on using OMM in their practice?

Although I'm still working on my undergrad and far from the application period, I hope to use OMM with my patients. Of course, this all depend on what type of specialty I choose and how practical it is to use OMM. In any case, I know my family will bennefit from it. Wish everyone luck in their future as DO's.

Student247

My Dr uses OMM (somewhat) and has really helped my husband (he has shoulder problems). I don't plan on specializing in OMM, but I can certainly see myself using it if I choose to go into primary care. Outside of that, I'm not sure.

My husband is excited for me to learn it so that he can benefit! :D

Thought I would say a word...
The techniques I learned in PT blend with OMM, so I guess I use a fusion of both techniques in clinic. I guess you really come to the point where it no longer distinguishes itself as "OMM-not OMM" in practice, but rather becomes "part of your normal approach to medicine".

I would NEVER have a patient leave the E.D. (say with a dx of 'lumbar strain') without getting postural education and BASIC stretches to ease them back into movement...it takes 60 seconds!

Welcome back, Happy. That's exactly my point. Your techniques become an amalgam of everything you've learned. That's where experience comes into play, and confidence. The more tricks you have in your bag, the more confident you are that you can handle 99% of what walks through the door. That's why I feel that learning OMM will make me a better manipulator (of joints, not people).

When you say that a DO specializes in OMM, do you mean that is all he does is OMM? How does one specialize in it? Do you just lay aside the medical aspect of the profession?

DrMom, manipulation is an excellent way to help some people who don't find relief any other way. Definately become proficient in it. It takes a lot of practice so try and get some in on all your patients you think can benefit from it. Your husband and your patients will love you for it. :)

OMM specialists are DO's that go through normal training through their undergrad medical school and rotating internship. They then do a residency in OMM, or "neuromuscular medicine" as some places call it. Many OMM specialists still use much of what they learned in medical school the way any other doctor would. Some of the competition between chiropractors and DO's, I think, stems from the fact that superficially OMM specialists and chiropractors look very similar in practice.

OMM specialists have a very sophisticated ability to diagnose diseases and dysfunction, rooted in their medical training. Since I don't know exactly what chiropractors are taught (except what I've heard on this board and via the links here), it would be difficult for me to draw a comparison. Perhaps treybird can get back to us on the matter after a few years of DO school!

OMM specialists make it their goal to treat patients that come in as if OMM is a medical treatment. Treatment attempts to target the cause of the problem, and alleviate that cause on the first visit (rather than ongoing treatments for patients without significant symptoms for the purpose of "wellness"- though I don't know how many chiropractors do this). If the symptoms do not resolve on the first visit, sometimes the patient must come in a few more times. If no improvement is shown, obviously other treatment options are available. Some OMM specialsts operate as primary care providers, though typically it is best to do a Family med/OMM dual residency for this (or do a +1 program-&gt; most OMM residencies take only 1 year if you already have another residency under your belt).

OMM specialists do, however, charge normal doctor wages- which is significantly more than chiropractors.

What is the recommendation? many would say for serious neuromuscular issues it is better to see an OMM specialist, since thier medical background will aid them in determining the best course of action, and perhaps how to most directly treat the presenting symptoms. Whether this is necessarily true- I can't say. I haven't seen outcome studies, and I suspect the effectiveness varies a lot by the individual practicioner as well.

this is a complicated subject, and I'd like to discuss it some more once finals are over...
I'll see if I can find any sources then.

peace,
bones :cool:
KCOM '05

The way that I view Chiropractic is that it is similar to PT in that rehabing an injured joint is like rehabing any other injured MS area, which means it's a process. This is why it may take several visits to a Chiro, depending on the activity level of the patient, their age, occupation, sex, injury etc. It can take a while for the body to heal so while it's working through the healing stages, the adjustments keep the spine aligned, more to the point, keep the joints moving, while stressing the ligaments in a way that stimulates proper healing, avoiding the formation of fibrosis and adhesions. Just like you would get an injured football player with a torn ACL back on the exercise equipment as soon as possible, to add stress to those ligaments, causing the healing fibers to realign in the direction of stress, thereby assuring the strongest possible heal, avoiding scar tissue as much as possible and therefore chronic pain.

I keep hearing that people would go to a DO instead of a Chiro b/c of the medical background in case something else is the underlying cause, etc. First of all, we all know that a patient's history will tell you the diagnosis 90% of the time if you listen close enough. If a patient was at work and he went to lift something and felt his back go pop and now has sharp SI joint pain, what is there to medically diagnose?? Come on, seriously.

You read through the history to look for red flags of previous conditions that may have set up this injury (i.e. cancer, etc.); do a patient interview to find out the mode of injury onset, location of pain, description of pain, presence of any radiating pain, what makes it worse, what makes it better, etc.; do the orthos/neuro tests to rule out a disk problem, or other more serious injury; and then do the motion palpation of the SI joint to confirm your diagnosis, but you already know what the problem is. Tests are run to confirm or deny a diagnosis, not to make a diagnosis. No, I don't X-ray/MRI every patient, only when looking for pathology. So what makes you think that chiros are different in this regard. We are very well trained in A & P and have an excellent knowledge of how the body works. Granted, we don't spend as much time in path, pharm, and surgery, but I'm not interested in the organic basis for cholecystitis b/c I'm not going to treat it. All I want to do is recognize what it is and refer that patient out. Most people who have a DC also have a family doc. So we just call the family doc, explain what I think is going on, set up an appt and send the patient on his/her way.

You guys are making this harder than it is. When you hear hoofbeats, think horses, not zebras. If a patient comes in with insidious onset pain and has a history of blood clots or prostatic cancer, then you start to do some investigating. Yes, we have the training to pick out the red flags, investigate, and refer. I don't know why everyone in here feels that we're just not qualified to do this. We don't usually have the life-threatening cases walking in our doors, but if one did I am confident that I know enough to recognize that and send them on to the proper specialist. I have before.

It's not brain surgery, well, unless you're a neurosurgeon of course. I meant Chiropractic is not brain surgery. For those of you in internship or residency, don't overthink everything. Use some common sense, and I'm not saying that to be an ass or directing it at anyone in particular. It's just a reminder to take your knowledge of anatomy and physiology and just use common sense. Sometimes we get too tunnel-visioned and lose sight of the big picture. DO's, I think, are much better at looking at the big picture than any other allopathic professions.

Ok, bring on the onslaught of disagreements...... <img border="0" alt="[Laughy]" title="" src="graemlins/laughy.gif" />

TB

Nice post Trey! I just think it's sad that because we, as DC's, have so many loony representatives of our profession, we are all automatically stereotyped to be witch doctors. Not pointing any fingers at anyone but ourselves, of course! :) But the perceptions are slowly changing, and definitely for the better. I was just hoping to spread some awareness to the fact that DC's do have something wonderful and valuble (and valid) to add to medicine. :cool: Trey here, has been my hero in that respect!

JenMac <img border="0" alt="[Lovey]" title="" src="graemlins/lovey.gif" /> Well put, Jen.

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Treybird:
<strong>I keep hearing that people would go to a DO instead of a Chiro b/c of the medical background in case something else is the underlying cause, etc. First of all, we all know that a patient's history will tell you the diagnosis 90% of the time if you listen close enough. If a patient was at work and he went to lift something and felt his back go pop and now has sharp SI joint pain, what is there to medically diagnose?? Come on, seriously.

You read through the history to look for red flags of previous conditions that may have set up this injury (i.e. cancer, etc.); do a patient interview to find out the mode of injury onset, location of pain, description of pain, presence of any radiating pain, what makes it worse, what makes it better, etc.; do the orthos/neuro tests to rule out a disk problem, or other more serious injury; and then do the motion palpation of the SI joint to confirm your diagnosis, but you already know what the problem is. Tests are run to confirm or deny a diagnosis, not to make a diagnosis. No, I don't X-ray/MRI every patient, only when looking for pathology. So what makes you think that chiros are different in this regard. We are very well trained in A & P and have an excellent knowledge of how the body works. Granted, we don't spend as much time in path, pharm, and surgery, but I'm not interested in the organic basis for cholecystitis b/c I'm not going to treat it. All I want to do is recognize what it is and refer that patient out. Most people who have a DC also have a family doc. So we just call the family doc, explain what I think is going on, set up an appt and send the patient on his/her way.

You guys are making this harder than it is. When you hear hoofbeats, think horses, not zebras. If a patient comes in with insidious onset pain and has a history of blood clots or prostatic cancer, then you start to do some investigating. Yes, we have the training to pick out the red flags, investigate, and refer. I don't know why everyone in here feels that we're just not qualified to do this. We don't usually have the life-threatening cases walking in our doors, but if one did I am confident that I know enough to recognize that and send them on to the proper specialist. I have before.

It's not brain surgery, well, unless you're a neurosurgeon of course. I meant Chiropractic is not brain surgery. For those of you in internship or residency, don't overthink everything. Use some common sense, and I'm not saying that to be an ass or directing it at anyone in particular. It's just a reminder to take your knowledge of anatomy and physiology and just use common sense. Sometimes we get too tunnel-visioned and lose sight of the big picture. DO's, I think, are much better at looking at the big picture than any other allopathic professions.

Ok, bring on the onslaught of disagreements...... <img border="0" alt="[Laughy]" title="" src="graemlins/laughy.gif" />

TB</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">The biggest issue that I have is that I have no knowledge of a chiro's clinical skills. Chiro's simply do not see the pathology that doctors see through out their training. It's one thing to have read about a disease and how it presents. It's a totally different thing to actually see the patient and how they present with that particular disease. By seeing pathology, you hone your clinical skills that are necessary for that group of diseases. If chiro's do not see the volume of pathology that doctors do, how can they develop that clinical skill set? How can I be sure that when you auscultate someone's heart, you can interpret the sounds in an accurate fashion? How can I be sure that you can effectively rule out PE when someone presents with MSK sounding chest pain? As medical students/doctors, we do not look for red flags, we look for a diagnosis. There isn't a specific sign that we look for, we look at the whole picture of the patient as they present to us. If you're not interested in the organic basis of cholecystitis, we are. We are interested in organic disease (by which I assume you mean internal, non-MSK organs) as well as MSK disease. Everything that our patient presents with, from their psyche to their lungs to their elbows, is our concern. That is the big picture.

As for DO's being more concerned with the big picture, DO's are the same as MD's. They will treat the same diseases and the same patients in the exact same way as an MD. Any difference between the two will be entirely based on the individual doctor.

The biggest issue that I have is that I have no knowledge of a chiro's clinical skills.

Exactly. Go shadow one for a day and see what we do. You might learn something about a new profession. Just a suggestion, not a dig.

If chiro's do not see the volume of pathology that doctors do, how can they develop that clinical skill set? How can I be sure that when you auscultate someone's heart, you can interpret the sounds in an accurate fashion?

Ponyboy, I know enough to know when something doesn't sound normal. That's all I'm concerned about at this point because I'm not going to treat cardiac tamponade or any other cardiac condition. I'm going to refer them out to their cardiologist or family doc. You keep looking at this from the perspective of a medical student. We're not medical doctors. That's what I've been saying all along.

If you're not interested in the organic basis of cholecystitis, we are. We are interested in organic disease (by which I assume you mean internal, non-MSK organs) as well as MSK disease.

I agree with that. I never said that you guys weren't interested in those things. I just said that we weren't as interested in the pathology of organic, non-MSK diseases, because we don't treat the pathology of those conditions. You do, so naturally you would have an interest in it, I would hope. I just said that we're trained enough to know when something is outside our scope of practice to refer that patient on. Organic, non-MSK diseases are outside our scope of practice. Certainly any MSK conditions that require surgery or medicine are also outside of our scope of practice as well.

Everything that our patient presents with, from their psyche to their lungs to their elbows, is our concern. That is the big picture.

I'm absolutely concerned for my patients. Enough so that I make sure they get the proper medical care when necessary.

As for DO's being more concerned with the big picture, DO's are the same as MD's. They will treat the same diseases and the same patients in the exact same way as an MD. Any difference between the two will be entirely based on the individual doctor.

I stated that as a compliment. I'm sorry if you didn't see it that way.

TB

The problem is not whether chiros can recognize typical red flags of serious disease but can if they can recognize atypical presentations of serious disease. Sometimes an MI presents as heartburn. Sometimes pericarditis presents as costochondritis. Even seasoned doctors can miss things like this. Think about how much easier for someone who doesn't have the same training could also make the same mistake.
There is also the minor diseases that must be looked after as well. If chiros admit that they are not medical doctors and that they do not treat diseases outside of a spectrum of MSK ailments, then why do some of them insist they are primary care providers? Even minor illnesses such as a sore throat can be harzardous if they are not given the appropriate investigation and therapy (sore throat that's actually Strep that leads to rheumatic fever).

