Current Views of Chiropractic; What Do You See?

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vanbamm

VanbammDC
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As a current chiropractic intern, I have been lucky that my school facilitates rotations in the hospital and private practices to interact with current pnysicians. I have gotten a lot of different perspectives from M.D./D.O's. The views have been similiar depending on the specialty. What do you know about it? What do you think of it? Does it have a place?...use your doctor hat, businessman hat- or just wear your own personal hat when replying.

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As a current chiropractic intern, I have been lucky that my school facilitates rotations in the hospital and private practices to interact with current pnysicians. I have gotten a lot of different perspectives from M.D./D.O's. The views have been similiar depending on the specialty. What do you know about it? What do you think of it? Does it have a place?...use your doctor hat, businessman hat- or just wear your own personal hat when replying.

I hope you have thick skin. I think insurance companies and medicaid have found it more financially feasible than most other interventions (which, let's be honest, most fusions and disk replacements aren't exactly backed in the literature as being cures to back pain maladies) but that's likely because

a. other interventions are WAY more expensive
b. likely to get the same results no matter the course; pain that would have went away with manipulation, surgery, or bed-rest. But of course patients want something done now.

Personally, I think Chiropractors have some place in adjusting backs, if it is scientifically backed or not. However, I think that is it. They should not be able to advertise for most of the things they do. I am sorry, but adjustment isn't going to alter your cluster migraines. I also believe they should stay away from the neck, because of the chance of vertebral artery dissection (which has been linked to adjustments before).
 
My personal opinion is one shared by the majority of the preceptors I've worked with so far: Chiropracters have some place in adjusting backs for lower back pain. They may also have a small place for neck pain, though I'd never want one anywhere near my neck. Any chiropracter who claims to be able to do anything else other than help out MSK back or neck pain is a quack.
 
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I have given referrals to patients to see chiropractors but only for muscular back pain without neurological symptoms.

Where I have a problem is with the assertion that manipulation of the spine can affect other diseases and organs. There is no scientific basis for this theory and no clinical studies to support the claims. Then there is the promotion of useless homeopathic remedies by chiropractors and unproven herbal treatments and supplements which is problematic and veyr common in chiropractic practices.

I am very selective about the chiropractors that I will let my patients see because of this issue. I don't want my patients to get the idea I am supporting those sorts of fraudulent treatments.
 
I am very selective about the chiropractors that I will let my patients see because of this issue. I don't want my patients to get the idea I am supporting those sorts of fraudulent treatments.

How do you judge this? Do you meet with them before you start referring patients to them? I can see this being very tricky territory.
 
What I see? An attempt to grab more of the healthcare pie by expanding their scope of practice outside of where it should be expanded. This is true of nearly every healthcare profession out there (DNP, DC, naturopaths, optometrists, etc etc etc). Everyone wants to be a physician, few want to put in the time. I am not surprised in the least, this is generally par for the course.
 
What I see? An attempt to grab more of the healthcare pie by expanding their scope of practice outside of where it should be expanded. This is true of nearly every healthcare profession out there (DNP, DC, naturopaths, optometrists, etc etc etc). Everyone wants to be a physician, few want to put in the time. I am not surprised in the least, this is generally par for the course.

Please don't lump us in with those three. I'd much rather you lump us in with the podiatrists, dentists, pharmacists :) The American healthcare system is screwed up but nobody will admit it. Honestly, if ODs only RX'ed glasses and contacts I would have def gone the MD route. You can't blame people for choosing what is the best option for their circumstances.

You also got the useless MD/DO division in medicine too. Fix that first then we'll talk :)
If it were up to me we'd only have MDs and Nurses.
 
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acute musculoskeletal pain, posture alignment sure. My view is that half are quacks and half are honest and know their limits. But I'm wary of neck manipulation as I have seen vertebral and carotid dissections before as a result of this. I've also seen it as a result of yoga and as a result of who knows what.
 
To be completely honest I believe chiros are con-men although most don't even know it. I went to one in high school and I feel like we wasted a huge amount of money.
 
How do you judge this? Do you meet with them before you start referring patients to them? I can see this being very tricky territory.

