•••quote:•••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.••••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.
•••quote:•••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.••••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!)
•••quote:•••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.••••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.
•••quote:•••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.••••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.
•••quote:•••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?••••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.
•••quote:•••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.••••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.
•••quote:•••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. ••••Thank you, and we are working on research that shows that chiropractic care is effective for more than just the low back.
•••quote:•••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.••••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.
•••quote:•••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]••••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!