I've seen chiros in action. But I've never seen them evaluate chest pain, use a stethescope or read a CXR (other than looking at the spine). There isn't really an environment for them to do so.

Sometimes pericarditis presents as costochondritis. Even seasoned doctors can miss things like this.

If that's the case then why would you expect more from a Chiro under the same circumstances? Nevertheless, let's use this as an example.

If I had a patient come in with pain in the costal cartilage region, these are the questions I would ask.
1: First thing I would do is ask the patient if it is a specific pain or a diffuse pain, then I would touch the costal cartilage where it hurts and see if pressure on that area increases pain. How would you describe the quality of pain (i.e. sharp or dull - typical of a MSK conditon)
2: Does it hurt when they move that cartilage or at times independent of movement, esp. when using the chest muscles that attach to that region?
3: What was their history? Have they had this pain in the past? If so, what was the diagnosis?
4: Do they have a history of a recent illness or other heart condition (rheumatic fever as a child)?
5: Are they having trouble breathing that feels like it originates from the lungs or a sharp pain in the costal cartilage area?
6: Do they have an abnormal or weak pulse, abnormal breath sounds, bradycardia, etc?
7: Does ice on the costal cartilage make it feel better?
8: Have they recently played any sports or done any new activities that may have caused that patient to strain the costal cartilage (i.e. a new racquet sport, new weightlifting program, weekend warrior-type housework, etc.)?
9:Have they felt very run down lately, esp. when they exert themselves, indicating hypoxia due to cardiac compromise?
10: Have they been running a fever lately?
11: Have they noticed any digital cyanosis, esp. with exertion?
12. Does swallowing make it worse?
13: Is there any radiating or referred pain to the neck or inferior scapula?
14: Is there a change in pain with a change in position, i.e. sitting and leaning forward?

You mean to tell me that with this information you couldn't take a reasonable guess as to whether or not their conditon was life threatening?? Keep in mind, I only have to have enough info to suspect that a referral is warrented, not a diagnosis. If after a few adjustments and directions for the use of ice and massage the pain remains or gets worse (assuming the patient is compliant in following their restrictions), then I start to suspect something beyond a MSK problem.

TB

If I had a patient come in with pain in the costal cartilage region, these are the questions I would ask.

1: First thing I would do is ask the patient if it is a specific pain or a diffuse pain, then I would touch the costal cartilage where it hurts and see if pressure on that area increases pain. How would you describe the quality of pain (i.e. sharp or dull - typical of a MSK conditon)
A: Yeah, it hurts when you push on it. It's a little between a sharp pain and an ache. Kinda like a muscle ache.

2: Does it hurt when they move that cartilage or at times independent of movement, esp. when using the chest muscles that attach to that region?
A: It hurts when I stretch my arms out. Otherwise it aches like if I bruised my chest or the muscles.

3: What was their history? Have they had this pain in the past? If so, what was the diagnosis?
A: Was exercising for the first time in a few weeks because I had the flu. It feels very similar to what I've had in the past but it usually goes away after a few days.

4: Do they have a history of a recent illness or other heart condition (rheumatic fever as a child)?
A: Just the flu.

5: Are they having trouble breathing that feels like it originates from the lungs or a sharp pain in the costal cartilage area?
A: Feels like it's in my chest wall. And its sharp whenever I breathe and stretch my arms.

6: Do they have an abnormal or weak pulse, abnormal breath sounds, bradycardia, etc?
A: That depends on your clinical skills. You tell me.

7: Does ice on the costal cartilage make it feel better?
A: A little.

8: Have they recently played any sports or done any new activities that may have caused that patient to strain the costal cartilage (i.e. a new racquet sport, new weightlifting program, weekend warrior-type housework, etc.)?
A: As above.

9:Have they felt very run down lately, esp. when they exert themselves, indicating hypoxia due to cardiac compromise?
A: Just had the flu. Stayed home from work a few days. Better now.

10: Have they been running a fever lately?
A: Nope.

11: Have they noticed any digital cyanosis, esp. with exertion?
A: Nope.

12. Does swallowing make it worse?
A: Nope.

13: Is there any radiating or referred pain to the neck or inferior scapula?
A: Nope.

14: Is there a change in pain with a change in position, i.e. sitting and leaning forward?
A: Sitting feels a little better than lying down. But not much difference. Pretty much the same actually.

From this history (from a previous patient of mine), can you honestly say that you are sure that this isn't MSK related? How long would you wait before referring this patient? I've had diabetic patients with PE's come into the hospital thinking that they were going hypoglycemic. I've had TIA's come in thinking that they've sprained their ankle. I have yet to see a textbook presentation of anything but warts. There will be some patients who will always be an enigma, no matter how many questions you ask. And even after a physical exam, you may still be wondering.

But what I really want to know is my second question: Do chiros truly try to function as primary care providers, even if they assert that they only treat a certain spectrum of MSK illnesses?

I'm gonna leave the question to Trey since he has the chiro clincal experience here, but I wanted to interject and mention that with the training I am receiving now, we have a problem based learning class in every term (starting with the very first term) where we are presented with cases, and we must figure out the tests to run to determine the probable diagnosis, method of treatment (referral? comanage? treat? how?), the questions to ask them, info we need, blah , blah, blah. Then we all research it, and come back with what we found, all researching different probable diff dx's, and different variables that may be affecting the pt. Then we discuss. Every case we have gotten has not been textbook, so there is a lot of discussion. It's a very cool way to learn. The longer we are in the program, the more complex the cases get. Of course, we can't cover everything, but it's a really good experience to apply to future clinical experience. Correct me if I'm wrong Trey (or anybody), but I am thinking that most of the time, patients won't come to a chiropractor for these complaints. However, when they do, we can catch them, and even if they are coming to a chiro for a different reason, we are still able to catch things that they need attention for beyond our scope.

Sorry i just have to laugh a bit regarding the questions...coming from an Emergency Dept perspective, many of the questions you guys are asking are virtually inconsequential (sp?) and skip over the more dangerous causes of chest pain. Not only have you done that, but your questions automatically attempt to RULE OUT/RULE IN costochondritis.
From a new intern to you guys...rule out the most dangerous causes of chest pain first (ones that cause sudden death)...it may seem like overkill, but I am coming from an ED point of view.

Well, it's all a matter of perspective. If you're a neurosurgeon, you're going to recommend surgery for LBP. If your a PT, you recommend exercise. If you're a chiro, you recommend adjustments. Simplistic, but do you see what I mean?

You'll never view the patient in my office the way I will, and I'll never view the patient in the ER the way you do. We are coming at the patient from two completely different views. The chance that a patient is going to come in to my office with near death heart spasms is very remote. Is it a possibility? Of course. But statistically very remote. You guys play the statistics game all the time. You have to for practicality's sake b/c we can't run through every battery of tests for every patient. I'm not going to immediately jump to pericarditis for a patient complaining of specific MSK pain. You know as well as I do that it's just not feasable, or necessary, to run to an EKG machine every time a patient has some soreness in his pectoral region.

Ponyboy was addressing a situation in which a patient was showing atypical symptoms of a serious condition that even experienced docs miss. My point was if that's the case than we can expect that it will happen to everyone at least once throughout the course of a career. So if you can accept that it happens to seasoned medical docs, why would it make you think twice about going to a Chiro, unless you are holding us to a HIGHER standard than your seasoned docs. That is just unrealistic for the situation posed.

I've been to the ER with MSK inguinal pain and the ER doc didn't have the first clue as to how to approach me. He asked very basic MSK questions, was very nervous and unsure, and really didn't know what to do outside of giving me drugs. I ended up telling him what to do, and I'm not saying that egotistically or condescendingly, it just was what it was. I wanted X-rays to rule out a hip fracture or dislocation. I ended up getting adjusted and PT from a PT friend of mine for 3 days in a row (I did take the Demoral shot that night, though, I wasn't stupid). Both PT and CHiropractic worked great together and I was back to normal in 3 - 4 days. My point is that this ER doc probably kicked ass on life-threatening conditions, but was clueless with basic MSK issues, which was my area of expertise. It was all a matter of perspective b/c to me it was a no brainer. As long as I wasn't dying or bleeding or unconcious, he didn't know how to treat me, other than to turf me.

We're like at three different corners of a triangle all looking in at the same patient. I find that both funny and sad, but it's true. Even you two DO's see things differently.

TB

Clown, I asked an entirely different set of questions than those posed by TB. I was simply answering all of his, using my patient's history (relatively asymptomatic except for MSK sounding pain). After spending considerable time in the ER as well as the ICU, I find I have a mind set similar to yours (dead or alive or checking out quickly).

TB, the point is, if even seasoned docs can make these mistakes, how easy do you think it'll be for other allied health professionals (who see much less pathology) to also miss treatable diseases, life-threatening or otherwise. Even if chiros function as portals into the healthcare system, they must pick up signs of disease to refer the patient to the doctor. Moreover, I'd still like this answered: how can chiros function as PCP's if they admittedly only treat certain MSK diseases?

PS I'm not a DO or a DO student.

TB, the point is, if even seasoned docs can make these mistakes, how easy do you think it'll be for other allied health professionals (who see much less pathology) to also miss treatable diseases, life-threatening or otherwise.

I agree that it would be easier for those in the allied health field to miss those pathologies. We're agreed there. But, you also have to admit that the chances of those patients walking into my office (i.e. serious disease exhibiting atypical symptoms) is much less than them walking into yours. Agreed?

Let's just say that in 8 years in practice this has never been an issue for me. We're talking about what could theoretically happen, but doesn't usually happen. It goes back to what I previously wrote, what conditions am I most likely going to see in my office? You're still using an extreme example to prove a point that statistically isn't as likely. I just don't see those type of patients. If I did, and the patient wasn't exhibiting obvious symptoms that could be drawn out through some Q & A than what could I do differently than you? How many patients have cancer but are given aspirin and sent home? It all goes back to the think horses, not zebras.

Ponyboy, it's like you're trying to drag some big confession out of me that Chiros aren't competent doctors b/c they can't diagnose atypical serious diseases, but you chose to ignore the field docs who do this all the time, so how is that DIFFERENT from me?? How is that different from YOU?? That is just the risk of being in healthcare. We all share that same risk. Many doctors don't even take the time to listen to their patients to find out what is going on. I feel confident b/c I take the time with my patients and ask a lot of questions. If something doesn't sound right to me than I refer them for a second opinion. That's all any of us can do. I can't sit and worry about every potential atypical thing it could be. It's just not practical. I'm not going to run them through an ER protocal in my office. None of you guys seem to address this point, and I don't understand how you can't agree with me on that. Man, getting you guys to give on any issue becomes a total battle of wills. It's like Bones says, sometimes you guys disagree with me just to disagree. If someone is that ill then we lie them down and call the EMS. Fortunately that's never happende to me. Doesn't exactly look good for business (ha ha).

Moreover, I'd still like this answered: how can chiros function as PCP's if they admittedly only treat certain MSK diseases?

I've never held myself out to be a primary care provider, only a Chiropractor.

What is your occupation if not a DO or DO student? I must have missed something or even worse, assumed something.

TB

<strong>Even if chiros function as portals into the healthcare system, they must pick up signs of disease to refer the patient to the doctor. </strong>

I'm using an extreme example to support an argument. Yes, pericarditis is something that you might not see, but I'm not only concerned about serious diseases. As I've said before, I'm concerned about even the minor illnesses that are missed as they can have bad outcomes if they are left for too long. For example, asthma is a very common disease and research has shown that if it isn't treated promptly, the outcomes of patients are much worse than if they had been treated right away. Yes, doctors miss things. There's no question about that, but think about how much easier it would be for someone else with not as much training to do the same. I'm not trying to make you say that chiros are not competent doctors. They're not doctors. What I'm trying to say is that I have no evidence to suggest that chiros can effectively screen out patients that need to be seen by a doctor from those that do not.

As for being a PCP, the only reason why I joined this debate was because you remarked that chiros can be PCP's and I disagreed. It's about four pages back.

PS. I'm an MD student, not DO. Not that there's a difference.

I'm not trying to make you say that chiros are not competent doctors. They're not doctors.

We're Doctors of Chiropractic, just like podiatrists are Doctors of Podiatry. Do you realize that when you say we're not doctors that it makes you appear insecure. Do you feel threatened somehow by the idea that we are called doctors too? If you want to say thet we're not Doctors of Medicine than I can accept that. But don't insult my education. I don't understand the need for people to be so ego-driven here.

Yes, doctors miss things. There's no question about that, but think about how much easier it would be for someone else with not as much training to do the same.

I think I can recognize and refer an asthma patient, thank you. So you feel that all professions less than MD's and DO's should not see patients b/c of the possibility that something might be missed? Nurse pracitioners? Mid-wives? PA's? Do you know how condescending this is? I mean honestly stand back and think about what you're saying. You're saying that I should not be in practice b/c of the possibility of missing something seriously atypical. If I've misinterpreted this, please tell me where you see Chiropractic fitting in to the healthcare system. Let's start there b/c I want to make sure that I'm not being overly sensitive here. I think if MD's had their way, we would not be in business.