Its not really that tricky although you never have as much information as you would like. As a primary care physician I am often asked for referral to all sorts of providers who are physicians or allied health professionals such as dietitians or physical therapists and you can't realistically interview and investigate each one as thoroughly as you would like. You make your recommendation based on reputation or conversations you have had with the provider.

I have in fact met or spoken to a number of chiropractors because patients were already seeing them before they came to me. Ive been very honest with them about this topic. If I hear from a patient that a particular chiropractor is using these unproven ( or as in the case of homeopathy, completely useless) treatments I will steer my patients clear of that chiropractor and if a chiropractor makes a promise not to use these things then I will consider giving a referral if a patent asks for it. I never volunteer a chiropractic referral though. My first choice is to use physical therapists when the patient has a musculoskeletal injury. I only refer to chiropractors when the patient expresses a definite preference and even then I caution them about the limits they should impose on any care they get there.
 
To be completely honest I believe chiros are con-men although most don't even know it. I went to one in high school and I feel like we wasted a huge amount of money.

True dat. I don't understand why you always get a sales pitch, have to watch a video explaining chiropractic "medicine" and buy a package of 20 visits in order to see the chiropractor.

I've had my back/neck worked on numerous times with wonderful results, but don't start trying to make me believe anything about the energy flow in my body.
 
I think that if chiropractors want to be taken seriously, they need to do a much better job of policing themselves. The fact that there are enough chiropractors doing flu adjustments and the ilk without any internal body slapping them down colors my distaste for the entire industry.

There's just not enough control and regulation in that industry and education. As long as there is no standard, any views I have will remain negative.
 
Can chiropractors even be sued for malpractice? I saw several patients on my Family Medicine rotation who had gone to chiropractors first, were grossly mismanaged, then came to us to clean up the mess.

My opinion is the very limited amount of things they can do with any efficacy doesn't really necessitate the field as a whole. It'd be like having a whole separate school to teach people how to adjust blood pressure medicine and only blood pressure medicine.
 
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I only refer to chiropractors when the patient expresses a definite preference and even then I caution them about the limits they should impose on any care they get there.

I guess I never really thought about, but why should you ever refer to a D.C. if you could first refer to a PT? Just because a patient insists on it?

I did a pubmed search a couple of months ago about chiro care and I don't recall reading any papers on if adjustment is actually better than seeing a PT.
 
To be completely honest I believe chiros are con-men although most don't even know it. I went to one in high school and I feel like we wasted a huge amount of money.

I agree with the bolded. I think a lot of chiropractic is placebo at best, but I also believe that chiros in general are well meaning and trying to make a difference in patient's health. I think this is a very redeeming quality that might allow chiropractic to become more evidence and efficacy based over time.
 
I read a large clinical study on NEJM once, and it appears that chiropractic treatment for lower back pain is better than doing nothing, but no better than self-performed back exercise.

In other words, we do not need chiropractors. My 2 cents.
 
Can chiropractors even be sued for malpractice? I saw several patients on my Family Medicine rotation who had gone to chiropractors first, were grossly mismanaged, then came to us to clean up the mess.

My opinion is the very limited amount of things they can do with any efficacy doesn't really necessitate the field as a whole. It'd be like having a whole separate school to teach people how to adjust blood pressure medicine and only blood pressure medicine.

I saw a pt when I was on cardiothoracic surgery who had to have her sternum wired back together after a chiropractor placed his knee in her back and pulled posterior on her shoulders. :eek: I don't know if any lawsuit ensued but I'd imagine there has to be some sort of recourse for mistakes like that.
 
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I guess I never really thought about, but why should you ever refer to a D.C. if you could first refer to a PT? Just because a patient insists on it?

I did a pubmed search a couple of months ago about chiro care and I don't recall reading any papers on if adjustment is actually better than seeing a PT.

IMO PTs treat everything and more that a chiropractor would - except in a modern, evidence based fashion. I'm in favor of PTs achieving direct access status; why should you need a referral for evidence based treatment from a PT when any chiro can open up shop and crack away with impunity?
 
