Hey Ms Jones should have just gone to a PMR doc! so she wouldn't have to worry about a PT misdiagnosing or being able to find the unidentifiable "other" and then see a physician! How you find something when you don't even know what you are looking for is beyond me
Then she can go to rehab with her physical therapist
I have respect for every profession Vtech, just not this growing trend of health professionals seeking autonomy they are not prepared for because of their lobby groups and unions (which docs aren't allowed) If we need more docs, increase residency spots! If you want to practice medicine go to medical school!
Well a PMR doc (as you refer) is going to misdiagnose "Ms. Jones" just as much as any other doc you want to mention. I'm sure many of my colleagues will agree w/ me when I say that we get just as many referrals from MDs w/ the correct diagnosis as we do the incorrect diagnosis. In fact, in most cases, the referring physician won't give anything more than a generic diagnosis such as lumbago, cervicalgia, hip pain, knee pain, shoulder pain. I mean, I'm glad you could come up w/ something like that, helps a lot. Especially when you've asked your patient to pay anywhere form $20-100+ dollars to label them w/ "lumbago." Great job!
If you want to be more specific and talk about the MDs that are trained to know the musculoskeletal system better than anyone, I will still state that approximately 25% of the referrals I receive from many (not all) orthopedic physicians are w/ an incorrect or very vague diagnosis.
Now smart guy, to ask you your own question, how are you going to "diagnose" someone that walks into your office with c/o LBP? You're probably going to do some x-rays, maybe an MRI, ask the patient where the back hurts or what they did? I would agree that you will probably order some imaging to rule out any type of serious pathology. However then when those x-rays come back w/ nothing more than a "disc bulge," mild DDD/DJD, or something that approximately >80% of the population presents with, what are you going to tell that patient when they ask why their back hurts? You will probably say that all they need is some pain meds, a muscle relaxor, or an anti-inflammatory and to come back in 2 weeks if they still hurt. Why? Because you probably won't take the time to talk to them to collect the proper information, or even put your hands on the patient to determine what may be occuring around their spine.
You know, maybe if some individuals in the MD profession (I want to be clear, it's not the profession, but individuals, probably those w/ the same thought process as you) weren't so self centered, and would relinquish the rights to order imaging - which I will say any idiot can be trained on which studies to order, as well as how to read them - then I could order some x-rays to rule out serious pathology and then continue w/ my very thorough examination process to determine the PROPER diagnosis and what they actually need for treatment. Rather than having to send this patient to someone like YOU so they can pay their co-pay, and then have insurance pay $300 for an office visit where nothing is done but some generic x-rays.
I won't go into pharmacology, because honestly I don't feel it is in our professions best interests. PT along w/ Chiropractic medicine both have been around (in some form) since Hippocrates (since he performed many techniques related to both) and both are the most natural practices of medicine. These days, every physician thinks there is a pill that can cure everything, probably why there are so many patients now w/ decreased kidney and liver function, as well as what seems like an epidemic of "GI bleeds" in the hospital that are possibly due to chronic use of certain medications.
You state "how you find something when you don't even know what you are looking for is beyond me..."
Yet then you go on to say "if you want to practice medicine then go to medical school..."
You are obviously very insecure, not only w/ yourself, but with your own professions abilities to diagnose neuromusculoskeletal conditions.
Here's a bit of information that maybe you missed in your 1st semester of medical school (which was probably recently).
We all practice medicine. Medicine is defined as "the science of diagnosing, treating, or preventing disease and other damage to the body or mind." This is done by MDs, DOs, DPTs, DCs, DMD, DDSs, NPs, OTDs, etc etc. There's a reason it is called "the practice of medicine," because I don't care how good, experienced, or smart you are as a practitioner, you do not know how to treat everyone each and everytime. Maybe one day if you learn this, and realize how valuable other medical professionals are around you, you might one day be able to call your self a valuable practitioner. Until then, you're an idiot prescribing drugs while referring to other specialized MDs.
Good Luck buddy!