When I say doctor, I mean doctor of medicine. No slight intended.

What I'm trying to say is that I have no evidence to suggest that chiros can effectively screen out patients that need to be seen by a doctor from those that do not.

The training for an NP and a PA is much different from that of a chiro. I think chiros provide good care for certain MSK pain. However, I have no evidence to suggest their abilities on any other front.

Well, I guess until a study is done, this will all be nothing more than opinion and conjecture. I would venture to say that Chiros don't miss an atypical diagnosis more than medical doctors. Not b/c we're better, we just don't come across those situations as frequently as you do. You're still talking about a theoretical situation. I know that we can pose a million theoretical situations regarding medical doctors and what they miss. Do we want to play that game though?

I've already admitted that we don't have the clinical training on par with medical doctors. I guess I don't know where you want to go with this. I've never run across the situation your proposing, nor have any of my friends or coworkers.

I use my training and instincts to rule out anything I consider questionable and if I find something that doesn't quite sound or feel right, then I refer them on for further study. No matter how the medical profession tries to twist this to make it sound like patients who go to Chiros are at risk for strokes, or missed diagnoses, or fractures, or whatever, the fact is that the chances for any serious injury are statistically way lower than in medicine. That's a fact.

Do we want to talk about all the surgical and drug mishaps that happen every day? I know what happens when interns and residents have been up for 36 hours straight. How can you, in all seriousness, even point a finger at us when you have these serious issues on your plate? It's like that whole misdirection thing, the medical smoke screen. "Look at the Chiros and what they're doing...just don't look over here at what we're doing..." You still have this superiority attitude that the Chiros could just NEVER compete with the medical profession. We're not trying ot compete.

I will be the first to admit that there are many Chiros out there that I can't stand b/c they're nothing but car salesman. That makes my skin crawl b/c Chiropractic works, and it works well. And you're arguement that we could miss something serious is moot b/c so could you. It's all relative. We come in contact with many, many less patients with atypical symptoms than you do. I noticed you still haven't acknowledged the things I asked if we agreed upon. This tells me you have no intention of actually having a give and take discussion. I will never say that we shouldn't be in practice b/c we might miss something serious, b/c I don't believe that for a second. And you know what, let's not play the "Oh, my, those poor patients at risk for a Chiropractic missed diagnosis...will they survive the Chiro visit?" But you just can't have an open mind on this issue at all. So how can we discuss this? We can't. All we do is go in circles.

1. The more experience one has treating patients with illnesses, the more adept one becomes at recognizing illness, serious or minor, atypical or otherwise.

2. Medical doctors, NP's and PA's have more experience treating patients with illnesses than chiropractors.

3. MD's, DO's, NP's and PA's are more likely to recognize illness in a patient (serious or otherwise, atypical or otherwise) than a chiropractor.

4. The chances of a patient with serious illness (atypical or otherwise) presenting to a chiropractor is much less than if they were to present to a medical doctor. Therefore, the absolute number of missed serious illnesses is lower than compared to physicians.

5. The relative risk (ie. the odds) of a missed illness (serious or otherwise, atypical or otherwise) is greater in a chiropractor than a medical doctor, NP or PA.

6. This is not a theoretical situation. It occurs and can be found in the literature and legal records.

6.5. This is not a moot point. The possibility of a missed diagnosis is always present. However, the risk is different between the two professions.

7. Please show me a disease by which the chiropractic treatment is more efficacious and safer than the corresponding medical treatment.

8. You do not know what happens when interns and residents have been up for 36 hours straight. You have never been a resident and have never been on call in the hospital for 36 hours straight. You are not aware of both the risks as well as the benefits of long call duties.

9. Do I think that chiros should shut down their practice? For some, yes. Others, no.

10. Do I think that anyone who has an illness and wants to see a chiro should also see their PCP? Yes.

Finally, page 9. I was so tired of waiting for page 8 to load. On to business.

I bow to your overwhelming expertise. I can't argue the same thing over and over again. My head is going to explode. You're absoultely right, medical doctors rule on all fronts and Chiros have absoultely no business seeing patients. What was I thinking? What were my patients thinking? Those silly, live-on-the-edge, MD-defying loonies.

Regardless of where you stand on the issue, however, we will still continue to see patients, and will continue to provide a service where none exists in certain areas of healthcare. Fortunately you don't make the laws, and hopefully you never will. We'll never be under the MD domain, and after talking with you, I support Chiropractic's continued fight for autonomy. I see that nothing has changed in the medical community and it appears that you will not be happy until all healthcare professions are under your control, but, it ain't gonna happen.

Please show me a disease by which the chiropractic treatment is more efficacious and safer than the corresponding medical treatment.

First off, most things that we do are safer than medical tx. Need I remind you that every drug has a side effect, some potentially lethal. Be that as it may. You seem to avoid those issues rather pointently. Ok, sciatica, lumablgia, CTS, cervicalgia, whiplash, sacral segmental dysfunction, facet syndrome, thoracic outlet syndrome, and any other pain syndrome that can be helped through manipulation over medicine.

You do not know what happens when interns and residents have been up for 36 hours straight. You have never been a resident and have never been on call in the hospital for 36 hours straight. You are not aware of both the risks as well as the benefits of long call duties.

It's amazing how you have such an awareness of my life and professional experiences. I'll chalk that one up to the MD omnipotence too. And yes there is a big difference between DO's and MD's. You'll just never see it.

1. Wow, great idea. Side step the simple step-wise argument with more rhetoric and sarcasm. Then totally ignore point number 10. That makes for great discussion! I laid out every point that I had to make. Which one do you not agree with?

2. Did I say I wanted to control all areas of healthcare? Did I ever say I wanted to control chiros? Did I?

3. I didn't know that chiropractic was efficacious for thoracic outlet syndrome. Next time I see my patient with lymphoma (who presented with thoracic outlet syndrome), I'll tell her to stop chemo and get herself adjusted. Oh, before I do that, could I get that little thing called evidence? (please, well-controlled, blinded studies with comparisons to medical therapies).

4. You're right, I made an assumption about you and your professional life. I was totally mistaken into thinking that since you had not yet gone to medical school, that you could not have previously been a resident or even a sub-intern. Please tell me where and when you have functioned at a medical resident level and I will rescind my comment.

5. You didn't even notice I was an MD student until I brought it up. Apparently, this big difference was lost on you as well.

Okay, we are getting nowhere all over again. Egos are getting inflamed, and things are being taken personally because we are thinking these are personal attacks. Time for a deep cleansing breath! :) Now, Ponyboy, I think the whole different perspectives conversation has been completely lost on you. The chances for missed disease are not greater in a chiros office because we are not likely to see these patients. Period. You are talking chances which are based on statistics, and statistically speaking, it's not likely to happen. If and when it does, I am confident any properly trained chiro (that paid attention in basic science classes, not just in philosophy) will be able to pick up on these signs and symptoms. We are trained to look at patients from a different angle, and it's amazing what you can learn when you get a group of people together with different educations looking at the same problem. As long as you respect the other persons perspective of course. Second of all, you asked what diseases are better helped with chiropractic care (which has been stated NUMEROUS times on this forum that our scope of practice is focused on musculoskeletal diagnoses), and Trey listed off specific diseases and you throw back a lymphoma case which presented as thoracic outlet syndrome and made it seem like Trey was suggesting that he adjust to make her cancer *poof* go away. That is not what was stated, and you know it. If a patient HAS thoracic outlet syndrome, he or she can definitely benefit from chiro care. That's all that was asked, that's all that was answered. It's easy to get caught up in pointing fingers...but this is just getting stupid. I just have to ask you, do you think that chiropractic, in general, is a valid form of treatment? Do you plan to refer any patients to a chiropractor who may benefit from treatment? Or are you just going to prescribe really strong NSAIDS? (after all, that's what I took for my LBP before I went to a chiro). What do you want to gain from this discussion?

1. You're confusing your statistics. I agreed the absolute number would be low. However, the relative risk would be higher.

2. The chances of patient presenting to a DC with an illness are increased when you go around telling people that you are PCP's (and yes, both of you have posted that on this board).

3. I'm glad you are confident in your pre-clinical training. However, you will soon find that there is a large difference between what you learn in books and what you learn in the hospital.

4. Thoracic outlet syndrome (like all syndromes) is a constellation of signs and symptoms that are caused by an underlying disease. If anything, chiropractic may provide symptomatic relief but does not treat the underlying illness. To say that chiropractic is more efficacious in treating thoracic outlet syndrome than medical therapy is shortsighted. That's like saying that tylenol is more effective than antibiotics at treating pneumonia because it brings down the fever.

5. If I had a patient who could benefit from chiropractic treatment, I would send them to a reputable chiropractor.

Off to work. More later.

For now,
The only thing I have ever said is that we are better adjusters than DO's, and, in my experience, I have seen some pretty awesome diagnoses made by a DC. We can diagnose. It's not like we don't get any clinical experince, we do. Just not as much as allopaths. You all make it seem like they arm us with a "how to diagnose" text and turn us loose with all of our patients, praying we don't miss something. We have more experience than that. This taken into account, if you go to a good chiro, the relative risk is not higher that they'll miss something. But, alas, I don't have the much needed research, so I really don't know. I'm speaking solely from experience.

Jen made excellent points. Glad to get some perspective here. And you're right, the reason that the AMSA is trying to cut the number of residency hours in a row down from 36 to 24 is becaue 36 hours is much SAFER than 24. Come on, Pony, don't insult my intelligence. The reasearch shows that after being up for 24 hours, your awareness level is similar to a BAC of .1%, which is over the legal BAC in Indiana.

And, I've never gone around telling anyone I was a PCP. I tell people I'm a Chiropractor. Who have you been talking to? You didn't have to say you wanted to control Chiros but you seem to know exactly what our competency level is without having any practical Chiro experience or training. Sounds like you're doing the same things you accused me of...and I quote:

You're right, I made an assumption about you and your professional life. I was totally mistaken into thinking that since you had not yet gone to medical school, that you could not have previously been a resident or even a sub-intern. Please tell me where and when you have functioned at a medical resident level and I will rescind my comment.

Good old medical double standard.

No, I didn't know you were an MD student until you mentioned it. Up until then I thought you were a sefl-hating DO. It makes more sense now.

Thoracic outlet syndrome (like all syndromes) is a constellation of signs and symptoms that are caused by an underlying disease.

Let me be more specific....costoclavicular syndrome, which I 've treated successfully many times after their MD's diagnosed it as CTS. Yes, adjustments alone won't do it until the patient makes some lifestyle changes that lower their risk of reinjury. That's true of most MSK conditions.

Do I think that anyone who has an illness and wants to see a chiro should also see their
PCP? yes

For the 1,576,298th time, we don't treat illnesses, so yes, if a person has an illness, they should see their PCP. What part of that is not registering?

Also, you always seem to avoid the point that there are many more medical mishaps and injuries in medicine than in Chiropractic.
Would you agree? Simple yes or no....no modifiers with your answer. I made it in bold and italic so you wouldn't miss it this time.

Which one of is more likely to miss a diagnosis or cause a patient serious injury due to mismanagement? Should I dig up the stats on medical mishaps and deaths or maimings from drug interactions or surgical blunders (i.e. cutting off the wrong leg or taking out the wrong side of a patients brain.) These are extreme examples that obviously don't represent the majority of doctors, yet you still choose to use an extreme example to represent Chiropractic. Does that seem like a fair way to make a point to you?? That tells me that you have no interest in reaching a middle ground. And by the way, are you going to be the judge over which Chiros are competent and which ones aren't? By what method? Do you know our scope of practice? Do you know our protocal that you can make these judement calls?

I'm not trying to be sarcastic, I'm trying to understand how you would make these distinctions within a profession you don't know much about.

1. Re: telling people or believing that chiros are PCP's:
It is GREAT to be a chiro and now matter how much you think we can't be primary care providers, we are.
Posted by you on this discussion board. It just doesn't make any sense. I mean we are agreed that sick people should see their PCP. But first you say you are a PCP, then you say you're not. I'm confused. So what is it? Are you a PCP or not? Do I know your scope of practice? Here's a better question: Do you know your scope of practice?

2. Did I say that I wanted to control chiros? Did I say that I wanted to accredit the competencies of chiros? I simply stated the opinion that I thought some chiros should not practice and that some should. Just like I think some doctors should be in practice and some shouldn't.