I was actually curious about malpractice suits, so I did a quick search of just last year.

http://research.lawyers.com/blogs/a...-Malpractice-in-Michigan-Disc-Herniation.html

"The client presented to the chiropractor for discomfort in her neck and
back. Due to the overly aggressive and forceful adjustments and
manipulations of her cervical spine, the patient suffered a two-level
disc herniation . Her injuries were so severe that a cervical discectomy
and two-level fusion was required by a local neurosurgeon."

So, it looks it is possible to sue a chiropractor. One interesting thing I noticed is that it doesn't seem to be required for chiropractors to carry malpractice insurance (correct me if I'm wrong). Which would mean that it can be futile to try to sue someone with very little assets.
 
From the article...

View attachment 18473

I think the highlighted portion is about as much as we need to know.
I kind of interpret that as a way to say "Oh, we're preventative with these kids..."
I was actually curious about malpractice suits, so I did a quick search of just last year.

http://research.lawyers.com/blogs/a...-Malpractice-in-Michigan-Disc-Herniation.html

"The client presented to the chiropractor for discomfort in her neck and
back. Due to the overly aggressive and forceful adjustments and
manipulations of her cervical spine, the patient suffered a two-level
disc herniation . Her injuries were so severe that a cervical discectomy
and two-level fusion was required by a local neurosurgeon.
"
:eek:
 
I think a neurologist lecturing at my school said it best: "There's a reason why neurologists hate chiropractors, they cause hundreds (if not at least a thousand) of preventable strokes a year."

Specifically he was addressing those doing neck manipulations, which stress the basilar artery, but it's kind of crazy if you do a pubmed search, and see how many strokes they can cause.
 
Chiropractors could get more respect if they did two things:

1. Stop claiming that their manipulations can cure everything, including Lupus and HIV
2. Stop claiming that the man is holding them down and actually publish some real evidence in a decent journal.

And now for some trolling: anyone notice that Chiros almost always INSIST you call them "Doctor"? Like "We're real doctors! Really! Hey you guys! Really! Serious!"
 
I was really interested in whether there was any scientific basis for chiropractic care so I did a search awhile back and I was shocked to find that there exists a large group of chiropractors that aggressively push not vaccinating your kids. I found this shocking and irresponsible. While I believe there may be some utility of chiropractors in alleviating mild back pain I overall believe they have greatly overstepped their limits and are causing harm to the public at large with promises they can't keep and agendas that directly harm patients. I will not be referring patients to chiropractors.
 
I was really interested in whether there was any scientific basis for chiropractic care so I did a search awhile back and I was shocked to find that there exists a large group of chiropractors that aggressively push not vaccinating your kids. I found this shocking and irresponsible. While I believe there may be some utility of chiropractors in alleviating mild back pain I overall believe they have greatly overstepped their limits and are causing harm to the public at large with promises they can't keep and agendas that directly harm patients. I will not be referring patients to chiropractors.


In defense, kinda, of Chiros they will usually appeal to the argument that building an immune system the natural way is better for the child unless its absolutely necessary as opposed to citing the faked research data.

There are still some quacky people that claim conspiracy and will continue waving around that bad article, though.
 
And now for some trolling: anyone notice that Chiros almost always INSIST you call them "Doctor"? Like "We're real doctors! Really! Hey you guys! Really! Serious!"

Maybe this is stereotyping, but I hate when they go into how we always discredit their training when it really is rigorous(and governed with what standards?), their anatomy educations are far superior, and EBM is really controlled by big pharma, insurance companies, and the AAMC.

Anecdotal, but one of my friend's dad is a neurologist. My friend did horrible in undergrad and on the MCAT and actually applied to and got into chiro schools. His dad told him he would disown his son if he went, haha.
 
Maybe this is stereotyping, but I hate when they go into how we always discredit their training when it really is rigorous(and governed with what standards?), their anatomy educations are far superior, and EBM is really controlled by big pharma, insurance companies, and the AAMC.

Anecdotal, but one of my friend's dad is a neurologist. My friend did horrible in undergrad and on the MCAT and actually applied to and got into chiro schools. His dad told him he would disown his son if he went, haha.

This is one of my favorite websites: search for yourmedicaldetective MD vs DC. It goes on and on about how DC education is actually more rigorous and in depth than medical school.

Another anecdote: I once was in a CAM talk at one of my undergraduate courses and the student put up a picture of Johns Hopkins medical school and a picture of a DC school that had a relatively similar appearance and he tried to make the argument that because they looked similar they were similar in education. I raised my hand and asked him if he thought sharks and dolphins looked similar.
 
Another anecdote: I once was in a CAM talk at one of my undergraduate courses and the student put up a picture of Johns Hopkins medical school and a picture of a DC school that had a relatively similar appearance and he tried to make the argument that because they looked similar they were similar in education. I raised my hand and asked him if he thought sharks and dolphins looked similar.

We had one of these talks in med school, where a chiropractor came in. He spent 2/3 of his talk attempting to demonstrate that his curriculum was actually more rigorous than an MDs. I tuned him out and decided then and there that I would never refer to a chiro.
 
In defense, kinda, of Chiros they will usually appeal to the argument that building an immune system the natural way is better for the child unless its absolutely necessary as opposed to citing the faked research data.

There are still some quacky people that claim conspiracy and will continue waving around that bad article, though.
Meh, that isn't a defense of the Chiros at all. The natural way to build your immunity to these diseases that vaccines protect against is for virtually everyone to get sick, and some number of them to die from it. Congratulations, if your child didn't die, they gained immunity to it the natural way!
 
IMO PTs treat everything and more that a chiropractor would - except in a modern, evidence based fashion. I'm in favor of PTs achieving direct access status; why should you need a referral for evidence based treatment from a PT when any chiro can open up shop and crack away with impunity?

:thumbup:
 
In the end it all comes down to money $$$, its no different for the junk science used to sell supplements, the junk science used to support mid level providers, etc

When people put their mind to it they can find ways to support just about anything, its terrifying

Is there some good somewhere in chiropractic manipulation - I think yes, but they can't even "cure" scoliosis or prove it wards off arthritis yet, which are both supposed to be in their area of expertise

The two DC's I know personally both believe that vaccines cause autism and ACTIVELY tell their patients not to vaccinate their children... scary
 
The two DC's I know personally both believe that vaccines cause autism and ACTIVELY tell their patients not to vaccinate their children... scary

Up to me? Class action lawsuit for millions against chiro school who teach this from people who follow their advice and get sick from something totally preventable.
 
Back to the OP tho, your post was respectful and not an attack (thank you for that) so I want to say - I am open to the benefits of chiropractic if they have good scientific basis and I would be happy to refer patients for those benefits as long as the DC doesn't overstep the scope of his practice and fall into the realms of junk science and quackery

That said, it is difficult to be open to this when things like the DC v. MD article are out there..... there is no other way to look at that type of attack on MD/DO's than as a power grab by DC's to erode our authority and expand their scope of practice into areas they are not qualified or licensed for.....

Full Disclosure - I have used chiropractic care in the past, did it work? who knows
 
Guess I will chime an alternate opinion in here. I've had a very positive experience with a chiropractor. In college I suffered from lower back pain, it progressively got worse until the point where I couldn't drive in the car for more then one hour without an excruciating pain which started at my lower back and radiated down my left leg.

I didn't believe in chiropractors but my dad offered for me to see one and since it was free I opted to go. Well he manipulated me and adjusted my spine with HVLA and upon his thrust my entire lower spine cracked, about 6-8 cracks. I felt an electric pulse run down my leg and the pain was gone. I walked out of there pain free.

Now that I am in medical school I can adequately dx myself and I am confident that I had a hypertonic left sided psoas muscle pulling my lumbar vertebrae out of alignment causing secondary left sided sciatic pain. The HVLA maneuver realigned my vertebrae and released the compression on sciatic nerve.

The caveat to this story and concerns I have with chiropractors is this. First off, the chiropractor didn't dx me, he just heard left sided lower back pain and went into the technique. Additionally, he didn't treat the underlying pathology which was a hypertonic and shortened psoas muscle (and bilateral hypertonic and shortened hamstrings). Since he didn't address this issue sure enough after one year the back pain returned, less though.