3. I suppose that working with a chiro for 3 years is no practical experience? And I have never said that I know the competencies of chiros. I simply said that NP's, PA's and MD/DO's have more training treating illnesses than DC's. As such, they are more adept at recognizing and treating illnesses than DC's. If for some reason you don't agree, I'll outline my argument and you can show me which point you disagree with:

4. The more experience one has treating patients with illnesses, the more adept one becomes at recognizing illness, serious or minor, atypical or otherwise.

5. Medical doctors, NP's and PA's have more experience treating patients with illnesses than chiropractors.

6. MD's, DO's, NP's and PA's are more likely to recognize illness in a patient (serious or otherwise, atypical or otherwise) than a chiropractor.

7. Which part of points 4,5, and 6 do you not agree with?

8. I'll repeat, I'm not making any judgements about chiropractor competencies other than their ability to recognize illness is not comparable to NP's, PA's and MD/DO's. So, don't you think that patients deserve the best health surveillance possible? Do you not think that if someone tries to enter into the healthcare system through a DC, that they should also be screened for preventative health measures by the most qualified person?

9. You're right, I made an assumption about the training of DC's in comparison to medical training without any actual chiro training myself. Please show me where DC's interview and examine patients with all types of pathology, admit to a hospital, write orders, prescribe, perform surgery, order and interpret all forms of diagnostic tests at a level comparable to medical trainees and I will rescind my comments. Because I have never seen nor heard of a DC or DC student do any of the above, I assumed that DC's do not have as much training treating illnesses as medical professionals. Please show me otherwise.

10. The reason why I am not answering the question whether there are more mishaps in medicine than in chiropractic is because the question is ridiculous. You are comparing two treatments that are radically different. First, the number of patients treated by physicians and DC's are much different. Secondly, the therapies used in medicine are much more varied than chiropractic. Third, the medical patient population is more acute, varied and serious than the chiropractic population. Fourth, because the patient population is much sicker in medicine, there are many more ethical and therapeutic dilemnas to be faced as well. Fifth, because the patient population is sicker in medicine, smaller errors have much more dire consequences. Sixth, because the patient population is sicker, the therapies involved are more aggressive than chiropractic. Seventh, aside from neck manipulation and other questionable practices, chiropractic is a relatively innocuous therapy (ie. much like PT) and as such, any mistakes that are made are likely to have very little effect on an otherwise healthy patient. Eighth, there is no mention about effectiveness of either treatment for any specific disease. Wow. Off the top of my head, that's seven confounding variables and one question pertaining to the relevance that make this question ridiculous. Why not ask me if there are more associated deaths from medicine as compared to giving healthy children Vitamin C? Why not compare the morbidity and mortality of gardening and medicine?

11. Where have I ever stated that I hated DO's?

12. Again, the benefits and the risks involved with cutting down on-call duties is more involved than you think. The research that suggests that sleep deprivation is equal to a BAC of 0.1% is flawed and a poor comparison to being on call. While 36 hours is a bit much, the AMSA is a student society with it's head in the clouds.

13. JenMac, I'm sure that you do get clinical experience but what experience is this? Are you in the hospital, caring for any patient that walks in, regardless of the nature of the complaint? Are you performing head-to-toe physicals, medical histories, ordering every kind of drug under the sun, interpretting any and all tests that you order? Do you see and treat dozens of cases of URTI's, COPD, strokes, diabetes and any other of the thousands of diseases out there?

14. Jen, I'm assuming that the question to number 13 will be no. That being said, who do you think is more likely to miss a diagnosis: the second year medical student who has read about the disease and maybe even seen a few cases in his limited clinical activities or the second year resident who has read more about the disease, seen maybe hundreds of cases and has treated probably the same number of cases.

15. Jen, if you want to know my stance on chiros, it's this:

16. Spinal manipulation, including chiropractic, OMM and deep tissue massage, has been shown to be an effective second-line therapy for lower back pain.

17. Manipulation has not been shown to be effective for the treatment of any other ailment.

18. There is an association between neck manipulation and vertebral artery stroke. The association has not been fully quantified but it is established that the risk of stroke is increased with neck manipulation.

19. If I had a patient with lower back pain that was unamenable to first-line therapy, I would send him to a DC whom I trust. I would warn my patient to avoid neck manipulation and that I would like to check up on him/her at regular intervals.

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Ponyboy:

4. The more experience one has treating patients with illnesses, the more adept one becomes at recognizing illness, serious or minor, atypical or otherwise.

5. Medical doctors, NP's and PA's have more experience treating patients with illnesses than chiropractors.

6. MD's, DO's, NP's and PA's are more likely to recognize illness in a patient (serious or otherwise, atypical or otherwise) than a chiropractor.</font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Very good points. I have never disagreed with them. I was just introducing the fact that DC's can do it too. On your level? No. Because we don't get as much training. I know this. Is our training rigorous? Yes. Is it as intense as a medical students in this aspect? No. We concentrate on adjusting and manipulation technique more than pharmatoxicology and pathology. But we do learn it.

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">10. The reason why I am not answering the question whether there are more mishaps in medicine than in chiropractic is because the question is ridiculous. You are comparing two treatments that are radically different. First, the number of patients treated by physicians and DC's are much different.</font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">There are DC's out there that treat up to 300 patients A DAY. Do I advocate this? Hell no! But I think they are more apt to miss something even though most of their patients are there for wellness visits. (it just doesn't seem right!)

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Secondly, the therapies used in medicine are much more varied than chiropractic. Third, the medical patient population is more acute, varied and serious than the chiropractic population. Fourth, because the patient population is much sicker in medicine, there are many more ethical and therapeutic dilemnas to be faced as well. Fifth, because the patient population is sicker in medicine, smaller errors have much more dire consequences. Sixth, because the patient population is sicker, the therapies involved are more aggressive than chiropractic. Seventh, aside from neck manipulation and other questionable practices, chiropractic is a relatively innocuous therapy (ie. much like PT) and as such, any mistakes that are made are likely to have very little effect on an otherwise healthy patient. Eighth, there is no mention about effectiveness of either treatment for any specific disease.</font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">You are absolutely right. I think you just made all of our points. Chiropractic is a much more conservative form of treatment, and therefore we have fewer accidents and mistakes. (How'd this get tied together....it's not making sense.) Either that, or I'm talking myself into a corner...I hate when that happens! Don't get me wrong, I am all for aggressive treatment if necessary, but I think it is used too often. No, I have no research by my side to back me up, that's just my opinion.

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">12. Again, the benefits and the risks involved with cutting down on-call duties is more involved than you think. The research that suggests that sleep deprivation is equal to a BAC of 0.1% is flawed and a poor comparison to being on call. While 36 hours is a bit much, the AMSA is a student society with it's head in the clouds.</font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Again, I think this is more of a common sense kind of thing. Doesn't everyone who has been up for forever feel a bit loopy, slow to respond, not quite as aware? Also, that schedule promotes bad health habits such as caffeine addictions....now, I like my chai tea like anyone else, but I don't rely on it to keep me going. I think it's so weird that to get to be a doctor, you have to lead such an unhealthy lifestyle (if only on the lack of sleep thing alone). Even if you are caffeine free, the amount of adrenaline and cortisone levels in your body to keep you on top of things has got to be wearing too. How do you guys do it? Seriously, just asking....that would be the hardest thing for me.

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">13. JenMac, I'm sure that you do get clinical experience but what experience is this? Are you in the hospital, caring for any patient that walks in, regardless of the nature of the complaint? Are you performing head-to-toe physicals, medical histories, ordering every kind of drug under the sun, interpretting any and all tests that you order? Do you see and treat dozens of cases of URTI's, COPD, strokes, diabetes and any other of the thousands of diseases out there?</font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Our clinical experience comes from the time we spend in clinic in our last year (which is a 12 month time period). People from the community come in and we treat them. We take full historys. Of course we don't see every major complaint. Would you go to a chiro if you had just accidentally cut off one of your fingers? He he he, of course not! But we have already acknowledged that. Oh wait, I already addressed this comment above. We don't have as much experience as allopaths in diagnosing illnesses. But we do have enough experience to do it. And of course we don't order drugs! But we do know their effects (targeted and side) on the body, and often, get people to get off of them. In fact, we see all kinds of cases. Even if the patient has not come to see us for that condition, often it is a musculoskeletal complication of that condition, we can help them out. Take diabetes, for example, and this is just an example. A lot of doctors don't have time to advise the patient on their disease. They prescribe some meds, give them some pamphlets, and tell them to monitor their blood glucose level. When they come to a good DC, we can advise them on how to make lifestyle changes, help them make goals, advise them on better nutrition habits, and encourage them to regularly monitor blood glucose levels, and the proper ways, times, and methods to do this. This takes a lot of time, and that seems to be the sole reason that MD's don't get credit for that process. That is our role in treating diabetes. We aren't only a resource, we are a support system. And then we treat their musculoskeletal complaints too, and continue to comanage with their PCP. It's just an example, I'm not saying it happens like that all the time, but it does happen. We do work with all kinds of patients. And more recently, DC's are doing rotations and even residencies.

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">14. Jen, I'm assuming that the question to number 13 will be no. That being said, who do you think is more likely to miss a diagnosis: the second year medical student who has read about the disease and maybe even seen a few cases in his limited clinical activities or the second year resident who has read more about the disease, seen maybe hundreds of cases and has treated probably the same number of cases.</font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Well, you know what happens when you assume...
But, I can't argue anymore. I never said we were better. I just said we could do it. I also said we were good.

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">15. Jen, if you want to know my stance on chiros, it's this:

16. Spinal manipulation, including chiropractic, OMM and deep tissue massage, has been shown to be an effective second-line therapy for lower back pain. </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Thank you, and we are working on research that shows that chiropractic care is effective for more than just the low back.

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">18. There is an association between neck manipulation and vertebral artery stroke. The association has not been fully quantified but it is established that the risk of stroke is increased with neck manipulation.</font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Like your lack of sleep study, this is a poor association. This person who wrote this association was very anti-chiro and therefore biased. When looked into, the cases that were stated to have had a stroke immediatly after a cervical manipulation, it was rarely the case. One happened in a barber shop, one was performed by a wife on her husband (she wasn't trained), one was a week after the adjustment. One happened when the person was in the waiting room for an adjustment! The protocol was very shoddy and basicly just asked the people if their stroke occured within a weeks time period of a cervical adjustment. Most often, it is just an accident waiting to happen, and any rotation/extension movement will trigger the stroke. It is now estimated that the risks are 1 in a million. It has even been estimated at 1 in 5.6 million. Either way, you are more likely to get hit by lightning. I will still probably inform the patient that there is a risk (as it is a material risk, and ethically, I think I should), however, I am extremely confident that I won't run into any problems.

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">19. If I had a patient with lower back pain that was unamenable to first-line therapy, I would send him to a DC whom I trust. I would warn my patient to avoid neck manipulation and that I would like to check up on him/her at regular intervals.[/QB]</font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">And that's definitely an MD talking. I don't mean that in a condescending way, but that just seems to be the attitude towards chiropractic in general. I think it's good that you are at least open to the idea, as many MD's are not.
Have a good one!

1. The seven confounding factors and one question of relevance were listed to show the silliness of TB's question. Why not compare the mortality of medicine versus stretching exercises in healthy adults? Or medicine versus model airplane building?

2. I never said the chiropractic allows one to make fewer mistakes. It's just that any mistakes that are made are less likely to result in serious harm because of chiropractic's weak effects in comparison to medical therapy as well as the sicker patient population in medicine.

3. Yes, chiropractic (excluding neck manipulation) is a conservative therapy. It's also an ineffective therapy for everything except LBP.

4. The safety of a therapy is useless if the therapy is ineffective. Orange juice is one of the safest methods of treatment of pulmonary embolism. However, it is also one of the most ineffective treatments of PE.

5. Working long hours is part of the training. After the first month, you get used to thinking quickly when you're tired and you get used to functioning well on little sleep. By the third month of rotations, it's not much of a consideration.

6. Do you really try to get people off drugs on your own? Which ones? Do you consult the PCP before you start messing with a patient's beta-blocker?

7. Your diabetic picture paints MD's without any time and DC's with an abundance time. This is somewhat hard for me to comprehend, especially after you mention DC's that see 300 patients per day. Anyone in an office, be it a DC or an MD, must see patients at a rate quick enough to pay for the upkeep of the office and to earn a living. To tell me that DC's spend more time with their patients is a gross generalization that is entirely unfounded. BTW, for a patient to go through the diabetic clinic at my hospital, an entire morning is booked off and the patient spends half an hour with the MD, the Nurse Advisor and the dietician individually.

8. I've read about these "residencies" and they are nothing compared to a medical residency (and I suspect, they do not compare with the latter half of medical school). However, they allow DCs to call themselves, family practioners and internists, which is very misleading and might lead a lay person to believe they were seeing a medical professional.

9. There has been more than one study associating stroke with neck manipulation. The American Heart Association is one of them and not what I would call an anti-chiro association. The "estimations" that are quoted are vague and often estimations from chiropractors. Biased? I wonder. Regardless, estimations are just that: estimations. Several studies point to a risk and while it's unquantifiable now, it is still a present risk.