My issue could have been addressed by a few week of soft tissue tech by a PT given an accurate dx, but I gotta say it was pretty awesome to walk in the office in pain and leave without pain.
 
In defense, kinda, of Chiros they will usually appeal to the argument that building an immune system the natural way is better for the child unless its absolutely necessary as opposed to citing the faked research data.

There are still some quacky people that claim conspiracy and will continue waving around that bad article, though.

They do appeal to this argument as some lay people do but its a false argument. Vaccines offer excellent protection and while contracting the illness itself may in some cases offer more long lasting immunity,getting immunity the "natural way" puts the child at great risk of harm for no good reason.

This is a dangerous and foolish idea. There have even been misguided parents selling "pox pops" on ebay which are lollipops that have been sucked on briefly by children with chicken pox and sold to other parents as a way to "naturally" immunize children. Aside from the yuck factor this is clearly dangerous and irresponsible. I'm not saying that chiropractors promote this but anyone who promotes the idea of "natural immunity" is creating fertile ground for the acceptance of such nonsense
 
So, it looks it is possible to sue a chiropractor. One interesting thing I noticed is that it doesn't seem to be required for chiropractors to carry malpractice insurance (correct me if I'm wrong). Which would mean that it can be futile to try to sue someone with very little assets.

You really shouldn't be surprised. You can sue anyone for almost anything. A chiropractor is providing a service just like a carpenter, plumber, hairdresser, priest,nurse, or doctor. If you feel the person committed an act that caused you harm you can sue each and every one of them. No one is immune from law suits with the exception of the military and maybe a few other limited exceptions.

Also a point of clarification. You are right that chiro's are not required to carry malpractice insurance, but MD's are not required by law to carry it either in most states. The requirement is usually an insurance or hospital requirement. In other words if you want privileges at hospital X or you want to participate in insurance Y they will usually require proof of insurance, but if you are practicing out in the community and don't need admitting privileges and are a non-participating physician who only takes cash, checks or credit cards then you can practice without any malpractice insurance and are not breaking any laws in most states. There have been situations where this has happened on a large scale such as Florida a few years ago when Malpractice insurance rates became too high. Doctors there decided to "go bare" and forgo insurance. Some of them put their assets in protective trusts or in the names of family members and just took their chances partly as a protest of the high rates and partly out of necessity.
 
Just a couple facts.

MCAT is not required for most chiro schools.
Avg GPA is very close to 3.0 with science GPA below 3.0
Only 3 years of school but some claim abilities to diagnose complex diseases (NOT ALL DCs)
Some claim subluxations are the cause of all illnesses
Suspicious that most treatment plans require 2x a week visits, DCs subscribe their patients to ensure flow of cash?
Why not go to a DO who is trained in OMM
What self-respecting DC would allow themself/charge a patient to treat a broken hand?
Rampant cheating and very little institutional control over students at DC schools
No hospital allows DCs anywhere near them
Most health insurance plans don't cover DCs
DCs work very closely with lawyers and auto insurance companies.
 
My anecdotal experience with chiro:
1)My friend worked with a chiropractor at a gym who told him he sould NOT perform cardio exercise because you only get a certain number of heart beats in a lifetime and raiseing your heart rate makes you die sooner.
2) I saw a patient who had been seeing a chiro for months because of chronic knee pain and instability, he finally went to an MD and was diagnosed with a torn ACL. Please tell me why a chiro was taking this mans money for months to treat a torn ligament with knee manipulations.
3) I saw one for my back, didnt seem to do anything. There was a lot of showmanship in the office (ie look I can push you over because your out of alignment, then I align you and now you have better balnce......uhhh that was because I wasnt expecting you to shove me at first.)
Anyway my personal (unresearched) opinion is that they take peoples money and put on a big show to keep you coming back with little if any effect (except placebo) for most diagnoses. Because of the situation with many insurances not covering their care they have to be salespeople and buissness people but it leaves a bad taste in my mouth when people have to be convinced to keep coming back and paying out of pocket for "medical care."
 
Interestingly I do not see a chiropractic section on SDN.....
 
At the end of the day, the question is whether or not the profession is based on peer-reviewed research that is held to the highest rigors science. The answer to that is a resounding no!