10. The risk of stroke with neck manipulation should be a moot point because neck manipulation has not been proven to be effective for the treatment of any disease. Why would a patient want a treatment with an unquantified risk, if it has not been proven to be effective for anything?

11. Maybe it's an MD thing but I will only refer to people I trust. Whether they be surgeons, psychologists or DC's. The welfare of my patients comes first and I will not send them to anyone I would not go to myself.

12. Maybe DC's can function at some level of health supervision and maybe some of them are good. However, they do not compare with trained medical professionals. The question is not whether they can do it but whether it is in the patients best interest to be seen by a DC or by someone with more training and experience at recognizing and treating illnesses.

Jen is a little more tactful than me, but I agree with what she's said, esp. about the cervical manipulation/stroke study. Talk about a sloppy, usless study that the medical profession LOVES to quote. Should Chiros be PCP...no. I recind my earlier remark. Should we still be primary for MSK conditons that aren't medical emergencies? In my opinon, absolutely yes. Primary treatment, not secondary, but, that's a difference in perspective that we will never agree on. But, like Jen said, at least you're willing to keep a slightly ajar mind, which is more than some.

Seventh, aside from neck manipulation and other questionable practices, chiropractic is a relatively innocuous therapy (ie. much like PT) and as such, any mistakes that are made are likely to have very little effect on an otherwise healthy patient.

Isn't that a good thing? Wouldn't that be one more reason to try conservative treatment options before trying something with the potential for side effects, the feeling one gets from being on meds (i.e. feeling loopy, as Jen puts it, and not being able to function), or further injury sustained when people mask their pain and overdo activities that cause more harm in the long run??? If you truly want what's best for the patient than try something conservative, non-invasive before running to the meds.

Cervical manipulation is not questionable, by the way, it's actually very effective. Now I'm sure you'll argue this b/c you seem to find fault in EVERYTHING positive I say about Chiropractic, but thousands of Chiros give cervicalgia, whiplash, headache, CTS, and TOS relief to patients every day, regardless of the studies that prove or disprove it. That's a fact. I don't need a study to tell me that. Chiros have been doing it for 100 years and if it were that dangerous, it would have died out a long time ago instead of flourishing and growing. That must give some evidence of it's worth. It's called supply and demand. Again, I use the example of aspirin.

There is an association between neck manipulation and vertebral artery stroke. The association has not been fully quantified but it is established that the risk of stroke is increased with neck manipulation.

It is estimated to be between 1 in 1 - 3 million. That is statistically insignificant. Pure chance, and the examples that are used in studies are so pathetic as to be laughable. No direct cause and effect.

Here we go with the condescending, holier-than-thou, medical God complex again. Let's make sure we beat everyone else down so you feel more important. Just a little overcompensation there? Whatever. Since you can't seem to keep an opne mind for more than a millisecond, my conversation with you is over and maybe we'll be lucky enough NOT to cross paths someday.

Thanks Trey.
Hey Ponyboy, thanks for taking what I said out of context again. RIGHT after I used DC's as a bad example for seeing 300 pts/day, I said there was no way a good DC pratices that way, most of the patients go there for wellness visits, and that I would never practice that way. As for the time issue, I was referring to the changing politics between medical care and insurance companies. More and more, I hear that patients have to reschedule with thier PCP (family practice, internal medicine) because they don't have time to answer their questions. I have heard that this is because the insurance cos are paying them crap in a crap contract, so they have to see more patients, and do more paperwork.....ya know, I really don't know. I have just heard it over and over and over again from patients coming to see their DC.

Oh yeah, we do consult with the PCP before any drug interaction...part of that whole comanagement thing....it's not a goal of the DC, it sometimes works out to be an added bonus for the patient, and only when necessary. I think I'm with Trey though...I don't know why I keep arguing with you. I'm not changing your mind, I'm not even planting a seed, and you're not changing mine. What is the point of this again?

Hey for all of you that are freaked out about Chiropractors as primary care providers. Check out this info from the Bastyr University web on the scope of practice of Naturopathic Doctors, N.D.

<a href="http://www.bastyr.edu/academic/naturopath/pizzorno.asp" target="_blank">http://www.bastyr.edu/academic/naturopath/pizzorno.asp</a>

What is an ND legally authorized to do?

Naturopathic physicians have complete diagnostic rights and complete prescriptive rights for all natural medicines and prescription rights for specific legend drugs.

Naturopathic physicians can also perform office surgery and vaccinations, have the authority to direct RNs, and are approved by the public health office to issue birth and death certificates.

Which states license NDs?

As of December 1999, naturopathic physicians are licensed as primary health care providers in Alaska, Arizona, Connecticut, Hawaii, Maine, Montana, New Hampshire, Oregon, Utah, Vermont and Washington. In the District of Columbia, naturopathic physicians must register in order to practice. Legal provisions allow the practice of naturopathic medicine in most other states. Naturopathic physicians are also recognized in Alberta, British Columbia, Manitoba, Ontario and Saskatchewan.

And they do manipulation!! LOL

<a href="http://www.bastyr.edu/catalog/translate.asp?linkpage=courses/default.asp?PID=PM" target="_blank">http://www.bastyr.edu/catalog/translate.asp?linkpage=courses/default.asp?PID=PM</a>

Naturopathic Manipulation 1-4 1 credit
This four (4) course sequence in naturopathic manipulation emphasizes structure and gait analysis, evaluation of musculoskeletal conditions, differential diagnosis, assessment and treatment. A comprehensive approach to therapeutic protocols utilizing appropriate physical medicine modalities is emphasized.
Prerequisites: PM5304

PM6300 Naturopathic Manipulation 1 2 credits
See description above. This course includes structural analysis and gait analysis. Students are introduced to various forms of soft tissue manipulation, such as muscle energy, strain/counterstrain, trigger point therapy, and craniosacral manipulation.
Prerequisites: BC5127, PM5300

PM7301 Naturopathic Manipulation 2 3 credits
See description preceding PM6300. Evaluation of soft tissue pathologies, differential diagnoses and rationale for use of soft tissue manipulation are covered. Soft tissue treatment?primarily strain/counterstrain, neuromuscular technique, muscle energy and therapeutic massage. Osseous manipulation is introduced.
Prerequisites: PM6300

PM7302 Naturopathic Manipulation 3 3 credits
See description preceding PM6300. General osseous manipulation in uncomplicated cases is covered. The course focuses primarily on spinal manipulation. Treatment protocols emphasize a well-rounded approach, including the appropriate use of osseous and soft tissue manipulation, physiotherapy and hydrotherapy.
Prerequisites: PM7301

"Wouldn't that be one more reason to try conservative treatment options before trying something with the potential for side effects, the feeling one gets from being on meds (i.e. feeling loopy, as Jen puts it, and not being able to function), or further injury sustained when people mask their pain and overdo activities that cause more harm in the long run??? If you truly want what's best for the patient than try something conservative, non-invasive before running to the meds."

What part of "ineffective" and "unproven" do you not understand? I will only prescribe treatment that has been proven to work. Yes, that's pretty closed minded but it's also very effective.

"Cervical manipulation is not questionable, by the way, it's actually very effective. Now I'm sure you'll argue this b/c you seem to find fault in EVERYTHING positive I say about Chiropractic, but thousands of Chiros give cervicalgia, whiplash, headache, CTS, and TOS relief to patients every day, regardless of the studies that prove or disprove it. That's a fact. I don't need a study to tell me that. Chiros have been doing it for 100 years and if it were that dangerous, it would have died out a long time ago instead of flourishing and growing. That must give some evidence of it's worth. It's called supply and demand. Again, I use the example of aspirin."

I don't know how you like to care for your patients but I treat them with something I like to call "evidence-based medicine". When my patients present with an illness, I give them the first line therapy. Why do I do that? Because research has shown first-line therapy to be better than second-line therapy and I want the best for my patients. If you don't need a study to prove that it's effective, then you go right ahead and treat them as you see fit. However, I will treat them by what's proven to be effective. (God complex? I'm not the one who thinks that they know better than research substantiated guidelines.)

Like I said before, there has been more than one study; although you seem closed-minded about the possibility of there being more than one study. 1 in 1-3 million is your (and other DC's) estimation of the risk. Others have estimated it to be as low as 1 in 100, 000. You don't know the actual risk, neither do I. However, because I have no evidence to prove that it is beneficial, I will not recommend it to my patients.

Jen, the comment about the DC seeing 300 patients/day was a facetious comment. I take it back. However, you are making a gross and innaccurate generalization about doctors and their interactions with their patients.

Listen, if you think that I'm being closed minded, so be it. However, I want what's best for my patients. If I think that they're wasting their money and time on unproven therapies, I will tell them. I will not suggest that they submit to therapies that have no proven use and have the possibility of harm. If you (or anyone else) says that method X works, I say maybe. Before I'm going to prescribe it, I want proof. Maybe I'm stubborn, maybe I'm closed-minded but you had better believe that I will keep my patients welfare at the top of my priorities. If you think that it's a God complex that makes me want my patients to see the most qualified person for health surveillance, then that's fine with me. If you think it's a holier-than-thou attitude that makes me not recommend unproven treatment, so be it. I could care less what you think, as long as my patients get the best care possible.

Is this conversation over? Aww. It was just starting to get fun. Oh well. I guess it works out cuz I'm going on vacation! TB, maybe we'll never cross paths, maybe we'll see each other in passing, maybe I'll be your resident! Wouldn't that be fun? Think of all the interesting conversations we might have!
Jen, it's been a pleasure.

Stillfocused, are you thinking about going this route? I've heard of ND's but didn't know anything about what they do. Thanks for the website, I'll check it out. Maybe we can into a discussion about ND's so Ponyboy can slam them too. No, I'm sorry, so he can "keep my patients welfare at the top of my priorities"....cuz "I could care less what you think, as long as my patients get the best care possible." Hippocrates reincarnate.

Wow, more rhetoric, sarcasm and some thinly veiled personal insults without addressing any points. Now, who would have expected that from TB?

Have a good summer. Med school starts soon.

You too, Ponyboy. Yea, maybe you'll be my senior resident someday. That would definately make for an interesting residency.

[QUOTE]Originally posted by Treybird:
[QB]In Texas, you can get into chiropractic school with 60 hours of college and a pulse

And that's different from Lake Erie Osteopathic College how???]

I'm a Lake Erie College of Osteopathic Medicine student. I would like to clarify that NO ONE has been or will be accepted into the D.O. program with just 60 hours of undergraduate work.

There are two accelerated 3+4 programs with Gannon University/LECOM and Penn State University/LECOM. I know of only one person out of 200 in the 2005 class who is part of this accelerated program.

I am not thinking about ND at all. But, I am a bit suprised by their scope of practice, especially when compared with DCs.

Hey stillfocused, why does this surprise you? Actually I was surprised when I heard they do manipulation too, but I just wanted to know what exactly was surprising. I had no idea their scope was so broad either....
Good luck Ponyboy. One day we'll have that RCT research to prove the efficacy of adjustments beyond the low back (even in extremities!), for now we have to settle with clinical experience and case reports. (No sarcasm intended, it's just not widely accepted as proof....as you obviously know!) Have a good vacation everyone, I am outta here for a few too

Wow this is STILL going on?? I left town a week ago and I think this debate is going nowhere...personally, the ND crud should be discussed and exposed.

I always envisioned the title of DOCTOR of anything to be a high-level academic achievement. How is it that DC's call themselves doctors rather than technicians? NP's and PA's don't call themselves doctor with the same or more hours of trainng. That would be like a BS or MS student in a university setting trying to pass him or her self off as a full professor (Doctor of) to the students, when there is really no comparison between the levels of education. It seems that anyone with knowledge of all the periphery of medicine can hang a shingle and call him or her self doctor without having to bother with all the important and often obscure details. This is troubling on many fronts and we should fight it with vigor. Agreed?

Slingblade the Surgeon wrote:

How is it that DC's call themselves doctors rather than technicians? NP's and PA's don't call themselves doctor with the same or more hours of trainng.

Mr. Slingblade,

How many years of training do DC's, NP's, and PA's have? Why don't you look that up somewhere and report back to us.
And if you become a D.O., please do the Osteopathic profession a favor--research a topic before write about it--don't display your ignorance in a public forum.

To become a PA, you must have a 4 year undergrad degree. Not 60 college credits. After completing a 4 year degree, a PA goes to 3 years of PA school. All together, if you go to school full time with no breaks in between, it takes 7 years to become a PA. Some may be able to do it in 6 if they really bust their behinds.
On another note, my undergrad college had a program where you attend their college for 2 years as a Bio major, and then go to New York Chiropractic College for another 2 years. After that, you spend 1 year doing an apprentice sort of thing with another chiro. If you entered this program, you could become a chiropractor in 4-5 years! If you would like to learn more about this program, I will give you the info on my undergrad college gladly.
So I think a very good point was made. We don't call PA's by doctor, yet it takes more time and education to earn a PA degree.