Just like alternative medicine, naturopaths, homeopaths, chiropractors operate on junk "science" and marketing skills. The problem is there are always poor saps out there willing to believe these claims.
 
In defense, kinda, of Chiros they will usually appeal to the argument that building an immune system the natural way is better for the child unless its absolutely necessary as opposed to citing the faked research data.

There are still some quacky people that claim conspiracy and will continue waving around that bad article, though.

can you define building an immune system the natural way? because I am worried you mean sans vaccines.....
 
can you define building an immune system the natural way? because I am worried you mean sans vaccines.....

I think s/he is referring to the hygiene theory where it might be best to allow a child to develop in an unsterile environment and in fact promote exposure to pathogens so the child develops immunities to such organisms.

On a side note, can anyone chime in whether it is better to develop immunity the traditional way vs. vaccines? Is it better to "work out" our immune system responses to pathogens that are rarely life threatening and keep it at an optimal level vs. direct vaccination? Or is there no difference to have an "exercised immune system" when it comes to a response to a new threat (pathogen)?
 
Maybe this is stereotyping, but I hate when they go into how we always discredit their training when it really is rigorous(and governed with what standards?), their anatomy educations are far superior, and EBM is really controlled by big pharma, insurance companies, and the AAMC.

Anecdotal, but one of my friend's dad is a neurologist. My friend did horrible in undergrad and on the MCAT and actually applied to and got into chiro schools. His dad told him he would disown his son if he went, haha.
We ha a chiropractor come in and talk to us. although this was actually during a genetics seminar and she was the mother of a patient with a genetic condtion. it was cool until she said something along the lines of "and we actually get quite a bit more neuro than you guys do".


here is the problem with that statement, simply having more classes in something doesnt mean you have more training. Palmer has 3 whole semesters in gross anatomy IIRC. We had 1. Does this mean they are better at it? Id say no... it means they need more time with it and as a result will probably not be as proficient even after their YEAR AND A HALF to learn the structure of the human body. same thing applies to any other course we can find overlap in.


Guess I will chime an alternate opinion in here. I've had a very positive experience with a chiropractor. In college I suffered from lower back pain, it progressively got worse until the point where I couldn't drive in the car for more then one hour without an excruciating pain which started at my lower back and radiated down my left leg.

I didn't believe in chiropractors but my dad offered for me to see one and since it was free I opted to go. Well he manipulated me and adjusted my spine with HVLA and upon his thrust my entire lower spine cracked, about 6-8 cracks. I felt an electric pulse run down my leg and the pain was gone. I walked out of there pain free.

Now that I am in medical school I can adequately dx myself and I am confident that I had a hypertonic left sided psoas muscle pulling my lumbar vertebrae out of alignment causing secondary left sided sciatic pain. The HVLA maneuver realigned my vertebrae and released the compression on sciatic nerve.

The caveat to this story and concerns I have with chiropractors is this. First off, the chiropractor didn't dx me, he just heard left sided lower back pain and went into the technique. Additionally, he didn't treat the underlying pathology which was a hypertonic and shortened psoas muscle (and bilateral hypertonic and shortened hamstrings). Since he didn't address this issue sure enough after one year the back pain returned, less though.

My issue could have been addressed by a few week of soft tissue tech by a PT given an accurate dx, but I gotta say it was pretty awesome to walk in the office in pain and leave without pain.

I would challenge you about your vertebra being pulled "out of alignment". ur a medical student so I assume you have played with a vertebral column. you just try to pull one of those suckers out of alignment... it really isnt happening, especially to the degree chiropractors would have you believe (at least not without SERIOUS neurological deficit).

in my mind, chiropractics is a musculoskeletal treatment where the practitioners are still stuck thinking they are a skeletal-nervous treatment. If you have issues with your psoas I would be surprised if you DIDNT have back pain... but the claim that this is due to subluxation is a fallacy. muscle strain is the primary cause of back pain. if you have neurological defects due to spinal alignment you will have more than pain... (im not trying to pick on u or call u out here, just make a point) mean, are we assuming your mis alignment was confined specifically to an area affecting the only dorsal root components which feed dorsal rami fibers? THAT would be impressive. if the spine was affecting dorsal root the pain would not be so local, and there would be motor weakness if we hit rami. the explanation of illness doesnt fit, and even if the treatment brings relief i think we are obligated to understand cause

Just a couple facts.