Hi Jersey Girl,

Hmmm, I guess the U.S. Department of Labor, Bureau of Labor Statistics is wrong. According to them:

RE: Physician's Assistant--The typical physician assistant program lasts about 2 years and usually requires at least 2 years of college and some healthcare experience for admission.

<a href="http://www.bls.gov/oco/ocos081.htm" target="_blank">http://www.bls.gov/oco/ocos081.htm</a>

RE: Chiropractors--Most State boards require at least 2 years of undergraduate education, and an increasing number require a 4-year bachelor's degree. All boards require completion of a 4-year chiropractic college course at an accredited program leading to the Doctor of Chiropractic degree.

For licensure, most State boards recognize either all or part of the four-part test administered by the National Board of Chiropractic Examiners. State examinations may supplement the National Board tests, depending on State requirements.

<a href="http://www.bls.gov/oco/ocos071.htm" target="_blank">http://www.bls.gov/oco/ocos071.htm</a>

<a href="http://www.medicine.uiowa.edu/pa/PAWebNew/admissio.htm" target="_blank">http://www.medicine.uiowa.edu/pa/PAWebNew/admissio.htm</a>

<a href="http://www.medinfo.ufl.edu/pa/program/admit.htm" target="_blank">http://www.medinfo.ufl.edu/pa/program/admit.htm</a>

<a href="http://pa.mc.duke.edu/s_admiss_prereq.asp" target="_blank">http://pa.mc.duke.edu/s_admiss_prereq.asp</a>

<a href="http://www.ohsu.edu/pa/prereq.html" target="_blank">http://www.ohsu.edu/pa/prereq.html</a>

<a href="http://www2.umdnj.edu/paweb/overview.html" target="_blank">http://www2.umdnj.edu/paweb/overview.html</a>

Yes, that internet link is innaccurate. If you look at the above links I have posted, you will find the admissions requirements for 5 PA schools which I randomly found by doing a simple Yahoo search. There may be some PA schools which only require 2 years of undergrad education. However,I could not find any. If there are, it makes the amount of education a PA recieves ( in only some instances) equal to that of a chiropractor. Yet, a PA does not have Dr. in front of his or her name and a chiropractor does. And then what about all of the PA's who have had 6-7 years of education as illustrated in the links I provided? They don't have Dr. in front of their name, yet they have had far more education than Chiro's.

Here's a P.A. program that appears as though you only need a highschool diploma or GED to enter their 2 year P.A. program.

Admission requirments:

<a href="http://www.mdcc.edu/medical/PA/pa_req.htm" target="_blank">http://www.mdcc.edu/medical/PA/pa_req.htm</a>

Curriculum:

<a href="http://www.mdcc.edu/medical/PA/pa_curr.htm" target="_blank">http://www.mdcc.edu/medical/PA/pa_curr.htm</a>

I realize that this probably does not represent a the majority of the licensed P.A.s out there, but I think that it is significatly less education than any chiropractic program. There are no associate DC programs that I'm aware of.

But you are missing the take home point. The take home point is, there are many, many PA's out there who have spent 6 and 7 years getting their education in an academic setting, not clinical setting. That is 6-7 years spent in a classroom. It does not take that long to become a chiropractor. For the most part, 60 college credits are required, and then 2 maybe 3 years of chiro school. The main point here is that there are many PA's out there with more education than Chiro's, yet we do not call them doctor. So you found 2 instances where they have the same amount of education, they still aren't called dr. and chiro's are. The same thing happens here with Nurse Practicioners. They are not called Dr. iether, yet you have to have a BSN (4yr degree)and then after receiving a BSN you can go to school to become an NP which is another few years. In light of this, how do you explain Chiropractors deserving to have dr. in front of their name, when an NP or PA (like I have illustrated) does not?

<a href="http://www.parkercc.edu/admissions/prerequisites.shtml" target="_blank">http://www.parkercc.edu/admissions/prerequisites.shtml</a>

<a href="http://www.clevelandchiropractic.edu/Admissions/req_dc_program.htm" target="_blank">http://www.clevelandchiropractic.edu/Admissions/req_dc_program.htm</a>

<a href="http://www.nwhealth.edu/admit/require/chiro.html" target="_blank">http://www.nwhealth.edu/admit/require/chiro.html</a>

<a href="http://www.bridgeport.edu/chiro/" target="_blank">http://www.bridgeport.edu/chiro/</a>

I went and looked up four chiro colleges. None require a Bachelors degree. They require 90 semester hour credits. So in a previous post, I gave you 5 PA schools which require a Bachelors degree, and GRE score, and here I gave you 4 chiro schools which only require 90 credits and nothing else.

Jersey Girl wrote:

But you are missing the take home point. The take home point is, there are many, many PA's out there who have spent 6 and 7 years getting their education in an academic setting, not clinical setting. That is 6-7 years spent in a classroom. It does not take that long to become a chiropractor. For the most part, 60 college credits are required, and then 2 maybe 3 years of chiro school.

Jersey Girl, I'm afraid you're grossly mistaken.
Every chiropractic college has a four year curriculum at least. Most require at least 90 hours of college credit, but from what I understand, a majority of the students have a B.A. or B.S. before they start chiro school. That means it takes a MINIMUM of 6 years of school to become a chiropractor, but most students probably have at least 8 years.

In contrast, there are many associate P.A. degree programs available (from what I've seen on the internet) so you can actually get a P.A. degree in 4 years of school. You cannot get a D.C. degree in four years.

So in summary,
the MINIMUM amount of school to obtain a chiropractic degree is 6 years.
The MINIMUM amount of school to obtain a P.A. degree is 4 years.

and 6 &gt; 4 , correct?

So that makes this part of your statement incorrect---&gt; It does not take that long to become a chiropractor. For the most part, 60 college credits are required, and then 2 maybe 3 years of chiro school

I know there are probably MANY PAs out there with more than 4 years (and probably 6-7 years as you stated) but there ARE some with only 4 years.

I'm not bashing PAs or trying to glorify DCs; I'm just trying to get the facts straight.

By the way, there are also Allopathic medicine degree programs that can be completed in 6 years:

<a href="http://www.med.umkc.edu/redirect/prospective_default.html" target="_blank">http://www.med.umkc.edu/redirect/prospective_default.html</a>

P.S. I will going out of town for a while, so I will have to let someone else take over this argument if it continues. Take care.

It's not worth discussing, you are still missing the point. You obviously didn't read the links I provided.

So, Jersey Girl returns. Thanks for the return e-mail I never received after sending you a very nice one. It just shows me that you have no interest in looking at this objectively, which is par for the course in the forum. Just to let you know, I had 9 years of school to become a Chiro. Four years of undergrad, getting my BS in Exercise Phys, and 5 years at Palmer. Palmer Chiro College is a 10 semester program. It's amazing how you really try and minimize our education.
I don't know how many times this needs to be said before it starts to sink in. We call ourselves Doctors of Chiropractic, not Doctors of Medicine. It sounds like you PA's, and surgeons apparently, have a big chip on your shoulders. Don't whine about what you don't have. If you feel you should be called Doctors of Medical Assisting, than go fight for it. You don't need to slam everyone else to feel better. Did you expect Dmon to just say, "Yea, JG, you're right we're just not as good as you...we're sorry. We'll just call ourselves Doctors of Being Less Than PA's." We're talking about two DIFFERENT healthcare fields. You're trying to compare apples and oranges.

I just wanted to add some more support for dmon and Treybird--

I've got quite a few friends in chiropractic school, so I asked around about what it takes to get admitted. Although their school publishes that a minimum of 90 credits is required, in their class 98% of them have received their BSc degree prior to being accepted. Many students have also completed MSc degrees as well.

Just because someone meets the minimum requirements, it does not guarantee acceptance--far from it! So, because chiropractic school is 4 years long, add that to a 4 year BSc and you really get a minimum of of 8 years of education to become a chiropractor.

In my opinion, a chiropractor deserves the respect of being called a Doctor of Chiropractic. I've seen the coursework required in the program, and it's pretty intense. My friends really know their stuff, and I'd trust them with any kind of musculoskeletal diagnosis.

I don't believe a PA or NP has the depth of knowledge (of medicine, as with DOs/MDs, or of musculoskeletal anatomy/biomechanics, etc., as with DCs) required to earn the title of "Doctor." Don't get me wrong, though--I really appreciate and understand the valuable roles PAs and NPs play in patient care. I just don't believe they should be called doctors.

Just my 2 cents. :)

Solie, you're welcome in my clinic any day. Thanks for the support and, more importantly, an objective opinion.

My bad then...I didn't realize that chiros had to have finished a BA/BS... My info came from a friend who has been a chiro for 25+ years and had only gotten 60 hours undergrad before going to chiro school. I think the requirements have changed. The new breed of chiro is apparently more educated.

"Most State boards require at least 2 years of undergraduate education, and an increasing number require a 4-year bachelor's degree. All boards require completion of a 4-year chiropractic college course at an accredited program leading to the Doctor of Chiropractic degree."

"All required applicants to have at least 60 semester hours of undergraduate study leading toward a bachelor's degree, including courses in English, the social sciences or humanities, organic and inorganic chemistry, biology, physics, and psychology. Many applicants have a bachelor's degree, which may eventually become the minimum entry requirement."

<a href="http://www.bls.gov/oco/ocos071.htm#training" target="_blank">Occupational outlook handbook Chiropractic</a>

Objective Smobjective! No one has to be objective when their scarcasm can be protected by distance and relative anonymity as in an internet forum. I certainly would not allow someone to stand in front of me in person and use some of the inflamatory and scarcastic language I've seen on these forums directed toward people.

For example: "And if you become a D.O., please do the Osteopathic profession a favor--research a topic before write about it--don't display your ignorance in a public forum."

I don't play those silly word games and calling me ignorant in person would most likely get you b|tch-slapped...However, in this forum I suppose you feel it is acceptable behavior. I don't care how you define ignorant or even how you meant it...the simple fact is that you feel safe enough to insult me directly because you are behind a keyboard somewhere in cyberland. I believe that is why these forums sometimes get so out of hand with the name-calling, etc. If people were face-to-face where they could be held personally accountable for their malicious rhetoric, conversations would be much more productive and much less childish.

As an aside...I used to do phone technical support and I can say that people get pret-ty brave talking smack on the phone too, but the big picture is that if people were even half as domineering or "tough" as their online/phone personas there would be so many face-to-face clashes that no one would ever get anything done for fighting.

Hehehe cool that turned into a long post. <img border="0" alt="[Laughy]" title="" src="graemlins/laughy.gif" />

Seriously though, look around you. People don't talk like that to each other in real life when they're discussing something unless they're trying to start an argument. So lets not make enemies unnecessarily by using accusatory and/or inflammatory language toward one another. You wouldn't take that in person from a stranger and neither would I.

My bad then...I didn't realize that chiros had to have finished a BA/BS... My info came from a friend who has been a chiro for 25+ years and had only gotten 60 hours undergrad before going to chiro school. I think the requirements have changed. The new breed of chiro is apparently more educated.

FINALLY!! Someone from the medical profession who actually has the balls to admit that things have changed in Chiropractic and realizes it's not like it was even 20 years ago. That to me is the sign of an excellent doctor. Someone who has the flexibility and open-mindedness, when faced with proof, to change his or her mind and admit they were wrong.

Are you in med school or out practicing? What specialty in surgery do you want to go into, or are in?

TB

I am not a PA. I just finished up undergrad with a dual BS in Chemistry and Biology. By the way,Georgian Court College in Lakewood NJ has an affiliation with New York Chiropractic College. 2 years at Georgian Court, 3 years at New York Chiropractic College. Completion of 5 years total = DC. I have friends who went through this program. I have friends who became PA's and are spending 7 years to do so. Oh, and Treybird, I never got your e-mail. If I had, I would have read it. I Don't know what you are talking about.
I don't want to participate in this discussion any longer. You guys get so hung up on the minor details, that you miss the big picture.

Funny that JG should point out that WE'RE missing the big picture. I apologize if you never got my e-mail, JG, but I used the one that you have listed on this forum so you may want to check that again. And I thought you were so disgusted with Chiropractors that you just couldn't bring yourself to read anymore of this forum or associate with Chiros in general. Now you have friends that are Chiros?? Hmmm, some friend you are. Maybe you could show your friends some support, or just get your story straight in general.

As for combined programs, Rutgers and UMDNJ have a combined 6 year BS/MD program. And let's get this straight once and for all, it is a 3 year program that runs all year round...10 semesters, which is 5 academic years. Once again, JG, get the facts straight. That makes it a combined 7 year program, not 5.

wwwoowwww! This is a very nasty, angry thread. Can I add something? A professor at our school said something I try to keep in mind (I said try): That you will never do yourself or anyone else any good by insulting or criticizing a colleague-he was directly refering to other MDs/DOs but I think I applies equally to all health professions and even outside our health professions.

We are all professionals or studying to be so...could everyone take a deep breath and accept that the public benefits when we work as a health care team. I'm going to be a DO but if I go into a specialty my musculoskeletal pts are going to a DO, DC, or PT and to whoever I think does a good job regardless or the letters after their name. Every profession has its quacks and thats not the profession's fault-but it is the responsibility of that profession to recognize those people and deal with them.

I come from a chiropractic family and find it humorous when I hear people slam D.C.'s. My mother and I have very different training and we will be doing very different jobs. The manip training we recieve is very good at my school-some students come out with excellent skills and some do not (because they do not practice, etc.) at a chiro school the classes are different and of course, your specialty (generally speaking) is predecided. DO students do not have to make a living with their hands if they do not want to (although I believe thats a shame). I do not think its worthwhile to compare the two groups (DO/DC) because patients will choose what works for them and we can only try to serve them as well as we can.

Also- I wanted to add that my mom sees a lot of 'sick' pts (cancer, etc.) and her treatments provide them with a lot of relief. She has also diagnosed a lot of things that other docs missed b/c she uses her head and pays attention to her pts. also-there was a post earlier that stated that manip was a second line therapy for LBP, I believe the current guidelines say its first line. (federal guidelines)

I do not want to stir up any beehives so if something I said above irks you, I'll be happy to talk about it...but no insults please.

Very well put and I agree with you 100%. We all have our specialties and we all have something to add to the field of healthcare. You sound very well adjusted (pun intended).

Treybird,
I just want to ask you something - what made you think that LECOM only requires 60 college credits? You think everyone else on this board is so misinformed, what about you?

I'm not getting into the whole DO vs. chiropractic discussion because I know chiropractors are good at what they do and can be very helpful for patients. I just want to know where you got such clearly incorrect information.

OH MY GOD! We have support Trey! I'm so sorry I missed the past few days! JG, like we said before, most schools only require 90 prereq university hours. If your school provides a co program with NYCC, more power to them. However, a lot of students don't necessarily know what they want to do with their Bachelors when going thru undergrad (I went back and forth from PT, to DC, to DO...to ....massage therapist....) A lot of people have their bachelors, no matter what the minimum requirement is. We are very well educated, I promise you!
dmon, thanks for backing up the chiro sector while we were away. You rock! macman, you rock too, it looks like we are getting some more diverse perspectives in here. It's all I ever wanted! People with open minds!!! (no offense Ponyboy :p ) I really think this could turn into something....good? Maybe?
Like someone said (and I forget who said it....sorry!) if you respect others in the healthcare profession, their is no limit to what we can accomplish for the patient. We are all trained differently, we look at each case slightly differently and each have something to offer the patient. (in most cases anyway!!!)
oh, Ponyboy, btw, sorry if I grossly misjudged time spent with patients on the MD's part, it was purely hearsay, and not always the case. have a good night all!

that was macman who said that (above quote from my previous post)....well put!!!

and thanks for jumping in solie!
oh, and Happy...no, this thread will NEVER DIE! I thought it might a few times, but no, we just keep reviving it....

DOtobe: I apologize if I underreported the number of hours for LECOM. I was repeating what a DO resident had said to me. My bad.

No problem Treybird! :D

Did everyone go on vacation?? Nothin' but the crickets.....chirp....chirp......

Aaahhh, the whole forum to myself. Just kick back and enjoy the solitude while I reflect on what it means to be alive in this great country. Does anybody have a bottle opener?? Come join me in the jacuzz, the water's warm!!!

Why, yes, everyone DID go on vacation! I just got back from vacation myself (again). St. Croix is beautiful this time of year! And it's the down season (some people don't like traveling to the caribbean during hurricane season....dunno why!) so everywhere was crowd free! I was all psyched to jump back in here, but no one has said anything I can reply to! Have we reached a (gulp) understanding? Trey, you still out there buddy? Have a great night y'all, catch ya later.

Treybird,

When you graduated from Chiropractics did you have difficulty getting started in your career? How easy was it for you to build a practice? Did you have trouble getting a loan for your business?

Regards,
student247

Hey Jen,

Maybe we just wore everyone down. Glad to hear that the Caribbean is still happenin'. Will you be posting those bikini pics online at the SDN forum?

Student247,

Everyone has a different experience starting out in practice. I entered into a partnership with someone who owned two clinics. The deal was that I would run the second one and we would be 50/50 partners in that clinic. Some Chiros start out as associates (i.e. slaves), or independent contractors. Or, you can buy out an established practice and work out some kind of pay arrangement. My situation didn't require me to put out any money, or take out a loan. If your credit is good, you should be able to get a loan. But, you may need a cosigner.

Building a practice was tough b/c I was in a town of 1500 people and the clinic I was in had had 3 Chiros in 2 years and it had been closed for 6 months. so it was a tough situation to start out in. We have a lot of industry in the area geared towards the auto industry so I approached them about working together on worker's comp stuff, etc. My undergrad degreee is in exercise physiology and I approached them by offering to do a free ergonomic analyses of their workplaces. This got my foot in the door and then I just focused on working on industrial musculoskeletal injuries. It worked out very well and gave me access to all of the people working the factories.

Just a little correction (not trying to be picky..just informative): It's Chiropractic not Chiropractics. There's only one profession so it's not plural.

Thanks for the questions student, anything else I can help you with?

Treybird,

Thanks for the information. I've always had a great deal of respect for Chiro's and have even contemplated becoming one myself. So thank you for the info.

Regards,
Student247

Hey Student,

Man, you really started a firestorm with this forum. Anyway, glad I could help. Just let me know if you have any more questions. Here are some very good Chiro websites that may help answer anymore questions you have:

<a href="http://www.essex1.com/people/cates/accc.html" target="_blank">http://www.essex1.com/people/cates/accc.html</a>

<a href="http://www.chiroweb.com/college/" target="_blank">http://www.chiroweb.com/college/</a>

<a href="http://www.chiro.org/main/" target="_blank">http://www.chiro.org/main/</a>

<a href="http://www.chiroweb.com/" target="_blank">http://www.chiroweb.com/</a>

<a href="http://www.Palmer.edu/" target="_blank">http://www.Palmer.edu/</a>

<a href="http://www.fcer.org/" target="_blank">http://www.fcer.org/</a>

Chiropractic is a great profession that has a lot to offer. You may see patients that have not received relief anywehere else and you have the opportunity to make a difference in their lives. That's awesome. BUT, our profession is very fragmented and very political and that seems to hold us back from everything. Things are changing, however. Good luck.

Sigh.....Why does it always come to this?? DOs are not chiropractors nor would we want to be. Enough said, stop comparing us.

jimdo-
Who said DOs are chiros? Who said DOs were all wannabe chiros? Not I. I think that would be obvious since you chose not to become a DC. I think the ENTIRE POINT of this thread was to point out the differences, as well as some similarities. But mostly to justify chiropractic's validity. My whole goal was only to increase recognition so that working together, as two separate professions, is a whole lot easier.

student247-
also check out <a href="http://www.nwhealth.edu" target="_blank">www.nwhealth.edu</a>
wouldn't you agree Trey? :p he he he
Later gators

also check out <a href="http://www.nwhealth.edu" target="_blank">www.nwhealth.edu</a> wouldn't you agree Trey?

Absolutely, Jen.

Hey Jen, don't even bother responding to people like jimdo. It's not worth your time and effort. He has no interest in learning anything new, or assimilating, he's just trying to take cheap pop shots because he has nothing better to do...and he's just another self-hating DO that has to slam everyone else to feel some sort of self-worth. I think they call it small-man complex.

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Treybird:

...and he's just another self-hating DO that has to slam everyone else to feel some sort of self-worth. I think they call it small-man complex.</font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">oooo OUCH. I just like trying to spread the love! Why I feel like I have to respond to nonsense posts, I dunno. Maybe I'm just a little defensive! He he he. :p

Treybird,
Where do I begin addressing such a post? I am always amazed by those that think they can psychoanalyze others based solely off of one post that is barely a few lines in length. I wonder if it is in an attempt to mask their own inadequacy or only if they are simply so immature or ignorant enough to have little else to say. Rational and intelligent converstaion must not be something youre either accustomed to or in which you are able to engage.
For the record, I am a PROUD DO and do not need to justify myself to you or anyone else. Simply because I disagree with the comparison of DOs and chiropractors does not mean that I am any less of a DO. If you were even marginally skilled in DO medicine you would know that at least. I guess I cannot expect that to be since this is a "PRE-Osteopathic" post after all. I should have anticipated the maturity level in this chatroom when i wandered over to see what those beginning their training were saying. Maybe after youve completed some medical training, have an ounce of experience and a clue about how medicine operates, youll be on par to have an intelligent converstaion with those of us who have.
Why is it that many with your viewpoint assume that those that disagree with you are "self-hating DOs"? I have supported osteopathic medicine as long as I have practiced, belong to the AOA, lobbied the US Congress on DO issues, participated in research and been awarded and recogniozed by the AOA for my work with them. What actual experience do YOU have with osteopathic medicine. Id better make sure I sit down when you respond because Im sure it is EXTENSIVE. I suspect that it is your immaturity and pure lack of meaningful DO experience that allows you to say and believe such immature and absurd comments. Grow up and when you do maybe then youll be on the same level to be able to judge me.
For the record, I am aware that this post was intended to point out similarities and differences between DOs and chiropractors. I also am open to learning new things which you of course would have no knowledge since Ive only posted here once. I need not give my opinion of chiropractors because it is irrelevant here. What is relevant is my experience with being a DO and the general fatigue by many in the profession with being compared with those of a different profession. How would the chiropractors feel if they were incessantly compared with another profession. DOs have far more training in medicine, are licensed physicians, can specialize in any area of medicine and are those of which patients seek counsel when sick. Therefore, the comparison between the two is moot regardless of any perceived similarity in treatment modality. Chiropractors have none of these capabilities. If you want to be compared with or even mentioned in the same sentence as a physician, you should have gone to medical school. Otherwise know your role and stop trying to overstep your bounds.
Lastly, to address the final immature comment about small man syndrome or however you characterized it. If I were Treybird and tried to analyze someone based only off of a few sentences, I would have to say that there must be some underlying feelings of inadequacy and "self-hate" such that the whole issue of smallness is the first thing that comes to mind. If you want to be in the ring with the big boys, at least have maturity to deal with us intelligently and please have some experience and knowledge about what you so ignorantly preach. Otherwise, go back to the playpen with your pacifier and when you grow up, maybe then Ill respect what you have to say.

oooooooooooooo ROUND 3!!!! Get out your gloves boys....
Here we go again!

Seems as though I was greatly mistaken. I was under the impression that Treybird was at least engaged somehow in the DO world. However, I see now that he is in fact a chiropractic grad.
This can mean one of two things. 1) He is currently a chiropractor with no idea regarding DO practice or concept or 2) since this is a pre-DO forum he is trying to enter DO medical school. The latter lends me to wonder why if chiro is so great he would want to become a physician. Either way, it is becoming more and more clear that Treybird really is not quailified to be speking about DO medicine. It is also clear that Treybird must feel pretty inadequate himself if as a chiro he comes to a pre-physician forum or is a pre-med or med student using insults to make a point that justifies his mistakes of the past.

jimdo-
maybe you should read the whole thread....I know it'll take you a while since we've all been bickering for months. Trey clearly stated (pages ago) that he wants to do everything for his patients, which is why he is going back. He recognizes the limitations of the DC degree, but he's not going to stop doing adjustments b/c they work. Please get your facts straight, you were complaining b/c of judgements made on you before anyone knew what you were about, so extend the same courtesy. Besides, I hate playing catch up!
:)

Oh my, seems we hit a raw nerve. First off, I love healthcare in general. I feel that the contributions made by Chiropractors are just as legitimate as those made by DO's of MD's, albeit different. The core of Osteopathic philosophy is similar to that of Chiropractic, regardless of what DO's do now. If you don't see it that way, then go read the early text by Dr. Still. I will be attending DO school in Aug, not b/c I hate CHiropractic but because the things I want to do in healthcare, such as join the military, can't be done as a Chiro right now. Osteopathy is the closest to Chiropractic in philosophy, hence my choosing that field. I can still use Chiropractic as a DO, I'll just call it OMM instead.