MCAT is not required for most chiro schools.
Avg GPA is very close to 3.0 with science GPA below 3.0
Only 3 years of school but some claim abilities to diagnose complex diseases (NOT ALL DCs)
Some claim subluxations are the cause of all illnesses
Suspicious that most treatment plans require 2x a week visits, DCs subscribe their patients to ensure flow of cash?
Why not go to a DO who is trained in OMM
What self-respecting DC would allow themself/charge a patient to treat a broken hand?
Rampant cheating and very little institutional control over students at DC schools
No hospital allows DCs anywhere near them
Most health insurance plans don't cover DCs
DCs work very closely with lawyers and auto insurance companies.

this is a great post IMO. and this is the part of what i say that may really ruffle some feathers.

grades, standardized tests, and... well thats it... these things have a purpose. for the vast majority of us they are directly indicative of academic and intellectual ability. a school which averages lower grades and lower MCAT's will have an average student who is less able to compete with the average student who is at a school with higher numbers. This is true of allopathic schools. I go to an average state school with an avg mcat of 31 and avg GPA of ~3.7 (nearly every state school in the country lol). I dont expect to have the credentials that most of the people at mayo, JH, or even some place like northwestern (avg 35 which is a substantial difference) have.

this same principle applies between MD and DO, which IMO accounts largely for the ~2/3 pass rate of USMLE1 for DO students vs ~90% for MD. now, for those DO students who passed step 1 or even did well, congrats, you defy the statistic and this is why a doctor should be evaluated on a personal basis and not just as a string of numbers. there are those who may have screwed around too much in undergrad or whatnot and didnt have the scores, or truly ascribe to the DO methodology and philosophy. and I am only bringing them up because I dont know of a valid testing comparison between MD and CD.

but my main point is this: outliers dont define a trend. we cannot assume that for each person who came up with a 21 on the mcat that they simple dont test well but are still just as academically capable as someone with a 38. the assumption has to be that this individual achieved a score which is indicative of his or her ability with some small % chance that he or she could be better (which is offset by the same % chance that he or she lucked out).


so no, chiropractics cannot be more rigorous in any fashion than medical school. for that to be true you are telling me that the kids who struggled to pass undergrad or skirted by with a 3.0 and got high teens on the MCAT are somehow and suddenly able to dance circles around me in a curriculum that I am currently busting my balls over
 
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I think s/he is referring to the hygiene theory where it might be best to allow a child to develop in an unsterile environment and in fact promote exposure to pathogens so the child develops immunities to such organisms.

On a side note, can anyone chime in whether it is better to develop immunity the traditional way vs. vaccines? Is it better to "work out" our immune system responses to pathogens that are rarely life threatening and keep it at an optimal level vs. direct vaccination? Or is there no difference to have an "exercised immune system" when it comes to a response to a new threat (pathogen)?

that may be so.... i honestly believe what doesnt kill you makes you stronger to a point.

there are some illnesses our immune systems just dont know how to deal with. or at the very least, an unacceptable number of people will die of the disease while we sort out who was fortunate enough to receive that randomly generated antibody.

vaccination doesnt "exercise" the immune system. vaccination takes advantage of the pre-existing machinery in place which your body uses to develop immunity.

From the body's point of view, vaccination IS the natural way. the body is presented an antigen and it responds. the systems which respond do not care at this point if the antigen is bound to a virulent invader or just floating around with crap that makes former playmates think their children were poisoned. for some diseases, your body will lose the fight against an actual pathogen. this is just fact. for others your body will deal with it easily. If I were to vaccinate you for one of those diseases that your body could fight off on its own the only difference would be a faster response (i.e. flu), but the immune profile at that point is indistinguishable from contracting the disease yourself.

the only argument that can be made is in partial immunity which has to do with systemic immune response to illness vs a small dose which doesnt put the system into full swing. but for our purposes right now, immune is immune is immune
 
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