You are self-hating becuase you incessantly feel the need to try and accentuate what Chiropractors can't do instead of what we can and do do. It must give you a sense of pride to slam Chiropractors. How do I know this? From your first post. Not constructive, just condescending maximus. I've never slammed DO's b/c of what they do, so why should you slam us? How about talking about how we can both benefit the patient in healthcare? That would be the mature way to approach this subject. Did you choose to discuss this issue? No, you choose to make some snotty, smart-ass remark. Go have a valium and relax. Stop taking yourself so seriously and just chill.

I see that the value judgements are still continuing here. Still being referred to a self hating because I dont buy into the chiropractic propaganda which is little more than self justification. My first post was, by the way, simple exasperation at something that is a constant illogical comparison. Let us remember that this is a pre-DO forum where people come for information of Osteopathic medicine that plan to enter the field. It is important that they receive fatcs about being a DO
As for taking myself seriously, I admit that I do take my career seriously. Im sorry that you do not seem to share this devotion to the field. I do not take myself that seriously and I really dont know how that has come across to you. I congratulate you for entrance to into medical school. However, be careful not to use medical school to be able to justify something that is not accepted otherwise (ie in the military and ultimately society). If you want to be a chiropractor...fine thats your choice. Stick with it. Dont use osteopathic medicine as a means to reap the rewards of being a physician (something chiropractic cannot offer) while continuing to practice as a chiropractor. Thats simply getting something in the back door which wont fit through the front door.
I applaud your devotion to your chiropractic profession. I have known other chiropractors, and have discussed the two fields at length respectfully. I have lashed out here out of response to a commment that was justifiably perceived as being an unjustified personal attack. I have learned a great deal about the history of the DO throughout my training. As you will find out in medical school, that is taught. You will also learn that OMM and chiropractice is not the same. I do not agree that OMM = chiropractic technique as it seems is implied in your post. I hope that the differences become apparent to you as you progress through your training.
Jen, I am sorry but Im not going to read all of through the posts. I certainly understand your wish not to play catch up. I came in here originally to inject some of my experience in the field, but got caught up in a shouting match.
Believe it or not, I am more than willing to answer questions and offer my experience to those that read this thread. I ask for a little maturity and that the name calling and personal attacks stop here and now. If that can be done, I will answer anything that is posed. I assume most people here are not yet medical students. It is a tough road and one in which your impressions will certainly change. I know that mine did and continue to change. Sometimes, the words of those who have already gone through it can be valuable, they certainly were for me.

By the way, I find it hard to believe that you actually want to discuss something maturely when comments like "just another self-hating DO" and small man complex" are thrown around ad nauseum. If my "condescending maximus" is offensive and you believe that we should focus on what chiros can do instead of can't, why decide to abandon chiropractic in order to practice medicine. If chiropractic is justifiable, why the need to enter medical school in order to practice something in which you are already proficient? It ought to be a clue that you cannot do what you want to do in chiropractic and that you need to enter medical school to justify practice as a chiropractor. Cant you see how inappropriate and offensive it can be to use one profession to justify onself and the limitations of another??

I REALLY don't think that just because one is trying to expand their avenues in education that they are abandoning what they have learned in order to leard the "real" profession. Talk about insulting! DC's don't view DO's as possessing any "more" skill, just different skills. I appreciate your willingness to share your experience with the rest of us, but your condescending tone is more than apperant.

P.S. Trey here is not the norm. Many other chiropractors do a fine job of justifying the profession jut through everyday practice, as I'm sure Trey has done as well. Chiropractic justifies itself if you can get past the nutjobs that tend to (and incorrectly so) represent the profession. The reason chiros can be compared (and contrasted) to DOs, MDs and everyone else is that DC's are healthcare providers whether you think so or not. I think this is very valid info for any pre-DO, as we all have to work with all kinds of doctors. It's good to know that a relaible DC can help you should you need it. Yes, you learn a lot in med school, and opinions often change, but it's best to keep an open mind.

This is your moderator...

I'd like to remind everyone to please keep this discussion on a professional level.

Well, JimDO, everyone has certainly seen how you feel about things. There's really no point in trying to have a discussion with you. If you feel that I am abadnoning my profession, so be it. I know what my motivations are and where I stand on things and that's all that matters to me. Jen has pretty much tried to explain things to you and you choose to ignore what she is saying so good luck in med school.

I see that this thread has disintegrated into something unfortunate. For my role in that I apologize. Good luck to you in whatever endeavors you choose.

No worries, this thread has been uglier before this....

JenMac
I respect your ability to disagree respectfully. Thank you.

Your welcome! My boyfriend and I get into these types of disagreements all the time, so I get practice! <img border="0" alt="[Laughy]" title="" src="graemlins/laughy.gif" />

wow! the fun just never ends-maybe someone could refer jimdo to my post a few pages back-I find it hard to believe he/she is who they say they are...I think trey bird deserves an award for still wanting a do degree...but in all fairness trey bird (pardon the psycho-analysis [sic]) I think you enjoy those sparring matches? Even though you were instigated, I think you enjoy this type of thread quite a bit-what do you think?

Hey macman,

I'm from Jersey, what can I say? I like to debate but I don't like pissing contests, even though it seems to get to that at times. You wanna a pizza wit' dat??

In all honesty, I was interested in this thread b/c I figured there would be an informative Q & A regarding the differences and similarities between chiros and DO's. I thought I could give some testimony to my experiences in healthcare and how I plan to make my crossover into osteopathy, which I consider a close relative of Chiropractic. Instead, what Jen and I got were massive attacks on how Chiropractic shouldn't exist and how we shouldn't even have the responsibility of a towel boy (or girl), none of which was based on any credible understanding of our education or training.

There have been a few DO students or perspective Chiro students who have asked honest questions and been supportive. That's when we've had very good discussions that were not pissing contests. But, every once in awhile, someone has to come from the shadows with some kind of attack and disappear....not discuss with an open mind, just attack.

I plan on supporting osteopathy with as much gusto as I do Chiropractic. If manipulation works for DC's then I assume it works just as well for DO's.

Posted Previously
"Chiropractic justifies itself if you can get past the nutjobs that tend to (and incorrectly so) represent the profession."

:) Something to think about :)

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by macman:
<strong>...I think trey bird deserves an award for still wanting a do degree...</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I agree. Talk about dedication to learning!

I really like this thread too. Maybe it's because in real life, I am really laid back...but some people who have posted here have the ability to push my buttons and get me fired up! AND, it's very interesting to see others perspectives...its very educational as I move toward my DC, it gives me a peek and what I may have to work with as a working professional.

macman, where are you going/do you go to school for your DO?

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Jersey Girl:
<strong>Posted Previously
"Chiropractic justifies itself if you can get past the nutjobs that tend to (and incorrectly so) represent the profession."

:) Something to think about :) </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I think this is true for all professions, not just Chiropractic. We've all seen our share of nutjob MD's, PT's, DO's, etc. Nice to know you still check in once in awhile Jersey Girl. It's kind of like Jerry Springer, you don't want to watch but you just can't turn away.

I think it's a different Jersey Girl.....

Macman
I am amazed that after I had let the disagreement end that you would come in with some inflammatory remarks to try to reinstigate a heated disagreement. First you insult me and then my profession. Frankly, it doesnt mater if you dont think Im who I say that I am. Secondly, dont insult my profession simply because you want to stir up the embers. Many devote their lives with nobility to it and couldnt care less whether your surprised Treybird still wants the degree. You can think whatever you will of me, but by insulting the profession you insult Treybird because he has devoted himself to the goal of being a physician, and every other DO that has struggled to become a physician. Think whatever of me, but at least have enough decency and respect not to insult something that so many have studied.

Oh, and by the way, I have no interest in reading your posts. I doubt Id find much there of quality and its just not worth my time to get into any further discussion with you.

.

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by jimdo:
Macman
I am amazed that after I had let the disagreement end that you would come in with some inflammatory remarks to try to reinstigate a heated disagreement. <strong>First you insult me and then my profession.</strong> Frankly, it doesnt mater if you dont think Im who I say that I am. Secondly, dont insult my profession simply because you want to stir up the embers. Many devote their lives with nobility to it and couldnt care less whether your surprised Treybird still wants the degree. You can think whatever you will of me, but by insulting the profession you insult Treybird because he has devoted himself to the goal of being a physician, and every other DO that has struggled to become a physician. Think whatever of me, but at least have enough decency and respect not to insult something that so many have studied.

Oh, and by the way, I have no interest in reading your posts. I doubt Id find much there of quality and its just not worth my time to get into any further discussion with you.

</font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">:confused: :confused: :confused: :confused:

Lost me on that one too, Jen. Feel the wrath.

Treybird, just a quick non-flamebait question. In your experience, what would you say is the majority of DC's opinions on childhood vaccinations? The reason I ask is that I see this on almost every website critical of chiropractic.
Thanks

Time to bow out of this room. I can hear the quacks now in every direction. But, I suppose its just my "wrath" acting up again. Good luck to you all.

jimdo - I was just wondering why you thought macman was cutting down DO's when that's what he is going to school for.....that's why I was confused....
As for vaccinations....(even though you didn't ask me :) ) I think that is not something you can attribute to the majority of chiropractors. Everyone has a different opinion. DC's have definitely gotten a bad rap for being the ones to encourage people not to get them though. And I know people who haven't had them and are just fine....however, I think they were able to be just fine because everyone else got them! (Group immunity). I'm just going to give my patients all the information and let them make an informed decision. But saying that all chiropractors hold the same opinion that is anti-vaccination is not right. Saying that we have the same opinion an anything isn't right! he he he This is part of how we can be our own worst enemy.

Chiropractic philosophy is rooted in the idea that the human body, under ideal circumstances, should be able to defend and repair itself. Ideal circumstances being that the nervous system can function uninterrupted. The body has evlolved over thousands of years to survive it's surroundings, and that includes bacterial infections, etc.

Now, that is where we were at one point. Do I agree with this? No, nor do most of my friends that I graduated with. However, there are older sects and traditional sects of Chiros that still follow this tenet and put a lot of faith in the body's ability to heal itself. Like Jen said, I don't think that most Chiros are against vaccinations, but they want their patients to be informed about the risks. Not all vaccinations are safe and people have to recognize which ones are and which ones aren't.

Treybird.

Which vaccinations would you think are unsafe and which ones are safe?

I think that you have to be careful with vaccinations that use weakened, but living, strains of the disease rather than dead material. How about you PAC?

Here is an excellent page regarding Chiropractic education including a comparison of hours between med school and Chiro school. (Tables 9 & 10 near the bottom of the page). Let's just say that Chiros are certainly well-educated in their field, regardless of the overall opinion in this forum.

<a href="http://www.chiroweb.com/archives/ahcpr/chapter3.htm" target="_blank">http://www.chiroweb.com/archives/ahcpr/chapter3.htm</a>

Where did everyone go??

I don't know....but I like that link you posted up there, Trey Very nice. I think it hammers home the "not better, but different" argument quite nicely.
And I just wanted to give a shout out "quack" to jimdo....I know you're still out there buddy....
<img border="0" alt="[Laughy]" title="" src="graemlins/laughy.gif" /> <img border="0" alt="[Laughy]" title="" src="graemlins/laughy.gif" /> <img border="0" alt="[Laughy]" title="" src="graemlins/laughy.gif" />
(I hope you all know I'm so kidding!!!)
Later gators

Hey Jen,

Thanks. Isn't that a great webpage?? I wonder how many people in this forum will actually check it out. Where did PacMatt go? He asked a question and then disappeared. Getting ready for your new school yet??

TB

P.S. QUACK! QUACK!
Damn, those pesky ducks. Watch out for duck poo.

NICE TOUCH!!

There he is....I knew you'd still follow this jimdo....it's too addicting. <img border="0" title="" alt="[Wink]" src="wink.gif" />
Trey, yep, getting ready for the big move.
I dunno where everyone went. Maybe you answered all the questions....
Are you getting ready for your new school? Have you let your patients know yet?

Hey Jen. Yea, I guess everybody went home. Too bad too because that website I posted dispels alot of the misinformation in this forum. Oh well. Hey jimdo, just in case you're watching, and Jersey Girl too.

Getting ready to start my life as a DO. I've contacted all my patients and lined up another doc to take my place. Now all I have to do is get Lori and the kids (our two pomeranians) there.

TB

OR, maybe everyone is just sick of us. Ah well, that was fun. Thanks for sticking in there and helping me dispel myths, and maybe, just maybe make some people consider that what they have thought all this time was outdated. Good luck at KCOM...I'm sure you're gonna be an awesome DO!
JM

P.S. Your kids are two pomeranians? <img border="0" alt="[Laughy]" title="" src="graemlins/laughy.gif" />

Hey Jen,

Well, it's been a fun ride. Keep checking in though. Someone usually jumps in from nowhere with a comment. Good luck in school and feel free to e-mail me if you have any questions or need some info. Yea, my two kids are Pomeranians (Jasmine (Jazz) and Dakota (Cody)). Trust me, they're a handful.

TB